TITLE 7 HEALTH
CHAPTER 30 FAMILY AND CHILDREN HEALTH SERVICES
PART 15 SCHOOL-BASED HEALTH CENTERS
7.30.15.1 ISSUING AGENCY: New Mexico department of health, public
health division.
[7.30.15.1 NMAC -
N, 5/6/2025]
7.30.15.2 SCOPE: These rules apply to school-based health
centers in New Mexico that are funded by the New Mexico department of health,
and all persons who provide services within those SBHCs.
[7.30.15.2 NMAC -
N, 5/6/2025]
7.30.15.3 STATUTORY AUTHORITY: These rules are promulgated pursuant to the
following statutory authorities: the Department of Health Act, Subsection E of
Section 9-7-6 NMSA 1978, which authorizes the secretary of the department of
health to “...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”; and the Public Health Act, Subsection F
of Section 24-1-44 NMSA 1978, which authorizes the department to adopt and
promulgate rules for the regulation, operation and oversight of school-based
health centers receiving funding from the department.
[7.30.15.3 NMAC -
N, 5/6/2025]
7.30.15.4 DURATION: Permanent.
[7.30.15.4 NMAC -
N, 5/6/2025]
7.30.15.5 EFFECTIVE DATE: May 6, 2025, unless a later date is cited at
the end of a section.
[7.30.15.5 NMAC -
N, 5/6/2025]
7.30.15.6 OBJECTIVE: The purpose of this rule is to implement
Section 24-1-44 NMSA 1978 of the Public Health Act. This rule governs the
regulation, operations and oversight of school-based health centers (SBHC) in
New Mexico receiving funding from the department, and establishes minimum
standards for implementation of the provisions of the statute. The school-based health center program
supports communities in promoting the health and well-being of the school-age
population and local community through the evidence-based best practice within
a public health framework. These rules
establish the procedure and criteria New Mexico department of health shall use
to certify, suspend, and decertify school-based health centers. Certification of an SBHC by the state SBHC
program is voluntary; an operating SBHC choose not to participate in
certification, only certified SBHCs are eligible for funding from New Mexico
department of health.
[7.30.15.6 NMAC -
N, 5/6/2025]
7.30.15.7 DEFINITIONS:
A. Definitions
beginning with “A”: [RESERVED]
B. Definitions beginning with “B”: “Behavioral health” means mental
health, lifestyle and health behaviors, substance misuse, life stressors and
crises.
C. Definitions beginning with “C”: “Child” means a person below the age of
18.
D. Definitions beginning with “D”: “Department” means the New Mexico
department of health.
E. Definitions beginning with “E”: [RESERVED]
F. Definitions beginning with
“F”: “FERPA” means Family
Educational Rights and Privacy Act.
G. Definitions beginning with “G”: [RESERVED]
H. Definitions
beginning with “H”:
(1) “Health” means a state of
physical and mental well-being, not merely the absence of disease.
(2) “HIPAA” means Health Insurance
Portability and Accountability Act.
I. Definitions beginning with “I”: [RESERVED]
J. Definitions beginning with “J”: [RESERVED]
K. Definitions beginning with “K”: [RESERVED]
L. Definitions beginning with “L”: [RESERVED]
M. Definitions beginning with “M”: “Medicaid” means medical assistance
eligibility, pursuant to Title XIX of the Social Security Act, by the medical
assistance division of the New Mexico health care authority.
N. Definitions beginning with “N”: [RESERVED]
O. Definitions beginning with “O”: [RESERVED]
P. Definitions beginning with “P”:
(1) “Provider” means any
individual or entity furnishing health care at the SBHC.
(2) “Primary health care” means
basic care of a patient’s health needs across a wide continuum, including
preventive and well care as well as minor and acute illness or injury.
Q. Definitions beginning with “Q”: [RESERVED]
R. Definitions beginning with “R”: “Reproductive health” means state of
wellbeing in all matters related to the reproductive system and to its
functions and process.
S. Definitions beginning with “S”:
(1) “School-based health center
(SBHC)” means a health care clinic located in a school, a school campus or
and is organized through school and health provider agreements and offer both
physical and behavioral health care.
(2) “School-based health center
program (program; SBHC program)” means the New Mexico department of health,
school-based health center program.
(3) “SBHC site” means an
individual SBHC clinic or access point.
(4) “SBHC system” means the SBHC
sponsoring agency and all the school-based health centers operating under that
entity.
(5) “Sponsoring agency” means an
entity that provides, either directly or via contract with another entity, SBHC
services that include (but need not be limited to):
(a) funding;
(b) staffing;
(c) clinical oversight;
(d) liability insurance; and
(e) billing support.
