LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
April 23, 1999
TO: Honorable Judith Zaffirini, Chair, Senate Committee on
Human Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB465 by Ogden (Relating to the parental consent before
medical services are provided to a child under the state
Medicaid program), Committee Report 1st House,
Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB465, Committee Report 1st House, Substituted: negative impact *
* of $(35,526,424) 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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The bill would amend Section 32.0242 of the Human Resources Code to
prohibit spending State Medicaid funds for medical or dental care for a
minor child without the consent of a parent, guardian or person
authorized to give consent under Section 32.001 of the Family Code.
According to the Department of Protective and Regulatory Services (DPRS),
the bill would apply to children in substitute care when the department
is serving as the court-appointed managing conservator.
General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2000 $(17,470,716) *
* 2001 (18,055,708) *
* 2002 (18,687,657) *
* 2003 (19,341,725) *
* 2004 (20,018,686) *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable (Cost) from General Probable Revenue (Loss) from *
* Year Revenue Fund Federal Funds *
* 0001 0555 *
* 2000 $(17,470,716) $(17,470,716) *
* 2001 (18,055,708) (18,055,708) *
* 2002 (18,687,657) (18,687,657) *
* 2003 (19,341,725) (19,341,725) *
* 2004 (20,018,686) (20,018,686) *
***************************************************************************
Fiscal Analysis
The Department of Protective and Regulatory Services reports that the
State Medicaid Program would be prohibited from paying for children's
medical and dental care who are under the state's conservatorship.
While DPRS would still be authorized to give consent for treatment and
providers would be able to render care, the payment for care would have
to come from sources other than the State Medicaid Program.
Methodology
According to the Department of Protective and Regulatory Services, the
state would be responsible for the medical and dental care payments for
those children under its conservatorship. In their estimation, the bill
would prohibit Medicaid payments (which are 39 percent state and 61
percent federal) and the state would pay the entire amount with General
Revenue Funds.
Federal fiscal year 1998 Medicaid payments for foster care children
totaled $27.5 million in All Funds including approximately $10.6 million
in General Revenue. Cost estimates in the table above net out the state
share that would have been maintained for Medicaid payments and assume
that the state would be responsible for the entire payment. Estimates
include a 3.5 percent growth rate per year.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies: 529 Health and Human Services Commission, 501
Department of Health, 530 Department of Protective
and Regulatory Services
LBB Staff: JK, TP, AZ