COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 4500-02
Bill No.: Truly Agreed to and Finally Passed HCS for SB 1094
Subject: Appropriations; Health Care; Nursing and Boarding Homes
Type: Original
Date: May 22, 2002
FISCAL SUMMARY
| FUND AFFECTED | FY 2003 | FY 2004 | FY 2005 |
| Nursing Facility Reimbursement Allowance Fund* | $0 | $0 | $0 |
| Nursing Facility Quality of Care Fund** | $0 | $0 | $0 |
| Total Estimated
Net Effect on All State Funds |
$0 | $0 | $0 |
*Revenues and expenditures of approximately $121,000,000 annually net to $0.
**Revenues and expenditures of approximately $9,500,000 annually net to $0.
| FUND AFFECTED | FY 2003 | FY 2004 | FY 2005 |
| Federal* | $0 | $0 | $0 |
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
*Revenues and expenditures of approximately $192,000,000 annually net to $0.
| FUND AFFECTED | FY 2003 | FY 2004 | FY 2005 |
| Local Government | $0 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 4 pages.
ASSUMPTION
Officials from the Department of Health and Senior Services assume this proposal would not fiscally impact their agency.
Officials from the Department of Social Services - Division of Medical Services (DMS) state that the proposed legislation would extend the sunset of the Nursing Facility Federal Reimbursement Allowance program to September 30, 2005. DMS states it is set to expire on September 30, 2002. DMS states if the extension of the Nursing Facility Federal Reimbursement Allowance does not pass, additional funding would be needed to maintain the current level of services.
Officials from the Department of Mental Health (DMH) state that all nursing facilities, except state-owned and operated facilities, are required to pay an additional fee for the privilege to provide nursing facility services in the state of Missouri. Therefore, the fiscal impact to the DMH would be zero.
Officials of the Department of Insurance stated that there is one PACE HMO in Missouri. It serves less than 150 persons and is not in the commercial market. They do not anticipate any fiscal impact on their Department.
| FISCAL IMPACT - State Government | FY 2003
(10 Mo.) |
FY 2004 | FY 2005 |
| NURSING FACILITY REIMBURSEMENT ALLOWANCE FUND | |||
| Income - Department of Social Services | |||
| Assessment on Nursing Facilities | $91,151,207 | $121,534,943 | $121,534,943 |
| Costs - Department of Social Services | |||
| Medicaid Program Costs | ($91,151,207) | ($121,534,943) | ($121,534,943) |
| ESTIMATED NET EFFECT ON NURSING FACILITY REIMBURSEMENT ALLOWANCE FUND |
$0 |
$0 |
$0 |
| NURSING FACILITY QUALITY OF CARE FUND | |||
| Transfer in - Department of Social
Services
Up to 5% from Federal Fund |
Unknown up to $7,197,818 |
Unknown up to $9,597,091 |
Unknown up to $9,597,091 |
| Expenditures - Department of Social Services | |||
| Program Expenditures | (Unknown up to $7,197,818) | (Unknown up to $9,597,091) | (Unknown up to $9,597,091) |
| ESTIMATED NET EFFECT ON NURSING FACILITY QUALITY OF CARE FUND |
$0 |
$0 |
$0 |
| FEDERAL | |||
| Income - Department of Social Services | |||
| Assessment on Nursing Facilities | $143,956,369 | $191,941,825 | $191,941,825 |
| Costs - Department of Social Services | |||
| Medicaid program expenditures | (Unknown up to $143,956,369) | (Unknown up to $191,941,825) | (Unknown up to $191,941,825) |
| Transfer out - Department of Social Services | |||
| To Nursing Facility Quality of Care Fund | (Unknown up to $7,197,818) | (Unknown up to $9,597,091) | (Unknown up to $9,597,091) |
| ESTIMATED NET EFFECT ON FEDERAL FUNDS |
$0 |
$0 |
$0 |
| FISCAL IMPACT - Local Government | FY 2003
(10 Mo.) |
FY 2004 | FY 2005 |
| $0 | $0 | $0 |
FISCAL IMPACT - Small Business
No direct fiscal impact to small businesses would be expected as a result of this proposal.
DESCRIPTION
This proposal extends the sunset for the nursing facility reimbursement allowance to September 30, 2005. Current law sunsets the reimbursement allowance on September 30, 2002.
This proposal would also allow certain health maintenance organizations acting as programs for all-inclusive care for the elderly (PACE) projects to be exempt from the certificate of authority requirement. This exemption would apply only to business conducted under terms of the approved PACE contract.
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
Department of Health and Senior Services
Department of Social Services
Department of Mental Health
Department of Insurance
Mickey Wilson, CPA
Acting Director
May 22, 2002