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F I S C A L I M P A C T R E P O R T

SPONSOR Nava

ORIGINAL DATE

LAST UPDATED

01/30/08

HB

SHORT TITLE Developmental Disabilities Medicaid Waiver

SB 488

ANALYST Geisler

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY08

FY09

$3,000.0

Recurring

General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Relates to HB 159 and SB 246

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

SUMMARY

Synopsis of Bill

Senate Bill 488 proposes to make an appropriation of $3,000,000 to the Department of Health

(DOH) to implement a cost of living adjustment for the Developmental Disabilities Medicaid

Waiver Program and to the Family, Infant, Toddler (FIT) Program.

FISCAL IMPLICATIONS

The funding contained in SB 488 was not included in the DOH FY09 operating budget request.

The House Appropriations and Finance Committee version of the General Appropriation Act

contains $4 million to reduce the waiting list for developmental disabilities services and $1

million to increase the number of infants and toddlers served by the FIT program.

SIGNIFICANT ISSUES

DOH notes that SB 488 is unclear as to how the appropriation is to be apportioned between the

two programs. If $2 million of this appropriation were to be applied to the DD waiver, this would

represent a cost of living adjustment of approximately 0.8% (2 / $244,000,000 X 100). If $1

Senate Bill 488 – Page

2

million of this appropriation were to be applied to the FIT Program, this would represent a cost

of living adjustment of approximately 3.2% (1 / $31,000,000 X 100). If the appropriation of $3

million is applied across both programs this would represent a cost of living adjustment of

approximately 1.1% (3 / $275,000,000 X 100). By comparison the Social Security

Administration calculated a Cost of Living Adjustment (COLA) in January 2008 of 2.3%, which

is equal to the percentage increase in the Consumer Price Index for Urban Wage Earners and

Clerical Workers (CPI-W) from the third quarter of one year to the third quarter of the next.

For Fiscal Year 2008, $2.4 million was appropriated for DD Waiver rate increases. This

appropriation provided a minimum of 3% increase for a variety of core waiver services including

supported living, day habilitation, respite, and supported employment. Human Services

Department increased the DD Waiver rates by 3% for all services not covered under the DOH

rate increase package.

RELATIONSHIP

SB 488 relates to HB 159 and SB 246 both of which would appropriate $5,500,000 to the

Department of Health (DOH) to fund the second phase of the 2003 cost study recommendations

for the Family, Infant Toddler (FIT) Program, to improve recruitment and retention, and to

expand quality services to children who are entitled to early intervention services.

OTHER SUBSTANTIVE ISSUES

Background on DD and FIT Programs

Developmental Disabilities Supports Division (DDSD) within DOH administers Developmental

Disabilities (DD) Medicaid Waiver, which provides supports to citizens with developmental

disabilities and their families. Approximately 3,707 individuals received an array of home and

community-based services through the DD Waiver in Fiscal Year 2007. Services through the

DD Waiver include: In-Home Supports (respite and personal care); Clinical Services (therapies,

nursing and nutritional counseling); Day Services (supported employment, community access

and adult habitation); Case Management; Other Services (environmental adaptations and non-

medical transportation); and Community Living Outlier Services (adult habilitation and

supported living outliers). The estimated total expenditures for the DD Waiver for Fiscal Year

2007 were approximately $244 million, which includes both Federal Medicaid dollars and State

General Fund Match.

The Family, Infant, Toddler Program (FIT Program) administers a statewide system of early

intervention services in accordance with the Federal Individuals with Disabilities Education Act

(IDEA) Part C. The FIT Program is an entitlement program for children from birth to age 3 years

who are eligible due to having or being at risk for a developmental delay or disability. Early

intervention services through the FIT Program include, but are not limited to: speech, physical

and occupational therapy; developmental specialist services; nursing; and social work. These

services are primarily provided in the family’s home. The FIT Program served 10,980 children in

Fiscal Year 2007. The total budget for the FIT program in FY2007 was about $31 million, which

includes federal Medicaid, State General Funds, private insurance and an IDEA Part C Grant.

GG/bb