LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session May 6, 2001 TO: Honorable Elliott Naishtat, Chair, House Committee on Human Services FROM: John Keel, Director, Legislative Budget Board IN RE: SB1245 by Moncrief (Relating to reporting certain acts of misconduct by and background checks of certain employees and applicants for employment of certain health care agencies and facilities.), Committee Report 2nd House, Substituted ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * SB1245, Committee Report 2nd House, Substituted: positive impact * * of $426,602 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 $247,758 * * 2003 178,844 * * 2004 177,153 * * 2005 176,018 * * 2006 175,450 * **************************************************** All Funds, Five-Year Impact: *************************************************************************** *Fiscal Probable Probable Probable Probable * * Year Savings/(Cost) Savings/(Cost) Savings/(Cost) Savings/(Cost) * * from General from General from GR Match from GR Match * * Revenue Fund Revenue Fund for Medicaid for Medicaid * * 0001 0001 0758 0758 * * 2002 $(224,015) $443,297 $(17,278) $45,754 * * 2003 (273,356) 443,297 (36,989) 45,892 * * 2004 (274,759) 443,297 (37,288) 45,903 * * 2005 (275,697) 443,297 (37,485) 45,903 * * 2006 (276,167) 443,297 (37,583) 45,903 * *************************************************************************** *************************************************************************** *Fiscal Probable Savings/(Cost) from Probable Savings/(Cost) from * * Year Federal Funds - Federal Federal Funds - Federal * * 0555 0555 * * 2002 $(14,632) $69,206 * * 2003 (23,560) 69,068 * * 2004 (23,737) 69,056 * * 2005 (23,854) 69,056 * * 2006 (23,913) 69,056 * *************************************************************************** Fiscal Analysis The bill would amend Chapter 48 of the Human Resources Code to require the Department of Protective and Regulatory Services (PRS) to implement procedures for reporting misconduct by certain unlicensed employees of home and community support services agencies. The procedures would encompass written notice of findings, informal proceedings, formal administrative hearings, final orders and provisions for judicial appeal. The bill would require PRS to forward findings of reportable conduct to the Department of Human Services (DHS) for recording in the employee misconduct registry. Home and community support services agencies could not employ a person listed on the registry. The bill would amend Chapter 250 of the Health and Safety Code to authorize long-term care facilities, unlicensed attendant care agencies that contract with DHS, adult foster care providers that contract with DHS, local mental health and mental retardation authorities, and home and community support services agencies to obtain criminal history record information directly from the Texas Department of Public Safety (DPS). These entities could not employ a person listed on the DHS employee misconduct registry or the DHS nurse aide registry. Section 1 of the bill which amends Chapter 48 of the Human Resources Code would take effect January 1, 2002. The rest of the bill would take effect immediately if it receives two-thirds vote in each chamber, or on September 1, 2001. Methodology It is assumed the bill would take effect on September 1, 2001, and PRS would implement the new reporting requirement under Chapter 48 of the Human Resources Code on March 1, 2002. Estimates have been updated to correctly reflect Medicaid match assumptions and information previously provided by the agencies. PRS estimates 177 persons would be affected by the new reporting requirement in FY 2002, 184 in FY 2003, 190 in FY 2004, 194 in FY 2005, and 196 in FY 2006. Ninety percent would request a formal or informal administrative review and 20% would go on to file an appeal. It is assumed the agency would require three FTEs to handle the new workload (an attorney, a program specialist and an adult protective services specialist). DHS estimates an annual savings of $295,314 in background check fees, $147,983 in postage costs for certified mail and four FTEs because the bill would allow direct care providers to obtain criminal history information directly from DPS. DHS also estimates the cost for handling additional phone calls from employers seeking information from the employee misconduct registry and the nurse aide registry would be $67,000 in FY 2002 and $50,000 each year thereafter. It is assumed the agency would require one FTE to handle the new workload (an administrative technician). The Texas Department of Mental Health and Mental Retardation indicates there would be a substantial (but not quantified) fiscal impact if the Chapter 250 bar on employment is absolute and retroactive to include persons who committed minor offenses in the past, corrected or not, due to the requirement that such persons be terminated and new persons attracted, hired and trained. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies: 324 Texas Department of Human Services, 530 Department of Protective and Regulatory Services LBB Staff: JK, HD, NM