COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 0889-13
Bill No.: Truly Agreed To And Finally Passed CCS #2 for HS for HCS for SCS for SB 236
Subject: Adds first cousins to the list of relatives eligible for adoption subsidies.
Type: Corrected
Date: June 13, 2001
# Correct computational error.
FISCAL SUMMARY
| FUND AFFECTED | FY 2002 | FY 2003 | FY 2004 |
| General Revenue# | $7,351,270 | $8,195,317 | $9,033,995 to $9,072,426 |
| Total Estimated
Net Effect on All State Funds |
$7,351,270 | $8,195,317 | $9,033,995 to $9,072,426 |
| FUND AFFECTED | FY 2002 | FY 2003 | FY 2004 |
| Total Estimated
Net Effect on All Federal Funds* |
$0 | $0 | $0 |
#* Revenues and expenditures to exceed $3.2 million annually and net to $0.
| FUND AFFECTED | FY 2002 | FY 2003 | FY 2004 |
| Local Government | $0 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 14 pages.
ASSUMPTION
Officials from the Department of Elementary and Secondary Education (DES) assume the proposal will require funding the Missouri transition to independence grant:
FY 02 $1,500 per grant x 84 estimated recipients = $126,000 estimated grant costs.
FY 03 $1,500 per grant x 92 estimated recipients = $138,000 estimated grant costs.
FY 04 $1,500 per grant x 102 estimated recipients = $153,000 estimated grant costs.
The number of estimated recipients is limited to those consumers with disabilities exiting the nursing home with the assistance of the Missouri transition grant. The estimate does not include those consumers eligible for this grant due to aging.
To administer the program, seek federal and private grant funding, write grants, review applications, and develop information and training, Vocational Rehabilitation would require 1 FTE Supervisor and 1 FTE Administrative Assistant plus related expense and equipment for each. Therefore, the DES estimates total expenditures for the Transition to Independence Grants to be $223,602 for FY 02; $248,788 for FY 03; and $266,598 for FY 04.
Regarding the licensure provisions of preschool and school-age child care programs operating on elementary and secondary public school property, the proposal would require such programs to comply with the licensure provisions in Chapter 210 RSMo. Current regulations allow such programs to operate under license-exempt status. The DES encourages such programs to operate in accordance with the licensing requirements; however, the DES does not monitor, nor can it be readily determined, the extent to which such programs are Chapter 210 deficient.
Oversight assumes that the DES will be able to administer the Transition to Independence Grant program with existing personnel and will not need additional FTE and related expenses.
Officials from the Department of Health, the Department of Public Safety - Missouri Highway Patrol, the Office of State Courts Administrator, and the Department of Insurance assume the legislation will have no fiscal impact on their agencies.
Officials from the Missouri Consolidated Health Care Plan (HCP) state this truly agreed and finally passed version removes all previous entries in section 376. The remaining provision of this bill that impacts the HCP is:
ASSUMPTION (continued)
Officials from the Department of Social Services (DOS) - Division of Family Services (DFS), Income Maintenance Unit (IMU) made the following assumptions regarding the proposed legislation:
TANF Education Components - Section 208.040
Federal law currently allows educational components with exception of graduate programs to count as a work component for the Temporary Assistance program. During the first 12 months of participation, the entire minimum hours of participation (30) may be in an education component (20 hours for a single parent with child under age 6). In the second 12 months, participants are required to enter another non-education component in combination with vocational education and training to equal 30 hours of participation (20 hours for a single parent with a child under age 6). After 24 months a participants required activity must be a non-education component for a minimum of 30 hours (20 hours for a single parent with a child under age 6). Any hours of education will be considered an additional component.
The costs for those participants in an educational component beyond 24 months will become State Maintenance of Effort (MOE) only. There is no fiscal impact to DFS with this piece of the bill.
