LEGISLATIVE BUDGET BOARD
                                   Austin, Texas
         
                                   FISCAL NOTE
                               75th Regular Session
         
                                  May 27, 1997
         
         
      TO: Honorable Bob Bullock            Honorable James E. "Pete" Laney
          Lieutenant Governor                Speaker of the House
          Senate
          Austin, Texas
         
         
         
         
         FROM:  John Keel, Director    
         
In response to your request for a Fiscal Note on SB190 ( Relating 
to the regulation of nursing homes and similar facilities; providing 
penalties.) this office has detemined the following:
         
         Biennial Net Impact to General Revenue Funds by SB190-Conference Committee Report
         
Implementing the provisions of the bill would result in a net 
positive impact of $472,000 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 and Chapter 
250 of the Health and Safety Code and Chapter 32 of the Human 
Resources Code to implement a number of changes relating to 
the regulation of convalescent and nursing homes in Texas.
         
 
Fiscal Analysis
 
Implementation of two provisions in the bill would result in 
a gain to the General Revenue fund.  The first provision would 
authorize the Board of Human Services to raise license fees 
by $100 per facility and $5 per bed.  The second provision would 
authorize the Board of Human Services to establish a background 
examination fee to defray the department's expenses in considering 
the background and qualifications of a wide range of individuals 
associated with license applications.

The bill would specify 
that fees and penalties collected by or on behalf of the department 
which are deposited to the credit of the General Revenue fund 
may be appropriated only to the department to administer and 
enforce the state licensing law. 

The bill would also require 
the Legislative Budget Board and the State Auditor to jointly 
prescribe the form and content of annual performance reports 
that the Office of the Attorney General and the Department of 
Human Services must prepare.  It would also establish a long-term 
care legislative oversight committee, staffed by existing resources 
of the Senate and House, to monitor the effectiveness and efficiency 
of the nursing facility regulatory system.

The effective 
date for the bill is September 1, 1997, and the Board of Human 
Services must adopt rules to implement the changes in law on 
or before January 1, 1998.
 
Methodolgy
 
It is assumed that the Board of Human Services would increase 
licensing fees on September 1, 1997.  The Comptroller of Public 
Accounts estimates that the annual gain to the General Revenue 
fund would be $236,000.  This amount was estimated by applying 
the proportional fee increase to the average level of nursing 
home license fee collections in fiscal years 1995 and 1996.

It 
is also assumed that the Board of Human Services would establish 
a background examination fee equaling the department's expenses.
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 Revenue   
            Gain/(Loss) from                                                                              
            General Revenue                                                                               
            Fund                                                                                          
            0001                                                                                           
       1998          $236,000                                                                        
       1998           236,000                                                                        
       2000           236,000                                                                        
       2001           236,000                                                                        
       2002           236,000                                                                        
 
 
         Net Impact on General Revenue Related Funds:
 

 
              Fiscal Year      Probable Net Postive/(Negative)
                               General Revenue Related Funds
                                             Funds
               1998             $236,000
               1999              236,000
               2000              236,000
               2001              236,000
               2002              236,000
 
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:   324   Department of Human Services
                                         302   Office of the Attorney General
                                         304   Comptroller of Public Accounts
                      LBB Staff:   JK ,BB ,NM