LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
March 6, 2001
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB1516 by Janek (Relating to the provision of
catastrophic case management services under the medical
assistance program.), As Introduced
**************************************************************************
* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB1516, As Introduced: positive impact of $4,069,000 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. *
**************************************************************************
The bill would implement e-Texas recommendation HHS 16. The estimated
net savings in funding and the FTE increase are based entirely on the
fiscal note prepared by the Comptroller's Office for House Bill 1516.
In order for the savings to be realized, the Legislature would have to
reduce appropriations to the Department of Health by the corresponding
amounts.
General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2002 $865,000 *
* 2003 3,204,000 *
* 2004 4,678,000 *
* 2005 4,678,000 *
* 2006 4,678,000 *
****************************************************
All Funds, Five-Year Impact:
**************************************************************************
*Fiscal Probable Probable Change in Number of *
* Year Savings/(Cost) from Savings/(Cost) from State Employees from *
* GR Match for Federal Funds - FY 2001 *
* Medicaid Federal *
* 0758 0555 *
* 2002 $865,000 $1,419,000 1.0 *
* 2003 3,204,000 5,249,000 1.0 *
* 2004 4,678,000 7,661,000 1.0 *
* 2005 4,678,000 7,661,000 1.0 *
* 2006 4,678,000 7,661,000 1.0 *
**************************************************************************
Fiscal Analysis
The bill would require the Department of Health to develop and implement
a catastrophic case management system to be used in providing medical
assistance to persons with catastrophic health problems. The agency
would be required to report to the Legislature no later than January 15
of odd-numbered years on the implementation of the system, providing
information on the number of clients assisted through the program and
the estimated savings resulting from the program.
Methodology
The above estimate reflects the assumption of the Comptroller's Office
that case management for catastrophically ill Medicaid clients would
reduce utilization by such clients, resulting in a net savings to General
Revenue Match for Medicaid as well as to federal Medicaid funds.
The Department of Health states that providing case management services
for catastrophically ill Medicaid clients would "not produce cost
savings to the Medicaid service." The agency instead estimates a net
cost to General Revenue Match for Medicaid totaling $3,236,659 in FY
2003, and $6,367,287 in FY 2003.
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, 304 Comptroller
of Public Accounts, 501 Texas Department of Health
LBB Staff: JK, HD, PP