LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE 75th Regular Session March 5, 1997 TO: Honorable Bill Ratliff, Chair IN RE: Senate Bill No. 606 Committee on Finance By: Lucio Senate Austin, Texas FROM: John Keel, Director In response to your request for a Fiscal Note on SB606 ( Relating to the establishment of a Regional Academic Health Center) this office has detemined the following: Biennial Net Impact to General Revenue Funds by SB606-As Introduced Implementing the provisions of the bill would result in a net negative impact of $(17,000,000) 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. Fiscal Analysis The bill would authorize the University of Texas System Board of Regents to establish and operate a Regional Academic Health Center (RAHC), serving Cameron, Hidalgo, Starr and Willacy counties. The RAHC would be managed by an undesignated University of Texas component health institution. The RAHC would provide clinical, postgraduate, including internship and residency, or other levels of medical professional education. The bill would authorize the Board of Regents to provide adequate physical facilities for use by the RAHC, including library, auditorium, research facilities, and medical education buildings. Funding for construction of the facilities may include, but not be limited to, general revenue appropriations and tuition revenue bonds. The bill would require that a teaching hospital be furnished and operated at no cost or expense to the state. Methodolgy This analysis assumes implementation with moderate costs and maximum use of existing resources. The assumptions made in developing this fiscal note include: (1) expansion of medical residencies; (2) use of existing classroom and clinical facilities with appropriate expansion for clinical teaching activities; (3) no new construction during the first biennium except for expansion and enhancements to existing clinical facilities; (4) geographic coverage would be limited to the four-county area designated in the bill; (5) the RAHC would train medical students, interns and residents; (6) faculty and staff would be hired; and (7) on-going instructional and program support would be needed in areas such as library and telecommunication resources and services, and faculty/student services. Based on the above assumptions, $3.5 million is estimated for enhancing existing classroom and clinical facilities, and $6.3 million is estimated for operating costs in fiscal year 1998. In 1999, operating costs are estimated to be $7.2 million and would increase in each successive year. Operating costs include professional and support salaries, employee benefits, stipends, institutional and program support resources and services, and other costs necessary to operate the RAHC. FY 2000 estimates include $2.5 million for capital expenditures. The four-county area currently supports 28 medical residents. The six-year implementation plan assumes 80 third- and fourth-year medical students doing rotations at the RAHC and 50 additional medical residents by 2003. No specific authority for issuance of tuition revenue bonds has be given pursuant to Chapter 55 of the Texas Education Code. Therefore, no cost for debt service has been included. 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 Change in Number Savings/(Cost) of State from General Employees from Revenue Fund FY 1997 0001 1998 ($9,800,000) 45.0 1998 (7,200,000) 60.0 2000 (12,070,000) 80.0 2001 (11,470,000) 100.0 2002 (13,680,000) 105.0 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 ($9,800,000) 1999 (7,200,000) 2000 (12,070,000) 2001 (11,470,000) 2002 (13,680,000) Similar annual fiscal implications would continue as long as the provisions of the bill are in effect. No significant fiscal implication to units of local government is anticipated. Source: Agencies: 720 University of Texas System Administration 352 Bond Review Board 781 Higher Education Coordinating Board LBB Staff: JK ,RR ,CF