(6) “Student” means a child or
adolescent who is enrolled in school.
T. Definitions beginning with “T”: “Telehealth” means patient
care via a two-way, real-time interactive communication between a patient and a
medical or behavioral health provider at a distant site through
telecommunications equipment that includes, at a minimum, audio and visual
equipment.
U. Definitions beginning with “U”: [RESERVED]
V. Definitions beginning with “V”: [RESERVED]
W. Definitions beginning with “W”: [RESERVED]
X. Definitions beginning with “X”: [RESERVED]
Y. Definitions beginning with “Y”: [RESERVED]
Z. Definitions beginning with “Z”: [RESERVED]
[7.30.15.7 NMAC -
N, 5/6/2025]
7.30.15.8 STANDARD
OF COMPLIANCE: The
degree of compliance required throughout these rules is designated using the
words “shall”, “must”, or “may”. “Shall”
or “must” means mandatory. “May” means
permissive. The use of the words,
“proper” and “appropriate” mean the degree of compliance that is generally
accepted throughout the professional field and by those who provide
school-based health center services to the public in facilities governed by
these rules. However, if any other
applicable statute or rule requires mandatory or stricter compliance for
school-based health center services than these rules, the school and the SBHC
sponsoring agency must comply with the stricter compliance requirements.
[7.30.15.8 NMAC -
N, 5/6/2025]
7.30.15.9 SCHOOL-BASED
HEALTH CENTER OPERATIONS AND SERVICES:
A. Location: A school-based health center shall be located
within a designated clinic space in a school, on a school campus, or adjacent
to a school campus within a safe walking distance. School-based health care may also be
delivered in a mobile clinic on or near a school campus or offered via
telehealth as determined by the school and SBHC sponsoring agency. An SBHC shall operate within an appropriate
physical space and comply with all federal, state, and local laws and
regulations governing health care practices.
B. Consent to
services: An SBHC shall obtain
parental, guardian, or student consent for services in accordance with
applicable state and federal laws.
C. Non-discrimination: In accordance with state and federal
non-discrimination laws, an SBHC shall not discriminate against patients based
upon race, color, sexual orientation, gender, gender identity, religion,
national origin, immigration status disability, health insurance status, or
ability to pay.
D. Hours
of operation: An SBHC shall be open
during hours accessible to students.
E. Clinical
services: SBHC clinical services
shall be provided by professionally qualified staff who are appropriately
certified and professionally licensed in the state of New Mexico. SBHC clinical providers shall provide age
appropriate, relevant health services to children and students. Services may include:
(1) Comprehensive
primary health care, including, health assessments, diagnosis, and treatment of
minor, acute, and chronic medical conditions;
(2) Well-child
examinations, referrals to and follow-up for specialty care, mental health and
substance use disorder assessments and treatment;
(3) Crisis
intervention, counseling and treatment;
(4) Oral health
services;
(5) Vision services; and
(6) Reproductive
health services, including but not limited to diagnosis and treatment of
sexually transmitted diseases, HIV testing and counseling, and provision of contraceptives.
F. Storage of
supplies and medications: SBHC sites
shall abide by state regulations and standards for the proper storage of
medical supplies, medications, 16.19.10 NMAC.
G. Referral for
services: SBHC shall refer to a
continuum of health services not available at the SBHC, including those related
to physical health conditions, mental health conditions, substance abuse
services, vision and oral health services as needed, services may include but
are not limited to:
(1) vaccinations;
(2) community support
programs;
(3) inpatient care; and
(4) outpatient care and
programs.
H. Health coverage: All school-based health centers shall
take steps to ascertain a student’s insurance coverage, health plan, and
primary care provider to ensure continuity of care.
[7.30.15.9 NMAC -
N, 5/6/2025]
7.30.15.10 SCHOOL-BASED HEALTH CENTER CERTIFICATION: School-based health centers must meet all
requirements for certification in the New Mexico standards and benchmarks for
school-based health Centers to be eligible to apply to the program for
certification. The department may
perform reviews of SBHCs as it deems necessary to ensure continued compliance
with the New Mexico standards and benchmarks for school-based health
centers. Reviews may include site
visits, reviews of records and documents, or such other oversight as determined
necessary by the department. An SBHC
shall make documents and premises available for inspection upon the program’s
request.
[7.30.15.10 NMAC -
N, 5/6/2025]
7.30.15.11 DATA COLLECTION AND SHARING:
A. Medical record:
A school-based health center shall maintain and store a medical
record for each patient in accordance with applicable laws. See, e.g., 16.10.17.10 NMAC
(“Retention, Maintenance and Destruction of Medical Records”).
