LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 81ST LEGISLATIVE REGULAR SESSION April 21, 2009 TO: Honorable Patrick M. Rose, Chair, House Committee on Human Services FROM: John S. O'Brien, Director, Legislative Budget Board IN RE:HB892 by Villarreal (Relating to the Women's Health Program.), Committee Report 1st House, Substituted Estimated Two-year Net Impact to General Revenue Related Funds for HB892, Committee Report 1st House, Substituted: a negative impact of ($2,415,036) 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 21, 2009
TO: Honorable Patrick M. Rose, Chair, House Committee on Human Services FROM: John S. O'Brien, Director, Legislative Budget Board IN RE:HB892 by Villarreal (Relating to the Women's Health Program.), 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: HB892 by Villarreal (Relating to the Women's Health Program.), 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
HB892 by Villarreal (Relating to the Women's Health Program.), Committee Report 1st House, Substituted
HB892 by Villarreal (Relating to the Women's Health Program.), Committee Report 1st House, Substituted
Estimated Two-year Net Impact to General Revenue Related Funds for HB892, Committee Report 1st House, Substituted: a negative impact of ($2,415,036) 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 HB892, Committee Report 1st House, Substituted: a negative impact of ($2,415,036) 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 ($969,921) 2011 ($1,445,115) 2012 ($1,851,975) 2013 $10,717,873 2014 $24,887,991
2010 ($969,921)
2011 ($1,445,115)
2012 ($1,851,975)
2013 $10,717,873
2014 $24,887,991
All Funds, Five-Year Impact: Fiscal Year Probable (Cost) fromGR Match For Medicaid758 Probable Savings fromGR Match For Medicaid758 Probable (Cost) fromFederal Funds555 Probable Savings fromFederal Funds555 2010 ($969,921) $0 ($3,544,199) $0 2011 ($1,445,115) $0 ($5,735,579) $0 2012 ($2,740,251) $888,276 ($11,493,436) $1,276,139 2013 ($2,757,971) $13,475,844 ($11,949,333) $19,360,033 2014 ($2,854,414) $27,742,405 ($12,508,925) $39,856,047 Fiscal Year Change in Number of State Employees from FY 2009 2010 18.9 2011 32.6 2012 65.2 2013 66.7 2014 68.4 Section 1: The bill would modify Chapter 531 of the Government Code to require the Health and Human Services Commission to implement certain measures to increase participation in the Women's Health Program (WHP). The bill would require that services designed to reduce unintended pregnancies and lower rates of sexually transmitted disease be maintained at a level at least equal to September 1, 2009. Section 2: The bill would modify the Human Resources code with respect to the WHP. The bill would require the program to identify women potentially eligible for the program following pregnancies covered by Medicaid. WHP benefits would begin on the first day of the month following termination of eligibility for Medicaid. This would require Medicaid to modify administrative procedures to provide continuous eligibility when transitioning from Medicaid to the WHP. The bill would require any entity that provides information and services to Medicaid recipients to provide certain information about the WHP. The bill would take effect September 1, 2009. Fiscal Analysis The fiscal impact of Section 1 results from expanded outreach efforts. The fiscal impact of Section 2 stems from the requirement to provide continuous enrollment when recipients transition from Medicaid to the Women's Health Program (WHP). Savings are anticipated in the Medicaid program due to recipients receiving WHP services. Methodology Section 1: HHSC estimates the cost of outreach would be $0.3 million per fiscal year. While there may be a caseload impact as a result of increased outreach, there is not sufficient reliable information to provide an estimate. It is possible that there would be increased costs associated with new caseload, and potential savings in the future due to averted births. Section 2: It is assumed that enrollment in the WHP would increase by 19,937 in fiscal year 2010, 33,229 in fiscal year 2011, 66,457 in fiscal year 2012, 68,437 in fiscal year 2013, and 70,475 in fiscal year 2014. This estimate allows for a phase in of 30% of estimated total caseload in fiscal year 2010, with full caseload expected in fiscal year 2012. HHSC would require time in fiscal year 2010 to obtain federal approval, adopt rules, make system changes, hire and train staff, amend contracts and conduct outreach. The average monthly cost of the WHP is estimated to be $13.45 in fiscal year 2010, rising to $14.27 in fiscal year 2014. The estimated cost of client services would be $3.2 million in fiscal year 2010, $5.4 million in fiscal year 2011, $8.8 million in fiscal year 2012, with savings of $21.3 million in fiscal year 2013, and $55.5 million in fiscal year 2014. The savings are based on HHSC's estimate of the proportion of averted births of the added caseload. It is assumed that the Medicaid program would have paid for these births and subsequent newborn health care absent the expanded program. The federal matching rate for the WHP is assumed to be 90 percent. Contracted costs for eligibility support, document processing, postage, and correspondence are estimated to be $0.2 million in fiscal year 2010, $0.3 