LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
March 19, 2001
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB126 by Madla (Relating to the creation of the Rural
Communities Health Care Investment Program to attract and
retain rural health care professionals.), Committee
Report 2nd House, Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB126, Committee Report 2nd House, Substituted: an impact of $0 *
* through the biennium ending August 31, 2003, for both an immediate *
* effective date and a September 1, 2001, effective date. *
* *
* 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 Revenue Change in Number of *
* Year Savings/(Cost) from Gain/(Loss) from State Employees from *
* Rural Communities Rural Communities FY 2001 *
* Health Care Health Care *
* Investment Program Investment Program *
* Trust Fund Trust Fund *
* 2001 $0 $0 0.0 *
* 2002 (400,000) 400,000 1.0 *
* 2003 (400,000) 400,000 1.0 *
* 2004 (400,000) 400,000 1.0 *
* 2005 (400,000) 400,000 1.0 *
* 2006 (400,000) 400,000 1.0 *
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The table above assumes an immediate effective date. A three month
implementation period is assumed.
All Funds, Five-Year Impact:
The table below assumes a September 1, 2001, effective date. Again, a
three month implementation period is assumed.
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*Fiscal Probable Probable Revenue Change in Number of *
* Year Savings/(Cost) from Gain/(Loss) from State Employees from *
* Rural Communities Rural Communities FY 2001 *
* Health Care Health Care *
* Investment Program Investment Program *
* Trust Fund Trust Fund *
* 2002 $(300,000) $300,000 0.8 *
* 2003 (400,000) 400,000 1.0 *
* 2004 (400,000) 400,000 1.0 *
* 2005 (400,000) 400,000 1.0 *
* 2006 (400,000) 400,000 1.0 *
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Fiscal Analysis
The bill would amend Chapter 106, by amending Section 106.025(a) and
adding Subchapter H, Health and Safety Code, to create and fund the
Rural Communities Health Care Investment Program. The purpose of the
program would be to attract and retain rural health care professionals,
not necessarily physicians. The bill would create the Rural Communities
Health Care Investment Program Trust Fund, a dedicated general revenue
account, to award stipends and loan reimbursements which would be
administered by the Center for Rural Health Initiatives (CRHI) or the
comptroller. The center would be required to report to the Legislative
Budget Board no later than November 1 of each year the details of the
fund. The bill would have an immediate effective date if it receives
the necessary two-thirds vote in each chamber. Otherwise, the bill would
have an effective date of September 1, 2001.
Methodology
The bill would establish the Loan Reimbursement and Stipend Programs
under the CRHI to provide loan reimbursements and stipends to health
professionals who agree to serve in medically underserved communities.
The health professional would be required to sign a contract, outlining
the time period to be served and provisions for noncompliance, with the
CRHI for the loan reimbursement or stipend. An initial implementation
period of three months is assumed for both effective dates. According to
the CRHI, one full-time equivalent (FTE) would be required to implement
and administer these programs. Total salary of one FTE for the 2002-003
biennium is $75,784 with an immediate effective date, and $66,451 with a
September 1, 2001, effective date. Other operating costs, including
travel, rent, and employee benefits for the biennium total $41,231 with
an immediate effective date and $36,117 with a September 1, 2001,
effective date. Equipment costs are estimated at $3,000 in FY 2002 only.
Revenues to the Rural Communities Health Care Investment Program Trust
Fund could be derived from public and private gifts and grants. It is
assumed the trust fund could receive $400,000 per year in revenue, except
with a September 1, 2001, effective date where $300,000 in revenue in FY
2002 is assumed because of start-up. Total revenues and expenditures
for the 2002-03 biennium are estimated to be $800,000 for immediate
effect and $700,000 for a September 1, 2001, effective date.
The bill would create an advisory committee to assist in the CRHI's
duties related to the Rural Communities Health Care Investment Program.
Reimbursement for travel and related expenses for the advisory committee
would have to be authorized in the General Appropriations Act.
Local Government Impact
No fiscal implication to units of local government is anticipated,
however, the bill states the CRHI may encourage a medically underserved
community served by a program recipient to contribute to the cost of the
loan reimbursement or stipend, when feasible.
Source Agencies: 50A Center for Rural Health Initiatives, 304
Comptroller of Public Accounts, 781 Texas Higher
Education Coordinating Board
LBB Staff: JK, HD, RM