LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
February 22, 1999
TO: Honorable Jane Nelson, Chair, Senate Committee on Health
Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB93 by Moncrief (Relating to the regulation of assisted
living facilities), As Introduced
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* Estimated two-year Net Impact to General Revenue Related Funds for *
* SB93, As Introduced: negative impact of $(535,428) 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 provision 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 $(180,053) *
* 2001 (355,375) *
* 2002 (363,442) *
* 2003 (378,573) *
* 2004 (400,968) *
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All Funds, Five-Year Impact:
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*Fiscal Probable (Cost) Probable Probable Change in *
* Year from General Revenue Gain to Revenue Gain to Number of State *
* Revenue Fund General Revenue New - GR Employees from *
* 0001 Fund Dedicated FY 1999 *
* 0001 (Assisted *
* Living Account) *
* 2000 $(199,673) $19,620 $3,750 4.0 *
* 2001 (395,923) 40,548 7,745 8.2 *
* 2002 (406,606) 43,164 8,248 8.6 *
* 2003 (424,571) 45,998 8,784 9.0 *
* 2004 (450,018) 49,050 9,355 9.5 *
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Fiscal Analysis
The bill would amend Chapter 247 of the Health and Safety Code to change
references to "personal care facilities" to "assisted living facilities"
and require licensure for facilities serving three or more persons
unrelated to the proprietor of the facility (Sec. 247.002). The bill
(Sec. 247.024) would remove limits on fees related to personal care
facility licensure. The Department of Human Services (DHS) estimates the
Board of Human Services will maintain the current rule-based fee
structure. If the Board of Human Services increased fees above the
current level, additional revenue would result. The bill (Sec. 247.0261)
would require DHS to review facility architectural plans and to charge a
reasonable fee for conducting such reviews. The bill (Sec. 247.0271)
would require DHS to provide specialized training to department employees
who inspect personal care facilities. The bill (Sec. 247.048) would
also require DHS to conduct periodic regional training programs related
to assisted living facilities for local governments and appropriate state
agencies.
Other Issues: It is assumed that the new classification and license
required by Sec. 247.030 would not result in a net increase in the
number of licensed facilities and would not result in increased revenue.
Current statute charges DHS (along with the Office of the Attorney
General) to enforce licensure requirements identified in Section 6 of
the bill. It is assumed that both agencies would continue to enforce
licensure standards within current funding and FTE levels. Potentially,
heightened regulatory efforts could generate additional revenue through
collection of licensing fees or civil monetary penalties. Section 8 of
the bill would require DHS to develop and implement a new reimbursement
method for assisted living facilities funded through the Community-based
Alternatives Medicaid waiver. It is assumed that the new method
developed by the agency would be budget neutral.
Methodology
It is assumed that DHS will begin licensing facilities serving three
persons March 1, 2000, the number of facilities serving three persons
will increase each year, and one additional surveyor will be needed for
every 60 facilities seeking an original or renewed license.
Consequently, regulation of facilities with three persons would require
3.0 additional FTEs in FY 2000, 6.2 in FY 2001, 6.6 in FY 2002, 7.0 in FY
2003, and 7.5 in FY 2004 (compared to FY 1999). It is assumed that the
starting salary for a surveyor (B-10) would total $33,900 per year,
travel expenditures would total $8,475 per year, and one-time start-up
costs would total $2,500 per new FTE. Licensure of each facility serving
three persons would generate $109 ($100 flat fee, plus $3 per bed) of
new revenue per year.
It is assumed that DHS would begin reviewing facility architectural plans
March 1, 2000. The workload would require an additional one-half FTE
(architect) at DHS in FY 2000, and one FTE in FY 2001 and subsequent
years (compared to FY 1999). It is assumed that the starting salary for
an architect (B-12) would total $38,508 per year, travel expenditures
would total $3,850 per year, and one-time start-up costs would total
$2,500. It is assumed that DHS would collect $150 from each facility
requesting an architectural review. New fee collections would be
deposited to a new, dedicated Assisted Living Account in the General
Revenue Fund.
It is assumed that DHS would provide specialized training beginning March
1, 2000. It is assumed this activity would require an additional
one-half FTE (trainer) at DHS in FY 2000, and one FTE in FY 2001 and
subsequent years (compared to FY 1999). It is assumed that the starting
salary for an trainer (B-11) would total $36,132 per year, travel
expenditures would total $7,500 per year, and one-time start-up costs
would total $2,500.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies:
LBB Staff: JK, TP, AZ, PP