SB0015

SENATE BILL 15

50th legislature - STATE OF NEW MEXICO - first session, 2011

INTRODUCED BY

Dede Feldman and Danice Picraux

AN ACT

RELATING TO HEALTH AND HUMAN SERVICES POLICY; ENACTING THE HEALTH POLICY AND FINANCE DEPARTMENT ACT; CREATING THE HEALTH POLICY AND FINANCE DEPARTMENT; CHANGING THE NAME OF THE JOINT INTERIM LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE TO THE LEGISLATIVE HEALTH COMMITTEE; CREATING A HEALTH UNIT OF THE LEGISLATIVE COUNCIL SERVICE; TRANSFERRING ADMINISTRATION AND OPERATION OF MEDICAL ASSISTANCE PROGRAMS AND BEHAVIORAL HEALTH SERVICES PROGRAMS TO THE HEALTH POLICY AND FINANCE DEPARTMENT; TRANSFERRING ADMINISTRATION AND OPERATION OF HOME- AND COMMUNITY-BASED WAIVER SERVICES AND CERTAIN OTHER LONG-TERM SERVICES PROGRAMS TO THE HEALTH POLICY AND FINANCE DEPARTMENT; PROVIDING FOR A STUDY ON THE EVENTUAL TRANSFER OF THE ADMINISTRATION OF HEALTH BENEFIT PLANS FOR PUBLIC SCHOOL EMPLOYEES, STATE AND LOCAL PUBLIC EMPLOYEES AND PUBLIC RETIREES TO THE HEALTH POLICY AND FINANCE DEPARTMENT; PROVIDING FOR HEALTH CARE COST-CONTAINMENT WORK FORCE PLANNING, DATA COLLECTION AND DELIVERY SYSTEM PLANNING; CHANGING THE NAME OF THE JOINT LEGISLATIVE WELFARE REFORM OVERSIGHT COMMITTEE TO THE HUMAN SERVICES COMMITTEE; AMENDING, REPEALING AND ENACTING SECTIONS OF THE NMSA 1978.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

SECTION 1. [NEW MATERIAL] SHORT TITLE.--Sections 1 through 6 of this act may be cited as the "Health Policy and Finance Department Act".

SECTION 2. [NEW MATERIAL] DEFINITIONS.--As used in the Health Policy and Finance Department Act:

A. "acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related condition waiver" means the home- and community-based services program established pursuant to federal waiver under the federal Social Security Act for individuals diagnosed with acquired immunodeficiency syndrome or an acquired immunodeficiency syndrome-related condition who require an institutional level of care;

B. "all-payer claims database" means a database containing claims in aggregate form from all public and private persons in the state that purchase health care services directly from a provider or through a health insurer or other third party;

C. "department" means the health policy and finance department;

D. "developmental disabilities" means developmental disability and mental retardation or specific related conditions as determined by rules the secretary has promulgated;

E. "health coverage" means the coverage of items and services associated with hospital care; surgical care and treatment; medical care and treatment; dental care; eye care; obstetrical benefits; prescribed drugs, medicines and prosthetic devices; and other benefits, supplies and services through the vehicles of self insurance, indemnity coverages, health maintenance organizations, preferred provider organizations and other health care delivery systems;

F. "medically fragile" means a condition that meets the level of care required for admission to an intermediate care facility for the mentally retarded;

G. "publicly funded health care agency" means the: (1) risk management division and the group benefits committee of the general services department;

(2) retiree health care authority;

(3) public school insurance authority; and

(4) publicly funded health care program of any public school district with a student enrollment in excess of sixty thousand students;

H. "secretary" means the secretary of health policy and finance; and

I. "superintendent" means the superintendent of insurance of the insurance division of the public regulation commission, or the commission's successor in interest.

SECTION 3. [NEW MATERIAL] HEALTH POLICY AND FINANCE DEPARTMENT ESTABLISHED.--

A. There is created in the executive branch the "health policy and finance department". The department shall be a cabinet department and shall consist of, at a minimum, the following divisions:

(1) the administrative services division;

(2) the medical assistance division;

(3) the behavioral health services division;

(4) the long-term services division; and

(5) the health policy and planning division.

B. As of July 1, 2011, the following references in law shall be construed as referring to the health policy and finance department:

(1) the medical assistance division of the human services department;

(2) the behavioral health services division of the human services department; and

(3) the interagency behavioral health purchasing collaborative.

