LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
April 1, 1999
TO: Honorable Jane Nelson, Chair, Senate Committee on Health
Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB1249 by Nelson (Relating to the regulatory of
ambulatory surgical centers; providing a penalty),
Committee Report 1st House, Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB1249, Committee Report 1st House, Substituted: positive impact *
* of $111,486 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 $3,548 *
* 2001 107,938 *
* 2002 141,120 *
* 2003 156,120 *
* 2004 171,120 *
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All Funds, Five-Year Impact:
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*Fiscal Probable Probable Probable Change in *
* Year Savings/(Cost) Revenue Revenue Number of State *
* from General Gain/(Loss) Gain/(Loss) Employees from *
* Revenue Fund from General from New - GR FY 1999 *
* 0001 Revenue Fund Dedicated *
* 0001 Account - *
* Ambulatory *
* Surgical Center *
* Penalty *
* 2000 $(71,452) $75,000 $11,250 2.2 *
* 2001 (207,062) 315,000 12,375 2.7 *
* 2002 (188,880) 330,000 13,613 2.7 *
* 2003 (188,880) 345,000 14,974 2.7 *
* 2004 (188,880) 360,000 16,471 2.7 *
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Fiscal Analysis
The bill relates to the regulation of ambulatory surgical centers and
provides a penalty. The bill would authorize the Department of Health to
conduct an on-site licensing inspection of a ambulatory surgical center
every three years. The bill would allow the Department of Health to
issue an emergency order to suspend the license of an ambulatory
surgical center if the department believes the license holder's conduct
endangers the public health and safety; 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 - Ambulatory Surgical Center Penalty. The bill would allow the
department to assess expenses and costs against the license holder found
in violation for an amount based on considerations described in the
bill. If payment of the expenses and costs assessed does not occur
within the time specified in the bill, the department may refer the
matter to the attorney general for collection.
Methodology
The Department of Health estimates the annual licensing fee would be
increased by $1,500 to a cost of $2,500 per license to cover increased
cost. According to the department, the annual growth rate in the number
of ambulatory surgical centers is five percent. The estimated total
generated in annual licensing fees for fiscal years 2000-2004 would be
$1,425,500.
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 a
baseline of five incidents in fiscal year 2000 at a rate of $3,000 per
incident. According to the department, the annual growth in the number
of incidents is 10 percent and collection rate is 75 percent each fiscal
year, 2000-2004. The estimated total generated in administrative
penalties collected and deposited in the state treasury to the credit of
the general revenue fund for the same period would be $68,682.
On-site licensing inspection of ambulatory surgical centers would be
allowed under the provisions of the bill. The Department of Health
estimates that it would need 2.2 additional FTEs in fiscal year 2000 and
2.7 FTEs in fiscal years 2001-2004 to administer the survey process;
conduct on-site licensing inspections and quality assurance review of
survey documents; and provide administrative support.
According to the Office of Court Administration, any increase in workload
resulting from the provisions of the bill would be offset by the
collection of penalties, costs and expenses.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies:
LBB Staff: JK, TP, RM