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

SPONSOR Komadina

DATE TYPED 3/10/05

HB

SHORT TITLE New Mexico Telehealth Commission Act

SB 473/aSPAC/aHGUAC

ANALYST Hanika-Ortiz

APPROPRIATION

Appropriation Contained Estimated Additional Impact Recurring

or Non-Rec

Fund

Affected

FY05

FY06

FY05

FY06

$50.0 - $100.0 Recurring

Various

SOURCES OF INFORMATION

LFC Files

Responses Received From

Health Policy Commission (HPC)

Department of Health (DOH)

Children, Youth & Families Department (CYFD)

Aging and Long-Term Services Department (ALTSD)

Public Education Department (PED)

Corrections Department (CD)

Developmental Disabilities Planning Council (DDPC)

Department of Indian Affairs (IAD)

Human Services Department (HSD)

SUMMARY

Synopsis of HGUAC Amendment

The House Government and Urban Affairs Committee amendment also requires one-third of the

Telehealth Commission members to be from rural areas, but positions the new language differ-

ently than the SPAC amendment but with the same intent.

Synopsis of SPAC Amendment

The Senate Public Affairs Committee amendment requires one-third of the Telehealth Commis-

sion members to be from rural areas.

Senate Bill 473/aSPAC/aHGUAC-- Page 2

Significant Issues

The Senate Public Affairs Committee amendment is unclear as to what are the determining fac-

tors for an area to be called “rural”.

Synopsis of Original Bill

Senate Bill 473 creates a New Mexico Telehealth Commission administratively attached to the

DOH, working in conjunction with the HPC. The purpose of the Commission is to encourage a

single, coordinated statewide effort to create a telehealth system that provides and supports

health care delivery, diagnosis, consultation, treatment, transfer of medical data and education

where the patient and the health care provider are separated by distance, or where there are mul-

tiple health care providers involved in patient care, education or other professional activities.

Significant Issues

Telehealth is the use of computer technology connected by high-speed or wireless communica-

tion to access health care providers, communicate diagnostic information and find best practice

advice and training. The videoconferencing facilitates patient-to-physician or physician-to-

physician consultation and provides education via videoconferencing. Clients have easier access

to providers, and providers have easier access to colleagues for collaboration. Telehealth will

help with recruitment efforts to attract and retain health care providers in rural areas.

The Telehealth Commission will be composed of state agencies, health care professionals, tele-

health technology experts, the business community, healthcare insurance providers, the tribes

and state legislators who will be appointed by the Governor. The Commission will be given re-

sponsibility to identify how telehealth can increase access, identify barriers to telehealth imple-

mentation, inventory the state’s telehealth assets, coordinate public and private telehealth initia-

tives, establish subcommittees to fulfill its purpose, identify actions to increase collaborative ef-

forts, develop and disseminate telehealth standards, review and comment on initiatives, meet

quarterly and report annually to the governor.

The IAD notes that Indian nations, tribes and pueblos frequently experience barriers to delivering

health care to tribal members and encourages the Commission to bridge the large gaps in geog-

raphy and culture that impede tribal communities’ access to necessary health care.

The DDPC notes that by implementing a telehealth system, the expertise of health personnel fa-

miliar with the needs of persons with developmental disabilities can be maximized to the benefit

of not only patients but medical providers across the state.

PERFORMANCE IMPLICATIONS

Agencies report this initiative is part of what may be needed to assist the School-Based Health

Centers initiative become a reality and ties to the Invest New Mexico initiative.

Agencies fully support initiative and believe it will help meet performance measures to increase

access and improve health outcomes. IAD would like the commission to consider linking with

the 22 New Mexico tribes, IHS, tribal colleges, and other tribal health providers to coordinate

and expand the telehealth telecommunications capacity of the tribes.

Senate Bill 473/aSPAC/aHGUAC-- Page 3

FISCAL IMPLICATIONS

There will be additional costs to agencies for staff time and travel, research, technical assistance,

subcommittee participation, development of policies, quarterly and annual reports for participa-

tion in the Telehealth Commission.

The cost benefits of telemedicine may accrue to the payers. A telemedicine program can target

patients with chronic diseases like diabetes and congestive heart failure. Regular monitoring can

head off a crisis before it results in an emergency room visit or a hospital stay. Also, if hospitals

have a telemedicine hookup, patients can be kept in the outlying hospital that otherwise might be

transferred avoiding the risk and cost of transport.

The HPC reports in theory, people get earlier care so it can reduce the cost, but this has not been

proven. It is possible that it may even increase utilization of services via better access with a re-

sulting cost increase.

ADMINISTRATIVE IMPLICATIONS

Agencies report they will assist in providing data, research, technical assistance and staff time to

assist the Commission in its mission.

CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP

The Telehealth Act passed into law in 2004 allows the framework whereby health care providers

can use telehealth for New Mexico citizens when it is impractical for patients to receive health

care face-to-face.

Duplicates HB 536

TECHNICAL ISSUES

None indicated

OTHER SUBSTANTIVE ISSUES

The HPC has the following comment:

This legislation is part of Governor Bill Richardson’s support of Telehealth technology to give

rural New Mexico communities access to state-of-the-art medical diagnosis and consultation. A

key aspect of the bill is the inclusion of the General Services Department and telecommunication

entities within New Mexico as part of the Commission.

The New Mexico Telehealth Alliance indicates there are currently six Telehealth interactive

video sites with two additional sites pending. They are located in Las Vegas, Santa Fe, Gallup,

Bernalillo, Albuquerque, Roswell, Lordsburg and Las Cruces. Additionally, there are 13 video-

phone sites, seven DOH interactive video sites, six CD sites and 14 distance education interac-

tive video sites related to telemedicine. Some of the services provided include teleradiology and

mental health. Consultations in dermatology, gastroenterology, pediatric pulmonary and diabetes

endocrinology and fluoroscopy have also been provided.

Senate Bill 473/aSPAC/aHGUAC-- Page 4

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL.

The HPC reports access to care for New Mexicans in rural and underserved areas may not im-

prove. Providers of health care may not have access to medical consults and the insights of their

colleagues. A multiplicity of information systems that may not interface would continue to frus-

trate medical care professionals.

AHO/sb:yr