LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
April 4, 2001
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB2348 by Raymond (Relating to the Texas Diabetes Care
Pilot Program.), As Introduced
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB2348, As Introduced: negative impact of $(37,041,782) for an *
* immediate effective date, and $(32,983,599) for a 90 day effective *
* date, 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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All Funds, Six-Year Impact:
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*Fiscal Probable Probable Probable Change in *
* Year Savings/(Cost) Savings/(Cost) Savings/(Cost) Number of State *
* from General from GR Match from Federal Employees from *
* Revenue Fund for Medicaid Funds - Federal FY 2000 *
* 0001 0758 0555 *
* 2001 $0 $0 $0 0.0 *
* 2002 (7,646,175) (10,978,374) (12,992,514) 49.5 *
* 2003 (10,398,560) (8,018,673) (10,725,615) 66.0 *
* 2004 (10,606,640) (8,127,302) (10,885,672) 66.0 *
* 2005 (10,818,800) (8,236,692) (11,050,237) 66.0 *
* 2006 0 0 0 0.0 *
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The table above assumes an immediate effective date. A six-month
start-up period is also assumed.
All Funds, Five-Year Impact:
The table below assumes a 90 day effective date. A six month start-up
period is also assumed.
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*Fiscal Probable Probable Probable Change in *
* Year Savings/(Cost) Savings/(Cost) Savings/(Cost) Number of State *
* from General from GR Match from Federal Employees from *
* Revenue Fund for Medicaid Funds - Federal FY 2001 *
* 0001 0758 0555 *
* 2002 $(5,097,450) $(9,468,916) $(10,811,676) 33.0 *
* 2003 (10,398,560) (8,018,673) (10,725,615) 66.0 *
* 2004 (10,606,640) (8,127,302) (10,885,672) 66.0 *
* 2005 (10,818,800) (8,236,692) (11,050,729) 66.0 *
* 2006 0 0 0 0.0 *
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Fiscal Analysis
The bill would require the Health and Human Services Commission (HHSC) to
develop a Texas Diabetes Care Pilot Program for Medicaid recipients in
counties selected by the commission with a high incidence of and a high
death rate from diabetes. The counties selected must include border
counties.
The bill would become effective immediately if it receives two-thirds
vote in both chambers, otherwise on the ninety-first day after the last
day of the Legislative session. The provisions of the bill would expire
September 1, 2005.
Methodology
The Department of Health (TDH) assumed the pilot would be implemented in
43 border counties, including Bexar county, which was the site of a
diabetes pilot program.
The number of participants is estimated to be 29,985 for FY 2002, is
expected to increase by 2% each year thereafter.
The pilot program would provide additional services including case
management, nutritional services, and diabetes education. It is assumed
the case management services would cost $236.03 per year per client and
nutritional services would cost $203 per year per client. Case
management and nutritional services would be matched at the Federal
Medical Assistance Percentage, which is assumed to be 60.20% in FY 2002,
60.08% in FY 2003, and 60.07% in subsequent years. Diabetes education is
assumed to cost $340 per client per year, and is assumed to be 100
percent General Revenue.
TDH estimated a need for an additional 66 Full-Time Equivalent positions
per year, along with associated costs such as benefits, computers, and
operating. In addition, it is assumed that outreach expenditures would
be $300,000 per county in the first year and $100,000 per county
afterwards. Staffing, related expenses, operating, and outreach costs
are assumed to be eligible for administrative matching funds, which would
be 50% federal.
It is assumed a delay of six months would be necessary for start-up, rule
making, and other implementation issues.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: 529 Health and Human Services Commission, 501
Texas Department of Health
LBB Staff: JK, HD, KF