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F I S C A L I M P A C T R E P O R T
SPONSOR King
DATE TYPED 2/12/05
HB HJM 21/aHGUAC
SHORT TITLE Study Establishing Office Of Women’s Health
SB
ANALYST Hanika-Ortiz
APPROPRIATION
Appropriation Contained Estimated Additional Impact Recurring
or Non-Rec
Fund
Affected
FY05
FY06
FY05
FY06
$0.1
$0.1
Recurring
Duplicates SJM 30
SOURCES OF INFORMATION
LFC Files
Responses Received From
Corrections Department (CD)
NM Commission on the Status of Women
Human Services Department (HSD)
Children, Youth & Families Department (CYFD)
Department of Health (DOH)
Health Policy Commission (HPC)
Department of Indian Affairs (IAD)
SUMMARY
Synopsis of HGUAC Amendment
The House Government and Urban Affairs committee amendment replaces local health depart-
ments with the term regional local health offices at the DOH’s request to better reflect the cen-
tralized nature of NM’s state health department structure. Suggest adding the word “and” be-
tween “regional” and “local” to correct typo.
Synopsis of Original Bill
HJM 21 makes a request of The Commission on the Status of Women to create a task force to
conduct a feasibility study for an Office of Women’s Health for New Mexico. HJM 21 would
request the task force review methods of developing women’s health policy and service delivery
in the following focus areas:
pg_0002
House Joint Memorial 21/aHGUAC -- Page 2
1.
Developing a comprehensive framework for women’s health policy and programs re-
flecting current research and best practice.
2.
Facilitating communication between state departments and programs, local health de-
partments and community organizations.
3.
Supporting and coordinating activities of the Women’s Health Council that advises
the Governor and Secretary of Health on women’s issues.
4.
Identifying duplication or gaps in services and improve coordination to create a seam-
less delivery system.
5.
Providing information on women’s health resources to policy makers and the public.
6.
Providing administrative support for a New Mexico women’s health survey to guide
the decision-making about women’s health issues by public health professionals and
policymakers.
In addition to the Commission on the Status of Women, the task force would include representa-
tives from the DOH, HPC, CYFD, HSD, IAD, the Veterans’ Services Department, Women’s
Health Services, Inc., regional and local health offices and other women’s health and human ser-
vices advocacy groups. The task force will report its finding to the Legislative Health and Hu-
man Services (LHHS) Committee by October of 2005.
Significant Issues
The DOH and CYFD reports:
•
HJM 21 refers to a national state-by-state report card for women’s health. The report
graded NM as failing or unsatisfactory in 19 of 34 health indicators. Included in the
measured indicators are: women’s access to health care services; addressing wellness and
prevention; key causes of death, chronic health conditions, reproductive health, mental
health and violence against women; and living in a healthy community. The same report
care evaluates the performance of New Mexico as “meets policy” in only twenty-one of
the sixty-seven state policy indicators on women’s health.
•
HJM 21 calls for a study to establish an Office of Women’s Health in NM; 19 states, in-
cluding Texas, Arizona and Colorado, have offices to promote preventative and primary
health care services throughout the lifespan, and to address policy and service delivery is-
sues affecting women of all ages.
The HPC reports on the National Report Card (2004):
•
The nation as a whole met only two of the 27 benchmarks assessed.
•
The only benchmark met by all states was annual dental visits.
•
No state met a “satisfactory” grade. NM ranked 37, with an “unsatisfactory” grade.
•
Benchmarks missed by all the states were:
Health insurance
Eating 5 fruits and vegetables daily
High blood pressure
Diabetes
Life expectancy
Infant Mortality
pg_0003
House Joint Memorial 21/aHGUAC -- Page 3
Poverty
Wage Gap
New Mexico Did Well
•
Mammogram Screening (%) S- 69.6 compared to US rate 76.1
•
Coronary Heart Disease Death Rate* S- 121.1 compared to US rate 154.8
•
Breast Cancer Death Rate* S- 22.8 compared to US rate 26.5
•
High Blood Pressure (%) S- 20.2 compared to US rate 26.1
•
AIDS rate* S- 1.5 compared to US 9.1
NM Did Poorly
•
Colorectal Cancer Screening (%) F 43.1 compared to US 48.1
•
Lung Cancer Death Rate* U 29.0 compared to US 41.0
•
Diabetes (%) F 6.5 compared to US 6.4
* per 100,000
The same report gave NM a Fail grade for the percentage of women living in poverty
(18.1%) of which:
•
21% are Hispanic
•
14% are White Non-Hispanic
•
24% are Black
•
31% are American Indian/Alaskan Native
•
22% are ages 18-44
•
13% are ages 45-64
•
18% are 65 years or older
Other National and New Mexico Data
•
One in five women in the United States is uninsured.
