0001| HOUSE BILL 358
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0002| 43rd legislature - STATE OF NEW MEXICO - first session, 1997
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0003| INTRODUCED BY
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0004| DANICE PICRAUX
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0005|
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0006|
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0007|
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0008| FOR THE HEALTH CARE REFORM COMMITTEE
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0009|
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0010| AN ACT
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0011| RELATING TO PUBLICLY FUNDED HEALTH CARE PROGRAMS; AMENDING AND
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0012| ENACTING SECTIONS OF THE NMSA 1978 TO PROVIDE FOR CONSOLIDATION
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0013| OF NEGOTIATION AND PURCHASING OF INSURANCE.
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0014|
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0015| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
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0016| Section 1. [NEW MATERIAL] SHORT TITLE.--Sections 1
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0017| through 4 of this act may be cited as the "Health Care
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0018| Purchasing Act".
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0019| Section 2. [NEW MATERIAL] PURPOSE OF ACT.--The purpose
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0020| of the Health Care Purchasing Act is to ensure public
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0021| employees, public school employees and retirees of public
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0022| employment and the public schools access to more affordable and
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0023| enhanced quality of health insurance through cost containment
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0024| and savings effected by procedures for consolidating and
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0025| purchasing of publicly financed health insurance.
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0001| Section 3. [NEW MATERIAL] DEFINITIONS.--As used in the
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0002| Health Care Purchasing Act:
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0003| A. "consolidated purchasing" means a single process
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0004| for the procurement and contracting for health care benefits
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0005| with one contractor for the same services by the publicly
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0006| funded health care agencies in compliance with the competitive
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0007| sealed proposal process of the Procurement Code and includes
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0008| related activities such as actuarial, cost containment and
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0009| benefits consultation and analysis; and
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0010| B. "publicly funded health care agency" means the:
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0011| (1) risk management division and the group
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0012| benefits committee of the general services department;
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0013| (2) retiree health care authority;
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0014| (3) public school insurance authority; and
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0015| (4) publicly funded health care program of any
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0016| public school district with a student enrollment in excess of
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0017| sixty thousand students.
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0018| Section 4. [NEW MATERIAL] MANDATORY CONSOLIDATED
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0019| PURCHASING.--Consolidated purchasing shall be required among
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0020| all publicly funded health care agencies' requests for
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0021| proposals for publicly funded health insurance on or after July
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0022| 1, 1999 and for all publicly funded health insurance contracts
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0023| renewed or issued on or after July 1, 2000. No such agency
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0024| shall enter into any other contracts for health benefits except
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0025| to the extent that medicare supplemental coverage and long-term
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0001| care coverage are not included in the scope of the consolidated
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0002| purchasing benefit plan. In conducting the consolidated
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0003| purchasing required by this section, the publicly funded health
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0004| care agencies shall offer a single consolidated purchasing
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0005| benefit plan for all the agencies.
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0006| Section 5. Section 10-7C-7 NMSA 1978 (being Laws 1990,
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0007| Chapter 6, Section 7) is amended to read:
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0008| "10-7C-7. BOARD--DUTIES.--In order to achieve the
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0009| purposes of the Retiree Health Care Act, the board may take all
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0010| actions reasonably necessary to implement that act, including
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0011| but not limited to the following:
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0012| A. employ or contract for the services of the state
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0013| fiscal agent or select its own fiscal agent in accordance with
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0014| the Procurement Code;
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0015| B. employ or contract for persons to assist it in
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0016| carrying out the Retiree Health Care Act and determine the
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0017| duties and compensation of these employees;
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0018| C. collect and disburse funds;
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0019| D. collect all current and historical claims and
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0020| financial information necessary for effective procurement of
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0021| lines of insurance coverage;
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0022| E. promulgate and adopt necessary rules,
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0023| regulations and procedures for implementation of the Retiree
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0024| Health Care Act;
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0025| F. negotiate insurance policies covering additional
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0001| or lesser benefits as determined appropriate by the board, but
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0002| the board shall maintain all coverage as required by federal or
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0003| state law for each eligible retiree. In the event it is
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0004| practical to wholly self-insure part or all of the retiree
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0005| health care coverages, the board may do so;
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0006| G. procure group health care and other coverages
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0007| authorized by the Retiree Health Care Act in accordance with
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0008| the Procurement Code and the Health Care Purchasing Act;
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0009| H. establish the procedures for contributions and
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0010| deductions;
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0011| I. determine methods and procedures for claims
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0012| administration;
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0013| J. administer the fund;
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0014| K. contract for and make available to all eligible
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0015| retirees and eligible dependents basic and optional group
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0016| health insurance plans. The optional coverage may include a
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0017| lower deductible, lower coinsurance or additional categories of
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0018| benefits permitted under this section and all other applicable
