LEGISLATIVE BUDGET BOARD
                                   Austin, Texas
         
                                   FISCAL NOTE
                               75th Regular Session
         
                                  March 2, 1997
         
         
      TO: Honorable Judith Zaffirini, Chair            IN RE:  Senate Bill No. 162, Committee Report 1st House
          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 the prevention and treatment of diabetes.) this office has 
detemined the following:
         
         Biennial Net Impact to General Revenue Funds by SB162-Committee Report 1st 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 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 
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:   501   Department of Health
                                         529   Health and Human Services Commission
                                         304   Comptroller of Public Accounts
                                         318   Commission for the Blind
                                         323   Teacher Retirement System and Optional Retirement Program
                                         324   Department of Human Services
                                         327   Employees Retirement System
                                         330   Rehabilitation Commission
                                         454   Department of Insurance
                                         701   Texas Education Agency - Administration
                      LBB Staff:   JK ,BB