C. As of January 1, 2014, the following references in law shall be construed as referring to the health policy and finance department:

(1) the long-term care division of the aging and long-term services department;

(2) the coordination of long-term services program of the aging and long-term services department;

(3) the brain injury services program of the aging and long-term services department;

(4) the program of all-inclusive care for the elderly of the aging and long-term services department;

(5) the home- and community-based waiver program of the department of health for individuals who are medically fragile; and

(6) the acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related condition waiver program of the department of health.

D. Those organizational units of the department and the officers of those units specified by law shall have all of the powers and duties enumerated in the specific laws involved. However, the carrying out of those powers and duties shall be subject to the direction and supervision of the secretary, who shall retain the final decision-making authority and responsibility for the administration of any those laws. The department shall have access to all records, data and information of other state departments, agencies and institutions, including its own organizational units not specifically held confidential by law.

SECTION 4. [NEW MATERIAL] SECRETARY OF HEALTH POLICY AND FINANCE--APPOINTMENT--DUTIES--POWERS.--

A. The administrative head of the health policy and finance department is the "secretary of health policy and finance", who shall be appointed by the governor with the consent of the senate and who shall serve in the executive cabinet. The secretary shall be exempt from the provisions of the Personnel Act.

B. An appointed secretary shall serve and have all the duties, responsibilities and authority of that office during the period of time prior to final action by the senate confirming or rejecting the secretary's appointment.

C. The secretary is responsible to the governor for the operation of the department. It is the secretary's duty to manage all operations of the department and to administer and enforce the laws with which the secretary or the department is charged.

D. To perform the secretary's duties, the secretary has every power expressly enumerated in the laws, whether granted to the secretary, to the department or to any division of the department, except where authority conferred upon any division is explicitly exempted from the secretary's authority by statute. In accordance with these provisions, the secretary shall:

(1) except as otherwise provided in the Health Policy and Finance Department Act, exercise general supervisory and appointing authority over all department employees, subject to any applicable personnel laws and regulations;

(2) with the approval of the governor, appoint "directors" of the divisions established within the department and a director of communications. These positions are exempt from the Personnel Act. Individuals appointed to these positions shall serve at the pleasure of the secretary;

(3) establish bureaus within each division of the department as the secretary deems necessary to carry out the provisions of the Health Policy and Finance Department Act. The secretary shall employ "chiefs" to be administrative heads of these bureaus. The chiefs and all subsidiary employees of the department shall be covered by the Personnel Act, unless otherwise provided by law;

(4) delegate authority to subordinates as the secretary deems necessary and appropriate, clearly delineating that delegated authority and the limitations of that authority;

(5) organize the department into those organizational units the secretary deems will enable it to function most efficiently, subject to any provisions of law requiring or establishing specific organizational units;

(6) within the limitations of available appropriations and applicable laws, employ and fix the compensation of those persons necessary to discharge the secretary's duties;

(7) take administrative action by issuing orders and instructions to assure implementation of and compliance with the provisions of law for whose administration or execution the secretary is responsible and to enforce those orders and instructions by appropriate administrative action in the courts;

(8) conduct research and studies that will improve the operations of the department and the provision of services to the residents of the state;

(9) provide courses of instruction and practical training for employees of the department and other persons involved in the administration of programs with the objective of improving the operations and efficiency of administration;

(10) prepare an annual budget of the department;

(11) give bond in the sum of twenty-five thousand dollars ($25,000) and require each director to give bond in the sum of ten thousand dollars ($10,000) conditioned upon the faithful performance of duties as provided in the Surety Bond Act. The department shall pay the costs of these bonds; and

(12) require performance bonds of department employees and officers as the secretary deems necessary, as provided in the Surety Bond Act. The department shall pay the costs of these bonds.

E. The secretary may apply for and receive, in the name of the department, any public or private funds, including United States government funds, available to the department to carry out its programs, duties or services.

F. Where functions of the department overlap with other state agencies or if a function assigned to the department could better be performed by another department, the secretary may recommend appropriate legislation to the next session of the legislature for its approval.