million in fiscal year 2011, $0.4 million in fiscal year 2012, $0.4 million in fiscal year 2013, and $0.5 million in fiscal year 2014. HHSC estimates a need for more staffing to address the requirement of continuous eligibility. The estimated costs of the full-time equivalents in the table above is $0.8 million in fiscal year 2010, $1.3 million in fiscal year 2011, $2.6 million in fiscal year 2012, $2.5 million in fiscal year 2013, and $2.6 million in fiscal year 2014. The staffing is assumed to increase relative to the WHP caseload. All administrative and staffing costs are assumed to be matched with federal funds at 50 percent. According to HHSC, savings are anticipated from lower costs in Medicaid related to the spacing of pregnancies, which would result in fewer prenatal, delivery and newborn costs in Medicaid. Savings are not anticipated until fiscal year 2012. The savings in All Funds are estimated to be $2.2 million in fiscal year 2012, $32.8 million in fiscal year 2013, and $67.6 million in fiscal year 2014. The federal matching rate is approximately 60 percent. Technology Technology costs included above include approximately $0.2 million in All Funds in fiscal year 2010 and fiscal year 2011; $0.3 million in All Funds in fiscal years 2012 through 2014. These costs include eligibility system changes, seat management, and data storage under the contract for data center services. Local Government Impact Local units of government operating public hospitals and clinics enrolled as Medicaid providers could see an increase in revenue from payments to providers. Source Agencies:529 Health and Human Services Commission, 537 State Health Services, Department of LBB Staff: JOB, MB, CL, PP
Fiscal Year Probable (Cost) fromGR Match For Medicaid758 Probable Savings fromGR Match For Medicaid758 Probable (Cost) fromFederal Funds555 Probable Savings fromFederal Funds555 2010 ($969,921) $0 ($3,544,199) $0 2011 ($1,445,115) $0 ($5,735,579) $0 2012 ($2,740,251) $888,276 ($11,493,436) $1,276,139 2013 ($2,757,971) $13,475,844 ($11,949,333) $19,360,033 2014 ($2,854,414) $27,742,405 ($12,508,925) $39,856,047
2010 ($969,921) $0 ($3,544,199) $0
2011 ($1,445,115) $0 ($5,735,579) $0
2012 ($2,740,251) $888,276 ($11,493,436) $1,276,139
2013 ($2,757,971) $13,475,844 ($11,949,333) $19,360,033
2014 ($2,854,414) $27,742,405 ($12,508,925) $39,856,047
Fiscal Year Change in Number of State Employees from FY 2009 2010 18.9 2011 32.6 2012 65.2 2013 66.7 2014 68.4
2010 18.9
2011 32.6
2012 65.2
2013 66.7
2014 68.4
Section 1: The bill would modify Chapter 531 of the Government Code to require the Health and Human Services Commission to implement certain measures to increase participation in the Women's Health Program (WHP). The bill would require that services designed to reduce unintended pregnancies and lower rates of sexually transmitted disease be maintained at a level at least equal to September 1, 2009. Section 2: The bill would modify the Human Resources code with respect to the WHP. The bill would require the program to identify women potentially eligible for the program following pregnancies covered by Medicaid. WHP benefits would begin on the first day of the month following termination of eligibility for Medicaid. This would require Medicaid to modify administrative procedures to provide continuous eligibility when transitioning from Medicaid to the WHP. The bill would require any entity that provides information and services to Medicaid recipients to provide certain information about the WHP. The bill would take effect September 1, 2009.
Section 1: The bill would modify Chapter 531 of the Government Code to require the Health and Human Services Commission to implement certain measures to increase participation in the Women's Health Program (WHP). The bill would require that services designed to reduce unintended pregnancies and lower rates of sexually transmitted disease be maintained at a level at least equal to September 1, 2009.
Section 2: The bill would modify the Human Resources code with respect to the WHP. The bill would require the program to identify women potentially eligible for the program following pregnancies covered by Medicaid. WHP benefits would begin on the first day of the month following termination of eligibility for Medicaid. This would require Medicaid to modify administrative procedures to provide continuous eligibility when transitioning from Medicaid to the WHP. The bill would require any entity that provides information and services to Medicaid recipients to provide certain information about the WHP.
The bill would take effect September 1, 2009.
Fiscal Analysis
The fiscal impact of Section 1 results from expanded outreach efforts. The fiscal impact of Section 2 stems from the requirement to provide continuous enrollment when recipients transition from Medicaid to the Women's Health Program (WHP). Savings are anticipated in the Medicaid program due to recipients receiving WHP services.
The fiscal impact of Section 1 results from expanded outreach efforts.
The fiscal impact of Section 2 stems from the requirement to provide continuous enrollment when recipients transition from Medicaid to the Women's Health Program (WHP). Savings are anticipated in the Medicaid program due to recipients receiving WHP services.
