0001| HOUSE BILL 1319
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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| BEN LUJAN
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0005|
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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| AN ACT
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0011| RELATING TO HEALTH ADMINISTRATION; TRANSFERRING FUNCTIONS,
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0012| PROPERTY AND LEGAL REFERENCES OF THE NEW MEXICO HEALTH POLICY
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0013| COMMISSION.
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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. Section 9-7-11.2 NMSA 1978 (being Laws 1991,
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0017| Chapter 139, Section 2, as amended) is amended to read:
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0018| "9-7-11.2. [NEW MEXICO] HEALTH POLICY [COMMISSION
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CREATED--COMPOSITION] PLANNING--DUTIES. [A. There is
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created the "New Mexico health policy commission", which is
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administratively attached to the department of finance and
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administration.
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B. The New Mexico health policy commission shall
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consist of eight members appointed by the governor with the
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advice and consent of the senate to reflect the ethnic,
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economic, geographic and professional diversity of the state.
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No member of the commission shall have a pecuniary or fiduciary
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interest in the health services industry for three years
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preceding his appointment to the commission. Two members shall
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be appointed for one-year terms, three members shall be
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appointed for two-year terms, three members shall be appointed
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for three-year terms and all subsequent appointments shall be
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made for three-year terms.
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C. The New Mexico health policy commission shall
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meet at the call of the chairman and shall meet not less than
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quarterly. The chairman shall be elected from among the
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members of the commission. Members of the New Mexico health
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policy commission shall not be paid but shall receive per diem
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and mileage expenses as provided in the Per Diem and Mileage
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Act.
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D. The New Mexico health policy commission shall
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establish task forces as needed to make recommendations to the
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commission on various health issues. Task force members may
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include individuals who have expertise or a pecuniary or
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fiduciary interest in the health services industry. Voting
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members of a task force may receive mileage expenses if they:
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(1) are members who represent consumer
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interests;
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(2) are individuals who were not appointed to
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represent the views of the organization or agency for which
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they work; or
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(3) represent an organization that has a
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policy of not reimbursing travel expenses of employees or
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representatives for travel to meetings.
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E. The New Mexico health policy commission] The
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0006| department shall:
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0007| [(1)] A. develop a plan for and monitor the
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0008| implementation of the state's health policy;
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0009| [(2)] B. obtain and evaluate information from a
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0010| broad spectrum of New Mexico's society to develop and monitor
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0011| the implementation of the state's health policy;
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0012| [(3)] C. obtain and evaluate information
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0013| relating to factors that affect the availability and
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0014| accessibility of health services and health care personnel in
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0015| the public and private sectors;
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0016| [(4)] D. perform needs assessments on health
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0017| personnel, health education and recruitment and retention and
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0018| make recommendations regarding the training, recruitment,
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0019| placement and retention of health professionals in underserved
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0020| areas of the state;
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0021| [(5)] E. prepare and publish an annual report
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0022| describing the progress in addressing the state's health policy
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0023| and planning issues. The report shall include a workplan of
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0024| goals and objectives for addressing the state's health policy
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0025| and planning issues in the upcoming year;
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0001| [(6)] F. distribute the annual report to the
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0002| governor, appropriate state agencies and interim legislative
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0003| committees and interested parties;
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0004| [(7)] G. establish a process to prioritize
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0005| recommendations on program development, resource allocation and
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0006| proposed legislation;
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0007| [(8)] H. provide information and analysis on
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0008| health issues;
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0009| [(9)] I. serve as a catalyst and synthesizer of
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0010| health policy in the public and private sectors; and
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0011| [(10)] J. respond to requests by the executive
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0012| and legislative branches of government."
