LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session March 12, 2001 TO: Honorable Elliott Naishtat, Chair, House Committee on Human Services FROM: John Keel, Director, Legislative Budget Board IN RE: HB2258 by Maxey (Relating to the assessment of certain nursing home residents for mental illness or mental retardation.), As Introduced ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * HB2258, As Introduced: negative impact of $(3,326,365) 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 Impact: **************************************************** * Fiscal Year Probable Net Positive/(Negative) * * Impact to General Revenue Related * * Funds * * 2002 $(1,642,195) * * 2003 (1,684,170) * * 2004 (1,726,130) * * 2005 (1,768,090) * * 2006 (1,810,050) * **************************************************** All Funds, Five-Year Impact: *************************************************************************** *Fiscal Probable Savings/(Cost) from Probable Savings/(Cost) from * * Year General Revenue Fund Federal Funds - Federal * * 0001 0555 * * 2002 $(1,642,195) $(4,809,951) * * 2003 (1,684,170) (4,819,122) * * 2004 (1,726,130) (4,828,308) * * 2005 (1,768,090) (4,837,494) * * 2006 (1,810,050) (4,846,680) * *************************************************************************** Fiscal Analysis The bill would amend Subchapter F, Chapter 242, Health and Safety Code, by adding Section 242.158 Mental Health Assessment. The bill would require that a mental health assessment be made for each resident of a nursing home before the resident makes a transition to a community-based care setting by the Department of Human Services (DHS). The bill requires the assessment to be at least as effective as the Preadmission Screening and Resident Review (PASARR) mental illness or mental retardation assessment. Upon completion of the assessment DHS would be required to notify and provide information to the Texas Department of Mental Health and Mental Retardation (MHMR) of any resident identified as having a mental illness or mental retardation before transitioned to a community-based setting. MHMR would determine the level of need and funding for mental health services for any resident making the transition, provide mental health services after the transition is made, and refer the resident to a local mental health or mental retardation authority or private provider for additional mental health services. Methodology DHS estimated there are 350 dual eligibles (new admissions) per month and 1,500 Medicaid admissions to nursing facilities per month. DHS also estimated 5 percent, or 75, of the Medicaid admissions are currently receiving PASARR assessments. DHS estimated the cost of an assessment to be $300. DHS cost projections were $6,390,000 per year for assessments and $11,000 per year for automation costs. The Department of Mental Health and Mental Retardation estimated approximately 112 individuals per year could be assessed for mental health services through MHMR and approximately 45 persons would be Medicaid eligible and thus have some services paid through rehabilitation and case management services. MHMR cost projections, $51,146 for FY 2002 ranging to $255,730 in FY 2006, represent funds that would be contracted to the local mental health authority. Local Government Impact No fiscal implication to units of local government is anticipated. Source Agencies: 324 Texas Department of Human Services, 655 TX Dept. of Mental Health & Mental Retardation LBB Staff: JK, HD, KF, ML