LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session April 19, 2001 TO: Honorable Bill Ratliff, Lieutenant Governor, Senate FROM: John Keel, Director, Legislative Budget Board IN RE: SB831 by Moncrief (Relating to the establishment of a medical assistance buy-in pilot program for certain persons with disabilities.), As Passed 2nd House ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * SB831, As Passed 2nd House: positive impact of $430,951 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 Net Impact: **************************************************** * Fiscal Year Probable Net Positive/(Negative) * * Impact to General Revenue Related * * Funds * * 2002 $57,995 * * 2003 372,956 * * 2004 0 * * 2005 0 * * 2006 0 * **************************************************** All Funds, Five-Year Impact: ************************************************************************** *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 $275,400 $(762,846) $(217,405) * * 2003 550,800 (303,406) (177,844) * * 2004 0 0 0 * * 2005 0 0 0 * * 2006 0 0 0 * ************************************************************************** Technology Impact For the pilot program, the Department of Human Services (DHS) estimates automation costs of $715,000 for FY 2002 and $71,500 for FY 2003. Fiscal Analysis The bill would provide for a pilot program 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 years of age, but not more than 64 years, 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 Health and Human Services Commission (HHSC) to set income, assets, and resource limitations for purposes of the pilot program. The bill would provide for cost-sharing. The bill would require HHSC to evaluate the effectiveness of the program by December 1, 2002. The bill would expire on September 1, 2003. Methodology 1. It is assumed that funding related to the evaluation and required systems changes at DHS would be funded with federal funds made available specifically for infrastructure relating to "Ticket to Work." 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 405 clients are currently receiving Medicaid but would return to work and participate in this program and 45 clients are clients new to the Medicaid program. It is assumed all clients would contribute in cost sharing as follows: 225 clients would pay $68 per month, and 225 clients would pay $136. 4. The project would begin providing services on March 1, 2002. Local Government Impact No fiscal implication to units of local government is anticipated. Source Agencies: 324 Texas Department of Human Services, 501 Texas Department of Health, 529 Health and Human Services Commission LBB Staff: JK, HD, KF, AJ