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
          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 

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 
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.
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
               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