Fiscal Impact Summary	FY 1999/2000	FY 2000/2001
State Revenues
State Expenditures* General Fund Federal Funds		$ 3,192,235 34,200
FTE Position Change	0.0 FTE	0.0 FTE
Other State Impact: None.
Effective Date: Upon signature of the Governor.
Appropriation Summary for FY 1999-2000: None required.
Local Government Impact: None.

* Expenditures for FY 2000-01 are an estimate. Review findings, as required in the bill, may demonstrate lower or higher costs for implementation of a prenatal care program for undocumented aliens.

The reengrossed bill requires the Department of Health Care Policy and Financing (DHCPF) to do the following relative to the provision of prenatal care for undocumented aliens:

• review options for providing prenatal care statewide for undocumented aliens through Medicaid providers and essential community providers;

• seek a federal waiver, including a request for any necessary change in federal regulations or statutes for implementation of a program which would include federal financial participation in reimbursement for prenatal care for undocumented aliens; and

• report to the Joint Budget Committee and the HEWI Committees of the House and Senate by October 1, 1999, on such findings.

DHCPF — FY 1999-00 — No costs incurred. The bill does not have a fiscal impact for FY 1999-00. The bill requires DHCPF to study options on providing and funding prenatal care statewide for undocumented aliens, and to seek a federal waiver to implement a program that will include federal financial participation for prenatal care for undocumented aliens.

Study Options — The department indicates it has sufficient resources within existing appropriations to conduct the study and report back to the General Assembly by October 1, 1999.

— The department indicates that it cannot submit a waiver by the October 1 deadline. The entire waiver process (including submission, review, acceptance/rejection) requires a maximum of three years. The department indicates that although it will contact federal authorities at the Health Care Financing Administration on the matter of federal funding for this benefit, the expectation is that the federal government will reject federal financial participation in such a program.

This fiscal note assumes that, based on study findings, the department will make recommendations on either the need for legislation or funding through budget decision items for implementation of a prenatal care program for undocumented aliens. It is assumed that any necessary appropriations would be addressed through those venues.

NOTE: Although the bill requires that reports be submitted to the HEWI Committees of the General Assembly no later than October 1, 1999, this fiscal note assumes that Legislative Council staff will accept those reports and forward copies to the HEWI Committee members. The fiscal note does not assume that the HEWI Committees must meet to receive such reports.