SENATE BILL 342

55th legislature - STATE OF NEW MEXICO - first session, 2021

INTRODUCED BY

Elizabeth "Liz” Stefanics

 

 

 

 

 

AN ACT

RELATING TO HEALTH; ENACTING THE MEDICAID WAIVER WAGE FAIRNESS AND WORKFORCE ACT; REQUIRING PROVIDER AGENCIES THAT PROVIDE SERVICES THROUGH CERTAIN MEDICAID WAIVER PROGRAMS TO INCREASE COMPENSATION FOR CERTAIN STAFF WHEN REIMBURSEMENT RATES INCREASE; REQUIRING PROVIDER AGENCIES TO MAINTAIN RECORDS AND REPORT ON STAFF COMPENSATION; PROVIDING FOR THE RECOUPMENT OF REIMBURSEMENT RATE INCREASES PAID TO PROVIDER AGENCIES UNDER CERTAIN CIRCUMSTANCES; REQUIRING PROVIDER AGENCIES TO COLLECT AND REPORT DATA REGARDING THE DIRECT SUPPORT PROFESSIONAL WORKFORCE.

 

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

     SECTION 1. [NEW MATERIAL] SHORT TITLE.--This act may be cited as the "Medicaid Waiver Wage Fairness and Workforce Act".

     SECTION 2. [NEW MATERIAL] DEFINITIONS.--As used in the Medicaid Waiver Wage Fairness and Workforce Act:

          A. "compensation" means any form of monetary payment, employer-paid health and other insurance programs, paid time off, payroll taxes and all other fixed and variable benefits conferred on or received by direct support professional staff;

          B. "department" means the department of health;

          C. "direct support professional" means a person employed by a provider agency who provides a range of supportive services to individuals with an intellectual or developmental disability on a day-to-day basis to enable those individuals to live and work in their communities;

          D. "intellectual and developmental disability program" means the developmental disabilities medicaid waiver or the medically fragile medicaid waiver authorized pursuant to Section 1915(c) of the federal Social Security Act and administered by the department;

          E. "provider agency" means an entity that:

                (1) has entered into a medicaid provider participation agreement with the medical assistance division of the human services department and a provider agreement with the department;

                (2) is eligible to be reimbursed for services provided to individuals through an intellectual and developmental disability program; and

                (3) employs direct support professionals to furnish services to those individuals with an intellectual or developmental disability; and

          F. "reimbursement rate" means the amount of the fee set by the department or by the human services department to compensate entities providing services through an intellectual and developmental disability program.

     SECTION 3. [NEW MATERIAL] REIMBURSEMENT RATE INCREASES TO BE PASSED ON TO DIRECT SUPPORT PROFESSIONALS.--When the reimbursement rates paid to a provider agency for services provided through an intellectual and developmental disability program and performed by a direct support professional are increased, at least seventy percent of the additional funds shall be used to increase compensation.

     SECTION 4. [NEW MATERIAL] REPORTING TOOL--CREATION--USE.--The department shall create a reporting tool, and provider agencies shall use the reporting tool to track and report to the department, on a schedule to be determined by the department:

          A. how increased reimbursement rates have been used to increase compensation; and

          B. data to enable the department to evaluate the status of the direct support professional workforce, including:

                (1) the number of full-time and part-time direct support professional staff employed by the provider agency;

                (2) measures of employment stability, including vacancy and turnover rates;

                (3) employee qualifications such as training and certification; and

                (4) compensation provided.

     SECTION 5. [NEW MATERIAL] PROVIDER AGENCY RECORDKEEPING REQUIREMENTS--COMPENSATION.--

          A. Each provider agency shall:

                (1) maintain all books, documents, records and other evidence required to support the reporting of information described in Section 4 of the Medicaid Waiver Wage Fairness and Workforce Act for at least three years from the reporting deadline set by the department; and

                (2) make the information and materials available for inspection by the department or its designee at all reasonable times.

          B. If the department has reason to believe that a provider agency has not used the required portion of a reimbursement rate increase to increase compensation, as required by Section 3 of the Medicaid Waiver Wage Fairness and Workforce Act, the department may at any time request information from the provider agency on how it used increased funding to increase compensation.

     SECTION 6. [NEW MATERIAL] RECOUPMENT OF REIMBURSEMENT RATE INCREASES.--The department may recoup from the provider agency all or part of the reimbursement rate increase if the department determines that the provider agency:

          A. did not use the rate increase to increase compensation as required by Section 3 of the Medicaid Waiver Wage Fairness and Workforce Act; or

          B. failed to track and report how it used the increase in the reimbursement rate as required by Section 4 of the Medicaid Waiver Wage Fairness and Workforce Act.

- 5 -