Date Requested:February 23, 2005
Time Requested:02:49 PM
Agency: Health and Human Resources, Department of
CBD Number: Version: Bill Number: Resolution Number:
2005R669 Intro HB2607
CBD Subject: Newborn Testing - Sickle Cell Anemia & H
FUND(S)
0407-Central Office General Administrative Fund, 5163-Office of Laboratory Services, 8802-Federal-Unclassified
Sources of Revenue
General Fund,Special Fund,Other Fund Federal
Legislation creates:
Neither Program nor Fund

Fiscal Note Summary

Effect this measure will have on costs and revenues of state government.

    The purpose of this legislation is to expand newborn testing to include sickle cell anemia and congenital adrenal hyperplasia (CAH).
    
    
    Beginning July 1, 2003, the Bureau for Public Health established, through public health policy issuance, the requirement that all infants born in a licensed health care facility be screened for sickle cell and other hemoglobinapathies. The expense of the hemoglobinopathy testing is covered by federal grant funds (Maternal and Child Health Block Grant, Title V) and general revenue (Maternal and Child Health Clinics, Clinicians and Medical Contracts and Fees).
    
    
    The Department estimates that it will cost an additional $82,000 for the Office of Maternal, Child and Family Health (MCFH) to perform the necessary case management, interventions, medical provider training, community education, hormone and salt replacement supplements, and disease surveillance if testing for CAH is implemented. Expansion of the newborn metabolic screen testing will create need for an additional nursing staff for the Office of Maternal, Child and Family Health. There is only one nurse dedicated to working with the Office of Laboratory Services, practicing medical community, the genetics consultant, and families; therefore any expansion of coverage will require additional personnel and fiscal resources. There are approximately 20,000 births per year but because of early discharge, etc., repeat testing is normal, requiring that families be contacted to obtain a second screening. This results in more than 38,000 tests provided each year and requires MCFH staff be dedicated to finding the child/family to assure repeat testing occurs, have contact with the primary medical practitioner serving the child, and linkage with genetics expertise to guide the care plan for children who are positive.
    
    
    Also, the Department estimates it will cost an additional $70,893 for the Office of Laboratory Services to purchase reagents to further expand testing to include CAH.
    

Fiscal Note Detail
Over-all effect
Effect of Proposal Fiscal Year
2005
Increase/Decrease
(use"-")
2006
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 152,893 152,893
Personal Services 0 48,000 48,000
Current Expenses 0 104,893 104,893
Repairs and Alterations 0 0 0
Assets 0 0 0
Other 0 0 0
2. Estimated Total Revenues 0 0 0
3. Explanation of above estimates (including long-range effect):
    Personal Services for Nurse III salary of $36,000; Fringe Benefits of $12,000; and Current Expenses totaling $104,893 for: Medical Consultant of $10,000 (to be used to augment existing medical expertise provided by the WVU School of Medicine, Department of Pediatrics/Genetics); Treatment and Intervention of $15,000; Educational Materials for families of $3,000; Telephone and postage of $3,000; Travel of $3,000; and laboratory fees of $70,893 based on testing 38,000 specimen for Congenital Adrenal Hyperplasia.
    


Memorandum
Person submitting Fiscal Note:
Martha Yeager Walker
Email Address:
fnbudoff@wvdhhr.org
    The Department's Bureau for Medical Services covers approximately 11,045 births annually, however the Office of Laboratory Services, at the present time, does not invoice for the testing. Based on the number of births and the payment rates for the tests it is possible that the Department could see an increase in costs within the Medicaid program, if the Office of Laboratory Services begins invoicing for the testing. This would result in a decrease in costs to the Bureau for Public Health, Office of Maternal, Child and Family Health, as well as an increase in revenue to the Bureau for Public Health, Office of Laboratory Services.