G. The secretary may make and adopt reasonable and procedural rules and regulations as may be necessary to carry out the duties of the department and its divisions. A rule or regulation promulgated by the director of any division of the department in carrying out the functions and duties of that division shall not be effective until the secretary approves it, unless otherwise provided by statute. Unless otherwise provided by statute, no rule or regulation affecting any person or agency outside of the department shall be adopted, amended or repealed without a public hearing on the proposed action before the secretary or a hearing officer that the secretary designates. The public hearing shall be held in Santa Fe unless otherwise permitted by statute. Notice of the subject matter of the rule or regulation, the action proposed to be taken, the time and place of the hearing, the manner in which interested persons may present their views and the method by which copies of the proposed rule or regulation or proposed amendment or repeal of an existing rule or regulation may be obtained shall be published once at least thirty days prior to the hearing date on the department's web site and in a newspaper of general circulation and mailed at least thirty days prior to the hearing date to all persons who have made a written request for advance notice of hearing.

H. In the event that the secretary anticipates that the adoption, amendment or repeal of a rule or regulation will be required by a cancellation, reduction or suspension of federal funds or by an order by a court of competent jurisdiction:

(1) if the secretary is notified by appropriate federal authorities or court order at least sixty days prior to the effective date of the cancellation, reduction or termination of federal funds, the department shall promulgate rules or regulations through the public hearing process to be effective on the date mandated by the appropriate federal authority; or

(2) if the secretary is notified by appropriate federal authorities or court order less than sixty days prior to the effective date of the cancellation, reduction or suspension of federal funds, the department shall, without a public hearing, promulgate interim rules or regulations effective for a period not to exceed ninety days. Interim rules or regulations shall not be promulgated without first providing a written notice twenty days in advance to providers of medical or behavioral health services and beneficiaries of department programs. At the time of the promulgation of the interim rules or regulations, the department shall give notice of the public hearing on the final rules or regulations in accordance with Subsection G of this section.

I. If the secretary certifies to the secretary of finance and administration and gives contemporaneous notice of that certification through a health policy and finance register that the department has insufficient state funds to operate any of the programs it administers and that reductions in services or benefit levels are necessary, the secretary may engage in interim rulemaking. Notwithstanding any provision to the contrary in the State Rules Act, interim rulemaking shall be conducted pursuant to Subsection G of this section, except that:

(1) the period of notice of public hearing shall be fifteen days;

(2) the department shall also send individual notices of the interim rulemaking and of the public hearing to affected providers and beneficiaries;

(3) rules and regulations promulgated pursuant to the provisions of this subsection shall be in effect not less than five days after the public hearing;

(4) rules and regulations promulgated pursuant to the provisions of this subsection shall not be in effect for more than ninety days; and

(5) if final rules and regulations are necessary to replace the interim rules and regulations, the department shall give notice of intent to promulgate final rules and regulations at the time of notice. The final rules and regulations shall be promulgated not more than forty-five days after the public hearing and filed in accordance with the State Rules Act.

J. At the time of the promulgation of the interim rules or regulations, the department shall give notice of the public hearing on the final rules or regulations in accordance with Subsection G of this section.

K. The secretary shall ensure that any behavioral health services, including mental health and substance abuse services, that are provided, contracted for or approved are in compliance with the requirements of Section 9-7-6.4 NMSA 1978.

L. All rules and regulations shall be filed in accordance with the State Rules Act.

M. At least once each calendar quarter, the secretary shall consult with the health care cost-containment and delivery system board and at least quarterly receive any policy recommendations from that board.

SECTION 5. [NEW MATERIAL] DUTIES OF THE HEALTH POLICY AND FINANCE DEPARTMENT.--

A. As of July 1, 2011, the department shall:

(1) provide medical assistance pursuant to the provisions of the Public Assistance Act;

(2) provide behavioral health services and operate the interagency behavioral health purchasing collaborative pursuant to the provisions of Section 9-7-6.4 NMSA 1978;

(3) conduct a study and, by September 1, 2012, make recommendations to the legislative health committee and to the legislative finance committee regarding the feasibility of transferring from the department of health and from the human services department to the health policy and finance department all of the home- and community-based waiver services and other programs delivering services to individuals living with developmental disabilities, including the administrative, finance, service delivery and any other components of those programs;

(4) undertake a feasibility study regarding the quality of care provided and cost-effectiveness of the state's reliance upon managed-care contracts to provide coordinated long-term services, behavioral health services through a statewide entity and other medical assistance. By September 1, 2014, the department shall provide the results of the feasibility study and make legislative recommendations pursuant to that study to the legislative health committee and to the legislative finance committee; and

(5) implement a health care work force database and collect data pertaining to health care providers who apply for licensure or renewal of health care provider licensure pursuant to Chapter 61 NMSA 1978.

