LEGISLATIVE FISCAL ESTIMATE

SENATE, No. 2491

STATE OF NEW JERSEY

221st LEGISLATURE

 

DATED: JULY 1, 2024

 

 

SUMMARY

 

Synopsis:

Increases maximum number of respite care service hours funded through DCF for certain families.

Type of Impact:

Annual State revenue and expenditure increases.

Agencies Affected:

Department of Children and Families.

 

 

Office of Legislative Services Estimate

Fiscal Impact

 

Annual

 

 

State Expenditure Increase

 

Up to $10.5 million

 

 

State Revenue Increase

 

Up to $5.2 million

 

 

 

 

 

·         The Office of Legislative Services (OLS) estimates that annual State expenditures will increase by up to $10.5 million to provide eligible families with up to 30 additional hours of respite services over a 90-day authorization period.  This estimate accounts for the fact that greater than 80 percent of families accessing respite care services through the Children’s System of Care utilize self-hired respite workers; in FY 2024, Medicaid reimbursement rates for self-hired respite workers are 34 percent lower than Medicaid rates for agency-hired respite workers.

 

·         To the extent that families of children with intellectual or developmental disabilities, and who are also enrolled in the NJ FamilyCare program, are authorized for respite care services, federal reimbursement will be available for qualifying State Medicaid expenditures on respite care.  The OLS estimates that federal Medicaid reimbursements for eligible State expenditures for respite care services for these families will increase by up to $5.2 million annually under the bill.

 

 

BILL DESCRIPTION

 

      This bill increases the maximum number of respite care service hours funded through the Department of Children and Families for families of children with an intellectual or developmental disability.  Currently, the Division of Children’s System of Care in the department authorizes eligible families for a maximum of 60 hours of respite services over a 90-day authorization period.  This bill would raise this cap to 90 hours of respite services, provided by either an agency-hired or self-hired respite worker, over a 90-day authorization period.  The bill additionally directs the Department of Children and Families to use available State and federal funds to effectuate the bill’s provisions.

 

 

FISCAL ANALYSIS

 

 

EXECUTIVE BRANCH

 

      None received.

 

OFFICE OF LEGISLATIVE SERVICES

 

      Based on current respite care utilization data available on the Department of Children and Families’ website, the OLS estimates that annual State expenditures will increase by up to $10.5 million to provide eligible families with up to 30 additional hours of respite services over a 90-day authorization period.  This estimate accounts for the fact that greater than 80 percent of families accessing respite care services through the Children’s System of Care utilize self-hired respite workers; in FY 2024, Medicaid reimbursement rates for self-hired respite workers are 34 percent lower than Medicaid rates for agency-hired respite workers.  Since not every family receiving respite services will be authorized for the maximum number of respite service hours available, total State costs could potentially be lower than this estimate.  The OLS, however, cannot anticipate the number of families that will be authorized for the maximum number of service hours on an annual basis.

      The OLS also determines that the department’s administrative costs will increase by an indeterminate amount for the department to update and track the additional respite service hours provided under the bill.

      To the extent that families of children with intellectual or developmental disabilities, and who are also enrolled in the NJ FamilyCare program, are authorized for respite care services, federal reimbursement will be available for qualifying State Medicaid expenditures on respite care.  The OLS estimates that federal Medicaid reimbursements for eligible State expenditures for respite care services for these families will increase by up to $5.2 million annually under the bill.

      According to the April 2024 Children’s Interagency Coordinating Council Summary of Activity report, PerformCare, the division’s contracted systems administrator, authorized a total of 2,398 requests for self-hired respite services and 456 requests for agency-hired respite services that month; this number includes services approved for existing clients of the division, as well as those approved for new clients. 

      Respite care services are one component of the family support services offered by the Division of Children’s System of Care for eligible families of children and youth with an intellectual or developmental disability.  Receipt of family support services, according to the division, is contingent upon the availability of State resources; moreover, prior to accessing family support services resources, a family must first access all other benefits for which their child may qualify, such as private insurance or Supplemental Security Insurance benefits.

      Reimbursement rates for respite services vary with the type and timing of the service provided, and are based on 15-minute service intervals.  According to information provided by the department in response to an FY 2024 OLS Discussion Point, proposed FY 2024 reimbursement rates range from a low of $28.24 per hour for self-hired respite service workers to a high of $42.76 per hour for agency-hired respite workers. 

 

 

Section:

Human Services

Analyst:

Anne Cappabianca

Senior Fiscal Analyst

Approved:

Thomas Koenig

Legislative Budget and Finance Officer

 

 

This legislative fiscal estimate has been produced by the Office of Legislative Services due to the failure of the Executive Branch to respond to our request for a fiscal note.

 

This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.).