Recent Columns

 Columns appear here a week after they're published in print.
 

© 2023 NEW MEXICO NEWS SERVICES 3/6/23

Clock ticks as lawmakers dither on medical malpractice

By Sherry Robinson

     In a two-hour debate on medical malpractice, what really got my attention was the unexpected sound of my own doctor’s voice. She talked about how, as a young physician, she was excited to join an independent outpatient facility and work with doctors she admired to care for thousands of patients all over the state. 

     Her organization and others like it will close their doors if lawmakers don’t address a flaw in legislation passed two years ago that’s come back to bite New Mexico’s already strained healthcare system.

     In 2021, legislators passed HB 75, a hard-fought overhaul of the state’s medical malpractice law. It raised caps on malpractice payouts, and it lumped independent outpatient facilities in with hospitals. Suddenly, operations like Southwest Gastroenterology Associates and Renal Medicine Associates couldn’t get malpractice insurance. Legislators had to return in a special session to pass a two-year fix.

     It’s gotten worse. Malpractice premiums have spiked, some providers can’t get insurance at all, and they can’t recruit new doctors.

     “We’re at the precipice right now,” Sen. Martin Hickey, D-Albuquerque, told the Senate Tax, Business and Transportation Committee recently. Hickey is one of two physicians in the Legislature.

     Hickey and Sen. Mark Moores, R-Albuquerque, co-sponsored SB 296, which would keep independently owned outpatient clinics under a $750,000 cap for malpractice payouts for another two years while a task force sorts out other malpractice issues. Without action, the independents’ cap will be $5 million in January 2024. 

     Doctors don’t mince words. 

     Renal Medicine Associates cares for patients with kidney disease across the state. “We are having difficulty recruiting new providers,” wrote Dr. Jayant Kumar in an op ed. “We are supposed to have coverage of $4 million for liability. We have not been able to find such coverage and will be forced to shut down a unique clinic by end of 2023.” That would be Valley Home Dialysis in Las Cruces, the only stand-alone home dialysis center in southern New Mexico.

     Several organizations have planned expansions or new facilities that are jeopardized. All doubt their future in New Mexico.

     “We’ve heard it’s a manufactured insurance crisis,” said Carrie Robin Brunder, lobbyist for the New Mexico Medical Society. “I assure you it’s not.”

On the other side is concern that patients are protected and properly compensated if medical procedures go south. However, in the hearing room doctors far outnumbered plaintiffs’ attorneys.

     One refrain heard in this hearing, especially from Dems, was: We had a deal. In 2021, hospitals, doctors and trial lawyers assured lawmakers that their compromise measure was solid. Somehow, everybody missed the sloppy wording that swept the independent operations in with hospitals.

     This is a violation of an unwritten Roundhouse rule. Our volunteer legislators can’t be experts on all subjects, and they like the warring parties to compromise. They count on those compromises. So now they’re asked again to support a compromise. Senate Majority Leader Peter Wirth said if they weren’t careful, they could end up back where they were two years ago.

“I’m committed to try to work this out,” Wirth said, but he wouldn’t vote for SB 296 that day.

     Sen. Gay Kernan, R-Hobbs, said: “Two years ago, under trying circumstances, we negotiated HB 75. It was the worst vote I have ever taken.” Doctors weren’t in the room, and the negotiation was “flawed from the beginning.” She voted out of fear the caps could disappear. 

     Kernan and the committee’s Republicans express more urgency about the state’s ebbing pool of doctors.

     “We are going to lose doctors,” she said. “This is an opportunity to undo what we did two years ago.”

     The committee’s five Ds voted against the four Rs to table the bill. 

     Dems are treating this looming debacle like a policy issue. If the session ends without movement on malpractice, they can kiss their comfy majorities goodbye.

© 2023 NEW MEXICO NEWS SERVICES  3-6-23

Governing the school boards

By Merilee Dannemann 

Triple Spaced Again

     Years ago, as a young reporter in Taos, I was assigned to interview candidates for the local school board. This was considered a booby prize for the new kid in the newsroom.

     Most candidates had no major policy positions and claimed to be qualified because of how much they loved children. The election process made no sense to me until someone whispered that school board members controlled the hiring of cafeteria and custodial workers, which, I was told, were the real power centers in the schools – teachers being barely relevant.

     As technology and new regulations have increased demands on school districts, there have been attempts to upgrade the qualifications of board members. Another such attempt is in the works now. It’s House Bill 325 (Natalie Figueroa, D-Albuquerque; Patricia Lundstrom, D-Gallup; and Susan Herrera, D-Embudo). 

     The only statutory requirement to serve on a school board – still – is to be a New Mexico qualified elector residing in the district. 

     Existing law allows the Public Education Department to suspend a school board. That has been done recently, including the Floyd board when it refused to follow COVID-19 safety restrictions. HB325 would allow PED to suspend individual members, but only after consulting with the elected Public Education Commission. PED analysis says that requirement renders this power virtually useless because the commission meets so infrequently.

     Law already requires board members to undergo five hours per year of training.

     HB325 expands the requirement and enumerates topics that must be covered. The list includes budgeting, public school finance, laws and regulations affecting schools, open meetings and open records, and other items that you might think should have been required long ago.

     Finally, HB325 goes high-tech, requiring school board meetings to be live-streamed, with recordings archived on the website for five years.

     This provision is very hip and 21st century, but overlooks a much more basic part of public transparency: Minutes. Written, published minutes, summarizing briefly, clearly and officially what the board did. Quick to read, as essential as ever, and nowhere to be found.

     For the public, video recordings of hours-long meetings are almost useless unless the person seeking information has plenty of time or knows exactly where to look. With written minutes, information can be found almost immediately.

     Minutes must be produced and approved, under the Open Meetings law, but there is no requirement to publish them. Few districts post board minutes online. I discovered this by hunting in vain on several school district websites.

      The New Mexico School Boards Association publishes an in-depth policy manual (300-plus pages) for school boards that includes a detailed, helpful description of how minutes are to be written. The manual is a model, which districts can choose to adopt – or not. Several of the largest districts seem not to have adopted it. Maybe they just did not post the manual.

     Section B-2100 of the manual says:

“The summary of minutes shall be filed with the Board Secretary and shall be a public record open to inspection of the public and a copy thereof shall be mailed to each and every legal newspaper published in the county for such use as such newspaper may see fit.”

     Mailed. A bit outdated, don’t you think?

     Being able to review the minutes is one way to check whether all that new training required by HB325 (if it passes) will improve the quality of boards’ decision-making. That’s our right as citizens. So next year let’s update the Open Meetings Law.

     Meanwhile, kudos to the Santa Fe school district for posting its minutes, which are comprehensive, well written, easy to find and only eight months behind. 

Contact Merilee Dannemann through www.triplespacedagain.com.