LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
Revision 1
April 19, 2001
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB896 by Coleman (Relating to a demonstration project to
provide certain service and medications through the
medical assistance program to persons with HIV infection
or AIDS.), Committee Report 1st House, Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB896, Committee Report 1st House, Substituted: positive impact *
* of $63,096 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 $(298,452) *
* 2003 361,548 *
* 2004 361,548 *
* 2005 361,548 *
* 2006 361,548 *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Probable Probable Probable *
* Year Savings/(Cost) Savings/(Cost) Savings/(Cost) Savings/(Cost) *
* from Counties from Federal from GR for HIV from Federal *
* Funds - Services Funds - (HIV) *
* (Medicaid) 8005 Federal *
* Federal 0555 *
* 0555 *
* 2002 $(7,688,602) $(12,289,493) $361,548 $724,183 *
* 2003 (7,711,784) (11,606,311) 361,548 724,183 *
* 2004 (7,713,715) (11,604,380) 361,548 724,183 *
* 2005 (7,713,715) (11,604,380) 361,548 724,183 *
* 2006 (7,713,715) (11,604,380) 361,548 724,183 *
***************************************************************************
*****************************************************
* Fiscal Year Probable Savings/(Cost) from GR *
* Match for Medicaid *
* 0758 *
* 2002 $(660,000) *
* 2003 0 *
* 2004 0 *
* 2005 0 *
* 2006 0 *
*****************************************************
Technology Impact
The Department of Human Services (DHS) estimates 12,000 hours of
programming at a cost of $110 per hour, for a total of $1,320,000 for FY
2002.
Fiscal Analysis
The bill would provide for a demonstration project to provide certain
medical services and medications through the Medicaid program for
certain persons with HIV infection or AIDS. The medical services would
include services provided by a physician, physician assistant, advanced
practice nurse, or other health care provider, other medications
necessary for the treatment of HIV or AIDS, certain vaccinations,
certain gynecologic services, hospitalizations, and other laboratory
services. The demonstration project would be established in at least a
two counties with a high prevalence of HIV and AIDS. A person would be
eligible if the person is diagnosed with HIV or AIDS by a physician, is
under 65 years of age, has a net family income that is at or below 200%
of federal poverty level, is a resident in the county where the project
is being conducted, is not adequately covered by a health benefits plan,
and is not otherwise eligible for medical assistance. The participants
would not be subject to a three prescription limit per month. The bill
states that the demonstration project would not create an entitlement.
The bill would require the department to submit a biennial report to the
legislature and evaluate the cost-effectiveness of the program. The
project would be financed with local funds serving as match for federal
funds. The project would expire on September 1, 2007. The effective date
is September 1, 2001.
Methodology
Based upon the Texas Department of Health's (TDH) estimates, it is
assumed 2700 clients will participate in the project and the annual cost
of outpatient services would be $4,306 per client. TDH also estimates the
cost of a hospitalization stay for a person with AIDS or HIV is $10,555,
based upon cost data from the University of Texas Medical Branch at
Galveston. TDH estimates 15% of the participants will require 1.8
hospitalization stays per year.
According to the Department of Health, the AIDS Drug Assistance Program
(ADAP) already funds anti-retroviral drug treatments for the majority of
these clients, thus there will be no significant impact to this program.
There will be a savings to the Department of Health's HIV program that
provides grants composed of State and federal funds to local entities and
other providers. TDH estimates 80% of these clients would be eligible
for the demonstration project for a cost savings of $1,085,731, composed
of State and federal funds.
It is assumed services provided through the demonstration project would
satisfy the maintenance of effort requirement for the HIV Care Formula
Grant.
Local Government Impact
See table above for impact to affected counties.
Source Agencies: 529 Health and Human Services Commission, 324
Texas Department of Human Services, 501 Texas
Department of Health
LBB Staff: JK, HD, AJ