HOUSE JOINT MEMORIAL 21

53rd legislature - STATE OF NEW MEXICO - first session, 2017

INTRODUCED BY

Georgene Louis and D. Wonda Johnson

A JOINT MEMORIAL

ASKING THE HUMAN SERVICES DEPARTMENT TO CONDUCT A STUDY TO ASSESS AND PREPARE A REPORT TO EXPLAIN WHETHER THE DEVELOPMENT OF ONE OR MORE TRIBALLY MANAGED CARE ORGANIZATIONS, MEDICAL MANAGEMENT ORGANIZATIONS, ACCOUNTABLE CARE ORGANIZATIONS OR A COMBINATION OF THOSE ORGANIZATIONS WOULD BEST ACHIEVE THE GOALS OF PROVIDING HIGH-QUALITY AND ACCESSIBLE HEALTH CARE TO NATIVE AMERICANS IN NEW MEXICO WHILE STILL MAXIMIZING COST SAVINGS TO THE STATE.

     WHEREAS, New Mexico is home to twenty-four Native American nations, tribes and pueblos; and

     WHEREAS, the Indian health service of the United States department of health and human services is the primary source of health care services for Native American patients; and

     WHEREAS, the Indian health service is currently underfunded at forty-three percent of actual need and relies on third-party funding to achieve the access and delivery it now provides; and

     WHEREAS, although New Mexico's Indian nations, tribes and pueblos rely on the Indian health service and have begun to build and manage health care facilities and providers within their respective lands, the need to utilize off-reservation health care providers continues to be great; and

     WHEREAS, one hundred seventeen thousand four hundred seventy-three Native Americans living in the state are enrolled in the medicaid program and are considered to have full coverage medical benefits; and

     WHEREAS, the Native American enrollees constitute sixteen and seven-tenths percent of all New Mexico medicaid enrollees in all similar categories; and

     WHEREAS, pursuant to medicaid law and implementing regulations, the cost for Native American medicaid patients who are referred by an Indian health service provider to an off- reservation non-Indian health service provider is split between the federal and state governments, under which the federal government currently pays seventy-one and thirteen hundredths percent of costs and New Mexico pays the remaining twenty-eight and eighty-seven hundredths percent; and

     WHEREAS, the New Mexico's medicaid cost share has created an enormous burden on the state's general fund; and

     WHEREAS, under a new policy proposed in October 2015 by the centers for medicare and medicaid services, the federal government could pay one hundred percent of the non-Indian health service provider costs for Native Americans enrolled in medicaid and referred by an Indian health service provider; and

     WHEREAS, a calculation based on data provided by the human services department regarding emergency room encounters by Native American medicaid patients reveals that implementation of the centers for medicare and medicaid services proposed policy would save New Mexico nine million nine hundred eighty-eight thousand seven hundred sixty dollars ($9,988,760); and

     WHEREAS, the centers for medicare and medicaid services proposed policy has certain requirements that the state would need to meet to qualify;

     WHEREAS, it is in the state's interest to consider adopting the requirements necessary to benefit from the proposed policy;

     NOW, THEREFORE, BE IT RESOLVED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO that the human services department be requested to conduct a study to assess and prepare a report explaining whether the development of one or more tribally managed care organizations, medical management organizations, accountable care organizations or a combination of those organizations would best achieve the goals of providing high- quality and accessible health care to Native Americans in New Mexico while still maximizing cost savings to the state; and

     BE IT FURTHER RESOLVED that the human services department be requested to work collaboratively with interested Indian nations, tribes and pueblos, health care providers, the Indian health service and other relevant entities in developing the study and producing the report; and

     BE IT FURTHER RESOLVED that by October 1, 2017, the human services department be requested to provide the report to the governor, the leadership of all New Mexico's Indian nations, tribes and pueblos and the secretary of Indian affairs; and

      BE IT FURTHER RESOLVED that by October 1, 2017, the human services department be requested to provide its findings to the legislative health and human services committee and the interim legislative committee concerned with Indian affairs; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the secretary of human services, the governor, the leadership of all New Mexico Indian nations, tribes and pueblos, the secretary of Indian affairs and the co-chairs of the New Mexico legislative council.

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