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.