LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
March 14, 2001
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB1801 by Maxey (Relating to establishment of a home
telemedicine pilot program for certain recipients of
medical assistance.), As Introduced
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB1801, As Introduced: negative impact of $(1,139,260) 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 Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2002 $(376,950) *
* 2003 (762,310) *
* 2004 (762,490) *
* 2005 (762,490) *
* 2006 0 *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Savings/(Cost) from GR Probable Savings/(Cost) from *
* Year Match for Medicaid Federal Funds - Federal *
* 0758 0555 *
* 2002 $(376,950) $(560,550) *
* 2003 (762,310) (1,125,190) *
* 2004 (762,490) (1,125,010) *
* 2005 (762,490) (1,125,010) *
* 2006 0 0 *
***************************************************************************
Fiscal Analysis
The bill would require the Department of Health (TDH) to establish a
pilot program under which certain Medicaid recipients with a chronic
illness would receive home health services through telemedicine in
addition to other home health care services for which the recipients are
eligible. Under the pilot, the agency could provide a participant with
the following home health telemedicine services: education regarding
self-care and preventive health, monitoring for compliance with
medication requirements, monitoring vital signs, counseling and social
support, and other services. Additionally, the bill would require the
agency to provide: telemedicine equipment (other than a telephone line
and telephone) that is necessary for receipt of home health care
telemedicine services at no cost to the recipient for the duration of
services, personal training and written instructions in the use and
maintenance of telemedicine equipment, frequent monitoring regarding the
quality of services and a participant's satisfaction with services, and
a report to the Legislature regarding the program December 1, 2004. The
bill would take effect September 1, 2001 and expire September 1, 2005.
Methodology
It is assumed that federal approval would allow for March 2002
implementation. It is assumed that 600 clients per month per year would
receive telemedicine services. Telemedicine services would cost $250 per
month and include the following: education by video, education by a
health professional, counseling related to depression, monitoring of
medication compliance and vital signs, and supplemental consultations.
The federal share of client services expenses would total 60.20% in FY
2002, 60.08% in FY 2003, and 60.07% in each subsequent year. A contract
related to collection and analysis of data, including an assessment of
client satisfaction, would total $37,500 in FY 2002 and $87,500 for each
subsequent year. This expense would be shared equally by the federal
government and the State.
Additional costs could result from the provision of telemedicine
equipment. However, these costs have not been estimated. Likewise,
potential improvements in the health status of waiver participants and
an associated savings in traditional health care costs have not been
estimated. It is assumed the bill applies only to TDH. If additional
Medicaid-operating agencies were affected, additional costs would
result.
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, PP