FISCAL NOTE
Date Requested: January 19, 2018
Time Requested: 11:47 AM |
| Agency: |
Health and Human Resources, WV Department of |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1761 |
Introduced |
HB4215 |
|
|---|
| CBD Subject: |
Health |
|---|
|
FUND(S):
0525 - Consolidated Medical Services Fund
Sources of Revenue:
General Fund
Legislation creates:
Increases Existing Expenses
Fiscal Note Summary
Effect this measure will have on costs and revenues of state government.
The purpose of this bill is to involuntarily hospitalize a person administered an opioid antagonist by an initial responder.
The Department estimates the fiscal impact of this bill to be approximately $211,200,000 and with potential to increase annually until the opioid epidemic is under control.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2018
Increase/Decrease
(use"-") |
2019
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
211,200,000 |
211,200,000 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
211,200,000 |
211,200,000 |
| 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):
The total estimated cost to the Bureau for Behavioral Health and Health Facilities of $211,200,000 is based upon the following calculation: $800/day*10 days) * 26,400* individuals = $211,200,000. The $800/day rate is the current average daily diversion rate. This rate is used based on the assumption state psychiatric facilities are at full capacity, as this is a common occurrence. The estimated number of individuals impacted by this bill (26,400) was calculated based upon (1) an August 2017 article in the Journal of the American Medical Association that stated "For every fatal opioid overdose, there are approximately 30 nonfatal overdoses" and (2) the estimated number of overdose deaths for 2016, according to the Bureau for Public Health, was 880.
Memorandum
In our calculations, we used a ten day stay however this could be longer or shorter depending upon the outcome of the assessment. Per WV Code 27-5-3, when an individual has been involuntarily committed there is a cap of 5 days for hospital physicians/clinicians to conduct an initial inpatient examination. The ten-day average length of stay estimate is fairly conservative in that it includes the initial five day examination period + five additional days for people who have overdosed and needs to be detoxed, clinically stabilized and initially engaged in Substance Use Disorder (SUD) treatment so they do not just return to the community and start using again.
In addition, it can be expected that a sizeable portion of these folks will have underlying mental health issues (mood disorders, anxiety etc.) that need to be addressed via both medication and counseling. According to the Substance Abuse and Mental Health Services Administration, (SAMHSA), sixteen percent of patients in drug rehab seeking help for addiction issues were also diagnosed with a co-occurring mental health disorder.
In addition, we also believe the number of overdoses NOT reported may rise if there was a perceived mandatory commitment if 911 was called.
Person submitting Fiscal Note: Bill J. Crouch
Email Address: Bill.J.Crouch@wv.gov