LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session April 17, 2001 TO: Honorable Patricia Gray, Chair, House Committee on Public Health FROM: John Keel, Director, Legislative Budget Board IN RE: HB803 by Junell (Relating to reimbursement for services provided by registered nurse first assistants.), Committee Report 1st House, Substituted ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * HB803, Committee Report 1st House, Substituted: an impact of $0 * * 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 $0 * * 2003 0 * * 2004 0 * * 2005 0 * * 2006 0 * **************************************************** All Funds, Five-Year Impact: ************************************************************************** *Fiscal Probable Probable Revenue Change in Number of * * Year Savings/(Cost) from Gain/(Loss) from State Employees from * * General Revenue Fund General Revenue Fund FY 2001 * * 0001 0001 * * 2002 $(83,198) $83,198 2.0 * * 2003 (78,615) 78,615 2.0 * * 2004 (81,093) 81,093 2.0 * * 2005 (83,664) 83,664 2.0 * * 2006 (86,312) 86,312 2.0 * ************************************************************************** Fiscal Analysis The bill would amend the Occupations Code by adding a new Section that requires the Board of Nurse Examiners (BNE) to adopt rules for the approval of Nurse First Assistants. The provisions of the bill would allow certification by an outside organization recognized by the BNE, setting guidelines for the approval process and monitoring continuing education beyond the existing requirements of a registered nurse. The bill would take effect September 1, 2001. Methodology BNE estimates it will need two additional Full-time Equivalent Positions (FTEs). BNE estimates they will need one full time program specialist to develop rules, interpret the rules, approve applications and answer practice questions. It would also requires one full time administrative technician to support the program specialist and to answer administrative questions regarding registration, renewal and continuing education requirements, which mirrors that of the Advanced Nurse Practitioner program. BNE currently has over 9,000 registered nurses who have provided statistical information they are working in an operating room environment. BNE assumes they will have to promulgate rules to implement this program which will require additional travel funds for a representative of the BNE. BNE assumes it will have to develop an approval mechanism by which each Nurse First Assistant will have to register with the BNE and create and maintain on ongoing program to re-register and update the registrant's status and monitor their continuing education requirements. It is assumed the BNE would adjust fees to cover the cost of implementing the bill. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies: 454 Texas Department of Insurance, 529 Health and Human Services Commission, 507 Board of Nurse Examiners LBB Staff: JK, HD, DE