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