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F I S C A L I M P A C T R E P O R T
SPONSOR Madalena
ORIGINAL DATE
LAST UPDATED
1/30/06
HB HJM 7
SHORT TITLE
REAUTHORIZE INDIAN HEALTH CARE
IMPROVEMENT
SB
ANALYST Weber
APPROPRIATION (dollars in thousands)
Appropriation
Recurring
or Non-Rec
Fund
Affected
FY06
FY07
NFI
(Parenthesis ( ) Indicate Expenditure Decreases)
SOURCES OF INFORMATION
LFC Files
Responses Received From
Indian Affairs Department(IAD)
Human Services Department(HSD)
Department of Health(DOH)
SUMMARY
House Joint Memorial 7 (HJM 7) urges the U.S. Congress and the President to prioritize the
reauthorization of the Indian Health Care Improvement Act (IHCIA) in the second session of the
109th Congress; supports adding Albuquerque to the demonstration projects list to support health
care services for urban Native Americans; recommends amendments to provide eligibility
workers in rural areas; and supports providing access to residential treatment centers for Native
American youth.
SIGNIFICANT ISSUES
Indian Affairs notes:
The Indian Health System is severely under funded, receiving only fifty seven percent of the
level of funding required to provide services. Approximately one-fourth of the Indian Health
Service (IHS) Clinical Services budget is in a Contract Health Services (CHS) line item which
pays for services not directly provided at the IHS or tribal site. Because CHS funding is unable
to meet all the needs, IHS has a priority system to ration care.
pg_0002
House Joint Memorial Bill 7 Page 2
Congress appropriates funds annually for the IHS. Unlike Medicaid and Medicare, the IHS is
not considered an entitlement program in the federal budgetary process. Because the IHS is in
the discretionary part of the federal budget, it is subject to funding limitations when Congress
imposes budgetary constraints on the discretionary budget. Thus, the IHS budget has not kept
pace with medical inflation and the growth in the population served.
The reauthorization of the IHCIA would provide needed funding and services to enhance,
improve and advance the health status of Native Americans throughout the state and the country.
NMs tribal leaders and community members have worked diligently on drafting the language
and supporting the passage of the IHCIA reauthorization bill. Most recently, at the Health and
Human Services Tribal Consultation Meeting (Nov. 17-18, 2005), tribal leaders requested that
Governor Richardson and the state agencies support the reauthorization of the IHCIA.
The Department of Health adds.
Due to severe federal budgetary cuts, the Albuquerque Area Indian Health Service had to
decrease health services at Albuquerque Indian Health Center for approximately 47,000 eligible
Native Americans, many of whom are urban Indians. By amending the IHCIA 2005 to include
the city of Albuquerque as a demonstration project would provide vital health services and, 1) be
a permanent program within the Service direct care program, 2) be treated as a Service Unit in
allocation of resources and coordination of care, and 3) continue to meet requirements and
definitions of urban Indian organization not subject to Indian Self-Determination and Education
Assistance. All of this would allow for more federal reoccurring funds.
MW/mt