0001| SENATE BILL 132 | 0002| 43RD LEGISLATURE - STATE OF NEW MEXICO - SECOND SESSION, 1998 | 0003| INTRODUCED BY | 0004| LINDA M. LOPEZ | 0005| | 0006| | 0007| | 0008| FOR THE HEALTH AND WELFARE REFORM COMMITTEE | 0009| | 0010| AN ACT | 0011| RELATING TO HEALTH; ENACTING THE CHILD HEALTH ACT; CREATING A | 0012| PROGRAM; MAKING AN APPROPRIATION; DECLARING AN EMERGENCY. | 0013| | 0014| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO: | 0015| Section 1. SHORT TITLE.--This act may be cited as the | 0016| "Child Health Act". | 0017| Section 2. PURPOSE.--The purpose of the Child Health Act | 0018| is to enable the state of New Mexico to provide child health | 0019| assistance to uninsured low-income children and their families | 0020| in an effective and efficient manner. | 0021| Section 3. DEFINITIONS.--As used in the Child Health | 0022| Act: | 0023| A. "child" means a natural person who has not | 0024| reached his nineteenth birthday; | 0025| B. "department" means the human services | - 1 - 0001| department; | 0002| C. "low-income children and their families" means | 0003| a family with a dependent child with income at or below the | 0004| level specified in Section 6 of the Child Health Act; and | 0005| D. "secretary" means the secretary of human | 0006| services. | 0007| Section 4. PROGRAM CREATED.--After consultation with the | 0008| secretary of health and the secretary of children, youth and | 0009| families, the secretary is directed to design and implement a | 0010| program to provide health services to low-income children and | 0011| their families in accordance with the provisions of the Child | 0012| Health Act. The program|| shall meet the requirements for | 0013| obtaining allotted federal funds pursuant to the provisions of | 0014| Title 21 of the federal Social Security Act. In accordance with | 0015| those requirements and the requirements of the Child Health Act, | 0016| the secretary shall prepare and submit a child health plan to | 0017| the federal secretary of health and human services. The | 0018| department is the designated state agency to administer the | 0019| program and cooperate with the federal government in its | 0020| administration. | 0021| Section 5. PROGRAM OBJECTIVES--DEVELOPMENT OF PLAN AND | 0022| ADOPTION OF RULES.-- | 0023| A. The child health plan and the program shall be | 0024| designed to achieve the following objectives: | 0025| (1) expand access to and coverage for full | - 2 - 0001| or partial payment for a comprehensive array of personal | 0002| health services for low-income children and their families who | 0003| do not have those services at present; | 0004| (2) increase measurably the quality of life | 0005| and well-being for the state's citizens by ensuring the good | 0006| health of children and adults in low-income families; | 0007| (3) reduce substantially the occurrence rates | 0008| of preventable illness and disease, morbidity and mortality in | 0009| the state's population; | 0010| (4) increase positively the benefit-to-cost | 0011| ratios of health services provided in the state to the | 0012| population as a whole while at the same time improving the | 0013| quality of service when measured by both scientifically | 0014| objective and beneficiary-perceived criteria; | 0015| (5) retard escalation of health care costs in | 0016| all segments of the health care industry; | 0017| (6) provide through demonstration projects, | 0018| coupled with any necessary and appropriate federal waivers of | 0019| conditions for expenditure approval, innovative and | 0020| imaginative methods of providing health care to all eligible | 0021| segments of the state's population; and | 0022| (7) comply with the terms and conditions set | 0023| forth in the state children's health insurance program | 0024| established pursuant to Title 21 of the federal Social | 0025| Security Act. | - 3 - 0001| B. Implementation of an approved child health plan | 0002| shall be in accordance with rules adopted by the secretary | 0003| after consultation with the department of health and the | 0004| children, youth and families department. The rules shall be | 0005| designed to achieve and be consistent with the objectives | 0006| specified in Subsection A of this section. Those objectives | 0007| are stated as mandatory standards by which the validity of | 0008| proposed rules shall be tested. Additionally, the rules must | 0009| be consistent with those provisions of the Child Health Act | 0010| that mandate program requirements. | 0011| Section 6. PLAN CONTENT--REQUIRED ELEMENTS.--The child | 0012| health plan and the program of services to be provided by it | 0013| shall include: | 0014| A. appropriate methods of outreach to increase the | 0015| enrollment of eligible children; | 0016| B. a "phase one" that shall include providing | 0017| health insurance to children living in households at or below | 0018| two hundred thirty-five percent of the federal poverty level; | 0019| C. a "phase two" that may consist of those | 0020| federally approved specialized services included in the child | 0021| health plan by the secretary, a continuum of prevention and | 0022| intervention services that may be developed and implemented, | 0023| including applications for any federal waivers of conditions | 0024| that are necessary and consisting of at least the following: | 0025| (1) implementation of a voluntary home | - 4 - 0001| visiting program available statewide for mothers having their | 0002| first child, beginning during pregnancy and extending for two | 0003| years, with a frequency of use as indicated by maternal desire | 0004| and home visiting team