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

SPONSOR Trujillo

ORIGINAL DATE

LAST UPDATED

1-28-06

2/11/06 HB HJM 26/aHFl#1

SHORT TITLE Recommendations for Public Health Code

SB

ANALYST Collard

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY06

FY07

Administrative

Implications

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

Heath Policy Commission (HPC)

New Mexico Environment Department (NMED)

Children, Youth and Families Department (CYFD)

SUMMARY

Synopsis of HFL #1 Amendment

The House Floor Amendment to House Joint Memorial 26 strikes the Department of Health from

the title of the Memorial and replaces it with New Mexico Health Policy Commission.

FISCAL IMPLICATIONS

HPC indicates it has been named as a lead or collaborative agency in at least 10 other bills and

memorials, which, if all were to pass and given their time constraints, could place some burden

on HPC staff, time and department resources.

SIGNIFICANT ISSUES

DOH indicates this is an appropriate change, in accordance with the Legislature’s directive on

Page 2, lines 18-20 that the New Mexico Health Policy Commission study the model state public

health act and related law in conjunction with the Department of Health, the Children, Youth and

Families Department, the Aging and Long-Term Services Department, the University of New

House Joint Memorial 26/aHFl#1 – Page

2

Mexico’s Institute of Public Law and other interested parties.

Synopsis of the Original Joint Memorial

House Joint Memorial 26 directs HPC, in collaboration with DOH, other state agencies, the Uni-

versity of New Mexico’s Institute of Public Law, and other interested parties, to study the Public

Health Act and make recommendations for revisions of the Public Health Act to the Health and

Human Services Committee November 2006 meeting.

FISCAL IMPLICATIONS

There is no appropriation associated with this joint memorial. The only expense to state agencies

would be the cost of existing staff’s time.

SIGNIFICANT ISSUES

DOH indicates the New Mexico laws affecting public health are sufficiently comprehensive, and

have received significant and timely legislative updating over the years. DOH does not perceive

any significant deficits in the legal structure within which it currently operates nor does DOH

perceive that the model act will actually enhance its ability to deliver services to New Mexicans

in accordance with federal and state mandates.

The most noticeable shortcoming in the current New Mexico public health laws is that they are

not compiled into a single, well organized code. This organizational deficit does not, however,

constitute an insufficiency in the substantive provisions of New Mexico’s current public health

laws.

The Center for Law and the Public’s Health has developed a Model Public Health Act (MPHA).

The website for the center,

http://www.publichealthlaw.net/Resources/ResourcesPDFs/MSPHA%20LegisTrack.pdf

tracks

states’ adoption of the model or parts of the model. No state has adopted the MPHA in total.

There is also commentary on the website indicating that the MPHA was developed as a tool for

states to review their own public health statutes, especially regarding the areas of isolation and

quarantine, public health surveillance and privacy. The New Mexico legislature addressed the

issues of quarantine and isolation with the passage in 2003 of the Public Health Emergency Re-

sponse Act (NMSA 1978, Sections 12-10A-7 and 9), and with the enactment in 2002 of the up-

dated procedures for dealing with persons with actively infectious and threatening communicable

diseases, as codified at NMSA 1978, Section 24-1-15. Privacy of health information is protected

in a variety of state and federal laws, most comprehensively in the federal HIPAA Privacy Rule,

45 CFR Sections 160 and 164, that became effective on April 14, 2003. DOH conducted inter-

nal reviews of the Model Public Health Act in 2004 and found that, current New Mexico statu-

tory provisions typically address more comprehensively, more appropriately or in a less costly

manner, virtually all public health issues addressed in the model law.

HPC indicates previous studies of the New Mexico Public Health Act have identified gaps and

omissions within the Act. Additionally, public health law reform has been advocated by the US

Department of Health, as well as several national health care organizations.

The laws of public health and community safety compose a common thread that connects local,

House Joint Memorial 26/aHFl#1 – Page

3

state, and federal governments. In consideration of potential biological, environmental, and ter-

rorist threats, it is essential that state laws relating to health are able to effectively serve the rights

of its citizens.

NMED should be involved in any effort to update New Mexico’s Public Health Act because the

department provides essential public health services to the citizens of New Mexico. These pub-

lic health services include ensuring that public drinking water standards are met, that public

pools are safe for public use, and that restaurants are safe for public use. As part of these func-

tions, NMED provides surveillance and sampling functions at restaurants to detect food borne

illnesses, in collaboration with DOH; has cutting edge grants with the Centers for Disease Con-

trol to ensure the safety of public water supplies; and participates in the public health council.

ADMINISTRATIVE IMPLICATIONS

DOH indicates there is no appropriation in the joint memorial, yet completing the work required

by the memorial will entail significant assignment of staff time and resources by the designated

agencies. DOH will be significantly involved in the work required by this Memorial, particularly

the staff of the office of general counsel.

TECHNICAL ISSUES

Line 23 on page 2 should be amended as follows: “institute of public law, New Mexico envi-

ronment department and other interested parties .…”

Lines 13 & 14 on page 3 should be amended as follows: “department, the aging and long-term

services department, and the university of New Mexico institute of public law and the New Mex-

ico environment department.”

OTHER SUBSTANTIVE ISSUES

HPC notes a November 18, 2005 draft paper, New Mexico Public Health Law Reform, by Clif-

ford Rees, JD and William Wiese, MN, MPH, identified the following samples of New Mexico

law that public health care law reform could address:

•

The New Mexico Public Health Act was enacted in its current form in 1973 and has been

amended several times since then. Several of the powers delegated to the DOH have re-

mained unchanged since the New Mexico laws of 1919, which was created in the after-

math of the Spanish Flu pandemic.

•

Health related privacy issues should be revisited in the light of the enactment of recent

federal legislation including the Health Insurance Portability and Accountability Act of

1996.

•

There is no provision in New Mexico law related to tracking people who may have been

exposed to a communicable disease by an infected person.

•

There is no recognition of related to topics of current importance to public health includ-

ing environmental health and nutrition.

House Joint Memorial 26/aHFl#1 – Page

4

ALTERNATIVES

DOH suggests an alternative would be to authorize and fund the compilation commission to ini-

tiate the demanding work involved in re-compiling the New Mexico statutes. Such a recompila-

tion would necessarily address concerns that the public health laws are not well organized in an

easy-to-access code. This alternative recognizes the need, after 28 years, to reexamine and reor-

ganize all the New Mexico statutes, not simply those dealing with public health laws.

KBC/nt:mt