Revision: March 25, 2010, midnight
SB 450-FN – AS AMENDED BY THE SENATE
03/24/10 1113s
03/24/10 1174s
2010 SESSION
01/10
SENATE BILL 450-FN
AN ACT relative to costs and expenditures at the department of health and human services, establishing a special fund for certain civil fines collected by the department, and relative to the due date for the Medicaid enhancement tax.
SPONSORS: Sen. Sgambati, Dist 4; Sen. D'Allesandro, Dist 20; Sen. Gallus, Dist 1; Sen. Janeway, Dist 7
This bill:
I. Consolidates the amount to be reduced by the department of health and human services, as required under HB 1-A of the 2009 legislative session, for the biennium instead of for each fiscal year.
II. Exempts certain rates for services, placements, and programs for children and families from RSA 541-A.
III. Clarifies the administration of the New Hampshire employment program.
IV. Makes the funded family assistance program (FANF) permissive rather than mandatory.
V. Requires recipients of medical assistance to name the state of New Hampshire as beneficiary of all life insurance policies, except under certain circumstances.
VI. Allows the department of health and human services to make a claim for recovery of assistance for a deceased recipient from the division of abandoned property.
VII. Authorizes the commissioner of the department of health and human services to transfer funds within and among all PAUs within the department, to address present or projected budget deficits, or to respond to changes in federal laws, regulations, or programs, and as otherwise necessary for the efficient management of the department.
VIII. Permits funds from the lead paint poisoning prevention fund to be used to support program staff and administrative costs.
IX. Transfers powers and duties for the New Hampshire refugee resettlement program from the governor’s office to the department of health and human services.
X. Establishes a special account for civil fines collected by the department of health and human services under RSA 151.
XI. Clarifies criteria for determining eligibility for services under the Medicaid waiver.
XII. Changes the due date for the Medicaid enhancement tax.
XIII. Renames the “multiple DWI offender intervention detention center program” as the “multiple DWI offender intervention program,” and authorizes the commissioner of the department of health and human services to directly operate the program, to approve community-based providers of the program, or to contract with public or private entities to operate the program.
XIV. Requires the commission to examine driving while impaired education and intervention programs to study penalties for intoxication or under the influence of drugs offenses and submit a report of its findings.
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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.
03/24/10 1113s
03/24/10 1174s
10-2705
01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Ten
AN ACT relative to costs and expenditures at the department of health and human services, establishing a special fund for certain civil fines collected by the department, and relative to the due date for the Medicaid enhancement tax.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Department; Powers and Duties; Publication of Rates of Reimbursement Exempt From Rulemaking. Amend RSA 170-G:4, XVII to read as follows:
XVII. Establish rates for all services, placements and programs which are paid for by the department pursuant to RSA 169-B:40, 169-C:27, 169-D:29, and any services required to be provided by the department pursuant to paragraph II of this section. When educational aspects are present in any service, placement or program subject to rate-setting by the department, rates for the educational component shall be addressed jointly by the department and the department of education. Publication of rates of reimbursement shall be exempt from the provisions of RSA 541-A.
2 New Paragraph; Administrative Procedure Act; Exception Added. Amend RSA 541-A:21 by inserting after paragraph VI the following new paragraph:
VII. RSA 170-G:4, XVII, relative to the publication of rates for services, placements, and programs which are paid for by the department of health and human services pursuant to RSA 169-B:40, RSA 169-C:27, and RSA 169-D:29 shall be exempt from RSA 541-A.
3 Administration of the New Hampshire Employment Program; Duties; Rulemaking. Amend RSA 167:83, V to read as follows:
V. The commissioner [shall] may enter into an agreement or contract with the commissioner of the department of employment security to carry out the employment program and may delegate authority and duties for the employment program to the commissioner of the department of employment security and other state agencies. The commissioner shall adopt rules for the employment program [in consultation with the commissioner of the department of employment security].
