LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE
75th Regular Session
February 20, 1997
TO: Honorable Judith Zaffirini, Chair IN RE: Senate Bill No. 208
Committee on Health & Human Services By: Haywood
Senate
Austin, Texas
FROM: John Keel, Director
In response to your request for a Fiscal Note on SB208 ( Relating
to the disclosure of certain information regarding certain patients
of a physician.) this office has detemined the following:
Biennial Net Impact to General Revenue Funds by SB208-As Introduced
Implementing the provisions of the bill would result in a net
negative impact of $(232,388) 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.
Fiscal Analysis
This bill amends the Health and Safety Code which currently
allows treating physicians to disclose information pertaining
to a patient to law enforcement or the patient's "legally authorized
representative" (parent, guardian, person with durable power
of attorney). The amendments of this bill provide that the
treating physician does not have to disclose information if
the physician has reason to believe that disclosure would be
harmful to the patient's physical, mental, or emotional health.
When these instances occur, the physician must inform the representative
that the release of additional information would be harmful
to the patient. Further, the physician must report to the Department
of Protective and Regulatory Services (DPRS) the representative's
request for information and request that DPRS obtain a protective
order on the patient's behalf. If a hearing is held, the court
shall then determine what information may be disclosed and issue
appropriate orders.
Methodolgy
A physician of the Department of Mental Health and Mental Retardation
(MHMR) will refuse to share records or information with legally
appointed guardians of patients in their care only on very rare
occasions. The number of these instances is estimated to be
approximately 50 per year. The amount of time required for
a physician to adhere to the requirements of this bill; meet
with the representative; report to the Department of Protective
and Regulatory Services (DPRS), requesting that DPRS obtain
a protective order; and attend a hearing is estimated to be
12 hours. For MHMR, the average hourly salary of $65.00 plus
estimated staff support and incidental travel places the cost
of this bill at $900 per incident or $45,000 for 50 instances
per year.
DPRS estimates a fiscal impact due to the addition
of legal personnel required to process protective orders. The
Department of Protective and Regulatory Services (DPRS) assumes
that one FTE attorney would be needed in the beginning followed
by another attorney as awareness of the law increases. Legal
secretaries would also be needed for the production of routine
filings, office support and development and dissemination of
information regarding the bill's requirements.
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 Probable Change in Number
Savings/(Cost) Savings/(Cost) of State
from General from Federal Funds Employees from
Revenue Fund FY 1997
0001 0555
1998 ($111,497) ($26,768) 2.0
1998 (146,982) (40,769) 3.0
2000 (142,517) (38,984) 3.0
2001 (164,861) (47,918) 4.0
2002 (160,397) (46,132) 4.0
Net Impact on General Revenue Related Funds:
The probable fiscal implication to General Revenue related funds
during each of the first five years is estimated as follows:
Fiscal Year Probable Net Postive/(Negative)
General Revenue Related Funds
Funds
1998 ($111,497)
1999 (146,982)
2000 (142,517)
2001 (164,861)
2002 (160,397)
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: 503 Board of Medical Examiners
655 Texas Department of Mental Health and Mental Retardation
530 Department of Protective and Regulatory Services
LBB Staff: JK ,BB ,AC