SB 7 — RURAL HEALTH CARE DELIVERY FUND

SENATEAN BILLACT 7RELATING 56THTO LEGISLATURERURAL -HEALTH STATEOFNEWMEXICO-CARE FIRSTPROVIDERS; SESSION, 2023 INTRODUCED BY Elizabeth "Liz" Stefanics and Gail Armstrong and Marian Matthews This document may incorporate amendments proposed by a committee, but not yet adopted, as well as amendments that have been adopted during the current legislative session.

TheCREATING documentTHE isRURAL aHEALTH toolCARE toDELIVERY showFUND amendmentsTO inPROVIDE contextGRANTS andTO cannotDEFRAY beOPERATING usedLOSSES forAND theSTART-UP purposeCOSTS ofOF addingRURAL amendmentsHEALTH toCARE legislation.PROVIDERS AND FACILITIES THAT PROVIDE NEW OR EXPANDED HEALTH CARE SERVICES.

AN8 ACTBE hIT RELATINGENACTED TOBY RURALTHE HEALTHLEGISLATURE CAREOF PROVIDERS;THE STATE OF NEW MEXICO:

CREATINGSECTION THE1. RURAL g o HEALTH CARE DELIVERY FUND TO PROVIDE GRANTS TO DEFRAY OPERATING t hr g e i k LOSSES SHPACºAND START-UP COSTS»SHPAC OF RURAL HEALTH CARE h r i s PROVIDERS AND FACILITIES THAT PROVIDE NEW OR EXPANDED HEALTH h , t, CARE SERVICES;

MAKINGRURAL ANHEALTH APPROPRIATION.CARE DELIVERY FUND.-- A.

e u g e b l e e h n d d i = = o h BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

l ] b ,d i a º e SECTION 1.

[NEW MATERIAL ] RURAL HEALTH CARE DELIVERY r i = r t e w d m a n o FUND.-- d m :

b e d s º o t n = .223357.3GLGAIC January 31, 2023 (1:30pm) s k m e e a n e d r e l u [ A d A.

A rural health care provider or rural health care facility may apply to the department for a grant to defray operating losseslosses, SHPACº , including rural health care provider or rural health care facility start-up costs,»SHPACcosts, incurred in providing inpatient, outpatient, primary, specialty or SFC/SB 7 Page 1 behavioral health services to New Mexico residents.

The h department may award a grant from the rural health care g o t hr delivery fund to a SHPACº newly constructed»SHPAC rural health g e i k care SHPACºfacility»SHPACprovider SHPACºprovider»SHPAC or rural h r i s health care facility that is providing a new or expanded health care h , t, e u g service as approved by the department that covers operating e b l e e h losses for the new or expanded health care service, subject to n d d i = = o h the following conditions and limitations:

l ] b ,d i a º e (1) the rural health care provider or rural rhealth icare =facility rmeets tstate elicensing wrequirements dto mprovide ahealth ncare oservices healthand careis facilityan meetsenrolled statemedicaid licensingprovider requirementsthat toactively dserves mmedicaid :recipients;

b e d s º o t n = .223357.3GLGAIC January 31, 2023 (1:30pm) s k m e - 2 - e a n e d r e l u [ A d provide heath care services;

(4) the rural health care provider or rural health care facility provides adequate cost data, as defined by rule of the department, based on financial and statistical records that can be verified by qualified auditors and which data are based on an approved method of cost finding and the accrual basis of accounting SHPACº ;»SHPAC and SHPACºcancan be confirmed as having been delivered through review of claims;»SHPACclaims; SHPACº(5) grant award amounts shall be h reconciled by the department to audited operating losses after u » r the close of the grant period;»SHPAC t h g e l i SHPACº(5)»SHPAC SHPACº(6)»SHPAC in the case h r i s of a rural health care provider, the provider commits to a h , e h period of operation equivalent to the number of years grants t u g e b l e e , gh are awarded SHPACº .»SHPAC SHPACº;

and»SHPAC(5) ngrant daward damounts ishall =be =reconciled oSFC/SB h7 SHPACº(7)Page in2 prioritizingby grant awards, the ldepartment ]to baudited ,doperating ilosses aafter º r department shall consider the healthclose needs of the stategrant andperiod; the e r = t e w d m a n o locality.»SHPAC d m :

b(6) rin ethe tcase ºof o t n = .223357.3GLGAIC January 31, 2023 (1:30pm) s k m e - 3 - e a nrural ehealth dcare rprovider, ethe lprovider ucommits [to: A d C.

(a) a period of operation equivalent to the number of years grants are awarded;

and (b) actively serve medicaid recipients throughout the duration of the grant period;

and (7) in prioritizing grant awards, the department shall consider the health needs of the state and the locality and the long-term sustainability of the new or expanded service.

