HB 502-FN-A-LOCAL – AS AMENDED BY THE HOUSE
02Jan2008… 2664h
2007 SESSION
08/04
HOUSE BILL 502-FN-A-LOCAL
AN ACT extending Medicaid coverage through age 20 to individuals who were foster children and are attending postsecondary school.
SPONSORS: Rep. Blanchard, Merr 10; Rep. Gargasz, Hills 5; Rep. French, Merr 5
COMMITTEE: Children and Family Law
This bill redefines which juveniles may be able to receive public medical assistance.
This bill also establishes a study committee to study the state of Washington program, and other state programs, that extend foster care and support services to certain juveniles and the feasibility of extending healthcare benefits for children over 21 years old and certain children over 17 years old.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
02Jan2008… 2664h
07-0930
08/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Seven
AN ACT extending Medicaid coverage through age 20 to individuals who were foster children and are attending postsecondary school.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Paragraph; Medical Assistance; Juveniles. Amend RSA 167:6 by inserting after paragraph V the following new paragraph:
V-a. For purposes of this section, a person shall be eligible to receive medical assistance who is under the age of 21, attending college, full-time or part-time, as defined by the educational institution and either
(a) Who was in foster care under the legal responsibility of the department on his or her 18th birthday pursuant to RSA 169-C, RSA 169-D, RSA 463; or RSA 170-B; or
(b) Who was in foster care under the legal responsibility of the department on his or her 17th birthday pursuant to RSA 169-B.
2 Committee Established. There is established a committee to study the state of Washington program that extends foster care and support services to youths who are in state-supervised foster care on their eighteenth birthday, provided such youths are enrolled in a postsecondary educational program and retain a grade point average of at least 2.0 on a 4.0 scale, or its equivalent, in such a program and the feasibility of extending health care benefits for children past age 21.
3 Membership and Compensation.
I. The members of the committee shall be as follows:
(a) Three members of the house of representatives, appointed by the speaker of the house of representatives, one of which will be a member of the committee on children and family law.
(b) Two members of the senate, appointed by the president of the senate.
II. Members of the committee shall receive mileage at the legislative rate when attending to the duties of the committee.
4 Duties. The committee shall study:
I. The state of Washington program, and any other state program, that extends foster care and support services to youths who are in state-supervised foster care on their eighteenth birthdays provided such youths are enrolled in a postsecondary educational program and retain a grade point average of at least 2.0 on a 4.0 scale, or its equivalent, in such a program; and
II. The feasibility of extending health care benefits for children past age 21 and for those who are unable to participate in juvenile justice programs because they are over 17 years old.
5 Chairperson; Quorum. The members of the study committee shall elect a chairperson from among the members. The first meeting of the committee shall be called by the first-named house member. The first meeting of the committee shall be held within 45 days of the effective date of this section. Four members of the committee shall constitute a quorum.
6 Report. The committee shall report its findings and any recommendations for proposed legislation to the speaker of the house of representatives, the president of the senate, the house clerk, the senate clerk, the governor, and the state library on or before November 1, 2008.
7 Effective Date. This act shall take effect upon its passage.
LBAO
07-0930
Amended 01/23/08
Revised 02/05/08
HB 502 FISCAL NOTE
AN ACT extending Medicaid coverage through age 20 to individuals who were foster children and are attending postsecondary school.
FISCAL IMPACT:
The Department of Health and Human Services states this bill, as amended by the House (Amendment #2007-2664h), will increase state general fund expenditures by $195,888 in FY 2009, $206,662 in FY 2010, $218,028 in FY 2011, and $230,020 in FY 2012. This bill will increase state restricted expenditures by $139,920 in FY 2009, $147,616 in FY 2010, $155,734 in FY 2011, and $164,300 in FY 2012. This bill will have no fiscal impact on state, county, and local revenue, or county and local expenditures.
METHODOLOGY:
The Department of Health and Human Services estimates there are 131 children/youth in foster care as of their eighteenth birthday under RSA 169-C (abuse and neglect), RSA 169-D (Children in Need of Services or CHINS), and RSA 463 (guardianship of minors). The Department further estimates that there would be 16 children/youth in foster care as of their seventeenth birthday under RSA 169-B (delinquency cases). The Department estimates that of these children/youth, approximately 20 eighteen year olds, and 3 seventeen year olds would go on to college either full or part-time, and be eligible for extended medical coverage under this bill. The Department states the scope of coverage under the bill extends to 18, 19, and 20 year olds who were in foster care in abuse and neglect, guardianship, and CHINS cases, and to 17, 18, and 19 year olds who were in foster care in delinquency cases. As a result, the Department multiplied their estimated eligibility numbers by 3 for children under RSA 169-C, 169-D, and 463 to arrive at an eligible population of 60 (3 x 20), and by 4 for children under RSA 169-B to arrive at an eligible population of 12 (4 x 3).
The Department estimates that the average Medicaid claims paid for this population would be $4,664 per child/per year, which excludes rehabilitation services, high end children who are in the Department’s custody, and certain categories of service that are unlikely to be used by youth pursing postsecondary education. Where 50% federal matching funds are available, the cost to the state would be $2,332 per child/per year or $194 per child/per month. By way of comparison, the American Public Human Services Association’s (APHSA) recent survey of the cost of extending Medicaid coverage to youth ages 18 to 21 who have “aged out” of foster care under the federal Foster Care Independence Act of 1999 (Chafee Act) found, that of the five states responding, the costs associated with providing this coverage varied from a low in California of approximately $110 per month/per child in a managed care setting to a high cost of $350 per month/per child in South Carolina. Assuming the Department is able to amend its Medicaid State Plan to qualify for federal financial participation (FFP) for children in foster care who “age out” under abuse, neglect, guardianship, and CHINS cases under the Chafee Act or other federal program, the cost share would be 50% state and 50% federal. However, as the Chafee Act requires that children be in custody of the state as of their eighteenth birthday as a condition of FFP, the Department assumes children “aging out” on their seventeenth birthday under RSA 169-B would not be eligible for federal match and that these costs would be borne entirely by the state. Assuming an effective date of July 1, 2008, and a 5.5% increase in Medicaid covered costs in FY 2009 and each year thereafter, the total fiscal impact (state and federal funds) is as follows:
FY 2009 FY 2010 FY 2011 FY 2012
60 eligible children under $279,840 $295,232 $311,468 $328,600
RSA 169-C and-D, & 463
12 children under RSA 169-B $55,968 $59,046 $62,294 $65,720
Total Costs $335,808 $354,278 $373,762 $394,320
Of these amounts, the state general fund and federal share would be as follows:
FY 2009 FY 2010 FY 2011 FY 2012
State General Funds $195,888 $206,662 $218,028 $230,020
Federal Funds $139,920 $147,616 $155,734 $164,300
Total Funds $335,808 $354,278 $373,762 $394,320