House Bill text for HB0120

HOUSE BILL 120

48th legislature - STATE OF NEW MEXICO - second session, 2008

INTRODUCED BY

Ben Lujan

AN ACT

RELATING TO HEALTH CARE; ENACTING THE AMERICAN INDIAN HEALTH CARE IMPROVEMENT ACT; CREATING THE AMERICAN INDIAN HEALTH DIVISION IN THE DEPARTMENT OF HEALTH; CREATING THE AMERICAN INDIAN HEALTH COUNCIL; CREATING A FUND; REQUIRING TRIBAL LIAISON POSITIONS IN CERTAIN DEPARTMENTS; MAKING APPROPRIATIONS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

Section 1. [NEW MATERIAL] SHORT TITLE.--Sections 1 through 8 of this act may be cited as the "American Indian Health Care Improvement Act".

Section 2. [NEW MATERIAL] PURPOSES.--The purposes of the American Indian Health Care Improvement Act are to:

A. increase accessibility of health care to all New Mexicans, including American Indians, an essential public health responsibility of all governments, including the state government of New Mexico;

B. address the chronic health disparities between American Indians and other populations that result in part from the federal government's failure to fully implement its federal trust responsibilities for Indian health care;

C. promote collaboration to improve the health of American Indians and prevent disease;

D. encourage, through directed funding, the use of existing and evolving technologies to improve health care delivery and services for American Indians;

E. strengthen the infrastructure for health care delivery programs, health care education and health care research to benefit and improve the health of American Indians;

F. reduce costs, improve coverage and quality of health care for American Indians; and

G. strengthen the capacity of state and tribal policymakers to improve health care delivery systems for American Indians.

Section 3. [NEW MATERIAL] DEFINITIONS.--As used in the American Indian Health Care Improvement Act:

A. "American Indian" means a person who meets the federal Indian health service eligibility requirements and who is a resident of New Mexico;

B. "applicant" means:

(1) a tribe, tribal entity, tribal organization or off-reservation nonprofit corporate body governed by an Indian-controlled board of directors, to the extent that the nonprofit organization is eligible pursuant to the constitution of New Mexico; or

(2) an organization that performs more than fifty percent of its research on improving health care services to, or the overall health of, American Indians;

C. "council" means the American Indian health council;

D. "department" means the department of health;

E. "designee" means a person selected by a council member to serve in the council member's absence;

F. "director" means the director of the division;

G. "division" means the American Indian health division of the department of health;

H. "fund" means the American Indian health care improvement fund;

I. "governor" means the governor of New Mexico;

J. "grant project" means a project, program, service or research initiative approved by the council for a grant funded pursuant to the American Indian Health Care Improvement Act;

K. "proposal" means a request for funding by an applicant to the council to implement a specific project, program, service or research initiative that provides the American Indian community that the applicant represents with:

(1) improved health care delivery;

(2) improved health of American Indians;

(3) community-based programs for the provision of health care; or

(4) research or development of tools that can improve either health care delivery or the health of American Indians;

L. "resident" means an individual who is domiciled and resides in this state;

M. "secretary" means the secretary of health;

N. "stakeholder departments" means the department, the human services department, the aging and long-term services department, the children, youth and families department and the Indian affairs department; and

O. "tribe" means a federally recognized Indian nation, tribe or pueblo located wholly or partly in New Mexico.

Section 4. [NEW MATERIAL] AMERICAN INDIAN HEALTH COUNCIL CREATED--MEMBERSHIP--STAFF.--

A. The "American Indian health council" is created to replace existing boards that advise the department on American Indian health issues and is administratively attached to the department. The council shall oversee the implementation of the American Indian Health Care Improvement Act.

B. The council shall encourage, facilitate and ensure coordination among stakeholder departments and collaborate with tribes, other health-related committees, councils and task forces working for American Indian communities in the state to improve access to health care and improve the health status and health outcomes for American Indians.

C. The department shall provide staff support for the council. The director shall oversee, manage and implement the activities of the council.

