HB1549 (2008) Detail

Relative to the duration of the disability requirement for aid to the permanently and totally disabled.


HB 1549-FN – AS AMENDED BY THE HOUSE

06Feb2008… 0265h

2008 SESSION

08-2586

01/05

HOUSE BILL 1549-FN

AN ACT relative to the duration of the disability requirement for aid to the permanently and totally disabled.

SPONSORS: Rep. Donovan, Sull 4; Rep. Skinder, Sull 1; Rep. Jillette, Sull 2; Rep. Butcher, Ches 3

COMMITTEE: Health, Human Services and Elderly Affairs

AMENDED ANALYSIS

This bill replaces the state requirement that an impairment exist for 48 months for the aid to the permanently and totally disabled program with the 12-month requirement used by the Social Security Administration. This bill also declares that a determination of eligibility for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) constitutes eligibility for aid to the permanently and totally disabled.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

06Feb2008… 0265h

08-2586

01/05

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Eight

AN ACT relative to the duration of the disability requirement for aid to the permanently and totally disabled.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 Aid to the Permanently and Totally Disabled; Duration of Disability. Amend RSA 167:6, VI to read as follows:

VI.(a) For the purposes hereof, a person shall be eligible for aid to the permanently and totally disabled who is between the ages of 18 and 64 years of age inclusive; is a resident of the state; and is disabled as defined in the federal Social Security Act, Titles II and XVI and the regulations adopted under such act[, except that the minimum required duration of the impairment shall be 48 months. In determining disability,]. For purposes of determining disability:

(1) A determination of eligibility for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) pursuant to Title II or Title XVI of the Social Security Act shall constitute a determination of disability for purposes of aid to the permanently and totally disabled; and

(2) The standards for “substantial gainful activity” as used in the Social Security Act shall apply, including all work incentive provisions including Impairment Related Work Expenses, Plans to Achieve Self Support, and subsidies.

(b) No person shall be eligible to receive such aid while receiving old age assistance, aid to the needy blind, or aid to families with dependent children.

2 Effective Date. This act shall take effect 60 days after its passage.

LBAO

08-2586

12/06/07

HB 1549-FN - FISCAL NOTE

AN ACT relative to the duration of the disability requirement for aid to the permanently and totally disabled.

FISCAL IMPACT:

      The Department of Health and Human Services states this bill would increase state expenditures by an indeterminable amount, and may decrease local expenditures by an indeterminable amount in FY 2009 and each year thereafter. This bill will have no fiscal impact on county and local revenue, or county expenditures.

METHODOLOGY:

    The Department of Health and Human Services states this bill changes the minimum duration of the disability for Aid to the Permanently and Totally Disabled (APTD) from 48 months to the duration as defined in the federal Social Security Act, Titles II and XVI (which is currently 12 months). The Department states this bill will increase the number of recipients of both APTD assistance payments and medical assistance because it will require the Department to use less restrictive medical eligibility criteria than it currently uses. The Department states that approximately 48.44% of the total APTD population receive assistance payments as well as medical assistance via the Medicaid program. The Department estimates the fiscal impact as follows:

    APTD Assistance Payments (AP)

    (100% State General Funds)

                      New APTD Average Monthly Annual APTD AP Recipients Grant per Recipient AP Cost (12 months)

    FY 2009 430 $193.34 $997,634

    FY 2010 512 $203.20 $1,248,461

    FY 2011 600 $213.56 $1,537,632

    FY 2012 695 $224.46 $1,871,996

    APTD Medical Assistance (MA)

    (50% State General Funds/ 50% Federal Funds)

                      New APTD Average Monthly Annual APTD

                      MA Recipients Cost per Recipient MA Cost (12 months)

    FY 2009 888 $1,723 $18,360,288

    FY 2010 1,057 $1,723 $21,854,532

    FY 2011 1,239 $1,723 $25,617,564

    FY 2012 1,435 $1,723 $29,670,060

    In summary, this bill may increase state expenditures for APTD assistance payments and medical assistance by $19,357,922 in FY 2009, $23,102,993 in FY 2010, $27,155,196 in FY 2011, and by $31,542,056 in FY 2012. Of this amount, the state general fund share would be $10,177,778 in FY 2009, $12,175,727 in FY 2010, $14,346,414 in FY 2011, and by $16,707,026 in FY 2012.

    In addition, the Department states APTD applicants who are currently Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) recipients at the time this bill goes into effect would be granted automatic medical eligibility. This will result in a one-time increase in the number of APTD AP and MA recipients. There are currently 133 applications pending for individuals who are currently SSI or SSDI beneficiaries. Of the 133, 64 applicants may be financially eligible for APTD assistance payments, as well as medical assistance. The Department estimates the one-time cost in FY 2009 would total approximately $149,472 for assistance payments, and $2,749,908 for medical assistance, for a total one-time cost of $2,899,380. The state general fund share would be $1,524,426, bringing the estimated total state general fund impact of APTD assistance payments and medical assistance to $11,702,204 ($10,177,778+$1,524,426) in FY 2009.

    The Department states the Disability Determination Unit (DDU) may experience some cost avoidance since it could expedite many cases. In addition the Administrative Appeals Unit (AAU) may also experience some cost avoidance. The AAU estimates that out of the 800-900 appeals requested each year approximately 300 are APTD disability appeals in which a

    majority cite duration as the issue or an issue in the case. A reduction in duration requirement would likely reduce the number of cases being appealed, however any such cost savings cannot be determined at this time. The Department states that individuals presently ineligible for APTD due to duration, and who are not yet open for Supplemental Security Income (SSI), look to their town for assistance under RSA 165. If such individuals were eligible for APTD, their dependence on local assistance is expected to drop by an indeterminable amount. In addition, the Department states that individuals served in the health care system earlier in the progression of their disability could save health care costs over time by increased access to preventative care and disease management, however any such cost reduction is indeterminable and may not be measurable until beyond FY 2012. The Department states that counties will no longer be responsible for APTD cash assistance beginning in FY 2009 based on current law.