Ticket to Work & Work Incentives Improvement Act of 1999 - Section 208.146
The DFS assumes that 441 individuals will meet the eligibility requirements as stated in this bill for individuals who are disabled and have income at or below 250% of the FPL. This data is derived from projections compiled by the Congressional Budget Office (CBO) as a result of estimates completed for the House version of the bill - HR 1108 (Work Incentives Improvement Act). According to the CBO, approximately 21,000 disabled individuals will return to work by 2004.
The DFS assumes that Missouri represents 2.1% of the overall population of the United States.
MO 5,438,559 / 270,298,524 = 2.1%
21,000
x 2.1%
441 New Eligibles
Not all individuals eligible will apply in the first year of the program. It is projected that there will be 294 eligibles in the first year, 357 eligibles in the second year and 441 eligibles in the third year.
ASSUMPTION (continued)
Data provided by the Division of Medical Services
An average adult Medicaid caseload is 480 cases.
441 / 480 = .92 or 1 new Caseworker FTEs needed to maintain new cases. Caseworker duties and responsibilities include take and process applications for eligibility, respond and answer both written and telephone requests for information or reported changes, and maintain all active cases in caseload.
Annual salary for a Caseworker is $29,040
Equipment and Expenses (E & E )
One Time Costs: (For FY 2003)
Systems furniture $4,500
Lateral File (4 drawer, 36'' width) 552
Chair 245
Side chair (1) 125
Calculator 60
PC 2,000
PC Software 300
Desktop Printer 310
Phone Installation 600
Data Line 175
Sub-Total $8,867
On-Going Costs for FY-2003 & FY 2004 (Costs based on a 12 month year)
Full Year 12 Month Year
Office Space $2,700
Utilities 520
Office Supplies 300
Copy Machine 200
Data Line 60
Phone Usage 500
DDP Maintenance 124
Sub-Total $4,404
Total E&E $13,271
ASSUMPTION (continued)
Travel Expenses
Travel expenses of $225 per year are being anticipated for caseworker FTE
$225 Caseworker annual travel costs
x 1 # of new FTEs
$225 Annual travel cost
Oversight assumes the DOS-DFS would be able to place one additional caseworker in existing space and rental space would not be necessary.
Transition to Independence Grants - Section 208.819
No fiscal impact for the implementation of this piece of the bill.
Multi-Ethnic Placement Act (MEPA) - Section 453-005
No cost for the DFS
Adoption Subsidy for First Cousins
No fiscal impact for the DFS.
Foreign Adoptions - Section 453.170
No cost for the DFS.
Grandparents as Foster Parents - Sections 453.320/453.325
Once Grandparents as Foster Parents (GAFP) funds are obligated, any new individuals determined eligible for the program would be placed on a waiting list until funding was available.
Based on the program's current anticipated growth rate, the following projections reflect the number of cash eligible children per month:
FY 02 5,197
FY 03 6,934
FY 04 8,091
ASSUMPTION (continued)
Based on the 1990 US Census Data, 59.2% of Missouri Households 50 years of age and older have an income below 200% of the Federal Poverty Level. Since there is currently no income limits for GAFP eligibility, assume that 59.2% of the above anticipated cash eligible children would remain eligible. The anticipated cash eligible children would reduce to:
FY 02 3,077
FY 03 4,105
FY 04 4,790
The number of children no longer eligible for GAFP are estimated at:
FY 02 2,120
FY 03 2,829
FY 04 3,301
The average cost of maintenance per child in the program is currently at $275.33. The maintenance reimbursement is tied to the Foster Care Maintenance Payment Rate. Therefore, the reduction of the reimbursement to 75% would reduce the maintenance cost to $206.50 per month per child. Cost savings of $275.33 - $206.50 = $68.83 per month per child.
The current rate of maintenance is $275.33 per month per child, regardless of the number of children in the household. This legislation requires DFS to establish a reduced cash benefit for households providing care for three or more children. The criteria DFS would use consists of
reducing the GAFP payment for the third and subsequent children in the household to no less than the Temporary Assistance grant amount for one person. The current rate is $136.00 per month.
