State of Alaska
Fiscal Note
Bill Version: CSSB 105(FIN)
2018 Legislative Session
Fiscal Note Number: 4
(S) Publish Date: 4/2/2018
Identifier: SB105CS(FIN)-DHSS-BHMS-3-30-18 Department: Department of Health and Social Services
Title: MARITAL & FAMILY THERAPY LIC. & SERVICES Appropriation: Medicaid Services
Sponsor: WILSON Allocation: Behavioral Health Medicaid Services
Requester: Senate FIN OMB Component Number: 2660
Expenditures/Revenues
Note: Amounts do not include inflation unless otherwise noted below. (Thousands of Dollars)
Included in
FY2019 Governor's
Appropriation FY2019 Out-Year Cost Estimates
Requested Request
OPERATING EXPENDITURES FY 2019 FY 2019 FY 2020 FY 2021 FY 2022 FY 2023 FY 2024
Personal Services
Travel
Services 50.0
Commodities
Capital Outlay
Grants & Benefits 1,000.8 1,000.8 1,000.8 1,000.8 1,000.8
Miscellaneous
Total Operating 50.0 0.0 1,000.8 1,000.8 1,000.8 1,000.8 1,000.8
Fund Source (Operating Only)
1002 Fed Rcpts (Fed) 25.0 660.5 660.5 660.5 660.5 660.5
1003 G/F Match (UGF) 25.0 340.3 340.3 340.3 340.3 340.3
Total 50.0 0.0 1,000.8 1,000.8 1,000.8 1,000.8 1,000.8
Positions
Full-time
Part-time
Temporary
Change in Revenues
1251 Non-UGF (Other) 25.0 660.5 660.5 660.5 660.5 660.5
Total 25.0 0.0 660.5 660.5 660.5 660.5 660.5
Estimated SUPPLEMENTAL (FY2018) cost: 0.0 (separate supplemental appropriation required)
(discuss reasons and fund source(s) in analysis section)
Estimated CAPITAL (FY2019) cost: 0.0 (separate capital appropriation required)
(discuss reasons and fund source(s) in analysis section)
ASSOCIATED REGULATIONS
Does the bill direct, or will the bill result in, regulation changes adopted by your agency? yes
If yes, by what date are the regulations to be adopted, amended or repealed? 07/01/19
Why this fiscal note differs from previous version/comments:
CS SB 105 (FIN) version N removes two sections that were in the previous version of the bill. While the removal does not change the
dollar amounts of the FN it does change the narrative explanation on page 2.
Prepared By: Randall Burns, Division Director Phone: (907)269-5948
Division: Behavioral Health
REPORT Date: 03/29/2018 10:00 AM
ED
SFC 04/0 OUT OF
Approved By: Shawnda O'Brien, Asst. Commissioner Date: 03/30/18
Agency: Health and Social Services
2/2018
Printed 4/2/2018 Page 1 of 2 Control Code: IsirZ
 CSSB 105(FIN) - Fiscal Note 4
FISCAL NOTE ANALYSIS
STATE OF ALASKA BILL NO. CSSB105(FIN)
2018 LEGISLATIVE SESSION
Analysis
CS SB 105 (FIN), Version N, amends requirements for marital and family therapists to obtain licenses; lists professions that
may perform group supervision for marital and family therapist applicants, adds marital and family services to the
optional list of services that may be reimbursed through Medicaid, and authorizes the Department of Health and Social
Services and the Board of Marital and Family Therapy to adopt regulations to implement the changes. This fiscal note
reflects the fact that licensed marriage and family therapist services have been added to the AS 47.07.030 list of Medicaid
optional services for which the State will reimburse. The projected expenditures represent the Medicaid reimbursement
for professional services provided by licensed marriage and family therapists to persons eligible for Medicaid services,
whether children or adults, including the Medicaid Expansion population. Sections 1 - 3 of the bill have a January 1, 2019
effective date and will drive the need for Medicaid system, administrative regulation, and Medicaid State Plan
Amendment changes. Any necessary regulations noted in Section 4 of the bill are estimated to be completed six months
later, by July 1, 2019.
