reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 20 - MENTAL HEALTH › Part 12 - LICENSING REQUIREMENTS FOR CHILD AND ADOLESCENT MENTAL HEALTH FACILITIES › Section 7.20.12.78 - CHILDREN'S ROOMS

Current through Register Vol. 35, No. 13, July 16, 2024
A. Each child's
				room is an outside room.
B. There
				is no through traffic in the children's rooms.
C. Single rooms have at least 80 square feet
				of floor area. Closet and locker areas are not counted as part of the floor
				area.
D. Not more than four
				children more than two years of age occupy a designated bedroom
				space.
E. Children's rooms have
				beds spaced at least three feet apart.
F. Residential treatment services facilities
				for developmentally disabled children which provide care and services to
				non-mobile children have at least 100 square feet of floor area for each
				non-mobile resident.
G. Rooms
				having more than one child must have at least 60 square feet for each bed or if
				double bunks are used at least 90 square feet of floor area for each bunk.
				Closet and locker area must not be counted as part of the available follow
				space.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 20 - MENTAL HEALTH › Part 12 - LICENSING REQUIREMENTS FOR CHILD AND ADOLESCENT MENTAL HEALTH FACILITIES › Section 7.20.12.79 - WINDOWS

Current through Register Vol. 35, No. 13, July 16, 2024
A. Children's
				sleeping rooms and activity rooms have window area of at least one-tenth the
				floor area with a minimum of at least 10 square feet.
B. Sleeping rooms provide at least one window
				for egress or rescue with a minimum net clear opening of 5.7 square feet. The
				minimum net clear opening for height dimensions is 24 inches. The minimum net
				clear opening width dimension is 20 inches.
C. Egress and rescue windows have a finished
				sill height of not more than forty-four inches above the floor.
D. Exception: If the sleeping room has a door
				directly to the outside, an egress/rescue window is not required.
E. Bars, grills, and grates or similar
				devices may be installed on emergency escape or rescue windows or doors only if
				equipped with release mechanisms which can be opened from the inside without
				the use of a key, knowledge or effort.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 20 - MENTAL HEALTH › Part 12 - LICENSING REQUIREMENTS FOR CHILD AND ADOLESCENT MENTAL HEALTH FACILITIES › Section 7.20.12.80 - ADMINISTRATION AND PUBLIC AREAS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Entrances are able to accommodate wheelchairs.
B. Public areas include:
(1) conveniently accessible wheelchair
				storage; and
(2) reception and
				information counter or desk; and
(3) conveniently accessible public toilets;
				and
(4) conveniently accessible
				drinking fountains.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 20 - MENTAL HEALTH › Part 12 - LICENSING REQUIREMENTS FOR CHILD AND ADOLESCENT MENTAL HEALTH FACILITIES › Section 7.20.12.81 - FLOORS AND WALLS

Current through Register Vol. 35, No. 13, July 16, 2024
A. Floor
				material is readily cleanable and wear resistant.
B. In all areas subject to wet cleaning,
				floor materials are not physically degradable by liquid germicidal or cleaning
				solution.
C. Floors subject to
				traffic while wet have a slip resistant surface.
D. Wall finishes are washable and in the
				proximity of plumbing fixtures, are smooth and moisture resistant.
E. Wall bases in areas subject to wet
				cleaning are covered with flooring and baseboards tightly sealed within the
				wall, and constructed without voids.
F. Floor and wall areas penetrated by pipes,
				ducts, and conduits are tightly sealed to minimize entry of rodents and
				insects. Joints of structural elements are similarly sealed.
G. Threshold and expansion joint covers are
				flush with the floor surface to facilitate use of wheelchairs and
				carts.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 20 - MENTAL HEALTH › Part 12 - LICENSING REQUIREMENTS FOR CHILD AND ADOLESCENT MENTAL HEALTH FACILITIES › Section 7.20.12.82 - ACCESS REQUIREMENTS FOR DISABLED IN NEW FACILITIES

Current through Register Vol. 35, No. 13, July 16, 2024
A. Accessibility to the disabled is provided
				in all new facilities and will include the following:
(1) main entry into the facility is level or
				has a ramp to allow for wheelchair access;
(2) building layout allows for access to main
				living area and dining area;
(3)
				access to at least one bedroom is required to have a door clearance of 32
				inches; the toilet/bathing unit also provides a 60-inch diameter clear space
				(turning radius);
(4) if ramps are
				provided to the building, the slope of each ramp is at least a 12-inch
				horizontal run for each inch of vertical rise;
(5) ramps exceeding a six-inch rise are
				provided with handrails.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 20 - MENTAL HEALTH › Part 12 - LICENSING REQUIREMENTS FOR CHILD AND ADOLESCENT MENTAL HEALTH FACILITIES › Section 7.20.12.83 - SPECIAL REQUIREMENTS FOR SECLUSION OR SECURITY ROOMS

