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F I S C A L I M P A C T R E P O R T
SPONSOR King
DATE TYPED 02/21/05 HB 786
SHORT TITLE UNM Special Perinatal Program
SB
ANALYST Woods
APPROPRIATION
Appropriation Contained Estimated Additional Impact Recurring
or Non-Rec
Fund
Affected
FY05
FY06
FY05
FY06
$319.0
Recurring General Fund
(Parenthesis ( ) Indicate Expenditure Decreases)
Relates to the appropriation for the University of New Mexico in the General Appropriations Act.
Duplicates SB107
SOURCES OF INFORMATION
LFC Files
Responses Received From
New Mexico Department of Health (DOH)
Health Policy Commission (HPC)
No Response Received From
New Mexico Commission ion Higher Education
SUMMARY
Synopsis of Bill
House Bill 786 – Making an Appropriation to the University of New Mexico to Expand the Spe-
cial Perinatal Program – appropriates $319,000 thousand from the general fund to University of
New Mexico Board of Regents to expand the Health Sciences Center’s perinatal program. Any
unexpended or unencumbered balance remaining at the end of FY06 shall revert to the general
fund.
pg_0002
House Bill 786 -- Page 2
Significant Issues
DOH indicates that high risk pregnancies require specialty medical-obstetric care as well as de-
livery at a specialty center to assure the best possible outcome for both mother and infant. An
estimated 30 percent of deliveries of very low birth weight infants who should be born at a spe-
cialty center are not. The University of New Mexico (UNM) Special Perinatal Outreach Pro-
gram has provided clinics for high risk obstetrical patients in New Mexico since 1982. The pro-
gram originally ran three outreach clinics staffed by UNM Fetal/Maternal Medicine faculty
members. This has expanded, mostly in the last two years, to twelve venues outside of Albu-
querque offering fifty-four clinics every month.
DOH adds that perinatal care saves between $2 and $3.60 in intensive care costs for newborns
for every perinatal dollar spent. The savings are considerably larger when the care is for high-
risk patients such as those seen in this program’s clinics. Further that, in FY04, the UNM Spe-
cial Perinatal Outreach Program saw 1,600 patients, at an average cost of $271 per high-risk pa-
tient. UNM estimates that 2.5 faculty FTE and 5 staff FTE are now needed to maintain the clin-
ics. The UNM Department of Obstetrics and Gynecology has been funding the expansion; how-
ever, UNM maintains it lacks the funds required to maintain the program.
A $319,000 increase in the UNM Health Science Center’s Special Perinatal Care Program was
included UNM’s FY06 funding request to the Commission on Higher Education (CHE). How-
ever, this increase was not included in the CHE’s FY06 budget recommendations that provided
the Perinatal Care Program a 3.7 percent funding increase, therein raising the CHE recommenda-
tion from $442,300in FY05 to $458,700 in FY06.
PERFORMANCE IMPLICATIONS
DOH notes that this legislation would support the department’s strategic plan, Program Area 1:
Prevention and Disease Control with the strategic direction of “Improving the Health of New
Mexicans.”
FISCAL IMPLICATIONS
The appropriation of $319,000 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 gen-
eral fund.
ADMINISTRATIVE IMPLICATIONS
UNM would retain oversight of this appropriation.
CONFLICT, DUPLICATION, COMPANIONSHIP OR RELATIONSHIP
Relates to the appropriation for the University of New Mexico in the General Appropriations Act.
Duplicates SB107 in that SB107 also seeks to $319,000 thousand from the general fund to Uni-
versity of New Mexico Board of Regents to expand the Health Sciences Center’s perinatal pro-
gram.
pg_0003
House Bill 786 -- Page 3
OTHER SUBSTANTIVE ISSUES
The UNM indicates the Specialized Perinatal Care Program is a statewide initiative to ensure that
complicated pregnancies can be addressed with the most up-to-date obstetrical technology and
expertise. The program was originally established in 1982 and is comprised of five general
components:
•
A woman’s inpatient unit, outpatient clinics, and substance abuse programs
•
Over twenty perinatal outreach clinics operated monthly in thirteen statewide venues
•
A maternal transport and obstetric referral system
•
Ultrasound, genetics and fetal therapy applications
•
Educational outreach and training progams
As general background to this issue, HPC offers the following observations with respect to New
Mexico’s high risk maternity patients:
•
New Mexico has one of the highest teen birth rates in the nation (17.3 percent).
•
Fifty percent of births are to single mothers.
•
High rates of congenital anomalies such as neural tube defects (7.9/10,000 popula-
tion) and cleft lip/palate (26.7/10,000 population).
•
Approximately 770-1300 infants were exposed to alcohol during the last trimester
of pregnancy (NM PRAMS Surveillance Report).
•
High prevalence of fetal alcohol syndrome compared to the national average.
•
Increased teen smoking rates.
•
High rate of partner abuse prior to or during pregnancy.
•
High prevalence of overweight mothers, gestational diabetes and preeclampsia,
particularly in Hispanic and Native American populations.
•
Approximately 8 of all babies delivered in New Mexico are born with low birth
weight.
•
Statistics show that infant and perinatal mortality rates have dropped significantly
since the Special Perinatal Outreach Program’s inception.
HPC additionally indicates that:
•
In 2002, New Mexico had the third highest teen birth rate in the nation.
•
Over 4,500 teens gave birth in 2002, which translates to 12 teen births in New
Mexico per day.
•
In New Mexico, 50 percent of the female teen population is Hispanic and repre-
pg_0004
House Bill 786 -- Page 4
sents 67 percent of teen births.
•
Approximately 4 in 10 teens become pregnant at least once.
•
Teen childbearing costs New Mexico taxpayers over a half a billion dollars per
year. About 40 percent of these costs could be avoided if teenagers delayed child-
birth until at least age 20.
•
In 2003, Medicaid paid for 49 percent of all births to teenage mothers in New
Mexico.
•
Babies of teen mothers are more likely to be born prematurely and are 50 percent
more likely to be of low birth weight.
BFW/lg