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0013| Section 2. Section 24-14A-2 NMSA 1978 (being Laws 1989,
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0014| Chapter 29, Section 2, as amended) is amended to read:
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0015| "24-14A-2. DEFINITIONS.--As used in the Health
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0016| Information System Act:
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0017| A. "aggregate data" means data which is obtained by
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0018| combining like data in a manner which precludes specific
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0019| identification of a single client or provider;
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0020| [B. "commission" means the New Mexico health
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policy commission;
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C.] B. "department" means the department of
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0023| health;
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0024| [D.] C. "health information" or "health data"
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0025| means any data relating to health care; health status,
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0001| including environmental, social and economic factors; the
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0002| health system; or health costs and financing;
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0003| [E.] D. "hospital" means any general or special
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0004| hospital licensed by the department, whether publicly or
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0005| privately owned;
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0006| [F.] E. "long-term care facility" means any
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0007| skilled nursing facility or nursing facility licensed by the
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0008| department, whether publicly or privately owned;
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0009| [G.] F. "data source" includes those categories
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0010| of persons or entities that possess health information,
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0011| including any public or private sector licensed health care
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0012| practitioner, primary care clinic, ambulatory surgery center,
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0013| ambulatory urgent care center, ambulatory dialysis unit, home
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0014| health agency, long-term care facility, hospital, pharmacy,
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0015| third-party payer and any public entity that has health
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0016| information; and
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0017| [H.] G. "third-party payer" means any public or
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0018| private payer of health care services and includes health
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0019| maintenance organizations and health insurers."
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0020| Section 3. Section 24-14A-3 NMSA 1978 (being Laws 1989,
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0021| Chapter 29, Section 3, as amended) is amended to read:
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0022| "24-14A-3. HEALTH INFORMATION SYSTEM--CREATION--DUTIES OF
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0023| [COMMISSION] DEPARTMENT.--
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0024| A. The "health information system" is created for
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0025| the purpose of assisting the [commission] department,
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0001| legislature and other agencies and organizations in the state's
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0002| efforts in collecting, analyzing and disseminating health
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0003| information to assist:
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0004| (1) in the performance of health planning and
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0005| policymaking functions, including identifying personnel,
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0006| facility, education and other resource needs and allocating
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0007| financial, personnel and other resources where appropriate;
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0008| (2) consumers in making informed decisions
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0009| regarding health care; and
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0010| (3) in administering, monitoring and
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0011| evaluating a statewide health plan.
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0012| B. In carrying out its powers and duties pursuant
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0013| to the Health Information System Act, the [commission]
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0014| department shall not duplicate databases that exist in the
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0015| public sector or databases in the private sector to which it
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0016| has electronic access. Every governmental entity shall provide
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0017| the [commission] department with access to its health-
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0018| related data as needed by the [commission] department. The
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0019| [commission] department shall collect data from data
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0020| sources in the most cost-effective and efficient manner.
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0021| C. The [commission] department shall establish,
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0022| operate and maintain the health information system.
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0023| D. In establishing, operating and maintaining the
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0024| health information system, the [commission] department
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0025| shall:
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0001| (1) obtain information on the following health
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0002| factors:
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0003| (a) mortality and natality, including
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0004| accidental causes of death;
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0005| (b) morbidity;
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0006| (c) health behavior;
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0007| (d) disability;
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0008| (e) health system costs, availability,
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0009| utilization and revenues;
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0010| (f) environmental factors;
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0011| (g) health personnel;
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0012| (h) demographic factors;
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0013| (i) social, cultural and economic
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0014| conditions affecting health;
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0015| (j) family status; and
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0016| (k) medical and practice outcomes as
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0017| measured by nationally accepted standards and quality of care;
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0018| (2) give the highest priority in data
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0019| gathering to information needed to implement and monitor
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0020| progress toward achievement of the state health policy,
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0021| including determining where additional health resources such as
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0022| personnel, programs and facilities are most needed, what those
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0023| additional resources should be and how existing resources
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0024| should be reallocated;
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0025| (3) standardize collection and specific
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0001| methods of measurement across databases and use scientific
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0002| sampling or complete enumeration for collecting and reporting
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0003| health information;
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0004| (4) take adequate measures to provide health
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0005| information system security for all health data acquired under
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0006| the Health Information System Act and protect individual
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0007| patient and provider confidentiality. The right to privacy for
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0008| the individual shall be a major consideration in the collection
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0009| and analysis of health data and shall be protected in the
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0010| reporting of results;
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0011| (5) adopt and promulgate regulations necessary
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0012| to establish and administer the provisions of the Health
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0013| Information System Act, including an appeals process for data
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0014| sources and procedures to protect data source proprietary
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0015| information from public disclosure;
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0016| (6) establish definitions, formats and other
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0017| common information standards for core health data elements of
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0018| the health information system in order to provide an integrated
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0019| financial, statistical and clinical health information system,
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0020| including a geographic information system, that allows data
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0021| sharing and linking across databases maintained by data sources