Current through Register Vol. 35, No. 13, July 16, 2024
Any facility licensed pursuant to these regulations and that
				  uses a seclusion or security room in its program complies with all of the
				  following:
A. the room has no less
				than 80 square feet of floor area;
B. the door is of substantial construction
				either one and three-quarter inches, bonded solid core or metal able to
				withstand unusual stress;
C. the
				door is at least 32 inches wide, preferably 36 inches;
D. the door swings outward to prevent
				children from barricading themselves in the room;
E. the door has a fixed wired glass vision
				panel not to exceed 1,296 square inches, and mounted in steel or other approved
				metal frame;
F. a dual lock system
				that is simple to operate is on the door; it has a quickly operated throw bolt
				and key lock;
G. the floor is of
				substantial construction with a smooth surface so that it presents no danger in
				terms of materials that peel, splinter, or cause burns;
H. walls are of high impact resistance with
				nothing protruding from the walls that would allow for climbing by
				children;
I. the ceiling is of
				monolithic construction and unreachable to children;
J. light fixtures are security rated and
				recessed so children cannot break the lens, bulbs, etc.;
K. windows in the room have security-rated
				screens with locks that cannot be picked;
L. there is nothing else in the room,
				including electrical outlets, switches, holes, hardware, or places to hook
				things; all heating and air-conditioning registers are out of reach; there are
				no sharp edges in the room such as window sills, baseboards, or
				wainscots;
M. rooms are approved in
				writing from the state fire marshal or fire authority having jurisdiction;
				these records are maintained by the facility;
N. the observation room is convenient to a
				staff's station to permit continuous close observation of clients;
O. a toilet room with a lavatory is
				immediately accessible.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 1 - GENERAL PROVISIONS › Section 7.21.1.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection F of Section
				  9-7-6.4
				  NMSA 1978 requires the interagency behavioral health purchasing collaborative
				  (the collaborative) to adopt rules through the human services department. The
				  collaborative is created by statute and comprised of the secretaries of aging
				  and long-term services; Indian affairs; human services; health; corrections;
				  children, youth and families; finance and administration; workforce solutions;
				  public education; and transportation; the directors of the administrative
				  office of the courts; the New Mexico mortgage finance authority; the governor's
				  commission on disability; the developmental disabilities planning council; the
				  vocational rehabilitation division of the public education department; the New
				  Mexico health policy commission; and the governor's health policy coordinator,
				  or their designees.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 1 - GENERAL PROVISIONS › Section 7.21.1.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of this rule is to provide policies for the
				  standard of delivery for behavioral health services through contracted
				  behavioral health entities and for approval of contracts by the
				  collaborative.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 1 - GENERAL PROVISIONS › Section 7.21.1.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
This section contains the glossary for the New Mexico
				  behavioral health system. The following definitions apply to terms used in this
				  chapter and shall guide any rules promulgated by collaborative members
				  regarding behavioral health.
A.
				Definitions beginning with letter "A":
(1)
Abuse, individual:
Any intentional, knowing or reckless act or
				failure to act that produces or is likely to produce physical or great mental
				or emotional harm, unreasonable confinement, sexual abuse or sexual assault
				consistent with 30- 47-1 NMSA 1978.
(2)
Abuse, provider:
Provider
				practices that are inconsistent with sound fiscal, business, medical or service
				related practices and result in an unnecessary cost to the program, or in
				reimbursement for services that are not medically, clinically, or
				psychosocially necessary or in services that fail to meet professionally
				recognized standards for behavioral health care.
(3)
Adult behavioral health procedures
				manual:
The procedures manual that includes the psychiatric
				rehabilitation program requirements and comprehensive community support
				services requirements.
(4)
Advance directive:
Written instructions such as a mental
				healthcare advance directive, psychiatric advance directive, living will,
				durable health care power of attorney, durable mental health care power of
				attorney, or advance health directive, relating to the provision of health care
				when an adult is incapacitated. (See generally,
				27-7A-1 -
				27-7A-18 NMSA, 1978, and
				24-7B-1 -
				24-7B-16
				NMSA 1978.)
(5)
Adverse
				determination:
A determination by the BHE that the behavioral health
				services furnished, or proposed to be furnished to a consumer, are not
				medically, clinically or psychosocially necessary or not appropriate.
(6)
American society of addiction
				medicine (ASAM):
An organization of professionals in addiction services
				that developed, in the early 1990s or a set of criteria and tools to identify
				the level of care best suited to an individual in need of addiction
				services.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 1 - GENERAL PROVISIONS › Section 7.21.1.8 - MISSION STATEMENT

