LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 77th Regular Session
                                Revision 1
  
                            February 27, 2001
  
  
          TO:  Honorable Patricia Gray, Chair, House Committee on Public
               Health
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB1087  by Coleman (Relating to a demonstration project
               to establish a medical assistance buy-in program for
               certain persons with disabilities.), As Introduced
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  HB1087, As Introduced:  positive impact of $244,385 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 Net Impact:
  
          ****************************************************
          *  Fiscal Year  Probable Net Positive/(Negative)   *
          *               Impact to General Revenue Related  *
          *                             Funds                *
          *       2002                             $(4,253)  *
          *       2003                              248,638  *
          *       2004                                    0  *
          *       2005                                    0  *
          *       2006                                    0  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
**************************************************************************
*Fiscal    Probable Revenue         Probable             Probable        *
* Year     Gain/(Loss) from    Savings/(Cost) from  Savings/(Cost) from  *
*        General Revenue Fund    Federal Funds -       GR Match for      *
*                0001                Federal             Medicaid        *
*                                     0555                 0758          *
*  2002               $183,600           $(718,147)           $(187,853) *
*  2003                367,200            (214,188)            (118,562) *
*  2004                      0                    0                    0 *
*  2005                      0                    0                    0 *
*  2006                      0                    0                    0 *
**************************************************************************
  
Technology Impact
  
For the demonstration project, the Department of Human Services estimates
an automation cost of $715,000 for FY2002 and $71,500 for FY2003.
  
  
Fiscal Analysis
  
The bill would provide for a demonstration project for a medical
assistance buy-in for certain recipients with disabilities in accordance
with the federal Ticket to Work and Work Incentives Improvement Act of
1999.
Eligibles would include persons who are (1) at least 16 but not more than
64 and have earned income which exceeds the limit for SSI but are
otherwise eligible, and (2) employed with a medically improved
disability.
The bill would authorize the department to set income, assets, and
resource limitations for purposes of the demonstration project.
The bill would provide for cost-sharing.
The bill would require the department to evaluate the effectiveness of
the project by December 1, 2002.
The bill would expire on September 1, 2003.
  
  
Methodology
  
1.  It is assumed that funding related to the evaluation and to the
required systems changes at the Department of Human Services would be
funded with federal funds made available specifically for infrastructure
relating to "Ticket to Work."
2.  Client medical benefits were estimated using a category relating to
disabled persons and include the full package of medical assistance
benefits.
3.  It is assumed that 270 clients are currently receiving Medicaid but
would return to work and participate in this program and 30 clients are
clients new to the Medicaid program.  It is assumed all clients would
contribute in cost sharing as follows: 150 clients would pay $68 per
month, and 150 clients would pay $136.
4. The project would begin providing services on March 1, 2002.
  
  
Local Government Impact
  
No fiscal implication to units of local government is anticipated.
  
  
Source Agencies:   655   TX Dept. of Mental Health & Mental Retardation,
                   324   Texas Department of Human Services, 529
                   Health and Human Services Commission, 501   Texas
                   Department of Health
LBB Staff:         JK, WP, HD, AJ, KF