LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
May 8, 1999
TO: Honorable Jane Nelson, Chair, Senate Committee on Health
Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB1652 by Maxey (Relating to an education and prevention
program for hepatitis C.), As Engrossed
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB1652, As Engrossed: negative impact of $(3,042,963) 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. *
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General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2000 $(609,667) *
* 2001 (2,433,296) *
* 2002 (3,658,271) *
* 2003 (3,369,318) *
* 2004 (1,903,532) *
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All Funds, Five-Year Impact:
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*Fiscal Probable Change in Number of State *
* Year (Cost) from General Revenue Employees from FY 1999 *
* Fund *
* 0001 *
* 2000 $(609,667) 8.0 *
* 2001 (2,433,296) 8.0 *
* 2002 (3,658,271) 8.0 *
* 2003 (3,369,318) 8.0 *
* 2004 (1,903,532) 8.0 *
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Technology Impact
Personal computers and printers for the additional staffing are included
in the estimates ($16,500).
Fiscal Analysis
The bill would require the Department of Health to develop a program to
heighten awareness and enhance knowledge and understanding of hepatitis
C. The program would include: conducting a study to estimate current and
future impact of hepatitis C on Texas; conducting health education,
public awareness and community outreach activities; providing training to
public health clinic staff about hepatitis C; training public health
clinic staff about treatment, detection and methods of transmission of
hepatitis C; and developing a prevention program to reduce risk of
transmission of hepatitis C. The bill would establish voluntary
hepatitis C testing programs at facilities providing voluntary HIV
testing and would require the department to develop and offer a training
course for persons providing hepatitis C counseling. The bill would
require the department to maintain a registry of persons who successfully
complete the training course.
Under the provisions of the bill, the department may charge a fee for the
training course to persons other than employees of entities receiving
state or federal funds for hepatitis C counseling and training programs
to cover the costs of providing the course.
Methodology
According to the Department of Health (TDH), 7,812 screening tests for
hepatitis C would be needed to study the seroprevalence of the disease
statewide. The department estimates a cost of $19.73 per test and two
additional FTEs to conduct the study.
According to the department, three FTEs will be needed to plan, implement
and coordinate public and professional education information programs as
well as provide training for counselors and administrative support. The
estimates include travel for current TDH contractors to attend training,
$100,000 per year in the 2000-01 biennium. The department anticipates
that current contractors would experience a 5 percent increase in
activities due to additional testing and counseling related to hepatitis
C. TDH estimates a cost of $286,290 would be required for these
activities each fiscal year beginning 2001. According to the department,
most HIV counselors are funded or trained using state or federal funds
through contracts with the department.
It is assumed that the Bureau of Laboratories would perform the screening
and confirmatory testing for hepatitis C. In addition to the screening
test mentioned above, it is estimated that confirmatory testing for
hepatitis C would cost $162 per test and three additional FTEs will be
needed to conduct the increased workload of hepatitis C screening and
confirmatory tests. Personnel costs are reduced by 25 percent for year
one due to an anticipated phase-in period.
According to the TDH, hepatitis C testing and counseling would not start
until fiscal year 2001. Only testing for the study would be conducted in
fiscal year 2000. The department estimates that 61 percent of
potentially medically indigent current injecting drug users (IDUs) and
10 percent of potentially medically indigent past IDUs would access
existing HIV counseling and testing sites for hepatitis C testing and
counseling, a total of 80,981 individuals. It is assumed that 74
percent of these individuals would access the services during the first
five years of the program with estimated cost for screening and
confirmatory testing of $5,039,422 for fiscal years 2001-2004.
Likewise, 23 percent of the potentially medically indigent transfusion
recipients would access existing sites for hepatitis C testing and
counseling services, a total of 95,248 individuals. It is assumed that
75 percent would access the services at an estimated cost of $1,638,599
for fiscal years 2001-2004. An estimated 71,7075 individuals,
potentially medically indigent and exhibiting high-risk sexual behavior,
would access the testing and counseling services at existing sites. It
is assumed that 59 percent would access the services at an estimated
cost of $674,816 for fiscal years 2001-2004. The department estimates
that testing for hepatitis C in the IDU and transfusion recipient groups
would decline in the fourth and fifth fiscal years of the program while
testing in the group exhibiting high-risk sexual behavior would
increase and then remain constant beginning in fiscal year 2002.
Local Government Impact
The provisions of the bill would add hepatitis C counseling and testing
responsibilities to the local health departments. According to the
Health Department, this responsibility would require the state to
increase their contract awards to these entities.
Source Agencies: 501 Department of Health
LBB Staff: JK, TP, AZ, RM