Date Requested:February 14, 2011
Time Requested:11:16 AM
Agency: Childrens Health Insurance Program
CBD Number: Version: Bill Number: Resolution Number:
Comm. Sub. Eng. HB2693
CBD Subject: INSURANCE COVERAGE FOR AUTISM SPECTRUM DISORDERS
FUND(S)
0588, 2154, 8838
Sources of Revenue
General Fund,Other Fund Federal Funds
Legislation creates:
Neither Program nor Fund

Fiscal Note Summary

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

    This bill requires WVCHIP provide coverage for the prevention, early detection, diagnosis and treatment of autism spectrum disorder and other related disorders. The original bill has now been amended and the requirement to cover applied behavioral analysis is limited to $30,000 annually for the first three years after diagnosis, and $2,000 monthly until the member reaches age 18.
    
    WVCHIP covers approximately 24,400 children per month (around 38,000 children per year) and estimates the prevalence of autism at 1.28% of children within the program, approximately 312 children per month. The estimates below, however, include some considerations for a "ramp-up" period - approximately 5 years - to allow time for provider networks to be established for these services. These numbers assume that the “ramp-up” period would equal 40%, 60%, 70%, 80%, and 90%, respectfully, of total projected costs once services are established.
    
    Assuming the "ramp-up" period, WVCHIP expects total costs for covering these services under this bill to be $2,592,773 ($2,095,738 federal and $497,035 state) for 121 children in SFY 2012, $3,327,392 ($2,689,531 federal and $637,861 state) for 141 children in SFY 2013, and $4,183,007 ($3,381,125 federal and $801,882 state) for 161 children in 2014. Costs are expected to be approximately $13,210,369 ($10,677,941 federal and $2,532,428 state) for 312 children in SFY 2017 when the services are fully implemented. Costs assume the Federal Fiscal Year 2012 match rate of 80.83%.
    

Fiscal Note Detail
Over-all effect
Effect of Proposal Fiscal Year
2011
Increase/Decrease
(use"-")
2012
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 637,861 2,532,428
Personal Services 0 0 0
Current Expenses 0 0 0
Repairs and Alterations 0 0 0
Assets 0 0 0
Other 0 637,861 2,532,428
2. Estimated Total Revenues 0 0 0
3. Explanation of above estimates (including long-range effect):
    This bill requires WVCHIP provide coverage for the prevention, early detection, diagnosis and treatment of autism spectrum disorder and other related disorders. The original bill has now been amended and the requirement to cover applied behavioral analysis is limited to $30,000 annually for the first three years after diagnosis, and $2,000 monthly until the member reaches age 18.
    
    WVCHIP covers approximately 24,400 children per month (around 38,000 children per year) and estimates the prevalence of autism at 1.28% of children within the program, approximately 312 children per month. The estimates below, however, include some considerations for a "ramp-up" period - approximately 5 years - to allow time for provider networks to be established for these services. These numbers assume that the “ramp-up” period would equal 40%, 60%, 70%, 80%, and 90%, respectfully, of total projected costs once services are established.
    
    Assuming the "ramp-up" period, WVCHIP expects total costs for covering these services under this bill to be $2,592,773 ($2,095,738 federal and $497,035 state) for 121 children in SFY 2012, $3,327,392 ($2,689,531 federal and $637,861 state) for 141 children in SFY 2013, and $4,183,007 ($3,381,125 federal and $801,882 state) for 161 children in 2014. Costs are expected to be approximately $13,210,369 ($10,677,941 federal and $2,532,428 state) for 312 children in SFY 2017 when the services are fully implemented. Costs assume the Federal Fiscal Year 2012 match rate of 80.83%.
    


Memorandum
Person submitting Fiscal Note:
Stacey Shamblin
Email Address:
Stacey.L.Shamblin@wv.gov
    WVCHIP is not sure the impact HB 2693 will have on its current program. Per current statute at 5-16b-6(c)(3), enrollment of children without insurance is to take precedence over enhancing benefits available under the program. The fiscal impact of HB 2693 would definitely hinder the program’s ability to cover the largest number of children it can with its available funding. The additional costs of services outlined in this bill equal the costs of allowing 1,360 children to access services under the program’s current benefit structure in state fiscal year 2012 in keeping with the original intent of 5-16b-6(c)(3). This number grows to 6,931 children upon full implementation in state fiscal year 2017.