Aging and Disability Services Council Sharon Swift Butterworth ...

Proposed new §48.6110 describes the circumstances permitting DADS to reduce the amount of a
CBA service, provides that an individual may request a fair hearing to contest the reduction of
the CBA service, and provides that a CBA provider must continue to provide the service at the
currently authorized level while the appeal is pending.
FISCAL NOTE
Gordon Taylor, DADS Chief Financial Officer, has determined that, for the first five years the
proposed amendments and new section are in effect, there are foreseeable implications relating to
costs or revenues of state government. There are no foreseeable implications relating to costs or
local governments.
The effect on state government for the first five years the proposed amendments and new section
are in effect is an estimated reduction in cost of $3,892,942 in fiscal year (FY) 2012; $3,715,678
in FY 2013; $0.00 in FY 2014; $0.00 in FY 2015; and $0.00 in FY 2016.
SMALL BUSINESS AND MICRO-BUSINESS IMPACT ANALYSIS
DADS has determined that the proposed amendments and new sections may have an adverse
economic effect on small businesses and micro-businesses, because DADS projects some CBA
providers will be adversely impacted by the loss of revenue when they are not permitted to
submit a claims for the costs of obtaining specifications for adaptive aids and minor home
modifications, or the administrative effort in requisitioning adaptive aids, dental treatment,
medical supplies, and minor home modifications. In 2008, approximately 239 entities provided
CBA services to DADS consumers. Based on 2008 Texas Medicaid cost reports for the CBA
program (the most recent data available), of these entities, approximately 213 were small
businesses, of which approximately 95 were micro-businesses.
The projected economic impact for a small business and micro-business is $9.68 per month, per
individual.
In preparing the proposed rules, the agency considered several alternatives to minimize the
adverse economic impact on small and micro-businesses. Specifically, the agency considered
continuing to reimburse all CBA providers for the cost of obtaining specifications and
requisitioning items, but determined that the savings required by the General Appropriations Act
(Article II, Special Provisions, Section 17(a)(5), H.B. 1, 82nd Legislature, Regular Session,
2011) would not be achieved using that alternative. Similarly, the agency considered continuing
to reimburse CBA providers that are small and micro-businesses for the cost of obtaining
specifications and requisitioning items, but determined that the required savings would not be
achieved using that alternative either, especially given the high percentage of CBA providers that
are small and micro-businesses. Finally, the agency considered reducing reimbursement for the
cost of obtaining specifications and requisitioning items to Home and Community Based
Services (HCS) Program providers, in addition to CBA and CLASS providers to save costs and,
lessen the effect on CBA providers. However, the agency determined that HCS providers would
be subjected to a disproportionately large reduction in revenue, as compared to CBA providers,
because other reductions in revenue have been imposed on HCS providers recently. Thus, the
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