SENATE MEMORIAL 132

52nd legislature - STATE OF NEW MEXICO - first session, 2015

INTRODUCED BY

Sue Wilson Beffort

A MEMORIAL

REQUESTING THE SECRETARY OF CORRECTIONS TO ESTABLISH A CORRECTIONS HEALTH CARE TASK FORCE TO STUDY WAYS TO OPTIMIZE QUALITY AND EFFICIENCY IN CORRECTIONS DEPARTMENT HEALTH CARE.

     WHEREAS, the legislative finance committee reports that, over the past five years, New Mexico has spent an estimated three hundred million dollars ($300,000,000) in corrections department-related spending, with roughly fifteen percent of those funds, or forty-five million dollars ($45,000,000), going to inmate health care; and

     WHEREAS, the legislative finance committee has identified three major "drivers" of correctional health care spending: the distance of prisons from hospitals and other health care providers; the prevalence of infections, chronic diseases, mental illnesses and substance use disorders among inmates; and the fact that the prison population is aging; and

     WHEREAS, before the legislative health and human services committee in 2014, Secretary of Corrections Gregg Marcantel reported that as of fall 2014, approximately eight thousand two hundred inmates have been screened for, and one thousand nine hundred eight have been diagnosed with, hepatitis C, for which treatment is extremely expensive; and

     WHEREAS, the corrections department has a contract with a Tennessee-based entity, Corazon health, incorporated, to manage the health care of inmates; and

     WHEREAS, the corrections department contract with Corazon health, incorporated, provides that inmate health care expenses, including gross receipts tax, pharmaceuticals and expenses, are not to exceed one hundred seventy-seven million six hundred fifty thousand dollars ($177,650,000) for the four- year term of the contract beginning June 1, 2012 and ending May 31, 2016; and

     WHEREAS, in 2009, the corrections department and the department of health had a joint powers agreement pursuant to which, for forty thousand dollars ($40,000), the department of health provided care for inmates living with human immunodeficiency virus disease, or "HIV", and the acquired immune deficiency syndrome, or "AIDS"; and

     WHEREAS, pursuant to that joint powers agreement, the department of health bills the corrections department for reimbursement of costs incurred purchasing HIV and AIDS medications via the deeply discounted pricing available under Section 340b of the federal Public Health Service Act, also know as the "340b program"; and

     WHEREAS, the department of health and corrections department joint powers agreement was not maintained due to budget and legal concerns; and

     WHEREAS, there may be possibilities for the corrections department to avail itself of discounted pharmaceuticals under the 340b program, but federal law requires that it partner with an institution such as the department of health or the university of New Mexico to provide health care services to inmates; and

     WHEREAS, legislative finance committee staff have identified opportunities for the university of New Mexico to provide services to inmates, some of which are currently provided by Corazon health care, incorporated, pursuant to its contract: clinical preventive services for disease prevention and health promotion; screening and treatment for sexually transmitted disease infections; family planning services; low-risk prenatal care services; breast and cervical cancer- screening services; counseling, laboratory testing, and medical consultation related to HIV, hepatitis C and opiate replacement therapy; screening and immunization for hepatitis A and hepatitis B, pursuant to which the department of health might provide hepatitis A and B vaccines; infectious disease rapid response for screening, contact investigations and prophylaxis during outbreak control; and education related to care and disease management for inmates with certain chronic diseases or conditions, including but not limited to cervical displasia, diabetes and asthma;

     NOW, THEREFORE, BE IT RESOLVED BY THE SENATE OF THE STATE OF NEW MEXICO that the secretary of corrections be requested to convene a "corrections health care task force" to undertake a study of health care quality and cost at the corrections department; and

     BE IT FURTHER RESOLVED that the secretary of corrections be requested to direct the health services administrator of the corrections department, and other corrections department personnel that the secretary deems appropriate, to participate in the corrections health care task force and to invite to participate representatives from the following:

          A. the department of health; 

          B. legislative finance committee staff;

          C. the office of the state auditor;

          D. the university of New Mexico health sciences center, including one representative from the project ECHO telehealth program;

          E. any managed-care entity that provides health care services to the corrections department;

          F. New Mexico health care practitioner organizations;

          G. the New Mexico sentencing commission;

          H. a national corrections health care accrediting body; and

          I. an advocacy organization for incarcerated individuals; and

     BE IT FURTHER RESOLVED that the corrections task force be requested to examine:

          A. relating to health care outcome measures:

                (1) an identification of the outcome measures that the corrections department uses to determine quality of care;

                (2) the health care outcomes that the department has tracked for the past five years, both generally and in terms of the three major "drivers" of correctional health care spending: the distance of prisons from hospitals and other health care providers; the prevalence of infections, chronic diseases, mental illnesses and substance use disorders among inmates; and the aging prison population;

                (3) the actions that the corrections department has taken to ensure that health care services are evidence-based services, as well as any other measure the department has implemented since fiscal year 2011 to ameliorate health care outcomes;

                (4) a gap analysis to identify the needs that exist among the department's patient population and an identification of the resources necessary to meet those needs, by the following health care service categories: physical health; behavioral health, including mental health and substance use disorders; long-term care, including chronic conditions; and prescription drugs and devices; and

                (5) an analysis of the effect that health care delivery within the corrections department system has upon the general public's health, safety and well-being;

          B. the cost of health care services that the corrections department receives from all sources, including any physical health, behavioral health, pharmacy and long-term services reimbursed through a managed-care contract and those for which the department makes direct reimbursement on a fee-for-service basis. For the purpose of this study, the department shall disclose to the task force reimbursement rates for:

                (1) each health care service or product for which it makes reimbursement on a fee-for-service basis; and

                (2) the capitated rate for which health care services are reimbursed pursuant to a managed-care contract;

          C. the measures that the corrections department would be required to take to achieve accreditation by a national corrections health care accrediting body;

          D. the possibilities that exist for the corrections department to maximize prescription drug discounts under the federal Section 340 program, either for all prescription drugs for which the department makes reimbursement or for specific categories of prescription drugs or medical conditions, such as to treat hepatitis C, HIV or AIDS;

          E. measures that the corrections department and its vendors and contractors have taken to maximize efficiency relating to health care claim reimbursement and a gap analysis to identify the barriers to maximizing efficiency in claim reimbursement and the resources necessary to maximize claim reimbursement efficiency;

          F. the opportunities for decreasing recidivism through the effective delivery of health care services to inmates; and

          G. the corrections department's implementation of COMPAS or another risk and needs assessment mechanism relating to health care services; and

     BE IT FURTHER RESOLVED that a copy of this memorial be transmitted to the secretary of corrections.

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