Date Requested:April 07, 2009
Time Requested:01:12 PM
Agency: Health and Human Resources, Department of
CBD Number: Version: Bill Number: Resolution Number:
Amendment SB414
CBD Subject: PATIENT CENTERED MEDICAL HOMES
FUND(S)
N/A
Sources of Revenue
General Fund,Other Fund Federal
Legislation creates:
A New Program

Fiscal Note Summary

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

    The purpose of this bill is to establish the Governor's Office of Health Enhancement and Lifestyle Planning for the purposes of improving health care delivery, achieving measurable cost saving for state agencies and promoting collaboration of state agencies on various types of health related pilot projects. This bill was recommended for passage during the 2009 Regular Session by Select Committee D on Health.
    Based on the information provided, no fiscal impact to the Department of Health and Human Resources can be determined; however given that the legislation allows pilot projects there are concerns that Medicaid may be precluded from drawing federal funds for the services provided under the pilot projects.
    

Fiscal Note Detail
Over-all effect
Effect of Proposal Fiscal Year
2009
Increase/Decrease
(use"-")
2010
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 0 0
Personal Services 0 0 0
Current Expenses 0 0 0
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):
    


Memorandum
Person submitting Fiscal Note:
Martha Yeager Walker
Email Address:
dhhrbudgetoffice@wv.gov
    The cost for developing and administering four medical home pilots based on a small pilot could range between $700,000 and $1.2 million.
    
    It’s difficult to estimate the cost for the polls and focus groups but a reasonable amount would be around $30,000 each for focus groups and $100,000 each for polls. The primary cost is in setting up the office which we estimate will take 15-18 people as well as consultants/contractors for pilot programs and the five-year plan. There is no cost to DHHR, the cost is in setting up and operating the new bureau. So we estimate that there would be approximately 18 employees at a cost of $1.2M including salaries and benefits. This estimate does not include the cost of contractors to establish the five-year strategic plan to implement health care system reform initiatives or current expense items. This fiscal note was prepared as if it were being established in our own department.
    
    
    Depending on the specific approach taken with each pilot project, Medicaid may be precluded from drawing FMAP for the services provided under the pilot project to the extent that those services do not comply with Federal Law and/or the Medicaid State Plan. Additionally, it is noted that national organizations are moving in the direction of including rather than excluding nurse practitioners in the definition of patient-centered medical homes. This legislation excludes nurse practitioners, which will impact access to medical homes and providers in rural areas.