FISCAL NOTE

Date Requested: February 08, 2016
Time Requested: 02:12 PM
Agency: Health and Human Resources, Department of
CBD Number: Version: Bill Number: Resolution Number:
2329 Introduced HB4438
CBD Subject: Health


FUND(S):

0525 - Consolidate Medical Services Fund

Sources of Revenue:

General Fund

Legislation creates:

Neither Program nor Fund



Fiscal Note Summary


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


The Department of Health and Human Resources, Bureau for Behavioral Health and Health Facilities (BBHHF) currently provides psychiatric and treatment services to individuals for which an order finding probable cause has been issued and certification has been provided by a physician, psychologist, licensed independent clinical social worker that the individual has been examined and that they are of the opinion that the individual is mentally ill or addicted and, because of such mental illness or addiction, is likely to cause serious harm to himself, herself or to others if not immediately restrained. The Department cannot adequately determine the number of new individuals who may be admitted to the State facilities for evaluation as a result of this bill, as the process of permitting physicians to certify individuals for involuntarily evaluation without a probable cause hearing would be new. Currently the Department treats over 3000 commitments annually and due to licensed bed capacity many individuals are diverted to private facilities for treatment at a cost of $800 per individual per day. While many of the individuals involuntarily held for evaluation may have recieved an order of probable cause the Department will incur increased costs for those individuals for which an order would not have been issued. There is not available data or a reliable methodology to calculate potential fiscal impact (if any) to the Department's Bureau for Medical Services (BMS).



Fiscal Note Detail


Effect of Proposal Fiscal Year
2016
Increase/Decrease
(use"-")
2017
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


The current commitment process provides for an evaluation to be performed by behavioral health professionals prior to the probable cause hearing and the potential involuntatry placement of the individual in one of the States Facilities. This bill would permit a physician to execute a certificate stating that he or she has examined a person and finds the person to be experiencing a psychiatric emergency prompting the involuntary admission of that individual without a probable cause hearing. The bill eliminates the requirement that an individual appear before a Mental Hygiene Commissioner prior to commitment to a mental health facility and thus has the potential to impact an individual's right to due process under both the State and Federal Constitutions. Specifically, in eliminating the requirement that an officer of the court determine whether probable cause exists to commit an individual to a mental health facility, an individual may lose (1) his or her physical liberty, (2) his or her ability to possess firearms pursuant to W.Va. Code §61-7-7, and (3) have his or her name added to state mental health registry pursuant to W.Va. Code §67-7a-3, all of which would occur without any procedural safeguards other than the signature of two physicians. The proposed legislation does not mandate any new benefits be added to the Medicaid benefit. As such any related services such as the examination, transportation or any treatment costs for involuntarily committed individuals who are Medicaid members would currently be 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 involuntary commitments increase, however the BMS does not have data for involuntary commitments or a reliable methodology to determine how many Medicaid members may potentially meet the criteria described in the proposed legislation beyond the current level of those related services.



    Person submitting Fiscal Note: Karen L. Bowling
    Email Address: dhhrbudgetoffice@wv.gov