LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 77th Regular Session
  
                              April 2, 2001
  
  
          TO:  Honorable Rene Oliveira, Chair, House Committee on Ways &
               Means
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB2456  by Gray (Relating to the creation of a pilot
               program to provide indigent health care services funded
               by a county sales and use tax.), As Introduced
  
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*  No fiscal implication to the State is anticipated.                    *
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The bill would amend Chapter 324 of the Tax Code to allow counties to
adopt a pilot program to provide indigent health care services and to
impose a sales and use tax to fund those services.  The rate of the sales
and use tax could not exceed 1 percent.   

The commissioners court of a county adopting such a pilot program could
adopt guidelines specifying that the program should provide secondary or
tertiary care services for county residents having no health insurance
and living at or below 100 percent of the federal poverty level, and
primary care services for county residents living at or below 200 percent
of the federal poverty level.  The guidelines would also specify that
the benefits provided under the program would include primary medical
services as outlined in the Indigent Health Care Act and secondary or
tertiary care services as outlined in the state medical assistance
program in Chapter 32 of the Human Resources Code.

The bill would provide that a sales and use tax adopted to fund a pilot
program could result in the combined rate of all sales and use taxes
imposed by political subdivisions of this state having territory in the
county exceeding 2 percent.

A pilot program would have a sunset date six years from the date the
program first provided services to county residents, unless otherwise
authorized by the voters of the county in an election.  The State Auditor
would have the right to review any pilot program and report the results
to the Legislature.

The bill would take effect immediately upon enactment, assuming that it
received the requisite two-thirds majority votes in both houses of the
Legislature.  Otherwise, it would take effect September 1, 2001.
  
Local Government Impact
  
Because a county would be allowed to impose a sales and use tax to
recover the costs of the pilot program, no significant fiscal impact to
units of local government is anticipated.
  
  
Source Agencies:   304   Comptroller of Public Accounts
LBB Staff:         JK, SD, DB