LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
May 13, 1999
TO: Honorable Jane Nelson, Chair, Senate Committee on Health
Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB2909 by Naishtat (Relating to the nursing and
convalescent home trust fund.), As Engrossed
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB2909, As Engrossed: positive impact of $0 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. *
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General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2000 $0 *
* 2001 0 *
* 2002 (507,825) *
* 2003 (507,825) *
* 2004 (507,825) *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Revenue Probable (Cost) to Probable (Cost) to *
* Year Gain to Nursing and General Revenue Fund Federal Funds *
* Convalescent Home (Medicaid Match) (Medicaid) *
* Trust Fund 0001 0555 *
* 0992 *
* 2000 $2,000,000 $0 $0 *
* 2001 2,000,000 0 0 *
* 2002 2,000,000 (507,825) (794,291) *
* 2003 2,000,000 (507,825) (794,291) *
* 2004 2,000,000 (507,825) (794,291) *
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Fiscal Analysis
The bill would amend the Health and Safety Code to require the Department
of Human Services (DHS) to charge and collect an annual fee in an amount
necessary to provide not more than $10,000,000 in the nursing and
convalescent home trust fund. If the department were to make more than
one assessment of fees in any year, it would be required to notify the
governor and members of the Legislative Budget Board. All collections
would be deposited to the trust fund. At the end of each fiscal year,
any unencumbered amount in the trust fund in excess of $10,000,000 would
be transferred to the credit of the general revenue fund.
The Health and Safety Code, Chapter 242, governs only nursing and
convalescent facilities. However, Chapters 247 and 252 require DHS to
charge and collect similar fees from personal care facilities and
intermediate care facilities for the mentally retarded (ICF-MR)
respectively. These fees must be deposited to the nursing and
convalescent home trust fund. Therefore, any increase in fees to build
the trust fund balance would affect nursing/convalescent facilities,
personal care facilities, and ICF-MR facilities.
Methodology
1) DHS would increase the trust fund balance to $10,000,000 over a
five-year period by charging and collecting fees totaling $2,000,000 per
year. DHS would charge and collect a fee of $12 per licensed bed (from
nursing/convalescent facilities, personal care facilities, and ICF-MR
facilities) each year. The total number of licensed beds for fiscal year
2000 is estimated to be 166,667. This number is assumed for each
subsequent year.
For purposes of this estimate, no expenditures from the trust fund are
assumed (beginning in fiscal year 2000). If trust funds are expended, it
is assumed DHS would increase the fee charged and collected in
subsequent years in order to produce a balance of $10,000,000 in the
trust fund at the end of fiscal year 2004. Any increase in the fee
amounts assumed would increase the cost to the state two years later.
2) Facilities that contract with the state to provide client services
would be reimbursed for costs related to nursing and convalescent home
trust fund fees. Reimbursement would occur two years after the expense
was incurred. Approximately 108,510 licensed beds would be eligible for
reimbursement, representing a cost to the state of $1,302,116 per year
(beginning in fiscal year 2002). Approximately 39 percent of costs
would be paid with general revenue, and 61 percent with matching federal
funds.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies: 324 Department of Human Services, 304 Comptroller
of Public Accounts
LBB Staff: JK, TP, BB, AZ, PP