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F I S C A L I M P A C T R E P O R T

SPONSOR Bandy

ORIGINAL DATE

LAST UPDATED

02/19/07

HB 1035

SHORT TITLE Northwest NM Preventative Health Programs

SB

ANALYST Geisler

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY07

FY08

$250.0

Recurring

General

(Parenthesis ( ) Indicate Expenditure Decreases)

Relates to: SB 916

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

SUMMARY

Synopsis of Bill

House Bill 1035 would appropriate $250,000 from the general fund to the Department of Health

(DOH) for expenditure in Fiscal Year (FY) 2008 for a preventive health pilot program in rural

areas of northwest New Mexico that works to identify and improve the health of persons who

suffer from diabetes, heart disease, obesity or other preventable health conditions. Any

unexpended balance remaining at the end of fiscal year 2008 shall revert to the general fund.

FISCAL IMPLICATIONS

DOH notes that HB 1035 is not part of the DOH executive budget request. Both the executive

and Legislative recommendations contain $1 million from Tobacco Settlement Funds for

diabetes prevention and treatment. Of this amount, almost $700,000 is used to support contract

services and more than $150,000 is used to purchase medical supplies.

SIGNIFICANT ISSUES

The economic burden of chronic diseases related to overweight and obesity is significant. NM

spends an estimated $324 million annually on direct adult medical expenditures (preventive,

House Bill 1035 – Page

2

diagnostic and treatment services) that can be attributed to obesity. Of this, $51 million is spent

within the Medicare population and $84 million is spent within the Medicaid population

(Finkelstein et al., 2004). The business sector also bears significant costs through lost work time,

decreased productivity and health benefit costs. Although these and other indirect costs of

obesity and overweight have not been measured in New Mexico, a national study shows them to

be nearly as high as direct medical costs (Wolf, 1998). Approximately 1 in 11 adults, or 130,000

New Mexicans have diabetes (Behavioral Risk Factor Surveillance System [BRFSS] 2004 and

National Health and Nutrition Examination Survey [NHANES]). In 2003, Cibola, McKinley and

San Juan counties had 17,440 adults with diabetes. Those with diabetes are at risk for limb

amputations, blindness, end-stage kidney disease and cardiovascular disease (Centers for Disease

Control and Prevention 2004). Children are at an increasing risk for type 2 diabetes due to

obesity, poor nutrition, and lack of physical exercise. Medical care and lost productivity for a

person with diabetes averages over $13,000 per year, totaling in excess of $1 billion a year for

the state (Diabetes Care study).

With diabetes on the rise, especially among children, these costs are increasing. Over 50% of

adults in New Mexico are overweight or obese (BRFSS), putting them at risk for diabetes. A

New England Journal of Medicine study indicated that one out of seven cases of diabetes could

be prevented in at-risk populations through exercise and diet. This could potentially save NM an

estimated $128 million every 3 years (based on 11,997 cases of diabetes prevented). Heart

disease and stroke continue to be two of the leading causes of death and disability in NM. In

2005, more New Mexicans (3,376) died from heart disease than any other cause, accounting for

22.7% of all deaths; stroke was the fifth leading cause of death, responsible for 4.2% of mortality

(625 deaths). Heart disease and stroke caused the greatest number of deaths in New Mexicans

ages 65 years and older. Heart disease was also the second leading cause of death in those 45 to

64 years old and the fourth leading cause in those 25-44 years old, representing an unfortunate

number of years of productive life lost (NMDOH, 2006).

RELATIONSHIP

HB 1035 relates to SB 916 which would appropriate $160,000 for the same purposes.

OTHER SUBSTANTIVE ISSUES

Adults living in New Mexico’s Northwest region have statistically higher rates of obesity

(23.4%) than those living in Bernalillo County 17.5% (BRFSS 2003). Hispanic (62.5%) and

Native American (73.3%) adults have statistically higher rates of overweight and obesity than do

White, non-Hispanic adults (51.3%) in New Mexico. The Northwest Counties of Cibola,

McKinley and San Juan have a larger percentage of Hispanics and Native America than non-

Hispanic Whites. American Indians are about 3 times more likely to have diagnosed diabetes

than non-Hispanic Whites. American Indians are approximately 3.5 times more likely to have a

diabetes-related amputation than non-Hispanic Whites (Health Policy Commission, NM Hospital

Inpatient Discharge Data, 2002; Santa Fe Indian Hospital data, 2001). NM Hispanics and Native

Americans have higher rates of heart disease and risks of stroke are elevated, particularly for NM

Hispanic women. Rural residents have limited access to local health resources and often must

travel long distances for specialized health care. Cibola, McKinley and San Juan Counties are

medically underserved.

GG/csd