| TO: | Honorable Patrick M. Rose, Chair, House Committee on Human Services |
| FROM: | John S. O'Brien, Director, Legislative Budget Board |
| IN RE: | HB1738 by Lucio III (Relating to medical assistance for children with Down syndrome.), As Introduced |
| Fiscal Year | Probable Net Positive/(Negative) Impact to General Revenue Related Funds |
|---|---|
| 2008 | ($22,925,429) |
| 2009 | ($65,740,021) |
| 2010 | ($65,740,021) |
| 2011 | ($65,740,021) |
| 2012 | ($65,740,021) |
| Fiscal Year | Probable (Cost) from GENERAL REVENUE FUND 1 |
Change in Number of State Employees from FY 2007 |
|---|---|---|
| 2008 | ($22,925,429) | 1.0 |
| 2009 | ($65,740,021) | 3.0 |
| 2010 | ($65,740,021) | 3.0 |
| 2011 | ($65,740,021) | 3.0 |
| 2012 | ($65,740,021) | 3.0 |
The bill would add Section 32.02491, Medical Assistance for Children with Down Syndrome, to Subchapter B, Chapter 32 of the Human Resources Code. It would require the Health and Human Services Commission (HHSC), regardless of the availability of federal matching funds, to provide medical services to a person younger than 18 who has a diagnosis of Down Syndrome, and who is not otherwise eligible for Medicaid. The bill would require HHSC to adopt rules that require the agency to provide services only to the extent that the person has no other health insurance or other plan under which services are available.
The bill requires HHSC to actively pursue federal authorization for Medicaid matching funds to provide services under this section. The bill would take effect September 1, 2007.
For the purposes of this cost estimate, it is assumed that medical services include both acute and long-term care services. Therefore, the cost of acute care, vendor drug and community-based care are included above. The cost is allocated to General Revenue; however, under the provisions of the bill the agency is directed to seek federal financial participation. Should this occur, approximately 60 percent of the cost could be funded with Federal Funds.
HHSC states that there are approximately 7,500 instances of Down Syndrome children per year. It is assumed that 40 percent are not currently on Medicaid and that 46 percent of this sub-set are people without private insurance. It is assumed that private insurance may cover some long-term care services.
The first year impact is assumed to be one-third, due to time required to implement the program. This provides a caseload impact of 460 in FY 08 and 1,380 in fiscal years 2009 through 2012. No growth in caseload is assumed from FY 09 forward.
Cost estimates are assumed to be $12,906 per year for acute care services through HHSC and $34,407 per year for community-based care at the Department of Aging and Disability Services (DADS). The cost for acute care services is based on the cost to serve disabled and blind individuals in the Medicaid program currently. DADS' estimate of cost is the same as that for the CLASS waiver.
Multiplying caseload times cost results in a total of $21.7 million in fiscal year 2008 and $65.3 million in fiscal year 2009 through fiscal year 2012.
In addition, HHSC states they would require 1 FTE in fiscal year 2008 at a cost of $95,364 and 3 FTEs in fiscal year 2009 and beyond, costing $286,092 per year. Professional services costs, travel, cost pool and start up costs add $201,291 in fiscal year 2008. These costs going forward are $159,936 per year.
| Source Agencies: | 529 Health and Human Services Commission, 539 Aging and Disability Services, Department of
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| LBB Staff: | JOB, SD, CL, PP, MB
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