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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

01/29/08

HB

SHORT TITLE UNM Native American Health Center

SB 250

ANALYST Escudero

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY08

FY09

$150.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Related To: HB120

SOURCES OF INFORMATION

LFC Files

Responses Received From

Indian Affairs Department (IAD)

Department of Health (DOH)

University of New Mexico (UNM)

Higher Education Department (HED)

SUMMARY

Synopsis of Bill

Senate Bill 250 appropriates $150,000 from the general fund to the Board of Regents of the

University of New Mexico for expenditure in FY09 for the Center for Native American Health

(CNAH) at the University of New Mexico Health Sciences Center.

FISCAL IMPLICATIONS

The appropriation of $150.0 contained in this bill is a recurring expense to the general fund. Any

unexpended or unencumbered balance remaining at the end of 2009 shall revert to the general

fund.

This request was not submitted by the UNM Health Sciences Center to the New Mexico Higher

Education Department for review. The Departments funding recommendation for FY09 is a

continuance of FY08 recurring funding in the amount of $324,000

.

Senate Bill 250 – Page

2

SIGNIFICANT ISSUES

As stated by HED, according to CNAH Director, Dr. Gayle Dine Chacon, SB250 funds the

development of a pipeline for student recruitment into health careers at the high school level.

SB250 supports a program that uses Native American students as advocates of health and

wellness in their communities. The program design creates a liaison/health educator position

within the high schools to promote student leadership and outreach.

•

The CNAH is a relatively new center committed to improving the health of Native

Americans in New Mexico by providing technical assistance, capacity building, student

pipeline initiatives, and health policy development to tribal and urban communities. The

primary mission of the CNAH is to build and strengthen health alliances between the

Native American and university communities and their partners for the purpose of

improving Native American health in New Mexico.

•

The grant funded Native American Research Centers for Health at CNAH has a student

development program to build a cadre of American Indian research scientists. This

student development initiative is a community driven effort aimed at addressing cultural

issues in education as well as improving how the university recruits American Indian

students into health careers. The student development team at CNAH works with

community-based advisory committees and focus groups to learn about barriers that

prevent students from becoming health professionals as well as which efforts are

effective in supporting students to complete college.

•

Outreach is critical to the success of obtaining community input and student recruitment

and retention. The Student Navigator Program works with students, teachers and

counselors to guide them to the resources and through the bureaucracies of a large

university. It helps students transition into the university and increase their exposure to

research and research opportunities. Finally, the Student Navigator Program promotes

career development and entry into graduate studies and mentoring among the students at

the university as well as in the community.

According to UNM, Native Americans in New Mexico have some of the worst health status

indicators in the nation. New Mexico native communities and Indian Health Service (IHS)

experience critical health professional shortage issues. Access to medical, behavioral health,

preventive services and health information is inadequate, especially in geographically isolated

native communities.

A few of the astounding statistics that bring to attention the issue of disparities in the American

Indian health workforce include: American Indians make up only .3% of Nations physicians;

tribal leaders continually express the need for more health professionals in their communities;

native patients have voiced concerns about having the doctor at their community clinic only one

day out of the week; and Indian Health Service facilities have an 11% vacancy rate for

physicians and 19% for nurses. The need to “grow our own" is continually voiced in our tribal

communities as a means to develop the student pipeline from the perspective and input of our

communities in which our future native health professionals will serve.

*This estimated revenue will materialize only if UNM “breaks out of the band" for formula

workload funding. The program revenue estimates are based on new student credit hours (SCH)

that the program will produce. However, the funding base for UNM is over 600,000 SCH,

Senate Bill 250 – Page

3

requiring an overall gain of some 18,000 SCH to be eligible for new funding. UNM’s

enrollment forecasts indicate relatively flat enrollments for the next 3-5 years.

OTHER SUBSTANTIVE ISSUES

According to UNM, there is no single agency in the state of New Mexico which coordinates the

many federal, state and community-based programs addressing the totality of the issues relating

to the health of Native Americans. CNAH strives to achieve this status with limited capacity. At

a time when the state’s Native American tribes are looking to transition to self-determination in

regard to their health care systems, they are not adequately prepared to do so from both a medical

and business perspective. As the state’s only academic health center and with networks and

programs that provide outreach and access to Native American communities in the area of

health, UNM, through CNAH’s efforts, is perfectly positioned to bring this essential discussion,

solution and implementation body together.

•

In coordination with the Office of Community Health at UNMHSC, CNAH will identify

and fund 2 to 3 Native American communities with a community liaison that will work to

bridge the communication and resource network between UNM HSC and the tribal

community.

•

The liaison will work with the University to understand and navigate the system for the

community in order to obtain resources in the areas of student development, tribal

participation in research, health care access, behavioral health, telehealth and other

priority areas identified by the community.

•

The establishment of a Community Health Extension Office will assure campus-

community communication and coordination, provide the institutional framework for

sustainable partnerships and produce targeted projects addressing community needs.

CNAH will gather together the numerous researchers, educators, and practitioners on the UNM

Health Sciences Campus and main campus who are involved in the health issues confronting

Native Americans. With Native Americans comprising 10.5% of New Mexico’s population,

nearly half of that number living at or below poverty level, a significant number of UNM

healthcare researchers, clinical practitioners and educators focus on health issues such as

diabetes, alcoholism, cirrhosis, heart disease, high rates of suicide and behavioral health needs

that confront the Indian community. Pulling together all of the UNM healthcare professionals

who are involved in Indian health initiatives and publicizing their efforts among Indian

communities will be the first step taken in establishing a comprehensive program to address

Native American healthcare needs.

Upon establishing a working coalition of UNM healthcare professionals, CNAH will then

incorporate into this coalition the large numbers of researchers and educators in UNM’s other

departments whose efforts contribute in a meaningful way to the status of health within the tribal

communities. These include Native American faculty and researchers from the Native American

Studies program and Indian Education Program. These UNM proponents of Native American

communities and the issues that affect them will be brought together with the health care faculty

and researchers to share program information and chart a coordinated path with community

members toward improving the status of Native American health in the state.

•

CNAH will assess the current status of health-related programs in the state as they relate

to Native Americans. Federal and state agencies will be targeted, but not limited to the

Senate Bill 250 – Page

4

Indian Health Service, NM Department of Indian Affairs, NM Department of Health, NM

Department of Health and Human Services, Southwest Tribal Epidemiology Center, and

the Albuquerque Indian Health Board.

•

CNAH will initiate a process by which to coordinate and inform the tribal communities

of the various resources afforded to them. With that information, CNAH will facilitate

the development of a list of desired outcomes pertaining to improving the state of health

and health programs in the variety of specialty fields which impact upon Native

American health and assist the communities in the development of actions plans to

achieve these outcomes.

•

The tribal community agencies will be represented, primarily, by the UNM Community

Liaison and representatives from the various health service providers in those

communities. Last, but not least, members of the legislature who serve on the Health and

Human Services Committee and Indian Affairs Committee will be targeted for inclusion

in the discussions pertaining to the health of the Native American population.

CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP

As stated by IAD, SB 250 relates to HB 120 American Indian Health Improvement Act,

sponsored by Speaker Lujan. Both SB 250 and HB 120 would appropriate funds to CNAH for

research and development activities. The appropriation amount, however, would differ; HB 120

would appropriate $600,000 and SB 250 would appropriate $150,000.

PME/mt