FY2019 General Fund Match in the Services Line: $50.0 for development of business rules in the Medicaid Management
Information System detailing the parameters for services/reimbursement.
FY2020 - FY2024 Federal Receipts and General Fund Match in the Grants, Benefits line:
Average annual per recipient cost X estimated number of recipients = Medicaid increment needed
$1,581 annual per recipient cost X 633 recipients = $1,000,773
The $1,581 average annual per recipient cost is based on FY2016 Medicaid claims data for those recipients receiving
Mental Health Only services. [Currently, Behavioral Health Medicaid reimburses an hour of clinic (counseling/therapy)
services at $100.00, family clinic services at $110.00 per hour, and group clinic services at $56.00 per hour, regardless of
the category of the professional providing that service.]
The estimated number of recipients is derived from two data sources:
- FY2016 Medicaid prevalence data (which indicates the number of unserved recipients who would benefit from
behavioral health services): 6,330
- 2011 National Survey for Drug Use and Health data (which estimates the percentage of unserved recipients that will
actually seek treatment in any given year): 10%
6,330 x 10% = 633 estimated recipients
Total General Funds Match request:
$1,000,773 Medicaid Mental Health Only
X 34.0% (blended match rate resulting from regular and Expansion population)
$ 340,263 General Funds Match
Recipients would be a mix of Medicaid Expansion recipients subject to an enhanced federal match rate and other
Medicaid recipients subject to the regular federal match rate for services. We estimate that for the combined expansion
and regular Medicaid, the average state match rate would be 34%.
There are presently just under 100 licensed marriage and family therapists in the State with an active license, and some of
those professionals are already billing for their services under the umbrella of a mental health physician clinic. Therefore,
we are unsure of the number of licensed marriage and family therapists who will be interested in beginning to
independently bill Medicaid, subjecting their practices to the documentation and audit requirements that follow on
enrollment in Medicaid as an independent provider. These cost projections are based on Medicaid utilization, and could
be higher or lower, depending on the demand for licensed licensed marriage and family therapist services from patients
with other payment sources, like private insurance, and the willingness of licensed marriage and family therapists to
provide services to Medicaid-eligible individuals.
(Revised 9/26/17 OMB/LFD) Page 2 of 2
SB105CS(FIN)-DHSS-BHMS-3-30-18 Page 2 of 2 Control Code: IsirZ


Statutes affected:
SB0105A, AM SB 105, introduced 04/04/2017: 08.63.100, 08.01.065, 08.63.210, 08.63.120, 47.07.030, 47.07.063, 21.42.375
SB0105B, AM CSSB 105(L&C), introduced 02/09/2018: 08.63.100, 08.01.065, 08.63.210, 08.63.120, 47.07.030, 47.07.063, 21.42.375
SB0105C, AM CSSB 105(FIN), introduced 03/29/2018, passed Senate 04/04/2018: 08.63.100, 08.01.065, 08.63.210, 08.63.120, 47.07.030, 47.07.063, 21.42.375
SB0105D, AM HCS CSSB 105(FIN), introduced 04/23/2018: 08.63.100, 08.01.065, 08.63.210, 08.63.120, 47.07.030, 47.07.063, 21.42.375
SB0105E, AM HCS CSSB 105(FIN) am H, introduced 05/12/2018, passed House 05/12/2018, passed Senate 05/12/2018: 08.63.100, 08.01.065, 08.63.210, 08.63.120, 18.15.360, 47.80.500, 18.23.400, 47.32.900, 47.33.990, 21.54.500, 47.05.060, 47.07.030, 47.07.063, 21.42.375
SB0105Z, AM Enrolled SB 105, introduced 05/12/2018: 08.63.100, 08.01.065, 08.63.210, 08.63.120, 18.15.360, 47.80.500, 18.23.400, 47.32.900, 47.33.990, 21.54.500, 47.05.060, 47.07.030, 47.07.063, 21.42.375