Current through Register Vol. 35, No. 13, July 16, 2024
The mission of the collaborative is to ensure that quality
				  behavioral health services are provided to both medicaid and non-medicaid
				  consumers; that providers are reimbursed timely and accurately; that services
				  promote prevention, recovery, resilience in consumers, and that available
				  resources are used in the most efficient and effective manner. This mission
				  serves the collaborative's vision of establishing a single service delivery
				  system in which consumers and family members are assisted in participating
				  fully in the life of their communities; support of recovery and development of
				  resiliency are expected; behavioral health is promoted; and the adverse effects
				  of substance abuse and mental illness are prevented or
				  reduced.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection F of Section
				  9-7-6.4
				  NMSA 1978 requires the interagency behavioral health purchasing collaborative
				  (the collaborative) to adopt rules through the human services department. The
				  collaborative is created by statute and comprised of the secretaries of aging
				  and long-term services; Indian affairs; human services; health; corrections;
				  children, youth and families; finance and administration; workforce solutions;
				  public education; and transportation; the directors of the administrative
				  office of the courts; the New Mexico mortgage finance authority; the governor's
				  commission on disability; the developmental disabilities planning council; the
				  vocational rehabilitation division of the public education department; the New
				  Mexico health policy commission; and the governor's health policy coordinator,
				  or their designees.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
September 1, 2011, unless a later date is cited at the end of
				  a section.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of this rule is to provide policies for the
				  standard of delivery for behavioral health services through contracted
				  behavioral health entities.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.8 - MISSION STATEMENT

Current through Register Vol. 35, No. 13, July 16, 2024
The mission of the interagency behavioral health
				  collaborative (the collaborative) is to ensure quality behavioral health
				  services are provided to medicaid and non-medicaid consumers; providers are
				  reimbursed timely and accurately; data is collected, and services promote
				  prevention, recovery, resilience, and efficient use of available resources.
				  This mission serves the collaborative vision to establish a behavioral health
				  service delivery system in which consumers and family members are assisted in
				  participating fully in the life of their communities; support of recovery and
				  development of resiliency are expected; behavioral health is promoted; and the
				  adverse effects of substance abuse and mental illness are prevented or
				  reduced.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.9 - QUALITY MANAGEMENT

Current through Register Vol. 35, No. 13, July 16, 2024
The collaborative recognizes that strong programs of quality
				  improvement and assurance help ensure that better care is delivered in a
				  cost-effective manner with better outcomes for consumers and families. Under
				  the terms of the interagency behavioral health collaborative contracts, quality
				  assurance and management programs are incorporated into behavioral health care
				  delivery and administrative systems.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.10 - BROAD STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Commitment to persons served:
The BHE and provider shall provide
				or ensure that:
(1) service delivery is
				individually centered and family-centered, and furthers an individual's
				capacity for recovery and resiliency;
(2) all services are designed to enhance,
				promote and expand the recovery, resiliency, independence, self-sufficiency,
				self-esteem and quality of life of the persons served;
(3) individuals served are involved in the
				individual planning, decision-making, implementation and evaluation of services
				provided;
(4) agents under an
				advance directive, family members, guardians or treatment guardians,
				caregivers, or other persons critical to the consumer's life and well-being are
				involved in the individual planning, decision-making, implementation and
				evaluation of services provided, subject to requirements or principles of
				confidentiality and individual choice;
(5) the system offers a full range of
				appropriate behavioral health services for multi-diagnosed clients, including
				facilitating access to and coordinating care with appropriate medical care
				providers;
(6) services are based
				on evidence of effectiveness;
(7)
				services consider the individual consumer's and family's preferences;
(8) services and providers comply with Title
				VI of the Civil Rights Act of 1964; Title IX of the Education Amendments of
				1972 (regarding education programs and activities); the Age Discrimination Act
				of 1975; the Rehabilitation Act of 1973; and the Americans with Disabilities
				Act.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.11 - STANDARDS FOR QUALITY MANAGEMENT AND IMPROVEMENT

