LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
May 26, 2001
TO: Honorable Bill Ratliff, Lieutenant Governor
Honorable James E. "Pete" Laney, Speaker of the House
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB154 by Thompson (Relating to the personal needs
allowance for certain Medicaid recipients who are
residents of long-term care facilities.), Conference
Committee Report
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB154, Conference Committee Report: negative impact of *
* $(14,367,801) through the biennium ending August 31, 2003. *
* *
* 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 *
* 2002 $(7,173,868) *
* 2003 (7,193,933) *
* 2004 (7,223,268) *
* 2005 (7,252,604) *
* 2006 (7,281,940) *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Probable Probable *
* Year Savings/(Cost) from Savings/(Cost) from Savings/(Cost) from *
* General Revenue Fund GR Match for Federal Funds - *
* 0001 Medicaid Federal *
* 0758 0555 *
* 2002 $(2,858,176) $(4,315,692) $(7,456,837) *
* 2003 (2,834,487) (4,359,446) (7,482,992) *
* 2004 (2,820,267) (4,403,001) (7,548,517) *
* 2005 (2,806,047) (4,446,557) (7,614,041) *
* 2006 (2,791,827) (4,490,113) (7,679,565) *
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Fiscal Analysis
The bill would amend Section 32.024 (v), Human Resources Code, by adding
a new subsection requiring the Department of Human Services (DHS) to set
a personal needs allowance (PNA) of not less than $60.00 per month
(currently $45.00 per month) for residents in a convalescent or nursing
home or related institution licensed under Chapter 242, Health and
Safety Code, personal care facility, Intermediate Care Facility/Mental
Retardation, ICF/MR, facility, or other similar long-term care facility
that receives medical assistance.
Methodology
The DHS estimate was based on the projected census of Nursing Facilities,
Personal Care Facilities and ICF/MR facilities per year for fiscal years
2002 to 2006 multiplied by the number of months per year (12) and the
need allowance difference ($60.00 - $45.00 = $15.00) per month. The cost
for Supplemental Security Income clients is 100 percent State, while the
cost for Medical Assistance Only is Medicaid matchable.
The Texas Department on Mental Health and Mental Retardation (MHMR)
estimated that of the 14,371 residents in ICF/MR facilities who would be
eligible for an increase in the personal needs allowance an estimated
8,501 would have income and thus qualify for the increase. The annual
increase in costs was calculated by multiplying the number of consumers
times the proposed $15 increase in the PNA. Currently, the PNA for
residents who earn no income is funded entirely with General Revenue.
The MHMR estimate also included 53 consumers in the state hospitals who
would also be eligible for an increase in the PNA. DHS included the cost
for the remaining 5,870 consumers out of the 14,371, in ICF/MR
facilities in their analysis.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: 324 Texas Department of Human Services, 655 TX
Dept. of Mental Health & Mental Retardation
LBB Staff: JK, HD, ML