LEGISLATIVE BUDGET BOARD
                          Austin, Texas

                           FISCAL NOTE
                       74th Regular Session

                          April 10, 1995



 TO:     Honorable Hugo Berlanga, Chair         IN RE:  House Bill No. 2377
         Committee on Public Health                     By: Delisi
         House of Representatives
         Austin, Texas






FROM: John Keel, Director

In response to your request for a Fiscal Note on House Bill No.
2377 (Relating to the provision and administration of mental
health and mental retardation services.) this office has
determined the following:

The bill would make no appropriation but could provide the legal
basis for an appropriation of funds to implement the provisions
of the bill.

This bill makes numerous changes in the authority/provider
relationships affecting the Department of Mental Health and
Mental Retardation, community centers, private providers and
consumers.  It designates the MHMR board, rather than the
commissioner, as the state's mental health and mental retardation
authority, and provides that the board may delegate its authority
to a single entity in each region of the state when appropriate.

The bill allows the implementation of pilot projects to study
authority structures for service delivery and to evaluate them
and report the evaluation results to the legislature in January
1997 and 1999.

The bill adds the Health and Human Services Commission, as the
single state agency for Medicaid, to the participants in review
and discussion of ICF-MR rules.

The bill allows the Department to lease out any property
regardless of whether it is surplus property, but specifies this
does not give the Department authority to close or consolidate a
facility used to provide MH or MR services without legislative    




approval.
 
The bill removes the prohibition against competitive bidding in
the renewal of MH or MR services contracts and but mandates
requirements that continuity of services be facilitated and
disruption prevented.

This bill has the potential  effects on the efficiency and
effectiveness of MH and MR service delivery. The fiscal impact
cannot be measured until the pilot projects are implemented and
evaluated.


The fiscal implication to  the State or units of local government
cannot be determined.


Source:   Health and Human Services Commission,
                         Texas Department of Mental Health and
Mental Retardation
          LBB Staff: JK, GT, DF