LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE 75th Regular Session April 29, 1997 TO: Honorable Hugo Berlanga, Chair IN RE: House Bill No. 3258, Committee Report 1st House, Substituted Committee on Public Health By: Coleman House Austin, Texas FROM: John Keel, Director In response to your request for a Fiscal Note on HB3258 ( Relating to the implementation of the Medicaid managed care program.) this office has detemined the following: Biennial Net Impact to General Revenue Funds by HB3258-Committee Report 1st House, Substituted Implementing the provisions of the bill would result in a net negative impact of $(97,788) to General Revenue Related Funds through the biennium ending August 31, 1999. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. Fiscal Analysis The bill would amend current law governing the development of the health and human service delivery system by the Health and Human Services Commission. The bill would require the Commission to include certain considerations related to Medicaid managed care contracts to providers; ensure that Medicaid recipients are aware of care options available; ensure that contracting organization develop special disease management programs for conditions such as asthma and diabetes; appoint regional Medicaid Managed Care Advisory Committees; direct the Department of Health and Department of Human Services to submit a plan to the Governor and Legislative Budget Board that would realize cost savings for the state by simplifying eligibility criteria and streamlining eligibility processes for recipients of public assistance; and provide a number of reports related to Medicaid managed care implementation to the Governor, Lieutenant Governor and Speaker of the House of Representatives. Methodolgy It is assumed that HHSC would delegate some of the responsibilities to TDH and DHS but that the State Medicaid Office would add two full-time equivalent positions which would be phased in during the 1998-99 biennium to implement the provisions of the bill. In addition to the staff, it is assumed that other costs such as travel, postage, printing, sign language interpreters, personal computers and office supplies would be required. It is assumed that the costs would be funded in part with Medicaid matching federal dollars (50% federal and 50% state). The probable fiscal implications of implementing the provisions of the bill during each of the first five years following passage is estimated as follows: Five Year Impact: Fiscal Year Probable (Cost) Probable (Cost) Change in Number from General from Federal Funds of State Revenue Fund Employees from FY 1997 0001 0555 1998 ($43,008) ($43,008) 1.3 1998 (54,780) (54,780) 2.0 2000 (54,780) (54,780) 2.0 2001 (54,780) (54,780) 2.0 2002 (54,780) (54,780) 2.0 Net Impact on General Revenue Related Funds: The probable fiscal implication to General Revenue related funds during each of the first five years is estimated as follows: Fiscal Year Probable Net Postive/(Negative) General Revenue Related Funds Funds 1998 ($43,008) 1999 (54,780) 2000 (54,780) 2001 (54,780) 2002 (54,780) Similar annual fiscal implications would continue as long as the provisions of the bill are in effect. No significant fiscal implication to units of local government is anticipated. Source: Agencies: 501 Department of Health 529 Health and Human Services Commission LBB Staff: JK ,BB ,AZ