FISCAL NOTE
FUND(S):
0403 - Div of Human Services General Administration Fund, 8722 - Cons Federal Funds Div Human Services Gen Admn
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 payment to both individuals and married couples who are Medicaid recipients, who are residents in nursing homes or personal care homes, $45 or $65 a month respectively for their personal needs accounts, in addition to sums received from Medicaid. This shall be an increase of the current limits on said personal use accounts from $30 or $50 respectively.
Personal care homes are not covered by Medicaid therefore no estimate has been included for that component. The Department estimated an increased annual cost for Medicaid nursing home residents as $1,396,260, of which $272,969 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 |
1,396,260 |
1,396,260 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
0 |
| Repairs and Alterations |
0 |
0 |
0 |
| Assets |
0 |
0 |
0 |
| Other |
0 |
1,396,260 |
1,396,260 |
| 2. Estimated Total Revenues |
0 |
0 |
0 |
Explanation of above estimates (including long-range effect):
A $15 increase to each resident's personal needs allowance (from $30 to $45, or from $50 to $65) would result in an increase in the amount Medicaid contributes toward the resident's cost of care each month. The estimated increase for Medicaid nursing home residents was calculated as follows: The $15 difference 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 $116,355; annualized this would yield $1,396,260, of which $272,969 is estimated to be state funds. The state funds are estimated based on the enhanced FMAP from the stimulus package. The state share would increase in SFY2011 as the enhanced FMAP from the stimulus package ends.
Memorandum
ยง9-2-9(g) is vague and could be interpreted in different ways. The Department's response assumed the increase to $45 and $65 was based on the amount the current resident receives, not by marital status or type of facility they are in. Currently residents receive $30 or $50 respectively based on the funding they receive. For example, if a resident only receives SSI, the allowance is $30. If they receive additional funding from other sources, the allowance can be as much as $50. Therefore, the allowance is not based on whether the resident is married (which could be construed in the way this section of the bill is written) or whether they are in a nursing home versus a personal care home (which could also be construed in the way this section of the bill is written).
This will increase Medicaid's reimbursement responsibilities and, gone unused, becomes an asset that could affect Medicaid eligibility.
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 $91,080 per year if implemented for ICFMR residents also. As ICFMR was not included in the legislation the additional $91,080 has not been included in the $1,396,260 above (which is only for the impact to nursing home residents) and is included for informational purposes only.
Person submitting Fiscal Note: Martha Yeager Walker
Email Address: dhhrbudgetoffice@wv.gov