LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
April 18, 1999
TO: Honorable Judith Zaffirini, Chair, Senate 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.), As
Introduced
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB369, As Introduced: negative impact of $(7,385,145) 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 $(3,662,958) *
* 2001 (3,722,187) *
* 2002 (3,849,894) *
* 2003 (3,985,265) *
* 2004 (4,128,757) *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Probable Probable Probable *
* Year Revenue Savings/(Cost) Savings/(Cost) Savings/(Cost) *
* Gain/(Loss) from General from General from General *
* from General Revenue Fund Revenue Fund ( Revenue Fund *
* Revenue Fund 0001 Medicaid Match) (Medicaid *
* 0001 0001 Match) *
* 0001 *
* 2000 $16,500 $(688,431) $(3,248,772) $257,745 *
* 2001 16,500 (475,200) (3,521,232) 257,745 *
* 2002 16,500 (490,385) (3,633,754) 257,745 *
* 2003 16,500 (506,482) (3,753,028) 257,745 *
* 2004 16,500 (523,544) (3,879,458) 257,745 *
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*Fiscal Probable Savings/(Cost) from Probable Savings/(Cost) from *
* Year Federal Funds (Medicaid) Federal Funds (Medicaid) *
* 0555 0555 *
* 2000 $(5,081,413) $403,140 *
* 2001 (5,507,568) 403,140 *
* 2002 (5,683,564) 403,140 *
* 2003 (5,870,121) 403,140 *
* 2004 (6,067,870) 403,140 *
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Technology Impact
The bill would require programming changes on automation systems at the
Department of Human Services (DHS) and the Texas Education Agency (TEA).
It is assumed these costs could be absorbed within existing resources,
with the exception of revisions to the Child Nutrition Program
Information Management System. TEA estimates this effort would require
a one-time appropriation of $250,000 General Revenue.
Fiscal Analysis
The bill would continue the existence of DHS until August 31, 2007, make
numerous changes in agency operations, transfer contested case hearings
to the State Office of Administrative Hearings, and transfer several
nutrition programs to TEA. All transfers including funding and FTE
positions are assumed to have no net fiscal impact unless otherwise noted
below.
Section 10 of 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.
Section 12 would require DHS to perform presumptive eligibility for
certain community care programs, resulting in increased enrollment in the
Frail Elderly program and the Community-based Alternatives (CBA)
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. Note: Increased enrollment in the Frail Elderly
and CBA programs would require additional expenditures for acute care
and/or prescription drugs at the Department of Health. These costs have
not been included in this fiscal estimate. With further analysis, these
costs will be added.
Section 12 would require DHS to assess the needs of persons placed on a
waiting list for community care services. This would increase workload,
as the department does not currently perform this activity. However, it
is assumed the level of assessment would be minimal and therefore the
department could perform the new responsibility using existing resources.
If persons with higher levels of need are given priority for services,
the average cost per person for affected programs would likely increase.
Sections 22 and 24 would increase licensing fees, resulting in increased
revenue of $16,500 per year. Section 27 would transfer the Summer Food
Program to TEA, resulting in a one-time additional cost of $250,000
General Revenue, according to TEA.
Methodology
It is estimated implementation of presumptive eligibility (Section 12)
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-five 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 5 percent of additional clients would not qualify for Medicaid;
their benefits would be paid with unmatched General Revenue.
Presumptive eligibility would increase enrollment in the CBA program by
1.7 percent over the otherwise anticipated caseload. Therefore
enrollment would increase by 361 clients in fiscal year 2000 and in each
subsequent year. Ninety-five percent of additional clients would
qualify for Medicaid benefits, but 5 percent would not.
As a partial offset to these costs, it is assumed that 8 percent of the
additional clients in CBA would have been diverted from nursing facility
care, which is estimated to cost $22,896 per client per year. Therefore,
presumptive eligibility would reduce enrollment in nursing facilities by
29 clients in fiscal year 2000 and in each subsequent year, resulting in
an annual savings of $660,885 each year.
Section 24: Change in License Renewal Fees for Nursing Facility
Administrators
The bill would increase fees for approximately 112 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: 308 State Auditor's Office, 301 Office of the
Governor, 530 Department of Protective and
Regulatory Services, 360 State Office of
Administrative Hearings, 324 Department of Human
Services, 116 Sunset Advisory Commission, 701
Texas Education Agency - Administration
LBB Staff: JK, TH