•
Women are less likely to have employer based health insurance, partly due to part
time employment and type of employment.
•
Half of women diagnosed with breast cancer delay treatment 3 months to 8 years due
to lack of insurance coverage, no access to low fee or free mammograms, and long
waiting periods to be screened.
•
Nearly 51% of New Mexicans are female.
•
The median age for New Mexican women is 36.5.
•
46.4% of pregnant Native American women receive adequate prenatal care compared
to 57.4% of pregnant White women.
•
Teen birthrate was reduced almost 10% in 2004, but the teen birthrate of 62.3 (more
than 4,500) per 1,000 population in females ages 15-19 makes New Mexico the third
highest in the nation.
PERFORMANCE IMPLICATIONS
The task force will report its finding to the Legislative Health and Human Services (LHHS)
Committee by October of 2005.
The DOH reports HJM 21 supports the NM DOH Strategic Plan in the areas of prevention and
disease control, and access to health services for New Mexicans.
pg_0004
House Joint Memorial 21/aHGUAC -- Page 4
The IAD states HJM 21 is aligned with their mission to improve the quality of life for New Mex-
ico Indian citizens.
FISCAL IMPLICATIONS
The LFC considers this a recurring appropriation because once the study is completed; public
and private agencies and other community partnerships will be affected and will continue to be
in future years.
Agencies recognize they will incur costs associated with the memorial but agree to participate in
the task force with current staff and resources.
ADMINISTRATIVE IMPLICATIONS
Agencies report that due to the collaborative nature of the memorial, the additional staff, re-
sources and time commitment could be absorbed in the normal course of business. Agencies also
recognize the memorial proposes an extensive amount of work be done in a short period, and the
task force may need additional time to organize and fully meet their responsibilities.
CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP
Duplicates SJM 30
TECHNICAL ISSUES
The DOH suggests on page 4, line 13, the phrase “local health departments” be changed to “re-
gional and local health offices” to better reflect the centralized nature of NM’s state health de-
partment structure.
OTHER SUBSTANTIVE ISSUES
The IAD has the following comments:
•
American Indian women suffer significantly lower health status and disproportionate
rates of diseases compared with other Americans. There are various causes for the exist-
ing disparities in the health status of American Indian women, including the barriers that
inhibit access and the lack of education and outreach. Women’s health issues of concern
include cardiovascular disease, accidents, diabetes, and cancer. Associated social issues
include smoking, poverty, mental health, and family violence.
•
Increasing opportunities for community education on healthy lifestyles to delay or pre-
vent the onset of disease will yield long-term improvements in American Indian women’s
health. Research also shows that women have a major influence on the health of their
family and communities.
The DOH has the following comments:
•
The NM DOH and Women’s Health Inc., one of 12 centers designated as a “National
Community Center of Excellence in Women’s Health”, work with the federal Office on
Women’s Health (OWH), to address the disparities in access to health care for NM
pg_0005
House Joint Memorial 21/aHGUAC -- Page 5
women and girls, and supports culturally sensitive educational programs that encourage
personal responsibility for health and wellness. DOH has a series of media campaigns re-
garding preventative and primary care services which will support National Women’s
Health week coordinated by the federal OWH.
•
In 2004, the New Mexico Family Planning Program (FPP) conducted an assessment of
the need for low-cost women’s reproductive health clinical services within the state. The
assessment revealed the unmet need for 73,124 or 57.4% of New Mexico women. Al-
though nationally women have a longer life expectancy than men, health disparities con-
tinue to exist for women, particularly for cancer, diabetes, arthritis, osteoporosis, heart
disease and stroke.
•
There have been improvements in women’s health status indicators over time in NM.
Since 1990, the percentage of NM women aged 50-64 who have had a mammogram
within 2 years has risen significantly from 65% to 88%. There have been recent health
policy achievements in the areas of private insurance smoking cessation coverage and in-
creased excise tax on cigarettes. In 2004, 42% of New Mexicans were protected by local
clean indoor air policies, as compared to only 15% in 2002.
•
There are still many opportunities to develop and strengthen policies that would be ex-
pected to improve health status indicators for women and girls in NM. The Task Force to
study the proposed Office of Women’s Health may provide support to NM women of all
ages through the development of policy, coordination of resources, and improved access
to health care. Establishing a central point for the development of research, policy and
the coordination of services could reduce health disparities for NM women.
WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL.
The HPC reports New Mexican women may continue to suffer unnecessary high rates of morbid-
ity and mortality in otherwise preventable health conditions. Chronic diseases such as diabetes,
lung diseases and cardio vascular diseases may be avoided altogether with early education and
intervention, and access to prevention services and healthcare resources.
AHO/sb