Fiscal impact reports (FIRs) are prepared by the Legislative Finance Committee (LFC) for standing finance
committees of the Legislature. LFC does not assume responsibility for the accuracy of these reports if they
are used for other purposes.
F I S C A L I M P A C T R E P O R T
SPONSOR
Sen. Sedillo-Lopez/Reps. Herndon and
Cates
LAST UPDATED
ORIGINAL DATE 02/04/2025
SHORT TITLE Report on Direct Care Workforce
BILL
NUMBER Senate Bill 103
ANALYST Rommel
ESTIMATED ADDITIONAL OPERATING BUDGET IMPACT*
(dollars in thousands)
Agency/Program
FY25 FY26 FY27
3 Year
Total Cost
Recurring or
Nonrecurring
Fund
Affected HCA $0 Up to $20.0 Up to $150.0 Up to $170.0 Nonrecurring General Fund
HCA $0 $57.4 $57.4 $114.8 Recurring General Fund
Total $0 Up to $77.4 Up to $207.4 Up to $284.8 General Fund
Parentheses ( ) indicate expenditure decreases.
*Amounts reflect most recent analysis of this legislation.
Relates to House Bill 55
Sources of Information
LFC Files
Agency Analysis Received From
Health Care Authority (HCA) Department of Health (DOH)
SUMMARY
Synopsis of Senate Bill 103
Senate Bill 103 (SB103) pertains to the Developmental Disabilities Act, (28-16A-1 NMSA 1978,
et. seq.). The bill requires personal care service agencies to report data on direct care workers to
the Health Care Authority (HCA) for services that are provided to Medicaid members in the
Community Benefit (CB) program. Reporting is due by March 1, 2026 and annually thereafter.
By January 30, 2030, HCA shall perform a study to determine the cost of payment adequacy for
personal care service delivery and recommend reimbursement rates. Payment adequacy shall
address workforce stability, vacancy reductions, a wage at least 150 percent of the state
minimum wage, and ensuring adequate access for eligible Medicaid recipients.
SB103 builds on reporting requirements enacted in Laws 2023, Chapter 160 (House Bill 395). It
adds several additional reporting elements such as overtime wages paid, educational attainment,
certifications, and demographics for each direct care worker.
For personal care service under the Mi Via self-directed community benefit program, the Senate Bill 103 – Page 2
managed care organizations (MCOs) and/or the fiscal management agency would be required to
report certain data to HCA on the same timeframe. The bill would also require HCA to review
and analyze the data and submit a report to the Legislative Health and Human Services
Committee, the Legislative Finance Committee, the Governor’s Office, and an interested parties
advisory group.
This bill does not contain an effective date and, as a result, would go into effect 90 days after the
Legislature adjourns.
FISCAL IMPLICATIONS
SB103 contains no appropriation.
HCA estimates an additional recurring budget impact of one FTE to perform the work required
under the legislation, which would involve collecting data from over 100 PCS agencies, the
MCOs and the fiscal management agency, producing the required reports, managing the rate
study and procurement, and facilitating/managing the interested parties workgroup.
HCA estimates the nonrecurring cost of the 2030 cost study on a 2024 rate conducted for all
agency-based community benefit services including personal care services. If another rate study
by 2030 is needed, another rate study would cost approximately $300 thousand ($150 thousand
in general fund; $150 thousand in federal Medicaid funds). HCA estimates an additional
nonrecurring cost of $20 thousand to update data systems.
SIGNIFICANT ISSUES
The developmental disabilities (DD) and Mi Via waiver programs, administered by the
Developmental Disabilities Supports Division (DDSD) of HCA, serve approximately 7,900 New
Mexicans with intellectual and developmental disabilities. The waiver programs use federal and
state Medicaid dollars to contract with providers to deliver living supports, community services,
therapy, employment, and other services to allow participants to live in their homes and
communities rather than in an institutional setting.
The Department of Health notes that long-term care facilities that participate in Medicaid
Personal Care Services Programs are currently required to report similar information to the
Centers for Medicare and Medicaid Services on a quarterly basis.
HCA notes that homemaker services are referenced in the bill, but there are no homemaker
services that are approved by the federal Centers for Medicare and Medicaid Services or offered
in the CB program.
ADMINISTRATIVE IMPLICATIONS
HCA reports administrative impact involves collecting and analyzing data through an annual
report, procuring and collecting data to inform the rate study, overseeing the fiscal management
agency to ensure that data is collected in accordance with the bill, and establishing an advisory
group. This would require one FTE for the HCA. For the data collection requirements specified Senate Bill 103 – Page 3
in the bill, many of the fields are available today; however, some are not and would need to be
added.
CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP
Relates to House Bill 55 which sets a minimum fee schedule for reimbursing personal care
services under Medicaid; requires seventy percent of reimbursement to compensate direct care
workers; and appropriates $20.8 million for purposes of the legislation.
OTHER SUBSTANT IVE ISSUES
HCA oversees four home and community-based programs for individuals with intellectual and
developmental disabilities. The programs are referred to as waivers because they require a
waiver of standard Medicaid rules. These waivers allow the state to use Medicaid dollars, with a
state match, to support individuals with diverse needs. The waivers provide a large array of
supports to allow for community participation based on waiver participant’s needs and
preferences.
The traditional DD waiver, which serves the most participants (4,598 or 59 percent), offers
community-based services coordinated by a case manager at an average cost in FY24 of
approximately $116 thousand per client. The Mi Via waiver provides greater self-direction by
offering participants more flexibility in their program oversight and monitoring, with the aid of a
designated employer of record (the individual responsible for directing the work of employees
and providers for Mi Via participants), if needed.
HR/rl/SL2