Date Requested:January 17, 2008
Time Requested:10:13 AM
Agency: Health and Human Resources, Department of
CBD Number: Version: Bill Number: Resolution Number:
2008R1557 Introduced HB4074
CBD Subject: OFFICE OF ORAL HEALTH
FUND(S)
Sources of Revenue
General Fund
Legislation creates:
A New Fund

Fiscal Note Summary

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

    The purpose of the bill is to create an Office for Oral Health under the Bureau for Public Health and to authorize a full time director.
    
    The proposed legislation requires the Office for Oral Health to employ a director, with at least three years experience in health or management in a health care related setting and any administrative staff or professional employees required for operation of this new Office. The bill establishes an advisory board to advise the director in the development of a comprehensive plan with designated benchmarks and responsible parties to improve the oral health of citizens in the state. The Office for Oral Health will design oral health programs that assure children entering kindergarten, grade two and grade six have an oral health exam and appropriate preventive programs including recommendations for potential funding sources. The Office will design a training program for pediatricians, primary care providers and their staff in certain preventive oral health procedures.
    
    Programs designed to address school children at specific times having oral exams and appropriate preventive programs can be accomplished with proposed and current staff, with input from the advisory board at no additional cost at this time.
    
    Training programs designed for pediatricians, primary care providers and their staff in certain preventive oral health procedures has been completed and is available.
    
    The Department estimates the costs to be $128,277 in year one, and $123,377 upon full implementation

Fiscal Note Detail
Over-all effect
Effect of Proposal Fiscal Year
2008
Increase/Decrease
(use"-")
2009
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 128,277 123,377
Personal Services 0 107,153 107,153
Current Expenses 0 21,124 16,224
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 include the addition of the required Office Director I, and a Secretary I and associated fringe benefits. The breakdown of costs is: Office Director salary ($54,498) and benefits ($17,304); Secretary salary ($24,126) and benefits ($11,225). The estimated salary for these two positions was based upon the mid range of the current Division of Personnel pay grade.
    
    Current expense details include increases in rent and utilities ($6,324), phones ($1,200), office supplies and misc expenses ($500), and in-state and out-of-state travel ($3,200) for the new staff. In addition, there is one time expense for computers and printer ($4,900).
    
    This bill requires the establishment of an advisory board to advise the Director in the development of a comprehensive plan with designated benchmarks and responsible parties to improve the oral health of citizens in the state. There is currently a committee that the Oral Health Program has established, with representation similar to that proposed; members would need to be added to meet the bill requirements. Hospitality and travel for these meetings is estimated at $5,000.
    
    


Memorandum
Person submitting Fiscal Note:
Martha Yeager Walker
Email Address:
fnbudoff@wvdhhr.org
    Currently the Oral Health Program within the Bureau for Public Health, Office of Maternal, Child and Family Health is funded with approximately $300,000 of MCH Title V Block Grant Funds and $352,000 of general revenue funds (0407-575 $202,000 and 0407-550 $150,000) for a total budget of $652,000. This budget includes current staff of 3 FTEs ($106,000) and current expense for daily program administration and operations. In addition, the program has a dental consultant at a cost of $110,000 per year.
    The program currently spends approximately $304,000 on oral health education activities. This provides a minimal level of oral health education for school systems in every county. No additional funding has been requested. The legislation does not indicate that the Advisory Board is to be reimbursed for travel but the Department has made the assumption that it will reimburse for travel in accordance with current state travel policy.
    The legislation requires the Office to recommend potential funding sources. In order to consider an approximate amount to be covered, the Department calculated costs as follows: There are approximately 21,000 children in WV in each age group. It is estimated that 53% would be covered under Medicaid and CHIP, therefore there would be no additional cost for these children. For calculation purposes we assumed some would have other insurance coverage and that 30% would be uninsured. Based on this, approximately 18,900 children (21,000*3*30%) may require financial assistance. If providers were reimbursed at the current rate allowed by Medicaid and CHIP ($150/exam) it would cost $2,835,000 for exams alone with no cost for treatment included.
    The Department is able to design oral health programs for the specified school age groups but to ensure that the specified children have participated in such programs may better reside with the Department of Education.
    There are training programs that are available for pediatricians, primary care providers and their staff in certain preventive oral health procedures but the Dental Practice Act conflicts with the provision of these services by non-dental medical professionals.
    Possible technical flaw: 16-41-7 identifies July 1, 2007 as program end date, "unless sooner terminated, continued or reestablished."