4 Non-TANF Funded Program for 2-Parent Families With Dependent Children. Amend RSA 167:77-e to read as follows:
167:77-e Assistance Program for 2-Parent Families with Dependent Children. [By October 1, 2008,] The department [shall] may establish a non-TANF, state-funded financial assistance program for 2-parent needy families with dependent children in which one parent is underemployed or unemployed. With the exception of parental underemployment or unemployment, client eligibility and program requirements and administration shall be in accordance with this chapter and the rules adopted under this chapter. In order to meet the federal work participation rate and avoid federally-imposed penalties, the commissioner may add additional groups of families to this state-funded, financial assistance program as funding permits and also may transfer cases back to the TANF program, pursuant to rules adopted under RSA 541-A.
5 Eligibility for Medical Assistance. Amend RSA 167:4, IV(c) to read as follows:
(c) Notwithstanding any provision of law to the contrary, for purposes of medicaid eligibility, investment in life insurance policies with cash surrender, benefit, or face value in excess of $1,500 shall be limited to policies that ensure payment to the state of New Hampshire of all the proceeds of the policy in excess of amounts spent on burial up to the total of medicaid expenditures made on behalf of the individual, except that life insurance policies which name the Medicaid recipient’s spouse who remains living in the community or recipient’s disabled child who is under the age of 65 as the only beneficiary or beneficiaries shall be exempt from this eligibility requirement.
6 Authorizing the Department of Health and Human Services to File Claims for Medical and Financial Assistance Against Abandoned Property Held by the Treasury; Filing of Claim With Administrator. Amend RSA 471-C:26, I(c)(2)(3) to read as follows:
(2) Except as provided in subparagraphs (5)-(7), in the case of a closed estate where the unclaimed property is valued at less than $5,000 and does not include securities in share form, in accordance with the final distribution of assets as approved by the probate court.
(3) Except as provided in subparagraphs (5)-(7), in the absence of an open estate or probate court decree of final distribution, and the unclaimed property is valued at less than $5,000 and does not include securities in share form, by the surviving spouse of the deceased owner, or, if there is no surviving spouse, then to the next of kin in accordance with the provisions of RSA 561:1.
7 New Subparagraphs; Filing of Claim With Administrator. Amend RSA 471-C:26, I(c) by inserting after subparagraph (4) the following new subparagraphs:
(5) Before distributing any unclaimed property pursuant to subparagraphs (2) and (3), the administrator shall first ensure that the department of health and human services does not have a claim for medical and or financial assistance paid on behalf of the deceased owner.
(6) In the event that the department of health and human services has a claim for medical and or financial assistance paid on behalf of the deceased owner, the department may submit a claim for such assistance using an affidavit developed by the administrator that ensures that:
(A) No individual has moved to probate the deceased owner’s estate through which the department could assert its claim or probate administration for the deceased owner had been open and no individual has moved to reopen the estate through which the department could assert its claim;
(B) The department does not believe, based on the information available to it, there are known expenses for the deceased owner’s necessary funeral and burial; and
(C) Based on all facts known to the department, its recovery of this abandoned property is not limited by the prohibitions to recovery as set forth in 42 U.S.C. section 1396p and RSA 167:16-a, IV.
(7) If the department of health and human services has made a claim against a deceased owner’s unclaimed property as provided in subparagraph (6), under no circumstances shall the administrator distribute to the department more than the claimed amount.
8 Repeal. 2009, 144:211, relative to community mental health centers; administrative requirements suspended, is repealed.
9 Department of Health and Human Services; Transfer Among Accounts. Amend 2009, 144:39, III to read as follows:
III. Notwithstanding the provisions of RSA 9:17-a or any other provision of law to the contrary except RSA 9:17-c, and subject to the approval of the fiscal committee of the general court and governor and council, for the biennium ending June 30, 2011, the commissioner of the department of health and human services is hereby authorized to transfer funds within and among all PAUs within the department, as the commissioner deems necessary and appropriate to address present or projected budget deficits, or to respond to changes in federal laws, regulations, or programs, and otherwise as necessary for the efficient management of the department[, with the exception of class 60 transfers].
