LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 76th Regular Session
  
                              March 17, 1999
  
  
          TO:  Honorable Patricia Gray, Chair, House Committee on Public
               Health
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB1860  by Gutierrez (Relating to acanthosis nigricans
               screening in public and private schools.), As Introduced
  
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*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  HB1860, As Introduced:  negative impact of $(471,404) 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 require all schools, private and public, which serve   *
*  children aged 5 to 21 years, to screen students for acanthosis        *
*  nigricans at the same time of hearing and vision screening is         *
*  performed.                                                            *
**************************************************************************
  
General Revenue-Related Funds, Five-Year Impact:
  
          ****************************************************
          *  Fiscal Year  Probable Net Positive/(Negative)   *
          *               Impact to General Revenue Related  *
          *                             Funds                *
          *       2000                           $(412,312)  *
          *       2001                             (59,092)  *
          *       2002                             (59,092)  *
          *       2003                             (59,092)  *
          *       2004                             (59,092)  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
***************************************************************************
*Fiscal    Probable Savings/(Cost) from     Change in Number of State     *
* Year         General Revenue Fund           Employees from FY 1999      *
*                      0001                                               *
*  2000                        $(412,312)                             1.0 *
*  2001                          (59,092)                             1.0 *
*  2002                          (59,092)                             1.0 *
*  2003                          (59,092)                             1.0 *
*  2004                          (59,092)                             1.0 *
***************************************************************************
  
Technology Impact
  
Technology acquisitions of one computer ($2,000) and laser printer
($2,500) are assumed.
  
  
Fiscal Analysis
  
The bill would require the Department of Health to require screening of
public and private school children at the same time of hearing and
vision testing; develop rules outlining the procedures necessary to
administer screening activities; and monitor the quality of the
screening activities provided.
  
  
Methodology
  
It is assumed that one Health Program Specialist III would be required to
administer the program. Office setup costs, operating expenses and
travel are included for the full-time equivalent position.  In addition,
it is estimated that printing and duplication of materials would be
required ($27,535 in year one and $9,125 each year thereafter).

Training costs for a professional services contract with thirty (30)
trainers will be required to train an estimated 15,000 screeners
($300,000).  It is assumed that development and production of a training
videotape to be used by trainers would be required and that TDH would
contract for video production and tape duplication at an estimated cost
of $25,000.  Certification cards for screeners would cost $410 in  fiscal
year 2000 and report forms for annual reports are estimated to cost $125
annually.

It is assumed that the Texas Education Agency (TEA) would provide the
space for the training sessions for the school health professionals from
their district and any needed audio visual equipment required for the
training.  TEA would also provide the registration and notification of
the workshops, and that TEA would absorb these costs within existing
resources.

The bill would have a potential fiscal impact on Medicaid and Title V
programs in the event that children diagnosed as a result of these
screens seek services through the these state programs.  According to
the Department of Health, increased costs in the Medicaid and Title V
programs would be absorbed with current agency resources.
  
  
Local Government Impact
  
According to the Texas Education Agency school districts would be
required to ensure the screenings are conducted and to maintain
screening records for each student in attendance.  TEA indicates that if
the cost of screening and data/reporting requirements is as little as $1
per student, the annual local cost associated with this bill would be
roughly $3.9 million.  This cost would increase by approximately 2
percent per year due to enrollment growth.
  
  
Source Agencies:   
LBB Staff:         JK, TP, AZ, ER