Fiscal impact
reports (FIRs) are prepared by the Legislative
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Current FIRs (in HTML & Adobe PDF formats) are available on the
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SPONSOR |
Picraux |
DATE TYPED |
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HB |
559 |
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SHORT
TITLE |
Community-Based & Hospice Service
Provisions |
SB |
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ANALYST |
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APPROPRIATION
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Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
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FY04 |
FY05 |
FY04 |
FY05 |
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Indeterminate |
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LFC Files
No Responses Received From
Human Services Department (HSD)
Responses
Received From
Department
of Health (DOH)
SUMMARY
Synopsis of Bill
House Bill 559 adds a
new section to the Public Assistance Act to allow a Medicaid recipient eligible
to receive home and community- based services and hospice services concurrently. The hospice care program would be responsible
for assessing, planning, monitoring, directing and evaluating the recipient’s
care that relates to the recipient’s terminal illness and shall maintain
communications with the case manager of the home and community-based services,
or with the case manager’s designee. The
hospice program and the case manager shall develop a coordinated plan of
care. The home and community-based
services specifically mentioned are the developmentally disabled waiver
program, the disabled and elderly waiver program, the HIV/AIDS waiver program,
the medically fragile waiver program, and the personal care option program.
Significant Issues
The waiver programs mentioned are often dealing
with clients who are severely ill or compromised and may be at a terminal stage. For example, the HIV/AIDS Medicaid Waiver
Program is designed specifically to serve those persons with AIDS who are at or
near the end stage of the disease. The
addition of hospice services to home and community based waiver services is a
needed and appropriate service for these home and community-based
services. DOH manages the
developmentally disability waiver and the AIDs waiver
Medicaid programs.
If HB 559 is enacted, the Centers for Medicare
and Medicaid (CMS) may need to need to approve any additional services provided
through the auspices of the Medicaid waiver programs because currently Medicaid
regulations do not allow that Medicaid eligible recipients receive both
home and community based services and hospice.
FISCAL IMPLICATIONS
The impact on the HIV/AIDS waiver program would
be minimal since there are only currently only about 40 clients and those
numbers are declining as fewer people die from AIDS. As with other waiver programs, the vast
majority of the costs are borne by the federal Medicaid program.
OTHER SUBSTANTIVE ISSUES
DOH notes HB559 would
allow terminally ill individuals to live their final days in as natural and comfortable
a setting as possible. For example, persons on the
AIDS waiver are terminally ill and at the end stages of the disease. Hospice, therefore, for most of these clients
and their families, is a needed and desirable addition to the services
currently provided under the waiver.
AIDS devastates the body. Hospice
services emphasis is on symptom control and support to individuals and their
families before and after death. While
the stigma once associated with AIDS is not as prevalent as in the past, it
still exists. As a result, families of
persons dying from AIDS may not have adequate support during this difficult
time. Hospice services may make the passing
of a loved one easier to cope with.
BD/dm