TITLE: CONCERNING THE PROVISION OF HEALTH CARE TO PERSONS IN THE AID TO THE NEEDY DISABLED PROGRAM WHO ARE NOT RECEIVING MEDICAID.

Fiscal Impact Summary	FY 1999/2000	FY 2000/2001	FY 2001/2002
State Revenues General Fund
State Expenditures Cash Fund General Fund		-$618 618	-$310,647 310,647
FTE Position Change		0.0 FTE	0.0 FTE
Other State Impact: None
Effective Date: January 1, 2001 or upon proclamation by the Governor of the vote of the registered electors at the November 2000 general election approving SCR99-002. This act shall not take effect if the voters disapprove of SCR99-002.
Appropriation Summary for FY 1999-2000: None required
Local Government Impact: None

The reengrossed bill provides that this act implement the provisions of SCR99-002 if such resolution is approved by the registered electors at the November 2000 general election. SCR99-002 refers to the voters a constitutional amendment to change the Old Age Pension (OAP) Program to allow the state to be reimbursed for OAP payments made to a pensioner during the interim period while the pensioner is applying for benefits under the federal supplemental security income program (SSI), and directs that moneys recovered through this provision shall be transferred to the Aid to the Needy Disabled (AND) Program to equalize the benefits between the OAP and AND Programs.

The bill states the intent of the General Assembly that the moneys transferred to the AND Program should be used for two purposes:

• to fund a basic Health and Medical Care Program for recipients of AND who are not receiving Medicaid — which is to commence January 1, 2002.

The bill also requires the Department of Health Care Policy and Financing to submit a written plan to the Joint Budget Committee on or before January 1, 2001, on what type of health and medical care services can be provided for recipients of AND within available appropriations.

The bill is assessed as having a conditional fiscal impact, contingent upon voter approval of SCR99-002 to change the OAP Program. If adopted, the measure will be placed on the November 2000 general election ballot. Interim assistance reimbursement (IARs) payments received by the state on behalf of OAP clients will be applied to the AND Program only if the measure is approved by the voters.

Department of Human Services — Background. According to the Department of Human Services, during FY 1997-98, the OAP/SSI coordinators assisted 44 OAP clients in obtaining either SSI or SSDI benefits. Of these clients, 3 were OAP-A (65 years and over) and 41 were OAP-B (60-64 years). The total number of OAP clients who received SSI in FY 1997-98 is not known.

DHS indicates that the American Association of Retired Persons (AARP) funds a program called Economic Personal Benefits Outreach, the mission of which is to: (1) identify seniors qualifying for SSI benefits; and (2) help with the eligibility process. The AARP-funded program shows that the number of seniors needing SSI is lower than original projections indicated. Thus, based on FY 1997-98 data and the AARP-funded program, IAR collection projections for the purpose of this fiscal note are conservative. The following assumptions were used in identifying the resolution's impact to both the OAP and AND Programs:

• counties will require OAP applicants to sign permission forms authorizing the Social Security Administration to send SSI retroactive checks to the county departments effective January 1, 2001;

• counties will collect OAP IARs and receive 5 percent of the collections to reimburse county staff for the workload increase.

IAR collections for FY 2000-01 are estimated at $618 in FY 2000-01 and $310,647 for FY 2001-02. The table on page 3 provides a summary of collections for FY 2000-01 and FY 2001-02.

Department of Health Care Policy and Financing. At this time, anticipated IAR payments are insufficient for the Department of Health Care Policy and Financing to provide a health care benefit package for the disabled solely from IAR payment collections. The department indicates that should SCR99-002 be adopted by the voters, it will comply with the bill's reporting requirements and submit options and recommendations to the JBC by January 1, 2001.

Current Appropriations. SB99-215 includes a General Fund appropriation of $157,145 for the Medically Correctable Pilot Program. Although the bill requires that IAR collections be applied to both the Medically Correctable Program and a newly created Health and Medical Care Program, the fiscal note assumes that all IAR payments transferred to the AND Program would be applied to the Medically Correctable Program. At this time, anticipated collections are insuffucient to support a Health and Medical Care Program.

FY 2000-01	# of IAR Months	# SSI Approvals Per Month	Avg. IAR Collections	# of Months Retroactive	Gross Collections
OAP-A	4	0.75	$108.43	2	$651
OAP-B	0	0.0	$0.00	0	$0
SUBTOTAL					$651
TOTAL — Less 5% — County Incentive Payments					$618

FY 2001-02
OAP-A	12	0.75	$109.30	2	$1,967
OAP-B	12	10.25	$440.42	6	$325,030
TOTAL					$326,997
TOTAL — Less 5% — County Incentive Payments					$310,647