LEGISLATIVE BUDGET BOARD
Austin, Texas
 
FISCAL NOTE, 86TH LEGISLATIVE REGULAR SESSION
 
April 1, 2019

TO:
Honorable James B. Frank, Chair, House Committee on Human Services
 
FROM:
John McGeady, Assistant Director     Sarah Keyton, Assistant Director
Legislative Budget Board
 
IN RE:
HB4533 by Klick (Relating to the system redesign for delivery of Medicaid acute care services and long-term services and supports to persons with an intellectual or developmental disability.), As Introduced

The fiscal implications of the bill relating to the establishment of a pilot program developed in consultation with the IDD System Redesign Advisory Committee cannot be determined at this time as the eligibility criteria and benefits to be included in the pilot are unknown.

The bill would require HHSC to collaborate with the Intellectual and Developmental Disability System Redesign Advisory Committee to develop and implement a Medicaid pilot program to provide home and community-based services for adults in STAR+PLUS who have intellectual or developmental disabilities (IDD). The pilot would begin on September 1, 2023 and operate for at least two years. The bill would require HHSC to collaborate and consult with the IDD System Redesign Advisory Committee to perform an evaluation and submit a report after the conclusion of the pilot program. The bill would require HHSC to consider a second pilot to test the provision of residential services in managed care after completing the evaluation of report.

Based on the LBB's analysis of HHSC, duties and responsibilities associated with collecting and analyzing data, conducting the evaluation, and reporting the findings of the pilot program could be accomplished by utilizing existing resources. The costs associated with developing and implementing the pilot program cannot be determined at this time, as information is not available to determine the criteria for selecting MCOs to participate in the pilot, the eligibility criteria for the pilot, and the exact benefits included in the pilot. Costs could include client services and information technology systems changes that could vary depending on the size and scope of the pilot program.

The Department of Family and Protective Services (DFPS) and the Department of State Health
Services (DSHS) may have a cost associated with the Public Assistance Cost Allocation Plan. It is
assumed these costs could be absorbed within DFPS's and DSHS's existing agency resources.  

The bill would take effect September 1, 2019.

Local Government Impact

No significant fiscal implication to units of local government is anticipated.


Source Agencies:
529 Health and Human Services Commission
LBB Staff:
WP, AKi, EP, MDI