Committee advances funding for Medicaid rates, personal-care pay and accessibility measures; contentious optometry scope bill amended

The House committee on Health heard public testimony and advanced several health- and access-related measures Wednesday, moving appropriations and policy proposals to the next stage while amending a disputed scope-of-practice bill for eye care.

The committee gave a “do pass” recommendation to an appropriations measure to fund rate increases for seven services under the developmental disability waiver, a one-page bill to make the state’s 2023 rate study “whole” and allow the Health Care Authority to seek federal matching funds, sponsors said. Representative Cates introduced the request and called it a “simple Appropriations Act to make sure that we are whole from the state funded rate study.”

Why it matters: Providers and disability advocates told the panel the affected services — supported living and several customized supports — have not had a rate increase since 2019 and that staffing shortages and new statutory costs have left providers unable to expand or, in some cases, to accept more people. Jim Copeland, executive director of the Association of Developmental Disabilities Community Providers, said, “there were 7 services under the developmental disability waiver that did not re get a recommended rate increase,” and asked the legislature to appropriate money so the Health Care Authority can submit a state plan amendment to draw down federal match.

Other major actions and discussion: - Personal-care wage floor: Lawmakers advanced House Bill 55 to establish a minimum Medicaid reimbursement for personal-care services at $23.50 per hour (the advocates described this as roughly a 15% increase to current agency reimbursement). Adrienne Smith of the New Mexico Caregivers Coalition and other advocates said the increase is aimed at keeping caregivers in the workforce and recognizing unpaid costs providers now absorb.

- Adult changing tables: The panel advanced House Bill 40, a “Traveling with Dignity” initiative to place hydraulic adult changing tables in state-owned or state-funded facilities that receive high annual traffic (sponsor Representative Cates said the program would be rolled onto capital outlay requests rather than an immediate appropriation). Proponents said tables cost roughly $15,000–$23,000 all-in for retrofits and asked members to support capital outlay requests to cover installations.

- Birth centers and Medicaid parity: House Bill 56 was advanced to raise Medicaid reimbursement parity for births at licensed birth centers, proponents said, so birth centers would be paid at rates closer to hospital noncomplicated birth codes. Supporters, including midwives, doulas and patient advocates, said parity would make birth-center care financially viable and help address maternal-health deserts.

- Mental-health rooms in schools: Lawmakers advanced funding to expand school-based mental-health and wellness rooms and suicide-prevention supports. Sponsors said earlier pilot grants funded rooms in 14 schools and that many additional schools requested the same support.

- AEDs in high schools: House Bill 54, to provide automated external defibrillators (AEDs) and training at high schools, was advanced. Supporters cited national survival gains when AEDs and CPR are applied quickly; a student volunteer who works with Simon’s Heart told the committee an AED used within three minutes plus CPR can produce survival rates “up to 95 percent.”

- Rural health tax credit: Lawmakers advanced an expansion of the rural health-care practitioner tax credit to include several additional practitioner types (speech-language pathologists, occupational therapists, licensed nurse practitioners, EMTs/paramedics and chiropractic physicians). Sponsors said the fiscal impact on the general fund is relatively small and that the change will help recruitment to rural areas.

- Optometry scope amendment: House Bill 36, a contentious scope-of-practice bill to allow properly credentialed optometrists to perform in-office laser procedures for glaucoma and posterior capsulotomy, advanced on an amendment that removed proposals for anterior chamber paracentesis and intracameral drug-eluting implant placement. The amendment also clarified that the New Mexico Board of Optometry would create credentialing rules for any optometrist who chooses to be certified. The bill drew extensive opposition from ophthalmologists and other physicians who said surgical lasers require medical training and years of postgraduate clinical experience; proponents and some optometrists said current school curricula and certification courses provide the training needed for limited in-office laser procedures.

Votes at a glance: - HB42 (DD waiver rate funding appropriation) — Motion: Representative Ferrari; Second: Representative Anaya; Outcome: Do pass (committee). Motion recorded in committee; vote tally not specified in transcript. - HB40 (Traveling with Dignity adult changing tables) — Motion: Representative Ferrari; Second: Representative E. Chavis; Outcome: Do pass. - HB55 (Minimum Medicaid fee schedule for personal care services, $23.50) — Motion: Representative Kates; Second: Representative Ferrari; Outcome: Do pass (9–0 roll call recorded by committee clerk). - HB36 (Optometry laser procedures; amended) — Motion to adopt amendment: Representative Ferrari; Second: Representative Anaya; Outcome: Amended bill received a do pass recommendation (committee vote 7–2–2 as recorded; several members explained their votes on the record). - HB56 (Birth-center Medicaid parity) — Motion: Representative Kates; Second: Representative Ann Chavis; Outcome: Do pass (committee recorded 6–0). - HB58 (Mental-health rooms in schools; appropriations request) — Motion: Representative E. Chavis; Second: Representative Kates; Outcome: Do pass (committee recorded 6–0). - HB54 (AEDs and training in high schools) — Motion: Representative Ferrari; Second: Representative E. Chavis; Outcome: Do pass (committee recorded 7–0). - HB52 (Expand rural health practitioner tax credit eligibility) — Motion: Representative Cates; Second: Representative E. Chavis; Outcome: Do pass (committee recorded 7–0).

Context and next steps: All measures that received a “do pass” move to the House floor or to the appropriations process, depending on whether they carry appropriations. Several bills that rely on capital outlay or general-fund appropriations will face further budget review in the Appropriations Committee. The optometry scope bill is expected to see additional technical rulemaking if it reaches the floor because the amendment delegates credentialing details to the Board of Optometry. The committee recorded many public comments for the bills; advocates and provider groups generally framed the package as a workforce, access and dignity set of measures.

Quotes (selected): "There were 7 services under the developmental disability waiver that did not re get a recommended rate increase," Jim Copeland, executive director of the Association of Developmental Disabilities Community Providers, told the committee.

"This is a small request to make sure that this industry — Medicaid dollars are matched 4 to 1," Representative Cates said, urging funding to draw federal match.

"These caregivers should be paid for the work they're doing," Adrienne Smith of the New Mexico Caregivers Coalition said in support of HB55.

"Optometrists complete a 4 year doctorate program...and pass 3 national board exams," Doctor Sarah Bortz, an optometrist, said in support of the amended HB36 and described school-based training and certification approaches.

"The urgent need in New Mexico is primary eye care," pediatric ophthalmologist Krista Hyder told the committee in opposition to scope expansion, saying data from other states did not show improved access after similar laws.

Ending: The committee's votes send most bills onward for floor consideration or budget review; lawmakers and advocates said they will continue outreach to finalize funding amounts and rule details before the measures reach final votes.