LEGISLATIVE BUDGET BOARD
                                   Austin, Texas
         
                                   FISCAL NOTE
                               75th Regular Session
         
                                  May 26, 1997
         
         
      TO: Honorable Bob Bullock            IN RE:  Senate Bill No. 162, As Passed 2nd House
          Lieutenant Governor                Barrientos
          Senate
          Austin, Texas
         
         
         
         
         FROM:  John Keel, Director    
         
In response to your request for a Fiscal Note on SB162 ( Relating 
to the prevention and treatment of diabetes.) this office has 
detemined the following:
         
         Biennial Net Impact to General Revenue Funds by SB162-As Passed 2nd House
         
No significant fiscal implication to the State is anticipated.
         
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 authorize the Health and Human 
Services Commission to develop a Texas Diabetes Care Pilot Program 
for Medicaid recipients.  The program would be initially implemented 
in counties with a high incidence of and a high death rate from 
diabetes.  The Texas Diabetes Council would administer the program 
under the direction of HHSC.  The program would be implemented 
by November 1, 1997, unless federal approval of any necessary 
waiver or other authorization has not been obtained.  The program 
would be authorized for fiscal years 1998-2001.

Under the 
provisions of the bill, the program would provide continuous 
care, preventive services, and case management to Medicaid recipients 
who have diabetes-related conditions.  The HHSC would be required 
to consider a pilot program operated in Maryland in developing 
the program.  The Commission would be required to submit interim 
and final reports to the Lieutenant Governor and Speaker of 
the House of Representatives on the effectiveness of the program 
by specific dates during the 1998-99 biennium.

The bill would 
require the Texas Diabetes Council to develop and provide materials 
about diabetes to school-based clinics for primary and secondary 
school students and their parents.  The bill would also require 
the Council, State Board of Education, and Department of Health 
to develop a diabetes education program for school districts 
to use in their health curricula.

Increased General Revenue 
costs were identified by the Health and Human Services Commission 
($28,656 in 1998; $26,081 in 1999), Department of Health ($141,473:1998; 
$136,926:1999; $107,726:2000; $107,726:2001; $78,526:2002), 
and the Texas Education Agency ($167,901 in 1998).  No estimates 
of potential savings were identified.  However, given the size 
and resources available to these agencies, no significant fiscal 
implication to the state is anticipated.

The bill would implement 
TPR recommendation HHS13 as described in Disturbing the Peace: 
 The Challenge of Change in Texas Government.
         
 
          
No significant fiscal implication to units of local government 
is anticipated.
          
   Source:            Agencies:   
                                         
                      LBB Staff:   JK ,BB