D. Tribal leaders and their designees may attend council meetings and be seated with appointed members.

E. Only gubernatorial appointees to the American Indian health council or their designees shall vote.

F. The council shall consist of the following eighteen voting members, appointed by the governor:

(1) five ex-officio members or their designees as follows:

(a) the secretary of health, who shall serve as a co-chair of the council;

(b) the secretary of Indian affairs;

(d) the secretary of human services; and

(e) the secretary of children, youth and families;

(2) eight members or their designees, one of whom shall serve as a co-chair, each representing one or more tribes, as follows:

(a) three members from the nineteen Indian pueblos in New Mexico selected from lists submitted from the eight northern Indian pueblos council, the southern Indian pueblos council and the western pueblos;

(b) three members selected from a list submitted by the president of the Navajo Nation representing the geographic distribution of Navajo people in the Navajo Nation located in New Mexico;

(d) one member selected from a list submitted by the president of the Mescalero Apache Tribe;

(3) one member who is American Indian and is a representative of the behavioral health planning council;

(4) one member engaged in providing health care services to American Indians not living on a reservation;

(5) two members who are American Indians not living on a reservation; and

(6) one member engaged in providing health care to American Indians living within a tribal community.

G. Council members shall be appointed to terms of two years and are eligible to serve two complete terms. Vacancies shall be filled by appointment by the governor for unexpired terms.

H. Council members and designees who are not state employees already being paid are entitled to per diem and mileage paid from the fund as provided in the Per Diem and Mileage Act.

I. The council shall meet at the call of the chair, but no fewer than four times per year.

J. A quorum consists of ten members of the council, one of whom shall be a co-chair.

K. Official action of the council shall be taken upon a majority vote.

Section 5. [NEW MATERIAL] AMERICAN INDIAN HEALTH COUNCIL--DUTIES.--The council shall:

A. provide input to the interagency behavioral health purchasing collaborative established in Section 9-7-6.4 NMSA 1978 and the behavioral health planning council created in Section 24-1-28 NMSA 1978 regarding the parts of the comprehensive behavioral health plan developed by the interagency behavioral health purchasing collaborative and the behavioral health planning council to address the mental health and substance abuse needs of American Indians in New Mexico;

B. provide guidance to the department to address health issues that have an impact on American Indians and develop strategies to eliminate health disparities between American Indian populations and other populations;

C. advise and recommend analyses of policies and programs regarding American Indian health coverage and health care delivery, working with tribal and pueblo health care planning processes;

D. recommend policies and programs to improve access to health care for American Indian communities and to improve the health status of American Indians;

E. analyze ways to improve strategic planning for healthier American Indian communities and recommend ways to maximize analytical input;

F. identify training and technical assistance needs and strategize how to address them for all American Indian communities;

G. identify gaps in existing health care delivery systems and develop strategies to address these gaps;

H. provide input on any proposed changes to state policies that would affect the health of American Indians;

I. provide input on the allocation of department resources and federal resources flowing through the department used to remedy health disparities that disproportionately affect American Indian communities;

J. develop a five-year strategic plan that defines a general strategy for improving health care for American Indians;

K. identify priorities that need to be accomplished each year to further the purposes of the American Indian Health Care Improvement Act in order to maximize available funding;

L. prepare and revise at least each year an action plan that sets forth the actions to be undertaken in the next year that will lead to:

(1) achieving the priorities identified by the council to meet the goals set forth in the strategic plan; and

(2) coordinate the use of available funding for improvement of health care delivery to and the health of American Indians;

M. issue requests for proposals and review proposals submitted for grants from the fund or through sources of capital outlay funding;

N. identify and prioritize proposals and capital improvement projects that meet strategic plan priorities, research initiatives and capacity-building for American Indian communities, including:

(1) projects, services or training that advance the goals of the strategic plan and are within the action plan;

(2) capital improvement projects necessary to achieve the goals of the strategic plan;

(3) research that corresponds to the overall purpose of the American Indian Health Care Improvement Act;

(4) capacity building for organizations providing health care services to American Indians; and

(5) successful models of health care provision in tribal or other American Indian communities;

O. conduct training sessions to familiarize applicants and grant recipients with the purposes of the American Indian Health Care Improvement Act, the strategic plan and the most recent action plan developed by the council and train applicants and grant recipients as to the purposes and priorities of the American Indian Health Care Improvement Act and the council's annual priorities;

P. formalize collaborations for improved access to and quality of American Indian health care, research and services focused on diabetes, alcohol or substance abuse and other critical behavioral health concerns, disease prevention and post-traumatic stress disorder;

Q. require submission of progress reports at least two times during each fiscal year to ensure the satisfactory completion of grant projects, including submission of a final report to the council prior to final payment;

R. disseminate information about successful programs providing American Indian health care to encourage replication of successful programs;

S. encourage through funding and other support the cooperative use of existing technology infrastructure, including telehealth services; and

T. develop collaboration and information sharing consistent with state and federal law regarding medical records and state-tribal agreements.

