FISCAL NOTE

Date Requested: March 08, 2017
Time Requested: 01:02 PM
Agency: Health and Human Resources, WV Department of
CBD Number: Version: Bill Number: Resolution Number:
2140 Introduced HB2847
CBD Subject: Human Services


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 the West Virginia Bureau for Medical Services to file a request with the Centers for Medicare & Medicaid Services for an amendment to the current I/DD Waiver that will reinstate the terms of the amended waiver that was approved and in place prior to July 1, 2015; and to require the Bureau to seek legislative approval before filing a future request to amend or renew a waiver in a manner that alters the scope or nature of services provided under a current waiver. The Department estimates the fiscal impact related to the bill to be $48 million. Reductions to the Medical Services budget were made in anticipation of savings resulting from the implementation of services within the renewal waiver. If reinstated the Department estimates the annual impact would be $48 million ($34.5 Federal and $13.5 State).



Fiscal Note Detail


Effect of Proposal Fiscal Year
2017
Increase/Decrease
(use"-")
2018
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 48,000,000 48,000,000
Personal Services 0 0 0
Current Expenses 0 48,000,000 48,000,000
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):


SFY15 was the last year in which the service levels referenced in the legislation (prior approved Waiver effective prior to 7/1/15) were in place. I/DD Waiver costs for SFY15 were $364M. After 7/1/15, as participating members' annual service plans expired, the new service levels were established in individual member service plans. It is anticipated that during SFY17 all members' service plans will be in line with the service configuration of the current CMS-approved I/DD Waiver. As of 12/31/16, I/DD costs were $157.9M; annualizing that yields an estimated SFY17 I/DD cost of approximately $316M. The difference in the I/DD costs from the period of the prior approved Waiver services to the current approved Waiver services is $48M ($364M-$316M). Using the current FFY17 FMAP of 71.80% is $34.5 Federal/$13.5 State.



Memorandum


If current trends continue, the federal class action suit yields a successful suit, and federal funding does not decrease, it may be feasible to request CMS approval for an additional 50 Waiver slots and take 50 individuals off the wait list during SFY18. The required legislative approval of any IDD waiver amendments would also cause substantial delay in the CMS approval process, and potentially have a fiscal impact and/or affect members. As one example, if the decision is made in July 2017 to add 50 slots to the waiver (i.e. take 50 people off the waiting list), it would either have to wait until the legislature is in session 9 months later or hold a special session. The same issues would exist if there were a desire to change the budget of the program, which could be required, if the federal government changes Medicaid funding to block grants.



    Person submitting Fiscal Note: Bill J. Crouch
    Email Address: dhhrbudgetoffice@wv.gov