LEGISLATIVE BUDGET BOARD
                                   Austin, Texas
         
                                   FISCAL NOTE
                               75th Regular Session
         
                                  May 7, 1997
         
         
      TO: Honorable Tom Craddick, Chair            IN RE:  Senate Bill No. 102,
 As Engrossed
          Committee on Ways & Means                              By: Zaffirini
          House
          Austin, Texas
         
         
         
         
         FROM:  John Keel, Director    
         
In response to your request for a Fiscal Note on SB102 ( relating 
to the creation and use of an emergency medical services and 
trauma care system fund.) this office has detemined the following:
         
         Biennial Net Impact to General Revenue Funds by SB102-As Engrossed
         
Implementing the provisions of the bill would result in a net 
impact of $0 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 create the Emergency Medical Services and Trauma 
Care System Fund as a new special fund outside of the general 
revenue fund.  Revenues in the fund would be appropriated to 
the Department of Health to fund county and regional emergency 
medical services and trauma care systems and administrative 
expenses at the Department of Health.  The creation and/or continuation 
of special funds outside the general revenue fund could further 
restrict the Legislature's ability to appropriate revenues for 
general operating purposes.

The bill would amend the Transportation 
Code to require an applicant for issuance or renewal of a driver's 
license or commercial driver's license to pay an emergency medical 
services and trauma care system fund fee of $2.

The bill 
would require the Commissioner of Health to maintain a reserve 
of $250,000 of funds appropriated for extraordinary emergencies. 
 The remaining amounts appropriated would be allocated as follows 
during each fiscal year: at least 70 percent would fund the 
cost of supplies, operational expenses, education and training, 
equipment, vehicles, and communications systems for local emergency 
medical services; no more than 25 percent would fund operations 
of the 22 trauma support areas; not more than 3 percent would 
fund the administrative costs of the Bureau of Emergency Management; 
and at least 2 percent would fund a portion of uncompensated 
trauma care provided at facilities designated as state trauma 
facilities.
 
Methodolgy
 
The Comptroller's revenue estimates, shown in the table below, 
are based on Department of Public Safety data on the number 
of issuances and renewals of driver's licenses, projected for 
the five year horizon and multiplied by $2.

It is estimated 
that, after subtracting the $250,000 reserve, approximately 
$5 million per year would be available to the local emergency 
medical services, approximately $2 million per year would be 
available to fund the operations of the 22 trauma support areas, 
approximately $200,000 would be available to the Department 
of Health for administrative costs, including the addition of 
3 full-time equivalent positions, and approximately $170,000 
to $180,000 would be available to fund a portion of uncompensated 
trauma care at state trauma facilities.
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 Revenue   Probable           Change in Number   
            Gain/(Loss) from   Savings/(Cost)     of State                                                
            New - Emergency    from New -         Employees from                                          
            Services and       Emergency          FY 1997                                                 
            Trauma Care        Services and                                                               
            System Fund        Trauma Care                                                                
                               System Fund                                                                
            NEW-OTH            NEW-OTH                                                                     
       1998        $8,003,000      ($8,003,000)               3.0                                    
       1998         8,079,000       (8,079,000)               3.0                                    
       2000         8,156,000       (8,156,000)               3.0                                    
       2001         8,233,000       (8,233,000)               3.0                                    
       2002         8,312,000       (8,312,000)               3.0                                    
 
 
         Net Impact on General Revenue Related Funds:
 

 
              Fiscal Year      Probable Net Postive/(Negative)
                               General Revenue Related Funds
                                             Funds
               1998                   $0
               1999                    0
               2000                    0
               2001                    0
               2002                    0
 
Similar annual fiscal implications would continue as long as 
the provisions of the bill are in effect.
          
Counties would realize positive fiscal impacts from the provisions 
of the bill, since 70% of funds appropriated, or at least approximately 
$5.4 to $5.6 million in each fiscal year after 1998, would be 
allocated to counties.  The distribution of the  appropriated 
funds would be based on the relative geographic size and population 
of the county and the relative number of emergency trauma runs 
performed by eligible recipients in the county.  It is estimated 
that the 254 counties in the state would receive annual grants 
from the Department of Health ranging from $1,000 to each of 
the smallest counties with low levels of trauma runs to $200,000 
per fiscal year in the largest and most populous counties with 
highly active trauma service providers.

          
   Source:            Agencies:   
                                         
                      LBB Staff:   JK ,RR ,KF