Section 6. [NEW MATERIAL] AMERICAN INDIAN HEALTH CARE IMPROVEMENT FUND--CREATED--DISTRIBUTIONS--REQUIREMENTS FOR FUNDING.--

A. The "American Indian health care improvement fund" is created in the state treasury. The fund consists of money appropriated by the legislature and grants, bequests, gifts or money otherwise distributed to or designated for the fund from government or private sources. Earnings from investment of the fund shall be credited to the fund for planning, development and coordination of improvements for health care infrastructure and health care services for American Indians residing in New Mexico and for grants as authorized by the council.

B. The department shall administer the fund.

C. The fund may be divided into accounts as deemed necessary by the department, one of which shall be the account required pursuant to Subsection F of this section.

D. Money in the fund is appropriated to the council to implement the provisions of and to administer the American Indian Health Care Improvement Act.

E. Money in the fund may be disbursed to fund grants authorized by the council.

F. Money in the fund may be used for administration of the fund, implementing the American Indian Health Care Improvement Act and paying related per diem and mileage, in an amount equal to no more than ten percent of the fund, not to exceed four hundred thousand dollars ($400,000) in a fiscal year.

G. Expenditures shall be made from the fund on warrants issued by the secretary of finance and administration on vouchers signed by the secretary of health.

H. Balances in the fund shall not revert to the general fund at the end of any fiscal year.

Section 7. [NEW MATERIAL] AMERICAN INDIAN HEALTH COUNCIL--GRANTS.--

A. The council shall authorize an amount of funding for grants in accordance with the council's priorities. The secretary shall enter into contracts with grantees and distribute money from the fund for proposals approved and funding authorized by the council and made available by the legislature or other private or public funding sources.

B. The council shall approve proposals only from applicants who demonstrate knowledge of current capacity to provide health care in the community in which the applicant will be working and who fit with the council's annual priorities and strategic plan, the need for the project in that community and the need for the grant project in furthering the goals of the American Indian Health Care Improvement Act.

C. A grant project may be revised or terminated at the request of the council through the division if the grant project as implemented is not achieving goals.

Section 8. [NEW MATERIAL] AMERICAN INDIAN HEALTH DIVISION CREATED--DIRECTOR--POWERS AND DUTIES.--

A. The "American Indian health division" is created within the department. The secretary shall appoint a director for the division, who shall direct the activities of the division and advise the secretary on the development of policies and programs that address the health care needs of American Indians.

B. The secretary and the director, in cooperation with the council, shall collaborate with state and federal departments and agencies and tribal governments to identify strategies for implementing the American Indian Health Care Improvement Act and to improve access to health care services for American Indians.

C. The secretary and the director shall coordinate with appropriate administrators and state agencies to ensure that the department:

(1) makes implementation of the American Indian Health Care Improvement Act a priority;

(2) supplements rather than supplants existing programs benefiting American Indian health accessibility and quality of care; and

(3) promotes government-to-government relationships between the tribes and the state of New Mexico based on mutual respect and open communications.

D. The director shall:

(1) direct the staffing of the division and the council;

(2) review and evaluate proposals submitted to the council and recommend approval, modification or rejection of a proposal;

(3) issue contracts or joint powers agreements with tribal governments as authorized by the secretary pursuant to the Joint Powers Agreements Act;

(4) oversee the grants awarded by the council, gather information necessary to evaluate the effectiveness of grant projects, report the findings to the council on a monthly basis and recommend revisions or termination of grant projects as deemed necessary to achieve the objectives of the American Indian Health Care Improvement Act;

(5) by July 31 of each year, provide the council with an assessment of the progress or shortcomings of grants authorized by the council in the previous fiscal year;

(6) when requested by a prospective applicant, provide:

(a) technical assistance to assess a tribe's needs and develop a health care improvement plan for a tribe or agency; or

(b) training to assist in the development of proposals to improve the health of or the delivery of health care to American Indians of the applicant; (7) provide technical assistance to implement a grant project to help the grantee successfully complete the grant project or to revise the project to redirect the funding in a manner that leads to the successful completion of the project;

(8) recommend best practices identified and successful programs that can be duplicated in other American Indian communities to the council; and

(9) propose rules for the council to adopt to implement the American Indian Health Care Improvement Act that are necessary to carry out the purposes of that act.

