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(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

Board of Nursing

Health Policy Commission

SUMMARY

Synopsis of Bill

SB 600 creates a process for objective review of proposed changes in the scope of practice for licensed health-related professionals. The act establishes the responsibilities of the respective licensing board and the New Mexico Health Policy Commission in the process.

Significant Issues

SB 600 provides for persons proposing a scope of practice change to notify the respective licensing board. The appropriate health professional board will:

• •Collect relevant data and information.
• •Conduct a technical assessment.
• •Analyze, access and make recommendation on the proposal to the Health Policy Commission.

The Health Policy Commission will appoint and staff a review panel for each proposed change. The ad hoc review panel will review the data and technical assessment received from the board in a public hearing. After hearing testimony and assessing the proposal, the panel will provide a full report to Legislative Finance Committee and the Health and Human Services Committee. The criteria the review panel is to consider when evaluating a proposal includes:

• •The impact on health, safety and the welfare of consumers.
• •The economic impact on overall health care delivery.
• •If the potential benefits outweigh potential harm.
• •The extent to which the proposed changes will affect the availability, accessibility delivery and quality of health care in New Mexico.

PERFORMANCE IMPLICATIONS

The performance impact to HPC is dependent on the complexity and number of change of scope of practice proposals presented during the year. For FY 2003 HPC is required to conduct performance based budgeting and this job responsibility will have performance implications attached that need to be assigned.

FISCAL IMPLICATIONS

HPC states that for FY 2001, based on the current budget, the additional work required by this legislation will be absorbed. However, if proposals changes increase in conjunction with the complexity of proposals, additional funding may be required for temporary support staff.

The Board of Nursing notes that SB 600 could have impact on staff and Board member time and travel, thereby increasing the cost to the agency.

ADMINISTRATIVE IMPLICATIONS

The administrative impact to HPC is dependent on the complexity and number of change of scope of practice proposals presented during the year.

The Board of Nursing projects the legislation will impact on current staff time due to the required development of new policies and procedures. Staff will need to collect data, conduct assessments, and provide recommendations to the Commission. Staff time and/or board member time would be needed to travel to meetings.

OTHER SUBSTANTIVE ISSUES

HPC identified the following issues:

• There are 19 health profession licensing acts and boards in New Mexico and within each statute, multiple health profession' scopes of practice.
• The number of scope of practice changes varies substantially between 60 and 30 day sessions. At minimum, 14 bills have been introduced during the 2001 Legislative Session affecting health professional scope of practice changes including those that would create new health professional licensing bureaus.
• The scope of practice of a health profession may have a significant impact on the quality, cost and geographic availability of health services. Rapid changes in such areas as professional education and training, treatment technologies and methodologies, reimbursement, cost containment and the health care delivery structure can also impact the demand for and complexity of scope of practice changes.
• New Mexico's voluntary Legislature must consider many complex issues in a very short period of time, limiting the time available to research and consider complex and controversial scope of practice changes.
• The proposed process uses available the technical expertise within the licensing board combined with assessment by an independent review panel that will offer legislators more complete information upon which to base their decisions.

The Board of Nursing advises that the board staff, and board advisory committees have the expertise to identify the need for expanding the scope of nursing practice based on familiarity with and expertise in current nursing education, clinical practice, requirements for licensure, and advanced practice certifications. The Board of Nursing already has the authority to conduct public hearings. Consequently, the Board of Nursing asks the following question:

What additional expertise does the Commission bring to the review of health professionals scope of practice changes?

AMENDMENTS

• Page 3, Line 2-4: Strike", to determine whether the proposal is in the profession's current scope of practice"

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