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 ************************************************************************** * 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