B. Data
collection: An SBHC shall
participate in data collection for statewide evaluation. Data measures shall be determined by the
state of New Mexico school based health center program. School-based health centers shall ensure
confidentiality in the storage and sharing of health information, in accordance
with applicable state and federal confidentiality laws, including HIPAA and
FERPA.
C. Student confidentiality: SBHCs shall follow applicable state and
federal laws concerning student confidentiality when billing for services.
[7.30.15.11 NMAC -
N, 5/6/2025]
7.30.15.12 SBHC STAFFING:
A. AN SBHC shall provide services
through health professionals who maintain up to date New Mexico licensure,
training, and proper certification in their individual discipline for the
population to be served.
B. The organizational structure of the
SBHC must be adequate to provide for appropriate clinic supervision of staff,
and to ensure that staff are assigned responsibilities that are consistent with
their education and experience and legally within their scope of practice.
[7.30.15.12 NMAC -
N, 5/6/2025]
7.30.15.13 FINANCIAL SUSTAINABILITY:
A. The
SBHC sponsoring agency is responsible for employing financial practices that
balance the long-term fiscal health of the SBHC.
B. The
SBHC sponsoring agency shall maintain financial policies and procedures that:
(1) Support
and guide a sound business plan based on financial strategies that rely on
stable and predictable funding sources, maximize patient revenue, and minimize
the role of grants to support operations for the long-term; and
(2) Require
billing Medicaid and other insurers whenever possible.
[7.30.15.13 NMAC -
N, 5/6/2025]
7.30.15.14 WAIVERS:
A. An
SBHC system must notify the program within 20 calendar days of any change that
brings an SBHC out of compliance with the certification requirements. An SBHC
system must submit a request to the program that includes an explanation of the
non-compliant requirement, a plan for corrective action, and date for meeting
compliance.
B. The
program will review the waiver request and inform the SBHC system of approval
or denial of the waiver within two weeks of submission.
C. If
the waiver is approved, the SBHC must comply with certification requirements by
the identified deadline for compliance.
D. If a
waiver is denied; an SBHC site or system does not come into compliance by the
deadline for compliance stated on the waiver; or an SBHC is out of compliance
with certification requirements and has not submitted a waiver, the program
may, within its discretion:
(1) require
the SBHC to complete an additional waiver with an updated plan for corrective
action and updated date for meeting compliance;
(2) issue
a written warning with a timeline for corrective action; or
(3) issue
a notice of contemplated action to suspend or revoke SBHC certification(s) or
take other disciplinary action in accordance with this rule.
E. An
SBHC site with its certification status suspended may have its suspension
lifted once the program determines that compliance with certification
requirements has been satisfactorily achieved.
F. An
SBHC that has been decertified may reapply.
G. If
these rules are amended in a manner that requires an SBHC to make any
operational changes, the program will allow the SBHC system until the beginning
of the next certification year or a minimum of 90 days to come into compliance.
H. The New Mexico school based health center program
reserves the right to review any or all selected standards for compliance at
all certified sites with a minimum notification of at least five center working
days if issues of compliance are raised or come into question.
[7.30.15.14 NMAC -
N, 5/6/2025]
7.30.15.15 DISCIPLINARY ACTION; RIGHT OF
APPEAL:
A. Denial, suspension, and revocation: SBHC certification may be denied, suspended,
or revoked, or may be subject to any other disciplinary action, for violation
of or failure to satisfy any requirement of this rule, and on any of the
following grounds:
(1) abuse, neglect, or exploitation;
(2) failure to follow established
procedures regarding controlled substances;
(4) disclosure of patient information
in a manner not consistent with applicable law(s);
(3) dispensing, administering, or
distributing medications in a manner not consistent with applicable law(s);
(4) failure to comply with other
applicable law(s);
(5) any false, fraudulent, or deceptive
statement made to the program;
(6) failure to cooperate with the
program’s review of the SBHC; and
(7) any conduct that poses a substantial
risk of harm to public health or safety.
B. Notification; other action: If final disciplinary action is taken, the
program may notify the New Mexico health care authority, licensing bodies, and
others.
C. Notice of contemplated action: The program may issue a notice of
contemplated action to deny, suspend, or revoke certification, or take other
disciplinary action against an SBHC. The
notice shall be served by certified U.S. postal mail (return receipt
requested). The notice shall state the
grounds for taking the proposed action, and shall state that the program will
take the proposed action unless the SBHC or SBHC applicant mails, within 20
days after service of the notice, a letter (via certified mail, return receipt
requested), requesting a hearing.