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0022| and federal, state and local public agencies;
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0023| (7) develop and maintain health and health-
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0024| related data inventories and technical documentation on data
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0025| holdings in the public and private sectors;
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0001| (8) collect, analyze and make available health
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0002| data to support preventive health care practices and to
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0003| facilitate the establishment of appropriate benchmark data to
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0004| measure performance improvements over time;
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0005| (9) establish and maintain a systematic
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0006| approach to the collection and storage of health data for
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0007| longitudinal, demographic and policy impact studies;
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0008| (10) use expert system-based protocols to
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0009| identify individual and population health risk profiles and to
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0010| assist in the delivery of primary and preventive health care
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0011| services;
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0012| (11) collect health data sufficient for
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0013| consumers to be able to evaluate health care services, plans,
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0014| providers and payers and to make informed decisions regarding
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0015| quality, cost and outcome of care across the spectrum of health
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0016| care services, providers and payers;
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0017| (12) collect comprehensive information on
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0018| major capital expenditures for facilities, equipment by type
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0019| and by data source and significant facility capacity
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0020| reductions; provided that for the purposes of this paragraph
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0021| and Section
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0022| 24-14A-5 NMSA 1978, "major capital expenditure" means purchases
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0023| of at least one million dollars ($1,000,000) for construction
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0024| or renovation of facilities and at least five hundred thousand
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0025| dollars ($500,000) for purchase or lease of equipment, and
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0001| "significant facility capacity reductions" means those
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0002| reductions in facility capacities as defined by the advisory
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0003| committee established by the [commission] department;
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0004| (13) serve as a health information
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0005| clearinghouse, including facilitating private and public
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0006| collaborative, coordinated data collection and sharing and
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0007| access to appropriate data and information, maintaining patient
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0008| and client confidentiality in accordance with state and federal
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0009| requirements; and
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0010| (14) collect data in the most cost-efficient
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0011| and effective method feasible and adopt regulations, after
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0012| receiving recommendations from the advisory committee, that
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0013| place a limit on the maximum amount of unreimbursed costs that
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0014| a data source can incur in any year for the purposes of
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0015| complying with the data requirements of the Health Information
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0016| System Act."
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0017| Section 4. Section 24-14A-3.1 NMSA 1978 (being Laws 1994,
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0018| Chapter 59, Section 13) is amended to read:
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0019| "24-14A-3.1. ADVISORY COMMITTEE.--
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0020| A. The [commission] department shall establish
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0021| an advisory committee to assist it in identifying data needs,
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0022| reviewing data and collection and reporting procedures,
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0023| reviewing costs and benefits of obtaining data and determining
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0024| report formats.
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0025| B. The advisory committee shall consist of
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0001| representatives of private and public data sources; consumers;
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0002| state agencies that deliver or pay for health care; and
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0003| professionals with expertise in areas such as epidemiology,
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0004| health economics, health care financing and information
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0005| systems. Members of the advisory committee shall be appointed
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0006| by the [commission] department.
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0007| C. The nonpublic voting members may receive per
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0008| diem and mileage under the following conditions:
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0009| (1) they are members who represent consumer
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0010| interest;
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0011| (2) they are individuals who were not
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0012| appointed to represent the views of the organization or agency
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0013| for which they work; or
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0014| (3) they represent an organization that has a
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0015| policy of not reimbursing travel expenses of employees or
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0016| representatives for travel to meetings.
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0017| D. The advisory committee shall develop
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0018| recommendations on:
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0019| (1) the specific data elements and their data
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0020| sources to ascertain information on:
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0021| (a) quality of health care services,
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0022| including access, appropriateness and consumer satisfaction;
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0023| (b) medical and practice outcomes, based
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0024| on national standards;
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0025| (c) health system economics and
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0001| finances, such as: 1) how much money is being spent on health
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0002| care in New Mexico; 2) what health care services are being
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0003| purchased; 3) where health care services are being purchased,
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0004| both geographically and among health care providers; 4) what
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0005| health care services are being used at what rates; 5)
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0006| variations in costs and billed charges for the same health care
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0007| services geographically and among health care providers; 6)
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0008| causes of health care inflation in New Mexico; 7) rates and
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0009| causes of increase in health care spending for different health
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0010| services; and 8) reasonable premiums for given packages of
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0011| benefits; and
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0012| (d) the release of patient information
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0013| by physicians to ensure protection of confidentiality and
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0014| privacy for patients;
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0015| (2) an appropriate procedure for processing
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0016| non-aggregate data for public information and a schedule for
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0017| phasing in the public release of non-aggregate information so
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0018| that [no later than July 1, 1997] the public will have access
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0019| to information on which to base health care purchasing
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0020| decisions;
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0021| (3) criteria and procedures to assess the
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0022| costs and benefits of collecting and submitting data and
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0023| criteria to determine when data sources need not provide data
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0024| or may furnish data in an alternative form, due to unreasonable
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0025| cost or burden of reporting; and
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0001| (4) a common definition of "proprietary" for
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0002| all data sources."