Section 9. Section 9-2A-3 NMSA 1978 (being Laws 1992, Chapter 57, Section 3) is amended to read:

"9-2A-3. DEFINITIONS.--As used in the Children, Youth and Families Department Act:

A. "department" means the children, youth and families department; [and]

B. "secretary" means the secretary of children, youth and families;

C. "tribal" means of or belonging to a tribe; and

D. "tribe" means a federally recognized Indian nation, tribe or pueblo located wholly or partly in New Mexico."

Section 10. Section 9-2A-7 NMSA 1978 (being Laws 1992, Chapter 57, Section 7, as amended) is amended to read:

"9-2A-7. SECRETARY--DUTIES AND GENERAL POWERS.--

A. The secretary is responsible to the governor for the operation of the department. It is the secretary's duty to manage all operations of the department and to administer and enforce the laws with which [he] the secretary or the department is charged.

B. To perform [his] the secretary's duties, the secretary has every power expressly enumerated in the law, whether granted to the secretary, the department or any division of the department, except when any division is explicitly exempted from the secretary's power by statute. In accordance with these provisions, the secretary shall:

(1) except as otherwise provided in the Children, Youth and Families Department Act, exercise general supervisory and appointing power over all department employees, subject to applicable personnel laws and regulations;

(2) delegate power to subordinates as [he] the secretary deems necessary and appropriate, clearly delineating such delegated power and the limitations to that power;

(3) organize the department into organizational units as necessary to enable it to function most efficiently, subject to any provisions of law requiring or establishing specific organizational units;

(4) within the limitations of available appropriations and applicable laws, employ and fix the

compensation of those persons necessary to discharge [his] the secretary's duties;

(5) take administrative action by issuing orders and instructions, not inconsistent with law, to assure implementation of and compliance with the provisions of law for which administration or execution [he] the secretary is responsible and to enforce those orders and instructions by appropriate administrative action in the courts;

(6) conduct research and studies that will improve the operation of the department and the provision of services to the citizens of the state;

(7) provide courses of instruction and practical training for employees of the department and other persons involved in the administration of programs with the objectives of improving the operations and efficiency of administration and of promoting comprehensive, coordinated, culturally sensitive services that address the whole child;

(8) prepare an annual budget for the department;

(9) provide cooperation, at the request of administratively attached agencies and adjunct agencies, in order to:

(a) minimize or eliminate duplication of services and jurisdictional conflicts;

(b) coordinate activities and resolve problems of mutual concern; and

(c) resolve by agreement the manner and extent to which the department shall provide budgeting, recordkeeping and related clerical assistance to administratively attached agencies; and

(10) provide for surety bond coverage for all employees of the department as provided in the Surety Bond Act. The department shall pay the costs of [such] the bonds.

C. The secretary may apply for and receive, with the governor's approval, in the name of the department, any public or private funds, including United States government funds, available to the department to carry out its programs, duties or services.

D. The secretary may make and adopt such reasonable and procedural rules and regulations as may be necessary to carry out the duties of the department and its divisions. No rule or regulation promulgated by the director of any division in carrying out the functions and duties of the division shall be effective until approved by the secretary. Unless otherwise provided by statute, no regulation affecting any person or agency outside the department shall be adopted, amended or repealed without a public hearing on the proposed action before the secretary or a hearing officer designated by the secretary. The public hearing shall be held in Santa Fe unless otherwise permitted by statute. Notice of the subject matter of the regulation, the action proposed to be taken, the time and place of the hearing, the manner in which interested persons may present their views and the method by which copies of the proposed regulation or proposed amendment or repeal of an existing regulation may be obtained shall be published once at least thirty days prior to the hearing date in a newspaper of general circulation and mailed at least thirty days prior to the hearing date to all persons who have made a written request for advance notice of hearing. All rules and regulations shall be filed in accordance with the State Rules Act.

E. If the secretary certifies to the secretary of finance and administration and gives contemporaneous notice of such certification through the human services register that the department has insufficient state funds to operate any of the programs it administers and that reductions in services or benefit levels are necessary, the secretary may engage in interim rulemaking. Notwithstanding any provision to the contrary in the State Rules Act, interim rulemaking shall be conducted pursuant to Subsection D of this section, except:

(1) the period of notice of public hearing shall be fifteen days;

(2) the department shall send individual notices of the interim rulemaking and of the public hearing to affected providers and beneficiaries;

(3) rules and regulations promulgated [under] pursuant to the provisions of this subsection shall be in effect not less than five days after the public hearing;

(4) rules and regulations promulgated under this subsection shall not be in effect for more than ninety days; and

(5) if final rules and regulations are necessary to replace the interim rules and regulations, the department shall give notice of intent to promulgate final rules and regulations at the time of notice herein. The final rules and regulations shall be promulgated not more than forty-five days after the public hearing and filed in accordance with the State Rules Act.

