NOTE: As provided in LFC policy, this report is
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legislature. The Legislative Finance Committee does not assume
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SPONSOR: |
SPAC |
DATE TYPED: |
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HB |
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SHORT TITLE: |
Amend Nursing Home Administrators Act |
SB |
598/SPACS |
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ANALYST: |
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APPROPRIATION
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Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
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FY03 |
FY04 |
FY03 |
FY04 |
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$50.0 |
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Indeterminate See Narrative |
Recurring
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GF |
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(Parenthesis
( ) Indicate Expenditure Decreases)
Responses
Received From
Department
of Health (DOH)
Health
Policy Commission (HPC)
Regulation
and Licensing Department (RLD)
Synopsis
of Bill
The Senate Public Affairs Committee Substitute
appropriates $50.0 from the general fund to the Regulation and Licensing
department for expenditure in FY 03 and FY 04 to study the duties and
responsibilities of administrators of residential care facilities. The bill also proposes a review and
evaluation of a new board to license residential care administrators. Finally, the bill provides for the
development of legislation and rules to create a new licensing board to govern
the licensure of residential care administrators.
The
bill contains an emergency provision.
Significant
Issues
The
bill requires:
·
The
Regulation and Licensing Department (RLD) to review and evaluate the proposed licensure
of residential care administrators (RCFA) in accordance with the Sunrise Act
and submit findings and recommendation to the Legislative Finance Committee
(LFC) by
RLD notes that the Sunrise Act requires the “applicant group” (i.e. the
group seeking licensure of the profession in question) to submit to the Sunrise
Program managed by RLD the following:
·
A letter of intent and;
·
An
application requesting licensure of the group in question with sufficient
information and supporting materials to enable RLD to ‘fairly, adequately, and
completely evaluate” the request for licensure of the profession.
RLD
does not have legal jurisdiction to enter the RC facilities and obtain
information substantiating the statements in the bill that “the unregulated
practice of RCFAs has resulted in many instances of
actual harm to residents of RCFs.” This information is critical to RLDs ability to evaluate whether RCFAs
pose an actual threat and should be regulated to protect the health safety and
welfare of the public.
SAA has legal authority to enter RCFs and gather and provide to RLD the information required
by the Sunrise Act to support SAA’s proposed
recommendation that RCFAs be licensed.
If the RLD report finds a need for the creation of a new board,
and the LFC approves that finding, a substantial number of the administrators
of contract providers of services to DOH under the Developmentally Disabled and
other federal waiver programs may be required to obtain licensure or cease
operations. This could have a
significant impact on DOH long-term service programs. However, under the current provisions of the
bill, only the RLD would participate in the review and evaluation of the
proposed regulatory extension.
In addition, the bill could require dual licensure for some
administrators of DOH facilities. Currently some administrators are licensed as
Long Term Care Administrators, but these facilities offer both long-term care
and residential care services.
FISCAL IMPLICATIONS
The appropriation of
$50.0 contained in this bill is a recurring expense to the general fund. Any
unexpended or unencumbered balance remaining at the end of FY 04 shall revert
to the general fund.
RLD
indicates that the $50,000 appropriation contained in this bill is enough to pay
the Sunrise Manager’s salary, to conduct the necessary investigations and
hearings and to arrive at RLD’s recommendation to
LFC. Any remaining amount of the
appropriation will be used to pay for costs associated with drafting and
supporting the legislation.
However, RLD
indicates that funds are needed for start-up costs for the new board. That would include costs associated with
staffing and with convening meetings of the newly enacted board in order to
draft regulations after the bill is signed; to conduct public rule hearings
around the state; to promulgate, prepare, and distribute the regulations; and
to administratively implement the regulations by July 1, 2004, as required in
SPACS.