B. As of January 1, 2014, the department shall:

(1) purchase health care benefits on behalf of the publicly funded health care agencies; and

(2) administer long-term services, including:

(a) the coordinated long-term services home- and community-based waiver program;

(b) the Mi Via self-directed home- and community-based waiver program as it relates to individuals who are elderly, disabled or brain-injured and require a nursing facility level of care;

(d) the brain injury services program;

(e) the home- and community-based waiver program for individuals living with acquired immunodeficiency syndrome or conditions related to acquired immunodeficiency syndrome;

(f) the home- and community-based waiver program for individuals who are medically fragile; and

(g) quality assurance programs related to the programs in Subparagraphs (a) through (f) of this paragraph.

C. As of January 1, 2014, the department shall implement an all-payer claims database.

D. Before executing any contracts to provide long-term services, behavioral health services or medical assistance through a managed care organization, the department shall:

(1) provide a draft of the proposed contract and any bids received from managed care organizations to the interim legislative health committee and the legislative finance committee;

(2) provide to the health unit of the legislative council service as provided in Section 7 of the Health Policy and Finance Department Act a draft of the proposed contract and any bids received from managed care organizations and receive the recommendations of those advisory councils; and

(3) post the proposed contract in a manner easily accessible to the public on the department's web site.

E. In the event that there is established in the state a health benefits exchange, the department shall cooperate with the exchange to share information and facilitate transitions between the exchange and medicaid, the children's health insurance program or any other state public health coverage program.

SECTION 6. [NEW MATERIAL] BEHAVIORAL HEALTH SERVICES DIVISION--POWERS AND DUTIES.--Subject to appropriation, the behavioral health services division of the department shall:

A. contract for behavioral health treatment and support services, including mental health services, and alcohol abuse services and other substance abuse services;

B. establish standards for the delivery of behavioral health services, including quality management and improvement, performance measures, accessibility and availability of services, utilization management, credentialing and recredentialing, rights and responsibilities of behavioral health services providers, preventive behavioral health services, clinical treatment and evaluation and the documentation and confidentiality of client records;

C. ensure that all behavioral health services, including mental health and substance abuse services, that are provided, contracted for or approved are in compliance with the requirements of Section 9-7-6.4 NMSA 1978;

D. assume responsibility for and implement adult mental health and substance abuse services in the state in coordination with the children, youth and families department;

E. establish criteria for determining individual eligibility for behavioral health services; and

F. maintain a management information system in accordance with standards for reporting.

SECTION 7. [NEW MATERIAL] HEALTH UNIT.--

A. The legislative council service shall establish a "health unit", staffed by persons knowledgeable and proficient in the areas of health coverage and delivery of health care services, health care economics, research, law or policy analysis.

B. The health unit shall staff the legislative health committee, conduct research and develop policy options regarding health coverage and access to health care services, health care provider supply and quality of health care services, health coverage and other health issues.

SECTION 8. Section 2-13-1 NMSA 1978 (being Laws 1989, Chapter 349, Section 1) is amended to read:

"2-13-1. CREATION OF COMMITTEE--MEMBERS--APPOINTMENT--TERMS.--There is created a permanent joint interim committee of the legislature to be called the "legislative health [and human services] committee". The committee shall be composed of eight members. The New Mexico legislative council shall appoint four members from the house of representatives and four members from the senate. At the time of making the appointment, the legislative council shall designate the [chairman] chair and vice [chairman] chair of the committee. Members shall be appointed so as to give the two major political parties in each house the same proportionate representation on the committee as prevails in each house; provided, in no event shall either of such parties have less than one member from each house on the committee. Members may be removed from the committee by the legislative council, at the request of the committee [chairman] chair, for nonattendance according to council policy. Vacancies on the committee, however caused, may be filled by the legislative council, or the council may reduce the size of the committee by not making replacement appointments and in such case need not readjust party representation. No action shall be taken by the committee if a majority of the total membership from either house on the committee rejects such action."

