LEGISLATIVE BUDGET BOARD
Austin, Texas
 
FISCAL NOTE, 80TH LEGISLATIVE REGULAR SESSION
 
April 9, 2007

TO:
Honorable Jane Nelson, Chair, Senate Committee on Health & Human Services
 
FROM:
John S. O'Brien, Director, Legislative Budget Board
 
IN RE:
SB938 by Uresti (Relating to providing medical assistance to certain former foster care adolescents.), As Introduced



Estimated Two-year Net Impact to General Revenue Related Funds for SB938, As Introduced: a negative impact of ($1,710,060) through the biennium ending August 31, 2009.

The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.



Fiscal Year Probable Net Positive/(Negative) Impact to General Revenue Related Funds
2008 ($410,700)
2009 ($1,299,360)
2010 ($1,275,878)
2011 ($1,275,878)
2012 ($1,275,878)




Fiscal Year Probable (Cost) from
GR MATCH FOR MEDICAID
758
Probable (Cost) from
FEDERAL FUNDS
555
Change in Number of State Employees from FY 2007
2008 ($410,700) ($410,700) 0.0
2009 ($1,299,360) ($1,912,004) 1.0
2010 ($1,275,878) ($1,888,522) 1.0
2011 ($1,275,878) ($1,888,522) 1.0
2012 ($1,275,878) ($1,888,522) 1.0

Fiscal Analysis

The bill requires the Health and Human Services Commission (HHSC) to provide Medicaid to former foster children 21 years of age or older, but younger than age 25, who are not otherwise eligible for Medicaid and do not have adequate coverage under another health benefits plan if the person is enrolled in at least 12 credit hours at an institution of higher education located in Texas. HHSC is required to pursue any necessary federal waiver or authorization.

Methodology

It is assumed that it would take a year to receive federal approval and implement the program.

Based on data from the Higher Education Coordinating Board 1,324 former foster children were enrolled in institutions of higher education in Texas and receiving tuition subsidies in fiscal year 2005; it is assumed that all were enrolled in at least 12 credit hours. Based on historical growth and assumed increases in the proportion of former foster children enrolling in institutions of higher education, it is assumed that growth in this program would be double that of projected growth in average monthly foster care FTEs at the Department of Family and Protective Services. It is assumed that 1,806 former foster children will be enrolled in fiscal year 2008 and 2,002 in fiscal year 2009 and subsequent years. It is assumed that these persons range in age from 18 to 24 years old, with the majority 22 years old or younger; the assumed distribution is 90 percent evenly distributed among ages 18 to 22, 6 percent age 23, and 4 percent age 24. Based on this distribution, 46 percent would be 21 to 24 years of age. Due to the year delay in implementation, no client services impact is assumed in fiscal year 2008; 921 (46 percent of 2,002) clients are assumed to receive services in fiscal year 2009 and beyond.

The average cost per recipient month is assumed to be $276.06, the estimated cost to provide services to TANF Adults in the Medicaid program (these are the only non-elderly, non-disabled, non-pregnant adults enrolled in Texas Medicaid). Total client services cost is estimated to be $3.1 million All Funds, including $1.2 million in General Revenue Funds, in fiscal year 2009 and subsequent years.

It is assumed that the additional Medicaid caseload will result in a need for 1.0 additional FTE (eligibility worker) in fiscal year 2009 and beyond. Other administrative costs include $0.8 million in fiscal year 2008 for one-time costs for system modifications and $0.1 million in the 2008-09 biennium for costs to the Medicaid claims payment contractor. Additional enrollment broker and eligibility determination costs totaling $75,356 are assumed each year beginning in fiscal year 2009.

The total estimated cost to implement the provisions of the bill are $0.8 million All Funds, including $0.4 million in General Revenue Funds, in fiscal year 2008 and $3.2 million All Funds, including $1.2 million in General Revenue Funds in fiscal year 2009 and subsequent years.


Technology

Included in costs above are $0.8 million All Funds, including $0.4 million in General Revenue Funds, for one-time system modifications in fiscal year 2008.

Local Government Impact

No fiscal implication to units of local government is anticipated.


Source Agencies:
530 Family and Protective Services, Department of, 529 Health and Human Services Commission
LBB Staff:
JOB, CL, PP, LR