SENATE BILL 290

54th legislature - STATE OF NEW MEXICO - first session, 2019

INTRODUCED BY

Gerald Ortiz y Pino

 

 

 

 

 

AN ACT

RELATING TO PUBLIC ASSISTANCE; ENACTING A NEW SECTION OF THE PUBLIC ASSISTANCE ACT; REQUIRING THE SECRETARY OF HUMAN SERVICES TO ESTABLISH MEDICAID HOME VISITING SERVICES TO IMPROVE THE HEALTH AND DEVELOPMENT OF NEW MEXICO CHILDREN AND FAMILIES; ESTABLISHING A MEDICAID HOME VISITING ADVISORY COUNCIL; PROVIDING FOR RULEMAKING.

 

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

     SECTION 1. A new section of the Public Assistance Act is enacted to read:

     "[NEW MATERIAL] MEDICAID HOME VISITING SERVICES.--

          A. Beginning January 1, 2020, consistent with federal law and subject to the appropriation and availability of state and federal funds, the secretary shall provide home visiting services to medicaid recipients whom the department deems eligible for those services.

          B. The medical assistance division of the department shall work with home visiting services providers to execute provider participation agreements establishing these providers as eligible for reimbursement for furnishing home visiting services to medicaid recipients. The medical assistance division shall ensure that home visiting services providers are able to receive reimbursement through managed care or fee-for-service arrangements.

          C. The secretary shall:

                (1) ensure that the home visiting services provided under this section are aligned with home visiting standards and are not duplicative in the provision of services;

                (2) develop a mechanism for reimbursing home visiting services providers to prevent duplicative payments and to maximize available federal funding to the greatest extent possible, including for any services that are federally reimbursable through the medical assistance division, such as:

                     (a) case management services;

                     (b) licensed practitioner services;

                     (c) preventive services;

                     (d) services that meet federal requirements under the early, periodic, screening, diagnostic and treatment program benefit;

                     (e) rehabilitative services;

                     (f) therapy services;

                     (g) home health services as prescribed by a physician;

                     (h) home health for individuals with chronic conditions;

                     (i) language translation and interpreting services; and

                     (j) extended services to pregnant women; and

                (3) ensure meaningful access to language access services pursuant to federal law and United States department of health and human services guidelines.

          D. The secretary shall adopt and promulgate rules consistent with this section.

          E. The department, in consultation with New Mexico tribal governments, providers of home visiting services and one or more experts in home visiting, shall:

                (1) jointly develop an outcomes measurement plan to monitor outcomes for infants, toddlers and families receiving services through home visiting services programs;

                (2) develop indicators that measure each outcome measure established pursuant to Subparagraph (c) of Paragraph (1) of Subsection I of this section; and

                (3) complete and submit the outcomes measurement plan by December 1, 2019 to the legislature, the governor, the medicaid home visiting advisory council and all New Mexico tribal governors.

          F. Beginning July 1, 2019, the secretary shall establish a "medicaid home visiting advisory council" that shall consist of the following:

                (1) the secretary of human services, or the secretary's designee;

                (2) the secretary of children, youth and families, or the secretary's designee;

                (3) the secretary of health, or the secretary's designee;

                (4) at least five home visiting services providers, including at least one each from the northern, central and southern New Mexico regions;

                (5) at least one tribal home visiting expert from a provider in New Mexico; and

                (6) at least one community-based advocacy group working on home visiting and other early childhood issues.

          G. The medicaid home visiting advisory council shall:

                (1) review and evaluate the outcomes set forth in Subparagraph (c) of Paragraph (1) of Subsection I of this section;

                (2) review the annual outcomes report analyzing outcomes of the measures set forth in Subparagraph (c) of Paragraph (1) of Subsection I of this section;

                (3) develop a community-oriented plan that includes outreach strategies to families prenatally or at birth; and

                (4) develop a plan that includes strategies to ensure that children and families at the highest risk are targeted and receive appropriate services.

          H. Beginning July 1, 2020, and annually thereafter, the department shall produce an annual outcomes report to the legislature and the governor. The annual outcomes report shall include:

                (1) achieved outcomes in each area outlined in Subparagraph (c) of Paragraph (1) of Subsection I of this section;

                (2) data regarding:

                     (a) the cost per family served;

                     (b) the number of families served;

                     (c) demographic data on families served;

                     (d) the number of visits provided to families; and

                     (e) the percentages of families served respectively in rural, tribal and urban areas;

                (3) recommendations for health outcome and program quality improvements; and

                (4) recommendations to ensure that reimbursement to home visiting services providers is effective and maximizing federal match dollars to the greatest extent possible.

          I. As used in this section:

                (1) "home visiting services" means a program that serves infants, toddlers and their families and:

                     (a) uses home visiting as a primary service delivery strategy;

                     (b) includes regular, voluntary visits provided in the home of eligible infants and toddlers and their families;

                     (c) is grounded in best practices that are designed to produce and measure the following outcomes: 1) improvement of infant, toddler and parental health outcomes; 2) positive parenting practices; 3) healthy parent and child relationships; 4) child well-being and prevention of adverse childhood experiences; 5) enhanced social-emotional development; 6) cognitive development of infants and toddlers; 7) increased use of early childhood learning programs; 8) increased school readiness; 9) increased parental engagement in education, vocational or job training; 10) the provision of a variety of information on education, child safety, health and development; and 11) referrals and other support provided to an infant or toddler and the infant or toddler's family;

                     (d) has comprehensive home visiting standards that ensure high-quality service delivery and continuous quality improvement;

                     (e) has demonstrated significant, sustained positive outcomes;

                     (f) follows a program manual or design that specifies the purpose, outcomes, duration and frequency of home visiting services;

                     (g) follows research-based protocols;

                     (h) employs well-trained, competent and culturally sensitive staff and provides continual professional supervision, training and development relevant to the specific program or model being delivered;

                     (i) provides professional training in diverse cultural practices of child rearing and family systems;

                     (j) demonstrates strong links to other community-based services, including behavioral health care, medical and dental care, public assistance programs, stable housing programs, transportation services, youth mentor programs, early childhood development programs, schools and vocation and job training;

                     (k) continually evaluates performance to ensure fidelity to the program model;

                     (l) collects and shares data on program activities and outcomes; and

                     (m) is adapted to a family's cultural and linguistic background; and

                (2) "medicaid" means the joint federal-state health coverage program pursuant to Title 19 or Title 21 of the federal act."

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