SECTION 9. Section 2-13-2 NMSA 1978 (being Laws 1989, Chapter 349, Section 2) is amended to read:

"2-13-2. DUTIES OF THE COMMITTEE.--The legislative health committee shall conduct a continuing study of the programs, agencies, policies, issues and needs relating to health [and human services], including review and study of the statutes, constitutional provisions, regulations and court decisions governing such programs, agencies and issues. The committee shall [also study the full continuum of programs and services available and needed for children, families and the aging population] oversee all aspects of medical assistance programs and other health-related programs of the health policy and finance department, the human services department, the department of health, the aging and long-term services department and the children, youth and families department. The committee shall make an annual report of its findings and recommendations and recommend any necessary legislation to each session of the legislature."

SECTION 10. Section 2-13-3 NMSA 1978 (being Laws 1989, Chapter 349, Section 3) is amended to read:

"2-13-3. SUBCOMMITTEES.--Subcommittees shall be created only by majority vote of all members appointed to the legislative health committee and with the prior approval of the New Mexico legislative council. A subcommittee shall be composed of at least one member from the senate and one member from the house of representatives, and at least one member of the minority party shall be a member of the subcommittee. All meetings and expenditures of a subcommittee shall be approved by the full committee in advance of such meeting or expenditure, and the approval shall be shown in the minutes of the committee."

SECTION 11. Section 2-13-4 NMSA 1978 (being Laws 1989, Chapter 349, Section 4) is amended to read:

"2-13-4. REPORT.--The legislative health committee shall make a report of its findings and recommendations for the consideration of each session of the legislature. The report and suggested legislation shall be made available to the New Mexico legislative council on or before December 15 preceding each session."

SECTION 12. Section 2-13-5 NMSA 1978 (being Laws 1989, Chapter 349, Section 5) is amended to read:

"2-13-5. STAFF.--The staff for the legislative health committee shall be provided by the health unit of the legislative council service."

SECTION 13. Section 2-17-1 NMSA 1978 (being Laws 1998, Chapter 8, Section 21 and Laws 1998, Chapter 9, Section 21, as amended by Laws 2003, Chapter 311, Section 1 and by Laws 2003, Chapter 432, Section 1) is amended to read:

"2-17-1. [WELFARE REFORM OVERSIGHT] HUMAN SERVICES COMMITTEE CREATED--TERMINATION.--The joint interim legislative ["welfare reform oversight] "human services committee" is created. The committee shall function from the date of its appointment until December 15 prior to the first session of the [forty-ninth] sixtieth legislature."

SECTION 14. Section 2-17-2 NMSA 1978 (being Laws 1998, Chapter 8, Section 22 and Laws 1998, Chapter 9, Section 22) is amended to read:

"2-17-2. MEMBERSHIP--APPOINTMENT--VACANCIES.--

A. The [welfare reform oversight] human services committee shall be composed of twelve members. The New Mexico legislative council shall appoint six members from the house of representatives and six members from the senate. At the time of making the appointment, the legislative council shall designate the [chairman] chair and vice [chairman] chair of the committee.

B. Members shall be appointed from each house so as to give the two major political parties in each house the same proportionate representation on the committee as prevails in each house; however, in no event shall either party have less than one member from each house on the committee. At the request of the committee [chairman] chair, members may be removed from the committee by the New Mexico legislative council for nonattendance according to legislative council policy. Vacancies on the committee, however caused, may be filled by the legislative council, or the legislative council may reduce the size of the committee by not making replacement appointments and in that case need not readjust party representation.

C. An action shall not be taken by the committee if a majority of the total membership from either house on the committee rejects that action."

SECTION 15. Section 2-17-3 NMSA 1978 (being Laws 1998, Chapter 8, Section 23 and Laws 1998, Chapter 9, Section 23) is amended to read:

"2-17-3. DUTIES.--

A. After its appointment, the [welfare reform oversight] human services committee shall hold one organizational meeting to develop a work plan and budget for the ensuing interim. The work plan and budget shall be submitted to the New Mexico legislative council for approval. Upon approval of the work plan and budget by the legislative council, the committee shall:

(1) examine the statutes, constitutional provisions and rules governing welfare reform in New Mexico;

(2) monitor and oversee the implementation of the New Mexico Works Act;

(3) review issues related to [welfare reform, including] job training and public benefits programs and related contracts; cash assistance; child care, transportation and other job-related services; alleviation of poverty, homelessness and hunger and other issues [that arise because of the devolution of the federal welfare programs to the states; and] related to helping New Mexicans rise out of poverty, take part in the work force and earn a family-sustaining wage;

(4) make recommendations relating to the adoption of rules and legislation, if any are found to be necessary;

(5) conduct a continuing study of the programs, agencies, policies, issues and needs relating to human services in New Mexico, including review and study of the statutes, constitutional provisions, regulations and court decisions governing such programs, agencies, policies, issues and needs; and

(6) study the full continuum of programs and services available and needed for children, families and the aging population.

