Appendix X Possible Sources of Revenue

The chart below outlines possible sources of revenue, originally identified by the SB12-078 Task Force. The SB15-109 Task Force believes that these continue to be viable sources of revenue, in various degrees.

Revenue Source

Overall Viability Not likely to generate substantial and sustainable revenue

Likely to generate substantial and sustainable revenue

Surcharge on birth/death certificates

X

Statute authorizes the Colorado Department of Public Health and Environment to set birth and death certificate fees that reflect the Office of the State Registrar’s direct and indirect costs. A recent $3 dollar increase on death certificates resulted in roughly $700,000 to be used for a new electronic death certificate registration system. An additional increase is not likely, nor would it generate sufficient funds.

Increase in county fees for various financial and legal documents

X

The fees associated with many of these documents have not been changed for years. While some may have a nexus to APS, others do not.

Create a means test for the senior homestead exemption and use the balance for APS

X

Means testing the homestead exemption requires a constitutional amendment.

Revenue Source

Overall Viability

OAP sponsor deeming savings

X

In 2010, the General Assembly passed HB 10-1384, which modified the Old Age Pension (OAP) program provisions related to qualified aliens who apply for the state’s OAP cash benefit. The bill delayed eligibility for qualified aliens to receive OAP benefits until they have been in the United States for at least five years. The Bill had two phases, the first was estimated to generate a $13 million savings to the General Fund in the first year of implementation and approximately $14 million in savings in subsequent years. The second phase is expected to save an additional $15 million annually beginning in FY 201314. Unused OAP savings flow into the General Fund. All or a portion of these projected savings could be used for mandatory reporting and related infrastructure improvements without negatively impacting existing funding for other programs. This legislation has already been passed so there is no identified downside related to this option.

Revenue Source Medicaid targeted case management

Overall Viability X

Medicaid case management services help beneficiaries receive care by identifying needed services, finding providers, and monitoring and evaluating the services delivered. Targeted Case Management (TCM) refers to case management restricted to specific beneficiary groups defined by disease or medical condition, by geographic regions, or other groups identified by a state and approved by the Centers for Medicare and Medicaid Services (CMS). TCM reimbursement is currently used for APS in at least eight (8) states with an average annual reimbursement of approximately $1,000,000 per state. Adults currently receiving TCM in Colorado include Medicaid eligible persons with:  A developmental disability;  A mental illness who are in need of case management services; or  A need for substance abuse treatment. TCM reimbursement could be a viable source of funding for Colorado APS as it is estimated that APS caseworkers assist up to 50% of their clients with applying for and accessing Medicaid services. However, TCM spending has increased rapidly and adding another target population may be challenging as it requires a state

Revenue Source

Overall Viability

Surcharge on probate cases on wills

X

Long-term care estate recovery

Adding an additional surcharge to the probate of wills could result in $60,000 - $120,000 in revenue, depending on the surcharge amount. X

Federal regulations may prohibit this option.