FISCAL NOTE

Date Requested: March 07, 2017
Time Requested: 01:27 PM
Agency: Health and Human Resources, WV Department of
CBD Number: Version: Bill Number: Resolution Number:
2825 Introduced HB2808
CBD Subject: Health


FUND(S):

0525 - CONSOLIDATED MEDICAL SERVICES FUND, 0403 - DIV OF HUMAN SERVICES GENERAL ADMINISTRATION FUND, 8722 - CONS FEDERAL FUNDS DIV HUMAN SERVICES GEN ADMN FD

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 provide assisted outpatient treatment to individuals suffering from mental illness to prevent such individuals from decompensating to the point of likelihood to cause serious harm to self or others for safety of the public, to prevent the costs of inpatient involuntary hospitalization, and costs of incarceration due to untreated mental illness. The bill defines terms, requires legal proceedings, and provides for limitation of liability to examiners and providers. The proposed legislation does not mandate any new benefits be added to the Medicaid benefit, which currently includes mental health treatment, therefore treatment costs for outpatient mental health services are currently included in the costs of the program. It is possible that expenditures for those types of services could increase as a result of this legislation if individuals treated under the provisions of this legislation (that otherwise would not have received treatment) are covered by Medicaid. However the Department does not have data or a model to predict the potential increase, if any, in the number of Medicaid members that may potentially meet the criteria described in the proposed legislation beyond the current level of mental health outpatient services. The Department does not have information to accurately estimate the fiscal impact this legislation may have on the Bureau for Behavioral Health and Health Facilities.



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 0 0
Personal Services 0 0 0
Current Expenses 0 0 0
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):






Memorandum


There is a likelihood of an increase in the number of individuals receiving treatment services in the community, in lieu of incarceration. The bill states that “the order may also require the respondent’s care providers to supply any or all of the following categories of services to the individuals: (1) Medication; (2) Periodic Blood Tests; Individual or Group Therapy; (4) Day or partial day programming activities; (5) education and vocational training or activities; (6) alcohol or substance use disorder treatment; (7) supervision of living arrangements; any other services prescribed to treat the persons mental illness or co-occurring disorder… The Department is the payor of last resort and therefore, could be mandated (court ordered) to provide payment for services that are not covered by Medicaid and/or any other insurer. This would result in making state funded payments for services provided to patients who signed up voluntarily knowing that DHHR is the payor of last resort. Additionally, the Department could also be required to cover payments for third party insured patients receiving non-covered services by their insurer. Finally, while the ultimate goal is to prevent individuals from decompensating and thus being committed, the Department does not have a standard measure for this population on the costs of those deemed necessary of receiving voluntary outpatient treatment vs. those who could be involuntarily committed. The costs for treatment of this population vs. the committed population, as well as the size of the population that would be eligible or receiving voluntary outpatient treatment as an alternative to decompensating, is unknown.



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