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0019| sections of the Retiree Health Care Act to provide additional
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0020| levels of coverages and benefits. Any additional contributions
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0021| for these optional plans shall be paid for by the eligible
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0022| retiree or eligible dependent. The coverage provided by the
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0023| [plan or] plans shall be secondary to all other benefit
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0024| coverages to which the eligible retiree or eligible dependent
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0025| is entitled. In the event a covered eligible retiree becomes
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0001| employed by an employer offering its employees a basic plan of
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0002| benefits, the coverage provided by the plan under the Retiree
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0003| Health Care Act shall be secondary to such coverage regardless
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0004| of whether the employee enrolls in that employer's plan. In
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0005| the event the eligible retiree or eligible dependent is en-
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0006|
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0007| titled to receive medicare hospital insurance benefits at no
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0008| charge, then the coverage provided by the plan under the
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0009| Retiree Health Care Act shall be secondary to medicare hospital
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0010| and medical insurance to the extent permitted by federal law;
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0011| L. provide, at its discretion, different plans for
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0012| eligible retirees and eligible dependents covered by medicare
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0013| than the plans provided for eligible retirees and eligible
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0014| dependents who are not covered by medicare; and
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0015| M. promulgate and adopt rules and regulations
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0016| governing eligibility, participation, enrollment, length of
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0017| service and any other conditions or requirements for providing
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0018| substantially equal treatment to participating employers who
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0019| are independent public employers and their retirees and
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0020| participating employees."
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0021| Section 6. Section 15-7-3 NMSA 1978 (being Laws 1978,
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0022| Chapter 166, Section 8, as amended) is amended to read:
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0023| "15-7-3. ADDITIONAL POWERS AND DUTIES OF THE RISK
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0024| MANAGEMENT DIVISION.--
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0025| A. The risk management division of the general
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0001| services department may:
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0002| (1) enter into contracts;
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0003| (2) procure insurance, reinsurance or employee
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0004| group benefits; provided that any proposal or contract for the
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0005| procurement of any group health care benefits shall be subject
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0006| to the provisions of the Health Care Purchasing Act; and
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0007| provided further that reinsurance or excess coverage
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0008| insurance may be placed by private negotiation, notwithstanding
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0009| the provisions of the Procurement Code, if [such] the
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0010| insurance or reinsurance has a restricted number of interested
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0011| carriers, the board determines that [such] the coverage is
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0012| in the interest of the state and cannot otherwise be procured
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0013| for a reasonable cost and the director seeks the advice and
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0014| review of the board in [such] the placement and in
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0015| designing private negotiation procedures;
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0016| (3) in the manner prescribed by Subsection E
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0017| of Section 9-17-5 NMSA 1978, after a notice and a public
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0018| hearing, prescribe by regulation reasonable and objective
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0019| underwriting and safety standards for governmental entities and
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0020| reasonable standards for municipal self-insurance pooling
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0021| agreements covering liability under the Tort Claims Act and
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0022| adopt such other regulations as may be deemed necessary;
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0023| (4) compromise, adjust, settle and pay claims;
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0024| (5) pay expenses and costs;
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0025| (6) in the manner prescribed by Subsection E
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0001| of Section 9-17-5 NMSA 1978, prescribe by rule or regulation
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0002| the rating bases, assessments, penalties and risks to be
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0003| covered by the public liability fund, the workers' compensation
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0004| retention fund and the public property reserve fund and the
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0005| extent such risks are to be covered;
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0006| (7) issue certificates of coverage in
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0007| accordance with Paragraph (6) of this subsection:
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0008| (a) to any governmental entity for any
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0009| tort liability risk covered by the public liability fund;
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0010| (b) to any governmental entity for any
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0011| personal injury liability risk or for the defense of any errors
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0012| or act or omission or neglect or breach of duty, including the
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0013| risks set forth in Paragraph (2) of Subsection B and Paragraph
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0014| (2) of Subsection D of Section 41-4-4 NMSA 1978; and
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0015| (c) to any governmental entity for any
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0016| part of risk covered by the workers' compensation retention
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0017| fund, the surety bond fund or the public property reserve fund;
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0018| (8) study the risks of all governmental
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0019| entities;
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0020| (9) initiate the establishment of safety
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0021| programs and adopt regulations to carry out such programs in
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0022| the manner prescribed by Subsection E of Section 9-17-5 NMSA
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0023| 1978;
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0024| (10) hire a safety program director who shall
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0025| coordinate all safety programs of all state agencies;
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0001| (11) consult with and advise local public
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0002| bodies on their risk management problems; and
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0003| (12) employ full-time legal counsel who shall
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0004| be under the exclusive control and supervision of the director
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0005| and the secretary of general services.
