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

SPONSOR Sanchez, M.

DATE TYPED 2/14/95

HB

SHORT TITLE Improve Stroke Patient Treatment Outcomes

SB 513

ANALYST Hanika-Ortiz

APPROPRIATION

Appropriation Contained Estimated Additional Impact Recurring

or Non-Rec

Fund

Affected

FY05

FY06

FY05

FY06

$41.0

Recurring

GF

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

Aging and Long-Term Services Department (ALTSD)

SUMMARY

Synopsis of Bill

SB 513 appropriates $41 thousand from the general fund to the DOH for four hospital-based

primary stroke centers to provide rapid stroke treatment; develop emergency treatment protocols

and continuing education requirements for state emergency providers; and develop a stroke reg-

istry.

Significant Issues

SB 513 relates to recommendations made by the Stroke Task Force, created as a result of SJM 31

passed by the 2003 New Mexico Legislative Session. The Stroke Task Force resulted in the part-

nership of the DOH and the American Heart Association/American Stroke Association in exam-

ining stroke prevention and treatment in New Mexico.

Two New Mexicans die every day from stroke and there are an estimated eight stroke survivors

every day. Stroke is the leading cause of long-term disability in New Mexico and nationwide. It

is the 3

rd

most common fatal disease in New Mexico

A system of rapid, effective stroke treatment does not exist in New Mexico. Even when patients

are transported quickly, 68% of New Mexico hospitals do not have the resources, trained staff or

Senate Bill 513-- Page 2

protocol to begin quick treatment. When stroke victims receive appropriate treatment, such as a

clot-dissolving drug within three hours, patients are 30% less likely to have permanent disability.

Development of four hospital-based primary stroke centers in hospitals would provide support

for the creation and development of acute stroke teams, stroke units, written protocols, and an

integrated emergency response system. A standard protocol for EMS treatment and transport of a

stroke patient would be incorporated into the training and education curricula as an update every

two years during licensure renewal.

PERFORMANCE IMPLICATIONS

Meets DOH performance objectives of preventing and controlling chronic disease and improving

the state’s response to health emergencies.

FISCAL IMPLICATIONS

There will be administrative and direct service costs for continuing education requirement for

emergency medical service providers.

Two New Mexicans die every day from stroke and there are an estimated 8 stroke survivors

every day. In 2002, an estimated $65 million was spent on hospital stroke care in New Mexico.

In 2004, an estimated $53 billion was spent on the direct and indirect costs of stroke in the U.S.

DOH reports the number of stroke victims is expected to double in the next 20 years.

Funding for this bill is not part of the Governor’s budget request.

The appropriation of $41 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.

The LF considers this a recurring appropriation because once the program is started; the expecta-

tion will be that it continues.

CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP

Relates to SB 513 that appropriates $4 thousand to the DOH for a computer and software for a

stroke registry, also includes a $6 thousand allocation for the development of a stroke registry.

Relates to SB 227 that appropriates $105 to establish statewide hospital stroke centers, stroke

treatment protocol and a stroke registry.

TECHNICAL ISSUES

The bill is unclear as to whether the continuing education requirement for “emergency medical

personnel” would be a requirement for re-licensure, or whether the individual, hospital or DOH

would incur the cost of training.

SB 513 offers no definition of “emergency medical service providers” and could mean anyone

from ambulance attendants to physicians. Each has their own licensing requirements and license

Senate Bill 513-- Page 3

renewals are at different times throughout the year. Each discipline has their own licensing body

and requirements for renewal and they would need to be consulted before creating any additional

requirements for licensure. Recommend deleting “during the renewal of their licenses” on page

2, line 3; placing a period after the word “providers”.

OTHER SUBSTANTIVE ISSUES

Stroke risk factors may be identified early and related behaviors modified, such as hypertension,

heart disease, diabetes, and cigarette smoking. Early recognition of warning signs would allow

swift transport and treatment at a stroke center, mitigating the long-term impact of stroke.

New Mexican Hispanics and Native Americans are disproportionately affected by stroke when

compared to the U.S. rate for the same populations: NM Hispanics 106/100,000 vs. U.S. Hispan-

ics 79/100,000; NM Native Americans 85/100,000 vs. U.S. Native Americans 79/100,000.

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL.

Emergency personnel may not have all the information and resources they need to positively im-

pact a stroke emergency.

AHO/sb