F. The secretary shall employ in a full-time classified position a tribal liaison, who reports directly to the secretary, to:

(1) serve as a contact person to aid in communication between the department and tribal communities or American Indians residing in New Mexico;

(2) provide training to the staff of the department in protocol, culturally competent behavior and cultural history to assist the department in providing effective service to tribes;

(3) work with the tribes, tribal members, American Indians not living on a reservation and American Indians representing off-reservation American Indian populations to resolve issues that arise with actions or programs of the department; and

(4) interact with other state agency tribal liaisons and attend meetings of legislative committees that are discussing issues that involve both the department and American Indian communities in New Mexico."

Section 11. Section 9-7-2 NMSA 1978 (being Laws 1977, Chapter 253, Section 2, as amended) is amended to read:

"9-7-2. DEFINITIONS.--As used in the Department of Health Act:

A. "department" means the department of health created under the Department of Health Act; [and]

B. "secretary" means the secretary of health;

C. "tribal" means of or belonging to a tribe; and

D. "tribe" means a federally recognized Indian nation, tribe or pueblo located wholly or partly in New Mexico."

Section 12. Section 9-7-6 NMSA 1978 (being Laws 1977, Chapter 253, Section 7, as amended) is amended to read:

"9-7-6. SECRETARY--DUTIES AND GENERAL POWERS.--

A. The secretary is responsible to the governor for the operation of the department. It is [his] the secretary's duty to manage all operations of the department and to administer and enforce the laws with which [he] the secretary or the department is charged.

B. To perform [his] the secretary's duties, the secretary has every power expressly enumerated in the laws, whether granted to the secretary or the department or any division of the department, except where authority conferred upon any division is explicitly exempted from the secretary's authority by statute. In accordance with these provisions, the secretary shall:

(1) except as otherwise provided in the Department of Health Act, exercise general supervisory and appointing authority over all department employees, subject to any applicable personnel laws and regulations;

(2) delegate authority to subordinates as [he] the secretary deems necessary and appropriate, clearly delineating such delegated authority and the limitations thereto;

(3) organize the department into those organizational units [he] the secretary deems will enable it to function most efficiently, subject to any provisions of law requiring or establishing specific organizational units;

(4) within the limitations of available appropriations and applicable laws, employ and fix the compensation of those persons necessary to discharge [his] the secretary's duties;

(5) take administrative action by issuing orders and instructions, not inconsistent with the law, to assure implementation of and compliance with the provisions of law for which administration or execution [he] the secretary is responsible and to enforce those orders and instructions by appropriate administrative action in the courts;

(6) conduct research and studies that will improve the operations of the department and the provision of services to the citizens of the state;

(7) conduct quality assurance and quality improvement activities;

(8) provide courses of instruction and practical training for employees of the department and other persons involved in the administration of programs with the objective of improving the operations and efficiency of administration;

(9) prepare an annual budget of the department;

(10) appoint, with the governor's consent, a "director" for each division. These appointed positions are exempt from the provisions of the Personnel Act. Persons appointed to these positions shall serve at the pleasure of the secretary;

(11) give bond in the penal sum of twenty-five thousand dollars ($25,000) and require directors to each give bond in the penal sum of ten thousand dollars ($10,000) conditioned upon the faithful performance of duties, as provided in the Surety Bond Act. The department shall pay the costs of those bonds; and

(12) require performance bonds of such department employees and officers as [he] the secretary deems necessary, as provided in the Surety Bond Act. The department shall pay the costs of those bonds.

C. The secretary may apply for and receive, with the governor's approval, in the name of the department any public or private funds, including but not limited to United States government funds, available to the department to carry out its programs, duties or services.

