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(Parenthesis ( ) Indicate Expenditure Decreases)

Duplicates/Conflicts with/Companion to/Relates to House Bill 138

SUMMARY

Synopsis of Committee Substitute for Senate Bill 424-Senate

     Corporations & Transportation Committee

The Committee Substitute to this bill reduces the 13 page defined requirements bill to a one page bill that requires the Department of Health to develop regulations to establish requirements for minimum nursing department staff in nursing facilities by December 31,1999. The bill requires the Department of Health to seek input from the Human Services Department, the State Agency on Agency, consumers, providers and advocates regarding the fiscal and service criteria applicable to the regulations. The effective date of the new regulations is July1, 2000.

Synopsis of Bill

Senate Bill 424 amends Section 24-1-5 NMSA 1978 to establish minimum staffing ratios in nursing facilities and further establishes civil penalties for those found in violation of the provisions of the proposed amended statute.

Significant Issues

Like House Bill 138, this proposed legislation seeks to demand minimum staffing levels for nurses and other care givers. Unlike the house bill, Senate Bill 424 imposes minimum staffing levels in the proposed legislation and does not contemplate going to a regulation making process to arrive at the proper level of staff based on the public record.

FISCAL IMPLICATIONS

Passage of this legislation will have the effect of increasing the cost of health care in these facilities if the new staff ratios exceed those presently in use.

ADMINISTRATIVE IMPLICATIONS

As part of it's inspection protocol, the Department of Health could verify the minimum staff ratios and make that fact part of the inspection record. It is anticipated that the addition of this task in the inspection process would not have a major administrative impact on the department.

CONFLICT/DUPLICATION/COMPANIONSHIP/RELATIONSHIP

This bill as well as HB138 attempt to establish minimum staffing levels in nursing facilities.

TECHNICAL ISSUES

The development of legislation that requires specific numbers of health care staff is a departure from the standards that are presently utilized by accrediting agencies. In years past, there were specific numbers of health care professionals required based on the number of patients or residents and other factors such as the size of the facility and other considerations. The federal government and the accrediting agencies moved their process into a mode that was geared to quality of care issues such as "how long it took to answer a call button" or "how long were residents restrained in their chairs" etc.

Both approaches to regulation of these facilities are successful, and both approaches serve to improve the quality of care in these facilities.

OTHER SUBSTANTIVE ISSUES

The cost of health care is increasing at rates that exceed other sectors. Any new approach to the regulation of these facilities should include very careful analysis of all the factors to be considered including the incremental costs associated with this proposed approach.

POSSIBLE QUESTIONS

1. Are there other approaches that improve the quality of care at these facilities and that do not demand minimum staffing levels?

2. Has there been a cost estimate done to determine the increased costs associated with this approach if indeed it increases the numbers of health care staff required?

MB/njw