Based on data supplied by DSS Research and Evaluation, 16.5% of the children currently receiving will receive a reduced grant. The reduced grant shall be no less than $136.00 per child. Cost savings $206.50 - $136.00 = $70.50.
The decreased number of eligible families will reduce the overall supportive services costs. Cost savings of $83.60 for each child no longer eligible.
Currently all GAFP children are eligible for child care assistance regardless of the household income. GAFP households would need to meet child care income guidelines to be eligible under this legislation, thereby reducing support service costs.
ASSUMPTION (continued)
Grandparents who are no longer eligible for GAFP become eligible for either Temporary Assistance as a Non Parent Caretaker Relative who is not needy, or Subsidized Guardianship. Approximately 25% of the children currently receiving GAFP would be eligible for Subsidized Guardianship through Children's Services. The remaining 75% would be eligible for Temporary Assistance.
The average GAFP household has 1.8 children. The Temporary Assistance grant for a two person household is $234.00. As all Federal TANF funds are obligated, Temporary Assistance payments for Grandparents shifting from GFAP will come from General Revenue.
No staff was appropriated with the passage of the GAFP legislation in 1999, therefore no staff reduction anticipated as result of this legislation.
Child Care in Schools - Section 1
No cost to the DFS.
Officials from the DOS - Division of Family Services (DFS) - Children's Services Unit (CSU) stated the proposed legislation would not fiscally impact their organization at the present time. However, if because of lesser reimbursements and fewer services provided, grandparents and relatives apply for and become eligible for Subsidized Guardianship, there will be an impact upon Adoption Subsidy funds.
The CSU officials stated that in FY 02, it is estimated that 5,197 children will receive Grandparents As Foster Parents (GAFP) benefits. The proposed legislation would result in 2,120 children losing eligibility. Of that number, the CSU estimates that 527 (25%) would have previously been in the custody of the DFS and would remain eligible for Subsidized Guardianship.
The CSU estimates the fiscal impact of the proposed legislation to the General Revenue Fund to be $1,892,773 for FY 02 (10 months); $3,030,476 for FY 03; and $3,536,138 for FY 04.
Officials from the DOS - Division of Aging (DA) stated:
208.146 Ticket to Work and Work Incentives Improvement Act of 1999
This bill would create a new population of Medicaid eligibles by extending medical assistance to working individuals who have income less than 250% of the Federal Poverty Level and meet the definition of disabled under SSI or have a medically improved disability under the federal TWWIIA. The proposed legislation would increase the number of individuals eligible for Medicaid.
ASSUMPTION (continued)
The DA assumes that proposed funding for services are for federal Medicaid program funded services and not state GR appropriated services.
The DFS and the DMS assumes that 441 new individuals will meet the eligibility requirements as stated in this bill for individuals who are disabled and have income at or below 250% of the federal poverty level. Of these 441 eligibles, 294 will enter the program in the first year, 63 additional eligibles will enter the program the second year (294 + 63 = 357 total eligibles) and 84 additional eligibles will enter the program the third year (294 + 63 + 84 = 441 total eligibles). Based on the assumption that the participation rate for in-home services is 29.12% (20,363 / 69,928) the DA estimates that 86 (294 x 29.12%) additional recipients will access home care as
an alternative to facility placement and will require case management. Based upon the assumption that these clients enter the Medicaid program who previously would not have qualified for the program, the DA estimates that 86 new clients will require case management in the first year. The DA estimates that 104 (357 x 29.12%) clients will require case management in the second year and 128 (441 x 29.12%) in the third year. The DA will need one (1) additional Social Service Worker II (SSW) position the first year to case manage the new eligibles based on current average caseload size of 80 cases per SSW (86 / 80 =1.075). The DA
will need one (1) SSW position or no additional worker the second year (104 / 80 = 1.300) and
two (2) SSW positions or one (1) additional position the third year (128 / 80 = 1.600). The one (1) Social Service Worker position in Year 1 will be placed in Greene county. The additional one (1) worker in Year 3 will be placed in Jackson county.
