LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
April 30, 2001
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB1702 by Green (Relating to immunizations and the
immunization registry.), Committee Report 1st House,
Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB1702, Committee Report 1st House, Substituted: negative impact *
* of $(447,826) 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. *
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General Revenue-Related Funds, Five-Year Net Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2002 $(226,418) *
* 2003 (221,408) *
* 2004 (161,054) *
* 2005 (146,698) *
* 2006 (146,698) *
****************************************************
All Funds, Five-Year Impact:
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*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 $(226,418) $(439,517) 3.0 *
* 2003 (221,408) (429,793) 4.0 *
* 2004 (161,054) (312,634) 4.0 *
* 2005 (146,698) (284,765) 4.0 *
* 2006 (146,698) (284,765) 4.0 *
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Technology Impact
One time cost include $40,000 for telecommunications/computer consulting
contract and $12,600 for personal computers, a laser printer and label
printer
Fiscal Analysis
The bill would require the Department of Health (TDH) to develop and
provide an exemption form for a person who declines a required
immunization for reasons of conscience or a religious belief. TDH would
also be required to provide instructions to a parent, managing
conservator, or guardian to request TDH not to send future notices of a
child's need for immunizations and to remove the child's immunization
record from the registry and all department files. TDH would be required
to destroy a child's immunization records no later than the 30th day
after receiving a written request to exclude the child's records from the
registry. The bill would also require TDH to notify a parent, managing
conservator, or guardian when TDH receives immunization data for a child
the first time or when TDH receive an exclusion request and has removed
the child's records from the registry.
The bill would allow TDH to receive immunization data from an insurance
company, a health maintenance organization or any other organization that
pays or reimburses a claim for immunization or any physician, health
care professional, or health care facility personnel licensed or
authorized to administer vaccines. The bill would require all public
schools to maintain a record of personal or religious exemption and to
submit a report annually to TDH stating the number and type of exemption
on file for children attending the school and exercising the exemption.
The bill would require TDH to submit a report to the Legislative Budget
Board and Governor no later than September 30 of each even-numbered year.
The bill would require all public schools to maintain a record of
personal or religious exemption and to submit a report annually to TDH
stating the number and type of exemption on file for children attending
the school and exercising the exemption. The bill would require TDH by
rule to develop guidelines to encourage schools to become authorized by
TDH to use the ImmTrac immunization registry.
Methodology
TDH assumes a three month start-up period. According to TDH, four
additional FTEs would be need to implement the provisions of the bill.
TDH estimates salary and benefits would total $106,135 in FY 2002, and
$141,513 in FYs 2003-06. TDH estimates costs would also include:
$144,975 in FY 2002, $217,463 in FY 2003 and $289,950 in FY 2004-06, for
printing and postage for various forms and notices required by the bill
and $50,000 to develop and print a scannable form for physician offices
or facilities without computers/internet connection. TDH estimate costs
would also include $250,000 in FYs 2002-03, for a marketing campaign for
education and awareness and $42,225 in FYs 2002-04, for educational tool
kits for providers on the immunization registry. TDH indicates other
cost would include travel, and other operating expenses. Although
included in TDH's cost estimates, reimbursement for travel and related
expenses for council members would have to be authorized by the General
Appropriations Act. The Department of Protective and Regulatory
Services indicates costs could be absorbed within existing resources.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated. School districts would be required to maintain copies of
exemption documents and submit annual reports to the Texas Department of
Health concerning the number and types of exemptions granted for students
attending the school. School districts are required under current law
to maintain an individual immunization record for each student. Based on
anecdotal evidence from several school districts, it is believed that
the practice of documenting the lack of an immunization record for an
individual exempted under current law is common. Because some type of
documentation currently appears to be maintained even for students who
lack immunization records, it is assumed the revised requirement would
not result in significant new costs to school districts.
School district immunization data reported on the Texas Department of
Health website indicates that 97% of public school students are
immunized. Accordingly, the number of exemptions to be maintained and
reported would be relatively small at any given school. It is assumed
that exemption data would be reported along with immunization data.
Based on the very small population of students likely to have an
exemption and the likelihood of combined reporting, the cost of annually
reporting exemption data is not anticipated to be significant.
Source Agencies: 701 Texas Education Agency, 530 Department of
Protective and Regulatory Services, 501 Texas
Department of Health
LBB Staff: JK, HD, KF, RM