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Program structure and
				operations:
Quality management is an integrated approach that links
				knowledge, structure and processes together throughout a BHE's system to assess
				and improve quality. The BHE's quality management (QM) and improvement (QI)
				structures and processes shall be planned, systematic, clearly defined, and in
				full compliance with the BHE contract. The BHE shall comply with the provisions
				of 8.305.8.12 NMAC, regardless of the funding source of services. The BHE shall
				ensure that the QM/QI program is applied to the entire range of covered
				services and all major demographic population groups in accordance with the BHE
				contract. The BHE shall have an annual QM/QI work plan, prior approved by the
				collaborative, and as specified in its BHE contact with the collaborative.
B.
Continuous quality
				improvement/total quality management:
The BHE shall base its
				administrative operations and service delivery on principles of continuous
				quality improvement/total quality management (QM/QI). Such an approach shall
				include at least the following:
(1) recognize
				that opportunities for improvement are unlimited;
(2) ensure that the QM/QI process shall be
				data driven;
(3) require the
				continual measurement of clinical and non-clinical effectiveness and
				programmatic improvements of clinical and non-clinical processes driven by such
				measurements;
(4) require the
				re-measurement of effectiveness and continuing development and implementation
				of improvements as appropriate; and
(5) rely on consumer and stakeholder
				input.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.12 - PERFORMANCE MEASURES

Current through Register Vol. 35, No. 13, July 16, 2024
A. BHE
				shall be accountable as specified in its contract for the achievement of any
				performance measure targets identified by the collaborative. The BHE shall
				measure and track performance measures, report on such measures at intervals
				defined by the collaborative, and incorporate performance measures as part of
				its QM/QI program. Performance measures include those required by the federal
				government or specified by the collaborative.
B.
Effectiveness of the QI
				program:
The BHE shall evaluate the overall effectiveness of its QI
				program and demonstrate improvements in the quality of clinical care and
				non-clinical service to consumers. The BHE shall conduct data-driven
				evaluations of clinical practices to improve quality of care. The BHE shall
				demonstrate how it has influenced or changed provider practice
				patterns.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.13 - STANDARDS FOR UTILIZATION MANAGEMENT

Current through Register Vol. 35, No. 13, July 16, 2024
The collaborative requires appropriate utilization management
				  (UM) standards to be implemented as well as activities to be performed so that
				  excellent services are provided in a coordinated fashion with neither over nor
				  under-utilization. The BHE shall manage the use of resources, maximize the
				  effectiveness of care by evaluating clinical appropriateness, and authorize the
				  type and volume of services through fair, consistent and culturally competent
				  decision-making processes while ensuring equitable access to care and a
				  successful link between care and outcomes. The consumer's service plan or
				  treatment plan priorities, advance directives, and prolonged service
				  authorizations for individuals with chronic conditions shall be considered in
				  the decision-making process.
A.
Necessity requirement:
The BHE shall comply with 8.305.8.13 NMAC
				regarding standards for utilization management. References to "medical
				necessity" in 8.305.8.13 NMAC shall be read as "clinical and psychosocial
				necessity" as defined in these rules. References to "member" in 8.305.8.13 NMAC
				shall be read as "consumer" and shall include the consumer's family, legal
				guardian, and designated representative as appropriate. All requirements in
				8.305.8.13 NMAC regarding providing notice to providers shall include notice to
				the consumer and consumer's family, legal guardian, and designated
				representative as appropriate.
B.
Use of qualified professionals:
The BHE shall ensure the
				involvement of representative practicing providers, consumers and family
				members in the development of its UM procedures. The BHE shall evaluate network
				provider satisfaction with the UM process as part of its annual provider
				satisfaction survey.
C.
Decisions:
The BHE shall make available UM decision criteria to
				providers, consumers, their families, and the public. The BHE shall ensure that
				consumers have an optimal choice of providers consistent with their treatment
				needs and available providers.
D.
Records:
The BHE shall maintain records (both hard and electronic)
				that verify its utilization management activities and compliance with UM
				requirements specified in this rule and the specific contractual requirements
				of the BHE contract.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.14 - STANDARDS FOR CREDENTIALING AND RECREDENTIALING

Current through Register Vol. 35, No. 13, July 16, 2024
The BHE shall have and implement policies and procedures that
				  comply with 8.305.8.14 NMAC, as well as any other applicable credentialing or
				  recredentialing requirements from collaborative member departments and
				  agencies, including but not limited to any federal block grant or other
				  collaborative practice protocols, rules or other requirements.
A.
Practitioner participation:
The BHE shall have a process for receiving input from participating providers
				regarding credentialing and recredentialing of providers.
B.
Credentialing application:
The BHE shall use a collaborative-approved application for network
				participation.
C.
Evaluation
				of practitioner site:
The BHE shall perform an initial visit to the
				offices of potential high volume behavioral health care providers, as
				determined by the BHE with approval of the collaborative.
D.
Assessment of organizational
				providers:
For organizational providers, the BHE shall confirm that the
				provider is in good standing with state and federal regulatory bodies and has
				been certified by the appropriate state certification agency, when
				applicable.
E.
Performance
				evaluation:
The BHE shall ensure that all providers maintain the
				certification and training necessary to provide the services they offer. The
				BHE shall utilize QM/QI data in conducting provider recredentialing,
				recontracting or performance evaluations.
F.
Practices and programs:
The
				BHE shall ensure that credentialing and recredentialing requirements shall
				recognize and promote approaches to services such as consumer- and family-run
				programs, Native American healing practices and programs, traditional
				curanderismo, and other legally acceptable programs.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.15 - RIGHTS AND RESPONSIBILITIES

