Austin, Texas
                    FISCAL NOTE, 77th Regular Session
                              March 29, 2001
          TO:  Honorable Mike Moncrief, Chair, Senate Committee on
               Health & Human Services
        FROM:  John Keel, Director, Legislative Budget Board
       IN RE:  SB1245  by Moncrief (Relating to providing for the
               registry of acts of misconduct by certain employees of
               certain health care agencies and facilities.), As
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  SB1245, As Introduced:  negative impact of $(553,462) 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                           $(235,242)  *
          *       2003                            (318,220)  *
          *       2004                            (319,930)  *
          *       2005                            (321,070)  *
          *       2006                            (321,640)  *
All Funds, Five-Year Impact:
*Fiscal        Probable             Probable        Change in Number of  *
* Year    Savings/(Cost) from  Savings/(Cost) from State Employees from  *
*        General Revenue Fund    Federal Funds -          FY 2001        *
*                0001                Federal                             *
*                                     0555                               *
*  2002             $(235,242)            $(14,013)                  4.0 *
*  2003              (318,220)             (22,558)                  4.0 *
*  2004              (319,930)             (22,727)                  4.0 *
*  2005              (321,070)             (22,839)                  4.0 *
*  2006              (321,640)             (22,896)                  4.0 *
Fiscal Analysis
The bill would require the Department of Protective and Regulatory
Services (PRS) to develop and implement procedures for reporting
misconduct by certain unlicensed employees of home and community support
services (home health) agencies.  Reportable conduct would include abuse
or neglect that harms an individual receiving agency services and
financial exploitation ($25 or more) of an individual receiving agency
services.  The procedures would include but not be limited to providing
written notice of findings to the employee; offering the employee a
formal administrative hearing; issuing an order based on the hearings
examiner's findings of fact, conclusions of law and recommended decision;
and providing for judicial appeal of the order.

The bill would also require PRS by rule to adopt procedures governing
informal proceedings and to forward findings of reportable conduct to
the Department of Human Services (DHS) for recording in the employee
misconduct registry.  Nursing facilities and home and community support
services agencies would not be allowed to employ a person listed on the
registry.  The bill would only apply to reportable conduct occurring on
or after September 1, 2001.
PRS estimates the number of home and community support services agency
employees subject to the reporting requirement ("confirmed perpetrators")
would be 177 for 2002, 184 for 2003, 190 for 2004, 194 for 2005, and 196
for 2006.  PRS also estimates that 90% of these individuals would
request a formal or informal administrative review.  It is assumed 20% of
those requesting an administrative review would file an appeal.  PRS
would require three additional FTE positions to handle the workload
associated with the new program including an attorney, a program
specialist, and an adult protective services specialist.  The
method-of-finance assumes 90% General Revenue Funds and 10% federal
matching funds from Medicaid.  A six-month delay is assumed for the first
year of operation.

DHS estimates there will be an annual telecommunications cost of
approximately $50,000 to handle an increased volume of calls from home
and community support services agency employers seeking information
about unlicensed direct care staff.  The agency would require an
additional FTE position (Administrative Technician III) to manually
enter information on to the registry, provide notification and handle
direct caller inquiries.  The method-of-finance would be 100% General
Revenue Funds.  A six-month delay is assumed for the first year of
Local Government Impact
No significant fiscal implication to units of local government is
Source Agencies:   530   Department of Protective and Regulatory
                   Services, 324   Texas Department of Human Services
LBB Staff:         JK, HD, NM