B. The committee shall regularly receive testimony from the secretaries of health policy and finance; human services; [labor] workforce solutions; children, youth and families; [and] health; higher education; and [the superintendent of public instruction] public education on poverty issues [arising from the implementation of the New Mexico Works Act] and shall review proposed rules, schedules and formulae before adoption."

SECTION 16. Section 2-17-4 NMSA 1978 (being Laws 1998, Chapter 8, Section 24 and Laws 1998, Chapter 9, Section 24) is amended to read:

"2-17-4. SUBCOMMITTEES.--Subcommittees shall be created only by majority vote of all members appointed to the [welfare reform oversight] human services committee and with the prior approval of the New Mexico legislative council. A subcommittee shall be composed of at least one member from the senate and one member from the house of representatives, and at least one member of the minority party shall be a member of the subcommittee. Any meeting or expenditure of a subcommittee shall be approved by the full committee in advance of that meeting or expenditure, and the approval shall be shown in the minutes of the committee."

SECTION 17. A new section of Chapter 2, Article 17 NMSA 1978 is enacted to read:

"[NEW MATERIAL] STAFF.--The staff for the human services committee shall be provided by the legislative council service."

SECTION 18. Section 9-7-6.4 NMSA 1978 (being Laws 2004, Chapter 46, Section 8, as amended) is amended to read:

"9-7-6.4. INTERAGENCY BEHAVIORAL HEALTH PURCHASING COLLABORATIVE.--

A. There is created the "interagency behavioral health purchasing collaborative", consisting of the secretaries of aging and long-term services; health policy and finance; Indian affairs; [human services] health; corrections; children, youth and families; finance and administration; workforce solutions; public education; and transportation; the directors of the administrative office of the courts; the New Mexico mortgage finance authority; the governor's commission on disability; the developmental disabilities planning council; the instructional support and vocational [rehabilitation] education division of the public education department; and the New Mexico health policy commission; and the governor's health policy coordinator, or their designees. The collaborative shall be chaired by the secretary of [human services] health policy and finance, with the respective secretaries of health and children, youth and families alternating annually as co-chairs.

B. The collaborative shall meet regularly and at the call of either co-chair and shall:

(1) identify behavioral health needs statewide, with an emphasis on that hiatus between needs and services set forth in the department of health's gap analysis and in ongoing needs assessments, and develop a master plan for statewide delivery of services;

(2) give special attention to regional differences, including cultural, rural, frontier, urban and border issues;

(3) inventory all expenditures for behavioral health, including mental health and substance abuse;

(4) plan, design and direct a statewide behavioral health system, ensuring both availability of services and efficient use of all behavioral health funding, taking into consideration funding appropriated to specific affected departments; and

(5) make recommendations to the secretary of health policy and finance on provisions to be contained in a contract for operation of one or more behavioral health entities to ensure availability of services throughout the state.

C. The plan for delivery of behavioral health services shall include specific service plans to address the needs of infants, children, adolescents, adults and seniors, as well as to address work force development and retention and quality improvement issues. The plan shall be revised every two years and shall be adopted by the department of health as part of the statewide health plan.

D. The plan shall take the following principles into consideration, to the extent practicable and within available resources:

(1) services should be individually centered and family-focused based on principles of individual capacity for recovery and resiliency;

(2) services should be delivered in a culturally responsive manner in a home- or community-based setting, where possible;

(3) services should be delivered in the least restrictive and most appropriate manner;

(4) individualized service planning and case management should take into consideration individual and family circumstances, abilities and strengths and be accomplished in consultation with appropriate family, caregivers and other persons critical to the individual's life and well-being;

(5) services should be coordinated, accessible, accountable and of high quality;

(6) services should be directed by the individual or family served to the extent possible;

(7) services may be consumer- or family- provided, as defined by the collaborative;

(8) services should include behavioral health promotion, prevention, early intervention, treatment and community support; and

(9) services should consider regional differences, including cultural, rural, frontier, urban and border issues.