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0006| B. The risk management division of the general
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0007| services department shall provide liability coverage for the
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0008| following risks:
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0009| (1) a claim made pursuant to the provisions of
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0010| 42 U.S.C. Section 1983 against a nonprofit corporation, members
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0011| of its board of directors or its employees when the claim is
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0012| based upon action taken pursuant to the provisions of a
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0013| contract between the corporation and the department of health
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0014| under which the corporation provides developmental disability
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0015| services to clients of the department and the claim is made by
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0016| or on behalf of a client; and
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0017| (2) a claim made pursuant to the provisions of
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0018| 42 U.S.C. Section 1983 against a nonprofit corporation, members
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0019| of its board of directors or its employees when the corporation
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0020| operates a facility licensed by the department of health as an
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0021| intermediate care facility for the mentally retarded and the
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0022| claim is based upon action taken pursuant to the provisions of
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0023| the license and is made by or on behalf of a resident of the
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0024| licensed facility.
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0025| C. The director shall report his findings and
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0001| recommendations, if any, for the consideration of each
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0002| legislature. The report shall include the amount and name of
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0003| any person receiving payment from the public liability fund of
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0004| any claim paid during the previous fiscal year exceeding one
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0005| thousand dollars ($1,000). The report shall be made available
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0006| to the legislature on or before December 15 preceding each
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0007| regular legislative session."
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0008| Section 7. Section 22-2-6.7 NMSA 1978 (being Laws 1986,
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0009| Chapter 94, Section 7, as amended) is amended to read:
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0010| "22-2-6.7. AUTHORITY--DUTIES.--In order to effectuate the
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0011| purposes of the Public School Insurance Authority Act, the
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0012| authority has the power to:
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0013| A. employ the services of the state fiscal agent or
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0014| select its own fiscal agent pursuant to regulations adopted by
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0015| the board; provided that for the purposes of disbursing all
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0016| money other than that in the fund, the secretary of finance and
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0017| administration shall be the fiscal agent for the authority;
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0018| B. enter into professional services and consulting
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0019| contracts or agreements as necessary;
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0020| C. collect, provide for the investment of and
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0021| disburse money in the fund;
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0022| D. collect all current and historical claims and
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0023| financial information necessary for effective procurement of
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0024| lines of insurance coverage;
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0025| E. promulgate necessary rules, regulations and
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0001| procedures for implementation of the Public School Insurance
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0002| Authority Act;
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0003| F. negotiate new insurance policies covering
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0004| additional or lesser benefits as determined appropriate by the
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0005| authority, but the authority shall maintain all coverage levels
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0006| required by federal and state law for each participating
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0007| member. In the event it is practical to wholly self-insure a
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0008| particular line of coverage, the authority may do so;
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0009| G. procure lines of insurance coverage in
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0010| compliance with the provisions of the Health Care Purchasing
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0011| Act and the competitive sealed proposal process of the
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0012| Procurement Code; provided that any group medical insurance
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0013| plan offered pursuant to this section shall include effective
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0014| cost-containment measures to control the growth of health care
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0015| costs. The board shall report annually by September 1 to
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0016| appropriate interim legislative committees on the effectiveness
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0017| of the cost-containment measures required by this subsection;
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0018| H. purchase, renovate, equip and furnish a building
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0019| for the board. The board shall consider purchasing a building
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0020| in a community with a population of forty thousand or less; and
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0021| I. loan from its seventy-eighth fiscal year budget
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0022| to the retiree health care authority an amount not exceeding
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0023| five hundred thousand dollars ($500,000) to be used for retiree
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0024| health care authority start-up costs. The loan shall bear
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0025| interest at a rate equal to the rate of return or yield for
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0001| ten-year United States treasury bonds existing on the date of
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0002| the loan closing. Principal and interest shall be paid back
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0003| before the end of the seventy-ninth fiscal year."
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0004| Section 8. EFFECTIVE DATE.--The effective date of the
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0005| provisions of this act is July 1, 1997.
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0006|
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0007| State of New Mexico
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0008| House of Representatives
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0009|
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0010| FORTY-THIRD LEGISLATURE
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0011| FIRST SESSION, 1997
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0012|
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0013|
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0014| February 20, 1997
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0015|
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0016|
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0017| Mr. Speaker:
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0018|
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0019| Your BUSINESS AND INDUSTRY COMMITTEE, to whom
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0020| has been referred
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0021|
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0022| HOUSE BILL 358
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0023|
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0024| has had it under consideration and reports same with
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0025| recommendation that it DO PASS, amended as follows:
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0001|
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0002| 1. On page 1, line 24, strike "and" and insert in lieu
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0003| thereof "the".
