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

SPONSOR Begaye

DATE TYPED 02/09/05 HB 342

SHORT TITLE Urban Indian Health Service Solution Study

SB

ANALYST Weber

APPROPRIATION

Appropriation Contained Estimated Additional Impact Recurring

or Non-Rec

Fund

Affected

FY05

FY06

FY05

FY06

$50.0

Recurring General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Human Services Department (HSD)

Health Policy Commission((HPPC)

Department of Health (DOH)

Department of Indian Affairs (DIA)

SUMMARY

Synopsis of Bill

Senate Bill 342 appropriates $50 thousand from the general fund to the Indian Affairs Depart-

ment for a study and report on strategies for solving the long-range problem of identifying and

generating adequate funding of urban Indian health services. The department is to contract with

an organization capable of integrating the input of all tribal entities currently involved in the ad-

ministration of the Indian health services in New Mexico’ urban areas. A report is to be deliv-

ered to the Indian Affairs Committee by October 2005. The bill contains an emergency clause.

Significant Issues

The Indian Affairs Department notes.

Currently, the Albuquerque Indian Health Center faces a budget deficit as a result of numerous

factors including the general under-funding of the Indian Health Service. A federal appropria-

House Bill 342 -- Page 2

tion of $5 million will help the Albuquerque Indian Center to maintain and provide an adequate

level of health care services to the Native American user population.

According to the 2000 U.S. Census, over 10% of New Mexico’s population is American Indian.

The state’s urban Indian population lives predominately in the Albuquerque metropolitan area,

which makes Albuquerque the 7

th

in the nation for largest American Indian and Alaska Native

population. The Albuquerque Indian Health Center serves a majority of this urban Indian popu-

lation. The lack of federal funding to the Albuquerque Indian Health Center will result in urban

Indians having to seek alternative health care resources and significantly impacting the state,

county, Tribal and local private and public health care systems and resources.

Human Services adds.

Albuquerque Indian Hospital (AIH), part of the IHS system, has recently experienced financial

difficulties. Several New Mexico Pueblos implementing Public Law 93-638 contracts removed

their portion of AIH’s funding in order to deliver health care services locally. AIH serves a large

number of urban Native Americans, many of whom are not eligible for Medicaid. For example,

low-income or working poor adults without children may not have commercial health care cov-

erage, but also would not be eligible for Medicaid. Additionally, AIH lost their inpatient hospital

certification and are now billing Medicaid only for outpatient and pharmacy services.

Medicaid makes significant payments on behalf of eligible Native Americans to the Indian

Health Service with roughly $63 million projected for FY05.

The Department of Health echoes the above.

The Indian Self-Determination and Education Assistance Act, Public Law (P.L.) 93-638, permits

local tribes and pueblos to take their share of funds out of the Albuquerque service unit. As a

result, the Albuquerque Indian Health Center (AIHC - previously known as the Albuquerque In-

dian Hospital) is experiencing further reductions in funding and is planning to close its urgent

care center in February 2005. Estimates are that from 17,000 to 40,000 urban Indians will be

impacted by this closure.

Urban Indians will have to seek care at other health agencies, which may limit access to cultur-

ally appropriate care such as: attention to cultural beliefs, addressing of linguistic barriers, and

building trust.

FISCAL IMPLICATIONS

The appropriation of $50 thousand contained in this bill is a recurring expense to the general

fund. Any unexpended or unencumbered balance remaining at the end of FY06 shall revert to

the general fund.

MW/njw