E. The collaborative shall seek and consider suggestions of Native American representatives from Indian nations, tribes and pueblos and the urban Indian population, located wholly or partially within New Mexico, in the development of the plan for delivery of behavioral health services.

F. Pursuant to the State Rules Act, the collaborative shall adopt rules through the [human services] health policy and finance department for:

(1) standards of delivery for behavioral health services provided through contracted behavioral health entities, including:

(a) quality management and improvement;

(b) performance measures;

(d) utilization management;

(e) credentialing of providers;

(f) rights and responsibilities of consumers and providers;

(g) clinical evaluation and treatment and supporting documentation; and

(h) confidentiality of consumer records; and

(2) approval of contracts and contract amendments by the collaborative, including public notice of the proposed final contract.

G. The collaborative shall, through the [human services] health policy and finance department, submit a separately identifiable consolidated behavioral health budget request. The consolidated behavioral health budget request shall account for requested funding for the behavioral health services program at the [human services] health policy and finance department and any other requested funding for behavioral health services from agencies identified in Subsection A of this section that will be used pursuant to Paragraph (5) of Subsection B of this section. Any contract proposed, negotiated or entered into by the collaborative is subject to the provisions of the Procurement Code.

H. The collaborative shall, with the consent of the governor, appoint a "director of the collaborative". The director is responsible for the coordination of day-to-day activities of the collaborative, including the coordination of staff from the collaborative member agencies.

I. The collaborative shall provide a quarterly report to the legislative health committee and the legislative finance committee on performance outcome measures. The collaborative shall submit an annual report to the legislative finance committee and the [interim] legislative health committee that provides information on:

(1) the collaborative's progress toward achieving its strategic plans and goals;

(2) the collaborative's performance information, including contractors and providers; and

(3) the number of people receiving services, the most frequently treated diagnoses, expenditures by type of service and other aggregate claims data relating to services rendered and program operations."

SECTION 19. Section 27-2-12 NMSA 1978 (being Laws 1973, Chapter 376, Section 16, as amended) is amended to read:

"27-2-12. MEDICAL ASSISTANCE PROGRAMS.--

A. Consistent with the federal act and subject to the appropriation and availability of federal and state funds, the [medical assistance division of the department] health policy and finance department may by rule provide medical assistance, including the services of licensed doctors of oriental medicine, licensed chiropractic physicians and licensed dental hygienists in collaborating practice, to persons eligible for public assistance programs under the federal act.

B. Subject to appropriation and availability of federal, state or other funds received by the state from public or private grants or donations, the [medical assistance division of the department] health policy and finance department may, by rule, provide medical assistance, including assistance in the payment of premiums for medical or long-term care insurance, to children up to the age of twelve if not part of a sibling group; children up to the age of eighteen if part of a sibling group that includes a child up to the age of twelve; and pregnant women who are residents of the state of New Mexico and who are ineligible for public assistance under the federal act. The health policy and finance department, in implementing the provisions of this subsection, shall:

(1) establish rules that encourage pregnant women to participate in prenatal care; and

(2) not provide a benefit package that exceeds the benefit package provided to state employees."

SECTION 20. TEMPORARY PROVISION--TRANSFER OF STATE EMPLOYEE AND RETIREE HEALTH COVERAGE FUNCTIONS TO THE HEALTH POLICY AND FINANCE DEPARTMENT--STUDY--REPORTING.--From July 1, 2011 through July 31, 2012, the secretary of health policy and finance; the director of the health unit of the legislative council service; staff of the legislative finance committee; the superintendent of any school district with a student enrollment in excess of sixty thousand students; and the directors of the public school insurance authority, the retiree health care authority and the risk management division of the general services department shall meet at least quarterly and analyze how to transfer the health coverage functions of the public school insurance authority, the retiree health care authority, any school district with a student enrollment in excess of sixty thousand students and the risk management division of the general services department to the health policy and finance department. By August 1, 2012, the secretary of health policy and finance shall compile a report with legislative recommendations on how to implement the January 1, 2014 transfer of the health coverage functions of these entities and the potential for cost containment as a result of that transfer. The secretary of health policy and finance shall present the report to the legislative health committee and to the legislative finance committee.