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0004|
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0005| 2. On page 2, strike all of lines 3 through 9, and insert
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0006| in lieu thereof the following:
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0007|
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0008| "A. "consolidated purchasing" means a single process
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0009| for the procurement of all health care benefits by the publicly
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0010| funded insurance agencies in compliance with the Procurement Code
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0011| and includes associated activities related to the procurement
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0012| such as actuarial, cost containment, benefits consultation and
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0013| analysis; and".
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0014|
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0015| 3. On pages 2 and 3, strike all of Section 4 and insert in
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0016| lieu thereof the following new section:
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0017|
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0018| "Section 4. [NEW MATERIAL] MANDATORY CONSOLIDATED
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0019| PURCHASING.--
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0020|
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0021| A. The agencies shall enter into a cooperative
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0022| consolidated purchasing effort to provide plans of health care
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0023| benefits for the benefit of eligible participants of the
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0024| respective agencies. The request for proposal shall set forth
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0025| one or more plans of health care benefits and shall include
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0001| accommodation of fully funded arrangements as well as varying
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0002| degrees of self-funded pool options.
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0003|
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0004| B. A consolidated purchasing request for proposals
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0005| for all health care benefits by the publicly funded health care
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0006| agencies shall be issued on or before July 1, 1999 and any
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0007| contracts for health care benefits renewed or issued on or after
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0008| July 1, 2000 shall be the result of consolidated purchasing.
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0009|
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0010| C. All requests for proposals issued as part of the
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0011| consolidated purchasing shall include at least one distinct
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0012| service area consisting of the Albuquerque metropolitan area.
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0013| Proposals on a distinct service area shall be evaluated
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0014| separately.".
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0015|
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0016| 4. On page 10, line 17, after the period strike the
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0017| remainder of the line and lines 18 through 25, and on page ll,
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0018| strike all of line 1 up to the quotation marks.,
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0019|
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0020| and thence referred to the APPROPRIATIONS AND FINANCE
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0021| COMMITTEE.
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0022|
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0023| Respectfully submitted,
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0024|
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0025|
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0001|
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0002|
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0003|
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0004| Fred Luna, Chairman
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0005|
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0006|
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0007| Adopted Not Adopted
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0008|
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0009| (Chief Clerk) (Chief Clerk)
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0010|
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0011| Date
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0012|
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0013| The roll call vote was 9 For 0 Against
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0014| Yes: 9
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0015| Excused: Corley, Getty, Olguin, Varela
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0016| Absent: None
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0017|
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0018|
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0019| .116521.1
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0020| G:\BILLTEXT\BILLW_97\H0358 State of New Mexico
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0021| House of Representatives
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0022|
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0023| FORTY-THIRD LEGISLATURE
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0024| FIRST SESSION, 1997
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0025|
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0001|
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0002| February 25, 1997
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0003|
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0004|
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0005| Mr. Speaker:
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0006|
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0007| Your APPROPRIATIONS AND FINANCE COMMITTEE, to
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0008| whom has been referred
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0009|
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0010| HOUSE BILL 358, as amended
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0011|
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0012| has had it under consideration and reports same with
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0013| recommendation that it DO PASS.
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0014|
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0015| Respectfully submitted,
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0016|
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0017|
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0018|
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0019|
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0020|
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0021| Max Coll, Chairman
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0022|
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0023|
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0024| Adopted Not Adopted
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0025|
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0001| (Chief Clerk) (Chief Clerk)
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0002|
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0003| Date
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0004|
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0005| The roll call vote was 10 For 2 Against
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0006| Yes: 10
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0007| No: Bird, Buffett
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0008| Excused: Heaton, Saavedra, Varela, Wallace, Watchman
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0009| Absent: None
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0010|
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0011|
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0012| G:\BILLTEXT\BILLW_97\H0358
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0013|
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0014| FORTY-THIRD LEGISLATURE
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0015| FIRST SESSION, 1997
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0016|
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0017|
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0018| March 12, 1997
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0019|
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0020| Mr. President:
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0021|
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0022| Your CORPORATIONS & TRANSPORTATION COMMITTEE, to
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0023| whom has been referred
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0024|
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0025| HOUSE BILL 358, as amended
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0001|
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0002| has had it under consideration and reports same with
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0003| recommendation that it DO PASS.
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0004|
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0005| Respectfully submitted,
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0006|
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0007|
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0008|
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0009|
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0010| __________________________________
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0011| Roman M. Maes, III, Chairman
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0012|
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0013|
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0014|
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0015| Adopted_______________________ Not
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0016| Adopted_______________________
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0017| (Chief Clerk) (Chief Clerk)
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0018|
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0019|
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0020|
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0021| Date ________________________
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0022|
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0023|
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0024| The roll call vote was 8 For 0 Against
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0025| Yes: 8
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0001| No: 0
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0002| Excused: Fidel, Robinson
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0003| Absent: None
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0004|
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0005|
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0006| H0358CT1
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