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