| TO: | Honorable Richard Pena Raymond, Chair, House Committee on Human Services |
| FROM: | John S O'Brien, Director, Legislative Budget Board |
| IN RE: | HB329 by Guillen (Relating to a pilot project to establish a comprehensive access point for long-term services and supports provided to older persons and persons with physical disabilities.), As Introduced |
| Fiscal Year | Probable Net Positive/(Negative) Impact to General Revenue Related Funds |
|---|---|
| 2012 | ($1,752,988) |
| 2013 | ($1,241,846) |
| 2014 | ($1,284,503) |
| 2015 | ($1,326,583) |
| 2016 | $0 |
| Fiscal Year | Probable (Cost) from General Revenue Fund 1 |
Probable (Cost) from GR Match For Medicaid 758 |
Probable (Cost) from Federal Funds 555 |
|---|---|---|---|
| 2012 | ($89,361) | ($1,663,627) | ($2,061,987) |
| 2013 | ($42,099) | ($1,199,747) | ($1,624,342) |
| 2014 | ($42,099) | ($1,242,404) | ($1,677,120) |
| 2015 | ($42,099) | ($1,284,484) | ($1,733,591) |
| 2016 | $0 | $0 | $0 |
The bill would amend Subchapter B, Chapter 531, Government Code to require the Health and Human Services Commission (HHSC) to establish a comprehensive pilot project in not more than three geographic areas of the state to establish a single point of entry system for certain long-term services. HHSC would be required to establish a tentative eligibility determination for these services. The bill would direct the co-location of Department of Aging and Disability Services (DADS), HHSC, and area agency on aging staff. The bill would also require that HHSC submit a report no later than January 31, 2013 concerning the project to the presiding officers of the standing committee of the senate and house of representatives having primary jurisdiction over health and human services. The pilot project would expire on September 1, 2015.
The bill would require that at least one site of the pilot be in operation no later than December 31, 2011.
The bill would take effect immediately if it receives a two-thirds vote in each house; if not, it would take effect September 1, 2011.
DADS assumes the pilot projects would be established in Belton, Amarillo and El Paso. Approximately 167 average monthly program recipients would be anticipated in the Community Attendant Services, Day Activity and Health Servcies, and Primary Home Care programs. The agency has assumed that the intent is to serve clients in programs that do not have a waiting list. If all programs in the bill were included, the costs would be higher. The cost to serve Medicaid eligible clients is assumed to be $1.3 million in All Funds in fiscal year 2012 and $2.0 million in fiscal year 2013. DADS assumes that when a final eligibility determination is made, 5% of the cases would turn out ineligible for Medicaid and would therefore require unmatched state funding.
For purposes of this analysis, HHSC has assumed that the Centers for Medicare and Medicaid Services would approve the State Plan Amendment to establish the pilot program by December 1, 2011. It is also assumed that General Revenue Funds would be matched at the Medicaid Federal Matching Assistance Percentage (FMAP) of 58.42 in fiscal year 2012 and 57.45 in fiscal year 2013.
HHSC estimates costs for eligibility determination including contractor costs, travel and technology costs. The contractor costs include document processing, Data Broker, Bureau of Vital Statistics, and other items, totaling $27.56 per recipient in fiscal year 2012 and $27.97 per recipient in fiscal year 2013. HHSC anticipates the need for a financial eligiblity determination for 55 average monthly recipients in fiscal year 2012 (assuming a start date of December 31, 2011), increasing to 109 average monthly recipients in fiscal year 2013. The total eligibility costs would be $1,885,066 in fiscal year 2012 and $3,049 in fiscal year 2013. This includes one-time costs for modifications to the Texas Integrated Eligibility Redesign Systems (TIERS) of $1,657,500 in fiscal year 2012.
DADS anticipates one-time costs totaling $350,054 for systems changes to the Long Term Care Intake System and the Consolidated Interest List System. DADS also estimates costs for Data Center Services to be $25,000 per year.
Based on HHSC cost estimates, systems modifications for TIERS would total $1,657,500 in fiscal year 2012. The modifications would include on-line screening modules for Long Term Services and Support, new codes for tentative Medicaid eligibility required by the provisions of the bill, modifications for storage of additional data, and other interface, correspondence, hearing, reports and alerts modifications.
| Source Agencies: | 529 Health and Human Services Commission, 539 Aging and Disability Services, Department of
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| LBB Staff: | JOB, CL, MB, ES
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