LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
April 28, 1999
TO: Honorable Jane Nelson, Chair, Senate Committee on Health
Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB1400 by Gray (relating to the continuation and
functions of the Texas Commission for the Blind),
Committee Report 2nd House, Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB1400, Committee Report 2nd House, Substituted: positive impact *
* of $149,952 through the biennium ending August 31, 2001. *
* *
* 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 Sec. 91.001 of the Human Resources Code to *
* continue the Texas Commission for the Blind (TCB) for eight years, *
* setting the date for the next Sunset review as September 1, 2011. *
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General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2000 $74,976 *
* 2001 74,976 *
* 2002 74,976 *
* 2003 74,976 *
* 2004 74,976 *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Probable Probable Probable *
* Year Savings from Savings from Revenue Gain Revenue Gain *
* General Revenue Federal Funds from Federal from New - *
* Fund 0555 Funds Business *
* 0001 0555 Enterprise *
* Trust Fund *
* 2000 $74,976 $277,024 $378,000 $3,778,581 *
* 2001 74,976 277,024 378,000 443,000 *
* 2002 74,976 277,024 378,000 443,000 *
* 2003 74,976 277,024 378,000 443,000 *
* 2004 74,976 277,024 378,000 443,000 *
***************************************************************************
*****************************************************
* Fiscal Year Probable Revenue (Loss) from *
* Business Enterprise Program *
* Account/ GR-Dedicated *
* 0492 *
* 2000 $(3,778,581) *
* 2001 (443,000) *
* 2002 (443,000) *
* 2003 (443,000) *
* 2004 (443,000) *
*****************************************************
Fiscal Analysis
The Sunset Advisory Commission estimates savings for purchased services
as a result of improving service delivery guidelines and adopting rules
and standards for medical and optometric services rate setting.
The bill would authorize TCB to administer a retirement program for
individuals licensed to operate vending facilities under the Business
Enterprise Program. It is assumed that balances on hand (estimated to
be $3,778,581), and all new contributions (estimated to be $443,000 each
fiscal year) would be deposited into a new Business Enterprise Trust
Fund for the purposes of administering the Business Enterprise
Retirement Program.
Methodology
The Sunset Advisory Commission (SAC) conducted a comparison of TCB rates
for services and Medicare rates for services. The conclusion was that
agency rates, as compared to Medicare rates, were $352,000 higher in
fiscal year 1997.
The bill would require amounts paid for services to be comparable if not
the same as standard Medicare rates and would result in estimated savings
for purchased services of $277,024 in Federal Funds and $74,976 in
General Revenue Funds in fiscal year 2000 and each year thereafter. The
bill would require the Commission to verify client eligibility for
Medicaid. SAC estimates increases in Medicaid federal reimbursements of
$378,000 for the Children's Program in fiscal year 2000 and each year
thereafter.
The Sunset Advisory Commission assumed savings based on the agency's 30
most frequently purchased medical and optometric services, which
represent 95 percent of the number of services purchased and 91 percent
of the total dollars spent on these services. For these top 30 services,
the agency exceeds Medicare reimbursement for 18 procedures, ranging
from 12 percent to 153 percent, with an average excess of 43 percent.
New patient eye exams using the TCB rate would be $115, while
the Medicare rate would be $75. Eye exams using the TCB rate cost $50,
and Medicare rates are $33.
Based on information provided by the TCB, the Sunset Advisory Commission
examined the difference between the actual rates paid for medical and
optometric services in fiscal year 1997 and the Medicare rates for the
same procedures from the American Medical Association's Medicare Resource
Based Relative Value Scale (RBRVS): The Physician's Guide, 1997.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies: 318 Commission for the Blind, 304 Comptroller of
Public Accounts
LBB Staff: JK, TP, ER