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

SPONSOR Ortiz Y Pino

ORIGINAL DATE

LAST UPDATED

1-27-06

HB

SHORT TITLE NM Stroke Care System

SB 249

ANALYST Collard

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY06

FY07

$150.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

ESTIMATED ADDITIONAL OPERATING BUDGET IMPACT (dollars in thousands)

FY06

FY07

FY08 3 Year

Total Cost

Recurring

or Non-Rec

Fund

Affected

Total

NA

$114.0

$114.0 $228.0

Recurring General

Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Health Policy Commission (HPC)

Department of Health (DOH)

SUMMARY

Senate Bill 249 appropriates $150 thousand from the general fund to the Department of Health

(DOH) for the purpose of developing and maintaining stroke centers in hospitals statewide, de-

veloping and maintaining stroke prevention and treatment protocols, maintaining a stroke regis-

try and implementing a public education campaign.

FISCAL IMPLICATIONS

The appropriation of $150 thousand contained in this bill is a recurring expense to the general

fund. Any unexpended or unencumbered balance remaining at the end of FY07 shall revert to the

general fund.

Senate Bill 249 – Page

2

DOH indicates information technology and personnel costs to establish a stroke registry have not

been included in this bill.

SIGNIFICANT ISSUES

DOH notes this bill is the result of a recommendation by the New Mexico Stroke Task Force re-

port dated September 2004, prepared in response to Senate Joint Memorial 31 that was passed in

the 2003 Legislative session.

Stroke is a devastating disease that can result in death or life altering disabilities. Every day, two

New Mexicans die from stroke and eight more become stroke survivors. Data on stroke care

needs to be collected, complied and evaluated in order to make the necessary changes in the sys-

tem to improve outcomes. Registries often play an important role in helping researchers under-

stand the burden of disease and identify related health disparities and prevention strategies.

Stroke Registries measure and improve hospital delivery of emergency care for stroke victims in

order to reduce death and disabilities from stroke.

The department currently administers the FY06 one-time appropriation from Senate Bill 190

(2005 Legislative Session) and has established a Stroke Advisory Committee to meet on a regu-

lar basis, has purchased stroke detection equipment ($95 thousand appropriated in Senate Bill

190), and has employed a 180-day temporary employee to assist coordinate the efforts to imple-

ment the stroke program out of the department’s operating budget.

ADMINISTRATIVE IMPLICATIONS

DOH indicates current staff cannot absorb the proposed activities. DOH currently administers

the FY06 one-time appropriation from Senate Bill 190 (2005 Legislative Session) without dedi-

cated personnel. In order for stroke system development to be successful a minimum of a coordi-

nator FTE and ideally, an additional FTE as a Stroke Educator/Registrar would be needed.

OTHER SUBSTANTIVE ISSUES

HPC research indicates according to the 2006 Quick Facts report, stroke is the third most com-

mon fatal disease in New Mexico as well as in the U.S. and stroke is also one of the leading

causes of severe, long-term disability. It is estimated that two New Mexicans die each day from

stroke.

HPC also notes, according to the Henry J. Kaiser Family Foundation, in 2002, the stroke death

rate in New Mexico per 100,000 population was 41.7.

In 2004, the Stroke Task Force reported in SJM31 the following information regarding stroke:

stroke and cardiovascular disease have not been identified as a priority within the DOH.

Twenty-one states including New Mexico do not have Centers for Disease Control funding for

heart disease and stroke prevention programs.

HPC notes DOH spends an estimated $16 million on chronic disease, which is over 3 percent of

the department’s budget, yet specific programs to address cardiovascular disease or stroke do not

exist.

Senate Bill 249 – Page

3

The lack of a cohesive system of stroke care results in loss of life and disabilities for New Mexi-

cans. Protocols do not exist in most settings to define the necessary stroke assessment and

treatment needed in emergency medical systems or in most hospitals.

With regard to the economic costs of stroke, HPC reports, in 2004, $53 billion was estimated to

be spent on direct and indirect costs of stroke in the US. Based on the number of stroke occur-

rences in New Mexico, an estimated $65.4 million was spent on hospital care in 2002; however,

this figure does not include physician charges or the cost of rehabilitation.

POSSIBLE QUESTIONS

What assumptions and calculations does DOH use to determine additional operating expenses.

KBC/yr