Date Requested: January 16, 2015
Time Requested: 09:24 AM
Agency: Health and Human Resources, Department of
CBD Number: Version: Bill Number: Resolution Number:
1483 Introduced SB88
CBD Subject: Health


FUND(S):

8722

Sources of Revenue:

Special Fund

Legislation creates:

A New Fund



Fiscal Note Summary


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


    The purpose of this legislation is to require background checks for individuals who have direct access to residents, members or beneficiaries of covered providers participating in the West Virginia Clearance for Access: Registry and Employment Screening (WVCARES) program. The bill requires the Secretary of the Department of Health and Human Resources (DHHR) to develop a plan and a program for conducting background checks. The bill requires a centralized database to maintain criminal history record information and results; it establishes a prescreening process conducted by covered providers and requires applicants to provide fingerprints and undergo a criminal background check. The bill establishes procedures and criteria for obtaining and reviewing criminal history record information.
    In 2011 DHHR received a grant from the Centers for Medicaid and Medicare Services (CMS) to implement a criminal background check system with a rap-back process. The initial grant covered three years, with an expiration date of 9/30/14. In August 2014, a fourth year no-cost extension was granted by CMS to expire 9/30/15, which will make all SFY2015 and the first quarter of SFY2016 costs fully federally funded. Due to some delays in getting the program initiated, the program intends to request a fifth year no-cost extension from CMS to extend the grant until 9/30/16, which will cover all SFY2016 and the first quarter of SFY2017 costs. To date, the states that have requested the fifth year no-cost extension have been approved. The grant does require a 25% match; however CMS has allowed for background check fees that are paid by providers to be used as the in-kind match, resulting in no state revenue being needed to match the federal funds during the entire grant period. For full implementation of the program after the federal grant has expired, the program will rely upon a funding mechanism generated from the administrative fees assessed for the use of the WV CARES system. Estimated cost of this program for FY15 is $125,000, FY16 is $380,205 and on-going is $441,668. Federal Revenue and State Revenue, which is generated by fees, covers expected expenses. Revenue estimate for FY16 is $270,000 and $480,000 for FY17. Please see explanation below.
    



Fiscal Note Detail


Effect of Proposal Fiscal Year
2015
Increase/Decrease
(use"-")
2016
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 125,000 380,205 441,668
Personal Services 60,776 151,724 242,672
Current Expenses 64,224 228,481 198,996
Repairs and Alterations 0 0 0
Assets 0 0 0
Other 0 0 0
2. Estimated Total Revenues 0 270,000 480,000


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


    Programs costs of approximately $125,000 are anticipated for FY2015; which includes salary and benefits for the Program Manager, travel, supplies, office space, and a desktop computer to comply with FBI requirements to access background results. Estimated costs for FY2015 are covered by a federal grant from Centers for Medicaid and Medicare Services (CMS). It is anticipated that the associated startup costs will occur during state fiscal years 2015 and 2016.
    In FY2016, at least 25% of the anticipated costs will be covered by the federal grant, which will not expire until September 30, 2015. If the fifth year extension is approved, no state dollars will pay for the program during FY2016; however, revenues will be collected to continue the program upon full implementation. If the extension is not approved, the remaining nine months of expenses for FY2016 will equal 75% of estimated costs or $249,353 (this excludes costs of $47,735 to state hospitals, see explanation below). These costs are as follows: Program Manager (salary $45,696 plus benefits for a total of $60,776), and 2 Fitness Determination staff (salary of $34,105 each plus benefits for a total of $90,948). Current expenses of $180,746 include $54,500 for Office of Technology project management services, $18,946 for travel to national conferences and training through the state, $96,000 for annual rent costs, $5,300 for copier lease, $2,400 for cell phone/iPad usage and $3,600 for office supplies. The proposed fee is $20 per applicant; at this stage of implementation, it is anticipated that only long term care providers will participate with approximately 13,500 applications, based upon historical figures. FY2016 revenue is estimated at $270,000.
    For fiscal years beginning in SFY2017, the full estimated cost of $441,668 per year would be covered by the fees assessed to providers for utilizing the system as required by federal law. These costs are as follows: One FTE program manager (salary $45,696 plus benefits for a total of $60,776), and 4 Fitness Determination staff (salary of $34,105 each plus benefits for a total of $181,896). Current expenses of $180,746 include: Office of Technology project management services of $54,500, travel to national conferences and training through the state at $18,946; printing, supplies, office rent, and other miscellaneous costs of $107,300. Costs $18,250 related to state facilities for the WVCARES system will be absorbed by the Departments current budget (see explanation below). Revenue estimates are based on a current average of 6,000 background checks per quarter according to State Police data, approximately 24,000 background checks annually, assuming all quarters are equal and the statute as passed permits the Secretary to add provider types to the program to create a single point of contact for background checks. FY2017 revenue is estimated at $480,000 ($20 x 24,000 applicants).
    This legislation will result in additional costs for the state hospitals, which the Department will absorb with its current budget. FY2016 costs are based on all current facility employees obtaining the required FBI background check at $16.50 per employee; this includes 937 Long Term Care employees and 850 Psychiatric Facility employees. FBI background check costs for existing employees is $29,485.50. All new hires will require an FBI background check ($16.50), as well as the projected WVCARES Fee ($20.00); this is an additional $36.50 per new employee. There are approximately 500 new hires annually. This legislation will result in an additional $18,250 for new hires per year (FY2016 and on-going). Total cost for FY2016 is $47,735 and $18,250 on-going.
    



Memorandum


    SFY2015 and the first quarter of SFY2016 are entirely supported by a federal grant from CMS. DHHR will apply for the fifth year no cost extension in June 2015 and should receive a response prior to the fourth year extension expiration. If the fifth year extension is approved, all expenses stemming from operations in SFY2016 as well as the first quarter of SFY 2017 will be fully covered by the federal grant. Beginning in the second quarter of state fiscal year 2017, the program will be supported by a $20 per application administrative fee assessed on the providers requesting this service that has been mandated by federal law. It is anticipated that the fully implemented program will be self sustaining upon expiration of fifth year of the federal grant.
    In ยง16-46-8 of this proposed legislation, it states that the State Police may assess a fee to applicants or covered providers for conducting the criminal background check and for collecting and retaining fingerprints for rap back as authorized under this article; since this process has not been complete, additional fees may be assessed that are not included in the above cost.
    



    Person submitting Fiscal Note: Karen L. Bowling
    Email Address: karen.l.bowling@wv.gov