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Promising Practices in Providing Workers’ Compensation The New Mexico Experience November 1, 2007 Patrick Promising Practices in Providing Workers’ Compensation The New Mexico Experience November 1, 2007 Patrick L. Lopez, J. D. Former General Counsel Aging and Long-Term Services Department

How about a Legislative Mandate? New Mexico 2006 Regular Session House Memorial 25 Some How about a Legislative Mandate? New Mexico 2006 Regular Session House Memorial 25 Some Highlights

House Memorial 25 Some Highlights “A MEMORIAL REQUESTING THE INSURANCE DIVISION OF THE PUBLIC House Memorial 25 Some Highlights “A MEMORIAL REQUESTING THE INSURANCE DIVISION OF THE PUBLIC REGULATION COMMISSION TO CONVENE A TASK FORCE TO STUDY WAYS TO REDUCE WORKERS’ COMPENSATION PREMIUMS FOR NONPROFIT AGENCIES PROVIDING HEALTH AND HUMAN SERVICES. ”

House Memorial 25 Some Highlights “WHEREAS, workers’ compensation premiums for nonprofit agencies providing health House Memorial 25 Some Highlights “WHEREAS, workers’ compensation premiums for nonprofit agencies providing health and human services have dramatically increased in recent years, resulting in financial hardship for these agencies; and

House Memorial 25 Some Highlights WHEREAS, agencies providing health and human services may be House Memorial 25 Some Highlights WHEREAS, agencies providing health and human services may be assigned to the workers’ compensation assigned-risk pool with significantly higher costs, further jeopardizing fiscal solvency for these agencies; and

House Memorial 25 Some Highlights WHEREAS, independent contractors may have been erroneously classified as House Memorial 25 Some Highlights WHEREAS, independent contractors may have been erroneously classified as agency employees, resulting in increased premiums;

House Memorial 25 Some Highlights NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF House Memorial 25 Some Highlights NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES OF THE STATE OF NEW MEXICO that the insurance division of the public regulation commission be requested to convene a task force to study ways to reduce workers’ compensation premiums for nonprofit agencies providing health and human services; and

House Memorial 25 Some Highlights BE IT FURTHER RESOLVED that a copy of this House Memorial 25 Some Highlights BE IT FURTHER RESOLVED that a copy of this memorial be sent to the insurance division of the public regulation commission. ”

Identify the State Players New Mexico • The Public Regulation Commission – Department of Identify the State Players New Mexico • The Public Regulation Commission – Department of Insurance • Workers’ Compensation Division

Involve the Public Sector Major Insurance Underwriters New Mexico Mutual Find a Good Agent Involve the Public Sector Major Insurance Underwriters New Mexico Mutual Find a Good Agent

The Code NATIONAL COUNCIL ON COMPENSATION INSURANCE, INC. 01 -NM-2007 ITEM 01 -NM-2007–REVISIONS TO The Code NATIONAL COUNCIL ON COMPENSATION INSURANCE, INC. 01 -NM-2007 ITEM 01 -NM-2007–REVISIONS TO BASIC MANUAL CLASSIFICATIONS FOR DOMESTIC SERVICE WORKERS EXHIBIT 1 BASIC MANUAL – 2001 EDITION NEW MEXICO SPECIAL CLASSIFICATIONS 0918 DOMESTIC SERVICE WORKERS – INSIDE – PHYSICAL ASSISTANCE – CONSUMER DIRECTED PROGRAMS Code 0918 applies to those domestic workers, however named, engaged in providing physical assistance in the activities of daily living to an elderly, convalescent, acutely or chronically ill, or physically or mentally disabled person who is, or whose representative is, their common law employer.

Identify the Roadblocks New Mexico National Council for Compensation Insurance (NCCI) Frightened Actuaries Identify the Roadblocks New Mexico National Council for Compensation Insurance (NCCI) Frightened Actuaries

Identify the Roadblocks – Codes you don’t want Examples of duties assigned to Domestic Identify the Roadblocks – Codes you don’t want Examples of duties assigned to Domestic Codes 0908 or 0913: no physical assistance allowed • • General or light housekeeping Washing and drying laundry Meal preparation with no feeding allowed Shopping Accompanying the individual while traveling to community activities, the library, fitness center, self-advocacy meeting, and community events Companionship and social interactions No professional designation such as RN, CNA, etc.

Identify the Roadblocks – Codes you don’t want Examples of duties assigned to Home Identify the Roadblocks – Codes you don’t want Examples of duties assigned to Home Health Care Code 8835: physically assisting a household member with: • Walking or using prescribed equipment • Taking medications prescribed by a physician that otherwise would be self-administered • Bathing, personal hygiene, dressing, or grooming • Meal preparation, eating (including tube feeding and special nutritional/dietary needs) and cleanup • Transferring in and out of bed • Performing range-of-motion exercises • Health-related needs • All employees with professional designations

The Policy New Mexico • $3. 09 per $100. 00 of payroll Class code The Policy New Mexico • $3. 09 per $100. 00 of payroll Class code 0918 Domestic Service Workers – Inside – Physical Assistance – Consumer Directed Programs

The Policy New Mexico • Account Name: Mi Via Home and Community-Based Services The Policy New Mexico • Account Name: Mi Via Home and Community-Based Services

The Policy New Mexico General Amendatory Endorsement NCCI CODE: STATE CODE: NM(30) It is The Policy New Mexico General Amendatory Endorsement NCCI CODE: STATE CODE: NM(30) It is agreed that PPL is recognized as the Financial Management Agent (FMA) for the Mi Via Home and Community-Based Services Waiver (MV HCBSW) program and is assigned all rights, duties and responsibilities in regard to this policy as authorized by 8. 314. 6. 10 NMAC-N, 12 -1 -06.

The Policy New Mexico Named Insured Endorsement ALL PARTICIPANTS APPROVED FOR MV HCBSW PER The Policy New Mexico Named Insured Endorsement ALL PARTICIPANTS APPROVED FOR MV HCBSW PER 8. 314. 6 NMAC-N, 12 -1 -06. FMA TO MAINTAIN DOCUMENTATION AND RECORDS.

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