0525 - Consolidated Medical Services Fund

Sources of Revenue:

General Fund

Legislation creates:

A New Program

Fiscal Note Summary

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

    The purpose of this article is to create a new commission for the service to veterans and others suffering from traumatic brain injuries.
    The Department of Health and Human Resources (Department) shall report annually to the commission and to the Legislature on the status of services for West Virginians with traumatic brain injuries.
    It is unclear under which agency, the Commission will reside, however this section of the code falls under Veteran's Affairs.
    The bill states the Department will be responsible for all costs associated with compiling data on costs and actuarial information requested by the Commission. Costs of compiling this data cannot be determined at this time due to the uncertainty of the type of data to be requested, however, the current reporting rate with the Department's MMIS vendor is $132.14 per hour. This would be the hourly rate applied to any data request. Additionally, the Department has contracts in place that provide actuarial services for specific issues at an hourly rate of $342.00. This could possibly be the rate for each request if they fall within the confines of the contract.
    The commission will consist of representatives from multiple state agencies and outside parties as defined in the legislation. The Department anticipates a cost of approximately $10,300 in miscellaneous expenditures for travel, etc. for those non-state employed individuals appointed to the Commission.

Fiscal Note Detail

Effect of Proposal Fiscal Year
Fiscal Year
(Upon Full
1. Estmated Total Cost 0 10,300 10,300
Personal Services 0 0 0
Current Expenses 0 10,300 10,300
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):

    The Department anticipates that there may be approximately $10,300 in expenses (travel, printing) for members of this commission that are not state employees and do not have a mechanism to be reimbursed for their expenses.
    This estimate is based on approximately nine (9) non-state employed commission members with a maximum of four (4) meetings per year @ approximately $250 per meeting for a total of $9,000 per year for travel. Additionally, an estimated cost of $1,300 for printing and binding of annual report is included in the estimated expenditures.


    Without specifics of the types of data and actuarial information the TBI Commission will request, the total costs to provide data and actuarial information cannot be determined.
    An additional option for actuarial costs is to hire an actuary. There is a DOP classification for an actuarial analyst with a salary range of ($37,140-$68,712), however it is uncertain that a full-time position would be needed.
    Section 9A-5-4 (1) states that the Commission shall establish outreach efforts. The Bureau for Behavioral Health and Health Facilities has contracted with the Center on Excellence in Disabilities at WVU (CED-WVU) to develop a statewide infrastructure for persons who have a TBI as defined in WV Code 18-10k-1. Therefore, this appears to be a duplication.
    Section 9A-5-4 (3) states "The commission shall determine the costs of establishing a Medicaid waiver and a trust fund to provide services for individuals with traumatic brain injuries." The estimate for the services in the TBI Waiver (application submitted to CMS in October 2010-approval not yet received) $2,960,775 for the first year ($805,923 State, $2,154,852 Federal) and $3,930,900 for the second year ($1,089,645 State, $2,841,255 Federal).
    Section 9A-5-4 (B) refers to the Department of Health and Human Services. This should be the Department of Health and Human Resources. It also states “All costs of compiling data and responding to the commission’s requests shall be borne by the Department of Health and Human Services. However, the commission may not be limited to data from the department in determining the costs of establishing a Medicaid waiver and a trust fund to provide services for individuals with traumatic brain injuries.” Does this mean that DHHR must pay any costs for the provision of data, even from other entities? For example, if the commission asks for data from Veterans Administration and they want to charge a fee for it, does DHHR have to pay for that?
    Section 9A-5-5(2) states: "A gross receipts tax of one percent on all Limited Video Lottery Terminals shall be used to fund the operations of the commission to match federal funds from a Medicaid waiver or other services and to establish a trust fund to provide services for individuals with traumatic brain injuries." This sentence could be more clear if a comma was inserted after "commission", to appropriately indicate the lottery proceeds would fund the administrative costs of the commission, along with the federal match for the Medicaid waiver and establishment of a trust fund. The Department is not able to determine the gross tax receipts of one percent on all limited Video Lottery Terminals, therefore also unable to determine funding that will be available.

    Person submitting Fiscal Note: Michael J. Lewis, MD, PhD, Cabinet Secretary
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