NOTE: As provided in LFC policy, this report is
intended only for use by the standing finance committees of the
legislature. The Legislative Finance Committee does not assume
responsibility for the accuracy of the information in this report when used for
other purposes.
The most recent FIR
version (in HTML & Adobe PDF formats) is available on the Legislative
Website. The Adobe PDF version includes
all attachments, whereas the HTML version does not. Previously issued FIRs and attachments may be
obtained from the LFC in
SPONSOR: |
|
DATE TYPED: |
|
HB |
|
||
SHORT TITLE: |
Reduce Developmental Disabilities Wait List |
SB |
361 |
||||
|
ANALYST: |
|
|||||
APPROPRIATION
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
||
FY03 |
FY04 |
FY03 |
FY04 |
|
|
|
$15,
000.0 |
|
|
Recurring
|
GF |
(Parenthesis
( ) Indicate Expenditure Decreases)
Relates to: HB 309
Relates
to Appropriation in the General Appropriation Act
REVENUE
Estimated Revenue |
Subsequent Years Impact |
Recurring or
Non-Rec |
Fund Affected |
|
FY03 |
FY04 |
|
|
|
|
$45,000.0 |
|
Recurring
|
Federal Funds |
(Parenthesis ( ) Indicate Revenue Decreases)
Responses
Received From
Department
of Health (DOH)
Health
Policy Commission (HPC)
SUMMARY
Synopsis
of Bill
Senate
Bill 361 appropriates $15,000.0 in General Fund to the Department of Health
(DOH) to provide services under the Developmental Disabilities Home and
Community Based Medicaid Waiver Program (DD Waiver) to persons on the Central
Registry currently waiting for services.
Significant
Issues
The Long Term
Services Division‘s (LTSD) data indicates approximately 2800 persons are waiting
for service on the DD Waiver Central Registry. This funding could serve
approximately 983 of those individuals.
The current average length of wait for services through the DD Waiver is
48 months.
As of November 2002, the Human
Services Department reports that there are 2,833 clients enrolled in the
Developmentally Disabled Program. The data available from the Human Services
Department shows the program’s client base has grown continuously from 2,098 in
July 2000.
FISCAL IMPLICATIONS
The appropriation of
$15,000.0 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.
This appropriation could be matched with federal funds at a
rate of 74.56% (approximately $45,000,000), to equal $60,000,000 in additional
funding for the DD waiver program.
ADMINISTRATIVE IMPLICATIONS
The Division of Health Improvement (DHI), Incident
Management Bureau estimates it would require an additional 7 FTE to maintain
current caseloads for investigators and the intake unit. The Division of Health Improvement/Quality
Management Bureau estimates it would require an addition of 5 FTE to handle a
larger sample size for its current provider program audits and to address a
possible increase in the number of providers.
The Long Term Services Division would need 6 FTE
(especially in the Eligibility Unit) to ensure timely admission to the
DD Waiver Program, provide monitoring of individuals services and to provide
training and technical assistance to community providers.
The FTE’s would help reduce the exposure to the Department
with respect to the Lewis lawsuit and other lawsuits brought with regard to
federal Medicaid management standards.
RELATIONSHIP
Relates
to:
HB
309, which appropriates $1,610,000 to provide DD Waiver Program services to
persons registered on the LTSD Registry.
HB309, which makes a $3,264,656 appropriation to
provide cost of living, increases to providers and to reduce the waiting list.
HJM17 which requests the Human Services Department
to apply for a Medicaid waiver to make persons released from State institutions
eligible for Medicaid.
SB300, which makes a $3,163,200 appropriation to
provide cost of living, increases to providers and to address rate equity
between the State Developmental Disabilities Programs funded with waiver funds
versus General Funds.
OTHER SUBSTANTIVE ISSUES
DOH reports
that historically the capacity of the state’s provider system (case management
and direct service providers) to grow in response to new funding/individuals in
the system has been between 200-400 persons per year. Action to support the proposed level of
growth in the system will need to be implemented beginning in FY03 and
continuing as service demand increases in FY04. Without aggressive recruitment
and training initiatives the health and safety of individuals in the DD Waiver
system could be compromised. SB 361 does not include any appropriation to
support system development activities. Unused funds, resulting from limited
provider capacity cannot be redirected for other uses and will revert.
DOH expresses concern for the potential
to compromise the quality not only of legally mandated management standards for
bringing new individuals into service, but also the quality of care, because of
the effort to bring additional individuals into service. The department
indicates that the provider system is currently under strain. Staff turnover
rates, while below national levels, are nearly 50 percent. With this level of
turnover, ensuring appropriately trained staff is a significant issue. At a
maximum caseload of 30 individuals per case manager, the system would need up
to 33 new case managers to absorb this level of increase.
BD/yr