LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE
74th Regular Session
May 18, 1995
TO: Honorable Hugo Berlanga, Chair IN RE: Committee Substitute
Committee on Public Health forSenate Bill
House of Representatives No. 1675
Austin, Texas By: Zaffirini
FROM: John Keel, Director
In response to your request for a Fiscal Note on Senate Bill No.
1675 (Relating to powers and duties of the Health and Human
Services Commission.) 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.
The bill would strengthen the powers and duties of the Health and
Human Services Commission. The bill would authorize the HHSC to:
* Review and comment on health and human services (HHS)
agencies' strategic plans and biennial updates.
* Review and comment on HHS agency legislative
appropriations requests prior to agency submission to the
Legislature and the Governor.
* Review and comment on authority of HHS agency annual
operating budgets prior to adoption of the budget by the
respective agency's board.
* Review and comment on the transfer of funds between
strategies prior to the transfer of funds for agencies under its
jurisdiction.
* Issue a report on the projected expenditures by budget
strategy compared to the HHS agency's operating budget on a
quarterly basis.
* Review and comment on federal fund plans submitted by
agencies designated as the single state agency for the State.
* Approval of plans prior to submission to the Department
of Information Resources.
* Coordination and approval of caseload estimates made for
programs administered by health and human services agencies.
* Review and comment on health and human services agency
formulas which relate to the distribution of funds.
* Approval of office space for HHS agency needs.
* Use/assignment of existing HHS agency staff to the
extent requested.
* Determine the needs for space and location of health and
human services agency offices to enable the commission to achieve
a cost-effective one-stop or service center method of health and
human service delivery.
The bill would require the Commission to submit to the Governor,
Lieutenant Governor, Speaker of the House of Representatives,
Comptroller, and Legislative Budget Board, a work plan outlining
the activities of the commission for the fiscal year. The work
plan would be submitted by the end of the first month of a fiscal
year and would establish priorities for the commission's
activities based on available resources.
The bill would allow the Commissioner of Health and Human
Services to request specific actions of a health and human
service agency in order to streamline the delivery of services.
It would establish reporting requirements related to efforts made
by health and human services agencies to streamline services.
The bill would require the Commission to expand its existing
integrated eligibility pilot programs to include the Harris
County Hospital District and the University of Texas Medical
Branch at Galveston. In addition, the Commission would be
required to study the feasibility of enabling contractors or
agencies other than the Department of Human Services to provide
eligibility determinations and certifications. The study would
be required to consider error rates, the state's potential
liability, expansion of client population, and federal single
state agency restrictions.
The bill would require, by September 1, 1996, the HHSC complete
its development and substantial implementation of its plan for an
integrated eligibility determination and service delivery system
subject to the availability of funds to HHSC and HHS agencies.
The bill would require that the plan achieve at least one percent
savings in the cost of providing administrative and other
services resulting from streamlining and elimination of
duplicative costs and services.
The bill would implement a number of Comptroller's
recommendations from Gaining Ground. Estimates are reflected in
the table below.
* HHS3 strengthens the powers of the Commission.
Comptroller believes savings will be achieved but estimates
cannot be determined.
* HHS6 requires coordination of caseload estimates. The
fiscal impact of this provision of the bill cannot be
determined.
* HHS8 requires expansion of integrated eligibility pilot
programs in the Harris County Hospital District and the
University of Texas Medical Branch at Galveston. The Comptroller
estimates indicate that hospital and Department of Human Services
staff time required will be about 60% less than in the current
system. Savings would be offset by the additional evaluation and
auditing required to ensure error rates are maintained within
acceptable limits. Comptroller estimates of savings correspond
to HCHD (local funds) and UTMB at Galveston (state funds) and
relate to an anticipated reduction in the number of DHS
eligibility and clerical workers for which the entities pay
matching dollars.
The bill would require the Commission to develop and implement
policies that allow public input, information, and complaints.
The bill would require that implementation of certain provisions
of this bill be accomplished within available funds. To the
extent the Health and Human Services Commission exercises its
authority to use staff and other resources of HHS agencies to
carry out the provisions of the bill and such efforts do not
hamper the responsibilities of affected agencies, costs would be
absorbed within existing resources. To fully integrate service
delivery for health and human services would require investment
in automation systems. Costs for the 1996-97 biennium have been
estimated to be $47.3 million in all funds and $28.5 million in
general revenue if the system is purchased or $33.0 million in
all funds and $18.5 million in general revenue if the system is
acquired through the Master Lease Program. The Health and Human
Services Commission stated that the costs of the system is an
issue for the conference committee on appropriations because the
bill specifies that the integration effort be accomplished within
available funds.
The probable fiscal implication of implementing the provisions of
the bill during each of the first five years following passage
is estimated as follows:
Fiscal Probable Revenue Probable Savings Change in
Year Gain to Local to General Number of State
Funds Revenue Fund 001 Employees from
FY 1995
1996 $196,000 $233,000 (41.0)
1997 196,000 233,000 (41.0)
1998 196,000 233,000 (41.0)
1999 196,000 233,000 (41.0)
2000 196,000 233,000 (41.0)
Similar annual fiscal implications would continue as long as the
provisions of the bill are in effect.
Source: Health and Human Services Commission, Comptroller of
Public Accounts,
Department of Human Services
LBB Staff: JK, AZ, DF