SECTION 21. TEMPORARY PROVISION--REFERENCES IN LAW.--All references in law to the welfare reform oversight committee shall be deemed to be references to the human services committee. All references in law to the legislative health and human services committee shall be deemed to be references to the legislative health committee.

SECTION 22. TEMPORARY PROVISION--MEDICAL ASSISTANCE PROGRAMS AND BEHAVIORAL HEALTH SERVICES PROGRAMS--TRANSFER OF PROPERTY AND CONTRACTS.--On July 1, 2011:

A. all appropriations, money, records, equipment, supplies and other property directly related to medical assistance and behavioral health services programs shall be transferred from the human services department to the health policy and finance department; and

B. all contracts relating to medical assistance and behavioral health services programs currently binding and effective upon the human services department or the interagency behavioral health purchasing collaborative shall be binding and effective on the health policy and finance department.

SECTION 23. TEMPORARY PROVISION--LONG-TERM SERVICES PROGRAMS--TRANSFER OF PROPERTY AND CONTRACTS.--On January 1, 2014:

A. all appropriations, money, records, equipment, supplies and other property directly related to the following programs currently located at the aging and long-term services department shall be transferred from the aging and long-term services department to the health policy and finance department:

(1) the coordination of long-term services program for disabled, elderly or brain-injured individuals;

(2) that component of the Mi Via self-directed waiver program that serves disabled, elderly or brain-injured individuals who meet the criterion of needing a nursing-facility level of care;

(3) the program of all-inclusive care for the elderly;

(4) the brain injury services program; and

(5) quality assurance programs related to any of the programs listed in Paragraphs (1) through (4) of this subsection; and

B. all contracts relating to the programs listed in Subsection A of this section currently binding and effective upon the aging and long-term services department shall be binding and effective upon the health policy and finance department.

SECTION 24. TEMPORARY PROVISION--DEPARTMENT OF HEALTH MEDICALLY FRAGILE AND ACQUIRED IMMUNODEFICIENCY SYNDROME WAIVER PROGRAMS--TRANSFER OF PROPERTY AND CONTRACTS.--On January 1, 2014:

A. all personnel, appropriations, money, records, equipment, supplies and other property of the department of health directly related to the provision of services pursuant to the medically fragile and acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related condition waiver programs, including quality control and administrative support services related to those programs, shall be transferred to the health policy and finance department; and

B. all contracts directly related to the programs listed in Subsection A of this section currently binding and effective upon the department of health shall be binding and effective upon the health policy and finance department.

SECTION 25. REPEAL.--

A. Sections 10-7B-1 through 10-7B-8 NMSA 1978 (being Laws 1989, Chapter 231, Sections 1 through 6, Laws 2005, Chapter 301, Section 4 and Laws 1989, Chapter 23, Sections 7 and 8, as amended) are repealed effective January 1, 2014.

B. Sections 10-7C-1 through 10-7C-19 NMSA 1978 (being Laws 1990, Chapter 6, Sections 1 through 7; Laws 2000, Chapter 79, Sections 1 and 2; Laws 1990, Chapter 6, Sections 8 though 16; Laws 2002, Chapter 75, Section 2 and Laws 2002, Chapter 80, Section 2; Laws 2002, Chapter 75, Section 3 and Laws 2002, Chapter 80, Section 3; and Laws 2002, Chapter 75, Section 4 and Laws 2002, Chapter 80, Section 4, as amended) are repealed effective January 1, 2014.

C. Sections 13-7-1 through 13-7-11 NMSA 1978 (being Laws 1997, Chapter 74, Sections 1 through 4, Laws 2001, Chapter 351, Sections 1 through 3, Laws 2003, Chapter 391, Section 2, Laws 2007, Chapter 218, Section 1, Laws 2007, Chapter 356, Section 1 and Laws 2009, Chapter 212, Section 1, as amended) are repealed effective January 1, 2014.

D. Sections 22-29-1 through 22-29-12 NMSA 1978 (being Laws 1986, Chapter 94, Sections 1 through 9, Laws 1989, Chapter 373, Section 5, Laws 2005, Chapter 274, Section 18 and Laws 2007, Chapter 236, Section 3, as amended) are repealed effective January 1, 2014.

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