LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session February 20, 2001 TO: Honorable Pat Haggerty, Chair, House Committee on Corrections FROM: John Keel, Director, Legislative Budget Board IN RE: HB778 by Uher (Relating to the responsibility for payment of costs incurred in providing certain medical, dental, or health-related services to a state prisoner held in county jail.), As Introduced ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * HB778, As Introduced: negative impact of $(33,389,117) 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. * ************************************************************************** General Revenue-Related Funds, Five-Year Impact: **************************************************** * Fiscal Year Probable Net Positive/(Negative) * * Impact to General Revenue Related * * Funds * * 2002 $(15,581,588) * * 2003 (17,807,529) * * 2004 (17,807,529) * * 2005 (17,807,529) * * 2006 (17,807,529) * **************************************************** All Funds, Five-Year Impact: *************************************************************************** *Fiscal Probable Savings/(Cost) from Change in Number of State * * Year General Revenue Fund Employees from FY 2000 * * 0001 * * 2002 $(15,581,588) 0.0 * * 2003 (17,807,529) 0.0 * * 2004 (17,807,529) 0.0 * * 2005 (17,807,529) 0.0 * * 2006 (17,807,529) 0.0 * *************************************************************************** Fiscal Analysis The bill would require the state to reimburse a county or hospital district at reasonable cost for any necessary medical, dental or health-related services received by a person confined in county jail awaiting transfer to a confinement facility operated by or under contract with the Texas Department of Criminal Justice (TDCJ), the Texas Youth Commission or awaiting a hearing before a parole panel or a designated agent of the Board of Pardons and Paroles. The bill would require the Texas Department of Health (TDH) to establish guidelines, not later than October 1, 2001, for the state to determine whether a medical, dental, or health-related service is necessary and whether a cost is reasonable. After the Comptroller of Public Accounts reviews and determines that a certification of reimbursement submitted by a county judge complies with the guidelines established by TDH, the bill would require the Comptroller to issue the commissioner's court a warrant in the amount of the reasonable costs for the necessary services provided. The bill would take effect immediately if it receives two-thirds vote of members in each house, otherwise the bill becomes effective September 1, 2001. Even if the bill receives a two-thirds vote in each house and takes effect immediately, it would only apply to costs that are incurred on or after October 15, 2001. Methodology During the last twelve months for which data is available (February 29, 2000 to January 31, 2001), an average of 5,015 parole violators and 3,620 "paper ready" inmates were being held in county jails either awaiting a revocation decision by the Board of Pardons and Paroles or transfer to incarceration in a TDCJ facility. During fiscal year 2000, the average medical and dental care cost for inmates incarcerated by TDCJ was $5.65 per day. Applying this cost to the average number of inmates affected gives an annual estimated cost of $17,807,529 (8,635 inmates x 365 day/year x $5.65/day). For fiscal year 2001, the estimate is prorated since the bill would only apply to costs incurred on or after October 15, 2001 ($17,807,529 x 10.5 months/12 months = $15,581,588). It is assumed that any administrative costs the Department of Health may incur associated with implementing the provisions of the bill would be absorbed within its existing resources. Local Government Impact Under current statute, the jails and hospital districts incur expenses for health services provided to offenders and are reimbursed only if the offender is able to pay or has insurance or other means that cover the expenses. Under the provisions of the bill, county jails and hospital districts would be reimbursed by the state for the reasonable costs incurred in providing health care services. The county jails and hospitals would be able to recover more of their costs from the state than they are recovering directly from offenders or from subrogation, experiencing a positive fiscal impact. The Texas Commission on Jail Standards, based on a sampling of county comprehensive annual reports that provide medical cost data, estimates the average medical care cost for offenders in county jails at $2.27 per day. At a minimum, county jails would be reimbursed these expenses for offenders awaiting transfer to a TDCJ facility or awaiting a hearing before a parole panel or a designated agent of the Board of Pardons and Paroles. Applying this rate to the 8,635 offenders noted above, gives an annual cost savings of $7,154,529. For fiscal year 2001, the estimate savings are prorated to $6,260,213 since the bill would only apply to costs incurred on or after October 15, 2001 ($7,154,529 x 10.5 months/12 months = $6,260,213). The cost savings per county would vary depending on the number of eligible inmates held by the county and their eligible health care costs. Source Agencies: 409 Texas Commission on Jail Standards, 694 Texas Youth Commission, 696 Texas Department of Criminal Justice, 501 Texas Department of Health, 304 Comptroller of Public Accounts LBB Staff: JK, JC, VS, DB, RM