10 Lead Paint Poisoning Prevention and Control; Rulemaking. Amend RSA 130-A:10, IV to read as follows:
IV. Fees to be collected for the issuance of licenses to lead inspectors, lead risk assessors, lead abatement contractors, for certification of lead abatement workers and lead clearance testing technicians, for testing resulting from investigations, for certifications of training programs, exam and training fees, [and] for notifications under RSA 130-A, and other environmental fees. Property owners who own more than 4 but fewer than 7 dwelling units shall pay a fee for licensure which is 1/2 of that paid by other lead abatement contractor licensees. Such reduced fee license shall only be valid for work on dwellings or dwelling units owned by such license holder.
11 Lead Poisoning Prevention Fund. Amend RSA 130-A:15 to read as follows:
130-A:15 Lead Poisoning Prevention Fund. There is hereby established the lead poisoning prevention fund to be used to carry out the provisions of this chapter. The fund shall be composed of fees, fines, gifts, grants, donations, bequests, or other moneys from any public or private source and shall be used to implement and encourage lead paint removal and education, and to support program staff and administrative costs. The fund shall be nonlapsing and shall be continually appropriated to the commissioner of the department of health and human services for the purposes of this chapter.
12 New Paragraph; Department of Health and Human Services; Duties of the Department. Amend RSA 161:2 by inserting after paragraph XVII the following new paragraph:
XVIII. Refugee Resettlement. Administer the New Hampshire refugee resettlement program as funded by and in cooperation with the United States Department of Health and Human Services under the Refugee Act of 1980.
13 New Section; Special Fund; Civil Fines. Amend RSA 151 by inserting after section 16-a the following new section:
151:16-b Civil Fines. All administrative fines and other civil monetary penalties collected by the department from facilities licensed under this chapter shall be kept by the state treasurer in a separate, non-lapsing, interest bearing account. Interest earned on moneys deposited in the account shall be deposited into the account. The moneys in the account shall be used by the department for the protection of the health and property of residents of facilities licensed under this chapter.
14 New Subparagraph; Special Fund. Amend RSA 6:12, I(b) by inserting after subparagraph (299) the following new subparagraph:
(300) Civil fines collected under RSA 151:16-b, which shall be deposited as provided in such section.
15 Eligibility for Services Under the Medicaid Waiver. Amend RSA 151-E:3, II to read as follows:
II. A person is eligible for services under the medicaid waiver if the person has been determined clinically eligible under RSA 151-E:3, I(a), and financially eligible pursuant to rules adopted by the commissioner under RSA 541-A.
16 Medicaid Enhancement Tax; Due Date. Amend RSA 84-A:3, II-a to read as follows:
II-a. For the taxable period beginning July 1, 1993, and for every taxable period thereafter, each hospital shall pay 100 percent of its medicaid enhancement tax due and payable for the taxable period no later than the fifteenth day of the [third] fourth month of the taxable period. Notwithstanding any provision of this chapter or any other law, no penalty or interest shall be imposed for failure to make payment of tax when due if such payment is made on or before the last day of the month in which such payment is due.
