LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE 75th Regular Session April 28, 1997 TO: Honorable Bill Ratliff, Chair IN RE: Senate Bill No. 102, Committee Report 1st House, Substituted Committee on Finance By: Zaffirini Senate 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-Committee Report 1st House, Substituted 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 (8,709,000) 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: 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 $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: 304 Comptroller of Public Accounts LBB Staff: JK ,RR ,KF