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:
  
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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           $(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