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SPONSOR: |
HCPAC |
DATE TYPED: |
02/08/02 |
HB |
CS/199/aHAFC |
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SHORT TITLE: |
Recruit Rural Area Dentists & Hygienists |
SB |
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ANALYST: |
Dunbar |
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APPROPRIATION
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Appropriation
Contained |
Estimated
Additional Impact |
Recurring or Non-Rec |
Fund Affected |
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FY02 |
FY03 |
FY02 |
FY03 |
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NFI |
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(Parenthesis
( ) Indicate Expenditure Decreases)
Department of Health (DOH)
General Services Department (GSD)
Health Policy Commission (HPC)
SUMMARY
Synopsis
of HAFC Amendment
The House Appropriations and Finance Committee
amendment deletes the appropriation and language pertaining to the appropriation.
Synopsis
of Original Bill
House Consumer & Public Affairs Committee Substitute for House Bill 199 appropriates $100.0 from the general fund to the DOH for expenditure in fiscal years 2003 and 2004 to develop and implement a New Mexico Health Service Corp (NMHSC) dentist and dental hygienist recruitment program to provide dental services in medically underserved areas (MUAs).
The Committee Substitute for House Bill 199 amends Section 24-1D-2 NMSA 1978 of the (NMHSC) Act to include dentists and dental hygienists as eligible health professionals.
It further redefines “practice site” as follows: “A practice site is a public health clinic or community-based non-profit primary care center that serves a state-designated eligible underserved community or population and that uses a sliding fee scale approved by the Department” .
The committee substitute adds language to expand the definition of a practice site for nurse-midwives and emergency medical personnel to include an appropriate health care facility or system that has a formal arrangement for the service approved by the DOH and that serves a state-designated eligible underserved community or population. The bill allows the DOH to recruit and retain health professionals focused on primary care in these shortage areas.
The committee substitute removes the proposed procurement exemptions provided in the original HB 199.
Significant
Issues
DOH
explains that there are approximately twenty-eight (28) dental HPSAs in the
state which meet one of the following criterion: (a) the area has a population
to full-time-equivalent dentist ratio of at least 5,000:1; or (b) the area has
a population to full-time-equivalent dentist ratio of less than 5,000:1, but
still greater than 4,000:1 with unusually high needs for dental services or insufficient
capacity of existing dental providers
The
new practice site definition would promote the utilization of nurse-midwives
and emergency medical personnel to practice in MUAs where they have not been
authorized previously under the NMHSC Act.
FISCAL IMPLICATIONS
The appropriation of
$100.0 contained in this bill is a recurring expense to the general fund. Any
unexpended or unencumbered balance remaining at the end of FY04 shall revert to
the general fund.
The
proposed appropriation of $100.0 could be used to develop and implement a NMHSC
dentist and dental hygienist recruitment program, but the amendments are needed
and appropriate even with no appropriation.
ADMINISTRATIVE IMPLICATIONS
The committee substitute would improve administration of the NMHSC Act.
TECHNICAL ISSUES
DOH suggests eliminating the appropriation, as it is not needed for recruitment and retention activities. Recruitment and retention activities are contractual services of the DOH and the Department reports that there are sufficient dollars dedicated to these activities as provided through the New Mexico Rural Primary Health Care Act (RPHCA).
OTHER SUBSTANTIVE ISSUES
The
shortage of dentists in New Mexico has long been recognized by several agencies
and working committees addressing workforce development. The findings of the DOH sponsored Health
Professional Workforce Conference held in June, 2001 highlighted the need for
improved oral health care for New Mexicans.
The New Mexico Health Policy Commission summarized the severity of the
lack of dental services in the 2001 Senate Joint Memorial 21 study. Most recently, under the state Primary Care
Cooperative Agreement, a request for an additional dental shortage designation
was made to the federal Department of Health & Human Services. It has been estimated that (109) one hundred
nine more dentists would be needed to achieve a 3,000:1 population to dentist
ratio in state-designated dental HPSAs.
An increased pool of dental hygienists would assist the state to begin
to meet the oral health care needs of New Mexicans.
The proposed new language in this committee substitute would have a positive impact on the health status of New Mexicans because nurse-midwives and emergency medical personnel would be allowed to practice in health care systems and/or facilities approved by the DOH so that they can serve a population-based need, consistent with the nature of their practice.
AMENDMENTS
Strike
out appropriation language (refer to technical issues above)
HPC suggests the following
amendment: page 6, section 4, line 12
reads “…to provide dental services in medically underserved areas….” Striking the words “medically underserved
areas” and adding “Dental Health Professional Shortage Areas” in its place may
be more appropriate.
[1]Begin typing on the * in replace mode. Do not add or delete spaces.