LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
May 22, 2001
TO: Honorable Bill Ratliff, Lieutenant Governor, Senate
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB43 by Zaffirini (Relating to simplifying the
certification process for medical assistance provided to
children.), As Passed 2nd House
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB43, As Passed 2nd House: negative impact of $(117,174,739) *
* 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 $(27,942,205) *
* 2003 (89,232,534) *
* 2004 (221,829,492) *
* 2005 (250,098,886) *
* 2006 (263,045,462) *
****************************************************
All Funds, Five-Year Impact:
***********************************************************************
*Fiscal Probable Probable Probable Probable Change in *
* Year (Cost) to Savings to (Cost) to Savings to Number of *
* GR Match GR Match Federal Federal State *
* for for Funds - Funds - Employees *
* Medicaid Medicaid Medicaid Medicaid from FY 2001 *
* 0758 0758 0555 0555 *
* 2002 $7,149,041 $7,149,041 (408.1) *
* $(35,091, $(52,803, *
* 246) 674) *
* 2003 12,837,292 12,837,292 (712.6) *
* (102,069, (153,026, *
* 826) 908) *
* 2004 12,541,772 12,541,771 (696.2) *
* (234,371, (351,319, *
* 264) 726) *
* 2005 14,989,059 14,989,059 (832.0) *
* (265,087, (397,469, *
* 945) 493) *
* 2006 15,351,995 15,351,995 (852.2) *
* (278,397, (417,370, *
* 457) 262) *
***********************************************************************
Technology Impact
First year automation system changes to implement the bill at the Texas
Department of Health (TDH) and the Department of Human Services (DHS)
would cost an estimated $195,000 and $407,000, respectively.
Fiscal Analysis
The bill would provide for Medicaid simplification as follows:
(1) Eliminates the face-to-face interviews for eligibility determination
and recertification;
(2) Adopts application forms and procedures similar to those in the
Children's Health Insurance Program (CHIP) for children under 19 years
(Simplifies eligibility and verification);
(3) Guarantees continuous Medicaid eligibility for a period of six months
for children (in poverty-related groups) under the age of 19
(Implementation date is not later than February 1, 2002, and provisions
sunset upon adoption of rules relative to one year continuous
eligibility); and
(4) Guarantees continuous Medicaid eligibility for a period of one year
for children (in poverty-related groups) under the age of 19.
(Implementation date is between September 1, 2002, and June 1, 2003.)
Methodology
The costs and savings associated with these provisions are based upon a
joint cost estimate by Health and Human Services Commission, TDH, and
DHS. The agencies estimate the provisions would result in an increase in
the number of Medicaid recipient months per month, totaling $47,926 in
fiscal year 2002, $122,994 in fiscal year 2003, $254,090 in fiscal year
2004, and $255,890 in fiscal year 2005. It is estimated that the federal
match rate for client services would total 60.2 percent in fiscal year
2002, 60.08 percent in fiscal year 2003, and 60.07 in each subsequent
fiscal year.
It is estimated that the provisions would result in a Full Time
Equivalent (FTE) reduction at DHS. Salary and related benefits result in
administrative savings, which would accrue equally to federal funds and
General Revenue.
It is assumed that one year continuous eligibility would begin in June
2003.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies: 324 Texas Department of Human Services, 501 Texas
Department of Health, 529 Health and Human Services
Commission
LBB Staff: JK, SD, AJ, SW