LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 76th Regular Session
  
                                May 3, 1999
  
  
          TO:  Honorable Patricia Gray, Chair, House Committee on Public
               Health
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  SB1232  by Nelson (Relating to the regulation of birthing
               centers; providing an administrative penalty.), As
               Engrossed
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  SB1232, As Engrossed:  positive impact of $0 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.                                                             *
**************************************************************************
  
General Revenue-Related Funds, Five-Year Impact:
  
          ****************************************************
          *  Fiscal Year  Probable Net Positive/(Negative)   *
          *               Impact to General Revenue Related  *
          *                             Funds                *
          *       2000                                   $0  *
          *       2001                                    0  *
          *       2002                                    0  *
          *       2003                                    0  *
          *       2004                                    0  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
         *****************************************************
         * Fiscal Year    Probable Revenue Gain from New GR   *
         *                  Dedicated Account - Birthing      *
         *                         Center Penalty             *
         *      2000                                   $2,625 *
         *      2001                                   20,625 *
         *      2002                                   22,687 *
         *      2003                                   24,956 *
         *      2004                                   27,452 *
         *****************************************************
  
Fiscal Analysis
  
The bill would allow the Department of Health (TDH) to appoint a monitor
for a birthing center, at the center's expense, to ensure compliance
with the provisions of the bill; to deny, suspend, or revoke a license
because of a history of noncompliance; to issue an emergency order to
suspend a license; and to assess an administrative penalty.  The
provisions of the bill would provide a hearing process and require that
civil and administrative penalties collected be deposited in the state
treasury to the credit of a new General Revenue Dedicated Account -
Birthing Center Penalty. The bill would allow the department to assess
expenses and costs against a person found in violation for an amount
based on considerations described in the bill.  If the person does not
pay expenses and costs assessed within the time specified in the bill,
the department may refer the matter to the attorney general for
collection.
  
  
Methodology
  
According to the Department of Health, approximately one-third of the
cases recommended for enforcement go through the hearing process, with
the remaining cases resolved through other means.  TDH estimates that
$25,000 would have been assessed in  fiscal year 1999 if administrative
penalties had been available.  Using fiscal year 1999 as the baseline, it
is assumed that a 10 percent annual increase in the amount of
administrative penalties imposed would occur in fiscal years 2001-2004.
It is assumed that there would be a 75 percent collection rate in fiscal
years 2001-2004, with little collected in fiscal year 2000 due to time
needed for the negotiated rule making process. The department expects the
bill would not result in additional costs to TDH because it currently
performs complaint investigations and enforcement actions.

According to the Office of the Comptroller of Public Accounts, the bill
creates a new dedicated revenue source in the State Treasury which could
further restrict the Legislature's ability to appropriate revenues for
general operating purposes.
  
  
Local Government Impact
  
According to the Office of Court Administration, the bill may increase
the workload of the Travis County district courts because appeals from
administrative orders of the Department of Health would be filed by a
petition in Travis County District Court.
  
  
Source Agencies:   304   Comptroller of Public Accounts, 501
                   Department of Health, 212   Office of Court
                   Administration, 302   Office Of The Attorney General
LBB Staff:         JK, TP, RM