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

SPONSOR Campos

DATE TYPED 01/27/05 HB

SHORT TITLE Increase Primary Care Clinic Capacity

SB 8

ANALYST Hanika-Ortiz

APPROPRIATION

Appropriation Contained Estimated Additional Impact Recurring

or Non-Rec

Fund

Affected

FY05

FY06

FY05

FY06

$1,200.0

General Fund

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

SUMMARY

Synopsis of Bill

Senate Bill 8 appropriates $1.2 million from the general fund to the Department of Health (DOH)

for the purpose of obtaining additional federal grant funds under the President’s Community

Health Center Initiative to increase the capacity of primary care clinics providing medical, dental

and behavioral health services in New Mexico.

Significant Issues

A network of community-based primary care centers providing basic services to more than

230,000 patients each year helps to meet the health care needs of underserved New Mexicans.

The Rural Primary Health Care Act (RPHCA) administered by the DOH provides financial sup-

port to more than 80 clinics in the network. The primary purpose of the RPHCA is to provide

awards ranging from $64,000 (single clinic site) to over $1,000,000 (multiple clinic sites) for

nonprofit community or tribal facilities that provide primary health care services to residents of a

health care underserved area. The majority of patients are either indigent or Medicaid program

participants. Indigent patients receive services according to sliding fee schedules based upon

their ability to pay. All programs must have policies and procedures’ assuring no one is denied

services because of the inability to pay. According to the Department of Health an additional

Senate Bill 8 -- Page 2

200,000 New Mexicans statewide could benefit from the services of new or expanded health

centers.

The President has established a Community Health Center Initiative for the nation aiming to

double the number of new or expanded community-based primary care centers nationwide by

2006. All new centers receiving this funding are required to provide both medical and dental

services to their patients. According to the Department of Health, primary care centers in New

Mexico have competed successfully for this funding over the last few years with new or ex-

panded centers in Silver City, Edgewood, Mora, Santa Fe, East Mesa (Dona Ana County), Fort

Sumner, Socorro and Alamogordo. In the current fiscal year federal applications are pending for

new or expanded centers in Bernalillo and Hobbs. In addition, there have been numerous sup-

plemental grants given to existing health centers to expand the comprehensiveness of their ser-

vices to include dental and basic behavioral health care. During the next year, it is anticipated

that at least 5 applications could be developed for new or expanded health centers in New Mex-

ico.

PERFORMANCE IMPLICATIONS

The DOH claim the appropriation in SB 8 supports the DOH Strategic Plan, Program Area 2:

Health Care Delivery – Public Health Division; Strategic Direction: Improve access to health

services in agency-funded primary care centers.

Client date could be collected for reporting on identified performance measures, to include the

best practice preventative health and treatment modalities specific for each population.

FISCAL IMPLICATIONS

The appropriation of $1.2 million contained in this bill is a recurring expense to the general fund.

Any unexpended or unencumbered balance remaining at the end of fiscal year 2006 shall revert

to the general fund.

The appropriation in SB 8 is not included in the executive budget recommendation.

ADMINISTRATIVE IMPLICATIONS

The DOH has stated that they can fulfill the provisions of this bill with existing resources.

CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP

SB 8 relates to the base budget appropriation for the DOH for services provided through the Ru-

ral Primary Health Care Act Program; the base budget is contained in the General Appropriation

Act.

TECHNICAL ISSUES

None identified.

Senate Bill 8 -- Page 3

OTHER SUBSTANTIVE ISSUES

According to the Governor’s Task Force on Health Care Coverage and Access Report, access to

care is the ability of people to obtain timely, cost-effective, affordable health care. Access to

healthcare is not merely a problem of not having a local physician. If the patient cannot pay for

the physician visit and has no coverage, there is no access to health care. If a physician does not

accept Medicaid patients, it limits access to health care for that population. According to the NM

Health Policy Commission, access to primary care services for low-income and uninsured people

has improved in recent years. However, access to specialty medical care, mental health care and

dental services continues to lag.

Twenty-eight New Mexico counties are considered Health Professional Shortage Areas and/or

medically underserved areas. Several medical professional recruitment and retention programs

are underway in New Mexico. These programs are: J-1 Visa Waiver Program for foreign gradu-

ates, New Mexico Health Service Corps, Specialty Extension Services Program, Locum Tenens

Program, Health Loan-for-Service Program, Health Professional Loan Repayment Program,

Western Interstate Commission on Higher Education, and the Baylor Dentistry Program.

ALTERNATIVES

None identified.

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL.

According to the Department of Health, if SB 8 is not enacted, the amount of additional federal

funding support from the Community Health Center Initiative could restrict expansion of exist-

ing or the growth of additional primary care clinics in rural areas.

POSSIBLE QUESTIONS

What are the types of different services and specialties provided by community health centers

and how many clients are served in each.

Since funding under the RPHCA may not be used for specialty care or home health, how is the

DOH addressing these needs in rural areas.

What kind of preventative care services and programs are being offered in the rural areas through

the community health centers.

AHO/yr