LEGISLATIVE BUDGET BOARD 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 Introduced ************************************************************************** * 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. Methodology 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 operation. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies: 530 Department of Protective and Regulatory Services, 324 Texas Department of Human Services LBB Staff: JK, HD, NM