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: *************************************************************************** *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