LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 76th Regular Session
  
                              April 27, 1999
  
  
          TO:  Honorable Judith Zaffirini, Chair, Senate Committee on
               Human Services
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB2866  by Kuempel (Relating to assistance funds for
               mandatory health care services provided in certain
               counties.), As Engrossed
  
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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 would allow city/county-owned hospitals to become eligible to
participate in the County Indigent Health Care Program (CIHCP) and
receive state matching funds if they spend in excess of their counties'
10 percent general revenue levy for mandated health services.  In
addition, the hospitals would be allowed to set eligibility criteria at
levels higher than the current policy, which is tied to the Temporary
Assistance for Needy Families (TANF) eligibility.

According to the Department of Health, there are two entities that would
become eligible for assistance under this bill, Guadalupe and Medina
counties.  The department states that Medina county has not spent in
excess of 10 percent of the general revenue levy on eligible health
services in recent years and therefore inclusion of this county in the
program would not result in a probably fiscal impact.

It is assumed that participation by Guadalupe county in the program would
result in an increased expenditure by the CIHCP of no more than $74,560
per fiscal year.  It is anticipated that this increase can be absorbed
by the Department of Health within existing resources.
  
Local Government Impact
  
This bill could result in a revenue gain to Guadalupe county and possibly
other counties that have a city/county-owned hospital.
  
  
Source Agencies:   501   Department of Health
LBB Staff:         JK, TP, KF