LEGISLATIVE BUDGET BOARD
                                   Austin, Texas
         
                                   FISCAL NOTE
                               75th Regular Session
         
                                  April 21, 1997
         
         
      TO: Honorable Judith Zaffirini, Chair            IN RE:  Senate Bill No. 1163, Committee Report 1st House, Substituted
          Committee on Health & Human Services                              By: Zaffirini
          Senate
          Austin, Texas
         
         
         
         
         FROM:  John Keel, Director    
         
In response to your request for a Fiscal Note on SB1163 ( Relating 
to information and training about Medicaid managed care.) this 
office has detemined the following:
         
         Biennial Net Impact to General Revenue Funds by SB1163-Committee Report 1st House, Substituted
         
Implementing the provisions of the bill would result in a net 
negative impact of $(1,000,000) 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 require the Department of Health to implement 
a pilot project for not less than two years which would test 
the effectiveness and cost of peer outreach and health education 
for Medicaid clients in managed care plans.  The focus of the 
pilot would be:
  1)  to inform Medicaid recipients about the 
effective use of health care resources; 
  2)  to encourage 
recipients to seek health care regularly, including prenatal 
care, medical and dental check-ups, and follow-up care;
  3) 
 to follow provider instructions relating to their health; and
 
 4)  to keep health care appointments and follow up on missed 
appointments.
 
Methodolgy
 
It is assumed that the pilot would last two years and would 
be contracted through a competitive bid process after a location 
is determined by the Department of Health.  It is assumed that 
the approximately 50 contracted community workers would work 
with the clients to implement the provisions of the bill.

It 
is assumed that the project would be financed by both state 
and federal Medicaid dollars and that the Department of Health 
could implement the provisions of the bill without adding additional 
staff.
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           
            Savings/(Cost)     Savings/(Cost)                                                             
            from General       from Federal Funds                                                         
            Revenue Fund                                                                                  
            0001               0555                                                                        
       1998        ($500,000)        ($500,000)                                                      
       1998         (500,000)         (500,000)                                                      
       2000                                                                                          
       2001                                                                                          
       2002                                                                                          
 
 
         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           ($500,000)
               1999            (500,000)
               2000                    0
               2001                    0
               2002                    0
 
          
No fiscal implication to units of local government is anticipated.
          
   Source:            Agencies:   
                                         501   Department of Health
                      LBB Staff:   BB ,AZ