LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 81ST LEGISLATIVE REGULAR SESSION April 23, 2009 TO: Honorable Patrick M. Rose, Chair, House Committee on Human Services FROM: John S. O'Brien, Director, Legislative Budget Board IN RE:HB1398 by Guillen (Relating to a pilot project to establish a comprehensive single point of entry for long-term services and supports provided to older persons and persons with physical disabilities.), Committee Report 1st House, Substituted Estimated Two-year Net Impact to General Revenue Related Funds for HB1398, Committee Report 1st House, Substituted: a negative impact of ($3,340,113) through the biennium ending August 31, 2011. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 81ST LEGISLATIVE REGULAR SESSION
April 23, 2009
TO: Honorable Patrick M. Rose, Chair, House Committee on Human Services FROM: John S. O'Brien, Director, Legislative Budget Board IN RE:HB1398 by Guillen (Relating to a pilot project to establish a comprehensive single point of entry for long-term services and supports provided to older persons and persons with physical disabilities.), Committee Report 1st House, Substituted
TO: Honorable Patrick M. Rose, Chair, House Committee on Human Services
FROM: John S. O'Brien, Director, Legislative Budget Board
IN RE: HB1398 by Guillen (Relating to a pilot project to establish a comprehensive single point of entry for long-term services and supports provided to older persons and persons with physical disabilities.), Committee Report 1st House, Substituted
Honorable Patrick M. Rose, Chair, House Committee on Human Services
Honorable Patrick M. Rose, Chair, House Committee on Human Services
John S. O'Brien, Director, Legislative Budget Board
John S. O'Brien, Director, Legislative Budget Board
HB1398 by Guillen (Relating to a pilot project to establish a comprehensive single point of entry for long-term services and supports provided to older persons and persons with physical disabilities.), Committee Report 1st House, Substituted
HB1398 by Guillen (Relating to a pilot project to establish a comprehensive single point of entry for long-term services and supports provided to older persons and persons with physical disabilities.), Committee Report 1st House, Substituted
Estimated Two-year Net Impact to General Revenue Related Funds for HB1398, Committee Report 1st House, Substituted: a negative impact of ($3,340,113) through the biennium ending August 31, 2011. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
Estimated Two-year Net Impact to General Revenue Related Funds for HB1398, Committee Report 1st House, Substituted: a negative impact of ($3,340,113) through the biennium ending August 31, 2011.
The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
General Revenue-Related Funds, Five-Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact to General Revenue Related Funds 2010 ($2,110,450) 2011 ($1,229,663) 2012 ($1,183,817) 2013 ($1,183,817) 2014 ($1,183,817)
2010 ($2,110,450)
2011 ($1,229,663)
2012 ($1,183,817)
2013 ($1,183,817)
2014 ($1,183,817)
All Funds, Five-Year Impact: Fiscal Year Probable (Cost) fromGeneral Revenue Fund1 Probable (Cost) fromGR Match For Medicaid758 Probable (Cost) fromFederal Funds555 Change in Number of State Employees from FY 2009 2010 ($112,962) ($1,997,488) ($2,394,673) 2.0 2011 ($112,962) ($1,116,701) ($1,520,664) 2.0 2012 ($112,962) ($1,070,855) ($1,475,722) 2.0 2013 ($112,962) ($1,070,855) ($1,475,722) 2.0 2014 ($112,962) ($1,070,855) ($1,475,722) 2.0
Fiscal Year Probable (Cost) fromGeneral Revenue Fund1 Probable (Cost) fromGR Match For Medicaid758 Probable (Cost) fromFederal Funds555 Change in Number of State Employees from FY 2009 2010 ($112,962) ($1,997,488) ($2,394,673) 2.0 2011 ($112,962) ($1,116,701) ($1,520,664) 2.0 2012 ($112,962) ($1,070,855) ($1,475,722) 2.0 2013 ($112,962) ($1,070,855) ($1,475,722) 2.0 2014 ($112,962) ($1,070,855) ($1,475,722) 2.0
2010 ($112,962) ($1,997,488) ($2,394,673) 2.0
2011 ($112,962) ($1,116,701) ($1,520,664) 2.0
2012 ($112,962) ($1,070,855) ($1,475,722) 2.0
2013 ($112,962) ($1,070,855) ($1,475,722) 2.0
2014 ($112,962) ($1,070,855) ($1,475,722) 2.0
Fiscal Analysis
SECTION 1. The bill would amend Subchapter B, Chapter 531, Government Code to require the Health and Human Services Commission (HHSC) to establish a comprehensive pilot project in not more than three geographic areas of the state to establish a single point of entry system for certain long-term services. HHSC would be required to establish a tentative eligiblity determination for these services. The bill would direct the co-location of Department of Aging and Disability Services (DADS), HHSC, and area agency on aging staff. The bill would also require that HHSC submit a report no later than January 31, 2011 concerning the project to the presiding officers of the standing committee of the senate and house of representatives having primary jurisdiction over health and human services. The pilot project would expire on September 1, 2013. SECTION 2. This section would require that at least one site of the pilot be in operation no later than December 31, 2009. The bill would take effect immediately if it receives a two-thirds vote in each house; if not, it would take effect September 1, 2009.