recommendations; | 0005| (2) provision for home- and community-based | 0006| early intervention developmental services; | 0007| (3) provision for a behavioral health | 0008| identification, assessment and management system; | 0009| (4) provision for school-based health | 0010| services in the network of health care programs; | 0011| (5) provision for the existing healthier kids | 0012| fund administered by the department of health to enable | 0013| children to have effective access to health care; | 0014| (6) development of ways to increase | 0015| children's dental services, including such prevention services | 0016| as periodic examinations, radiographs, prophylactic cleanings, | 0017| fluoride treatments and sealants; and | 0018| (7) development of ways to increase | 0019| children's vision services including periodic professional eye | 0020| examinations and prescription eyeware; | 0021| D. provision for inhibiting or preventing both | 0022| employer crowd-out and employee crowd-in; | 0023| E. requirements that in the development and | 0024| implementation of the plan the interests of Native American | 0025| children are identified, and that appropriate provisions for | - 5 - 0001| their enrollment are made with recognition that the | 0002| application process and the delivery of services with respect | 0003| to those children present special cultural and other | 0004| considerations; | 0005| F. provision for coordination of the | 0006| administration of the program with other public and private | 0007| health programs; | 0008| G. identification and implementation of methods, | 0009| including monitoring used to ensure the quality and | 0010| appropriateness of care, particularly with respect to well | 0011| baby care, well child care and immunizations provided pursuant | 0012| to the plan and to ensure access to covered services, | 0013| including emergency services; | 0014| H. methods by which the state will collect data, | 0015| maintain the records and furnish required reports to the | 0016| secretary or his designees; | 0017| I. specific requirements for and description of | 0018| the means to be used to ensure that members of the public will | 0019| be involved in the design and implementation of the plan and a | 0020| description of a method to ensure ongoing public involvement; | 0021| and | 0022| J. operation and management of the program by the | 0023| department in the most fiscally responsible manner, subject to | 0024| all available legislative appropriations and federal | 0025| contributions for the program, so that low-income children and | - 6 - 0001| their families receive the optimum health care possible. | 0002| Section 7. CREATION OF LEGISLATIVE OVERSIGHT COMMITTEE-- | 0003| AUTHORITY AND DUTIES.-- | 0004| A. There is created a joint interim legislative | 0005| committee, which shall be known as the "program oversight | 0006| committee". | 0007| B. The committee shall be composed of eight | 0008| members. Four members of the house of representatives shall | 0009| be appointed by the speaker of the house of representatives | 0010| and four members of the senate shall be appointed by the | 0011| committees' committee of the senate or, if the senate | 0012| appointments are made in the interim, by the president pro | 0013| tempore of the senate after consultation with and agreement of | 0014| a majority of the members of the committees' committee. | 0015| Members shall be appointed so that there is a member from each | 0016| of the major political parties from each house. No member who | 0017| has a financial interest in an insurance company or health | 0018| care provider shall be appointed to the committee. | 0019| C. The program oversight committee shall oversee | 0020| the development and operations of the program created pursuant | 0021| to the Child Health Act. It shall fulfill any | 0022| responsibilities delegated to it pursuant to that act. | 0023| D. The committee shall report annually its | 0024| findings and recommendations regarding the program to each | 0025| regular session of the legislature and shall include in that | - 7 - 0001| report any recommendations for changes in the laws pertaining | 0002| to the program. | 0003| Section 8. APPROPRIATION.--Two million nine hundred | 0004| thousand dollars ($2,900,000) is appropriated from the general | 0005| fund to the human services department for expenditure in fiscal | 0006| years 1998 through 2000 for the purpose of providing the state | 0007| match to establish a new state children's health insurance | 0008| program authorized in the federal Budget Reconciliation Act of | 0009| 1997. In addition, the human services department, the | 0010| department of health and the children, youth and families | 0011| department are authorized to expend in fiscal years 1998, 1999 | 0012| and 2000, in contributions toward a higher state match, up to a | 0013| total of three million six hundred thousand dollars ($3,600,000) | 0014| from department balances, toward the establishment of the state | 0015| children's health insurance program. Pursuant to Sections | 0016| 6-3-23 through 6-3-25 NMSA 1978, the departments are | 0017| specifically authorized to request any budget adjustments | 0018| necessary to make the contributions. Any unexpended or | 0019| unencumbered balance remaining at the end of fiscal year 2008 | 0020| shall revert to the general fund. | 0021| Section 9. DELAYED REPEAL.--Effective July 1, 2007, the | 0022| Child Health Act is repealed. | 0023| Section 10. EMERGENCY.--It is necessary for the public | 0024| peace, health and safety that this act take effect immediately. | 0025|  | - 8 -