FISCAL NOTE
FUND(S):
0403 - Div of Human Services General Administration Fund, 8722 - Cons Federal Funds Div Human Services Gen Admn Fund
Sources of Revenue:
General 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 bill is to require development of program for payment of personal needs funds to Medicaid recipients in nursing homes in the amount of $75 a month. This amount is in addition to sums received from Medicaid.
Personal care homes are not covered by Medicaid and no estimate has been included for that component. The estimated annual cost to the Medicaid program for Medicaid nursing home residents is $6,981,300 of which $1,364,844 would be state funds for the first year. The state share would increase in SFY2011 as the enhanced FMAP from the stimulus package ends.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2009
Increase/Decrease
(use"-") |
2010
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
6,981,300 |
6,981,300 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
0 |
| Repairs and Alterations |
0 |
0 |
0 |
| Assets |
0 |
0 |
0 |
| Other |
0 |
6,981,300 |
6,981,300 |
| 2. Estimated Total Revenues |
0 |
0 |
0 |
Explanation of above estimates (including long-range effect):
The legislation addresses nursing homes and personal care homes; personal care homes are not a benefit covered by the Medicaid program and therefore are not addressed in this calculation. With respect to nursing homes, Medicaid residents currently keep $30 per month (SSI recipients) or $50 per month (non-SSI recipients) of their personal resources which is credited to their personal needs accounts. The legislation was interpreted to mean $75 per month in addition to the current personal needs allowance of $30 or $50, resulting in personal needs allowances of $105 or $125 per month. That $75 increase to each resident's personal needs allowance would result in an increase in the amount Medicaid contributes toward the resident's cost of care each month. The additional $75 was multiplied by the estimated number of Medicaid nursing home residents at a given point in time (7,757 residents) to arrive at an estimated monthly impact to Medicaid $581,775; annualized this would yield $6,981,300, of which $1,364,844 is estimated to be state funds. This calculation is based on federal participation of 80.45% based on enhanced FMAP effective with passage of the 2009 Federal Stimulus legislation (2008 FMAP of 74.25 (hold harmless) plus 6.2% from Stimulus); however this is effective for a limited time and Federal participation would decrease after expiration, which would in turn increase the amount of state funds needed for continued maintenance of this legislation.
An additional note for information purposes, Intermediate Care Facilities for the Mentally Retarded (ICFMR) residents also have a personal needs allowance that is the same as that applicable to nursing home residents ($30 or $50 per month), however that facility type was not included in the legislation. A calculation for ICFMR facility impact similar to the nursing home calculation above would yield an additional cost to the Medicaid program of $455,400 per year if implemented for ICFMR residents also. As ICFMR was not included in the legislation the additional $455,400 has not been included in the $6,981,300 above (which is only for the impact to nursing home residents) and is included for informational purposes only.
Memorandum
This will increase Medicaid's reimbursement responsibilities and, gone unused, becomes an asset that could affect Medicaid eligibility.
An additional note for information purposes, Intermediate Care Facilities for the Mentally Retarded (ICFMR) residents also have a personal needs allowance that is the same as that applicable to nursing home residents ($30 or $50 per month), however that facility type was not included in the legislation. A calculation for ICFMR facility impact similar to the nursing home calculation above would yield an additional cost to the Medicaid program of $455,400 per year if implemented for ICFMR residents also. As ICFMR was not included in the legislation the additional $455,400 has not been included in the $6,981,300 above (which is only for the impact to nursing home residents) and is included for informational purposes only.
Currently, according to the Office of Health Facility Licensure and Certification (OHFLAC) regulations, LTC residents may only carry a maximum balance of $50 in checking at any point in time. Any amount over $50 must be transferred to an interest-bearing savings account via wire transfer. Implementation of this bill would require the LTC facilities to make regular transfers on behalf of residents.
Person submitting Fiscal Note: Martha Yeager Walker
Email Address: dhhrbudgetoffice@wv.gov