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0003| Section 5. Section 24-14A-3.2 NMSA 1978 (being Laws 1994,
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0004| Chapter 59, Section 14) is amended to read:
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0005| "24-14A-3.2. HEALTH INFORMATION ALLIANCE.--
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0006| A. The [commission] department shall establish
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0007| a health information alliance that [will be] is broadly
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0008| representative of public and private entities interested in
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0009| gathering, sharing and evaluating health information and
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0010| advising the [commission] department on the design of the
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0011| health information system. The health information alliance
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0012| shall assist the [commission] department in applying for
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0013| grants to establish and maintain a comprehensive integrated
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0014| health information system.
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0015| B. The health information alliance shall:
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0016| (1) develop a conceptual strategic plan for a
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0017| coordinated and integrated statewide health information
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0018| network;
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0019| (2) advise the [commission] department on
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0020| the technical development of the health information network;
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0021| (3) assist the [commission] department
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0022| with modeling for collecting, organizing, processing, analyzing
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0023| and disseminating health information;
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0024| (4) serve as a neutral forum for the creative
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0025| and collaborative exploration of solutions to health
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0001| information needs;
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0002| (5) assist the [commission] department in
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0003| identifying and applying for potential funding sources for the
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0004| development of the health information network and the health
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0005| information alliance; and
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0006| (6) identify, prioritize and formulate
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0007| recommendations for funding software and hardware technology
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0008| and models to address short- and long-term health information
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0009| needs of the state.
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0010| [C. The health information alliance and the
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commission shall report to the appropriate interim legislative
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committee by August 1, 1994 and every six months thereafter on
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their progress in developing an integrated health information
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network.]"
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0015| Section 6. Section 24-14A-4 NMSA 1978 (being Laws 1989,
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0016| Chapter 29, Section 4, as amended) is amended to read:
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0017| "24-14A-4. HEALTH INFORMATION SYSTEM--APPLICABILITY.--
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0018| A. All data sources shall participate in the health
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0019| information system. Requests for health data under the Health
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0020| Information System Act from a member of a data source category
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0021| shall, where reasonable and equitable, be made to all members
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0022| of that data source category.
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0023| B. Upon making any request for health data pursuant
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0024| to the Health Information System Act, the [commission]
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0025| department shall provide reasonable deadlines for compliance
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0001| and shall give notice that noncompliance may subject the person
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0002| to a civil penalty pursuant to Section 24-14A-10 NMSA 1978.
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0003|
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0004| C. To the extent possible, the health information
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0005| system shall be established in a manner to facilitate the
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0006| exchange of information with other databases, including those
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0007| maintained by the Indian health service and various agencies of
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0008| the federal government."
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0009| Section 7. Section 24-14A-4.1 NMSA 1978 (being Laws 1994,
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0010| Chapter 59, Section 11) is amended to read:
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0011| "24-14A-4.1. ANNUAL REVIEW OF DATA NEEDS.--At least once
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0012| each year, the [commission] department, with the
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0013| recommendations of the advisory committee and health
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0014| information alliance, shall review its data collection
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0015| requirements to determine the relevancy of the data elements on
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0016| which it collects data and review its regulations and
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0017| procedures for collecting, analyzing and reporting data for
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0018| efficiency, effectiveness and appropriateness. The review
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0019| shall consider the cost incurred by data sources to collect and
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0020| submit data."
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0021| Section 8. Section 24-14A-4.2 NMSA 1978 (being Laws 1994,
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0022| Chapter 59, Section 12) is amended to read:
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0023| "24-14A-4.2. INVESTIGATORY POWERS.--The [commission]
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0024| department has the right to verify the accuracy of data
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0025| provided by any data source. The verification may include
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0001| requiring the data source to submit documentation sufficient to
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0002| verify the accuracy of the data in question or to provide
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0003| direct inspection during normal business hours of only the
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0004| records and documents that pertain directly to the data in
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0005| question; provided that no data source shall be required to
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0006| expend more than twenty-five thousand dollars ($25,000) each
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0007| year to comply with the provisions of this section."
