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

SPONSOR Altamirano

DATE TYPED 1/24/05

HB

SHORT TITLE Diabetes Education and Prevention Network

SB 82

ANALYST Collard

APPROPRIATION

Appropriation Contained Estimated Additional Impact Recurring

or Non-Rec

Fund

Affected

FY05

FY06

FY05

FY06

$825.0

Recurring General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Developmental Disabilities Planning Council (DDPC)

Department of Health (DOH)

SUMMARY

Synopsis of Bill

Senate Bill 82 appropriates $825 thousand from the general fund to the Department of Health for

the purpose of contracting with a statewide non-profit organization involved in diabetes educa-

tion and prevention to create a network of diabetes providers, including a toll-free telephone re-

source line and web site.

Significant Issues

The first governor's performance review suggested implementing a statewide 2-1-1 network in

New Mexico. According to the review, "2-1-1 is the national abbreviated dialing code for free

access to health and human services information for referrals, and could replace most of the ex-

isting toll-free 800 numbers maintained by New Mexico health and human services agencies."

The review placed DDPC in charge of the implementation.

DDPC notes the 2-1-1 telephone system being put into operation over time is a single point of

entry for information and referral. Calls to the 2-1-1 system concerning diabetes would be re-

Senate Bill 82 -- Page 2

ferred to the appropriate entity that provides diabetes information and services. Coordination

between or consolidation of the 2-1-1 system and diabetes phone system would be crucial.

DOH notes currently, 9 percent of the total population has the disease – over 85,000 people who

have been diagnosed with diabetes, (BRFSS 2003) and 37,000 who have the disease but do not yet

know it (NHANES 1988). In some Native American communities the rate is as high as 20 percent

(Albuquerque Area Indian Health Service 2004). Those with diabetes are at risk for limb amputa-

tions, blindness, end-stage kidney disease and cardiovascular disease (Centers for Disease Control

and Prevention 2004). Children are at increasing risk for Type-2 diabetes due to obesity, poor nutri-

tion, and lack of physical exercise.

The department further notes medical care and lost productivity for a person with diabetes aver-

ages over $13 thousand per year, totaling in excess of $1 billion a year for the state (Diabetes

Care study). With diabetes on the rise, especially among children, these costs are increasing. In

addition, over 50 percent of adults in New Mexico are overweight or obese (Behavioral Risk

Factor Surveillance System), putting them at risk for diabetes. However, with additional funds

supporting coordination of prevention services, money could be saved. A New England Journal

of Medicine study indicated that one case of diabetes out of 7 could be prevented in at-risk

populations through exercise and diet. This could save New Mexico an estimated $128 million

(based on 11,997 cases of diabetes prevented).

This bill would allow significant expansion of the Department’s diabetes education efforts. Con-

tinued funding of the program would then become an issue.

FISCAL IMPLICATIONS

The appropriation of $825 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 fund.

ADMINISTRATIVE IMPLICATIONS

DOH notes all funds expended through the department are subject to the NM Procurement Code

and indicates the proposed seventeen month timeline is not sufficient to contract for and imple-

ment activities. Additionally, under the current provisions of Senate Bill 82 no new diabetes

program staff will be hired and the bill does not include permissive language for coverage of

administrative costs.

OTHER SUBSTANTIVE ISSUES

DOH indicates this bill advances the primary recommendation of the August 2004 New Mexico

Diabetes Assessment, which was conducted by the Department of Health with input from a wide

range of organizations and individuals that make up New Mexico’s informal diabetes system.

Participants included representatives of Health Care Providers, Diabetes-Related Associations,

the Department of Health, Native American Programs, Universities and Colleges, the Commu-

nity (including People with Diabetes), the Insurance and Pharmaceutical Industries, the Border

Community, and the Legislature. The Assessment was funded by the U.S. Centers for Disease

Control and Prevention.

Senate Bill 82 -- Page 3

A principal finding of the assessment is that New Mexico has many diverse diabetes services and

programs; however, the workforce is overwhelmed, there are gaps in services, and little coordi-

nated statewide response to address the epidemic. An urgent need was identified for providers

and programs to work together in a more effective way.

The mechanism recommended to remedy this situation is the formation of a New Mexico Diabe-

tes Network, housed within an independent nonprofit organization, to facilitate comprehensive

collaboration in the areas of policy, information-sharing, program standards, data collection and

management, grant-writing, and legislative advocacy.

KBC/lg:yr