LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE 75th Regular Session February 25, 1997 TO: Honorable Judith Zaffirini, Chair IN RE: Senate Bill No. 118 Committee on Health & Human Services By: Zaffirini Senate Austin, Texas FROM: John Keel, Director In response to your request for a Fiscal Note on SB118 ( Relating to placement of certain children in certain long-term care institutions.) this office has detemined the following: Biennial Net Impact to General Revenue Funds by SB118-As Introduced Implementing the provisions of the bill would result in a net negative impact of $10,110,220 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. The bill would amend Chapter 242 of the Health and Safety Code to provide that an initial placement of a child (under 22 years of age) with a developmental disability in an institution may not exceed 45 days. The bill would require institutions admitting children to notify, within three days, a number of entities including the Texas Education Agency and relevant Community Resource Coordination Group (CRCG) and the school district for the area in which the institution is located. For notices relating to children younger than 37 months, TEA would be required to notify the Interagency Council on Early Childhood Intervention within two days of receipt of placement notification by an institution. The bill would also require the Commissioner of Health and Human Services to develop a statewide services system for families considering placing a child in a long-term care facility. The system would be required to: (1) provide 60 days of intensive services for the child and family considering placement of the child in a LTC facility to enable the child to remain at home during that 60-day period; and (2) identify alternative care options for the child. The appropriate health and human services agencies would implement the statewide services system at the direction of the HHS Commissioner. Fiscal Analysis Fiscal implications have been identified for the Health and Human Services Commission, Texas Education Agency, Department of Human Services, and the Department of Mental Health and Mental Retardation. 1. HHSC would add one full-time equivalent for the five year period to monitor CRCG referrals, provide case management assistance, follow-up on complaints about services provided by local CRCGs, and develop/direct the implementation of a statewide service system. 2. TEA reports that no fiscal implications for state aid are anticipated due to the provisions of the bill, but does anticipate administrative costs would be incurred. 3. Estimates assume that the children served by DHS would be those on waiting lists for either the Related Conditions Waiver (CLASS) or Medically Dependent Children's Waiver and that the children are not currently Medicaid eligible. No new administrative costs related to these services were assumed. 4. MHMR does not assume new administrative costs pursuant to the establishment of the statewide services network but does anticipate additional costs for client services. Methodolgy 1. HHSC would hire a Program Specialist II at Group 19, Step 5 of the Classification Schedule ($41,160). Equipment costs of $5,150 would be incurred in the first year. Travel and other operating costs would also be incurred. The cost for this new administrative responsibility would total $62,536 in 1998 and $57,387 each year thereafter. 2. TEA would add 1.5 FTEs: 0.5 Education Specialist II, Group 19-1($16,896) and one Administrative Secretary, Group 9-1 ($18,192). Travel and other operating costs would be incurred. Annual costs of $47,684 are estimated. 3. DHS would provide interim services to 715 children for a 60 day period each year at a daily rate of $67.11. It was assumed that these services would be not eligible for Medicaid matching funds because no additional waiver slots are anticipated to accommodate these families. 4. Assumptions related to client services estimates for MHMR include: i) The schedule for the provision of services would be 475 children in the first year; 475 the second year; and 100 children each year thereafter. ii) It is assumed that the children will be not be served through the Medicaid Program. Intensive services were assumed for the first sixty days (5 hours of services per day for 60 day/300 hours) for each child. The costs assume an hourly rate of $14.62. 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 Probable Savings/(Cost) Savings/(Cost) from General from Federal Funds Revenue Fund 0001 0555 1998 ($5,057,041) ($15,634) 1998 (5,053,179) (14,347) 2000 (3,409,429) (14,347) 2001 (3,408,429) (14,347) 2002 (3,408,429) (14,347) 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 ($5,057,041) 1999 (5,053,179) 2000 (3,409,429) 2001 (3,408,429) 2002 (3,408,429) Similar annual fiscal implications would continue as long as the provisions of the bill are in effect. No fiscal implication to units of local government is anticipated. Source: Agencies: 532 Interagency Council on Early Childhood Intervention 655 Texas Department of Mental Health and Mental Retardation 529 Health and Human Services Commission 701 Texas Education Agency - Administration 324 Department of Human Services 501 Department of Health LBB Staff: JK ,BB ,AZ