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

SPONSOR:	Feldman		DATE TYPED:	2/5/02		HB
SHORT TITLE:		Value of Community Health Workers Study				SB	SJM 53
					ANALYST:		Dunbar

APPROPRIATION

Appropriation Contained		Estimated Additional Impact		Recurring or Non-Rec	Fund Affected
FY02	FY03	FY02	FY03
		$0.1	See Narrative	Non-Recurring	General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Duplicates HJM 82

SOURCES OF INFORMATION

Responses Received From

Department of Health (DOH)

Health Policy Commission (HPC)

SUMMARY

Synopsis of Bill

Senate Joint Memorial 53 is introduced for the Legislative Health and Human Services Committee and recommends that a study be completed by the New Mexico Health Policy Commission to study the value of Community Health Workers (CHW) to the health care delivery system and their impact on public health outcomes, economic development and access to health care.

SJM 53 would direct the Health Policy Commission to lead a task force, to include representatives from Department of Health, Human Services Department, Statewide Association of Community Health Workers, health care providers, educators and other organizations as appropriate to study the value of community health workers and report to the Interim Legislative Health and Human Services Committee in October of 2002.

Significant Issues

New Mexico has been referred to as both a “rural” (fewer than 100 people per square mile in a county) and a “frontier” (6-10 or fewer people per square mile in a county) State, making the provision of health care services challenging. In addition, because New Mexico is challenged by economic development and health disparities, the State would benefit from linkage by community members with needed health services and outreach educators.

In New Mexico, community health workers work in various paid and volunteer positions are known as lay health advocates, promotoras, outreach educators, doulas, community health representatives, peer health promoters and community outreach workers.

DOH reports that study conducted by the University of Arizona found that the role of community health workers effectively bridges cultural differences between communities and health and social service systems by providing culturally appropriate health education and information, ensuring that people get the services they need, advocating for individual and community needs and providing direct services such as Medicaid application screening and transportation

FISCAL IMPLICATIONS

SJM 53 does not appropriate any funding to support the study. The recommended HPC budget in the HAFC CS/HB2 proposes $1.397 million for FY2003. This represents a reduction of approximately $428,000 from FY2002. In addition, SB 379 proposes to take an additional $400,000 from the HPC budget to support a Medicaid Reform Committee with the Legislative Council Service. The two proposals represent a 45% reduction in funds. If these recommendations are enacted, the Commission will not have sufficient funds to conduct its statutory requirements and additional Memorial studies.

ADMINISTRATIVE IMPLICATIONS

The activities proposed by SJM 53 requires HPC to assist the Task Force in its deliberations, conduct research and to prepare the findings and recommendations. While the proposed study is within the scope and mission of the Health Policy Commission, HPC acknowledges that the proposed budget reductions identified in the Fiscal Implications section will likely result in the need for the HPC to reduce staff by up to 9 FTEs. The remaining staff will need to prioritize their time to meet statutorily mandated requirements. Therefore, less time will be available to devote to studies such as the one proposed by SJM 53.

DUPLICATION/CONFLICTS

Duplicates HJM 82

Conflicts with SB 379

TECHNICAL ISSUES

Include Tribal entities and Health Maintenance Organizations in the list of participants in the study.

OTHER SUBSTANTIVE ISSUES

The Bernalillo County Community Health Workers Consortium, a member of the New Mexico Community Health Workers Association, supports SJM 53. The NM Community Health Workers Association is a statewide association of community health workers committed to addressing the training needs of community health workers, increasing and improving access to health care services in New Mexico, and identifying and increasing employment opportunities for CHW. The Association was loosely formed in 1993 and in 1995 received a 3-year grant from Robert Wood Johnson and the Kaiser Foundation, which served to formalize the organization. New Mexico is one of the first states to form a statewide Association of Community Health Workers to address training needs.

The American Public Health Association (2001) has issued a policy statement “Recognition and Support for Community Health Workers’ Contributions to Meeting our Nation’s Health Care Needs”, which also recognizes the strengths CHWs bring to the health care delivery system and the challenges these workers encounter because of a lack of standardized roles, definitions, funding streams, relationships to other health care professionals, policies and training.

HPC reports that Texas and Mississippi have mandated State certification of community health workers, and other states are reviewing certification requirements.

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

SOURCES OF INFORMATION

Responses Received From

ADMINISTRATIVE IMPLICATIONS

BD/njw