LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session May 24, 2001 TO: Honorable Bill Ratliff, Lieutenant Governor, Senate FROM: John Keel, Director, Legislative Budget Board IN RE: SB51 by Zaffirini (Relating to the provision of Medicaid to certain persons making the transition from foster care to independent living.), As Passed 2nd House ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * SB51, As Passed 2nd House: negative impact of $(822,672) 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. * ************************************************************************** General Revenue-Related Funds, Five-Year Impact: **************************************************** * Fiscal Year Probable Net Positive/(Negative) * * Impact to General Revenue Related * * Funds * * 2002 $(335,211) * * 2003 (487,461) * * 2004 (670,161) * * 2005 (749,733) * * 2006 (839,032) * **************************************************** All Funds, Five-Year Impact: *************************************************************************** *Fiscal Probable Savings/(Cost) from GR Probable Savings/(Cost) from * * Year Match for Medicaid Federal Funds - Federal * * 0758 0555 * * 2002 $(335,211) $(504,900) * * 2003 (487,461) (730,755) * * 2004 (670,161) (1,004,427) * * 2005 (749,733) (1,123,905) * * 2006 (839,032) (1,258,004) * *************************************************************************** Fiscal Analysis The bill would provide Medicaid coverage for individuals who are under 21 years of age and who on their 18th birthday were in foster care under the responsibility of the State. The coverage would be provided regardless of the individual's assets, resources or income. Methodology It is assumed that under current law individuals who are in foster care on their 18th birthday are eligible to participate in the Texas Medicaid program or the state Children's Health Insurance Program (CHIP) through the month of their 19th birthday. Therefore, this fiscal note only applies to individuals age 19 and 20 who were in foster care on their 18th birthday. The Department of Protective and Regulatory Services estimates that 849 individuals were in foster care on their 18th birthday during fiscal year 2001 and assumes that this number will rise by 2% annually through fiscal year 2003. It is assumed that the 2% annual rise will continue through fiscal year 2006 and that 832 individuals (98% of 849) were in foster care on their 18th birthday during fiscal year 2000. It is further assumed that individuals will attain the age of 18 in equal increments throughout the year with 1/12th celebrating their birthday in September and each month thereafter. It is assumed that 50% of the individuals who celebrate their 18th birthday during fiscal years 2000 and 2001 will enroll in the Medicaid program when they reach the age of 19 and continue their enrollment through the month of their 21st birthday. Eighty percent of the individuals who celebrate their 18th birthday during fiscal years 2002 to 2006 will enroll at age 19 and continue through age 20. The average monthly cost per individual participating in the Medicaid program includes the cost of providing insured services, cost-reimbursed services, vendor drugs, medical transportation and administrative services. The Texas Department of Health has projected this cost to be $153.77 for FY 2002, $168.89 for FY 2003, $185.09 for FY 2004, $203.00 for FY 2005, and $222.80 for FY 2006. The Federal Medical Assistance Percentage (FMAP) is assumed to be 60.02% for FY 2002, 60.08% for FY 2003 and 60.07% for FYs 2004 2005, and 2006. There will be no significant fiscal impact to the Department of Human Services which will process about 120 additional Medicaid applications each month. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies: 530 Department of Protective and Regulatory Services, 529 Health and Human Services Commission, 324 Texas Department of Human Services, 501 Texas Department of Health LBB Staff: JK, HD, NM