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
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* 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. *
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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:
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*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