C.

(1) "allowable costs" means necessary and proper costs defined by rule of the department based on medicare reimbursement principles, SHPACºincluding but "allowable costs" does not include fund transfers to parent corporations;»SHPAC SHPACºincluding reasonable direct expenses, but not including general overhead and management fees paid to a parent corporation;»SHPACcorporation; (2) "department" means the human services department;

(3)(2) "health"department" care services" means services for the diagnosis,human prevention,services treatment,department; cure or relief of a physical, SHPACº dental,»SHPAC behavioral or mental health condition, substance use disorder, illness, injury or disease SHPACºand for medical or behavioral health ground transportation»SHPAC ;

h(3) SHPACº(4)"health "newlycare constructed"services" means aservices ruralfor gthe odiagnosis, tprevention, hrtreatment, healthcure careor facilityrelief constructedof aftera Junephysical, 30,dental, 2023;»SHPACbehavioral gor emental ihealth kcondition, SHPACº(5)»SHPACsubstance SHPACº(4)»SHPACuse "operatingdisorder, hillness, rinjury ior sdisease losses" means the projected difference between recognized h , t, e u g revenue and allowablefor costsmedical foror abehavioral granthealth requestground period;transportation;

eSFC/SB b7 lPage e3 e(4) h"medicaid" SHPACº (6)»SHPAC SHPACº(5)»SHPAC "recognized n d d i = = o h revenue" means operatingthe revenue,medical includingassistance revenueprogram directlyestablished lpursuant ]to bTitle ,d19 iof a º e r i = r related to the renderingfederal ofSocial patientSecurity careAct services and revenueregulations tissued epursuant w d m a n o from nonpatient care services to patientsthat andact; persons other d m :

b(5) e"medicaid dprovider" smeans º o t n = .223357.3GLGAIC January 31, 2023 (1:30pm) s k m e - 4 - e a nperson ethat dprovides rmedicaid-related eservices lto umedicaid [recipients; A d than patients;

(6) "medicaid recipient" means a person whom the department has determined to be eligible to receive medicaid-related services in the state;

(7) "operating losses" means the projected difference between recognized revenue and allowable costs for a grant request period;

(8) "recognized revenue" means operating revenue, including revenue directly related to the rendering of patient care services and revenue from nonpatient care services to patients and persons other than patients;

SHPACº(9) (7)»SHPAC SHPACº(6)»SHPAC "rural health care facility" means a health care facility licensed byin the departmentstate of health that provides inpatient or outpatient physical or behavioral health services SHPACºor and is located»SHPAC SHPACºor programmatic services»SHPACservices in a county that has a population of one hundred thousand or fewer according to the most recent federal decennial census;

SHPACºSFC/SB and»SHPAC7 SHPACº(8)»SHPACPage SHPACº(7)»SHPAC4 (10) "rural health care provider" means an individual health professional SHPACºlicensedlicensed by the appropriate board, a medical or behavioral health ground transportation entity licensed by the public regulation commission»SHPACcommission or a health facility organization h licensed by the department of health to provide health care diagnosis and u » r treatment of physical or behavioral health SHPACºandor is t h g e l i located»SHPAC SHPACºor programmatic services»SHPACservices in a county h r i s that has a population of one hundred thousand or fewer h , e h according to the most recent federal decennial censuscensus; t u g e b l e e , gh SHPACº .»SHPAC SHPACº;

and»SHPACand n(11) d d i = = o h SHPACº(8) "start-up costs" means the planning, l ] b ,d i a º r e r = development and operation of rural health care services, t e w d m a n o including legal fees;

costs associated with dleasing mequipment, :a location or property;

b r e t º o t n = .223357.3GLGAIC January 31, 2023 (1:30pm) s k m e - 5 - e a n e d r e l u [ A d leasing equipment, a location or property;

"Start-up costs" does not mean the construction or purchase of land or buildings.»SHPACbuildings. SECTION 2.

APPROPRIATION.--TwoSFC/SB hundred7 millionPage dollars5 ($200,000,000)25 is appropriated from the general fund to the rural health care delivery fund for expenditure in fiscal year and subsequent fiscal years to carry out the purposes of the fund.

The human services department may use up to three hundred fifty thousand dollars ($350,000) each year from the fund to administer the fund.

Any unexpended or unencumbered balance remaining at the end of a fiscal year shall not revert to the general fund.

- 6 - h u » r t h g e l i h r i s h , e h t u g e b l e e , gh n d d i = = o h l ] b ,d i a º r e r = t e w d m a n o d m :

b r e t º o t n = .223357.3GLGAIC January 31, 2023 (1:30pm) s k m e e a n e d r e l u [ A d