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SPONSOR: |
Ruiz |
DATE TYPED: |
|
HB |
422/aHGUAC |
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SHORT TITLE: |
Developmental Disabilities Program Equity |
SB |
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ANALYST: |
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APPROPRIATION
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
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FY03 |
FY04 |
FY03 |
FY04 |
|
|
|
$3,163.2 |
|
|
Recurring |
GF |
(Parenthesis
( ) Indicate Expenditure Decreases)
Responses Received From
Department of Health (DOH)
Health Policy Commission (HPC)
SUMMARY
Synopsis of HGUAC Amendment
The House
Government and Urban Affairs Committee amended the bill relating to the two appropriations. The first appropriation of $163,200 tracks
the language of the original bill but changes the destination of the funds to
the Human Services Department. The
amendment is appropriate since DOH does not provide the Medicaid match nor the payment for ICF-MR services.
The second
appropriation of $3 million tracks the language of the original bill. The funds would go to DOH.
Synopsis of Original Bill
HB 422 appropriates $3,163,200
is appropriated from the General Fund to the Department of Health for
expenditure in fiscal year 2004 in the following amounts and for the following
purposes:
· $163,200 to provide cost-of-living increases for employees of intermediate care facilities for the mentally retarded, to address employee recruitment and retention, and to provide for employee health insurance, program liability insurance and other operational costs; and
·
$3,000,000
to address equity in reimbursement between developmental disabilities programs
that are funded entirely with General Fund dollars and those that are funded
with Medicaid Waiver dollars.
Significant
Issues
1. The first appropriation does not impact
directly on DOH, since the payment received by DOH to give a cost-of living
increase to ICF-MR facilities would be transferred to HSD. The second
appropriation would impact on the Long Term Services Division (LTSD) Adult DD
State General Fund (SGF) Program only.
2. The appropriation to the ICF-MRs for a cost-of-living increase addresses a loss of
anticipated funding, resulting from a recent change in the rate reimbursement
methods. The appropriation to the DD (SGF) program represents the second
appropriation for rate increases in two consecutive years. DOH/LTSD received $1
million for this purpose in FY03. LTSD
used the FY03 appropriation to provide an “equitable rate” by changing from a
range of rates across 35 provider agencies to a uniform rate, based on the
highest rate paid to any provider.
3. The bill also provides an appropriation to
address equity between the DD (SGF) Program and the DD Waiver (DDW), i.e., to
provide the same reimbursement for similar services to similar populations.
There are, however, significant differences in eligibility criteria, in
services offered, and service requirements between the two programs. The DD
(SGF) Program has fewer/less stringent requirements, due to the difference in
population needs.
4. This appropriation, according to DOH, may not
be the most efficient and effective use of general fund. For every dollar spent
to improve the ability to serve people in the DD (SGF) Program, three
additional dollars could be generated if these funds were instead appropriated
to the DD Waiver program (as Medicaid match).
5. DOH estimates an annual need of approximately
$9.3 million for rate equity. The proposed $3 million would meet approximately
1/3 of the need, and would not result in rate equity.
FISCAL IMPLICATIONS
The appropriation of
$3,163.2 contained in this bill is an expense to the general fund. Any unexpended
or unencumbered balance remaining at the end of FY 04 shall revert to the
general fund.
ADMINISTRATIVE
IMPLICATIONS
This
appropriation would not cause an administrative burden to DOH. A rate study to determine appropriate
reimbursement for DD services will be conducted in FY04, depending on the availability
of funds to obtain an independent contractor. The rate study would be the
mechanism by which DOH would determine the appropriate distribution of the
appropriation to the specific services offered under the LTSD (DOH) Adult
Service (SGF) Program.
TECHNICAL ISSUES
In
section one of the bill, $163,200 is appropriated to the Department of Health
to disburse to IMC/MR facilities. According to the New Mexico Health Care
Association, this appropriation should pass through the Humans Services
Department. DOH does not
provide the Medicaid match nor the payment for ICF-MR
services.
For those
individuals that are eligible for the DD Waiver, DOH suggests, that it would be
more effective to use the appropriation to provide the Medicaid match for the
DDW program, rather than to create an equitable, but 100% state-funded slot in
the DD (SGF) Program.
OTHER SUBSTANTIVE
ISSUES
HPC provides
the following information relative to the cost of living appropriation for
ICF-MR:
The level
of reimbursement for Developmental Disabilities Programs funded by General Fund
monies is less than reimbursement under those DD Programs funded with Medicaid
waiver dollars. According to the Departments of Health and Human Services,
although both programs serve populations requiring specialized care and
treatment, they provide differing services. The reimbursements for the programs
are therefore, difficult to compare.
BDyr:prr:yr