D. Right to appeal: An SBHC or SHBC applicant may request a
hearing to be held before a hearing officer appointed by the cabinet secretary
to contest a proposed action under this rule, by mailing a letter via certified
mail, return receipt requested, to the program within 20 days after service of
the notice of contemplated action. If an
SBHC or SBHC applicant fails to request a hearing in the time and manner
required, the SBHC or SBHC applicant shall forfeit the right to a hearing, and
the proposed action shall become final.
[7.30.15.15 NMAC -
N, 5/6/2025]
7.30.15.16 HEARINGS:
A. Scheduling the hearing:
(1) Appointment of hearing officer: Upon the program’s receipt of a conforming
request for hearing, the department shall appoint a hearing officer and
schedule a hearing.
(2) Hearing date: The hearing shall be held not more than 60
days and not less than 15 days from the date of service of the notice of the
hearing.
(3) Notice of hearing: The department shall notify the SBHC or SBHC
applicant of the date, time, and place of the hearing and the identity of the
hearing officer within 20 days of the program’s receipt of the conforming
request for hearing.
(4) Hearing venue: The hearing shall be held in Santa Fe, New
Mexico, or may be held via internet-based web video conference by agreement of
the parties.
B. Method of service:
Any notice or decision required to be served under this section may be
served either personally or by certified mail, return receipt requested,
directed to the SBHC or SBHC applicant at the last known mailing address shown
by the records of the program. The
notice or decision shall be deemed to have been served on the date borne by the
return receipt showing delivery, or the date of the last attempted delivery of
the notice or decision, or the date of the addressee’s refusal to accept
delivery.
C. Hearing officer duties:
The hearing officer shall conduct the hearing, rule on any motions or
other matters that arise prior to the hearing and issue a written report and
recommendation(s) to the secretary following the close of the hearing.
D. Official file: Upon appointment,
the hearing officer shall establish an official file which shall contain all
notices, hearing requests, pleadings, motions, written stipulations, evidence,
briefs, and correspondence received in the case. The official file shall also contain
proffered items not admitted into evidence, which shall be so identified and
shall be separately maintained. Upon
conclusion of the proceeding and following issuance of the final decision, the
hearing officer shall tender the complete official file to the department for
its retention as an official record of the proceedings.
E. Powers of hearing officer: The hearing officer shall have all the
powers necessary to conduct a hearing and to take all necessary action to avoid
delay, maintain order, and assure development of a clear and complete record,
including but not limited to the power to:
administer oaths or affirmations; schedule continuances; direct
discovery; examine witnesses and direct witnesses to testify; subpoena
witnesses and relevant books, papers, documents, and other evidence; limit repetitious
and cumulative testimony; set reasonable limits on the amount of time a witness
may testify; decide objections to the admissibility of evidence or receive the
evidence subject to later ruling; receive offers of proof for the record; take
notice of judicially cognizable facts or take notice of general, technical, or
scientific facts within the hearing officer’s specialized knowledge (provided
that the hearing officer notifies the parties beforehand and offers the parties
an opportunity to contest the fact so noticed); direct parties to appear and
confer for the settlement or simplification of issues, and otherwise conduct
pre-hearing conferences; impose appropriate evidentiary sanctions against a
party who fails to provide discovery or who fails to comply with a subpoena;
dispose of procedural requests or similar matters; and enter proposed findings
of fact and conclusions of law, orders, reports and recommendations. The hearing officer may utilize his or her
experience, technical competence, or specialized knowledge in the evaluation of
evidence presented.
F. Postponement or continuance: The hearing officer, at their
discretion, may postpone or continue a hearing upon his or her own motion, or
upon the motion of a party, for good cause shown. Notice of any postponement or continuance
shall be given in person, by telephone, or by mail to all parties within a
reasonable time in advance of the previously scheduled hearing date.
G. Conduct of hearing:
Hearings shall be open to the public; provided, however, that hearings
may be closed in part to prevent the disclosure of confidential information,
including but not limited to health information protected by state and federal
laws.
H. Recording: The hearing officer
or a designee shall record the hearing by means of a mechanical sound recording
device provided by the department for a record of the hearing. Such recording need not be transcribed,
unless requested by a party who shall arrange and pay for the transcription.
I. Burden of proof: Except as otherwise
provided in this rule, the department has the burden of proving by a
preponderance of the evidence the basis for the proposed action. Exception in denied application cases: in cases arising from the denial of an
application for certification, the SBHC applicant shall bear the initial burden
of proving by a preponderance of the evidence the applicant’s qualifications.
