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

SPONSOR Madalena

ORIGINAL DATE

LAST UPDATED

1/30/06

HB HJM 7

SHORT TITLE

REAUTHORIZE INDIAN HEALTH CARE

IMPROVEMENT

SB

ANALYST Weber

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY06

FY07

NFI

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Indian Affairs Department(IAD)

Human Services Department(HSD)

Department of Health(DOH)

SUMMARY

House Joint Memorial 7 (HJM 7) urges the U.S. Congress and the President to prioritize the

reauthorization of the Indian Health Care Improvement Act (IHCIA) in the second session of the

109th Congress; supports adding Albuquerque to the demonstration projects list to support health

care services for urban Native Americans; recommends amendments to provide eligibility

workers in rural areas; and supports providing access to residential treatment centers for Native

American youth.

SIGNIFICANT ISSUES

Indian Affairs notes:

The Indian Health System is severely under funded, receiving only fifty seven percent of the

level of funding required to provide services. Approximately one-fourth of the Indian Health

Service (IHS) Clinical Services budget is in a Contract Health Services (CHS) line item which

pays for services not directly provided at the IHS or tribal site. Because CHS funding is unable

to meet all the needs, IHS has a priority system to ration care.

House Joint Memorial Bill 7 – Page 2

Congress appropriates funds annually for the IHS. Unlike Medicaid and Medicare, the IHS is

not considered an entitlement program in the federal budgetary process. Because the IHS is in

the discretionary part of the federal budget, it is subject to funding limitations when Congress

imposes budgetary constraints on the discretionary budget. Thus, the IHS budget has not kept

pace with medical inflation and the growth in the population served.

The reauthorization of the IHCIA would provide needed funding and services to enhance,

improve and advance the health status of Native Americans throughout the state and the country.

NM’s tribal leaders and community members have worked diligently on drafting the language

and supporting the passage of the IHCIA reauthorization bill. Most recently, at the Health and

Human Services Tribal Consultation Meeting (Nov. 17-18, 2005), tribal leaders requested that

Governor Richardson and the state agencies support the reauthorization of the IHCIA.

The Department of Health adds.

Due to severe federal budgetary cuts, the Albuquerque Area Indian Health Service had to

decrease health services at Albuquerque Indian Health Center for approximately 47,000 eligible

Native Americans, many of whom are urban Indians. By amending the IHCIA 2005 to include

the city of Albuquerque as a demonstration project would provide vital health services and, 1) be

a permanent program within the Service direct care program, 2) be treated as a Service Unit in

allocation of resources and coordination of care, and 3) continue to meet requirements and

definitions of urban Indian organization not subject to Indian Self-Determination and Education

Assistance. All of this would allow for more federal reoccurring funds.

MW/mt