LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
March 28, 2001
TO: Honorable Elliott Naishtat, Chair, House Committee on
Human Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB2717 by Maxey (Relating to permanency procedures for
children in state institutions.), Committee Report 1st
House, Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB2717, Committee Report 1st House, Substituted: negative impact *
* of $(123,430) 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 $(55,153) *
* 2003 (68,277) *
* 2004 (68,277) *
* 2005 (68,277) *
* 2006 (68,277) *
****************************************************
All Funds, Five-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 2001 *
* 0001 0758 0555 *
* 2002 $(36,052) $(19,101) $(77,468) 3.0 *
* 2003 (42,808) (25,469) (92,198) 3.0 *
* 2004 (42,808) (25,469) (92,198) 3.0 *
* 2005 (42,808) (25,469) (92,198) 3.0 *
* 2006 (42,808) (25,469) (92,198) 3.0 *
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Fiscal Analysis
The bill would amend Chapter 531, Government Code, concerned with
permanency planning, by defining a "child" to be a person with a
developmental disability who is younger than 22 years of age. The bill
clarifies that "institution" means, generally, an Intermediate Care
Facility for the Mentally Retarded, a group home (including residential
service providers authorized under a Medicaid waiver) operated by the
Department of Mental Health and Mental Retardation (MHMR), a foster group
home or an agency foster group home, a nursing facility, an institution
for the mentally retarded operated by Department of Protective and
Regulatory Services (PRS) or another residential arrangement other than a
foster home that provides care to four or more children who are
unrelated to each other. This bill would require uniform procedures for
permanency planning and provide for a delegation of duties with regards
to permanency planning by Department of Human Services (DHS), MHMR, and
PRS to the local mental retardation authority (LMRA) or a private entity.
Agencies that contract with private entities shall ensure the entity is
provided training and available resources to assist a child residing in
an institution to make a successful transition to a community-based
residence.
Institutions receiving a placement shall notify: (1) DHS upon placement
of a child in a nursing home and the local mental retardation authority
where the child is located if the child is placed in an ICF/MR, (2) PRS
if a child is placed in an institution for the mentally retarded licensed
by that agency, (3) the community resource coordination group in the
county of residence of a parent or guardian of the child, (4) the school
district if the child is at least three years of age, or (5) the local
early intervention program for the area in which the institution is
located if the child is less than three years of age. DHS must notify
the LMRA of a child's placement in a nursing home if the child is known
or suspected to suffer from mental retardation or another disability for
which the child may receive services from MHMR.
Entities receiving notice from an institution may contact the person
making the placement to ensure that family members of the child are aware
of the entity's services and supports, available placement options and
opportunities for permanency planning. DHS must designate a person,
including a member of a community-based organization to serve as a
volunteer advocate for a child to assist in developing a permanency plan
as can MHMR. State agencies receiving notice of a placement shall ensure
that the child is placed on a waiting list for waiver program services.
Parents or guardians shall determine whether to accept waiver services.
The fiscal impact of the bill would encompass the costs of staff support
to ensure that uniform standards are in place, monitor compliance, review
extended placements, and provide periodic reports. The Health and Human
Services Commission (HHSC), MHMR, and PRS all estimate the need for a
staff person to provide these services. The HHSC, MHMR, and PRS assume
the other costs could be absorbed within current resources. However,
according to DHS, the level of services provided will be dependent upon
the level of funding appropriated through the Promoting Independence
Exceptional Item. Further, DHS estimates no additional impact from this
bill, based on the assumption that the Promoting Independence funding
will be provided.
The HHSC and appropriate agencies shall monitor permanency planning
efforts semiannually to ensure benefit to the child. Agency
commissioners or designees shall approve the placement of a child in an
institution. Initial placements are temporary, not to exceed six months
unless approved by the chief executive or designee after review.
Extensions may continue with approval and review every six-months
thereafter. Inspections, surveys or investigations of an institution,
including nursing homes, must include an examination of compliance with
permanency planning requirements. Each institution in which a child
resides shall allow the HHSC and the appropriate health and human service
agency access to the child's records to assist the commission or agency
in complying with the requirements.
The bill would require the HHSC to submit a semiannual report to the
Governor and appropriate Legislative committees of each house.
The act would take effect September 1, 2001.
Methodology
The total fiscal impact assumes one Program Specialist V at the HHSC,
one Program Administrator IV at MHMR, and one CPS Specialist at PRS, for
a total of three Full Time Equivalents. The staff costs are estimated
at 50/50 FMAP and are phased in during the first fiscal year (three
months). Other operating and equipment costs are also included. DHS
assumes funding will be provided through the Promoting Independence
exceptional item.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies: 324 Texas Department of Human Services, 529
Health and Human Services Commission, 655 TX Dept.
of Mental Health & Mental Retardation, 530
Department of Protective and Regulatory Services
LBB Staff: JK, HD, KF, MB