Fiscal impact reports (FIRs) are prepared by the Legislative Finance Committee (LFC) for standing finance

committees of the NM Legislature. The LFC does not assume responsibility for the accuracy of these reports

if they are used for other purposes.

Current FIRs (in HTML & Adobe PDF formats) are a vailable on the NM Legislative Website (legis.state.nm.us).

Adobe PDF versions include all attachments, whereas HTML versions may not. Previously issued FIRs and

attachments may be obtained from the LFC in Suite 101 of the State Capitol Building North.

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

SPONSOR Begaye

DATE TYPED 02/05/05 HB HJM 14

SHORT TITLE Increase Funding for Urban Indian Services

SB

ANALYST Weber

APPROPRIATION

Appropriation Contained Estimated Additional Impact Recurring

or Non-Rec

Fund

Affected

FY05

FY06

FY05

FY06

NFI

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Human Services Department

Department of health

Indian affairs Department

SUMMARY

Synopsis of Bill

House Joint Memorial 14 resolves that the New Mexico congressional delegation be requested to

urge the U.S. Congress to adequately fund the Indian Health Service to ensure that the urban In-

dian population of New Mexico is treated for accidents and persistent health problems.

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-

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,

House Joint Memorial 14 -- Page 2

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.

MW/rs