2016 SESSION
16-2868
01/05
SENATE BILL 496-FN
AN ACT relative to personal care attendant services.
SPONSORS: Sen. Sanborn, Dist 9; Sen. Avard, Dist 12; Sen. Birdsell, Dist 19; Sen. Boutin, Dist 16; Sen. Carson, Dist 14; Sen. Feltes, Dist 15; Sen. Kelly, Dist 10; Sen. Reagan, Dist 17
COMMITTEE: Health and Human Services
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ANALYSIS
This bill includes access to the community and providing non-medical transportation as services to be covered under the law governing personal care for the severely physically 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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
16-2868
01/05
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Sixteen
AN ACT relative to personal care attendant services.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Personal Care for the Severely Physically Disabled; Personal Care Attendant Services Program. Amend RSA 161-E:2 to read as follows:
161-E:2 Services Provided. The commissioner of the department of health and human services shall develop a program under which severely physically disabled persons eligible for coverage under medical assistance programs are provided with personal care attendants to provide on a periodic basis medically oriented long-term maintenance and supportive care to assist them, as is required in each individual case, to maintain themselves in their homes and gain greater control over their own lives. Services provided under this chapter shall include access to the community and providing non-medical transportation for severely physically disabled persons.
2 Effective Date. This act shall take effect 60 days after its passage.
16-2868
1/5/16
SB 496-FN- FISCAL NOTE
AN ACT relative to personal care attendant services.
FISCAL IMPACT:
The Department of Health and Human Services states this bill, as introduced, will increase state general fund expenditures in FY 2017 and each year thereafter. There will be no impact on county and local expenditures, or on state, county, and local revenue.
METHODOLOGY:
The Department of Health and Human Services states this bill amends RSA 161-E:2 to include access to the community and providing non-medical transportation for severely physically disabled people as part of the personal care attendant services program. The Department states under federal rule 42 CFR 440.167, personal care attendant (PCA) services are furnished in the home and at other locations at each state's option. Under New Hampshire's Medicaid State Plan as well as state administrative rule, PCA services can be provided outside of the home in locations such as school or work if those services would have otherwise been provided in the home. The Department notes it is unclear what is meant by "access to the community," since the bill does not define that term, but assumes the intent is to provide services anywhere that is desired by the recipient. In order to provide services in locations other than those currently permitted under the state plan, the Department would need to submit a State Plan amendment to the Centers for Medicare and Medicaid Services (CMS). The Department is unable to predict whether such an amendment would be approved, but assumes the bill would be effective regardless of whether CMS approves the amendment. In the event that CMS does not approve the amendment, it could elect to withhold the federal match for services delivered in locations other than the home, work, or school. The Department further notes expanding delivery of PCA services beyond the current locations would have a financial impact on the Managed Care Organizations (MCO) providing Medicaid services, which would necessitate an amendment to the managed care contract, an adjustment to the capitation rate paid to the MCOs, and review and approval by CMS of the managed care contract amendment.
With respect to non-medical transportation services, the Department states since these services would be provided for non-medical purposes, they would be funded entirely with general fund dollars. In order to provide such services, the Department would need to either procure a vendor or hire additional staff. The Department is unable to calculate the associated costs.