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

SPONSOR:	Saavedra		DATE TYPED:	02/06/02		HB	346
SHORT TITLE:		Immunizations for Preschoolers				SB
					ANALYST:		Esquibel

APPROPRIATION

Appropriation Contained

Estimated Additional Impact

Recurring

or Non-Rec

Fund

Affected

FY02

FY03

FY02

FY03

$107.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

Responses Received

Department of Health (DOH)

SUMMARY

Synopsis of Bill

House Bill 346 appropriates $107.0 from the general fund to DOH to immunize preschool children for hepatitis A as a condition of school enrollment.

Significant Issues

DOH reports:

Historically New Mexico has had high rates of Hepatitis A, which have been reduced dramatically as a result of a targeted vaccination strategy aimed at counties with high rates of Hepatitis A. During 2001, there were no cases of Hepatitis A among children 0-5 years of age.

In New Mexico, there is an existing mechanism by statute to determine school entry requirements. Section 24-5-1, NMSA 1978 authorizes the Public Health Division of the Department of Health, after consultation with the State Board of Education, to promulgate rules and regulations governing the immunization entry requirements of children attending public, private, home or parochial schools in the State. Following DOH public hearing held on January 30, 2001, the DOH regulations specify that Hepatitis A vaccine would be required for school entry in areas/counties targeted by

DOH’s Office of Epidemiology to include any area/county in which the three-year running average rate of Hepatitis A is at or above 20 cases per 100,000 people per year, or which has been determined by DOH’s Office of Epidemiology to have an elevated risk of Hepatitis, effective September 1, 2002. The most recent data from DOH’s Office of Epidemiology (1999-2000-2001 running averages) reports no county with a Hepatitis A rate at or above 20-cases/100,000 population.

DOH continues to recommend universal and routine Hepatitis A vaccine for all children, but not tied to school entry unless conditions arise as described above.

FISCAL IMPLICATIONS

The appropriation of $107.0 contained in this bill is a recurring expense to the general fund. Any unexpended or unencumbered balance remaining at the end of FY03 shall revert to the general fund.

HB2 contains $1,000.0 in other program revenue for the federal and state funded Vaccines for Children Program to be reimbursed by third-party payers when private physicians use government vaccines to immunize children for recommended vaccinations, including Hepatitis A.

ADMINISTRATIVE IMPLICATIONS

Implementation of the bill would require additional DOH administrative efforts to tie the appropriation to children receiving the Hepatitis A vaccine as a condition of school enrollment.

TECHNICAL ISSUES

DOH suggests deleting “a condition of school enrollment”.

OTHER SUBSTANTIVE ISSUES

DOH has concerns about tying conditions for school enrollment to an appropriation of funds for Hepatitis A vaccine. The national Advisory Committee on Immunization Practices (ACIP) does not require Hepatitis A vaccine as a school entry requirement. The targeted Hepatitis A vaccination strategy has been in place and successful since Hepatitis A vaccine became available in 1996. DOH does not believe that a condition of school enrollment is necessary to continue the success that the current targeted strategy has seen.

No children in New Mexico aged 0-5 years were reported with acute Hepatitis A disease in 2001. In fact, the State’s overall Hepatitis A rate in 2001 was 2.1 per 100,000.

The proposed funding would support Hepatitis A vaccine for an estimated 4,798 children.

RAE/ar