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

SPONSOR Ezzell

ORIGINAL DATE

LAST UPDATED

2-6-06

HB 575

SHORT TITLE

CYFD AUTISM SPECTRUM DISORDER

PROGRAMS

SB

ANALYST Lucero

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY06

FY07

$20.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Relates to HB671,

Relates to Appropriation in the General Appropriation Act

SOURCES OF INFORMATION

LFC Files

Responses Received From

New Mexico Health Policy Commission (NMHPC)

Children, Youth and Families Department (CYFD)

Developmental Disabilities Planning Council

Human Services Department (HSD)

Aging and Long Term Services Department (ALTSD)

SUMMARY

Synopsis of Bill

House Bill 575 appropriates $20.0 from the general fund to Children, Youth and Families De-

partment for the purpose of contracting with a community-based organization in Dexter to in-

crease social interactions for children and young adults with autism spectrum disorders and to

provide training to staff and caregivers.

FISCAL IMPLICATIONS

The appropriation of $20.0 contained in this bill is a recurring expense to the general fund. Any

unexpended or unencumbered balance remaining at the end of fiscal year 2007 shall revert to the

House Bill 575 – Page 2

general fund.

SIGNIFICANT ISSUES

According to the Centers for Disease Control and Prevention (CDC), autistic spectrum disorders

(ASD) “are a group of developmental disabilities caused by a problem with the brain. Scientists

do not know yet exactly what causes this problem. ASDs can impact a person's functioning at

different levels, from very mildly to severely.” Furthermore, “(p)eople with ASDs may have

problems with social, emotional, and communication skills. They might repeat certain behaviors

and might not want change in their daily activities. Many people with ASDs also have different

ways of learning, paying attention, or reacting to things. ASDs begin during early childhood and

last throughout a person's life.”

(

http://www.cdc.gov/ncbddd/autism/actearly/autism.html

)

The prevalence of ASD has continued grow nationwide and the Centers for Disease Control and

Prevention (CDC) estimates that a prevalence for ASD to be between 3 and 6 per 1,000 children

in the United States. Both nationally and in New Mexico there has been a significant growth in

the number of children diagnosed with ASD. Given these statistics there may be approximately

7,200 to 10,800 children and adults with ASD in New Mexico, with an estimated 540 to 810

children under the age of five. The Department of Health (DOH) does not have data specific to

ASD in Dexter or the surrounding area.

HB575 does not specify that Dexter, NM, has an extraordinary need for this type of service.

ADMINISTRATIVE IMPLICATIONS

CYFD will absorb the associated administrative costs.

Services funded by the appropriation should be coordinated with services already funded through

the DOH Developmental Disabilities Support Division’s Family Infant Toddler (FIT) Program,

the Southwest Autism Network and the University of New Mexico’s (UNM) Specialized Early

Treatment (SET) Project. The DOH FIT Program is the lead agency for the Individuals with Dis-

abilities Education Act (IDEA), Part C, and coordinates a statewide system of early intervention

for children aged birth to three with and at-risk for developmental delays and disabilities. The

contract with UNM also provides for ongoing training and technical assistance to early interven-

tion and pre-school staff serving young children with ASD through the SET Project. The SET

Project is jointly funded through DOH and the Public Education Department (PED).

CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP

This bill relates to HB671: UNM Autism Spectrum Disorder Programs.

TECHNICAL ISSUES

Although autism is typically first diagnosed in childhood, it is considered a long-term, socio-

cognitive disorder rather than a behavioral health disorder. Management and treatment typically

involve long-term education and support services.

The bill specifies the appropriation is intended to “contract with a community-based organization

in Dexter.” The procurement code would require an RFP process to select a vendor.

House Bill 575 – Page 2

The bill does not define an upper age limit for “young adults.”

Not clear if this is for all children and young adults in Dexter or for only those who are identified

and receiving services from CYFD.

The Medicaid Program covers medically necessary services for this population, but does not

cover “social interactions” or educational and other non-medical needs of the population. This

bill would appear to address those needs for one geographic area.

OTHER SUBSTANTIVE ISSUES

According to HB972, 2005, “both nationally and in New Mexico there has been a significant

growth in the number of children diagnosed with ASD. According to a study by the University of

Missouri-Columbia (Baker, D. L., 2004, March 16, Public Policy and the Shaping of Disability:

Incidence Growth in Educational Autism) the average growth rate nationwide for ASD between

1995 and 2002 has been 307%, compared with just 15% for all other disabilities.”

According to CDC studies done in Europe and Asia, since 1985, they have found that as many as

6 of every 1,000 children have ASD. CDC studies in the US have shown a prevalence of 3-6 per

1,000 children. Given these statistics it is estimated that there may be approximately 7,200 to

10,800 children and adults with ASDs in New Mexico, with an estimated 540 - 810 children un-

der the age of five.

HJM32, 2005 was passed and directed the Legislative Health and Human Services Committee

study the following:

•

The feasibility of establishing a system to determine the number and protect the confiden-

tiality of individuals with ASD;

•

How to deliver the necessary services to individuals with ASDs; and,

•

The feasibility of the center for development and disability, the department of health's

family, infant, toddler program, the public education department and the legislative edu-

cation study committee collaborating to develop a “one-stop shop” to coordinate all nec-

essary ASDs specialists to evaluate a child in one setting and to develop a comprehensive

plan of action for early intervention.

It is unclear what the findings of HJM32, 2005, were.

The Southwest Autism Network, located at the UNM Center for Development and Disability,

provides requested support to individuals with autism spectrum disorders and their families. The

Southwest Autism Network operates several programs including the Family and Community

Education in ASD (FACE), a statewide technical assistance and training network for families,

providers and other professionals. According to their website, “FACE is staffed by parents and

professionals with unique knowledge of the special needs of people with autism spectrum disor-

ders. Staff provide information to families and professionals about services and resources in the

community, conduct a variety of community training, and provide observation and recommenda-

tions to families and agencies to enable them to better understand and choose appropriate strate-

gies to assist a person with ASD.”

(

http://cdd.unm.edu/swan/face/index.htm

)

Human Services Department, through the Medicaid program, covers medically necessary ser-

House Bill 575 – Page 2

vices for this population, but does not cover “social interactions”, educational and other non-

medical needs of the population. This bill would appear to address those needs for one geo-

graphic area.

The Public Education Department and the Department of Health are the primary agencies

charged with providing community-based services to children and young adults with ASD.

ALTERNATIVES

The findings of HJM32, 2005 should be considered as well as collaboration with the Southwest

Autism Network at the UNM Center for Development and Disability,

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL

Children and young adults with autism spectrum disorders will continue to experience commu-

nity-related problems due to a lack of interaction with the community at large. And, staff and

service providers will not have access to some of the latest information and community involve-

ment techniques to continue work to effectively integrate children and young adults with dis-

abilities into the community fabric.

AMENDMENTS

Make the appropriation to the New Mexico Department of Vocational Rehabilitation or to the

Public Education Department.

DL/mt