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F I S C A L I M P A C T R E P O R T

SPONSOR Ryan

ORIGINAL DATE

LAST UPDATED

1-27-06

2-06-06 HB

SHORT TITLE

EXTEND MEDICAID ELIGIBILITY TO CERTAIN

YOUTH

SB 272/a SPAC

ANALYST Lucero

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY06

FY07

$136.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Children, Youth and Families Department (CYFD)

Human Services Department (HSD)

Indian Affairs Department (IAD)

SUMMARY

Synopsis of SB272/a SPAC

The Senate Public Affairs Committee amended SB272 as follows:

1. Page 3, lines 4 and 5 strikes “fifty-four thousand five hundred forty-seven dollars

(54,547)” and replaces it with “One hundred thirty-six thousand dollars ($136,000)”

The amendment increases the dollar amount to $136.0. The amendment allows for full compli-

ance with recommendations made by the Youth Advisory Panel to continue Medicaid eligibility

and coverage to age 21 for the approximate 100 youth who emancipate from the foster care sys-

tem each year. The amendment does not change the administrative or performance implications

for the department.

Approximately 100 – 120 children age out of CYFD Foster Care each year. Once a child turns

age 18 he is no longer eligible for foster care; however, this individual could be placed on cate-

gory 032 Medicaid for one additional year. This bill extends Medicaid eligibility for three addi-

tional years from his 19th birthday until age 21 years. The average capitation for this population

is $415/mo/individual. This equates to $4,980/yr/individual in capitation fees alone. The first

year, assuming 100 children turn age 19, the capitation (Title XIX) expenditure could be in the

Senate Bill 272/a SPAC – Page

2

neighborhood of $498,000. The amount of appropriation is insufficient to meet the costs of this

expansion. The State portion of the cost would be $136,000.

The Federal Government, Administration for Children and Families (ACF) encourages states to

extend Medicaid to former foster youth between ages 18-21 who are emancipating from foster

care. Approval of a State Plan Amendment from the Centers for Medicare and Medicaid Ser-

vices would be necessary to cover this expanded age group of CYFD children.

Synopsis of Original Bill

Senate Bill adds language to the Medicaid Eligibility Law extending eligibility to youth aged

eighteen to twenty-one who are eligible for independent living services from the Children, Youth

and Families Department. The bill appropriates $54.5 general fund to the Children, Youth and

Families Department for expenditure in FY07 to provide coverage for Medicaid benefits for

youth aged eighteen to twenty-one who are eligible for independent living services.

Senate Bill 272 appropriates $54,547 from the general fund to Children, Youth and Families De-

partment for the purpose of extending eligibility to youth aged eighteen to twenty-one who is

eligible for independent living services from the Children, Youth and Families Department.

FISCAL IMPLICATIONS

Children, Youth and Families Department contributed the following:

Approximately 100 – 120 children age out of CYFD Foster Care each year. Once a child turns

age 18 he is no longer eligible for foster care; however, this individual could be placed on cate-

gory 032 Medicaid for one additional year. This bill extends medicaid eligibility for three addi-

tional years from his 19th birthday until age 21 years. The average capitation for this population

is $415/mo/individual. This equates to $4,980/yr/individual in capitation fees alone. The first

year, assuming 100 children turn age 19, the capitation (Title XIX) expenditure could be in the

neighborhood of $498,000. The amount of appropriation is insufficient to meet the costs of this

expansion. The State portion of the cost would be $136,000.

SIGNIFICANT ISSUES

The Human Services Department contributes:

Approximately 100 – 120 children age out of CYFD Foster Care each year. Once a child turns

age 18 he is no longer eligible for foster care; however, this individual could be placed on cate-

gory 032 Medicaid for one additional year. This bill extends Medicaid eligibility for three addi-

tional years from his 19th birthday until age 21 years. The average capitation for this population

is $415/mo/individual. This equates to $4,980/yr/individual in capitation fees alone. The first

year, assuming 100 children turn age 19, the capitation (Title XIX) expenditure could be in the

neighborhood of $498,000. While not a recurring appropriation, any rate increase would need to

become part of the Medicaid base budget unless rates were to be decreased the following year.

This impact has been represented in the Estimated Additional Operating Budget Impact and has

been identified as recurring expenses and thus would require appropriation in FY08 and future

years.

Senate Bill 272/a SPAC – Page

3

The amount of appropriation is insufficient to meet the costs of this expansion.

The appropriation of $54.5 contained in this bill is a recurring expense to the general fund. Any

unexpended or unencumbered balance remaining at the end of 2007 shall revert to the general

fund.

The CYFD Independent Living Services includes NM Tribal Youth ages 16-21 in their services.

CYFD works with the following resources for placement: Intermountain Centers Human Devel-

opment Youth Center; Youth Development, Inc (YDI): Project Hope; Family Workshop; Casa

San Jose/ Agency of Catholic Charities of Gallup, Inc., Southwestern Advocates 4 Kids; Family

& Youth Inc.; and Guidance Center of Lea County , Inc. All these programs include Tribal

Youth, 16-21 years of age, and accept statewide referrals. They help youth who are involved

with Protective Services and/or Juvenile Justice Services, and youth who are at risk of involve-

ment, statewide. Their service components include: Independent Living Skills Screening and

Assessment; Individualized Transitional Living Plans; Mentoring Program; Individual and

Group Life Skills Curriculum and Instruction; Individual and Group Counseling; Client Support

Services; Case Management Services. (CYFD Independent Living Services Resource Manual,

July 2005)

ADMINISTRATIVE IMPLICATIONS

CYFD would absorb any associated administrative costs.

TECHNICAL ISSUES

Indian Affairs Department contributed the following:

New Mexico is home to over 190,000 people who identify themselves as American Indian/

Alaska Native including those from 19 pueblos, 2 Apache Nations, and the Navajo Nation.

American Indian people in New Mexico are served by two Indian Health Service (I.H.S.) areas;

Albuquerque Area I.H.S. and the Navajo Area I.H.S.. The NM portion of the Albuquerque Area

I.H.S. includes the 19 Pueblos, 2 Apache nations, and 3 Navajo chapters (Alamo, Ramah and

To’Hajiilee). The NM portion of the Navajo Area I.H.S. includes the Navajo reservation in New

Mexico, excluding the 3 chapters in the Albuquerque Area. The tribes in New Mexico are cul-

turally unique and sovereign governments. (New Mexico American Indian Health Status, New

Mexico Epidemiology, Nov. 25, 2005, Vol. 2005, No. 12).

Changes in the structure of Medicaid are of particular importance in tribal health issues because

it provides supplemental funding for tribal health care including AI/AN youth. (Tribal Consulta-

tion Report – draft, Nov. 17-19 2005, New Mexico Health and Human Services Tribal Consulta-

tion Meeting).

OTHER SUBSTANTIVE ISSUES

The Federal Government, Administration for Children and Families (ACF) encourages states to

extend Medicaid to former foster youth between ages 18-21 who are emancipating from foster

care. Approval of a State Plan Amendment from the Centers for Medicare and Medicaid Ser-

vices would be necessary to cover this expanded age group of CYFD children.

Senate Bill 272/a SPAC – Page

4

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL

The large proportion of New Mexico’s population identified as American Indian and Alaskan

Native youth, ages 18-21, would not benefit from Transitional Living Services including access

to service components like: Independent Living Skills Screening and Assessment; Individualized

Transitional Living Plans; Mentoring Program; Individual and Group Life Skills Curriculum and

Instruction; Individual and Group Counseling; Client Support Services; Case Management Ser-

vices.

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