LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 77th Regular Session
  
                              April 9, 2001
  
  
          TO:  Honorable Mike Moncrief, Chair, Senate Committee on
               Health & Human Services
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  SB1305  by Harris (Relating to incorporating services for
               children with special health care needs into the state
               child health plan for certain low-income children.), As
               Introduced
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  SB1305, As Introduced:  negative impact of $(57,529,486) 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                        $(27,890,776)  *
          *       2003                         (29,638,710)  *
          *       2004                         (30,917,574)  *
          *       2005                         (31,504,029)  *
          *       2006                         (31,910,610)  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
***************************************************************************
*Fiscal      Probable        Probable        Probable        Probable     *
* Year    Savings/(Cost)  Savings/(Cost)  Savings/(Cost)  Savings/(Cost)  *
*          from General   from  Title V   from GR Match     from  CHIP    *
*          Revenue Fund  Federal Funds -  for Title XXI  Federal Funds -  *
*              0001          Federal          (CHIP)         Federal      *
*                              0555            8010            0555       *
*  2002        $3,047,101      $4,055,699   $(30,937,877)   $(80,109,780) *
*  2003         3,047,101       4,055,699    (32,685,811)    (84,258,057) *
*  2004         3,047,101       4,055,699    (33,964,675)    (87,554,735) *
*  2005         3,047,101       4,055,699    (34,551,130)    (89,066,507) *
*  2006         3,047,101       4,055,699    (34,957,711)    (90,114,599) *
***************************************************************************
  
Fiscal Analysis
  
The bill would require the Health and Human Services Commission to
provide "wrap-around services" to children with special health care needs
in the Children's Health Insurance Program (CHIP).  The bill would also
require CHIP to adopt the Children with Special Care Needs program's
(CSHCN) definition of a "child with special care needs" which is broader
than the current CHIP definition.
The bill is similar to recommendation HHS-12 in the Comptroller's report,
e-Texas:  Smaller, Smarter, Faster Government.  The bill would take
immediate effect upon two-thirds vote of the Legislature, or September
1, 2001.
  
  
Methodology
  
1. The Texas Department of Health (TDH) estimates 1973 children in its
current program would qualify for CHIP.  There would be a savings at TDH
when these children transfer to CHIP.

2. TDH also estimates 6.5% of the general population would qualify as a
child with special care needs.

3. It is assumed 6.5% of the CHIP enrollees would qualify as a child with
special health care needs and qualify for wrap around services.

4. The Health and Human Services Commission estimates $3 in
administrative expenses per child with special health care needs and
that wrap around services benefit would cost $3,600 per child.
  
  
Local Government Impact
  
No fiscal implication to units of local government is anticipated.
  
  
Source Agencies:   324   Texas Department of Human Services, 655   TX
                   Dept. of Mental Health & Mental Retardation, 501
                   Texas Department of Health, 529   Health and Human
                   Services Commission, 304   Comptroller of Public
                   Accounts
LBB Staff:         JK, HD, AJ