D. The secretary shall be responsible for providing appropriate educational programs for all school-age persons, as defined in Section 22-1-2 NMSA 1978, who are clients, as defined in Section 43-1-3 NMSA 1978, of institutions under [his] the secretary's authority as follows:

(1) [he] the secretary shall arrange with school districts for the enrollment of all school-age residents of institutions under [his] the secretary's authority who have been evaluated and recommended for placement in a public school according to the provisions of the Department of Health Education Act. [He] The secretary shall notify the [superintendent of public instruction] secretary of public education prior to public school enrollment of any school-age resident under [his] the secretary's authority; and

(2) [he] the secretary shall provide educational programs, in accordance with the special education rules of the [state board of] public education department, for school-age persons who are clients of institutions under [his] the secretary's authority but who are enrolled in a public school by:

(a) using the facilities and personnel of the department;

(b) contracting with a school district for the provision of educational services; or

E. The secretary may make and adopt such reasonable and procedural rules as may be necessary to carry out the duties of the department and its divisions. No rule promulgated by the director of any division in carrying out the functions and duties of the division shall be effective until approved by the secretary unless otherwise provided by statute. Unless otherwise provided by statute, no rule affecting any person or agency outside the department shall be adopted, amended or repealed without a public hearing on the proposed action before the secretary or a hearing officer designated by [him] the secretary. The public hearing shall be held in Santa Fe unless otherwise permitted by statute. Notice of the subject matter of the rule, the action proposed to be taken, the time and place of the hearing, the manner in which interested persons may present their views and the method by which copies of the proposed rule, proposed amendment or repeal of an existing rule may be obtained shall be published once at least thirty days prior to the hearing date in a newspaper of general circulation and mailed at least thirty days prior to the hearing date to all persons who have made a written request for advance notice of hearing. All rules shall be filed in accordance with the State Rules Act.

F. The secretary shall employ in a full-time classified position a tribal liaison, who reports directly to the secretary, to:

(1) serve as a contact person to aid in communication between the department and tribal communities or American Indians residing in New Mexico;

(2) provide training to the staff of the department in protocol, culturally competent behavior and cultural history to assist the department in providing effective service to tribes;

Section 13. Section 9-8-2 NMSA 1978 (being Laws 1977, Chapter 252, Section 2) is amended to read:

"9-8-2. DEFINITIONS.--As used in the Human Services Department Act:

A. "department" means the human services department created under the Human Services Department Act; [and]

B. "secretary" means the secretary of the department;

C. "tribal" means of or belonging to a tribe; and

D. "tribe" means a federally recognized Indian nation, tribe or pueblo located wholly or partly in New Mexico."

Section 14. Section 9-8-6 NMSA 1978 (being Laws 1977, Chapter 252, Section 7, as amended) is amended to read:

"9-8-6. SECRETARY--DUTIES AND GENERAL POWERS.--

B. To perform [his] duties of office, the secretary has every power expressly enumerated in the laws, whether granted to the secretary or the department or any division of the department, except where authority conferred upon any division is explicitly exempted from the secretary's authority by statute. In accordance with these provisions, the secretary shall:

(1) except as otherwise provided in the Human Services Department Act, exercise general supervisory and appointing authority over all department employees, subject to any applicable personnel laws and regulations;

(2) delegate authority to subordinates as [he] the secretary deems necessary and appropriate, clearly delineating such delegated authority and the limitations thereto;

(4) within the limitations of available appropriations and applicable laws, employ and fix the compensation of those persons necessary to discharge [his] the secretary's duties;

(5) take administrative action by issuing orders and instructions, not inconsistent with the law, to assure implementation of and compliance with the provisions of law for whose administration or execution [he] the secretary is responsible and to enforce those orders and instructions by appropriate administrative action in the courts;

(6) conduct research and studies that will improve the operations of the department and the provision of services to the citizens of the state;

(7) provide courses of instruction and practical training for employees of the department and other persons involved in the administration of programs with the objective of improving the operations and efficiency of administration;

(8) prepare an annual budget of the department;

(9) provide cooperation, at the request of heads of administratively attached agencies, in order to:

(a) minimize or eliminate duplication of services and jurisdictional conflicts;

(b) coordinate activities and resolve problems of mutual concern; and

(c) resolve by agreement the manner and extent to which the department shall provide budgeting, recordkeeping and related clerical assistance to administratively attached agencies;

(11) give bond in the penal sum of twenty-five thousand dollars ($25,000) and require directors to each give bond in the penal sum of ten thousand dollars ($10,000) conditioned upon the faithful performance of duties as provided in the Surety Bond Act. The department shall pay the costs of these bonds; and

(12) require performance bonds of such department employees and officers as [he] the secretary deems necessary as provided in the Surety Bond Act. The department shall pay the costs of these bonds.

D. Where functions of departments overlap or a function assigned to one department could better be performed by another department, the secretary may recommend appropriate legislation to the next session of the legislature for its approval.

