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

SPONSOR Campos

ORIGINAL DATE

LAST UPDATED

02/08/08 HB 428

SHORT TITLE UNM Rural Health Care Outreach Program

SB

ANALYST Williams

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY08

FY09

$1,800.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Duplicates SB 93

Relates to General Appropriation Act, SB 7: Medical School Recruitment of Rural

Undergraduates and HB 25: Tribal Cooperative Extension Centers.

SOURCES OF INFORMATION

LFC Files

Responses Received From

University of New Mexico Health Sciences Center (UNM HSC)

Department of Health (DOH)

Health Policy Commission (HPC)

Higher Education Department (HED)

SUMMARY

Synopsis of Bill

House Bill 428 appropriates $1.8 million from the General Fund to the Board of Regents of the

University of New Mexico for the purpose of supporting a comprehensive rural health care

outreach program, including health extension rural offices, to address more effectively local

health priorities. The program is a partnership with the New Mexico State University

Cooperative Extension Service.

FISCAL IMPLICATIONS

The appropriation of $1.8 million contained in this bill is a recurring expense to the General

Fund. Any unexpended or unencumbered balance remaining at the end of FY 09 shall revert to

the General Fund.

House Bill 428 – Page

2

SIGNIFICANT ISSUES

UNM notes the state’s high uninsured rate, substantial health disparities, poor performance in

health outcomes and access to health care concerns. The proposal addresses strengthening health

infrastructure, building health workforce capacity, supporting community health services and

facilitating community health research.

HED notes the proposal would seek to fund at least 18 Health Extension Rural Offices (HERO)

to serve rural counties. The sites are budgeted at $100,000 each, which includes funding for

personnel and operations. In some communities, the HERO will be housed with the County

Extension Agent, while others have offered to share positions to implement the program. The

program will coordinate with county health councils, health service and provider organizations,

local government, state agencies and state universities.

According to a UNM website, the Cooperative Health Extension Regional Offices will:

•

Provide liaisons between communities and the UNM HSC partnership office

•

Assure campus-community communication and coordination

•

Provide the institutional framework for sustainable partnerships

•

Produce targeted projects addressing community needs

•

Sustain the financing and delivery system to improve community health status indicators

DOH discuses 31 of the state’s 33 counties are federally designated Health Professional Shortage

Areas (HPSA). DOH notes “The outreach effort supported by this proposed program could

serve as a bridge between the universities and the communities, helping community identify

ways in which UNM and NMSU could help improve access to care, provide education on health

care concerns and address medical workforce shortage issues."

HPC notes the intent of this bill is to develop a system of local Cooperative Health Extension

Officers to act as liaisons between communities and the UNM HSC Community Partnership

Office. HPC notes other sources of funding for these entities, i.e. the Cooperative Extension

Service receives federal funding from the U.S. Department of Agriculture.

An expansion proposal for $6 million for this project was submitted by UNM to the HED to

consideration in the Fall 2007 budget cycle, but was not included in the Department’s funding

request for FY09. The request was ranked #4 out of 6 requests by UNM HSC. In its November

2007 evaluation of research and public service project expansion requests and new initiatives,

HED rated the UNM expansion request as “would not oppose if funding is available". The

January 2008 LFC report “Higher Education Department Review of Selected Research and

Public Service Projects" discusses best practices for funding these types of projects.

TECHNICAL ISSUES

HPC notes the bill does not provide what the expected health status improvement would be

statewide as a result of implementing the proposed model. The bill also does not note that local

health priorities will be more effectively addressed.

House Bill 428 – Page

3

OTHER SUBSTANTIVE ISSUES

DOH notes “the proposed effort would complement and enhance the rural healthcare services

currently being provided by the University of New Mexico Health Sciences Center Project

ECHO (Extension of Community Healthcare Outcomes)."

At least three tribal communities have expressed an interested in developing a health extension

rural office.

POSSIBLE QUESTIONS

1.

How would performance outcomes be measured.

2.

To what extent are other funding sources available, including from federal sources and

foundations.

3.

What are the best practices in this area. How are other states addressing similar issues.

AW/bb