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

SPONSOR Papen

ORIGINAL DATE

LAST UPDATED

2/2/06

2/9/06 HB

SHORT TITLE Dona Ana County Health Care Needs Initiative

SB 485

ANALYST Lewis

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY06

FY07

150.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

Health Policy Commission (HPC)

Doņa Ana County Health and Human Services Department (DAHHS)

SUMMARY

Synopsis of Bill

Senate Bill 485 appropriates $150,000 from the general fund to the Department of Health to de-

velop a comprehensive strategic profile and initiative in Doņa Ana County that focuses on gaps

in health care services, health care needs and the use of health care resources, including an as-

sessment of the economic and health impact of those resources in the county.

FISCAL IMPLICATIONS

The appropriation of $150,000 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 general fund.

SIGNIFICANT ISSUES

According to the Department of Health (DOH), $2,822,700 is included in base in the executive

budget request for community assessments on health care needs and resources in order to de-

velop strategic profiles and plans to address the identified prioritized issues related to the County

Senate Bill 485 – Page

2

Maternal and Child Health Plan Act (CMCH Plan Act). Under the CMCH Plan Act, DOH funds

county/community-based health councils, including one in Doņa Ana County. The Doņa Ana

County Health Alliance (health council) has been funded for 2 years to develop a comprehensive

community health improvement profile and plan which includes a needs assessment and resource

inventory of health care services and gaps in the County. That plan is to guide the work of the

alliance to act as a catalyst in improving the current health care system in Doņa Ana County.

According to the Doņa Ana County Health and Human Services Department (DAHHS),

of the

$2,822,700 noted above by DOH, Doņa Ana County receives $169,663 in CMCH Plan Act

funds, of which $119,663 goes to local clinics to provide direct clinical services.

DAHHS notes the $150,000 appropriation requested by SB 485 would allow the HHS Alliance

to build on the outcomes of the CMCH contract deliverables and expand the scope beyond what

the CMCH Act provides. The CMCH funds are narrow in their scope and will not allow for the

in-depth, science-based research that the HHS Alliance is proposing. DAHHS asserts that his

request will go beyond maternal and child health issues and deal with the broad spectrum of

health care for residents, such as behavioral health services, access to specialty care services, oral

health needs, and the continuum of care for under and uninsured residents. This expanded analy-

sis will further assess the economic, social and other population-based factors impacting health

care in the county.

According to the DAHHS, the community health improvement profile funded last year by DOH,

is only a compilation of basic health-related data. It does not address population-based factors

impacting health care or the economic and social factors.

According to the Health Policy Commission (HPC), Doņa Ana County is the State’s second most

populated county with a 2004 population estimate of 186,095. Dona Ana County facts include:

20% of the county’s families are below the federal poverty level;

27.9% of the population is enrolled in Medicaid ;

13.3% of the population is enrolled in Medicare;

the rate of hospitalizations for persons diagnosed with a mental disease or disorder in Doņa

Ana County was 7.3 per 1,000 in 2001 compared to a statewide rate of 5.2; and

the average number of hospital days spent by Doņa Ana County residents for mental disease

treatment ranked 5th highest in the state and 13th highest for treatment of drug and alcohol

dependency.

The HPC notes, too, that Doņa Ana County faces significant border issues with Mexico. With

large numbers of people crossing the border daily in both directions, the risk of cross-border

transmission of communicable diseases such as HIV/AIDS and tuberculosis increases, as do

risky behaviors such as substance abuse. The HPC adds that the SB 485 appropriation would as-

sist in identifying the economic and health impact of the health care needs, gaps and resources.

ALTERNATIVES

The HPC suggests that federal grant money may be available to Doņa Ana County through the

United States-Mexico Border Health Commission and the center for Border Health Research.

DAHHS indicates that it has

received such funds in the past, and continues to explore various

funding options; but at this point none of the funds available allow for the type of local research

this appropriation is intended to support.

Senate Bill 485 – Page

3

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL

DOH suggests that the Doņa Ana County Health Alliance could respond to an upcoming Request

for Proposals (RFP) for funds allocated under the County Maternal and Child Health Plan Act,

contingent upon approval from the 2007 Legislature. DAHHS does expect to respond to the RFP,

but notes that the scope of funding available under the CMCH Plan Act is different

from the in-

tentions of the SB 485 appropriation.

DAHHS asserts that if this Bill is not enacted,

the HHS Alliance will be unable to create a plan for a comprehensive approach to deliver

health care services in Doņa Ana County; and

the sustainability and growth of the county’s community-based process for addressing com-

munity health issues would be impaired.

AMENDMENTS

DAHHS suggests an amendment to provide that the funds shall be appropriated to the Local

Government Division of the Department of Finance and Administration instead of the Depart-

ment of Health.

According to the DAHHS, the result would be to give the county more time and

latitude to accomplish the objectives of the bill.

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