FISCAL NOTE



FUND(S):



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 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 who may have co-occurring addiction and mental health issues. The DHHR is to set the fee schedule for services in accordance with Medicaid rates or the customary rate and adjusted schedule. The new language purposed in this bill is similar to the language provided in ยง49-7-33 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 $6,461,558. 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). 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. In 2012, the Department provided 15,099 clients with co-occuring addiction and mental health issues totaling approximately $90,130,692. 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.



Fiscal Note Detail


Effect of Proposal Fiscal Year
2013
Increase/Decrease
(use"-")
2014
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 5,124,502 6,461,558 6,461,558
Personal Services 0 0 0
Current Expenses 5,124,502 6,461,558 6,461,558
Repairs and Alterations 0 0 0
Assets 0 0 0
Other 0 0 0
2. Estimated Total Revenues 0 0 0


Explanation of above estimates (including long-range effect):


Based on Department expenditures, a simple average calculation of $90,130,692/15099 clients would equal an average cost of $5,969 per adult. For FY 2013, the Department estimates a cost of $4,524,502 ($5,969/person X 758 participants) for individuals participating in the drug court who may have co-occurring addiction and mental health issues. It is estimated that 982 clients will be served in 2014, therefore, the projected cost for FY 2014 will be $5,861,558 ($5,969/person X 982 drug court participants). Additionally, the cost to the Department's Bureau for Behavioral Health and Health Facilities to fund the current 20 drug courts would be $600,000 ($30,000/court X 20).



Memorandum






    Person submitting Fiscal Note: Rocco S. Fucillo
    Email Address: dhhrbudgetoffice@wv.gov