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LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 87TH LEGISLATIVE REGULAR SESSION
April 18, 2021
TO:
Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
FROM:
Jerry McGinty, Director, Legislative Budget Board
IN RE:
SB50 by Zaffirini (Relating to a competitive and integrated employment initiative for certain Medicaid recipients.), Committee Report 1st House, Substituted
The fiscal implications of the bill, relating to a competitive and integrated employment initiative of certain Medicaid recipients, cannot be determined at this time.
The Health and Human Services Commission is required to implement a provision of this Act only if the legislature appropriates money to the commission specifically for that purpose. If the legislature does not appropriate money specifically for that purpose, the commission may, but is not required to, implement a provision of this Act using other appropriations that are available for that purpose. If additional appropriations are not provided, the number of persons served in the waiver program may be reduced.
The bill would amend the Government Code to direct the Health and Human Services Commission (HHSC) to develop a uniform process that assesses the goals of competitive employment opportunities and related services available to an individual. The bill would require changes to existing program rules, the development and maintenance of data, and the hiring or training of staff and contractors on the changed policies, procedures, and systems.
The provisions would apply to recipients receiving services under any of the following Medicaid waiver programs: the home and community-based services waiver; the Texas home living waiver; the deaf-blind with multiple disabilities waiver; the community living assistance and support services waiver; and the STAR+PLUS home and community-based services waiver. Rules developed by the commissioner must identify strategies to increase the number of individuals receiving services and determine a reasonable number of individuals who indicate a desire to work to receive employment services and ensure those individuals receive employment services.
According to HHSC, the provisions of the bill would require employment services be provided to additional waiver recipients. While there would be a significant cost to provide the services, HHSC is unable to provide a specific estimate because the actual cost per client would vary, and there could be offsets for reductions in other services. With the exception of the STAR+PLUS home and community-based services waiver program, the programs targeted by the bill are not entitlements. If additional appropriations are not provided, the cost of providing additional services would be offset by serving fewer clients in the programs.
This bill would codify current practices at the Texas Workforce Commission (TWC). According to TWC, the provisions of the bill could be absorbed within existing resources.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies:
320 Texas Workforce Commission, 529 Hlth & Human Svcs Comm