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F I S C A L I M P A C T R E P O R T
SPONSOR Picraux
ORIGINAL DATE
LAST UPDATED
02/12/07
HB 731
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
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.
SOURCES OF INFORMATION
LFC Files
Responses Received From
Higher Education Department (HED)
Department of Health (DOH)
SUMMARY
Synopsis of Bill
House Bill 731 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.
pg_0002
House Bill 731 – 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.
DOH notes “approximately 24,000 to 28,000 persons may be infected with hepatitis C in the
state (Hepatitis C Surveillance Report 2006, DOH). 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.
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).
pg_0003
House Bill 731 – Page
3
POSSIBLE QUESTIONS
1.
What are the specific uses of current funding.
2.
What are the specific proposed uses of expansion funding.
AW/csd