LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE 75th Regular Session March 23, 1997 TO: Honorable Judith Zaffirini, Chair IN RE: Senate Bill No. 190, Committee Report 1st House, Substituted Committee on Health & Human Services By: Zaffirini/et al. 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-Committee Report 1st House, Substituted 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 amend Chapter 242 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. The bill 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. It is assumed that the board would establish a background examination fee equaling the department's expenses, but no data is currently available to calculate these expenses. The bill would require the department to establish an informal dispute resolution process in the department's central office to address provider concerns about monetary penalties assessed for violations of federal Medicaid standards. It would also restrict the ability of other state agencies to assess or collect investigation and attorney fees, and increase administrative and civil penalties. The bill would 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 the House, to monitor the effectiveness and efficiency of the nursing facility regulatory system. 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 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. No fiscal implication to units of local government is anticipated. Source: Agencies: 324 Department of Human Services LBB Staff: JK ,BB ,NM