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:  HB896  by Coleman (Relating to a demonstration project to
               provide certain services and medications through the
               medical assistance program to persons with HIV infection
               or AIDS.), As Introduced
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  HB896, As Introduced:  negative impact of $(6,090,522) 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                         $(3,352,581)  *
          *       2003                          (2,737,941)  *
          *       2004                          (2,741,721)  *
          *       2005                          (2,741,721)  *
          *       2006                          (2,741,721)  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
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*Fiscal      Probable        Probable        Probable        Probable     *
* Year    Savings/(Cost)  Savings/(Cost)  Savings/(Cost)  Savings/(Cost)  *
*         from GR Match  from GR for HIV   from Federal    from Federal   *
*          for Medicaid      Services         Funds       Funds - (HIV)   *
*              0758            8005        -(Medicaid)       Federal      *
*                                            Federal           0555       *
*                                              0555                       *
*  2002     $(15,704,400)     $12,351,819   $(22,755,600)     $24,740,730 *
*  2003      (15,089,760)      12,351,819    (22,710,240)      24,740,730 *
*  2004      (15,093,540)      12,351,819    (22,706,460)      24,740,730 *
*  2005      (15,093,540)      12,351,819    (22,706,460)      24,740,730 *
*  2006      (15,093,540)      12,351,819    (22,706,460)      24,740,730 *
***************************************************************************
  
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, anti-retroviral drug
treatments, other medications necessary for the treatment of HIV or
AIDS, certain vaccinations, certain gynecologic services, 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 percent 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 would require the department to
submit a biennial report to the legislature and evaluate the
cost-effectiveness of the program. The project would expire on September
1, 2007. The effective date is September 1, 2001.
  
  
Methodology
  
It is assumed that 2700 clients will participate in the project and that
the annual cost of the benefit package of medications and services is
$14,000 per client.
It is assumed that the annual cost of providing medications under the
current HIV program is $13,738 per client.
It is assumed that services provided through the demonstration project
would satisfy the maintenance of effort requirement for the HIV Care
Formula Grant.
  
  
Local Government Impact
  
No significant 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
LBB Staff:         JK, HD, AJ, PP