ADMINISTRATIVE IMPLICATIONS
The
Additionally, according to RLD, in order to evaluate the request, accurately and completely as required by the Sunrise Act, it will be necessary for the Sunrise Manager to gather additional information from the affected groups. This includes meeting with, the RCFAs, the residents, the residents’ families, and the professional associations; as well as other states’ agencies currently licensing RCFAs. The manager must also conduct public hearings around the state to arrive at a recommendation for the LFC. If LFC recommends licensure and if the legislature and the Governor enact legislation, additional administrative staff will be required to complete this process.
RLD expresses
concern that the proposed appropriation may only be sufficient if RLD utilizes
current management and administrative staff to complete the tasks required. The department states that this could have a
negative impact on customer service and performance criteria of the boards.
A substantial number of the
administrators of contract providers of services to DOH under the
Developmentally Disabled and other federal waiver programs may be required to
obtain licensure or cease operations.
This could have a significant impact on DOH long-term service programs. In addition, the bill could lead to dual
licensure for some DOH facility administrators.
TECHNICAL ISSUES
State Agency on Aging (SAA) is the “applicant
group” seeking that the RCFAs be licensed “in
accordance with the Sunrise Act”, but there is no provision in the bill for the
SAA to meet the
Therefore,
the bill should be amended to contain language identifying the State Agency on
Aging, as the “applicant group” requesting that RCFAs be licensed to meet the Sunrise Act requirements.
This would provide RLD with the necessary information and supportive materials
to conduct its study. (See proposed amendments below).
OTHER SUBSTANTIVE ISSUES
DOH is not opposed to a study. However, a requirement that all administrators of adult residential facilities be licensed would need to be addressed as part of future cost studies related to residential service provided by LTSD through both the DD Waiver and SGF programs. Agencies are currently facing increased administrative costs related to significantly higher insurance premiums and other operating costs. DOH/LTSD would need to study the impact of implementing this requirement and conduct a cost/benefit analysis related to our service providers. LTSD would like to participate in planning for the study and in making recommendations based on what is learned. (See Amendments below)
o
Inadequate employee training
o
Incorrect storage of food
o
Insufficient number of staff to take care
of patients
o
Inadequate housekeeping and maintenance
services
Residential care facilities
may provide services at different levels of care, and serve a wide range of
individuals. According to the NM Health
Care Association:
o There are 171 licensed residential care facilities in
the state, ranging in size from 2 residents to over 200 residents
o There are 37 licensed intermediate care facilities/mental
retardation facilities with an average number 7.65 residents per facility
o There are 82 licensed nursing home facilities in the
state.
AMENDMENTS
Specify that – in reviewing and evaluating the proposed licensure of residential care administrators – the RLD should work with an interagency task force including representatives from DOH, HSD, CYFD and the State Agency on Aging.
The following amendments suggestions were submitted by RLD:
On page 2, amend lines 13-16 as follows:
“(1) require the department to review and evaluate the application
and documenting materials required by the Sunrise Act and provided by the State
Agency on Aging that support and substantiate the need for the proposed
licensure of residential care administrators and provide a report to the
legislative finance committee; and”
On page 2, amend lines 21-22 as follows:
“F. The
department shall review and evaluate the application and documenting
materials required by the
On page 3, amend line 2-3 as follows:
“G. If the
department’s recommendation is for licensure of residential care
administrators, and if the recommendation is approved by the
legislative finance committee, the department shall proceed with the development
of…”
On page 3, amend lines 10-12 as follows:
“(2) “residential care facility”
means a congregate residence, maternity shelter or other facility for adults licensed
by the department of health, and whose primary purpose is to provide to the
residents…”
If this amendment is adopted, residential
facilities providing care to persons served by the DD waiver would not be effected by the legislation because most of these facilities
are unlicensed.
On page 3, amend lines 24-25 as follows:
“residential care administrators and develop
proposed legislation [and rules] to create a new licensing board to
govern…”
On page 4, amend line 1-2 as follows:
“the licensure of residential care
administrators, and if the legislation is enacted, to draft rules to
regulate the residential care administrators.”
BD/njw:yr