0001|                            HOUSE BILL 213
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0002|     43RD LEGISLATURE - STATE OF NEW MEXICO - SECOND SESSION, 1998
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0003|                            INTRODUCED BY
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0004|                          EDWARD C. SANDOVAL
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0005|     
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0006|                                   
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0007|     
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0008|             FOR THE HEALTH AND WELFARE REFORM COMMITTEE
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0009|                                   
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0010|                                AN ACT
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0011|     RELATING TO HEALTH; ENACTING THE CHILD HEALTH ACT; CREATING A
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0012|     PROGRAM; MAKING AN APPROPRIATION; DECLARING AN EMERGENCY.
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0013|     
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0014|     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
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0015|          Section 1.  SHORT TITLE.--This act may be cited as the
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0016|     "Child Health Act".
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0017|          Section 2.  PURPOSE.--The purpose of the Child Health Act
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0018|     is to enable the state of New Mexico to provide child health
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0019|     assistance to uninsured low-income children and their families
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0020|     in an effective and efficient manner.
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0021|          Section 3.  DEFINITIONS.--As used in the Child Health
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0022|     Act:
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0023|               A.  "child" means a natural person who has not
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0024|     reached his nineteenth birthday; 
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0025|               B.  "department" means the human services
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0001|     department;  
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0002|               C.  "low-income children and their families" means
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0003|     a family with a dependent child with income at or below the
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0004|     level specified in Section 6 of the Child Health Act; and
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0005|               D.  "secretary" means the secretary of human
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0006|     services. 
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0007|          Section 4.  PROGRAM CREATED.--After consultation with the
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0008|     secretary of health and the secretary of children, youth and
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0009|     families, the secretary is directed to design and implement a
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0010|     program to provide health services to low-income children and
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0011|     their families in accordance with the provisions of the Child
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0012|     Health Act.  The program<u></u> shall meet the requirements for
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0013|     obtaining allotted federal funds pursuant to the provisions of
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0014|     Title 21 of the federal Social Security Act.  In accordance with
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0015|     those requirements and the requirements of the Child Health Act,
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0016|     the secretary shall prepare and submit a child health plan to
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0017|     the federal secretary of health and human services.  The
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0018|     department is the designated state agency to administer the
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0019|     program and cooperate with the federal government in its
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0020|     administration.
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0021|      Section 5.  PROGRAM OBJECTIVES--DEVELOPMENT OF PLAN AND
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0022|     ADOPTION OF RULES.--
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0023|           A.  The child health plan and the program shall be
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0024|     designed to achieve the following objectives: 
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0025|                 (1)  expand access to and coverage for full
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0001|     or partial payment for a comprehensive array of personal
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0002|     health services for low-income children and their families who
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0003|     do not have those services at present;
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0004|                (2)  increase measurably the quality of life
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0005|     and well-being for the state's citizens by ensuring the good
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0006|     health of children and adults in low-income families; 
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0007|                (3)  reduce substantially the occurrence rates
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0008|     of preventable illness and disease, morbidity and mortality in
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0009|     the state's population;
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0010|                (4)  increase positively the benefit-to-cost
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0011|     ratios of health services provided in the state to the
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0012|     population as a whole while at the same time improving the
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0013|     quality of service when measured by both scientifically
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0014|     objective and beneficiary-perceived criteria; 
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0015|                (5)  retard escalation of health care costs in
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0016|     all segments of the health care industry;
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0017|                (6)  provide through demonstration projects,
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0018|     coupled with any necessary and appropriate federal waivers of
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0019|     conditions for expenditure approval, innovative and
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0020|     imaginative methods of providing health care to all eligible
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0021|     segments of the state's population; and
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0022|                (7)  comply with the terms and conditions set
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0023|     forth in the state children's health insurance program
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0024|     established pursuant to Title 21 of the federal Social
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0025|     Security Act.
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0001|           B.  Implementation of an approved child health plan
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0002|     shall be in accordance with rules adopted by the secretary
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0003|     after consultation with the department of health and the
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0004|     children, youth and families department.  The rules shall be
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0005|     designed to achieve and be consistent with the objectives
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0006|     specified in Subsection A of this section.  Those objectives
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0007|     are stated as mandatory standards by which the validity of
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0008|     proposed rules shall be tested.  Additionally, the rules must
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0009|     be consistent with those provisions of the Child Health Act
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0010|     that mandate program requirements.  