SECTION 1. The bill would amend Subchapter B, Chapter 531, Government Code to require the Health and Human Services Commission (HHSC) to establish a comprehensive pilot project in not more than three geographic areas of the state to establish a single point of entry system for certain long-term services. HHSC would be required to establish a tentative eligiblity determination for these services. The bill would direct the co-location of Department of Aging and Disability Services (DADS), HHSC, and area agency on aging staff. The bill would also require that HHSC submit a report no later than January 31, 2011 concerning the project to the presiding officers of the standing committee of the senate and house of representatives having primary jurisdiction over health and human services. The pilot project would expire on September 1, 2013. SECTION 2. This section would require that at least one site of the pilot be in operation no later than December 31, 2009. The bill would take effect immediately if it receives a two-thirds vote in each house; if not, it would take effect September 1, 2009.
Methodology
DADS assumes the pilot projects would be established in Belton, Amarillo and El Paso. Approximately 269 total new program recipients would be anticipated in the Community Attendant Services, Day Activity and Health Servcies, and Primary Home Care programs. The agency has assumed that the intent is to serve clients in programs that do not have a waiting list. If all programs in the bill were included, the costs would be higher. The cost to serve Medicaid eligible clients is assumed to be $2.2 million per fiscal year. DADS assumes that when a final eligibility determination is made, 5% of the cases would turn out ineligible for Medicaid and would therefore require state funding of $0.1 million per fiscal year. It is assumed that the Centers for Medicare and Medicaid Services will approve this pilot demonstration project and provide Federal matching funds at the standard client services FMAP (approximately 59%). If it does not, then General Revenue would be needed to cover the total cost. The cost of providing the Area Agency on Aging staff members would be passed through by DADS as a General Revenue expense. This is estimated to be $0.2 million in each fiscal year. DADS would require 2 FTEs at a cost of $0.1 million in each fiscal year for salaries, benefits and employee set-up costs. Information technology costs are estimated to be $0.5 million in fiscal year 2010 and $0.1 million in fiscal year 2011, to make changes to the long term care intake system, the consolidated interest list system and for data center service charges. HHSC assumes that current eligibility determination staff can absorb the pilots' caseload impact, due to the bill's provisions on co-located staff working collaboratively using technology. Automation costs for one-time eligibility system changes would be $1.3 million and ongoing contractor costs for document processing and customer care are assumed to be less than $0.1 million per fiscal year.
DADS assumes the pilot projects would be established in Belton, Amarillo and El Paso. Approximately 269 total new program recipients would be anticipated in the Community Attendant Services, Day Activity and Health Servcies, and Primary Home Care programs. The agency has assumed that the intent is to serve clients in programs that do not have a waiting list. If all programs in the bill were included, the costs would be higher. The cost to serve Medicaid eligible clients is assumed to be $2.2 million per fiscal year. DADS assumes that when a final eligibility determination is made, 5% of the cases would turn out ineligible for Medicaid and would therefore require state funding of $0.1 million per fiscal year.
It is assumed that the Centers for Medicare and Medicaid Services will approve this pilot demonstration project and provide Federal matching funds at the standard client services FMAP (approximately 59%). If it does not, then General Revenue would be needed to cover the total cost. The cost of providing the Area Agency on Aging staff members would be passed through by DADS as a General Revenue expense. This is estimated to be $0.2 million in each fiscal year. DADS would require 2 FTEs at a cost of $0.1 million in each fiscal year for salaries, benefits and employee set-up costs. Information technology costs are estimated to be $0.5 million in fiscal year 2010 and $0.1 million in fiscal year 2011, to make changes to the long term care intake system, the consolidated interest list system and for data center service charges.
HHSC assumes that current eligibility determination staff can absorb the pilots' caseload impact, due to the bill's provisions on co-located staff working collaboratively using technology. Automation costs for one-time eligibility system changes would be $1.3 million and ongoing contractor costs for document processing and customer care are assumed to be less than $0.1 million per fiscal year.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: 529 Health and Human Services Commission, 539 Aging and Disability Services, Department of
529 Health and Human Services Commission, 539 Aging and Disability Services, Department of
LBB Staff: JOB, CL, PP, MB
JOB, CL, PP, MB