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0008| Section 9. Section 24-14A-4.3 NMSA 1978 (being Laws 1994,
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0009| Chapter 59, Section 15) is amended to read:
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0010| "24-14A-4.3. AGENCY COOPERATION.--All state agencies and
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0011| political subdivisions shall cooperate with and assist the
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0012| [commission] department in carrying out the provisions of
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0013| the Health Information System Act, including sharing
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0014| information and joining in any appropriate health information
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0015| system."
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0016| Section 10. Section 24-14A-6 NMSA 1978 (being Laws 1989,
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0017| Chapter 29, Section 6, as amended) is amended to read:
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0018| "24-14A-6. HEALTH INFORMATION SYSTEM--ACCESS.--
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0019| A. Access to data in the health information system
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0020| shall be provided in accordance with regulations adopted by the
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0021| [commission] department pursuant to the Health Information
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0022| System Act.
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0023| B. A data provider may obtain data it has submitted
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0024| to the system, as well as aggregate data, but it may not access
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0025| data submitted by another provider [which] that is limited
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0001| only to that provider. In no event may a data provider obtain
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0002| data regarding an individual patient except in instances where
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0003| that data was originally submitted by the requesting provider.
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0004| Prior to the release of any data, in any form, data sources
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0005| shall be permitted the opportunity to verify the accuracy of
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0006| the data pertaining to that data source. Any data identified
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0007| in writing as inaccurate shall be corrected prior to the data's
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0008| release. Time limits shall be set for the submission and
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0009| review of data by data sources and penalties shall be
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0010| established for failure to submit and review the data within
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0011| the established time.
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0012| C. Any person may obtain any aggregate data."
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0013| Section 11. Section 24-14A-7 NMSA 1978 (being Laws 1989,
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0014| Chapter 29, Section 7, as amended) is amended to read:
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0015| "24-14A-7. HEALTH INFORMATION SYSTEM--REPORTS.--
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0016| A. A report in printed format that provides
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0017| information of use to the general public shall be produced
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0018| annually. The report shall be made available upon request.
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0019| The [commission] department may make the report available
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0020| on tape or other electronic format.
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0021| B. The [commission] department shall provide an
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0022| annual report of its activities, including health care system
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0023| statistics, to the legislature. The report shall be submitted
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0024| by November 15 each year."
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0025| Section 12. Section 24-14A-9 NMSA 1978 (being Laws 1989,
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0001| Chapter 29, Section 9, as amended) is amended to read:
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0002| "24-14A-9. HEALTH INFORMATION SYSTEM--FEES.--Except for
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0003| the annual reports required pursuant to the Health Information
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0004| System Act, the [commission] department may collect a fee
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0005| of up to one hundred dollars ($100) per hour to offset
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0006| partially the costs of producing public-use data aggregations
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0007| or data for single-use special studies. Entities contributing
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0008| data to the system shall be charged reduced rates. Rates shall
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0009| be established by regulation and shall be reviewed annually.
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0010| Fees collected pursuant to this section are appropriated to the
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0011| [commission] department to carry out the provisions of the
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0012| Health Information System Act."
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0013| Section 13. TEMPORARY PROVISION--TRANSFERS OF NEW MEXICO
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0014| HEALTH POLICY COMMISSION PERSONNEL, APPROPRIATIONS, PERSONAL
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0015| PROPERTY, CONTRACTS AND LEGAL REFERENCES TO THE DEPARTMENT OF
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0016| HEALTH.--
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0017| A. On the effective date of this act:
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0018| (1) all personnel, appropriations and personal
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0019| property belonging to or pertaining to the New Mexico health
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0020| policy commission are transferred to the department of health;
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0021| (2) all existing rules and regulations,
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0022| contracts and agreements in effect for the New Mexico health
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0023| policy commission are binding on the department of health; and
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0024| (3) all references in the law to the health
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0025| policy commission shall be construed to mean the department of
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0001| health.
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0002| B. In order to implement the provisions of this act
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0003| without an increase in general fund appropriations, during
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0004| fiscal year 1998 the governor by executive order may transfer
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0005| any personnel, functions, powers and duties, contracts,
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0006| agreements, grants, appropriations, funds, property, equipment
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0007| and supplies from the New Mexico health policy commission to
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0008| the department of health.
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0009|
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