LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
April 9, 2001
TO: Honorable Mike Moncrief, Chair, Senate Committee on
Health & Human Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB281 by Nelson (Relating to requiring the Texas
Department of Health to allow health care providers to
use certain vaccines in the federal vaccines for
children program.), Committee Report 1st House,
Substituted
**************************************************************************
* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB281, Committee Report 1st House, Substituted: an impact of $0 *
* 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. *
**************************************************************************
General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2002 $0 *
* 2003 0 *
* 2004 0 *
* 2005 0 *
* 2006 0 *
****************************************************
All Funds, Five-Year Impact:
*****************************************************
* Fiscal Year Probable Savings/(Cost) from *
* Federal Funds - Federal *
* 0555 *
* 2002 $(4,536,896) *
* 2003 (4,536,896) *
* 2004 (4,536,896) *
* 2005 (4,536,896) *
* 2006 (4,536,896) *
*****************************************************
Fiscal Analysis
The bill would require the Department of Health to allow health care
providers participating in the Vaccine for Children Program to select
vaccines from the list of all vaccines (choice) recommended and approved
by the Federal Advisory Committee on Immunization Practices and under
contract with the Centers for Disease Control, United States Public
Health Services. The bill would also require the Department of Health
to allow health care provider participating in the federal Vaccine for
Children (VFC) Program to use combination vaccines.
Methodology
The Department of Health assumes that with physician choice, physicians
participating in the federal Vaccine for Children Program, would select
the most expensive vaccine 100 percent of the time. TDH estimates the
increased cost for vaccines which have choice (Diphtheria Tetanus
acellular Pertussis (DTaP), Haemophilus influenzae type b (Hib),
DTaP-Hib combination, Hepatitis B (Hep B) pediatric PF, Hep B adolescent,
and Hepatitis A pediatric) would total $49,421,073 in FY 2002. According
to TDH, the difference in the cost for these vaccine in FY 2002 over the
cost for the same vaccines in FY 2000 would be $15,644,468 of which 92%
or $14,392,911 of the cost would be federally funded. TDH estimates it
would fund the increase with $4,536,896 in federal 317 funds and
$9,856,015 VFC direct assistance. The value of federal direct assistance
under the VFC Program is received by the state in vaccine and not in
funds deposited into the Treasury and therefore is not shown in the table
above.
Physician choice in vaccine selection would only affect federally funded
vaccine. According to the Department of Health (TDH), children who are
VFC eligible would be able to receive vaccine at VFC provider clinics.
Children who are not VFC eligible but underinsured would be referred to
Federally Qualified Health Clinics or the vaccine would be paid for out
of pocket. According to TDH, this would require the use of a two-tier
distribution system.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies:
LBB Staff: JK, HD, RM