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SPONSOR: |
Cordova |
DATE TYPED: |
|
HB |
309 |
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SHORT TITLE: |
Medicaid Developmental Disabilities Waiver |
SB |
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ANALYST: |
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APPROPRIATION
|
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
||
|
FY03 |
FY04 |
FY03 |
FY04 |
|
|
|
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$3,264.656 |
|
See Narrative |
Recurring |
GF |
|
|
|
|
|
|
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(Parenthesis
( ) Indicate Expenditure Decreases)
Relates
to Appropriation in the General Appropriation Act
REVENUE
|
Estimated Revenue |
Subsequent Years Impact |
Recurring or
Non-Rec |
Fund Affected |
|
|
FY03 |
FY04 |
|
|
|
|
|
$
4,417.816 |
|
Recurring |
Federal |
|
|
|
|
|
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(Parenthesis ( ) Indicate Revenue Decreases)
Responses
Received From
Department
of Health (DOH)
Health
Policy Commission (HPC)
SUMMARY
Synopsis
of Bill
·
$250,304 to provide cost-of-living
increases for providers of early intervention developmental disabilities
services in the family infant toddler program and to address recruitment,
retention, employee health insurance, and program liability insurance and other
operational costs.
·
$1,404,352
to provide cost-of-living increases for providers in the Medicaid Developmental
Disabilities Waiver Program and to address recruitment, retention, employee
health insurance, and program liability insurance and other operational costs.
·
$1,610,000
to reduce the waiting list in the Medicaid Developmental Disabilities Waiver Program
by providing services to one hundred new clients.
Significant
Issues
Currently, approximately 2,700
individuals are on the DD waiver waiting list, with an average waiting period
of four years. HB 309 would directly
reduce the number of individuals on the Developmental Disabilities (DD) waiting
list by approximately 100 to 105 individuals.
The Medicaid Developmental
Disabilities Program serves approximately 2,900 clients statewide. There are
approximately 200 providers statewide, who are under contract with the
Department of Health.
FISCAL IMPLICATIONS
The appropriation of
$3,264.665 contained in this bill is a recurring expense to the general fund.
Any unexpended or unencumbered balance remaining at the end of FY 04 shall
revert to the general fund.
HB 309 allocates $250,304 to the Family Infant
Toddler Program to provide cost of living increases to early intervention
providers. This increase amounts to 1.3% of the total direct services annual
expenditures of $18,526,855 (fiscal year 2002 amount) across Medicaid, State
General Funds and federal Individuals with Disabilities Education Act (IDEA)
funds.
HB
309 appropriates $1,610,000 to reduce the waiting list in the DD waiver
program. This amount can be matched with Federal funding at an approximate rate
of 74.56%. Federal match will equal
$4,417,816, which will result in a total of $6,328,616 available to reduce the
DD waiver wait list.
See “administrative
implications” below for costs associated for additional FTE not provided in the
legislation.
ADMINISTRATIVE IMPLICATIONS
DOH estimates that three additional FTE at a cost of $155,
000 per year, would be needed to cover the anticipated workload increase in the
DD Waiver Program. The Department points
out that the additional FTE would help reduce the exposure to DOH, which has
the obligation to monitor the risks and services, provided to clients receiving
services.
DOH
has established that for each individual on the waiver program, the Incident
Management Bureau (IMB) will receive one incident report per year. The Department states that an increase of 100
incidents per year could not be further absorbed without additional FTE or
significant program adjustments.
In
addition, the Quality Management Bureau monitors both the Family Infant and
Toddler providers, and the DD Waiver providers. Expanded program enrollment
increases the Quality Management Bureau’s workload by increasing the size of
the sample of individuals reviewed and the number of specific client-related
issues to be addressed.
OTHER SUBSTANTIVE ISSUES
DOH
states that a cost-of-living increase to address recruitment, retention,
employee health insurance, program liability and other operational costs would
contribute to improved quality of care for consumers. The inflation rate for the
In fiscal year 2002, 172,720 hours of early
intervention services were provided. The $250,304 contained in the bill would
translate to an increase of approximately $1.45 per hour of service. Medicaid
and State General revenues fund the FIT Program and any adjustment to rates
would have to factor in the state match for Medicaid funds.
AMENDMENTS
DOH makes the following recommendations on amending the
legislation:
Delete the phrase “other operational costs” or specify what
other operational costs are. In addition
include an additional $155,000 for three FTE’s.