LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session March 6, 2001 TO: Honorable Mike Moncrief, Chair, Senate Committee on Health & Human Services FROM: John Keel, Director, Legislative Budget Board IN RE: SB751 by Shapleigh (Relating to providing the services of promotoras to certain recipients of medical assistance.), As Introduced ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * SB751, As Introduced: negative impact of $(625,147) 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 (625,147) * * 2004 (3,126,519) * * 2005 (6,253,519) * * 2006 (7,503,646) * **************************************************** All Funds, Five-Year Impact: *************************************************************************** *Fiscal Probable Savings/(Cost) from GR Probable Savings/(Cost) from * * Year Match for Medicaid Federal Funds - Federal * * 0758 0555 * * 2002 $0 $0 * * 2003 (625,147) (940,853) * * 2004 (3,126,519) (4,703,481) * * 2005 (6,253,519) (9,406,962) * * 2006 (7,503,646) (11,288,354) * *************************************************************************** Fiscal Analysis The bill would direct the Department of Health (TDH) to provide the services of a promotora as needed to a person under the medical assistance program (Medicaid). Methodology TDH estimates that the following number of unduplicated clients would use promotora services: 15,000 in FY 2003, 57,000 in FY 2004, 150,000 in FY 2005, and 180,000 in FY 2006. It is assumed that each client on average would utilize promotora services 5.22 times per fiscal year. It is assumed that the average cost per service would total $20. The federal share of client services expenses would total 60.08% in FY 2003, and 60.07% in each subsequent fiscal year. TDH has determined that a waiver from the federal government as well an amendment to the state Medicaid plan would be required for implementation. The agency estimates implementation would begin March 2003, with a staged increase in the number of clients accessing promotora services. The agency also assumes that only state certified promotoras would be able to provide services. If promotora services were to made available to clients served at other Medicaid-operating agencies, there would be additional costs. 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 LBB Staff: JK, HD, PP