LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 76th Regular Session May 13, 1999 TO: Honorable Rodney Ellis, Chair, Senate Committee on Jurisprudence FROM: John Keel, Director, Legislative Budget Board IN RE: HB3517 by Goodman (Relating to the detention, adjudication, and disposition of certain persons within the juvenile justice system.), As Engrossed ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * HB3517, As Engrossed: negative impact of $(1,243,673) 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 $(621,671) * * 2001 (622,002) * * 2002 (622,002) * * 2003 (622,002) * * 2004 (622,002) * **************************************************** All Funds, Five-Year Impact: *************************************************************************** *Fiscal Probable Probable Probable Probable * * Year Savings/(Cost) Revenue Savings/(Cost) Savings/(Cost) * * from General Gain/(Loss) from General from Federal * * Revenue Fund from Other Revenue Fund Funds * * 0001 -Appropriated (GR-match for 0555 * * Receipts Medicaid) * * 0001 * * 2000 $(479,555) $368,653 $(142,116) $(226,537) * * 2001 (479,555) 368,653 (142,447) (226,205) * * 2002 (479,555) 368,653 (142,447) (226,205) * * 2003 (479,555) 368,653 (142,447) (226,205) * * 2004 (479,555) 368,653 (142,447) (226,205) * *************************************************************************** Fiscal Analysis The bill would amend sections of the Family Code to provide that a juvenile court may refer a child to a local MHMR authority for evaluation and services if there was probable cause to believe that a child suffered from a mental illness or mental retardation. If that determination was made, the juvenile proceedings would be stayed until a finding was made by the court. If the court found that evidence supported a finding of mental illness and the child met the Health and Safety Code commitment criteria, the court would initiate commitment or refer the matter to the appropriate court. If the child was found unfit to proceed by reason of mental retardation, the court would initiate civil commitment or refer the case to an appropriate court. The amendment requires the juvenile court to order the placement of a child who has been found unfit to proceed or lacks responsibility for his conduct in a facility designated by TDMHMR, in a private psychiatric inpatient facility at private expense, unless the court orders the state or a political subdivision of the state to pay the costs of placement in such a facility, or in an adequate outpatient setting for a period of no more than 90 days. Methodology It is assumed that the Texas Department of Mental Health and Mental Retardation (MHMR) would receive 38 additional referrals - 9 referrals for determination of fitness resulting from mental illness and 29 referrals for mental retardation. Medicaid eligible costs for Medicaid eligible clients will be assumed by the Department of Health. Non-medicaid eligible costs are assumed at MHMR. The cost methodology assumes the number of referrals X (times) cost per day X (times) 90 days as required in the bill. Cost assumptions are $260.90 per day for a mental health client in an MHMR facility, $950 per day for a mental health client in a private mental hospital, and $131.53 per day for a mental retardation client in an MHMR facility. It is assumed that half of the mental health client referrals will request placement in a private mental health facility. According to MHMR, approximately 24% of the total referrals for mental illness and 100% of mental retardation referrals are Medicaid eligible. Medicaid eligible costs are federally reimbursed at a rate of 61.45%. The General Revenue match for these Medicaid eligible clients is provided by the Department of Health. MHMR will receive the federal reimbursement. In addition, non-Medicaid medical costs of $500 per year per MR (Mental Retardation) referral are included which are not federally reimbursed. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies: 655 Texas Department of Mental Health and Mental Retardation, 694 Youth Commission LBB Staff: JK, PE, MG