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