LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session March 7, 2001 TO: Honorable Mike Moncrief, Chair, Senate Committee on Health & Human Services FROM: John Keel, Director, Legislative Budget Board IN RE: SB812 by Carona (Relating to expanding access to women's health care services.), As Introduced ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * SB812, As Introduced: negative impact of $(10,177,437) 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 Net Impact: **************************************************** * Fiscal Year Probable Net Positive/(Negative) * * Impact to General Revenue Related * * Funds * * 2002 $(924,000) * * 2003 (9,253,437) * * 2004 12,993,710 * * 2005 35,726,216 * * 2006 44,489,871 * **************************************************** All Funds, Five-Year Impact: *********************************************************************** *Fiscal Probable Probable Probable Probable Change in * * Year Savings/ Savings/ Savings/ Savings/ Number of * * (Cost) from (Cost) from (Cost) from (Cost) from State * * GR Match GR Match Federal Federal Employees * * for for Funds - Funds - from FY 2001 * * Medicaid Medicaid Federal Federal * * 0758 0758 0555 0555 * * 2002 $(924,000) $0 $(924,000) $0 0.0 * * 2003 5,641,091 8,489,899 692.0 * * (14,894,528) (37,226,321) * * 2004 31,746,253 47,758,513 691.0 * * (18,752,543) (71,351,644) * * 2005 54,676,605 82,254,537 691.0 * * (18,950,389) (73,148,844) * * 2006 65,007,548 97,796,288 691.0 * * (20,517,677) (87,254,436) * *********************************************************************** Technology Impact Automation for the Department of Human Services (DHS) to create a new type program is assumed at 16,800 hours at $110, resulting in a cost of $1,848,000. Fiscal Analysis The bill would increase the income eligibility cap for medical assistance (Medicaid) to 185 percent of the federal poverty level for preventative health and family planning services for women. It is assumed implementation would require waiver approval by the federal government. Automation changes would occur in FY 2002, with waiver clients being served beginning in FY 2003. Methodology 1. It is assumed the average monthly number of recipients served by the Department of Health's (TDH) Medicaid program would increase by 170,328 in FY 2003, 401,888 in FY 2004, 414,108 in FY 2005, and 509,908 in FY 2006 for new waiver clients. The average monthly cost per client is assumed to be $163.60. The federal share is assumed to be 90% in all years. 2. TDH assumes that births would be averted due to clients receiving waiver services. The number of births averted would total 1,378 in FY 2003, 7,753 in FY 2004, 13,353 in FY 2005, and 15,876 in FY 2006. The annual savings assumed per averted birth totals $10,254.71, resulting in an annual savings totaling $14,130,990 in FY 2003, $79,504,767 in FY 2004, $136,931,142 in FY 2005, and $162,803,776 in FY 2006. The federal share is assumed to be 60.08% in FY 2003, and 60.07% in subsequent years. 3. It is assumed that additional eligibility workers at DHS will be required, totaling 692 in FY 2003, and 691 in each subsequent year. The annual cost per worker (salary, operating expenses and benefits) is assumed to total $34,980. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies: 529 Health and Human Services Commission, 324 Texas Department of Human Services, 501 Texas Department of Health LBB Staff: JK, HD, KF, PP