FISCAL NOTE
FUND(S):
5156-Hospital Services Revenue, 5084-Medical Services Program Fund, 0407-Central Office General Administrative Fund, 5172-Health Facility Licensing Fund, 8802-Public Health Federal Fund
Sources of Revenue:
General Fund,Special 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 a minimum of two hours per year of basic training in Alzheimer's and dementia in certain health care facilities for all staff, employees and contractors. The total estimated cost to the department is $377,286, with a state share of approximately $62,339.
The Department estimates the impact to the Bureau for Behavioral Health and Health Facilities to be $145,750 annually. The estimate includes a cost for current staff, employees, and contractors at the facilities to be $98,750 annually based upon an estimated 1,975 people (1,802 staff and employees and 173 contractors) at an average hourly cost of $25 times 2 hours of training. In addition, cost consideration was given to the required "informational packets". The estimated cost of these packets would be $9,875 annually based upon 20 pages per packet at $0.25 per page for 1,975 people. Due to turnover rates at the facilities, approximately 675 new employees are hired each year, which would result in additional costs of training and materials for these new hires of $37,125 annually.
Additionally, the Department's Bureau for Medical Services is responsible for reimbursing nursing homes on a cost basis. The Department estimates that as a result of this legislation, nursing home rates would increase due to increased training requirements. Based on the number of FTE's in the non-state owned nursing facilities, their average hourly rate, and the ratio of Medicaid days to total days, the bill is expected to cost Medicaid $228,281 per year with a state share of $60,711.
Finally, the Department's Bureau for Public Health, Office of Health Facility Licensure and Certification, estimates an increased cost of approximately $3,255 due to additional time and resources needed to review records for compliance. These costs will participate in the Office of Health Facility Licensure and Certification cost allocation program. Up to fifty percent (or $1,628) of the cost may be general revenue, up to twenty-five (or $813.50) percent may be federal revenue funding, and up to twenty-five (or $813.50) percent may be special revenue funding.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2005
Increase/Decrease
(use"-") |
2006
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
377,286 |
377,286 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
0 |
| Repairs and Alterations |
0 |
0 |
0 |
| Assets |
0 |
0 |
0 |
| Other |
0 |
377,286 |
377,286 |
| 2. Estimated Total Revenues |
0 |
0 |
0 |
Explanation of above estimates (including long-range effect):
Bureau for Behavioral Health Costs = Annual Cost of Training for Current Staff and Contractors (1,975 people x $25hour x 2hours) for a total of $98,750. Annual Cost of Materials for informational packets (1,975 packets x 20 pages x $0.25 page) for a total of $9,875. Total Annual Cost for Current Staff and Contractors is $108,625.
Annual Cost of Training for new hires (675 people x $25hour x 2hours) for a total of $33,750. Annual Cost of Materials for information packets (675 packets x 20 pages x $0.25 page) for a total of $3,375. Total Annual Cost for New Hires is $37,125.
Total Cost to Behavioral Health and Health Facilities for current staff and new hires is $145,750.
Bureau for Medical Services Costs = An average staff rate which consisted of an average of 12 employee groups over all of the non-state operated nursing facilities. Average staff rate of approximately $1,336.91 X 2 hrs. of training X 116 non-state operated nursing facilities for a total industry cost of $310,164. Proportion of Medicaid Days (1,245,192 Medicaid days divided by 1,691,249 total days) = 73.6% for a Total Medicaid Cost of $310,164 X 73.6% = $228,281, with a state share of $60,711.
Bureau for Public Health, Office of Health Facility Licensure and Certification, estimates an increased cost of approximately $3,255 due to additional time and resources needed to review records for compliance. These costs will participate in the Office of Health Facility Licensure and Certification cost allocation program. Up to fifty percent (or $1,628) of the cost may be general revenue, up to twenty-five (or $813.50) percent may be federal revenue funding, and up to twenty-five (or $813.50) percent may be special revenue funding.
Memorandum
In preparing the fiscal note, the department included all staff and contractors, rather than limiting to only those who provide direct patient care. Should the intent of the legislation be to limit the training to those that provide direct patient care, the cost would be less.
Person submitting Fiscal Note: Martha Yeager Walker
Email Address: fnbudoff@wvdhhr.org