NurseAdvice New Mexico (NANM) has been providing free around-the-clock health advice to New Mexicans - insured and uninsured alike - for more than a decade, using New Mexican Registered Nurses. In the past 10 and -+ years, they have serviced more than 1.6 million New Mexican callers, helping them determine what the best option is for symptoms they are having, providing health-related information and education, or linking them to needed resources. But soon, NurseAdvice New Mexico may be no more.

The financing model on which the help line was developed has evaporated, a NANM official reports. When established in 2006, the Medicaid insurance contractors were required to use NANM, but that policy changed in 2014 and that participation is no longer required. As a result, most insurers have opted to provide nurseline services through their in-or-mostly out-of-state corporate-owned nurselines, or utilize a nationwide vendor, to service their insured members only, rather than support a model that serves a broader public health interest. In addition, 20% of the calls NANM handles have no funding source, as many healthcare facilities in New Mexico, such as hospitals, freely utilize the line to refer callers to, but don't contribute to supporting the line. Facing a 30% reduction in insurance partner revenue, and a sizeable number of unfunded calls, NurseAdvice New Mexico will need to cease operations in a few months, unless something drastic happens.

NANM is a private, non-profit, 501(c)3 organization. New Mexico is the only state offering a 24/7 nurseline service that is free to all residents'whether insured or not'that is a public-private collaborative model. Approximately 30% of NANM's funding is through public grants and contracts with some of New Mexico's IHS Service Units. The remaining 70% comes from private partners that NANM services, including private practitioner groups, community health center groups, two of the smaller commercial insurers in New Mexico, and four of the hospitals in New Mexico. A substantial practitioner benefit to partnering with NANM, particularly for rural practitioners, is the after-hours relief it provides. NANM is able to handle 95% of calls without contacting a practitioner, facilitating provider recruitment and retention in New Mexico, where 30 of our state's 33 counties are designated Health Professional Shortage Areas.

Among the symptomatic calls handled by NANM, 30% result in recommendations for self-care at home, rather than referring callers to the emergency department or other provider types. A study by a medical economist at the University of New Mexico demonstrated that the advice line helped to appropriately divert thousands of emergency room visits each year, saving the state's health systems and insurers $4-5 million annually, which is more than twice the amount in savings versus what the line costs to operate.

During its decade of service to the communities of New Mexico, NurseAdvice New Mexico has received both state and national recognition. The New Mexico Department of Health issued a Performance Excellence Award to NANM in 2015, Gǣfor a superlative contribution to public health which has benefitted all New Mexicans.Gǥ The National Centers for Disease Control, who conducted a case study analysis of NANM in 2014, sponsored NANM's attendance at the Preparedness Summit in 2015. At the Summit, the NANM model was recognized as a best practice model for Gǣthe use of nurse triage lines not only as 1) a mechanism for providing people with access to information and care during large-scale health emergencies, but also as 2) an innovative care delivery model to achieve better care for patients, improved health quality, and reduced healthcare costs.Gǥ NANM has also achieved and maintained certification as a Health Information Line from the National Committee for Quality Assurance.

NANM employs 37 New Mexican Registered Nurses and four New Mexican Certified Medical Assistant Call Screeners. NANM's workforce is highly experienced, with most of the nurses having 25 years or more experience in nursing; 50% have been with NANM for 5 years or more, and nearly 20% have been with NANM since the beginning. As a NANM official reported, Gǣall of our staff could be earning significantly more working elsewhere as opposed to our small non-profit, but they are here because they are dedicated to the mission of this line'serving the communities of New Mexico.Gǥ

For further information or to learn how you can help the future of Nurse Advice New Mexico, please contact the Program Director, Connie Fiorenzio at 505-855-7744 or email cfiorenzio@nmpca.org. Thank you for your time and attention to this matter. NANM hopes to continue to help and serve the people of New Mexico for many more years!

Respectfully,
NurseAdvice New Mexico

Contact email addresses:
Governor Martinez' office:
http://www.governor.state.nm.us/Contact_the_Governor.aspx
By phone: 505-476-2200 to speak with a Constituent Services representative in the Governor's office
To find your representative:
https://www.nmlegis.gov/Members/Find_My_Legislator
To view the KOAT interview with Connie Fiorenzo:
http://www.koat.com/news/nurse-advice-new-mexico-will-close-at-the-end-of-this-year/41982298

-NurseAdvice New Mexico (NANM) Fact Sheet

Success to Date-October 2015
( 1st state in the nation to create a 24/7/365 web-enabled, fully integrated, statewide Health Advice Line through a public and private partnership (the only model of its kind in the country)
( 36 Registered Nurses & 4 Certified Medical Assistants from New Mexico staffing the line, with 18 working from home
( 10,000+ calls per month for coordination of medical, behavioral, social service and emergency needs as well as health information
( 30+ private contracts serviced statewide
( Average 9% of Callers remain uninsured
( 98% overall caller satisfaction rate (sustained & ongoing since implementation)
( Statewide Immunization Hotline established in collaboration with DOH (not just flu - for all immunizations)
( Web based email health information available to patients
( Certification achieved as a Health Information Line from the National Committee for Quality Assurance (NCQA), in October 2014. NANM scored 100% on this survey, with no identified areas for improvement.
( National recognition received from the CDC, who conducted a case study analysis of NANM in 2014 and sponsored NANM's attendance at the Preparedness Summit 2015, to present on the NANM model as a best practice model for Gǣthe use of nurse triage lines not only as 1) a mechanism for providing people with access to information and care during large-scale health emergencies, but also as 2) an innovative care delivery model to achieve better care for patients, improved health quality, and reduced healthcare costs.Gǥ

Does New Mexico need a 24 Hour Statewide Nurse Advice Line?
( In a time of crisis, the average person is confused and unsure about whom to call.
( There is NO central system that provides health information to New Mexicans.
( There is NO system that integrates all existing social service and emergency lines (i.e. Department of Health, 911, 211, Poison Center, etc.)
( Emergency preparedness needs integration of these lines.
( Rural doctors need relief from constant after-hours calls.
( Each of these points was tested & validated during the 2009 Spring & Fall H1N1 crises in New Mexico, and the 2013 Hepatitis A outbreak. DOH referred the public to NurseAdvice as the first line of defense during the pandemic & epidemic surges, & together with the Immunization Line manned by our staff, NurseAdvice provided critical services to New Mexicans during these public health emergencies. Provider offices & emergency rooms would have been much more overwhelmed than they were if the public did not have access to NurseAdvice New Mexico.

What are the benefits of this Line to our State?
( One statewide number will benefit the health of all New Mexicans by addressing medical, behavioral health and social needs
( Costly unnecessary emergency room visits can be diverted to a more appropriate lower level of care (at least 65% of those reporting that they would have gone to the ER are referred to a lower more appropriate level of care, saving New Mexico $4-5 million annually).
( Recruitment and Retention of rural doctors by providing after-hours relief.
( Emergency preparedness assistance through Syndromic surveillance of the calls
( Assignment to a medical Home provided through the Primary Care DispatchG