17 Penalties for Intoxication or Under the Influence of Drugs Offenses. Amend RSA 265-A:18, I(a)(3) to read as follows:
(3) Required to furnish proof of successful completion of an impaired driver intervention program prior to the restoration of the person’s driver’s license or privilege to drive, provided that, if the person has previously completed, or been required by a court or the department of safety to complete, an impaired driver intervention program (I.D.I.P.) or any similar program in any jurisdiction, the person shall be required to furnish proof of successful completion of the multiple DWI offender intervention [detention center] program (M.O.P.) or an equivalent 7-day residential intervention program approved by the commissioner of health and human services;
18 Penalties for Intoxication or Under the Influence of Drugs Offenses. Amend RSA 265-A:18, I(b)(3) to read as follows:
(3) Sentenced to a mandatory sentence of not less than 10 consecutive days of which 3 consecutive 24-hour periods shall be served in the county correctional facility and 7 consecutive days shall be served at the [state-operated] 7-day multiple DWI offender intervention [detention center] program established under RSA 265-A:40, which sentence shall begin no later than [21] 45 days after conviction. In the event that the [state-operated] 7-day multiple DWI offender intervention [detention center] program has no available space, the person shall be assigned to an equivalent 7-day residential intervention program approved by the commissioner of health and human services. The person shall begin following any treatment recommendations arising out of the final evaluation given to the person at the multiple DWI offender intervention [detention center] program or equivalent program within 60 days after the person has completed serving the required 7 consecutive days or such other time as the court may order;
19 Penalties for Intoxication or Under the Influence of Drugs Offenses. Amend RSA 265-A:18, I(c)(3) to read as follows:
(3) Sentenced to a mandatory sentence of not less than 21 consecutive days of which 14 consecutive 24-hour periods shall be served in the county correctional facility followed by 7 consecutive days served at the [state-operated] 7-day multiple DWI offender intervention [detention center] program established under RSA 265-A:40, which sentence shall begin no later than 21 days after conviction. In the event that the [state-operated] 7-day multiple DWI offender intervention [detention center] program has no available space the person shall be assigned to an equivalent 7-day residential intervention program approved by the commissioner of health and human services, and the remainder of the sentence may be deferred at the court’s discretion. The person shall begin following any treatment recommendations arising out of the final evaluation given to the person at the multiple DWI offender intervention [detention center] program or equivalent program within 60 days after the person has completed serving the required 7 consecutive days or such other time as the court may order. The court may, at the satisfactory completion of any ordered treatment, suspend any remaining deferred sentence. Failure to successfully complete any court-ordered intervention program or recommended treatment shall result in the imposition of any remaining deferred sentence; and
20 Penalties for Intoxication or Under the Influence of Drugs Offenses. Amend RSA 265-A:18, IV(a)(3)-(5) to read as follows:
(3)(A) If the complaint alleges that the prior conviction occurred within 2 years preceding the date of the second offense, the person shall be sentenced to a mandatory sentence of not less than 37 consecutive days of which 30 consecutive 24-hour periods shall be served in the county correctional facility followed by 7 consecutive days to be served at the [state-operated] 7-day multiple DWI offender intervention [detention center] program established under RSA 265-A:40 within 21 days after conviction, except that in circumstances where the [state-operated] 7-day multiple DWI offender intervention [detention center] program has no available space the person shall be assigned to an equivalent 7-day residential intervention program approved by the commissioner of health and human services. The person shall begin following any treatment recommendations arising out of the final evaluation given to the person at the multiple DWI offender intervention [detention center] program or equivalent program within 60 days after the person has completed serving the required 30 consecutive 24-hour periods or such other time as the court may order.
(B) If the complaint alleges that the prior conviction occurred more than 2 but not more than 10 years preceding the date of the second offense, the person shall be sentenced to a mandatory sentence of not less than 10 consecutive days of which 3 consecutive 24-hour periods shall be served in the county correctional facility and 7 consecutive days shall be served at the [state-operated] 7-day multiple DWI offender intervention [detention center] program established under RSA 265-A:40, which sentence shall begin no later than 21 days after conviction. In the event that the [state-operated] 7-day multiple DWI offender intervention [detention center] program has no available space the person shall be assigned to an equivalent 7-day residential intervention program approved by the commissioner of health and human services. The person shall begin following any treatment recommendations arising out of the final evaluation given to the person at the multiple DWI offender intervention [detention center] program or equivalent program within 60 days after the person has completed serving the required 7 consecutive days or such other time as the court may order.
(4) The person’s driver’s license or privilege to drive shall be revoked for not less than 3 years.
(5) The person shall pay a fee to the commissioner, as established under RSA 126-A:43, for the costs of the [state-operated] 7-day multiple DWI offender intervention [detention center] program prior to license restoration. If the person attends an approved equivalent 7-day residential intervention program, the fees and costs shall be paid to the program.
