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F I S C A L I M P A C T R E P O R T
SPONSOR Sen. Campos
/Rep. Gonzales
LAST UPDATED
ORIGINAL DATE 02/14/2025
SHORT TITLE Hub & Spoke Health Care Pilot Project
BILL
NUMBER Senate Bill 261
ANALYST Chilton
APPROPRIATION*
(dollars in thousands)
FY25 FY26
Recurring or
Nonrecurring
Fund
Affected
$1,750.0 Recurring General Fund
Parentheses ( ) indicate expenditure decreases.
*Amounts reflect most recent analysis of this legislation.
Relates to House Bill 58
Sources of Information
LFC Files
Agency Analysis Received From
Department of Health (DOH) Health Care Authority (HCA) Agency Analysis was Solicited but Not Received From
Public Education Department (PED)
SUMMARY
Synopsis of Senate Bill 261
Senate Bill 261 (SB261), the Hub and Spoke Health Care Pilot Project, appropriates $1.75
million from the general fund to the Department of Health (DOH) for the purpose of establishing
a hub-and-spoke health care pilot project. “Hub-and-spoke model” is defined in Section 1A of
the bill as a network directed from a central “hub” of a comprehensive primary care clinic, with
mobile services and satellites, the “spokes,” reaching out into a surrounding community.
The hub would be a federally qualified health center (FQHC) in San Miguel County with
outreach to the “spokes” in schools in at least five school districts. Care would be provided in
these “spokes” by a cooperative care team, defined in the bill as a preventive health care team,
including the following licensed personnel: a school nurse, a primary care provider, a behavioral
health care provider as well as a certified athletic trainer, and a certified community health
worker. Senate Bill 261 – Page 2
DOH would contract with the FQHC, collect data regarding health and academic outcomes,
collaborate with the Public Education Department (PED), which would help evaluate student
academic outcomes, and report to the Legislature, including the Legislative Health and Human
Services Interim Committee, and the governor on at least an annual basis.
This bill does not contain an effective date and, as a result, would go into effect 90 days after the
Legislature adjourns if enacted, or June 20, 2025.
FISCAL IMPLICATIONS
The appropriation of $1.75 million contained in this bill is a recurring expense to the general
fund. Any unexpended or unencumbered balance remaining at the end of FY30 shall revert to the
general fund/other fund. Although SB261 does not specify future appropriations, establishing a
new program could create an expectation the program will continue in future fiscal years;
therefore, this cost is assumed to be recurring.
Neither HCA nor DOH identifies expenses to the respective departments resulting from the
possible passage of this bill.
SIGNIFICANT ISSUES
In describing a hub-and-spoke model implemented in Shreveport, Louisiana, an article in BMC
Health Services Research made note of the challenges of providing care in rural America:
Rural populations are among the most vulnerable in America. They are poorer, older, and
sicker than their counterparts residing in densely populated areas, and the communities
where they live are increasingly losing an already compromised pool of healthcare
resources. Convenient access to healthcare services in these small communities was
commonplace at one time, but the increasing urbanization and suburbanization of society
has taken a severe toll on the viability of rural America, reducing population, the tax base
associated with such, and related public and private investment. High poverty, reduced
employment opportunities, and high numbers of uninsured residents further characterize
and burden rural communities. These consequences understandably have negatively
impacted community infrastructure, notably including the availability of healthcare
services, their depth and breadth, and their accessibility to area residents.
These comments would apply to challenges facing health care for all ages, including school
populations, including those in San Miguel County. The report goes on to describe the hub-and-
spoke model employed in this Louisiana example:
The hub-and-spoke model, as applied in healthcare settings, is a method of organization
involving the establishment of a main campus or hub, which receives the heaviest
resource investments and supplies the most intensive medical services, complemented by
satellite campuses or spokes, which offer more limited service arrays at sites distributed
across the served market. Basic healthcare needs are addressed locally through the
network’s satellite facilities, but in cases where more intensive medical interventions are
required, patients are routed to the main campus or hub for treatment.
San Miguel County is designated as health care shortage area by the federal Health Resources Senate Bill 261 – Page 3
and Services Administration, as evidenced in part by its only hospital, Alta Vista Hospital,
having closed its maternity services in 2022.
DOH recommends adding telehealth as a means of extending services out from a hub in a rural
setting and continues, stating that:
Ensuring a successful program requires dedicated planning, development, and
implementation. Applying a standardized framework to program development may
contribute to reaching established goals and outcomes. Developing a strong collaborative
interprofessional network focused on achieving the same goals may not only improve
patient outcomes but also contribute to improved health equity for children.
DOH also states that it has partnered with PED to correlate student academic outcome with the
presence or absence of school behavioral health system; the collaboration would be helpful in
assessing the results of this pilot program.
The bill requires a final report to the governor and the Legislature by November 1, 2030, but the
period during which the appropriation is to be spent begins July 1, 2026, and ends June 30, 2031.
CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP
Relates to HB58, Mental Health Programs in Schools Funding, which would establish a pilot
program of school mental health provision in chosen schools throughout New Mexico.
LC/hj/SL2