E. The secretary may make and adopt such reasonable and procedural rules and regulations as may be necessary to carry out the duties of the department and its divisions. No rule or regulation promulgated by the director of any division in carrying out the functions and duties of the division shall be effective until approved by the secretary unless otherwise provided by statute. Unless otherwise provided by statute, no regulation affecting any person or agency outside the department shall be adopted, amended or repealed without a public hearing on the proposed action before the secretary or a hearing officer designated by [him] the secretary. The public hearing shall be held in Santa Fe unless otherwise permitted by statute. Notice of the subject matter of the regulation, the action proposed to be taken, the time and place of the hearing, the manner in which interested persons may present their views and the method by which copies of the proposed regulation, proposed amendment or repeal of an existing regulation may be obtained shall be published once at least thirty days prior to the hearing date in a newspaper of general circulation and mailed at least thirty days prior to the hearing date to all persons who have made a written request for advance notice of hearing.

F. In the event the secretary anticipates that adoption, amendment or repeal of a rule or regulation will be required by a cancellation, reduction or suspension of federal funds or order by a court of competent jurisdiction:

(1) if the secretary is notified by appropriate federal authorities at least sixty days prior to the effective date of such cancellation, reduction or termination of federal funds, the department is required to promulgate regulations through the public hearing process to be effective on the date mandated by the appropriate federal authority; or

(2) if the secretary is notified by appropriate federal authorities or court less than sixty days prior to the effective date of such cancellation, reduction or suspension of federal funds or court order, the department is authorized without a public hearing to promulgate interim rules or regulations effective for a period not to exceed ninety days. Interim regulations shall not be promulgated without first providing a written notice twenty days in advance to providers of medical or behavioral health services and beneficiaries of department programs. At the time of the promulgation of the interim rules or regulations, the department shall give notice of the public hearing on the final rules or regulations in accordance with Subsection E of this section.

G. If the secretary certifies to the secretary of finance and administration and gives contemporaneous notice of such certification through the human services register that the department has insufficient state funds to operate any of the programs it administers and that reductions in services or benefit levels are necessary, the secretary may engage in interim rulemaking. Notwithstanding any provision to the contrary in the State Rules Act, interim rulemaking shall be conducted pursuant to Subsection E of this section, except:

(1) the period of notice of public hearing shall be fifteen days;

(2) the department shall also send individual notices of the interim rulemaking and of the public hearing to affected providers and beneficiaries;

(3) rules and regulations promulgated pursuant to the provisions of this subsection shall be in effect not less than five days after the public hearing;

(4) rules and regulations promulgated pursuant to the provisions of this subsection shall not be in effect for more than ninety days; and

H. At the time of the promulgation of the interim rules or regulations, the department shall give notice of the public hearing on the final rules or regulations in accordance with Subsection E of this section.

I. The secretary shall ensure that any behavioral health services, including mental health and substance abuse services, provided, contracted for or approved are in compliance with the requirements of Section 9-7-6.4 NMSA 1978.

J. All rules and regulations shall be filed in accordance with the State Rules Act.

K. The secretary shall employ in a full-time classified position a tribal liaison, who reports directly to the secretary, to:

(1) serve as a contact person to aid in communication between the department and tribal communities or American Indians residing in New Mexico;

(2) provide training to the staff of the department in protocol, culturally competent behavior and cultural history to assist the department in providing effective service to tribes;

Section 15. Section 9-23-3 NMSA 1978 (being Laws 2004, Chapter 23, Section 3) is amended to read:

"9-23-3. DEFINITIONS.--As used in the Aging and Long-Term Services Department Act:

A. "department" means the aging and long-term services department; [and]

B. "secretary" means the secretary of aging and long-term services;

C. "tribal" means of or belonging to a tribe; and

D. "tribe" means a federally recognized Indian nation, tribe or pueblo located wholly or partly in New Mexico."

Section 16. Section 9-23-6 NMSA 1978 (being Laws 2004, Chapter 23, Section 6) is amended to read:

"9-23-6. SECRETARY--DUTIES AND GENERAL POWERS.--

B. To perform the secretary's duties, the secretary has every power expressly enumerated in the laws, whether granted to the secretary or the department or any division of the department, except where authority conferred upon any division is explicitly exempted from the secretary's authority by statute. In accordance with these provisions, the secretary shall:

(1) except as otherwise provided in the Aging and Long-Term Services Department Act, exercise general supervisory and appointing authority over all department employees, subject to any applicable personnel laws and regulations;

