Bill Summary – FastDemocracy

LEGISLATIVE FISCAL ESTIMATE
                                SENATE, No. 4033
                             STATE OF NEW JERSEY
                              220th LEGISLATURE
                                         DATED: SEPTEMBER 7, 2023
                                                  SUMMARY
    Synopsis:                   Establishes minimum Medicaid and NJ FamilyCare reimbursement
                                rate for pediatric special care nursing facilities.
    Type of Impact:             Annual increase in State costs and revenue; General Fund.
    Agencies Affected:          Department of Human Services.
                                       Office of Legislative Services Estimate
    Fiscal Impact                                                     Annual
    State Cost Increase                                     Approximately $5.7 million
    State Revenue Increase                                   Approximately $3 million
    The Office of Legislative Services (OLS) estimates that this bill will increase annual NJ
     FamilyCare expenditures by approximately $5.7 million.
    These increased costs concomitantly will grow annual State revenue in the form of federal
     Medicaid and Children’s Health Insurance Program cost reimbursements by approximately $3
     million, for a net annual State cost increase to the Department of Human Services of about
     $2.7 million.
                                            BILL DESCRIPTION
   This bill requires the Department of Human Services to establish a minimum NJ FamilyCare
reimbursement rate of $950 per day for pediatric special care nursing facilities. The bill
conditions the provision of this minimum reimbursement rate upon a facility’s compliance
with applicable State and federal laws and regulations concerning licensure, patient safety, and
quality of care. The department is to apply for any State plan amendments or waivers necessary
to ensure federal financial participation for State expenditures under the federal Medicaid
program and the Children’s Health Insurance Program.
      Office of Legislative Services                                    Legislative Budget and Finance Office
           State House Annex                                                    Phone (609) 847-3105
              P.O. Box 068                                                       Fax (609) 777-2442
      Trenton, New Jersey 08625                                                  www.njleg.state.nj.us
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                                    FISCAL ANALYSIS
EXECUTIVE BRANCH
   None received.
OFFICE OF LEGISLATIVE SERVICES
    The OLS estimates that this bill will increase annual NJ FamilyCare expenditures by
approximately $5.7 million. NJ FamilyCare provides health care coverage for individuals who
qualify for the Children’s Health Insurance Program or Medicaid, and it covers about half of the
children in the State. These increased costs concomitantly will grow annual State revenue in the
form of federal Medicaid and Children’s Health Insurance Program cost reimbursements by
approximately $3 million, for a net annual State cost increase to the Department of Human Services
of about $2.7 million. This estimate assumes an aggregate federal matching rate for eligible State
expenditures of 52 percent, which takes into account the proportion of children with NJ
FamilyCare coverage who are eligible under Medicaid (85 percent) and the proportion eligible
under the Children’s Health Insurance Program (15 percent).
    New Jersey currently has four pediatric special care nursing facilities that participate in the
NJ FamilyCare program. As shown below, of the four facilities’ per diem rates, rates at two
facilities currently would require an increase to meet the minimum $950 per diem rate
established under the bill.
       Facility Name            Number of          FY 2024 Per          Amount of Per Diem
                               Pediatric Beds     Diem Base Rate        Rate Increase Under
                                                                                Bill
  Children’s Specialized              50             $1,016.36                  N/A
  Hospital - Mountainside
    Voorhees Pediatric               119              $957.52                    N/A
    Facility - Voorhees
  Children’s Specialized              26              $938.82                   $11.18
   Hospital - Toms River
  The Phoenix Center for              92              $615.46                  $334.54
    Rehabilitation and
    Pediatrics - Haskell
    The estimate assumes that the two affected facilities comply with applicable State and
federal laws and regulations concerning licensure, patient safety, and quality of c are, and
would be eligible to receive the $950 minimum per diem rate. Moreover, since approximately
half of all New Jersey children are covered under NJ FamilyCare, the estimate further assumes
that 50 percent of each affected facilities’ beds are occupied by NJ FamilyCare beneficiaries.
If the number of beds occupied by NJ FamilyCare beneficiaries deviates from this assumption
in a given year, the estimates presented herein would need to be adjusted accordingly.
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  Section:     Human Services
  Analyst:     Sarah Schmidt
               Lead Research 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.).