Current through Register Vol. 35, No. 13, July 16, 2024
The BHE and the provider shall have a written policy,
				  approved by the collaborative as required, that states their commitment to
				  treating clients in a manner that respects their rights, respecting and
				  recognizing the consumer's dignity and need for privacy. This policy shall also
				  address the BHE and the provider's expectations with regard to clients'
				  responsibilities. The BHE shall comply with 8.305.12 NMAC and 8.349.2 NMAC
				  regarding grievances and appeals, regardless of funding source. The BHE shall
				  be required to comply with NMAC 8.305.8.15 NMAC, member (consumer) bill of
				  rights, any other collaborative member department or agency's rights'
				  statements, and all consumer rights and responsibilities provisions of the BHE
				  contract with the collaborative.
A.
Consumer handbook:
The BHE shall maintain a consumer handbook,
				prior approved by the collaborative, that includes but is not limited to
				information about consumer rights and responsibilities. The written information
				provided to consumers or clients of the BHE or provider shall be
				comprehensible, readable, easily understood and culturally sensitive.
B.
Complaints or grievances:
(1) Consumers, their families or legal
				guardians, and designated representatives have a right and shall have the means
				to voice complaints or file grievances and appeals about the care provided by
				the BHE or provider in its network.
(2) The BHE shall establish and maintain
				written policies and procedures for the filing of provider grievances and
				appeals.
(3) The BHE and the
				provider shall have written policies and procedures for the timely resolution
				of client or provider complaints or grievances.
(4) The BHE shall provide information
				specified in
				42 CFR Section
				438.10(g)(1) about its
				grievance system to all providers and subcontractors at the time they enter a
				contract.
(5) The BHE shall provide
				the collaborative regular reporting of all consumer and provider grievances,
				appeals, and fair hearings, and such other related data and information as
				specified in the BHE contract.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.16 - STANDARDS FOR CLINICAL RECORDS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Standards and policies:
The
				BHE shall require clinical records to be maintained in a format and manner that
				is timely, legible, current, and organized, and that permits effective and
				confidential consumer care and quality review. The BHE shall fully comply with
				all medical records, data, and confidentiality requirements of the BHE contract
				and any relevant state and federal law.
B.
Confidentiality:
The BHE
				shall have and implement clinical record confidentiality policies and
				procedures that implement the requirements of state and federal law and policy,
				this rule, and the BHE contract. These policies and procedures shall be
				consistent with confidentiality requirements in 45 CFR parts 160 and 164 for
				all medical records and any other health and enrollment information that
				identifies a particular consumer. Medical record contents shall be consistent
				with the utilization control required in 42 CFR Part 456,
				42 CFR
				431.305(b) and
				45 CFR
				164.530(c).
C.
Evaluation and treatment or service
				records:
(1) To promote effective
				service delivery and quality review, treatment or service records shall be
				maintained in a manner that is current, comprehensive, detailed, organized, and
				legible.
(2) The BHE and the
				provider shall ensure that consumers and family members participate in
				treatment or service planning, development, and implementation and maximize
				consumer and family recovery and resiliency. The BHE shall ensure that
				consumers and family members, where appropriate, are presented with
				opportunities to proactively engage and participate in the behavioral health
				service delivery system, with a focus on the family as a potential change agent
				where consistent with the consumer's preferences and wishes.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.17 - STANDARDS FOR ACCESS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Ensure access:
The BHE shall ensure the accessibility and
				availability of behavioral health providers for each medically, clinically or
				psychosocially necessary service. The BHE shall comply with 8.305.8.18 NMAC,
				regardless of the funding source and shall comply with such geo-access
				standards as the collaborative may require. The BHE shall maintain and update
				its service access plan, which shall describe the BHE's system for consumer
				access to services.
B.
Array
				of services:
The BHE shall ensure that in each region of the state there
				is an array of covered services that allow consumers to be served within the
				least restrictive setting and in close proximity to their places of residence,
				with preference given to in-state providers.
C.
Appointment standards:
The
				BHE shall ensure that appointment standards detailed in the BHE contract are
				met by the provider and shall report to the collaborative on the compliance of
				providers in meeting appointment standards.
D.
Access to transportation
				services:
The BHE shall assist consumers in accessing existing
				transportation benefits and resources to provide transportation to covered
				services, including transportation to address a behavioral health issue during
				non-business hours and transportation related to an emergency. The BHE shall
				coordinate behavioral health transportation services with the consumer's
				respective MCO, where applicable.
E.
Cultural competency:
The BHE
				and provider shall provide effective services to people of all cultures, races,
				ethnic backgrounds, religions in a manner that respects the worth of the
				individual and protects the dignity of each individual regardless of the
				circumstances under which services are sought.
(1) The BHE shall develop, implement,
				evaluate, and update a cultural competency plan for itself and for all network
				providers to ensure that consumers and their families, including individuals
				with disabilities, receive covered services that are culturally and
				linguistically appropriate to meet their needs.
(2) The BHE shall ensure that providers have
				access to specific clinical standards, service approaches, techniques and
				marketing programs that match an individual's culture to increase the quality
				and appropriateness of behavioral health care and outcomes. The BHE shall
				ensure compliance with 8.305.1.7 NMAC, regardless of funding source.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 2 - STANDARDS OF DELIVERY FOR BEHAVIORAL HEALTH SERVICES › Section 7.21.2.18 - DELEGATION

