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F I S C A L I M P A C T R E P O R T
SPONSOR Lujan
DATE
TYPED 2/2/05
HB 490
SHORT TITLE Community Health Worker Training Center
SB
ANALYST Hanika-Ortiz
APPROPRIATION
Appropriation Contained Estimated Additional Impact Recurring
or Non-Rec
Fund
Affected
FY05
FY06
FY05
FY06
$300.0
Recurring General Fund
SOURCES OF INFORMATION
LFC Files
Responses Received From
Health Policy Commission (HPC)
Department of Health (DOH)
SUMMARY
Synopsis of Bill
House Bill 490 appropriates $300 thousand from the general fund for expenditure in FY06
through FY08 to the DOH to establish and maintain a community health worker regional training
center in southern New Mexico. Any unexpended or unencumbered balance remaining at the end
of FY08 shall revert to the general fund.
Significant Issues
The appropriation would provide funding to the DOH Border Health Office to establish and
maintain a regional training center to provide resources, technical assistance and computer liter-
acy training opportunities. Building space is available to conduct the training sessions.
SJM 76 report assesses the core competency training needs of community health workers
through the identification of particular skills and knowledge areas that include computer literacy
as one of the most requested training needs. The report notes that almost all community health
workers said they are interested in receiving more training with computer literacy, leadership,
English as a Second Language, employee rights, and public relations/media. Nearly 70 percent of
the surveyed workers identified basic computer literacy as an area of need. Nearly 80 percent of
pg_0002
House Bill 490 -- Page 2
respondents from southern New Mexico and the Mescalero Indian Reservation consider com-
puter literacy an essential skill for their jobs.
PERFORMANCE IMPLICATIONS
HB 490 is consistent with the DOH Strategic Plan in Program Area 9: Administration, Strategic
Direction: Achieve excellence and accountability in administration and service and Objective 3:
Increase the health workforce supply.
HB 490 is consistent in its support of the training needs of community health workers identified
in the SJM 76 Report on the Development of a Community Health Advocacy Program in New
Mexico 2003 directed by the DOH, and the study report on the Development of a Promotor/a
Training Program in Southern New Mexico: Report and Recommendations 2004 completed for
the Office of Border Health.
The DOH proposes to track the number of community health workers attending and completing
the coursework under the new training program as a performance measure.
FISCAL IMPLICATIONS
The appropriation of $300 thousand contained in this bill is a recurring expense to the general
fund.
The appropriation in HB 490 was not part of the agencies budget request reviewed by the LFC in
2004.
The HPC expects future appropriations will be needed to maintain the training center after 2008
for maintenance of resources, upgrading of computer technology and outreach.
ADMINISTRATIVE IMPLICATIONS
The Office of Border Health made a presentation to support the development of a regional train-
ing center to the members of the Interim Legislative Health & Human Services Committee on
September 9, 2004. HB 490 is proposed on behalf of the Interim Legislative Health and Human
Services Committee.
TECHNICAL ISSUES
Review of computer literacy training programs in New Mexico indicate that curriculum used by
community health worker programs was not available for this population.
OTHER SUBSTANTIVE ISSUES
The Border Epidemiology & Environmental Health Center at NMSU was assisted by the Office
of Border Health in capturing $5,000 from the National Libraries of Medicine to initiate a pilot
training course on computer literacy in Dona Aña County during Spring 2004. The Office of
Border Health in conjunction with Families & Youth, Inc. of Las Cruces initiated a second pilot
course in Luna County with $5,000 provided by the Office of Minority Health, U.S. Department
of Health & Human Services.
pg_0003
House Bill 490 -- Page 3
The HPC reports studies have shown:
•
Residents of rural areas often have a limited range of medical services available, resulting
in a large number of people going without basic primary, dental and mental health ser-
vices.
•
Hospital emergency rooms are often used to treat basic, non-emergent medical care by
the uninsured, underinsured, and low-income populations, which results in a financial
drain for hospitals and longer wait times for patients.
•
New immigrants, especially of illegal status, will be less likely to access the healthcare
system.
•
Disparities in the health care system occur when those being treated do not speak Eng-
lish, or are a minority, or have a disability, or who may be socially disadvantaged and do
not have access to a healthcare representative that can understand or help them.
Border Demographics (HPC Quick Facts 2004)
•
Population increased from 3.1 million in 1970 to 6.6 million in 2000 in the US border ar-
eas.
•
Nearly 25% of US border population is under the age of 15, compared to 21% nationally.
•
Infectious diseases, diabetes and female breast cancer have high rates in border health
populations.
The HPC reports on community health care alternatives:
•
States, including New Mexico, have implemented Community Health Workers and Pro-
motora Programs, which teach laypersons to conduct basic health care outreach in their
local communities. The Promotoras reach many of the uninsured, low income and im-
migrant populations who might otherwise not receive any health care services at all.
•
More than 300 community health workers provide services in NM, approximately 150 on
tribal lands; providing referrals, translating health information, imparting knowledge of
culture and language.
•
Educating families on basic family health techniques, nutrition and home first aid may
prevent unnecessary trips to emergency rooms.
•
Training community health workers in basic computer basic technology to enter simple
health care/medical record information will enhance the documentation process, supple-
ment knowledge to succeed in the workplace and, by establishing some type of training
accreditation, provide more value to the program and the feelings of success for partici-
pants.
ALTERNATIVES
None indicated.
WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL.
The HPC reports communities may suffer socioeconomic consequences of not being able to pro-
vide basic services and support.
pg_0004
House Bill 490 -- Page 4
POSSIBLE QUESTIONS
What support and supervision will the community health workers have in the field.
What building is being provided for training. Will childcare be offered.
AHO/yr