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

SPONSOR Rainaldi

ORIGINAL DATE

LAST UPDATED

2/2/06

HB

SHORT TITLE

MCKINLEY COUNTY DIALYSIS

INFRASTRUCTURE NEEDS

SB 291

ANALYST Hadwiger

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY06

FY07

$3,000.0 Non-Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Duplicates,Relates to,Conflicts with, Companion to

Duplicates Appropriation in the General Appropriation Act

Relates to Appropriation in the General Appropriation Act

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Finance and Administration (DFA)

Department of Health (DOH)

Higher Education Department (HED)

SUMMARY

Synopsis of Bill

Senate Bill 291 appropriates $3 million from the general fund to the Local Government Division

(LGD) of the Department of Finance and Administration (DFA) in FY07 for operating funds for

dialysis infrastructure needs at the Rehoboth-McKinley County Hospital in McKinley County.

FISCAL IMPLICATIONS

The appropriation of $3 million contained in this bill is a non-recurring expense to the general

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

the general fund.

SenateBill 291 – Page 2

SIGNIFICANT ISSUES

DFA indicated McKinley County has the highest diabetes rate in the state of New Mexico, and

the 3rd highest per capita diabetes rate in the nation. The County has 388 patients in renal fail-

ure, who either currently receive dialysis or will receive in the near future. Rehoboth-McKinley

Christian Health (RMCH) in Gallup is the administering agency of three dialysis units in

McKinley County. The Gallup dialysis unit is not sufficiently accommodating its 168 patients.

The facility doesn't have enough dialysis machines to treat all the patients on a daily basis, and

space isn't available to house additional machines. Dialysis nurses are currently working 16-18

hour shifts to treat all patients in need, with the machines currently available. This situation cre-

ates not only a hardship on those nurses, but on the patients who have to attend the facility at un-

reasonable hours to receive treatment. Construction of a new building will create space for addi-

tional machines. The purchase of additional machines will not only accommodate more patients,

but regular patients will be able to receive treatment in a timely manner and on a more appropri-

ate schedule. McKinley County will be the fiscal agent of this appropriation. County officials

indicate the County has the capacity to administer this appropriation, and the board of commis-

sioners supports the proposed project.

DOH stated the appropriation would expand the three dialysis units operated by RMCH in order

to eliminate the current waiting list. The service area is McKinley County, with dialysis sites in

Zuni, Crownpoint and Gallup. Currently, approximately 400 patients are served per year. Most

patients have three visits per week. The unit has 2 shifts per day, six days per week.

HED indicated RMCH is a hospital of major importance to the small towns and rural communi-

ties it serves. RMCH has collaborated with other hospitals in the area to defray the costs of ex-

pensive equipment such as magnetic resonance imaging. A network of hospitals in the Four Cor-

ners Healthcare Alliance also allows hospitals to share specialties, including the dialysis at

Rehoboth. McKinley County has one of the highest levels of kidney and renal pelvic cancer

rates in New Mexico, and most studies have attributed these rates to the uranium mining activi-

ties that have taken place in the county. American Indians experience high rates of chronic kid-

ney disease (CKD), often resulting in end-stage renal disease (ESRD).The incidence of ESRD

for Native Americans has been noted to be as high as 2.7 times the Caucasian rate. In the Zuni

Pueblo, a community of 10,000 in western New Mexico, the prevalence of ESRD is 17,400 per

million population. This is 4.5, 5.7, and 21.3 fold higher than the rates for African Americans,

other American Indians, and European Americans, respectively.

ADMINISTRATIVE IMPLICATIONS

DFA has the capacity to administer this non-recurring appropriation.

DH/mt