21 Penalties for Intoxication or Under the Influence of Drugs Offenses. Amend RSA 265-A:18, VI to read as follows:
VI. If any person is convicted of a violation of RSA 265-A:2, I or RSA 265-A:3, and the conviction is not based upon a complaint which alleges prior convictions as provided in paragraph IV, but the person is found to have had one or more such prior convictions in this state or in an out-of-state jurisdiction within 10 years preceding the date of the offense, the person’s driver’s license or privilege to drive shall be revoked for not less than one year nor more than 3 years. Except for good cause found by the court and noted in writing, the court may suspend up to 6 months of this sentence, provided that within 45 days after conviction the person has entered the 7-day program at the [state-operated] multiple DWI offender intervention [detention center] program or an equivalent 7-day residential intervention program approved by the commissioner of health and human services, as provided in RSA 265-A:40 and RSA 265-A:42. The person’s license shall not be restored until the person has successfully completed the program. The court may further order attendance at a residential treatment center, for a period not to exceed 30 days, at the person’s own expense.
22 Penalties for Intoxication or Under the Influence of Drugs Offenses. Amend RSA 265-A:18, XI to read as follows:
XI. Any person convicted of a violation of RSA 265-A:2, RSA 265-A:3, or RSA 265-A:19, II, and who at the time of driving or attempting to drive a vehicle or off highway recreational vehicle or operating or attempting to operate a boat was transporting a person under the age of 16, shall have the driver’s license or privilege to drive revoked for the maximum time period under the section violated and the person’s license or privilege to drive shall not be restored until the offender has successfully completed a 7-day program at the [state-operated] multiple DWI offender program or an equivalent 7-day residential intervention program approved by the commissioner at the person’s own expense.
23 Penalties for Boating While Intoxicated. Amend RSA 265-A:19, II to read as follows:
II. Any person convicted of a violation of RSA 265-A:2, II who at the time of the violation was transporting a person under the age of 16 shall not operate a boat on the waters of this state until the offender has successfully completed a 7-day program at the [state operated] multiple DWI offender program or an equivalent 7-day residential intervention program approved by the department of health and human services at the person’s own expense. Any person operating a boat in violation of this paragraph is guilty of a misdemeanor.
24 Impaired Driver Intervention Programs. Amend RSA 265-A:39, I to read as follows:
I. Except as provided in paragraph IV, the commissioner of the department of health and human services shall be responsible for biennially approving the impaired driver intervention programs and 7-day residential intervention programs equivalent to the multiple DWI offender intervention [detention center] program (M.O.P.) which persons convicted under RSA 265-A:2 or RSA 265-A:3 shall attend in order to regain their driver’s licenses or driving privileges; but the commissioner of the department of health and human services shall not approve any impaired driver intervention program unless such program is conducted without cost to the state. Notwithstanding RSA 6:12, any fees collected under subparagraph IV(g) of this section shall be placed in a nonlapsing revolving account and shall be used by the commissioner for the purposes of this subdivision only.
25 Multiple DWI Offender Intervention Program. RSA 265-A:40 is repealed and reenacted to read as follows:
265-A:40 Multiple DWI Offender Intervention Program.
I. The commissioner of the department of health and human services shall be responsible for the establishment and administration of the 7-day multiple DWI offender intervention program which persons convicted under RSA 265-A:2 or RSA 265-A:3 or sentenced pursuant to RSA 651:2, V(h) may be required to attend. The commissioner shall have the authority to directly operate the program, to approve community-based providers to operate the program in accordance with rules adopted pursuant to RSA 541-A, or to contract with public or private entities to operate the program.
II. Any person who attends the 7-day multiple DWI offender intervention program shall be required to pay the fees for the program to the department of health and human services. Full payment shall be made in advance unless the person has entered into a payment plan contract with the office of reimbursements prior to entry into the program. Payment of all fees shall be made no later than one year after completion of the program. The fees shall be sufficient to make the program self-supporting, exclusive of start-up costs. The fees collected shall be deposited in a special account in the office of the state treasurer and utilized as provided in RSA 265-A:41.
III. The 7-day multiple DWI offender intervention program shall furnish to the courts a report indicating when a person has completed attendance at the program, and shall furnish to the division of motor vehicles, department of safety, a report indicating when a person who attends the program pursuant to RSA 265-A:18 has successfully completed the program and treatment or involvement in a substance abuse program when appropriate and warranted.
