LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
March 16, 2001
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB1087 by Coleman (Relating to a demonstration project
to establish a medical assistance buy-in program for
certain persons with disabilities.), Committee Report
1st House, Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB1087, Committee Report 1st House, Substituted: positive impact *
* of $248,638 through the biennium ending August 31, 2003. *
* *
* The bill would make no appropriation but could provide the legal *
* basis for an appropriation of funds to implement the provisions of *
* the bill. *
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General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2002 $0 *
* 2003 248,638 *
* 2004 0 *
* 2005 0 *
* 2006 0 *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Revenue Probable Probable *
* Year Gain/(Loss) from Savings/(Cost) from Savings/(Cost) from *
* General Revenue Fund Federal Funds - GR Match for *
* 0001 Federal Medicaid *
* 0555 0758 *
* 2002 $0 $(715,000) $0 *
* 2003 367,200 (521,188) (118,562) *
* 2004 0 0 0 *
* 2005 0 0 0 *
* 2006 0 0 0 *
**************************************************************************
Technology Impact
For the demonstration project, the Department of Human Services estimates
an automation cost of $715,000 for FY 2002 and $71,500 for FY 2003.
Fiscal Analysis
The bill would provide for a demonstration project for a medical
assistance buy-in for certain recipients with disabilities in accordance
with the federal Ticket to Work and Work Incentives Improvement Act of
1999.
Eligibles would include persons who are (1) at least 16 but not more than
64 and have earned income which exceeds the limit for SSI but are
otherwise eligible, and (2) employed with a medically improved
disability.
The bill would authorize the department to set income, assets, and
resource limitations for purposes of the demonstration project.
The bill would provide for cost-sharing.
The Health and Human Services Commission would be required to apply for
an infrastructure grant related to the Ticket to Work program and to
apply for necessary waivers for implementation not later than September
1, 2002.
The bill would require the department to evaluate the effectiveness of
the project by December 1, 2002.
The bill would expire on September 1, 2003.
Methodology
1. It is assumed that funding related to the evaluation and to the
required systems changes at the Department of Human Services would be
funded with federal funds made available specifically for infrastructure
relating to "Ticket to Work." It is further assumed the State and the
Health Care Financing Administration (HCFA) would agree to annual
benchmarks related to personal assistance services, which are necessary
for receipt of the federal funds.
2. Client medical benefits were estimated using a category relating to
disabled persons and include the full package of medical assistance
benefits.
3. It is assumed that 270 clients are currently receiving Medicaid but
would return to work and participate in this program and 30 clients are
clients new to the Medicaid program. It is assumed all clients would
contribute in cost sharing as follows: 150 clients would pay $68 per
month, and 150 clients would pay $136.
4. The project would begin providing services on September 1, 2002.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: 655 TX Dept. of Mental Health & Mental Retardation,
324 Texas Department of Human Services, 529
Health and Human Services Commission, 501 Texas
Department of Health
LBB Staff: JK, HD, KF, AJ