LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
May 22, 1999
TO: Honorable Elliott Naishtat, Chair, House Committee on
Human Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB369 by Zaffirini (Relating to the continuation and
functions of the Texas Department of Human Services),
Committee Report 2nd House, Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB369, Committee Report 2nd House, Substituted: negative impact *
* of $(4,360,043) 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:
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* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2000 $(2,007,964) *
* 2001 (2,352,079) *
* 2002 (2,494,194) *
* 2003 (2,644,835) *
* 2004 (2,804,515) *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Probable (Cost) Probable (Cost) Probable (Cost) *
* Year Revenue Gain to to General to General to Federal *
* General Revenue Revenue Fund Revenue Fund Funds *
* Fund 0001 (Medicaid (Medicaid) *
* 0001 Match) 0555 *
* 0001 *
* 2000 $16,500 $(86,527) $(1,937,937) $(3,031,133) *
* 2001 16,500 (101,235) (2,267,344) (3,546,359) *
* 2002 16,500 (107,309) (2,403,385) (3,759,140) *
* 2003 16,500 (113,747) (2,547,588) (3,984,689) *
* 2004 16,500 (120,572) (2,700,443) (4,223,770) *
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Technology Impact
The bill would require programming changes to information systems at the
Department of Human Services (DHS). It is assumed these costs could be
absorbed within existing resources.
Fiscal Analysis
The bill would continue the existence of DHS until August 31, 2011, make
numerous changes in agency operations, and transfer contested case
hearings to the State Office of Administrative Hearings. All changes,
including funding and FTE position transfers, are assumed to have no net
fiscal impact unless otherwise noted below.
The bill would require DHS to assist a recipient of financial assistance
to assess the needs of the recipient and those of the recipient's family
that, if addressed, would help the recipient and the recipient's family
attain and retain independence, and to refer the recipient and the
recipient's family to appropriate preventative and support services. It
is assumed that assistance and referral services provided by DHS would be
limited in scope and duration. Consequently, the department could
comply with the provision without requiring additional resources.
The bill would require DHS to perform presumptive eligibility for certain
community care programs, resulting in increased enrollment in the Frail
Elderly program. Most of the increased cost would be paid with Medicaid
funding. However, a portion of the additional clients would be
determined (subsequent to enrollment) to be ineligible for Medicaid. It
is assumed the department would continue to provide benefits for these
clients using General Revenue alone. Increased enrollment in the Frail
Elderly program would require additional expenditures for acute care at
the Department of Health. These costs have been included in this fiscal
estimate.
The bill would increase licensing fees, resulting in increased revenue of
$16,500 per year.
Methodology
It is estimated implementation of presumptive eligibility would increase
enrollment in the Frail Elderly program by 2.6 percent over the otherwise
anticipated caseload. Therefore, enrollment would increase by 721
clients in fiscal year 2000, 844 in 2001, 894 in 2002, 948 in 2003, and
1,005 in 2001. The average annual cost per client is estimated to be
$6,000. Ninety-eight percent of additional clients would qualify for
Medicaid benefits (paid with approximately 39 percent General Revenue,
and 61 percent matching Federal Funds). It is estimated the remaining 2
percent of additional clients would not qualify for Medicaid; their
benefits would be paid with unmatched General Revenue.
The additional number of Medicaid Frail Elderly clients would require
increased expenditures for acute care costs at the Department of Health
(TDH). The average monthly cost to TDH (including premium and
transportation) per client would total $86, resulting in an annual cost
of $729,249 in fiscal year 2000, $853,206 in 2001, $904,398 in 2002,
$958,662 in 2003, and $1,016,181 in 2004. Benefits would be paid with
approximately 39 percent General Revenue, and 61 percent matching Federal
Funds.
The bill would increase fees for approximately 112 nursing facility
administrators who renew their licenses within 90 days after expiration
by $50 resulting in an increased revenue of $5,600 per year. The bill
would increase fees for approximately 109 administrators who renew their
licenses after more than 90 days, but not longer than 1 year after
expiration, by $100--resulting in an increased revenue of $10,900 per
year.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies: 324 Department of Human Services
LBB Staff: JK, TP, PP