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

SPONSOR Saavedra

ORIGINAL DATE

LAST UPDATED

02/23/07

HB 850

SHORT TITLE UNM Hepatitis C Program

SB

ANALYST Williams

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY07

FY08

$2,000.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Duplicates Senate Bill 218 and House Bill 731

Relates to HB 174 that would appropriate $1.6 million to DOH for ECHO for provision of

chronic disease treatment services.

Relates to DOH base budget for annual contractual allocation to the ECHO Hepatitis C program

of $1.6 million, and an additional $300.0 thousand in the LFC budget recommendation.

Relates to appropriation of $150.0 thousand in Senate Bill 526 from 2006 legislative session

included in House Bill 2 under Section 4

SOURCES OF INFORMATION

LFC Files

Responses Received From

Higher Education Department (HED)

Department of Health (DOH)

University of New Mexico Health Sciences Center (UNM HSC)

Health Policy Commission (HPC)

SUMMARY

Synopsis of Bill

House Bill 850 appropriates $2 million from the general fund to the board of regents of

University of New Mexico for the Hepatitis C ECHO program.

According to HED, funding would expand the existing program and provide for centers of

excellence in rural/remote areas of the state, purchase equipment, cover uninsured patient

treatment and provide for cost of training/educational services and travel costs of UNM HSC

expert specialists.

House Bill 850 – Page

2

As well, funding would be used to expand the model to treat seven additional health conditions

affecting 30 percent of the New Mexico population: diabetes, hypertension, smoking cessation,

lipid management, obesity, diet and nutrition and exercise; support federal certification to

dispense a new drug (buprenorphine) to address substance abuse; build model programs of

rheumatology experts and mental health disorder experts.

FISCAL IMPLICATIONS

The appropriation of $2 million contained in this bill is a recurring expense to the general fund.

Any unexpended or unencumbered balance remaining at the end of fiscal year 08 shall revert to

the general fund.

SIGNIFICANT ISSUES

HED discusses that this program provides a mechanism for appropriate treatments locally, and

for community health providers to attend weekly clinics where they are linked via telehealth

communication technology. At these training clinics, the local health professionals review

patient cases with each other and designed UNM HSC expert specialists. The clinics have

proven successful in establishing consistent, best practices and promoting individual and group

learning.

HPC notes New Mexico ranks first in the nation for its death rate due to chronic liver disease and

cirrhosis, which is often the result of chronic Hepatitis C infection. DOH notes “approximately

24,000 to 28,000 persons may be infected with hepatitis C in the state (Hepatitis C Surveillance

Report 2006, DOH). HPC discusses of the three types of hepatitis, hepatitis C is usually spread

through contract with blood products, via dirty needles, IV drugs and sharing needles or

obtaining a blood transfusion before 1992. The disease can escalate into cirrhosis and liver

cancer. DOH notes specialist care for chronic diseases, such as hepatitis C, is frequently

unavailable in the rural communities of the state. Persons infected with hepatitis C may not

pursue care until the disease has progressed and adverse medical consequences have occurred

ultimately resulting in a higher cost of care.

PERFORMANCE IMPLICATIONS

DOH notes the importance of monitoring performance outcomes.

DOH discusses its Strategic Plan Program Area 2, Task 3: Decrease the transmission of

infectious disease cases and expand services for persons with infectious diseases. There are two

performance measures related to Project ECHO: 1) Number of Hepatitis C clients enrolled in a

disease management service through project ECHO; and 2) Number of Hepatitis C clients

receiving pharmaceutical treatment through project ECHO. These performance measures are also

included in the Governor’s Performance and Accountability Contract, “A Healthy New Mexico",

Goal 2: Improve Health Outcomes and Family Support for New Mexicans, Task 2.3 Decrease

the transmission of infectious disease cases and expand services for persons with infectious

disease.

House Bill 850 – Page

3

OTHER SUBSTANTIVE ISSUES

DOH notes Hepatitis C disproportionately affects injection drug users due to the high risk

behavior and rapid transmission associated with the sharing of injection equipment. A New

Mexico study among active injection drug users, showed 82% of the study respondents testing

positive for hepatitis C. In addition, epidemiological evidence strongly suggests hepatitis C

infection disproportionately impacts persons with a history of incarceration (Risk Factors for

Hepatitis B, Hepatitis C, and HIV Among Injection Drug Users in New Mexico, 1995-1997).

POSSIBLE QUESTIONS

1.

What are the specific uses of current funding.

2.

What are the specific proposed uses of expansion funding.

AW/nt