FISCAL NOTE

Date Requested: January 22, 2018
Time Requested: 11:49 AM
Agency: Health and Human Resources, WV Department of
CBD Number: Version: Bill Number: Resolution Number:
1941 Introduced HB4241
CBD Subject: Human Services


FUND(S):

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

Sources of Revenue:

Other Fund Federal

Legislation creates:

Decreases Existing Expenses



Fiscal Note Summary


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


    The purpose of this bill is to require DHHR to transition children placed in foster care into managed care.
    The Department, based on analysis in SFY2016, estimates a savings of $6.5 million (approximately $1.7M in state funds) by moving foster children into managed care. Additional analysis is needed to better estimate an impact to SFY2019, but some savings could be assumed.
    Currently all foster children are enrolled in Medicaid. However, there are cases where treatment received is not covered by Medicaid. This is especially true for clients placed out of state. A change to managed care from fee for service could impact these costs, either positively or negatively depending on the success of the Managed Care Organizations' provider negotiations and utilization management.
    



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 -3,250,000 -6,500,000
Personal Services 0 0 0
Current Expenses 0 -3,250,000 -6,500,000
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):


    WV Medicaid's most recent actuarial analysis to move foster children into managed care is dated 2016. The analysis demonstrated total savings of $6.5M and state dollar savings of $1.7M. Qualifying factors to consider in using the 2016 estimates for fiscal note evaluation are: a) the base data to produce the 2016 analysis would need to be trended forward to 2019. b) Changes in enrollment would need to be updated to reflect growth in the population. The calculation of an updated analysis for 2019 would need to be performed by an actuary.
    



Memorandum


    There also is risk of court ordered treatment not covered by Managed Care treatment services. This could cause increase cost of treatment that may or may not be covered by Medicaid.
    



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