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HOUSE BILL 70
57
TH LEGISLATURE
-
STATE
OF
NEW
MEXICO
-
FIRST SESSION
,
2025
INTRODUCED BY
Tara L. Lujan
AN ACT
RELATING TO HEALTH CARE; ENACTING THE BEHAVIORAL HEALTH
MEDICAID WAIVER ACT; MAKING AN APPROPRIATION; DECLARING AN
EMERGENCY.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. [NEW MATERIAL] SHORT TITLE.--This act may be
cited as the "Behavioral Health Medicaid Waiver Act".
SECTION 2. [NEW MATERIAL] DEFINITIONS.--As used in the
Behavioral Health Medicaid Waiver Act:
A. "behavioral health disability" means serious
mental illness, serious emotional disturbance, substance use
disorder or brain injury whenever that condition:
(1) substantially impairs a person's ability
to manage the person's own affairs; or
(2) makes a person eligible to receive
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disability benefits from New Mexico or the federal government;
B. "brain injury" means an injury to the brain of
traumatic or acquired origin, including an open or closed head
injury, caused by:
(1) an insult to the brain from an outside
physical force;
(2) anoxia;
(3) an electrical shock;
(4) shaken baby syndrome;
(5) a toxic or chemical substance;
(6) a near-drowning;
(7) an infection;
(8) a tumor;
(9) a vascular lesion; or
(10) an event that results in either temporary
or permanent, partial or total impairment in one or more areas
of the brain that results in total or partial functional
disability, including:
(a) cognition;
(b) language;
(c) memory;
(d) attention;
(e) reasoning;
(f) abstract thinking;
(g) judgment;
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(h) problem solving;
(i) sensory perception and motor
abilities;
(j) psychosocial behavior;
(k) physical functions;
(l) information processing; or
(m) speech;
C. "serious emotional disturbance" means a
diagnosable mental, behavioral or emotional disorder in a
person under the age of eighteen years and of sufficient
duration to meet diagnostic criteria that results in functional
impairment that substantially interferes with or limits the
person's role or functioning in family, school or community
activities;
D. "serious mental illness" means a diagnosable
mental, behavioral or emotional disorder in a person eighteen
years of age or older of sufficient duration to meet diagnostic
criteria that results in functional impairment that
substantially interferes with or limits one or more major life
activities; and
E. "substance use disorder" means dependence on or
abuse of alcohol, illicit drugs or psychotherapeutics,
including prescription pain relievers, sedatives, tranquilizers
or stimulants, in the past twelve months based on assessments
of individual diagnostic criteria from the current edition of
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the Diagnostic and Statistical Manual of Mental Disorders
published by the American psychiatric association.
SECTION 3. [NEW MATERIAL] HEALTH CARE AUTHORITY DUTIES--
PERSONS WITH BEHAVIORAL HEALTH DISABILITIES.--
A. Subject to the availability of appropriations
provided expressly for this purpose, the health care authority
shall:
(1) acquire, provide or coordinate support and
services for persons with behavioral health disabilities;
(2) enter into contracts and provider
agreements with agencies and persons capable of providing
support and services to persons with behavioral health
disabilities; and
(3) establish advisory councils and task
forces as necessary to guide the development of and to review
the operation of support and services to persons with
behavioral health disabilities.
B. Support and services shall be provided by the
health care authority based on individual support and service
plans developed by an interdisciplinary team. The team is
responsible for collectively evaluating a person's needs and
developing an individual support and service plan to meet the
needs.
C. The health care authority shall:
(1) solicit the involvement of persons with
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behavioral health disabilities and their family members,
providers, parents, professional organizations and other
governmental organizations prior to the adoption or revision of
rules concerning the provision of support, services, standards
or funding systems; provided that participants shall be
selected in a manner that reflects geographical, cultural,
organizational and professional representation across New
Mexico; and
(2) develop rules, including policies and
procedures that, to the extent possible, promote uniformity in
reimbursement and quality assurance systems regardless of the
source of funding.
SECTION 4. [NEW MATERIAL] TEMPORARY PROVISION--DUTIES OF
HEALTH CARE AUTHORITY--MEDICAID WAIVER PROGRAM.--
A. The health care authority shall immediately
conduct monthly meetings with persons with behavioral health
disabilities and their family members, providers of behavioral
health services, the university of New Mexico, advocates for
persons with behavioral health disabilities and county and
municipal officials who are serving persons with behavioral
health disabilities to determine the best way to apply to the
federal centers for medicare and medicaid services for
authorization to operate a medicaid waiver program for persons
with behavioral health disabilities. The meetings shall
continue until the health care authority has submitted an
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application to the federal centers for medicare and medicaid
services for authorization to operate a medicaid waiver program
for residents of New Mexico with behavioral health
disabilities.
B. The health care authority shall retain a
consulting entity to assist the health care authority in the
development of an application to the federal centers for
medicare and medicaid services for authorization to operate a
medicaid waiver program for persons with behavioral health
disabilities.
C. No later than December 31, 2025, the health care
authority shall submit an application to the federal centers
for medicare and medicaid services for authorization to operate
a medicaid waiver program for persons with behavioral health
disabilities, seeking authorization to operate a medicaid
waiver program for persons with behavioral health disabilities
that is comparable to New Mexico's home and community-based
medicaid waiver programs for persons with developmental
disabilities.
SECTION 5. APPROPRIATION.--One million one hundred
thousand dollars ($1,100,000) is appropriated from the general
fund to the health care authority for expenditure in fiscal
years 2026 and 2027 to retain a qualified consultant to guide
the health care authority in the development of an application
to the federal government for the creation of a behavioral
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health medicaid waiver program and to hire four full-time
employees to work exclusively to develop and submit the
application for a medicaid waiver program. Any unexpended or
unencumbered balance remaining at the end of fiscal year 2027
shall revert to the general fund.
SECTION 6. EMERGENCY.--It is necessary for the public
peace, health and safety that this act take effect immediately.
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