J. Order of presentation; general rule: Except as provided in this rule, the
order of presentation for hearings in all cases shall be:
(1) appearances: opening of proceeding and taking of
appearances by the hearing officer;
(2) pending matters: disposition by the hearing officer of
preliminary and pending matters;
(3) opening statements: the opening statement of the
department; and then the opening statement of the party challenging the
department's action or proposed action;
(4) cases: the department's case-in-chief, and
then the case-in-chief of the party challenging the department's action;
(5) rebuttal: the department's case-in-rebuttal;
(6) closing argument: the department's closing statement,
which may include legal argument; and then the closing statement of the party
opposing the department’s action or proposed action, which may include legal
argument; and
(7) close: close of proceedings by the hearing
officer.
K. Order of presentation in denied application cases: The order of presentation in cases
arising
from the denial of an application for certification shall be:
(1) appearances: opening of proceeding and taking of
appearances by the hearing officer;
(2) pending matters: disposition by the hearing officer of
preliminary and pending matters;
(3) opening statements: applicant's opening statement; and then
the opening statement of the department;
(4) cases: the applicant's case-in-chief, and
then the department’s case-in-chief;
(5) rebuttal: the applicant's case-in-rebuttal;
(6) closing argument: the applicant's closing statement, and
then the department’s closing statement; and
(7) close: close of proceedings by the hearing
officer.
L. Admissible evidence; rules of evidence not
applicable: The hearing officer
may admit evidence and may give probative effect to evidence that is of a kind
commonly relied on by reasonably prudent persons in the conduct of serious
affairs. Rules of evidence, such as the
New Mexico rules of evidence for the district courts, shall not apply but may
be considered in determining the weight to be given any item of evidence. The hearing officer may at his or her
discretion, upon his or her motion or the motion of a party or a party’s
representative, exclude incompetent, irrelevant, immaterial, or unduly
repetitious evidence, including testimony, and may exclude confidential or
privileged evidence.
M. Objections: A party may timely
object to evidentiary offers by stating the objection together with a succinct
statement of the grounds for the objection.
The hearing officer may rule on the admissibility of evidence at the
time an objection is made or may receive the evidence subject to later ruling.
N. Official notice: The hearing officer
may take notice of any facts of which judicial notice may be taken, and may
take notice of general, technical, or scientific facts within his or her
specialized knowledge. When the hearing
officer takes notice of a fact, the parties shall be notified either before or
during the hearing of the fact so noticed and its source, and the parties shall
be afforded an opportunity to contest the fact so noticed.
O. Record content: The record of a
hearing shall include all documents contained in the official file maintained
by the hearing officer, including all evidence received during the course of
the hearing, proposed findings of fact and conclusions of law, the
recommendations of the hearing officer, and the final decision of the
secretary.
P Written evidence from witnesses: The hearing officer may admit evidence
in the form of a written statement made by a witness, when doing so will serve
to expedite the hearing and will not substantially prejudice the interests of
the parties.
Q. Failure to appear:
If a party who has requested a hearing or a party’s representative fails
to appear on the date, time, or location announced for a hearing, and if no
continuance was previously granted, the hearing officer may proceed to hear the
evidence of such witnesses as may have appeared or may accept offers of proof
regarding anticipated testimony and other evidence, and the hearing officer may
further proceed to consider the matter and issue his report and
recommendation(s) based on the evidence presented; and the secretary may
subsequently render a final decision.
Where a person fails to appear at a hearing because of accident,
sickness, or other cause, the person may within a reasonable time apply to the
hearing officer to reopen the proceeding, and the hearing officer may, upon
finding sufficient cause, fix a time and place for a hearing and give notice to
the parties.
R. Hearing officer written report and
recommendation(s): The hearing officer
shall submit a written report and recommendation(s) to the secretary that
contains a statement of the issues raised at the hearing, proposed findings of
fact and conclusions of law, and a recommended determination. Proposed findings of fact shall be based upon
the evidence presented at the hearing or known to all parties, including
matters officially noticed by the hearing officer. The hearing officer's recommended decision is
a recommendation to the secretary of the New Mexico department of health and is
not a final order.
S. Submission for final decision: The hearing officer's report and
recommendation(s) shall be submitted together with the complete official file
to the secretary of the New Mexico department of health for a final decision no
later than 30 days after the last submission by a party.
T. Secretary’s final decision: The secretary shall render a final
decision within 45 calendar days of the secretary’s receipt of the hearing
officer’s written report. A copy of the
final decision shall be mailed to the SBHC or SBHC applicant by certified mail,
return receipt requested, within 15 days after the final decision is rendered
and signed.
[7.30.15.16 NMAC -
N, 5/6/2025]
History of 7.30.15
NMAC: [RESERVED]