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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 1/24/05

HB

SHORT TITLE Pharmacy Services in Primary Care Clinics

SB 11

ANALYST Collard

APPROPRIATION

Appropriation Contained Estimated Additional Impact Recurring

or Non-Rec

Fund

Affected

FY05

FY06

FY05

FY06

$1,200.0

Recurring General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Relates to SB 8

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

SUMMARY

Synopsis of Bill

Senate Bill 11 appropriates $1.2 million from the general fund to the Department of Health for

the purpose of increasing the number of pharmacy technicians and services available in primary

health care clinics, pursuant to the Rural Primary Health Care Act.

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 FY06 shall revert to the gen-

eral fund.

ADMINISTRATIVE IMPLICATIONS

DOH notes pharmacy services would have to be clarified in the request for proposals and scope

of work for contracts to distribute the funds proposed in the bill and the additional funding would

require additional procurement, contracting and monitoring activities to existing staff workloads.

Senate Bill 11 -- Page 2

RELATIONSHIP

Senate Bill 11 relates to Senate Bill 8 in that they are both expanding primary health care clinic

capacity.

OTHER SUBSTANTIVE ISSUES

According to DOH, the needs of underserved New Mexicans are met, in part, by a network of

community-based primary care centers. This network provides basic services to more than

230,000 patients each year. The state or federal RPHCA Program, administered by the DOH,

provides financial support to more than 75 clinics in the network. The majority of patients at

community-based primary care centers are either indigent or Medicaid program participants. In-

digent patients receive services according to sliding fee schedules, based upon their ability to

pay. It is estimated that an additional 200,000 New Mexicans statewide could benefit from the

services of new or expanded health centers.

Despite efforts over the years, there are still gaps in access to health care services for many New

Mexicans who reside in underserved areas of the state. The federal government has designated

all or part of 29 New Mexico counties as Health Professional Shortage Areas for Dental, Medical

or Mental Health.

Pharmacy professionals are trained to perform expanded roles and duties that are in demand by

many diverse organizations. Pharmacy technicians are also trained and certified to assist phar-

macists in their duties and state law requires that they be supervised by a licensed pharmacist, so

it would be necessary to include pharmacists. DOH notes it has been difficult for primary care

centers to compete with larger cities, chain pharmacies, hospitals and other health care organiza-

tions for these professionals. Other factors include many similar to those that have been identi-

fied for physicians and other health care professionals including geographic location, salaries and

benefits. Patients seen at primary health care centers have not often had the opportunity to ex-

perience the full benefits of pharmaceutical care services. Consulting with patients about the use

of their prescription drugs in a culturally appropriate manner is critical to discovering health be-

liefs and practices that have an impact on compliance with the prescribed health plan and overall

outcomes. DOH indicates, with the appropriation proposed in the bill, centers might be able to

offer services that will enhance the care they provide.

DOH notes nationally, the President has established a Community Health Center Initiative aim-

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

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

dental services to their patients. Primary care centers in New Mexico have competed successfully

for this funding over the last few years. New or expanded centers in Silver City, Edgewood,

Mora, Santa Fe, East Mesa (Dona Ana County), Fort Sumner, Socorro and Alamogordo have all

benefited from this initiative. In addition, there have been numerous supplemental grants given

to existing health centers to expand the comprehensiveness of their services to include dental and

basic behavioral health care. During the next 2 years it is anticipated that at least 5-10 applica-

tions could be developed for new or expanded health centers in New Mexico. This would permit

a significant expansion of New Mexico’s primary health care safety net.

KBC/yr/njw