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