Oversight assumes the DA would hire the necessary staff to maintain the current Social Services Worker (SSW) caseload of approximately 139 cases per caseworker and would place the SSW in the county having the greatest need. However, we are ranging the costs associated with implementing the proposed legislation based on current caseload standards to the caseload standards recommended by the caseload study and the DOS's FY 02 Budget Request.
208.819 Transition to Independence Grants
There would be no immediate fiscal impact on Division of Aging, Institutional Services (DAIS) as a result of the proposed legislation. As individuals with disabilities return to the community from institutional settings, it is possible that some facilities inspected by DAIS could see a decrease in their resident census; however, with the rapid growth expected over the next twenty
years in the elderly population, DAIS cannot readily determine the degree of impact on facilities. Additionally, since the decision to return to the community is vested with the individual, DAIS cannot determine the location or level-of-care of facilities that may a reduction in residents.
Although there is no immediate fiscal impact on the Division of Aging, Home and Community Services (DAHCS), there may be a long range fiscal impact from the proposed legislation due to a possible increase in the number of persons transitioning from the nursing homes or institutional
ASSUMPTION (continued)
based settings into the community. Therefore, based upon the increase in the number of persons returning to the community there may be additional individuals who will require in-home services which would result in a need for additional case managers (social service workers).
The DA assumes that working with the DMS and the Division of Vocational Rehabilitation to develop information and training on community-based services options for residents transitioning into the community could be handled with existing staff and resources. The DA
further assumes that the training of representatives of disability-related community organizations would be done by the Division of Vocational Rehabilitation and that any fiscal impact associated with this training would be reflected in their response to the proposed legislation.
Based on previous experience, the following amounts represent the average annual expense of an FTE:
In addition to the above standard costs, systems furniture for the new HCS staff in Jackson county will be needed at a cost of $4,500. A desktop PC will be needed the two (2) HCS field staff at a cost of $2,099 each.
FY 02 costs for the Social Service Worker positions are based on the 10-month period September 1, 2001 through June 20, 2002. FY 03 and FY 04 costs include a 3.0% inflation adjustment for expense and equipment costs and a 2.5% inflation adjustment for personal services.
| FISCAL IMPACT - State Government | FY 2002
(10 Mo.) |
FY 2003 | FY 2004 |
| GENERAL REVENUE FUND | |||
| Savings - Department of Social Services | |||
| Contracted Services Cost Savings | $360,414 | $360,414 | $360,414 |
| Program Savings - Department of Social | |||
| Services - Division of Family Services | |||
| Maintenance Cost Savings - | |||
| Non-Eligible Children | $7,004,395 | $9,346,903 | $10,906,372 |
| Maintenance Cost Savings - | |||
| Reduction in Maintenance Payments | $2,541,479 | $3,390,565 | $3,956,349 |
| Maintenance Cost Savings - | |||
| Reduction in Maintenance Payments - | |||
| Multiple Children | $429,519 | $573,017 | $668,636 |
| Support Services Cost Savings | $2,126,784 | $2,838,053 | $3,311,563 |
| Total Program Savings - Department of | |||
| Social Services - Division of Family | |||
| Services | $12,102,177 | $16,148,538 | $18,842,920 |
| Costs - Department of Social Services - | |||
| Division of Medical Services | |||
