LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session February 26, 2001 TO: Honorable Patricia Gray, Chair, House Committee on Public Health FROM: John Keel, Director, Legislative Budget Board IN RE: HB246 by Turner, Bob (Relating to the creation and funding of the Rural Communities Health Care Investment Program to attract and retain rural health care professionals.), As Introduced ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * HB246, As Introduced: an impact of $0 through the biennium ending * * August 31, 2003, for both an immediate effective date and a * * September 1, 2001, effective date. * * * * The bill would make no appropriation but could provide the legal * * basis for an appropriation of funds to implement the provisions of * * the bill. * ************************************************************************** All Funds, Six-Year Impact: ************************************************************************** *Fiscal Probable Probable Revenue Change in Number of * * Year Savings/(Cost) from Gain/(Loss) from State Employees from * * Rural Communities Rural Communities FY 2001 * * Health Care Health Care * * Investment Program Investment Program * * Trust Fund Trust Fund * * 2001 $0 $0 0.0 * * 2002 (400,000) 400,000 1.0 * * 2003 (400,000) 400,000 1.0 * * 2004 (400,000) 400,000 1.0 * * 2005 (400,000) 400,000 1.0 * * 2006 (400,000) 400,000 1.0 * ************************************************************************** The table above assumes an immediate effective date. A three month implementation period is assumed. All Funds, Five-Year Impact: The table below assumes a September 1, 2001, effective date. Again, a three month implementation period is assumed. ************************************************************************** *Fiscal Probable Probable Revenue Change in Number of * * Year Savings/(Cost) from Gain/(Loss) from State Employees from * * Rural Communities Rural Communities FY 2001 * * Health Care Health Care * * Investment Program Investment Program * * Trust Fund Trust Fund * * 2002 $(300,000) $300,000 0.8 * * 2003 (400,000) 400,000 1.0 * * 2004 (400,000) 400,000 1.0 * * 2005 (400,000) 400,000 1.0 * * 2006 (400,000) 400,000 1.0 * ************************************************************************** Fiscal Analysis The bill would amend Chapter 106, by adding Subchapter H, of the Health and Safety Code to create and fund the Rural Communities Health Care Investment Program. The purpose of the program would be to attract and retain rural health care professionals, not necessarily physicians. The bill would create the Rural Communities Health Care Investment Program Trust Fund, a dedicated general revenue account, to award stipends and loan reimbursements which would be administered by the Center for Rural Health Initiatives (CRHI). The bill would have an immediate effective date if it receives the necessary two-thirds vote in each chamber. Otherwise, the bill would have an effective date of September 1, 2001. Methodology The bill would establish the Loan Reimbursement and Stipend Programs under the CRHI to provide loan reimbursements and stipends to health professionals who agree to serve in medically underserved communities. The health professional would be required to sign a contract, outlining the time period to be served and provisions for noncompliance, with the CRHI for the loan reimbursement or stipend. An initial implementation period of three months is assumed for both effective dates. According to the CRHI, one full-time equivalent (FTE) would be required to implement and administer these programs. Total salary of one FTE for the 2002-003 biennium is $75,784 with an immediate effective date, and $66,451 with a September 1, 2001, effective date. Other operating costs, including travel, rent, and employee benefits for the biennium total $41,231 with an immediate effective date and $36,117 with a September 1, 2001, effective date. Equipment costs are estimated at $3,000 in FY2002 only. Revenues to the Rural Communities Health Care Investment Program Trust Fund could be derived from public and private gifts and grants. It is assumed the trust fund could receive $400,000 per year in revenue, except with a September 1, 2001, effective date where $300,000 in revenue in FY2002 is assumed because of start-up. Total revenues and expenditures for the 2002-03 biennium are estimated to be $800,000 for immediate effect and $700,000 for a September 1, 2001, effective date. The bill would create an advisory committee to assist in the CRHI's duties related to the Rural Communities Health Care Investment Program. Reimbursement for travel and related expenses for the advisory committee would have to be authorized in the General Appropriations Act. Local Government Impact No fiscal implication to units of local government is anticipated, however, the bill states the CRHI may encourage a medically underserved community served by a program recipient to contribute to the cost of the loan reimbursement or stipend, when feasible. Source Agencies: 50A Center for Rural Health Initiatives, 304 Comptroller of Public Accounts, 781 Texas Higher Education Coordinating Board LBB Staff: JK, HD, RM