Methodology
Section 1: HHSC estimates the cost of outreach would be $0.3 million per fiscal year. While there may be a caseload impact as a result of increased outreach, there is not sufficient reliable information to provide an estimate. It is possible that there would be increased costs associated with new caseload, and potential savings in the future due to averted births. Section 2: It is assumed that enrollment in the WHP would increase by 19,937 in fiscal year 2010, 33,229 in fiscal year 2011, 66,457 in fiscal year 2012, 68,437 in fiscal year 2013, and 70,475 in fiscal year 2014. This estimate allows for a phase in of 30% of estimated total caseload in fiscal year 2010, with full caseload expected in fiscal year 2012. HHSC would require time in fiscal year 2010 to obtain federal approval, adopt rules, make system changes, hire and train staff, amend contracts and conduct outreach. The average monthly cost of the WHP is estimated to be $13.45 in fiscal year 2010, rising to $14.27 in fiscal year 2014. The estimated cost of client services would be $3.2 million in fiscal year 2010, $5.4 million in fiscal year 2011, $8.8 million in fiscal year 2012, with savings of $21.3 million in fiscal year 2013, and $55.5 million in fiscal year 2014. The savings are based on HHSC's estimate of the proportion of averted births of the added caseload. It is assumed that the Medicaid program would have paid for these births and subsequent newborn health care absent the expanded program. The federal matching rate for the WHP is assumed to be 90 percent. Contracted costs for eligibility support, document processing, postage, and correspondence are estimated to be $0.2 million in fiscal year 2010, $0.3 million in fiscal year 2011, $0.4 million in fiscal year 2012, $0.4 million in fiscal year 2013, and $0.5 million in fiscal year 2014. HHSC estimates a need for more staffing to address the requirement of continuous eligibility. The estimated costs of the full-time equivalents in the table above is $0.8 million in fiscal year 2010, $1.3 million in fiscal year 2011, $2.6 million in fiscal year 2012, $2.5 million in fiscal year 2013, and $2.6 million in fiscal year 2014. The staffing is assumed to increase relative to the WHP caseload. All administrative and staffing costs are assumed to be matched with federal funds at 50 percent. According to HHSC, savings are anticipated from lower costs in Medicaid related to the spacing of pregnancies, which would result in fewer prenatal, delivery and newborn costs in Medicaid. Savings are not anticipated until fiscal year 2012. The savings in All Funds are estimated to be $2.2 million in fiscal year 2012, $32.8 million in fiscal year 2013, and $67.6 million in fiscal year 2014. The federal matching rate is approximately 60 percent.
Section 1: HHSC estimates the cost of outreach would be $0.3 million per fiscal year. While there may be a caseload impact as a result of increased outreach, there is not sufficient reliable information to provide an estimate. It is possible that there would be increased costs associated with new caseload, and potential savings in the future due to averted births.
Section 2: It is assumed that enrollment in the WHP would increase by 19,937 in fiscal year 2010, 33,229 in fiscal year 2011, 66,457 in fiscal year 2012, 68,437 in fiscal year 2013, and 70,475 in fiscal year 2014. This estimate allows for a phase in of 30% of estimated total caseload in fiscal year 2010, with full caseload expected in fiscal year 2012. HHSC would require time in fiscal year 2010 to obtain federal approval, adopt rules, make system changes, hire and train staff, amend contracts and conduct outreach.
The average monthly cost of the WHP is estimated to be $13.45 in fiscal year 2010, rising to $14.27 in fiscal year 2014. The estimated cost of client services would be $3.2 million in fiscal year 2010, $5.4 million in fiscal year 2011, $8.8 million in fiscal year 2012, with savings of $21.3 million in fiscal year 2013, and $55.5 million in fiscal year 2014. The savings are based on HHSC's estimate of the proportion of averted births of the added caseload. It is assumed that the Medicaid program would have paid for these births and subsequent newborn health care absent the expanded program. The federal matching rate for the WHP is assumed to be 90 percent. Contracted costs for eligibility support, document processing, postage, and correspondence are estimated to be $0.2 million in fiscal year 2010, $0.3 million in fiscal year 2011, $0.4 million in fiscal year 2012, $0.4 million in fiscal year 2013, and $0.5 million in fiscal year 2014.
HHSC estimates a need for more staffing to address the requirement of continuous eligibility. The estimated costs of the full-time equivalents in the table above is $0.8 million in fiscal year 2010, $1.3 million in fiscal year 2011, $2.6 million in fiscal year 2012, $2.5 million in fiscal year 2013, and $2.6 million in fiscal year 2014. The staffing is assumed to increase relative to the WHP caseload. All administrative and staffing costs are assumed to be matched with federal funds at 50 percent.
According to HHSC, savings are anticipated from lower costs in Medicaid related to the spacing of pregnancies, which would result in fewer prenatal, delivery and newborn costs in Medicaid. Savings are not anticipated until fiscal year 2012. The savings in All Funds are estimated to be $2.2 million in fiscal year 2012, $32.8 million in fiscal year 2013, and $67.6 million in fiscal year 2014. The federal matching rate is approximately 60 percent.
Technology
Technology costs included above include approximately $0.2 million in All Funds in fiscal year 2010 and fiscal year 2011; $0.3 million in All Funds in fiscal years 2012 through 2014. These costs include eligibility system changes, seat management, and data storage under the contract for data center services.
Local Government Impact
Local units of government operating public hospitals and clinics enrolled as Medicaid providers could see an increase in revenue from payments to providers.
Source Agencies: 529 Health and Human Services Commission, 537 State Health Services, Department of
529 Health and Human Services Commission, 537 State Health Services, Department of
LBB Staff: JOB, MB, CL, PP
JOB, MB, CL, PP