LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 83RD LEGISLATIVE REGULAR SESSION April 1, 2013 TO: Honorable Jane Nelson, Chair, Senate Committee on Health & Human Services FROM: Ursula Parks, Director, Legislative Budget Board IN RE:SB45 by Zaffirini (Relating to the provision of employment assistance and supported employment to certain Medicaid waiver program participants.), Committee Report 1st House, Substituted No significant fiscal implication to the State is anticipated. The bill would add employment assistance and supported employment as benefits in the Community Based Alternatives (CBA), Community Living Assistance and Support Services (CLASS), Deaf-Blind with Multiple Disabilities (DBMD), Home and Community-based Services (HCS), Medically Dependent Children Program (MDCP), Texas Home Living (TxHmL), and Youth Empowerment Services (YES) 1915(c) Medicaid waivers and in the STAR+PLUS Medicaid managed care program. The bill would be effective immediately if it receives a vote of two-thirds of all members elected to each house; otherwise, the bill would be effective September 1, 2013. Employment assistance is already a benefit in DBMD and TxHmL; supported employment is already a benefit in CLASS, DBMD, HCS, and TxHmL. It is assumed that adding the additional benefits to long-term-care waivers where they are not already available (both services to CBA and MDCP, employment assistance to CLASS and HCS) and to the STAR+PLUS program would not have a significant fiscal impact. Many of the clients in these programs are not working-age adults and would be unlikely to utilize the new benefit. It is assumed that any cost to provide employment assistance and supported employment services would be mostly offset by a savings from reduced need for attendant care services. The cost of system changes to accommodate the new benefits would also not be significant. Adding the additional benefits to the YES waiver is also not assumed to produce a significant cost, primarily due to the small number of clients affected. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies:537 State Health Services, Department of, 529 Health and Human Services Commission, 539 Aging and Disability Services, Department of LBB Staff: UP, LR, CL, NB
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 83RD LEGISLATIVE REGULAR SESSION
April 1, 2013
TO: Honorable Jane Nelson, Chair, Senate Committee on Health & Human Services FROM: Ursula Parks, Director, Legislative Budget Board IN RE:SB45 by Zaffirini (Relating to the provision of employment assistance and supported employment to certain Medicaid waiver program participants.), Committee Report 1st House, Substituted
TO: Honorable Jane Nelson, Chair, Senate Committee on Health & Human Services
FROM: Ursula Parks, Director, Legislative Budget Board
IN RE: SB45 by Zaffirini (Relating to the provision of employment assistance and supported employment to certain Medicaid waiver program participants.), Committee Report 1st House, Substituted
Honorable Jane Nelson, Chair, Senate Committee on Health & Human Services
Honorable Jane Nelson, Chair, Senate Committee on Health & Human Services
Ursula Parks, Director, Legislative Budget Board
Ursula Parks, Director, Legislative Budget Board
SB45 by Zaffirini (Relating to the provision of employment assistance and supported employment to certain Medicaid waiver program participants.), Committee Report 1st House, Substituted
SB45 by Zaffirini (Relating to the provision of employment assistance and supported employment to certain Medicaid waiver program participants.), Committee Report 1st House, Substituted
No significant fiscal implication to the State is anticipated.
No significant fiscal implication to the State is anticipated.
The bill would add employment assistance and supported employment as benefits in the Community Based Alternatives (CBA), Community Living Assistance and Support Services (CLASS), Deaf-Blind with Multiple Disabilities (DBMD), Home and Community-based Services (HCS), Medically Dependent Children Program (MDCP), Texas Home Living (TxHmL), and Youth Empowerment Services (YES) 1915(c) Medicaid waivers and in the STAR+PLUS Medicaid managed care program. The bill would be effective immediately if it receives a vote of two-thirds of all members elected to each house; otherwise, the bill would be effective September 1, 2013. Employment assistance is already a benefit in DBMD and TxHmL; supported employment is already a benefit in CLASS, DBMD, HCS, and TxHmL. It is assumed that adding the additional benefits to long-term-care waivers where they are not already available (both services to CBA and MDCP, employment assistance to CLASS and HCS) and to the STAR+PLUS program would not have a significant fiscal impact. Many of the clients in these programs are not working-age adults and would be unlikely to utilize the new benefit. It is assumed that any cost to provide employment assistance and supported employment services would be mostly offset by a savings from reduced need for attendant care services. The cost of system changes to accommodate the new benefits would also not be significant. Adding the additional benefits to the YES waiver is also not assumed to produce a significant cost, primarily due to the small number of clients affected.
The bill would add employment assistance and supported employment as benefits in the Community Based Alternatives (CBA), Community Living Assistance and Support Services (CLASS), Deaf-Blind with Multiple Disabilities (DBMD), Home and Community-based Services (HCS), Medically Dependent Children Program (MDCP), Texas Home Living (TxHmL), and Youth Empowerment Services (YES) 1915(c) Medicaid waivers and in the STAR+PLUS Medicaid managed care program. The bill would be effective immediately if it receives a vote of two-thirds of all members elected to each house; otherwise, the bill would be effective September 1, 2013.
Employment assistance is already a benefit in DBMD and TxHmL; supported employment is already a benefit in CLASS, DBMD, HCS, and TxHmL. It is assumed that adding the additional benefits to long-term-care waivers where they are not already available (both services to CBA and MDCP, employment assistance to CLASS and HCS) and to the STAR+PLUS program would not have a significant fiscal impact. Many of the clients in these programs are not working-age adults and would be unlikely to utilize the new benefit. It is assumed that any cost to provide employment assistance and supported employment services would be mostly offset by a savings from reduced need for attendant care services. The cost of system changes to accommodate the new benefits would also not be significant. Adding the additional benefits to the YES waiver is also not assumed to produce a significant cost, primarily due to the small number of clients affected.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies: 537 State Health Services, Department of, 529 Health and Human Services Commission, 539 Aging and Disability Services, Department of
537 State Health Services, Department of, 529 Health and Human Services Commission, 539 Aging and Disability Services, Department of
LBB Staff: UP, LR, CL, NB
UP, LR, CL, NB