| Personal Service (2.5 FTE) | ($96,463) | ($98,875) | ($101,348) |
| Fringe Benefits | ($32,151) | ($32,955) | ($33,779) |
| Equipment and Expenses | ($30,270) | ($9,374) | ($9,429) |
| Medical Assistance Payments | ($424,386) | ($1,626,433) | ($2,371,838) |
| Total Costs-Division of Medical Services | ($583,270) | ($1,767,637) | ($2,516,394) |
| Costs - Department of Social Services - | |||
| Division of Family Services | |||
| Personal Services (1 FTE) | $0 | ($20,442) | ($20,953) |
| Fringe Benefits | $0 | ($6,813) | ($6,984) |
| Equipment and Expense | $0 | ($7,272) | ($1,372) |
| Subsidized Guardianship Expenditures | ($1,892,773) | ($3,030,476) | ($3,536,138) |
| Movement from GAFP to TANF | ($2,480,400) | ($3,310,320) | ($3,862,560) |
| Total Costs - Division of Family Services | ($4,373,173) | ($6,375,323) | ($7,428,007) |
|
GENERAL REVENUE (cont.) |
|||
| Costs - Department of Social Services - | |||
| Division of Aging | |||
| Personal Services (0.65 to 1.3 FTE) | ($18,475) | ($22,724) | ($23,292) to |
| ($46,584) | |||
| Fringe Benefits | ($5,681) | ($6,988) | ($7,163)) to |
| ($14,325) | |||
| Equipment and Expense | ($4,722) | ($2,963) | ($3,052) to |
| ($11,029) | |||
| Total Costs - Division of Aging | ($28,878) | ($32,675) | ($33,507) to |
| ($71,938) | |||
| Costs - Department of Elementary | |||
| and Secondary Education | |||
| Missouri Transition Grants | ($126,000) | ($138,000) | ($153,000) |
| Total Costs - Department of Elementary | |||
| and Secondary Education | ($126,000) | ($138,000) | ($153,000) |
| ESTIMATED NET EFFECT ON | $9,033,995 to | ||
| GENERAL REVENUE FUND | $7,351,270 | $8,195,317 | $9,072,426 |
| FEDERAL FUNDS | |||
| Program Savings - Department of Social | |||
| Services | |||
| Contract Cost Savings | $360,414 | $360,414 | $360,414 |
| Income - Department of Social Services - | |||
| Division of Aging | |||
| Medicaid Reimbursements | $15,551 | $17,595 | $18,042 to |
| $38,737 | |||
| Income - Department of Social Services - | |||
| Division of Family Services | |||
| Medicaid Reimbursements | $0 | $17,007 | $14,435 |
| FEDERAL FUNDS (cont.) | |||
| Income - Department of Social Services - | |||
| Division of Medical Services | |||
| Medical Assistance Payments | $1,029,083 | $2,896,275 | $4,068,461 |
| Total Income and Program Savings - | |||
| Department of Social Services | $1,405,048 | $3,291,291 | $4,461,352 to |
| $4,482,047 | |||
| Costs - Department of Social Services - | |||
| Division of Medical Services | |||
| Personal Services (2.5 FTE) | ($96,466) | ($98,877) | ($101,348) |
| Fringe Benefits | ($32,152) | ($32,956) | ($33,779) |
| Equipment and Expenses | ($30,270) | ($9,375) | ($9,432) |
| Medical Assistance Payments | ($870,195) | ($2,755,067) | ($3,923,902) |
| Total Costs-Division of Medical Services | ($1,029,083) | ($2,896,275) | ($4,068,461) |
| Costs - Department of Social Services - | |||
| Division of Family Services | |||
| Personal Services (0.33 FTE) | $0 | ($10,069) | ($10,320) |
| Fringe Benefits | $0 | ($3,356) | ($3,440) |
| Equipment and Expense | $0 | ($3,582) | ($675) |
| Total Costs - Division of Family Services | $0 | ($17,007) | ($14,435) |
| Costs - Department of Social Services - | |||
| Division of Aging | |||
| Personal Services (0.35 - 0.7 FTE) | ($9,948) | ($12,236) | ($12,542) to |
| ($25,084) | |||
| Fringe Benefits | ($3,059) | ($3,763) | ($3,857) to |
| ($7,713) | |||
| Equipment and Expenses | ($2,544) | ($1,596) | ($1,643) to |
| ($5,940) | |||
| Total Costs - Division of Aging | ($15,551) | ($17,595) | ($18,042) to |
| ($38,737) | |||
| Loss - Department of Social Services | |||
| Reduction in Medicaid Funding - | |||
| Contract Cost Savings | ($360,414) | ($360,414) | ($360,414) |
| NET ESTIMATED EFFECT ON | |||
| FEDERAL FUNDS* | $0 | $0 | $0 |
* Revenues and expenditures to exceed $3.2 million annually and net to $0.
