LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 76th Regular Session April 21, 1999 TO: Honorable Patricia Gray, Chair, House Committee on Public Health FROM: John Keel, Director, Legislative Budget Board IN RE: HB2393 by Maxey (Relating to authorizing harm reduction programs to reduce the risk of HIV infection, AIDS, hepatitis B, and hepatitis C.), As Introduced No significant fiscal implication to the State is anticipated. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. It is assumed that the Department of Health could obtain federal funds to underwrite the study. If federal funds are not obtained then it is assumed that the department could fund a less comprehensive study within existing resources. Local Government Impact Local health authorities opting to establish harm reduction programs could experience costs associated with the following activities: providing needles and syringes free of charge; offering education on the transmission of certain diseases; assisting program participants in obtaining drug treatment and other health services; and providing materials to promote safe health-related practices. These costs would depend on the amount of supplies a local health authority would require, the amount of staff time that would be necessary to distribute supplies and provide services, and whether employee training would be required. In some cases, a portion of the costs could be recovered using federal or private grant proceeds. Several local governments were contacted to estimate the cost of establishing a harm reduction program. Denton County, Montgomery County and Tarrant County all report that there would be no significant fiscal impact. The City of San Antonio reports that a locally-run program could cost the metropolitan health authority $150,898 per year, including staffing costs and the cost of supplies and equipment. Source Agencies: 501 Department of Health LBB Staff: JK, TP, TL, RM