Current through Register Vol. 35, No. 13, July 16, 2024
Delegation is a process whereby the BHE gives another entity
				  the authority to perform certain functions on its behalf. The BHE shall be
				  fully accountable for the quality of clinical care and services provided to
				  consumers through its delivery system. The BHE may not delegate the
				  accountability for the quality of services provided. The BHE will be
				  responsible for the QM/QI program and not delegate this responsibility to
				  subcontractors. The BHE shall not assign, transfer or delegate key management
				  functions such as utilization review/utilization management or care
				  coordination without the explicit written approval of the collaborative. The
				  BHE shall ensure its full compliance with all delegation requirements of the
				  BHE contract.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 3 - BEHAVIORAL HEALTH ENTITY CONTRACTING › Section 7.21.3.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection F of Section
				  9-7-6.4
				  NMSA 1978 requires the interagency behavioral health purchasing collaborative
				  (the collaborative) to adopt rules through the human services department. The
				  collaborative is created by statute and comprised of the secretaries of aging
				  and long-term services; Indian affairs; human services; health; corrections;
				  children, youth and families; finance and administration; workforce solutions;
				  public education; and transportation; the directors of the administrative
				  office of the courts; the New Mexico mortgage finance authority; the governor's
				  commission on disability; the developmental disabilities planning council; the
				  vocational rehabilitation division of the public education department; the New
				  Mexico health policy commission; and the governor's health policy coordinator,
				  or their designees.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 3 - BEHAVIORAL HEALTH ENTITY CONTRACTING › Section 7.21.3.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of this rule is to provide policies for the
				  standard of delivery for behavioral health services through contracted
				  behavioral health entities and for approval of contracts by the
				  collaborative.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 3 - BEHAVIORAL HEALTH ENTITY CONTRACTING › Section 7.21.3.8 - MISSION STATEMENT

Current through Register Vol. 35, No. 13, July 16, 2024
The mission of the collaborative is to ensure that quality
				  behavioral health services are provided to medicaid and non-medicaid consumers;
				  that providers are reimbursed timely and accurately; that services promote
				  prevention, recovery, resilience in consumers, and that available resources are
				  used in the most efficient and effective manner. This mission serves the
				  collaborative's vision of establishing a behavioral health service delivery
				  system in which consumers and family members are assisted in participating
				  fully in the life of their communities; support of recovery and development of
				  resiliency are expected; behavioral health is promoted; and the adverse effects
				  of substance abuse and mental illness are prevented or
				  reduced.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 3 - BEHAVIORAL HEALTH ENTITY CONTRACTING › Section 7.21.3.9 - ELIGIBLE BEHAVIORAL HEALTH ENTITY (BHE)

