LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 76th Regular Session
  
                               May 14, 1999
  
  
          TO:  Honorable Teel Bivins, Chair, Senate Committee on
               Education
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB2202  by Tillery (Relating to health centers on public
               school campuses), As Engrossed
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  HB2202, As Engrossed:  negative impact of $(2,500,000) 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.                                                             *
**************************************************************************
  
General Revenue-Related Funds, Five-Year Impact:
  
          ****************************************************
          *  Fiscal Year  Probable Net Positive/(Negative)   *
          *               Impact to General Revenue Related  *
          *                             Funds                *
          *       2000                         $(1,250,000)  *
          *       2001                          (1,250,000)  *
          *       2002                          (1,250,000)  *
          *       2003                          (1,250,000)  *
          *       2004                          (1,250,000)  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
         *****************************************************
         * Fiscal Year      Probable Savings/(Cost) from      *
         *                      General Revenue Fund          *
         *                              0001                  *
         *      2000                             $(1,250,000) *
         *      2001                              (1,250,000) *
         *      2002                              (1,250,000) *
         *      2003                              (1,250,000) *
         *      2004                              (1,250,000) *
         *****************************************************
  
Fiscal Analysis
  
The bill would require the commissioners of education and health, subject
to the availability of state or federal funds, to jointly administer a
grant program to assist districts with the costs of operating
school-based health centers.  Grants awarded under the program could not
exceed $250,000 per district per biennium.  Districts would provide
matching funds as determined by the commissioners. The bill would require
that the grants be awarded on a competitive basis with preference given
to districts that are in rural areas or that have low property wealth per
student.

The Texas Education Agency and the Department of Health would be directed
to enter into a memorandum of understanding concerning the grant
program.  The memorandum would have to provide that the commissioner of
health be responsible for administering state and federal funds used to
provide the grants; that the commissioner of health adopt certain rules
related to health care delivery in centers funded under the grants; that
all programs be designed to meet certain specified goals; and that the
commissioner of education would determine which school districts receive
grants.  The commissioners must jointly issue an annual report to the
Legislature regarding the school-based health centers.
  
  
Methodology
  
Currently there are about 125 school based health centers.  In fiscal
year 1998, the Texas Department of Health, through Title V federal funds,
provided grants to 10 health centers, at $125,000 per center, for a
total cost of $1,250,000.

The note assumes that 5 health centers would be provided competitive
grant funding at a total cost $1,250,000 per year.
  
  
Local Government Impact
  
Cost to school districts would vary depending on whether they chose to
establish a student health center under the provisions of the bill.
  
  
Source Agencies:   501   Department of Health, 701   Texas Education
                   Agency - Administration, 529   Health and Human
                   Services Commission
LBB Staff:         JK, CT, RN