LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
February 28, 2001
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB895 by Coleman (Relating to a demonstration project to
provide certain medications and related services through
the medical assistance program.), As Introduced
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB895, As Introduced: positive impact of $62,297 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 $537,491 *
* 2003 (475,194) *
* 2004 (3,187,060) *
* 2005 (6,120,673) *
* 2006 (9,275,879) *
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All Funds, Five-Year Impact:
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*Fiscal Probable Probable Probable Change in *
* Year Savings/(Cost) Savings/(Cost) Savings/(Cost) Number of State *
* from General from GR Match from Federal Employees from *
* Revenue Fund for Medicaid Funds - Federal FY 2001 *
* 0001 0758 0555 *
* 2002 $19,609,900 $(19,072,409) $(27,916,290) 72.0 *
* 2003 39,219,799 (39,694,993) (58,439,513) 137.6 *
* 2004 39,219,799 (42,406,859) (62,499,930) 137.6 *
* 2005 39,219,799 (45,340,472) (66,913,206) 137.6 *
* 2006 39,219,799 (48,495,678) (71,659,843) 137.6 *
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Technology Impact
The Department of Human Services (DHS) would require 12,000 hours of
programming to adapt the eligibility system for a one-time cost of
$1,320,000. National Heritage Insurance Company (via the Texas
Department of Health) would require $71,500 per year for processing of
claims.
Fiscal Analysis
The bill would amend Chapter 32, Medical Assistance Programs (Medicaid),
Human Resources Code by establishing a demonstration project for a
period of five years. The demonstration project, through Medicaid,
would provide eligible persons with a limited benefit package of
psychotropic medications and related laboratory and physician services
necessary to conform to a prescribed medical regime for those
medications. Eligible persons would be those between the ages of 19 and
64, with incomes below 200 percent of the federal poverty level, and
have been diagnosed with schizophrenia or bipolar disorder.
Methodology
1. The bill would provide a limited benefits package of physician,
laboratory, and medication services to persons with schizophrenia or
bipolar disorder. It is assumed that no more than 21,000 total clients
would be served in the waiver. It is also assumed that benefits are
limited but the participants are not subject to the monthly three
prescription limit under the Medicaid program. The average cost for
services is assumed to be $3,821 per month, as found in the waiver
application to HCFA dated October 2000. The federal matching rate is
assumed to be 60.20% in FY 2002, 60.08% in FY 2003 and 60.07% in the
remaining years.
2. General Revenue savings in the table above results from no longer
serving 12,697 clients in General Revenue funded programs at the
Department of Mental Health and Mental Retardation (MHMR). It is assumed
that these clients would be served in the new waiver program.
3. DHS would need and additional 66 FTEs in FY 2002 and an additional
131.6 in FYs 2003-06 for additional eligibility workers. Average cost per
FTE would be $39,178. MHMR would need an additional 6 FTEs at an
average cost of $64,832. Average costs include salaries, benefits, and
operating expenses.
4. There is an assumption of a six month phase-in period for FY 2002.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: 529 Health and Human Services Commission, 324
Texas Department of Human Services, 501 Texas
Department of Health, 655 TX Dept. of Mental
Health & Mental Retardation
LBB Staff: JK, HD, MB