IV. The commissioner of the department of health and human services shall adopt rules, pursuant to RSA 541-A, relative to the operation of the 7-day multiple DWI offender intervention program with respect to:
(a) Program curriculum and content.
(b) Any other matter related to the proper administration of this section.
26 Impaired Driver Intervention Programs; Utilization of Funds. Amend RSA 265-A:41 to read as follows:
265-A:41 Utilization of Funds. All funds derived from the fees collected by the commissioner of the department of health and human services under RSA 265-A:18 shall be paid over to the state treasurer within 10 days of the subsequent month, or at an earlier date, for deposit into a separate account in the treasury known as the 7-day multiple DWI offender intervention [detention center] program account. These funds are appropriated as indicated in the operating budget as a source of funds for the 7-day multiple DWI offender intervention [detention center] program. Any funds remaining in the account over the appropriation indicated in the operating budget shall lapse into the general fund at the end of each fiscal year.
27 Impaired Driver Intervention Programs; Attendance Required. Amend RSA 265-A:42, IV(b) to read as follows:
(b) In the case of enrollment in the [state-operated] 7-day multiple DWI offender intervention [detention center] program, a person shall provide such certified copy at the time of enrollment or prior to the issuance of a report under RSA 265-A:40, III and RSA 265-A:18, VIII.
28 Sentences and Limitations. Amend RSA 651:2, V(h) to read as follows:
(h) In cases of a person convicted of a felony or class A misdemeanor, a court may sentence such person to 7 consecutive 24-hour periods to be served at the [state-operated] 7-day multiple DWI offender intervention [detention center] program established under RSA 265-A:40, if the evidence demonstrates that alcohol was a contributing factor in the commission of the offense and provided that space is available in the program and such person pays the fees for the program in full prior to admission.
29 Report Required. The commission to examine driving while impaired education and intervention programs shall, pursuant to the authority under 2008, 256:10, as extended by 2009, 202:5, study the penalties for intoxication or under the influence of drugs offenses, including but not limited to the multiple DWI offender intervention program. Based upon available research and data, the commission shall review and evaluate the merits of the penalties and the program in order to develop recommendations on these issues. On or before November 1, 2010, the commission shall report its findings to the governor’s commission on alcohol and drug abuse prevention, intervention, and treatment, the speaker of the house of representatives, the president of the senate, the commissioner of the department of health and human services, the house clerk, the senate clerk, the state library, and the governor and shall make recommendations, if appropriate, for future legislation to address these issues.
30 State Treasurer; Application of Receipts. Amend RSA 6:12, I (b)(147) to read as follows:
(147) Moneys deposited in the 7-day multiple DWI offender intervention [detention center] program account under RSA 265-A:41.
31 Department of Health and Human Services; Office of Reimbursements; Duties. Amend RSA 126-A:34, I(a) to read as follows:
(a) Review and investigate all records of the New Hampshire hospital, Laconia developmental services, the secure psychiatric unit, the Glencliff home, the Anna Philbrook center, and the multiple DWI offender intervention [detention center] program (M.O.P.), relative to expenses incurred by patients, residents, or clients at such institutions, facilities, or programs or expenses incurred by patients, residents, or clients receiving care, treatment, services, or maintenance at the direction of the commissioner of health and human services, and make recommendations to the commissioner and to the respective superintendents or directors of such institutions, facilities, or programs as to the rates to be charged for the care, treatment, and maintenance of such patients, residents, or clients.
32 Department of Health and Human Services; Office of Reimbursements; Financial Statements. Amend RSA 126-A:38, II-III to read as follows:
II. Persons admitted to the multiple DWI offender intervention [detention center] program (M.O.P.) who do not pay program fees in full at the time of admission shall file a financial statement under penalty of perjury on forms provided for this purpose by the office of reimbursements and shall enter a payment contract for balance of fees due. The office of reimbursements shall be entitled to recover reasonable attorneys fees and costs of collection for program fees not paid in accordance with a payment contract.