Current through Register Vol. 35, No. 13, July 16, 2024
The collaborative shall award a contract to one or more
				  behavioral health entities which meets applicable requirements and standards
				  delineated under state and federal law including Title IV of the Civil Rights
				  Act of 1964, Title IX of the Education Amendments of 1972 (regarding education
				  programs and activities), the Age Discrimination Act of 1975, the
				  Rehabilitation Act of 1973 and the Americans with Disabilities Act. The BHE
				  contract shall, at a minimum, manage delivery of all covered behavioral health
				  services (both medicaid and non-medicaid services), including network
				  development and management, tracking funding and expenditures from various
				  funding sources, conducting utilization management, ensuring coordination of
				  services, ensuring quality management and improvement, and conducting various
				  administrative functions.
A.
BHE
				contract procurement:
The collaborative may, in conjunction with human
				services department, jointly procure contractors to provide both BH and other
				medicaid services.
B.
BHE
				contract issuance:
Prior to execution of a contract with a BHE, the
				collaborative must meet and give approval as to the substance and form of the
				proposed contract. The executive committee is authorized to negotiate, sign and
				execute the contract with a BHE without further approval from the other
				members.
C.
BHE contract
				amendments:
The BHE contract shall not be altered, changed or amended
				other than by an instrument in writing executed by the contractor and the
				co-chairs of the collaborative. The executive committee is authorized to adopt
				and execute an amendment to a BHE contract on behalf of the collaborative
				without obtaining prior approval of the other members.
D.
Other contracts:
The chair
				and co-chairs are authorized to negotiate any additional contracts, memoranda
				of understanding or other agreements, and any amendments or modifications
				thereto, on behalf of the collaborative without obtaining the prior approval of
				the members.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 3 - BEHAVIORAL HEALTH ENTITY CONTRACTING › Section 7.21.3.11 - READINESS REVIEW

Current through Register Vol. 35, No. 13, July 16, 2024
Following full execution and prior to the effective date of
				  the BHE contract, the contractor shall demonstrate to the satisfaction of the
				  collaborative that it is able to meet the requirements of the RFP. The
				  readiness review may include, but is not limited to, desk and on-site reviews,
				  system demonstrations, interviews with the contractor's staff and such other
				  review of any and all requirements of the RFP as determined by the
				  collaborative.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 21 - BEHAVIORAL HEALTH › Part 3 - BEHAVIORAL HEALTH ENTITY CONTRACTING › Section 7.21.3.12 - CONTRACT MANAGEMENT

Current through Register Vol. 35, No. 13, July 16, 2024
The collaborative or its designee shall provide collective
				  and coordinated oversight and administrative functions to ensure BHE compliance
				  with the terms of its contract, assuring each member agency with fiduciary
				  responsibility for funds within the contract is involved and is able to meet
				  its obligations to oversee state and federal funds for which it is responsible.
				  Further, the provisions of 8.305.3.10 apply to all BHE
				  contracts.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 25 - STATE HEALTH INSTITUTIONS › Part 2 - DRUG AND ALCOHOL TESTING OF EMPLOYEES › Section 7.25.2.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule applies to all employees providing direct health
				  care services in state health facilities as defined in NMSA 1978, Section
				  9-7-18.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 25 - STATE HEALTH INSTITUTIONS › Part 2 - DRUG AND ALCOHOL TESTING OF EMPLOYEES › Section 7.25.2.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Section
				  9-7-18
				  of the Department of Health Act, NMSA 1978, Sections
				  9-7-1 through
				  9-7-18.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 25 - STATE HEALTH INSTITUTIONS › Part 2 - DRUG AND ALCOHOL TESTING OF EMPLOYEES › Section 7.25.2.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
To protect the health and welfare of those served in state
				  health care facilities operated by the department of health by ensuring that
				  employees providing direct health care are not impaired by any illegal or
				  prescription drug, or alcohol, while providing services.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 25 - STATE HEALTH INSTITUTIONS › Part 2 - DRUG AND ALCOHOL TESTING OF EMPLOYEES › Section 7.25.2.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A. "Direct care"
				means health care providers authorized or permitted to offer health care
				services directly to a patient without another employee's assistance or
				presence.
B. "Department" means the
				department of health.
C. "For
				cause" means upon reasonable suspicion of impairment as set forth in 1.7.8
				NMAC.
D. "Health care provider"
				means any health care staff member who is licensed, certified or otherwise
				authorized or permitted by law to provide direct, unsupervised health care to a
				patient.
E. "Illegal or
				prescription drug" means a substance listed in any of Schedules I through V of
				the Controlled Substances Act.
F.
				"State health care facility" means a hospital, an entity providing services for
				the developmentally disabled, a shelter care home, a free-standing hospice or a
				home health agency operated by the department.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 25 - STATE HEALTH INSTITUTIONS › Part 2 - DRUG AND ALCOHOL TESTING OF EMPLOYEES › Section 7.25.2.8 - TESTING REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A. All
				direct care health care providers shall be deemed employed in safety-sensitive
				positions to be tested for drug or alcohol abuse prior to employment, and
				subject to both random and for cause drug and alcohol testing thereafter
				pursuant to the rules promulgated by the state personnel board set forth at
				1.7.8 NMAC, which rules are hereby incorporated by reference.
B. Any safety-sensitive employee may be
				tested without prior notice for drug or alcohol abuse upon reasonable suspicion
				of impairment.
(1) All reports of suspected
				drug or alcohol impairment while working shall be investigated by the allegedly
				impaired employee's supervisor, and if believed credible based upon direct
				observation of the factors listed in Subsection C of 1.7.8.11 NMAC, the
				employee shall be tested immediately upon approval of the next level supervisor
				as set forth in that section.
(2)
				The immediate supervisor must provide a succinct memorandum of the factors
				which led him or her to conclude the allegation was credible to the
				department's substance abuse coordinator or designee within 24 hours of
				testing.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 25 - STATE HEALTH INSTITUTIONS › Part 10 - NEW MEXICO VETERANS CENTER POLICY › Section 7.25.10.8 - MISSION STATEMENT

