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

SPONSOR Harrison

DATE TYPED 03/03/05 HB 936

SHORT TITLE Northwest New Mexico Diabetes Education

SB

ANALYST

APPROPRIATION

Appropriation Contained Estimated Additional Impact Recurring

or Non-Rec

Fund

Affected

FY05

FY06

FY05

FY06

$200.0

Recurring General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Relates to SB 82, HB 339 and SB 355

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Indian Affairs (DIA)

Human Services Department (HSD)

Department of Health (DOH)

SUMMARY

Synopsis of Bill

House Bill 936 appropriates $200 thousand from the general fund to the Department of Indian

Affairs for the purpose of expansion and implementation of a diabetes education program in

northwest New Mexico.

Significant Issues

The Department of Health notes.

Diabetes is the sixth leading cause of death in New Mexico (Office of NM Vital Records and

Health Statistics, NMVRHS, 2002) and is a growing health care problem for New Mexicans, es-

pecially among Hispanics and American Indians. Hispanics and American Indians are 2 to 3

times more likely to develop diabetes than non-Hispanic whites (Behavioral Risk Factor Surveil-

lance System, BRFSS, 2002).

House Bill 936 -- Page 2

Diabetes education interventions exist in the Northwestern part of the state. There are providers

and supporters of these services, including DOH, tribal governments, schools, the University of

New Mexico, Indian Health Services, and other public and private health care organizations and

clinical sites.

In August 2004, the New Mexico Diabetes Assessment was conducted by the Department of

Health with input from a wide range of organizations and individuals. A principal finding of the

Assessment is that New Mexico has many diverse diabetes services and programs; however,

there are gaps in services, and a need for more coordinated statewide response to address this

disease. A need was identified for providers and programs to work together in a coordinated

way.

The Department of Indian Affairs echoes.

Numerous health reports indicate Natives Americans have the highest prevalence of Type 2 dia-

betes in the world. Diabetes is no longer a disease of older people, but is being diagnosed at

young ages, and is rising to crisis proportions in NM Indian communities. In fact, the Centers

for Disease Control (2002) reports that the prevalence of diabetes among Native Americans is

more than twice that for all adults in the U.S. The Indian Health Service reports that Native

Americans experience 210% higher mortality rates from diabetes compared to other Americans.

A Department of Health 2004 Assessment of the New Mexico Diabetes System found that one in

eleven New Mexicans (8.9% of the total population) has diabetes -- approximately 121,000

adults and 2000 children. Native Americans are about three times more likely to have diabetes

than white people; Hispanic and African Americans, about twice as likely. Differences in risk

among different populations in New Mexico are reflected at the county level. The hardest hit

counties, with over 10% prevalence of diagnosed diabetes are Cibola, Guadalupe, Mora,

McKinley, Rio Arriba and San Miguel . These are also among the lowest income counties in the

State.

A 2003 Centers for Disease Control study of 21 Native American communities found that ap-

proximately half of the adult population in some tribes have diabetes. It was reported that the

epidemic of obesity also is a relatively recent phenomenon and is believed to contribute to the

rising prevalence of diabetes, hypertension, and heart disease. Given the high burden of diabetes

complications (e.g., eye and kidney disease, cardiovascular disease, and lower extremity amputa-

tion) among Native Americans, it was recommended that culturally sensitive primary prevention

strategies to reduce diabetes risk factors and disease burden in Native American communities be

developed and implemented.

It can be inferred that HB 936 would address the high proportion of diabetes among Native

Americans residing in northwest NM, i.e. McKinley County and neighboring areas.

FISCAL IMPLICATIONS

The appropriation of $200 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.

MW/yr