III. Persons admitted to the multiple DWI offender intervention [detention center] program (M.O.P.) shall notify the office of reimbursements of each change of mail address and actual street address until that person has made payment in full of fees due in accordance with an M.O.P. payment contract. Whenever notice to a person subject to a payment contract is required, notice to the last mail address on file with the office of reimbursements shall be deemed notice to and binding on the payer.
33 Applicability. Section 5 of this act shall take effect on the first day of the following month upon certification by the secretary of state to the director of legislative services that increased funding under the American Recovery and Reinvestment Act has expired.
34 Authorization. The general court may authorize additional modifications to the 2010-2011 state budget, 2009, 143, as may be required to accomplish a balanced budget in a time of fluctuating revenues.
35 Effective Date.
I. Section 5 of this act shall take effect as provided in section 33 of this act.
II. Sections 13, 14, and 16 of this act shall take effect July 1, 2010.
II. The remainder of this act shall take effect upon its passage.
LBAO
10-2705
Revised 01/21/10
SB 450 FISCAL NOTE
AN ACT relative to costs and expenditures at the department of health and human services.
FISCAL IMPACT:
The Department of Health and Human Services states this bill would have an indeterminable fiscal impact on state revenue and expenditures, and county revenue in FY 2010 and FY 2011. This bill will have no fiscal impact on county and local expenditures, or local revenue.
METHODOLOGY:
Section 1 - The Department of Health and Human Services (DHHS) states Chapter 143:9, Laws of 2009 (HB 1) requires the Department to reduce state general fund appropriations by $7,359,331 in FY 2010 and $12,199,900 in FY 2011. The proposed bill would remove the annual amounts, and require a reduction of $19,559,231 over the FY 2010-2011 biennium. This would allow the Department flexibility in determining how much to reduce each year. State expenditures would be impacted to the extent annual reduction amounts differ from the amounts contained in Chapter 143.
Sections 2 and 3 – The Department states these sections would exempt publication of the rates for services placements and programs under RSA 169-B, C & D from the provisions of RSA 541-A and should have no fiscal impact on the Department.
Section 4 – The Department states RSA 167:83, V currently requires the commissioner of DHHS to enter into a contract with the Department of Employment Security (DES) to carry out the New Hampshire Employment Program (NHEP). This section would amend RSA 167:83, V to make such contracting optional at the discretion of the Commissioner of DHHS. The change, in and of itself, has no fiscal impact as it does not actually change the way NHEP is administered. If DHHS were to actually exercise the option to no longer contract with DES to carry out the NHEP, there could potentially be a fiscal impact at that time.
Section 5 – The Department states this section would make the Non-TANF Funded Program for 2-Parent Families with Dependent Children permissive rather than mandatory. This section may decrease state general fund expenditures to the extent the Department decides not to continue the program. The FY 2010-FY 2011 operating budget includes state general fund appropriations of $5,889,537 in each fiscal year for this program.
