LEGISLATIVE BUDGET BOARD
                                   Austin, Texas
         
                                   FISCAL NOTE
                               75th Regular Session
         
                                  February 17, 1997
         
         
      TO: Honorable Judith Zaffirini, Chair            IN RE:  Senate Bill No. 162
          Committee on Health & Human Services                              By: Barrientos
          Senate
          Austin, Texas
         
         
         
         
         FROM:  John Keel, Director    
         
In response to your request for a Fiscal Note on SB162 ( Relating 
to prevention and treatment of diabetes.) this office has detemined 
the following:
         
         Biennial Net Impact to General Revenue Funds by SB162-As Introduced
         
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 Pilot Program 
for Medicaid recipients.  The pilot would be 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 pilot 
would be authorized for fiscal years 1998-2001.

Under the 
provisions of the bill, the pilot program would provide continuous 
care, preventive services, and case management to Medicaid recipients 
who have been hospitalized for diabetes-related conditions. 
 The HHSC would be required to consider an analogous 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 also amend the Insurance 
Code to establish guidelines for diabetes care.  The Department 
of Insurance, in consultation with the Texas Diabetes Council, 
would be required to adopt minimum standards for the care that 
is provided to enrollees with diabetes.  The standards would 
be applied only to health benefit plans delivered, issued for 
delivery, or renewed on or after January 1, 1999.

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 fiscal implication to units of local government is anticipated.
          
   Source:            Agencies:   529   Health and Human Services Commission
                                         330   Rehabilitation Commission
                                         454   Department of Insurance
                                         701   Texas Education Agency - Administration
                                         304   Comptroller of Public Accounts
                                         324   Department of Human Services
                                         318   Commission for the Blind
                                         501   Department of Health
                                         323   Teacher Retirement System and Optional Retirement Program
                                         327   Employees Retirement System
                                         
                      LBB Staff:   JK ,BB ,AZ