LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 76th Regular Session
  
                               May 12, 1999
  
  
          TO:  Honorable Jane Nelson, Chair, Senate Committee on Health
               Services
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB2573  by Wolens (Relating to tertiary medical care),
               Committee Report 2nd House, Substituted
  
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*  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.                                                             *
**************************************************************************
  
The bill states that the bill would only go into effect if an
appropriation to implement the provisions of the bill is provided in the
General Approprations Act of the 76th Legislature.

The bill would require the Department of Health to designate tertiary
care facilities.  The bill would create a new account in the state
treasury, the Tertiary Care Facility Account, to be composed of money
appropriated to the account and gifts, grants, and donations.  The
Department of Health would be required to certify to the Comptroller, for
each designated tertiary care facility, the cost of unreimbursed
tertiary care provided by the facility to persons who reside outside of
the service area of the facility or unit of local government.  In
addition, the department would be required to allocate funds available in
the Tertiary Care Facility Account to facilities based on the
percentages computed by dividing the cost of the facility's unreimbursed
tertiary medical services by the total cost of all facilities'
unreimbursed tertiary medical services.  No more than five percent of the
amounts remaining in the account could be used for the costs of
administering the account.

According to the Comptroller, the amount of gifts, grants, and donations
allocated to the new account is not known.  The Department of Health
estimates that it would cost approximately $290,000 in fiscal year 2000
and approximately $250,000 per year in subsequent years to administer
the provisions of this bill.
  
Technology Impact
  
Four personal computers, one laptop computer, and four printers are
assumed in the numbers included above.
  
  
Local Government Impact
  
No significant fiscal implication to units of local government is
anticipated.
  
  
Source Agencies:   301   Office of the Governor, 501   Department of
                   Health, 304   Comptroller of Public Accounts
LBB Staff:         JK, TP, KF