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0011|      Section 6.  PLAN CONTENT--REQUIRED ELEMENTS.--The child
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0012|     health plan and the program of services to be provided by it
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0013|     shall include:
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0014|           A.  appropriate methods of outreach to increase the
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0015|     enrollment of eligible children;
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0016|           B.  a "phase one" that shall include providing
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0017|     health insurance to children living in households at or below
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0018|     two hundred thirty-five percent of the federal poverty level;
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0019|           C.  a "phase two" that may consist of those
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0020|     federally approved specialized services included in the child
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0021|     health plan by the secretary, a continuum of prevention and
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0022|     intervention services that may be developed and implemented,
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0023|     including applications for any federal waivers of conditions
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0024|     that are necessary and consisting of at least the following:
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0025|                (1)  implementation of a voluntary home
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0001|     visiting program available statewide for mothers having their
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0002|     first child, beginning during pregnancy and extending for two
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0003|     years, with a frequency of use as indicated by maternal desire
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0004|     and home visiting team recommendations;
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0005|                (2)  provision for home- and community-based 
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0006|     early intervention developmental services;
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0007|                (3)  provision for a behavioral health
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0008|     identification, assessment and management system;
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0009|                (4)  provision for school-based health
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0010|     services in the network of health care programs;
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0011|                (5)  provision for the existing healthier kids
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0012|     fund administered by the department of health to enable
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0013|     children to have effective access to health care; 
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0014|                (6)  development of ways to increase
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0015|     children's dental services, including such prevention services
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0016|     as periodic examinations, radiographs, prophylactic cleanings,
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0017|     fluoride treatments and sealants; and
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0018|                (7)  development of ways to increase
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0019|     children's vision services including periodic professional eye
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0020|     examinations and prescription eyeware;
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0021|           D.  provision for inhibiting or preventing both
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0022|     employer crowd-out and employee crowd-in;
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0023|           E.  requirements that in the development and
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0024|     implementation of the plan the interests of Native American
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0025|     children are identified, and that appropriate provisions for
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0001|     their enrollment are made with recognition that the
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0002|     application process and the delivery of services with respect
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0003|     to those children present special cultural and other
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0004|     considerations;
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0005|           F.  provision for coordination of the
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0006|     administration of the program with other public and private
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0007|     health programs;
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0008|           G.  identification and implementation of methods,
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0009|     including monitoring used to ensure the quality and
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0010|     appropriateness of care, particularly with respect to well
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0011|     baby care, well child care and immunizations provided pursuant
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0012|     to the plan and to ensure access to covered services,
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0013|     including emergency services;
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0014|           H.  methods by which the state will collect data,
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0015|     maintain the records and furnish required reports to the
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0016|     secretary or his designees;
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0017|           I.  specific requirements for and description of
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0018|     the means to be used to ensure that members of the public will
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0019|     be involved in the design and implementation of the plan and a
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0020|     description of a method to ensure ongoing public involvement;
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0021|     and
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0022|           J.  operation and management of the program by the
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0023|     department in the most fiscally responsible manner, subject to
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0024|     all available legislative appropriations and federal
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0025|     contributions for the program, so that low-income children and
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0001|     their families receive the optimum health care possible.
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0002|      Section 7.  CREATION OF LEGISLATIVE OVERSIGHT COMMITTEE--
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0003|     AUTHORITY AND DUTIES.--
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0004|           A.  There is created a joint interim legislative
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0005|     committee, which shall be known as the "program oversight
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0006|     committee". 
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0007|           B.  The committee shall be composed of eight
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0008|     members.  Four members of the house of representatives shall
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0009|     be appointed by the speaker of the house of representatives
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0010|     and four members of the senate shall be appointed by the
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0011|     committees' committee of the senate or, if the senate
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0012|     appointments are made in the interim, by the president pro
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0013|     tempore of the senate after consultation with and agreement of
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0014|     a majority of the members of the committees' committee.
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0015|     Members shall be appointed so that there is a member from each
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0016|     of the major political parties from each house.  No member who
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0017|     has a financial interest in an insurance company or health
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0018|     care provider shall be appointed to the committee. 
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0019|           C.  The program oversight committee shall oversee
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0020|     the development and operations of the program created pursuant
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0021|     to the Child Health Act.  It shall fulfill any
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0022|     responsibilities delegated to it pursuant to that act. 
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0023|           D.  The committee shall report annually its
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0024|     findings and recommendations regarding the program to each
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0025|     regular session of the legislature and shall include in that
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0001|     report any recommendations for changes in the laws pertaining
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0002|     to the program.  
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0003|      Section 8.  APPROPRIATION.--Two million nine hundred
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0004|     thousand dollars ($2,900,000) is appropriated from the general
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0005|     fund to the human services department for expenditure in fiscal
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0006|     years 1998 through 2000 for the purpose of providing the state
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0007|     match to establish a new state children's health insurance
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0008|     program authorized in the federal Budget Reconciliation Act of
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0009|     1997.  In addition, the human services department, the
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0010|     department of health and the children, youth and families
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0011|     department are authorized to expend in fiscal years 1998, 1999
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0012|     and 2000, in contributions toward a higher state match, up to a
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0013|     total of three million six hundred thousand dollars ($3,600,000)
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0014|     from department balances, toward the establishment of the state
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0015|     children's health insurance program.  Pursuant to Sections
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0016|     6-3-23 through 6-3-25 NMSA 1978, the departments are
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0017|     specifically authorized to request any budget adjustments
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0018|     necessary to make the contributions.  Any unexpended or
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0019|     unencumbered balance remaining at the end of fiscal year 2008
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0020|     shall revert to the general fund.
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0021|      Section 9.  DELAYED REPEAL.--Effective July 1, 2007, the
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0022|     Child Health Act is repealed.
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0023|      Section 10.  EMERGENCY.--It is necessary for the public
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0024|     peace, health and safety that this act take effect immediately.
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0025|                               
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