Current through Register Vol. 35, No. 13, July 16, 2024
A. It is
				the mission of the New Mexico veterans center to provide the highest quality of
				nursing and domiciliary services to veterans honorably discharged from the
				United States armed services and who are disabled by age, disease, or otherwise
				and by reason of such disability are incapable of earning a living. The center
				supports the principle of prohibiting discrimination based on race, religion,
				color or national origin.
B. The
				ultimate aim of the facility is to create and maintain an environment of
				friendliness, warmth and understanding between residents and staff and to
				provide a community where aging and disabled veterans can live out their lives
				in comfort and dignity. Service provided by the center includes medical and
				twenty-four hour nursing care; physical therapy; occupational therapy; social
				services; housekeeping services; dietary services; recreation services; and
				spiritual comfort.
C. The center
				recognizes that the needs of the disabled veterans are not static, and thus
				each person served must receive comprehensive recurring assessments as his or
				her needs change. A number of different staff specialists are employed to
				provide assessments and can furnish medical diagnosis; assessment of health
				status; nutritional assessment; rehabilitative assessment and social
				assessment.
D. Since the New Mexico
				veterans center is the only facility of its type in New Mexico, we must be
				aware of the needs of veterans throughout the state, and the resources that
				exist in each area. In addition, we can be looked upon as a resource center for
				assisting veterans and families of veterans. We will work closely with other
				providers in the public and private sector to achieve a continuum of
				appropriate services. We will continue to develop relationships with schools of
				higher education in New Mexico and support and participate in training and
				research activities that increase the body of knowledge in long-term care
				facilities.
New Mexico Administrative Code › Title 7 - HEALTH › Chapter 25 - STATE HEALTH INSTITUTIONS › Part 10 - NEW MEXICO VETERANS CENTER POLICY › Section 7.25.10.9 - GOVERNING BODY AND ADMINISTRATION

Current through Register Vol. 35, No. 13, July 16, 2024
A. Purpose: To define the ultimate
				responsibility of the veterans service commission in relationship to the
				administrator and the New Mexico veterans center.
B. Policy: It shall be the policy of the New
				Mexico veterans center, in accordance with New Mexico Statutes Annotated, 1978
				Compilation, Section
				23-4-1
				through
				23-4-2, that
				the center shall be under the control of the New Mexico veterans service
				commision which shall appoint an executive director for the center. The
				executive director shall appoint, subject to the provisions of the State
				Personnel Act, such personnel as may be necessary for the efficient performance
				of the duties prescribed in Sections
				23-4-1
				through
				23-4-4.1,
				NMSA 1978 Compilation.
C. Governing
				body responsibilities:
(1) Appointing an
				executive director as the official representative of the governing body and
				formalizing responsibilities and authority of the administration.
(2) Adopting a statement of the facility's
				missions and objectives to include the types of services to be
				offered.
(3) Adopting, reviewing
				and revising policies describing the organization of the facility and
				establishing authority and responsibility.
(4) Adopting effective administrative and
				resident care policies designed to assure maintenance of professional
				standards.
(5) Designating veterans
				service commission officers and their duties. This will include scheduling of
				meetings, attendance requirements, and recording minutes.
(6) Providing for regular attendance at
				committee meetings by the administrator or his designee and providing for
				submission of regular reports to the governing body.
(7) Providing a physical plant, equipment,
				and staff appropriate to the needs of residents.
(8) Approving annual budgets that reflect and
				carry out the objectives of the facility.
(9) Assuring that the facility is licensed
				and certified by the appropriate agencies, and that all facility personnel meet
				the legal requirements of licensing, certification, or requisition of their
				occupations in accordance with federal, state, and local
				requirements.