Section 6 – The Department states RSA 167:4, IV(c) currently requires recipients of medical assistance to name the state of New Hampshire as the beneficiary of any life insurance policy that has a cash surrender value greater than $1,500 as a condition of eligibility. The proposed legislative change would amend RSA 167:4, IV(c) to require recipients of medical assistance to name the state of New Hampshire as primary beneficiary of any life insurance policy that has a cash surrender value, benefit or face value in excess of $1,500 unless the recipient has a spouse who remains living in the community as the only beneficiary. Policies must ensure payment to the state of New Hampshire of all the proceeds of the policy in excess of amounts spent on burial up to the total of Medicaid expenditures made on behalf of the individual. There are currently 1,919 Medicaid recipients who own life insurance policies that currently have a cash surrender value, benefit or face value in excess of $1,500 and who are not currently required to name the state of New Hampshire as primary beneficiary. It is assumed that approximately 4% of the 1,919 or 77 Medicaid recipients with life insurance have spouses that live in the community. These individuals will not be required to name the State of New Hampshire as primary beneficiary. As a result, the approximate number of recipients that will be affected by the change is 1,842 (1,919 - 77). The average face value of life insurance policies owned by the 1,919 Medicaid recipients is $16,000. The Department estimates the average cost for a funeral would be $6,000 which would result in $10,000 in insurance available for recovery. The DHHS Office of Recoveries handled a total of 352 estates in FY 2009. Almost all of these estates were State Supplement Program Medicaid (Old Age Assistance, Aid to the Needy Blind, or Aid to the Permanently and Totally Disabled) recipients. The 352 estates represent 1.5% of the adult category caseload in any given state fiscal year. As a result, it is assumed that 1.5% of the 1,842 Medicaid recipients with life insurance (28) will be subject to recovery in any given state fiscal year. The Department estimates recovery revenue will increase by $280,000 annually (28 recipients X $10,000 average available insurance). In FY 2009, the Office of Recoveries recovered a total of $4.9 million. Of the $4.9 million, $3.8 million (78%) represented long-term care cases and $1.1 million (22%) represented recoveries from other Medicaid cases. Using these percentages, the Department estimates the additional recovery revenue will be distributed as follows -
• 78% of the additional revenue will be for long-term care cases:
o Total revenue: $218,400
o Federal share: (50%): $109,200
o County share: (38.41%): $83,887
o State share (11.59%): $25,313
• 22% of the additional revenue will be for other Medicaid cases:
o Total revenue: $61,600
o Federal share (50%): $30,800
o State share (50%): $30,800
• Total additional revenue:
o Federal share: $140,000
o County share: $83,887
o State share: $56,113
Sections 7 and 9 – The Department believes that Treatment Authorization for Program Services (TAPS) will reduce costs related to Children in Need of Services (CHINS) and delinquents rehabilitative services. Currently Judges vary from Division of Juvenile Justice Service (DJJS) recommended treatment plan for a significant number of youths served. Some of these variances could result in high, medium, and/or low cost savings if the original DJJS treatment plan was followed to begin with. Using calculations based on the FY 2010 average monthly expenditures of placements and other services currently provided by DJJS, the Department estimates the maximum monthly cost reduction for all levels of cost savings at $69,588. Assuming that the proposed changes will be effective for only 2 months in FY 2010, and inflation of 2% annually, the Department estimates the fiscal impact as follows –
Total General Federal Other
Funds Funds (53%) Funds (42%) Funds (5%)
FY 2010 $139,117 $73,732 $58,429 $6,956
FY 2011 $851,395 $451,239 $357,586 $42,570
FY 2012 $868,089 $460,087 $364,597 $43,405
FY 2013 $884,783 $468,935 $371,609 $44,239
FY 2014 $901,477 $477,783 $378,620 $45,074
Section 8 – The Department states this section provides that the court shall adopt, in the first instance, the Department’s recommendations for services placements and programs at the dispositional hearing in cases under RSA 169-C. The fiscal impact of this change is difficult to estimate, as the type, number and cost of these services can vary significantly with any given case, and the difference between the services recommended by the Department and those that would otherwise have been ordered by the court is somewhat speculative. The Department, however, assumes that the change will result in an indeterminate decrease in the costs for court ordered services.
Section 10 - The Department states this section requires the Department to file a report on the efficacy of the process established elsewhere in the bill for the timely and cost effective delivery of services placements and programs under RSA 169-B, C & D. The Department estimates that preparation of the report can be done with existing resources.
Sections 11 and 12 – The Department states these sections will make certain changes to RSA 471-C:26 relative to claims for abandoned property to allow the state to claim against abandoned property where the state has paid medical or financial assistance for the benefit of the deceased owner of the property. This change in the law would result in an increase in revenue of an indeterminable amount.
Section 13 – The Department states this section would repeal the Chapter 144:211, Laws of 2009 that requires the Commissioner of DHHS to provide a report to the HHS Oversight Committee detailing administrative and reporting requirements for community mental health centers that could be suspended without jeopardizing public health and safety. The report was to be submitted by September 30, 2009. The Commissioner submitted a report to the HHS Oversight Committee on September 29, 2009 that described an ongoing review of administrative requirements on the mental health centers. There will no fiscal impact as a result of this repeal.