Carrie Armijo, cabinet secretary of the Health Care Authority, told a legislative committee that New Mexico is moving to make major changes to the state’s Comprehensive Addiction and Recovery Act (CARA) implementation and to implement Senate Bill 42, with full regulations due by July 1, 2026.

The changes, Armijo said, include universal prenatal screening with SBIRT at prenatal visits, a mandatory plan of safe care for substance‑exposed newborns, mandatory reporting of plan noncompliance to the Children, Youth and Families Department (CYFD), and more rigorous training and data reporting overseen by the Health Care Authority.

The reforms matter because Medicaid is the primary payer for most births in New Mexico: Armijo gave July enrollment figures of 809,454 Medicaid members and 297,329 children, and said Medicaid pays for 55 percent of births in the state and covers 72 percent of infants under age 1. Armijo also said there are a little over 1,000 infants currently enrolled in CARA, and that “almost 98 percent of those infants are covered by the Medicaid program.”

Agency officials described a cross‑agency implementation plan and new operational steps. Gina de Blasio, secretary of the Department of Health, described priority categories for substance exposure and said, “Those priority 1 babies are those that have a substance exposure to fentanyl, meth, or their polysubstance, or have a fetal alcohol spectrum, disorder.” Under the new approach, hospitals will identify priority 1 newborns and the Department of Health and CYFD will perform enhanced safety assessments and follow‑up prior to discharge.

Department of Health and CYFD staff described recent field work: the agencies carried out roughly 149 cross‑agency home visits for priority cases identified after Jan. 1, 2025. Officials said 148 of those visits were successful; seven children were removed (three newborns on CARA plus four other children in the home). After issuing the CARA directive officials identified an additional 57 infants meeting priority‑1 criteria; CYFD reported petitions filed on 29 infants with 15 successful court outcomes, three unsuccessful petitions, 11 still pending, six guardianships established and 17 other interventions. Officials said five of that cohort remained in hospital care while monitored.

The Health Care Authority has issued a hospital and birth center directive (June 27) requiring hospitals to report statewide‑central‑intake any newborn exposed to fentanyl, methamphetamine, fentanyl plus other substances, fetal alcohol spectrum disorder, or polysubstance exposure that includes an illicit drug. Armijo said the authority will promulgate regulations and run a portal for cross‑agency reporting and provider notification, provide training for hospital staff, select an evidence‑based universal screening tool, and require SBIRT screening at prenatal visits.

Committee members raised operational and equity questions. Representative Ferrari asked, “When you have the 72‑hour assessment period where you can hold the baby in the hospital … does the mother get to stay there with the baby so that there’s still that bonding or if she’s nursing?” Secretary Teresa Casados of CYFD responded that mothers are not prohibited from visiting and that hospitals often restrict NICU access for medical reasons; CYFD and DOH officials also said they will try to facilitate visitation and treatment options that preserve bonding where clinically possible.

Tribal notification and ICWA were discussed: officials said intake screens aim to identify children of Native American heritage and to follow requirements for tribal notification and consultation; Senator Charlie and other members of the committee urged transparent communication with tribes and raised allegations from commenters that removals have occurred without tribal notice.

Several legislators and public commenters urged more emphasis on kinship supports and treatment for parents. Representative Chavis and others asked about programs that allow parents to stay with infants during treatment; agency officials said capacity for parent‑and‑child treatment is limited but that the agencies will pursue options and connections to home visiting and ECECD supports. Advocates warned the directive could deter prenatal care; Misha Bitsini of Bold Futures said, “Parents tell us that reaching out for care during pregnancy often comes with fear,” and urged that policies be implemented in ways that center family supports rather than surveillance.

Officials listed near‑term deliverables: continuing priority‑1 in‑person visits, convening a stakeholder process on rule promulgation (including rural outreach Oct–Dec), issuing training materials and a hospital checklist, issuing an RFP for the CARA portal, selecting the universal screening tool and completing final regulations by July 2026.

Officials and public commenters also documented concerns about removals, guardianships and reporting transparency. Senator Charlie and public commenters pressed for public reporting of home visits, petitions, removals and guardianships and raised concerns about state‑tribal interactions and the sufficiency of kinship supports.

The agencies emphasized distinctions between current practice and the future regulatory regime. Armijo said today participation in plans of safe care is voluntary, but under Senate Bill 42 participation will be required beginning next July and noncompliance will be reported to CYFD. Officials described the current operational picture and the planned shift to mandatory screening, mandatory plans of safe care and mandatory reporting as statutory deadlines approach.

The session concluded with committee members pressing for ongoing updates and for attention to training, tribal consultation and kinship funding as the agencies move to implement the new requirements.

Ending note: agencies told the committee they will continue the cross‑agency hospital outreach, convene biweekly hospital meetings and publish opportunities for public stakeholder input as they prepare to finalize regulations and operational tools before July 1, 2026.