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F I S C A L I M P A C T R E P O R T

SPONSOR:	Heaton		DATE TYPED:	02/04/02		HB	308
SHORT TITLE:		Health Professions Review Act				SB
					ANALYST:		Wilson

APPROPRIATION

Appropriation Contained

Estimated Additional Impact

Recurring

or Non-Rec

Fund

Affected

FY02

FY03

FY02

FY03

$25.0

Recurring

General Fund

SOURCES OF INFORMATION

Health Policy Commission (HPC)

Department of Health (DOH)

Board of Medical Examiners (BME)

Regulation and Licensing (RLD)

SUMMARY

Synopsis of Bill

House Bill 308 appropriates $25.0 from the General Fund to the HPC for the purpose of administering the provisions of the Health Professions Review Act.

HB 308 requires the objective review of proposed changes in the scope of practice of health care professionals licensed by the State. HB 308 provides for State Licensing Boards to collect information on proposed changes to health professionals' licensing scope of practice; conduct a technical assessment of the proposal for change; and provide analysis, conclusions and recommendations to the Commission. The Commission is required to establish advisory panels to review materials submitted by respective Licensing Boards and conduct reviews as public hearings. The reviews of the HPC will be provided to the Legislature as background for proposed statutory changes

The duties of the HPC will include annual notification to all licensing boards of the Commission's role in reviewing proposed changes,ensure the advisory panels are conducted as public hearings, provide staff support services for the advisory panels and provide assistance to the legislature on proposals.

The composition of the advisory panels will include one board member from the respective licensing board, one additional member from the profession, and will have consumer members equal to one half of the panel's membership.

The Director of the HPC or his or her designee will chair each advisory panel.Each advisory panel must be familiar with the Commission's rules and procedures, ensure appropriate public notice, invite testimony, assess proposals, conduct analysis of proposals and provide a full report on legislative recommendations and proposed changes to scope of practice to the LFC, Legislative Health and Human Services Committee, and Legislative Council Services.

Significant Issues:

The problem HB 308 seeks to address is that the licensing boards of various health professions currently bring to the legislature recommendations for changes in scope of practice of their licensees. Legislators may not have readily available to them a thorough, professional and independent understanding of the health and economic implications of such recommendations. The scope of practice of a health profession may have significant impact on the quality, cost and geographic availability of health services.

Currently in New Mexico scope of practice policy is established by statute in the relevant health profession-licensing act that is specific to each health profession. However, there are 19 health professional licensing acts and boards, and within each, multiple health professionals may be separately addressed. Also, there is concern that mid-level practitioners may not be adequately represented by the licensing boards. New Mexico is very dependent upon mid-level practitioners, especially in the rural and underserved areas of the State.

Currently, when a scope of practice change is proposed, New Mexico’s voluntary legislature must consider many complex issues in a very short period of time. Effective legislative decision-making is dependent on each legislator having access to balanced, thoroughly researched information. However, the legislature has limited expert support staff and legislators may be called upon to make decisions based on incomplete or contradictory data.

Effective policy making by the Legislature is dependent on access to objective, complete and thoroughly researched information. HB 308 seeks to assure that proposed scope of practice changes are adequately reviewed by an independent body prior to be submitted to the legislature for approval.

HB 308 is an outgrowth of a previous memorial calling for a Workgroup that was convened by the HPC addressing scope of practice for health professionals. It incorporates many of the recommendations of that Workgroup. HB 308 will create a rational procedure for evaluating the many proposed changes in the scope of practice laws covering health professions in New Mexico.

The proposed role for the Commission is new and extensive.

FISCAL IMPLICATIONS

The appropriation of $25.0 contained in this bill is a recurring expense to the General Fund. Any unexpended or unencumbered balance remaining at the end of FY2003 shall revert to the General Fund.

The HPC states that the actual fiscal impact on the HPC is dependent on the complexity and scope of practice proposals presented during the fiscal year, but they believe that if the current base budget is approved they can perform the provisions of SB 308 with the appropriation for FY2003.

ADMINISTRATIVE IMPLICATIONS

The HPC can perform the requirements of SB 308 with the appropriation contained in SB 308

Other agencies may be called upon to participate on the advisory panels as experts in the professions under study.

TECHNICAL ISSUES

The BME notes that Section 3C should not include a reference to 14C since it is only a requirement that physicians who employ physician assistants must post a notice with certain other requirements. It contains no scope of practice or specific occupation not addressed elsewhere.

OTHER SUBSTANTIVE ISSUES

The HPC has provided the following:

In 1998, in response to House Joint Memorial 34 (1998), the HPC convened a Task Force of stakeholders and interested parties “to develop recommendations and assess the desirability of a process to objectively review proposed health professional scope of work.” In the September 1998 report on HJM 34, the HPC and the Task Force:

· Identified guiding principles and objective criteria for evaluating proposed scope of practice changes.

· Identified the HPC to perform the objective review function “with advice, support and assistance from a technical advisory group that convenes only when indicated for substantive scope of practice changes and whose composition changes according to need.”

· Identified that approximately $60,000 would be required to staff and operate the process.

· Identified that for substantive scope of practice changes, 4 months must be allowed for completion of the evaluation process.

· The provisions of HB 308 are in keeping with the recommendations of the 1998 HJM 34 Task Force and the HPC. However, to maintain the integrity of the proposed process, additional resources may be required depending on the number and complexity of proposals submitted to the HPC process uses the available 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.

· There are 19 health profession licensing acts and boards in New Mexico and within each statute, multiple health profession’ scopes of practice may be separately specified.

· The number of scope of practice changes varies substantially between 60 and 30 day sessions. No less than 8 bills have been introduced during the 2002 Legislative Session and 14 bills were 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.

· The New Mexico Medical Society supports the legislation proposed in HB 308.

DW/ar:prr