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

SPONSOR Martinez

ORIGINAL DATE

LAST UPDATED

1/21/08

HB 40

SHORT TITLE

Diabetes Prevention & Outreach

SB

ANALYST Wilson

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY08

FY09

$1,000.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Relates to Appropriation in the General Appropriation Act

ESTIMATED ADDITIONAL OPERATING BUDGET IMPACT (dollars in thousands)

FY08

FY09

FY10 3 Year

Total Cost

Recurring

or Non-Rec

Fund

Affected

Total

$150.0 $150.0

Recurring General

Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

SUMMARY

Synopsis of Bill

House Bill 40 appropriates $1,000,000 from the general fund to DOH for expenditure to fund for

diabetes prevention, education and outreach.

FISCAL IMPLICATIONS

The appropriation of $1,000,000 contained in this bill is a recurring expense to the general fund.

Any unexpended or unencumbered balance remaining at the end of fiscal year 2009 shall revert

to the general fund.

House Bill 40 – Page

2

HB 40 is proposing an additional $1,000,000 from general funds to fund diabetes prevention,

education and outreach activities in addition to the general appropriations act which contains

$585,000 from general funds and $1,000,000 from Tobacco Settlement funds.

DOH will require to FTEs for health educators to implement and oversee the grants at an

estimated cost of 150,000.

SIGNIFICANT ISSUES

Approximately one in ten adults, or 150,300 New Mexicans has diabetes. People with diabetes

are at risk for limb amputations, blindness, end-stage kidney disease and cardiovascular disease

(Centers for Disease Control and Prevention 2004). Children are at increasing risk for type 2

diabetes due to increasing rates of obesity, poor nutrition, and lack of physical exercise.

Costs for medical care and lost productivity for a person with diabetes average more than

$13,000 per year and current estimates are almost $2 billion a year for the state estimated

forward based on data from a Diabetes Care study, 2002. With diabetes on the rise, especially

among children, these costs are increasing. Of New Mexicans without diabetes, more than half

are overweight or obese and one in five do no leisure-time exercise, increasing their risk for

diabetes. A New England Journal of Medicine (2002) study indicated that one of every seven

cases of diabetes could be prevented in at-risk populations through exercise and diet.

People with diabetes do not always have access to the preventive services and health care they

need in their communities, underscoring the need for a comprehensive and coordinated response.

Such a response would include prevention programs and education initiatives, as well as health

care for uninsured and underinsured populations.

In 2004, DOH conducted a statewide diabetes assessment. One of the top priorities identified

was to provide a coordinated response to the increasing prevalence of diabetes. Participants in

the assessment included health care providers, diabetes-related associations, DOH, Native

American programs, universities and colleges, community members including people with

diabetes, the insurance and pharmaceutical industries, the border community, and the legislature.

A coordinated response is also a priority of the Diabetes Advisory Council’s 2010 Strategic Plan

Outreach efforts to communities and tribes throughout the state would enhance the New Mexico

Department of Health Diabetes Prevention and Control Program’s (DPCP) ability to identify and

fund areas of highest need.

ADMINISTRATIVE IMPLICATIONS

DOH notes

d

istribution of this appropriation to professional services contractors would require

application and/or Request for Proposal (RFP) processes. The increase in administrative

workload will also require additional DOH staff of two Health Educators. Staff time will mainly

be dedicated to overseeing community programs that have a direct impact on diabetes in

communities, community outreach, development and monitoring of contracts, technical

assistance, and evaluation.

House Bill 40 – Page

3

OTHER SUBSTANTIVE ISSUES

Populations experiencing diabetes-related disparities include Native Americans, Hispanics,

African Americans, and rural communities. Native Americans in New Mexico are about twice

as likely to be diagnosed with diabetes as non-Native Americans and non-Hispanics. Hispanics

are about 1.5 times more likely to be diagnosed with diabetes than non-Hispanics. Non-Native

American and non-Hispanic men are 1/2 to 1/5 as likely as African American men to have or

develop diabetes, and African American women are approximately twice as likely as non-

African American women to have or develop the disease. Yearly diabetes estimates for African

American and Asian American populations in NM are based on numbers too small and imprecise

to be able to compare to other New Mexico racial and ethnic groups.

Native Americans are about 3.5 times more likely to have a diabetes-related amputation than

non-Native Americans and non-Hispanics 31, 2003).

In rural communities, residents have limited access to local health resources and services,

experience isolation and often must travel long distances for specialized health care. 42% of New

Mexicans live in rural areas and 32 out of 33 counties have areas that are medically underserved.

DW/mt