LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session March 19, 2001 TO: Honorable Elliott Naishtat, Chair, House Committee on Human Services FROM: John Keel, Director, Legislative Budget Board IN RE: HB2326 by Kitchen (Relating to creating a pilot case management program to provide health-related education, medical, housing, and job training services to homeless people with chronic illnesses.), As Introduced ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * HB2326, As Introduced: negative impact of $(6,033,465) 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 $(2,081,002) * * 2003 (3,952,463) * * 2004 0 * * 2005 0 * * 2006 0 * **************************************************** 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 $(2,081,002) $(2,980,189) 2.0 * * 2003 (3,952,463) (5,948,497) 2.0 * * 2004 0 0 0.0 * * 2005 0 0 0.0 * * 2006 0 0 0.0 * ************************************************************************** Technology Impact Two new computer systems, $5,000 ($2,500/employee for new computer and software) Fiscal Analysis The bill would create a pilot case management program to provide health-related education, medical, housing, and job training services to homeless persons with chronic illnesses. It is assumed the Department of Housing and Community Affairs (TDHCA) would be responsible for the administration of all homeless services in the State and for oversight of the Texas Interagency Council for the Homeless (TICH). The bill would be effective immediately if it receives the necessary two-thirds vote in each chamber. Otherwise, it would be effective September 1, 2001. The bill would expire September 1, 2003. Methodology TDHCA estimates a need for a Program Administrator and an Administrative Technician at a cost of $110,711 in FY 2002 to coordinate oversight of the pilot project. Provision of Medical Care for Homeless People with Chronic Illnesses It is anticipated the Department of Health (TDH) would provide medical care for the pilot population through the Medicaid program. Federal approvals regarding waiver and or state plan requests are assumed to allow a March 2002 implementation. The assumed number of clients per month per year is 1,000. The estimated average monthly cost per recipient is $825.08. This amount would provide inpatient and outpatient services, including hospitalization and prescription drugs, and other medically necessary services. The cost would not include long-term care services such as assisted living or nursing home care. The federal share of client services expenses would total 60.20% in FY 2002 and 60.08% in FY 2003. The Department of Human Services could incur expenses related to required modifications in Medicaid automation systems, however, these costs have not been estimated. 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, 332 Texas Department of Housing and Community Affairs LBB Staff: JK, HD, ER, RT