LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
April 22, 1999
TO: Honorable Florence Shapiro, Chair, Senate Committee on
State Affairs
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB1615 by Lucio (Relating to the creation and operation
of health services districts; granting the power of
eminent domain and the authority to issue bonds.), As
Introduced
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB1615, As Introduced: negative impact of $(4,437,000) 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 $(2,218,500) *
* 2001 (2,218,500) *
* 2002 (2,218,500) *
* 2003 (2,218,500) *
* 2004 (2,218,500) *
****************************************************
All Funds, Five-Year Impact:
**************************************************************************
*Fiscal Probable Probable Probable Revenue *
* Year Savings/(Cost) from Savings/(Cost) from Gain/(Loss) from *
* General Revenue Fund Local Local *
* 0001 *
* 2000 $(2,218,500) $(2,773,126) $2,218,500 *
* 2001 (2,218,500) (2,773,126) 2,218,500 *
* 2002 (2,218,500) (2,773,126) 2,218,500 *
* 2003 (2,218,500) (2,773,126) 2,218,500 *
* 2004 (2,218,500) (2,773,126) 2,218,500 *
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Fiscal Analysis
The bill would allow for the creation and operation of health services
districts.
A county that creates and contracts with the district would be allowed to
credit a district expenditure for the care and treatment of a county
resident who qualifies for payment on the sliding-fee scale toward
eligibility for state assistance in the County Indigent Health Care
Program even if the resident does not meet eligibility standards under
Chapter 61, Health and Safety Code.
Methodology
According to the Department of Health, the provision cited above that
would allow expenditures for clients under different eligibility
standards for counties in the health services districts towards state
assistance would result in no fiscal impact. According to the Department
of Health, when the state expends all available General Revenue in the
County Indigent Program, counties would shut down their indigent health
programs until the next state fiscal year begins.
There are no data available to this office on the number of counties that
would choose to create and contract with a health services district.
Assuming three selected counties currently participating in the County
Indigent Health Care Program elect to create and participate in a health
services district, and the counties choose to set county eligibility
standards at a 25 percent of the Federal Poverty Level, a level higher
than the current eligibility level of approximately 12 percent of the
Federal Poverty Level, then the annual increased General Revenue
expenditure would be approximately $2.2 million. If more counties elect
to create and contract with a health services district, or if
eligibility standards were raised to higher levels, then the fiscal
implications noted above would be understated.
Local Government Impact
Numbers in the table above assume increased local expenditures for the
participating counties if the income eligibility level for indigent
health care services is increased and increased offsetting revenue for
the participating counties from state matching contributions.
Source Agencies: 501 Department of Health
LBB Staff: JK, SD, TP, KF