03/19/1993 03:00 PM House HES

  HB 178 - MEDICAID COVERAGE FOR CERTAIN CHILDREN                              
                                                                               
  DAVE WILLIAMS, FROM THE DIVISION OF MEDICAL ASSISTANCE IN                    
  THE DEPARTMENT OF HEALTH AND SOCIAL SERVICES, read a                         
  statement saying that HB 178 would continue, after adoption,                 
  the Medicaid coverage already provided to children in foster                 
  homes under state custody whose mental or medical problems                   
  carried large potential financial liabilities which made                     
  them difficult to place in adoptive homes.  Several years                    
  ago the state began to contract with adoptive parents to pay                 
  some of the costs associated with these children in an                       
  effort to place the children in adoption, he said.  The                      
  federal government later made Medicaid coverage available to                 
  such children in such states that chose to accept it.  He                    
  said HB 178 would allow the state to leave the medical cost                  
  of adopting such children to the Medicaid program, leaving                   
  the state to provide, through contracts, money for the                       
  nonmedical expenses associated with the adoption of such                     
  children.                                                                    
                                                                               
  MR. WILLIAMS pointed out that the fiscal notes for the bill                  
  reflect the transfer of $35,000 in FY94 from the Department                  
  of Family and Youth Services to the general fund, which is                   
  offset by another $35,000 allocation to the Division of                      
  Medical Assistance, half of which will come from Medicaid                    
  and half of which will come from the general fund.  The                      
  Division of Medical Assistance would pay the costs for                       
  medical care for the children in future years, he said.                      
                                                                               
  Number 339                                                                   
                                                                               
  REP. VEZEY expressed skepticism that the program would not                   
  somehow cost the state more money.                                           
                                                                               
  MR. WILLIAMS explained again that the state was already                      
  subsidizing all the medical costs for some hard-to-adopt                     
  children under the subsidized adoption program.  Before that                 
  program, such children remained in state custody with the                    
  state paying all their living costs, not just medical costs.                 
  Under HB 178, the state could get half those medical bills                   
  paid for by the federal government by taking advantage of                    
  the federal government's offer to provide Medicaid coverage                  
  for the children.  He said the bill would save the state                     
  $17,700 in the first year, and the savings would increase as                 
  more children take advantage of the program.                                 
                                                                               
  Number 365                                                                   
                                                                               
  There followed a free-flowing discussion in which Rep.                       
  Vezey, Rep. Brice, and Rep. Toohey asked several questions                   
  about the fiscal notes for the bill, how the different                       
  accounts listed in the fiscal notes would be affected, and                   
  how the bill would save the state money.  Mr. Williams                       
  answered those questions with substantially the same                         
  information as he presented earlier.                                         
                                                                               
  Number 432                                                                   
                                                                               
  REP. OLBERG said HB 178 would free up $17,700 for use                        
  elsewhere in the department, and he speculated that the                      
  money might be used by the commissioner for travel expenses.                 
                                                                               
  Number 467                                                                   
                                                                               
  REP. BRICE moved for passage of HB 178 from the committee                    
  with individual recommendations.                                             
                                                                               
  CHAIR TOOHEY asked for objections, and, hearing none,                        
  declared HB 178 passed with individual recommendations.                      
  There being no further business before the committee, CHAIR                  
  TOOHEY ADJOURNED the meeting at approximately 3:45 p.m.