|Date Requested:March 01, 2013
Time Requested:02:24 PM
| FUND(S) |
0403 - Div of Human Services General Administrative Fund, 8722 - Cons Federal Funds Div of Human Services Gen Admin Fd, 0525 - Consolidated Medical Services Fund
Sources of Revenue
|General Fund,Other Fund Federal|
Legislation creates:Neither Program nor Fund
Effect this measure will have on costs and revenues of state government.
| The purpose of this bill is to require the Department of Health and Human Resources to pay for properly licensed, certified, or court approved programs for adult drug offenders participating in drug courts. The new language purposed in this bill is similar to the language provided in §49-7-33 which requires the department to pay for such services for juveniles.
The Department of Health and Human Resources (Department) estimates the fiscal impact of the proposed legislation, based on assumptions outlined in the fiscal note to be $1,422,138. The Department's Bureau for Medical Services currently provides coverage for substance abuse services that are included in the proposed legislation, however in order to cover the services and access the federal funding available through Medicaid, the services would have to be medically necessary and the individual must be eligible for Medicaid on the date of service and the services would have to meet established utilization management (UM) guidelines, as the services are subject to prior authorization (PA). During SFY 2010, the Medicaid program expended a total of approximately $53.7 million dollars for substance abuse services. This expenditure consisted of payments for inpatient and outpatient services of approximately $43.8 million for 14,011 adults and $9.9 million for 1,795 children under the age of 21. The proposed legislation stipulates that the drug court determines the length of stay in the treatment, so if any of the duration would be outside the medical necessity, member eligibility or UM criteria, the costs would not be covered by the Medicaid program and would have to be funded with State dollars.
The Department's Bureau for Behavioral Health and Health Facilities estimates that, based on the current 16 drug court programs that cover 20 different Drug Courts and 30 different counties, estimated amounts for Drug Court related group and limited individual substance abuse treatment counselor costs would be $30,000 per program. For the 20 current drug courts the total estimated costs is $600,000 in state dollars. Additionally, it should be noted, that current participants in Drug Court Programs are likely receiving referral to or some level of substance abuse treatment services from the Department's funded Comprehensive Providers through indigent care services.
|Effect of Proposal||Fiscal Year|
|1. Estmated Total Cost||0||1,422,138||1,422,138|
|Repairs and Alterations||0||0||0|
|2. Estimated Total Revenues||0||0||0|
3. Explanation of above estimates (including long-range effect):
Based on SFY 2010 Medicaid expenditures a simple average calculation of $43.8M/14,011 would equal an average cost of $3,126 per adult. This is not an accurate way of providing an estimate as the total costs is a combination of inpatient and outpatient services. According to the Justice Reinvestment in West Virginia report, the drug court has a capacity to provide services to 430 individuals and there currently an estimated demand for services of 263 adults. Based on this demand (263) and the average adult cost of $3,126 the estimated cost to the Medicaid program could be $822,138. Additionally, the cost to the Department's Bureau for Behavioral Health and Health Facilities to fund the current 20 drug courts the additional cost would be $600,000 ($30,000/court X 20).