Colorado Legislative Council Staff
STATE
REVISED FISCAL NOTE
(replaces Fiscal Note dated January 15, 1998)
General Fund Expenditure Impact
Federal Funds Expenditure Impact
Drafting Number: Prime Sponsor(s): |
LLS 98-392 Rep. K. Alexander Sen. B. Alexander |
Date: Bill Status: Fiscal Analyst: |
March 27, 1998 House Appropriations Janis Baron (866-3523) |
TITLE: CONCERNING REIMBURSEMENT UNDER THE MEDICAID PROGRAM FOR PERSONAL CARE SERVICES PROVIDED BY A FAMILY MEMBER.
Summary of Legislation
STATE FISCAL IMPACT SUMMARY |
FY 1998/99 |
FY 1999/2000 |
State Revenues General Fund Other Fund |
|
|
State Expenditures General Fund Federal Funds |
$ 497,735 514,333 |
$ 497,735 514,333 |
FTE Position Change |
None |
None |
Local Government Impact — None |
The bill, as amended, changes the cap for personal care services provided by a family member from $5,000 to $7,000 per year. The bill includes an effective date of July 1, 1998.
State Expenditures
The Department of Health Care Policy and Financing. The department will require $1,012,069 in both FY 1998-99 and FY 1999-00 to implement the bill’s provisions. The fiscal note is based on the current hourly rate for personal care services of $10.81, as identified in the Long Appropriations Bill, HB 98-1401. Costs for FY 1999-00 do not assume a rate increase.
Background. For FY 1996-97, the most recent claims year, 15 percent of Home- and Community-Based Services for the Elderly, Blind, and Disabled (HCBS-EBD) were receiving relative personal care, or 1,291 out of 8,608 clients. Relative personal care services are appropriated to personal care agencies at the same rate as personal care by nonrelatives — $9.78 per hour. Reimbursement to relative caregivers varies from personal care agency to agency, and payments for services are made by the agency, not the state department. DHCPF rules require that relative caregivers be employees of personal care agencies. The current cap of $5,000 is the limit which agencies can bill DHCPF, and may not reflect the actual amounts passed on to the relative caregiver. The personal care agencies incur workers’ compensation, unemployment insurance, administrative, training, and supervision costs. The agencies are required to supervise relative caregivers to the same extent they do their nonrelative employees.
Currently, HCBS-EBD clients receive an average of 1.4 hours per day of relative care: [($5,000 cap / $9.78) / 365 days = 1.4 hrs. per day]. The bill establishes a new cap of $7,000, or 1.77 hours per day [($7,000 cap / $10.81)/365 days = 1.77 hrs. per day]. The hourly rate of $10.81 is the recommended rate for FY 1998-99 in HB 98-1401. To increase the amount of relative personal care by 0.37 hours per day requires a 26 percent increase in funding (0.37/1.4 = 0.26). A 26 percent increase over the current base of $3,892,572 is $1,012,069. HB 98-1134 requires $1,012,069 in new funding to implement the cap increase of $2,000.
Spending Authority
The fiscal note indicates that for FY 1998-99, the Department of Health Care Policy and Financing should receive an appropriation of $1,012,069, and of that amount, $497,735 is General Fund and $514,333 is federal funds.
Departments Contacted
Health Care Policy and Financing