LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 76th Regular Session March 1, 1999 TO: Honorable Elliott Naishtat, Chair, House Committee on Human Services FROM: John Keel, Director, Legislative Budget Board IN RE: HB143 by Thompson (Relating to the personal needs allowance for certain Medicaid recipients who are residents of long-term care facilities.), As Introduced ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * HB143, As Introduced: negative impact of $(26,476,418) through * * the biennium ending August 31, 2001. * * * * 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 * * 2000 $(13,227,486) * * 2001 (13,248,932) * * 2002 (13,248,932) * * 2003 (13,248,932) * * 2004 (13,248,932) * **************************************************** All Funds, Five-Year Impact: *************************************************************************** *Fiscal Probable Savings/(Cost) from Probable Savings/(Cost) from * * Year General Revenue Fund Federal Funds * * 0001 0555 * * 2000 $(13,227,486) $(14,642,994) * * 2001 (13,248,932) (14,621,548) * * 2002 (13,248,932) (14,621,548) * * 2003 (13,248,932) (14,621,548) * * 2004 (13,248,932) (14,621,548) * *************************************************************************** Technology Impact It is assumed that any automation costs associated with increasing the personal needs allowance could be absorbed by current resources. Fiscal Analysis The bill would increase the personal needs allowance to not less than $60 per month for residents of nursing facilities, Intermediate Care Facilities for the Mentally Retarded (ICF-MR), personal care facilities, and other similar long-term care facilities who receive medical assistance, by adding Section 32.024 (v) to the Human Resources Code. The bill would not apply to residents who are participating in a medical assistance waiver program. The bill would take effect September 1, 1999. The bill would impact two populations: institutional residents of Medical Assistance Only (MAO), and institutional recipients of Supplemental Security Income (SSI). Both populations currently receive a $30 per month personal needs allowance. The bill would increase the personal needs allowance for both groups. The additional $30 allowance to MAO recipients would be paid by both the state and the federal government. The Medicaid ratio for 2000 is 38.55 percent state (general revenue) and 61.45 percent federal. The estimated Medicaid ratio for 2001 and subsequent years is 38.64 percent state (general revenue) and 61.36 percent. The additional $30 allowance to SSI recipients would be paid entirely by the state (general revenue). Methodology 1. It is estimated the Department of Human Service will serve 58,591 MAO clients in 2000 and in each subsequent year. It is estimated the Department of Mental Health and Mental Retardation will serve 7,601 MAO clients in 2000 and in each subsequent year. The total MAO population (66,192), when multiplied by the additional personal needs per month ($30) and by the number of months per year (12), results in an additional annual cost of $23,829,120 in all funds. Applying the pertinent Medicaid ratio, the General Revenue cost would be $9,186,126 for 2000, and $9,207,572 for 2001 and each subsequent year. The federal funds cost would be $14,642,994 for 2000, and $14,621,548 for 2001 and each subsequent year. 2. It is estimated the Department of Human Services will serve 5,978 SSI clients in 2000 and in each subsequent year. It is estimated the Department of Mental Health and Mental Retardation will serve 5,248 SSI clients in 2000 and in each subsequent year. The total SSI population (11,226), when multiplied by the additional personal needs per month ($30) and by the number of months per year (12), results in an additional annual cost of $4,041,360 in General Revenue. Local Government Impact No fiscal implication to units of local government is anticipated. Source Agencies: LBB Staff: JK, TP, PP