LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
May 6, 1999
TO: Honorable Jane Nelson, Chair, Senate Committee on Health
Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB458 by Moncrief (relating to the establishment of a
newborn hearing screening, tracking, and intervention
program), Committee Report 1st House, Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB458, Committee Report 1st House, Substituted: negative impact *
* of $(1,629,940) 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. *
* *
* The bill contains a provision that states that the Act would only *
* take effect if a specific appropriation for the implementation of *
* the Act is provided in the General Appropriations Act of the *
* Seventy-sixth Legislature. *
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General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2000 $(1,099,564) *
* 2001 (530,376) *
* 2002 (185,858) *
* 2003 (186,631) *
* 2004 (187,790) *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Savings/(Cost) from Probable Savings/(Cost) from *
* Year General Revenue Fund Federal Funds *
* 0001 0555 *
* 2000 $(1,099,564) $(1,172,386) *
* 2001 (530,376) (620,574) *
* 2002 (185,858) (295,142) *
* 2003 (186,631) (296,369) *
* 2004 (187,790) (298,210) *
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Technology Impact
Software licenses for the newborn hearing screening reporting software is
assumed to total $1.2 million in fiscal year 2000. The service plan for
implementation of the software, according to the Department of Health,
is $750,000 in fiscal year 2000 and $750,000 in fiscal year 2001.
Fiscal Analysis
The bill would allow a birthing facility to offer the parents of a
newborn a hearing screening for the newborn for the detection of hearing
loss. The Department of Health would be allowed to approve program
protocols, maintain data on each newborn who receives services. The
Department would be required to ensure that intervention is available to
families for a newborn identified as having hearing loss. The bill would
require the department or the department's designee to establish
certification criteria for implementing a hearing screening program. The
bill would require the Department of Health to provide each birthing
facility that provides newborn screening under the medical assistance
(Medicaid) program with the appropriate software for the program.
The bill would require the Medicaid program to provide a hearing
screening for infants in the Medicaid program.
Methodology
General Revenue and Federal Funds impact numbers in the tables above were
calculated by the Department of Health.
The Department of Health assumes new costs would be incurred by the
Medicaid program in association with the implementation of the provisions
of this bill. Increased costs in the Program for Amplification for
Children of Texas (PACT) for hearing aids, audiological assessments, etc.
These would be reimbursed at the client services matching rate
(approximately 39 percent state, 61 percent federal) .
The department assumes that distribution of software and technical
assistance would be required. The state would receive a fifty-fifty
match rate for software and training related to providing these services
for Medicaid-eligible clients.
The bill would require the department to ensure that intervention is
available to families for a newborn identified as having a hearing loss
and that the intervention is managed by state programs operating under
the Individuals with Disabilities Education Act.
The hospital reimbursement for the screen would become part of the
Diagnosis Related Group (DRG) reimbursement in the Medicaid program.
However, the Department of Health has not provided the dollar value of
this impact; therefore, the cost estimates understate the impact to the
General Revenue Fund.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies: 501 Department of Health
LBB Staff: JK, TP, KF