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

SPONSOR Lovejoy

ORIGINAL DATE

LAST UPDATED

01/28/08

HB

SHORT TITLE Navajo Nation Kidney Health Study

SB 360

ANALYST Hanika-Ortiz

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY08

FY09

FY10

$100.0

Non-recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

SUMMARY

Synopsis of Bill

Senate Bill 360 appropriates $100 thousand from the General Fund to the DOH for expenditure

in FY09 and FY10 to undertake a comprehensive kidney health study of the residents of the

eastern agency of the Navajo Nation.

FISCAL IMPLICATIONS

The appropriation of $100 thousand contained in this bill is a non-recurring expense to the

General Fund. Any unexpended or unencumbered balance remaining at the end of FY10 shall

revert to the General Fund.

The appropriation included in SB 360 was not part of the DOH Executive Budget Request or the

Legislative Request for expenditures in FY09. The DOH base budget does not contain any funds

for this purpose.

DOH notes the Department could contract the study with UNM-CEHP if this bill is enacted.

Senate Bill 360 – Page

2

SIGNIFICANT ISSUES

SB360 was introduced for the Indian Affairs Committee.

DOH provided the following:

The leading causes of kidney failure are diabetes, high blood pressure and family history

of kidney failure. American Indians are twice as likely to experience kidney failure as

Whites. Kidney disease is only one of the many serious and costly complications of

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

diabetes. American Indians in New Mexico are about twice as likely to have diagnosed

diabetes as Whites.

Long-term exposures to elevated levels of uranium and other metals can also result in

kidney damage, neurological impairment, and may contribute to the increased occurrence

of chronic diseases such as diabetes. Kidney damage is the primary health effect of

ingested high uranium levels over long periods of time, such as several months or years.

Uranium-caused damage to the kidney occurs slowly; it may take years for the damage to

become apparent. The severity of uranium effect on the kidney increases with the level of

ingested uranium and duration of exposure.

The University of New Mexico Community Environmental Health Program (UNM-

CEHP) is currently working with six Navajo staff members to complete the first phase of a

National Institutes of Health funded study in the 20 chapters of the eastern agency of the

Navajo Nation. The intent of the initial grant was to build research capacity and the

understanding of health issues and environmental exposures in those communities. This

work has been ongoing for the past four years and is now transitioning into a

comprehensive assessment of risk factors for kidney health in this population.

PERFORMANCE IMPLICATIONS

SB360 relates to the DOH mission as stated in the FY09 Strategic Plan “to promote health and

prevent disease and disability". It supports FY09 DOH Strategic Plan, Program Area 1 Objective

2: Increase Awareness about Health Disparities. Strategy: Utilize the Department’s American

Indian Health Advisory Committee to inform and guide health policy development that affects

New Mexico’s Native American populations.

ADMINISTRATIVE IMPLICATIONS

Administrative oversight of a contract by a DOH staff person will be required.

CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP

SB360 relates to HB22, which would make an appropriation for a comprehensive health study of

the effects of past uranium mining and mill practices on the health of the residents of McKinley

and Cibola counties, including members of the Navajo Nation.

Senate Bill 360 – Page

3

ALTERNATIVES

DOH suggests that rather than having stand-alone funds, staff from the UNM-CEHP

recommends that any extra funds be used to employ additional Navajo staff to increase research

capacity, while answering the question of the impact of exposures to kidney health. Another

opportunity for the use of funds could be to support Navajo students to work on the project,

gaining technical skills.

DOH further suggests expanding UNM-CEHP’s ability to assess clinical kidney function and

urine uranium concentrations through laboratory analyses. Currently UNM-CEHP will only be

assessing 450 out of their sample of 1,300. Additional funds could be directed at expanding

clinical follow-up to that portion of their work.

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL

Additional funding may not be available for a comprehensive kidney health study among

residents of the eastern agency of the Navajo Nation.

AHO/mt