| FISCAL IMPACT - Local Government | FY 2002
(10 Mo.) |
FY 2003 | FY 2004 |
| $0 | $0 | $0 |
FISCAL IMPACT - Small Business
No direct fiscal impact to small businesses would be expected as a result of this proposal.
DESCRIPTION
TEMPORARY ASSISTANCE - Current law allows the grant of temporary assistance benefits (TANF) on behalf of a dependent child and applies federal time limits on assistance. New language allows enrollment in post-secondary education programs to qualify as a work activity if the recipient is making progress toward completion of the program. Class time and study time will apply toward the weekly work requirement. The five-year time limit on assistance will continue to apply, unless excepted by Division rule. As of January 1, 2002, the Department of Social Services must make a detailed report on TANF to certain standing committees in the General Assembly. (Section 208.040).
New provisions under the federal Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA) are implemented. It provides that medical assistance may be provided employed persons who:
1. Are considered disabled under supplemental security income definitions or have a medically improved disability under TWWIIA; 2. Meet specific asset limits; and 3. Have an annual income of 250 percent of the federal poverty level or less. Income does not include a spouse's income, up to $100,000 or a child's income. Persons with income of 150 percent of less will pay a premium.
In determining eligibility, certain assets are excluded. Eligibility will not be affected by the maintenance of an "independent living development account" held for specific purposes. Eligibility may be affected if an individual's employer offers a more cost-effective health care plan. The Department of Social Services, however, may pay premiums and other charges for the
individual and provide medical assistance as a supplemental policy. Specific premium amounts
are provided, based on an individual's income. The Department may not contract for the collection of premiums, but rather shall use monthly electronic funds transfers or employer deductions.(Section 208.146).
According to Section 208.819, Medicaid eligibles in nursing homes may be eligible for a one-time transition to independence grant of up to $1500. The Division of Vocational
Rehabilitation will administer the grants. Disability-related community organizations will
have access to institutionalized individuals in order to inform them of community-based living options. (Section 208.819).
DESCRIPTION (continued)
ADOPTION AND GUARDIANSHIP - Placement of a child may not be delayed or denied on the basis of race, color, or national origin. This act removes the requirement in adoptive placement that consideration be given to a child's cultural, racial, or ethnic background. (Section 453.005).
Currently, a grandparent, aunt, uncle, or adult sibling of a child MAY receive adoption subsidies if they are a child's legal guardian. This act adds adult first cousins of the child to the eligibility list. (Section 453.072).
Current law requires Missouri to honor adoption decrees from other states and foreign countries. New language provides that foreign adoptions are recognized when the child has migrated to the United States with permission. (Section 453.170).
GRANDPARENTS AS FOSTER PARENTS - This act recodifies the Grandparents as Foster Parents Program under sections 453.320 and 453.325. This act makes the Program subject to appropriations and adds a 200 percent of the federal poverty level income restriction to Program eligibility. The Program will reimburse up to 75 percent of the current foster care payment schedule. Finally, certain Program duties become discretionary rather than mandatory. (Sections 453.320 - 453.325).
CHILD CARE - This act deems any licensed child care program for school age children that is located on school property to be in compliance with safety, health, and fire regulations.
This legislation is not federally mandated, would not duplicate any other program and would not require additional capital improvements or rental space.
SOURCES OF INFORMATION
Office of State Courts Administrator
Department of Elementary and Secondary Education
Department of Health
Department of Social Services
Department of Public Safety - Missouri Highway Patrol
Missouri Consolidated Health Care Plan
Department of Insurance
Jeanne Jarrett, CPA
Director
June 13, 2001