NOTE: As provided in LFC policy, this report is intended for use by the standing finance committees of the legislature.  The Legislative Finance Committee does not assume responsibility for the accuracy of the information in this report when used in any other situation.



The LFC is only preparing FIRs on bills referred to the Senate Finance Committee, the Senate Ways and Means Committee, the House Appropriations and Finance Committee and the House Taxation and Revenue Committee. The chief clerks are responsible for preparing and issuing all other bill analyses.



Only the most recent FIR version, excluding attachments, is available on the Intranet. Previously issued FIRs and attachments may be obtained from the LFC office in Room 416 of the State Capitol Building.





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





SPONSOR: Garcia DATE TYPED: 02/21/99 HB
SHORT TITLE: Disabled and Elderly Services SB 33/aSPAC
ANALYST: Burris


APPROPRIATION



Appropriation Contained
Estimated Additional Impact
Recurring

or Non-Rec

Fund

Affected

FY99 FY2000 FY99 FY2000
$ 4,400.0 Rec GF



(Parenthesis ( ) Indicate Expenditure Decreases)





REVENUE



Estimated Revenue
Subsequent

Years Impact

Recurring

or Non-Rec

Fund

Affected

FY99 FY2000
$ 13,200.0 Recurring FF



(Parenthesis ( ) Indicate Revenue Decreases)





Relates to HB2 and SB2; SB24 DD and Disabled & Elderly Medicaid Waiver Eligibility.



SOURCES OF INFORMATION



LFC Files

Health Policy Commission

Governor's Committee on Concerns of the Handicapped

Human Services Department



Department of Health analysis not available



SUMMARY



Synopsis of SPAC Amendment



The Senate Public Affairs Committee amended Senate Bill 33 to strike the language referring to approximately 1,000 individuals being served by the appropriation. The amendment also changes the appropriation to the Department of Health rather than the Human Services Department.



Synopsis of Bill



Senate Bill 33 appropriates $4.4 million from the general fund to the Human Services Department to serve 1,000 persons eligible for the Medicaid Disabled and Elderly (D&E) Waiver program.



Significant Issues



The federal matching funds for the D&E program are approximately three to one. Thus, the state will receive approximately $13.2 million in federal matching funds.



FISCAL IMPLICATIONS



Because the average cost of serving patients in nursing homes averages $35.0 per year compared to the $15.0 per year to serve them through the D&E program, this appropriation will likely result in Medicaid program savings in years to come.



TECHNICAL ISSUES



The general fund appropriations for the D&E program are typically appropriated to the Department of Health. Senate Bill 2 and House Bill 2 recommendations for FY2000 appropriate the general fund portion to the Department of Health. In order to maintain uniformity, the appropriation should be directed to the Department of Health.



OTHER SUBSTANTIVE ISSUES



There is a long-standing waiting list for D&E program services. The D&E program is preferable to most patients because it allows them to remain at home and receive community-based services rather than enter a nursing home. It also allows patients more input into the type and quality of services they receive.



RLB/njw