(2) delegate authority to subordinates as the secretary deems necessary and appropriate, clearly delineating such delegated authority and the limitations thereto;

(3) organize the department into those organizational units the secretary deems will enable it to function most efficiently, subject to provisions of law requiring or establishing specific organizational units;

(4) within the limitations of available appropriations and applicable laws, employ and fix the compensation of those persons necessary to discharge the secretary's duties;

(5) take administrative action by issuing orders and instructions, not inconsistent with the law, to ensure implementation of and compliance with the provisions of law for whose administration or execution the secretary is responsible and to enforce those orders and instructions by appropriate administrative action in the courts;

(6) conduct research and studies that will improve the operations of the department and the provision of services to the citizens of the state;

(8) prepare an annual budget of the department;

(9) provide cooperation, at the request of heads of administratively attached agencies, in order to:

(a) minimize or eliminate duplication of services and jurisdictional conflicts;

(b) coordinate activities and resolve problems of mutual concern; and

(c) resolve by agreement the manner and extent to which the department shall provide budgeting, record-keeping and related clerical assistance to administratively attached agencies; and

(10) appoint, with the governor's consent, for each division, a "director". These appointed positions are exempt from the provisions of the Personnel Act. Persons appointed to these positions shall serve at the pleasure of the secretary.

E. The secretary may make and adopt such reasonable procedural rules as may be necessary to carry out the duties of the department and its divisions. A rule promulgated by the director of any division in carrying out the functions and duties of the division shall not be effective until approved by the secretary unless otherwise provided by statute. Unless otherwise provided by statute, no rule affecting any person or agency outside the department shall be adopted, amended or repealed without a public hearing on the proposed action before the secretary or a hearing officer designated by the secretary. The public hearing shall be held in Santa Fe unless otherwise permitted by statute. Notice of the subject matter of the rule, the action proposed to be taken, the time and place of the hearing, the manner in which interested persons may present their views and the method by which copies of the proposed rule, proposed amendment or repeal of an existing rule may be obtained shall be published once at least thirty days prior to the hearing date in a newspaper of general circulation and mailed at least thirty days prior to the hearing date to all persons who have made a written request for advance notice of hearing. Rules shall be filed in accordance with the State Rules Act.

F. The secretary shall employ in a full-time classified position a tribal liaison, who reports directly to the secretary, to:

(1) serve as a contact person to aid in communication between the department and tribal communities or American Indians residing in New Mexico;

(2) provide training to the staff of the department in protocol, culturally competent behavior and cultural history to assist the department in providing effective service to tribes;

Section 17. APPROPRIATIONS.--

A. Fifteen million dollars ($15,000,000) is appropriated from the general fund to the American Indian health care improvement fund for expenditure in fiscal year 2009 and subsequent fiscal years for the following purposes:

(1) two million two hundred thousand dollars ($2,200,000) to support the development of local plans for improvement of the delivery of health care to American Indian people and to conduct studies and analyses of health care and health coverage functions and trends, including type of coverage and cost of coverage, with a long-term trend analysis of all health care practices available for Americans Indians in New Mexico;

(2) ten million dollars ($10,000,000) to support, supplement or expand the existing components of the health care system providing services to American Indian people to improve delivery of health care to the American Indian

population, including enrolling as many eligible American Indians who meet the federal poverty level requirements;

(3) five hundred thousand dollars ($500,000) to expand the scope of investigation and research of the center for American Indian health of the health sciences center of the university of New Mexico;

(4) six hundred thousand dollars ($600,000) for recruitment and retention of students training for careers in medicine or ancillary fields to become medical practitioners or medical researchers;

(5) five hundred thousand dollars ($500,000) for research and epidemiological studies;

(6) four hundred thousand dollars ($400,000) for technical assistance and outreach provided by the center for Native American studies of the health sciences center of the university of New Mexico to implement the components of the American Indian Health Care Improvement Act;

(7) four hundred thousand dollars ($400,000) for information systems and technology support for tribal community health care delivery systems; and

(8) four hundred thousand dollars ($400,000) for the staffing and operations of the American Indian health division of the department of health.

B. Any unexpended or unencumbered balance remaining at the end of a fiscal year shall not revert to the general fund but shall remain in the American Indian health care improvement fund for future expenditure pursuant to the

American Indian Health Care Improvement Act.

C. Appropriations made pursuant to this section shall be made to supplement rather than to supplant existing American Indian health initiatives.

Section 18. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2008.

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