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BILL # SB 1031 |
TITLE: developmental disabilities; ALTCS services |
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SPONSOR: Rogers |
STATUS: As Introduced |
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PREPARED BY: Maggie Rocker |
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The bill would require the Department of Economic Security (DES) to provide long-term care system services to non-Medicaid eligible developmentally disabled clients.
Estimated Impact
DES estimates the bill would generate additional General Fund costs between$50.4 million[MR1] and $473[MR2] .6 million. The lower end of the estimate assumes a 10% utilization rate of long-term care services by new clients while the higher end assumes a 100% utilization rate. Since non-Medicaid eligible developmentally disabled clients are generally higher functioning, we believe 100% utilization of services by new clients would be unlikely, thus resulting in a cost lower than the high end of DES's provided range.
The Arizona Long Term Care System (ALTCS) provides long-term services, including home and community-based services, for developmentally disabled members determined to need institutional services. For developmentally disabled individuals who do not meet ALTCS program requirements, the DES Division of Developmental Disabilities (DDD) provides[MR3] support coordination through a state-funded program.
The bill would require long-term care services be provided to non-ALTCS eligible developmentally disabled individuals. DES estimates that 9,209 [MR4] DDD clients who receive either case management or state-only services would receive a full set of ALTCS services. In addition, the Department expects it would need to hire an additional 134 human service specialists[MR5] to address the increased caseload. Depending on the assumed utilization rate of ALTCS services by new clients, DES estimates the bill would generate additional costs of $50.4 million (10% utilization) to $473.6 million (100% utilization). Because state-only and targeted case management clients do not meet the eligibility requirements for Medicaid reimbursement, the General Fund would be required to cover the additional costs.
Given the more stringent functional requirements associated with the ALTCS program, we do not believe new, non-Medicaid eligible developmentally disabled clients would utilize services at 100%. Thus, the high-end estimated provided by DES is likely overstated.
Local Government Impact
None
[MR1]They've given the largest range possible – should we attempt to narrow down by selecting different utilization percentages?
[MR2]Two components to these numbers: actual cost for increased services and administrative cost for additional staffing. Provided that DES responds in time with the breakdown, should we break out those components separately here?
[MR3]I'm not clear about the interaction between State Only and Targeted Case Management clients? Stefan, could you help clarify the different populations?
[MR4]I'm confused by DES's follow-up email (Wed 1/26). DES says "the initial projection of $598 million assumed that every current non-ALTCS eligible client would now receive services and did not include projections for individuals receiving ALTCS services who are not currently DDD members." Based on this, DES has revised its estimate for the number of affected clients. I am following up to get an exact number.
Is the "individuals receiving ALTCS services who are not currently DDD members" referring to TCM?
[MR5]See comment in estimated impact section. I would expand this if we get more detail from DES on the exact breakout.