LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 77th Regular Session
  
                              April 4, 2001
  
  
          TO:  Honorable Mike Moncrief, Chair, Senate Committee on
               Health & Human Services
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  SB1470  by Moncrief (Relating to creating a pilot
               treatment program for certain juveniles on probation.),
               As Introduced
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  SB1470, As Introduced:  negative impact of $(575,000) 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                           $(575,000)  *
          *       2003                                    0  *
          *       2004                                    0  *
          *       2005                                    0  *
          *       2006                                    0  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
         *****************************************************
         * Fiscal Year      Probable Savings/(Cost) from      *
         *                      General Revenue Fund          *
         *                              0001                  *
         *      2002                               $(575,000) *
         *      2003                                        0 *
         *      2004                                        0 *
         *      2005                                        0 *
         *      2006                                        0 *
         *****************************************************
  
Fiscal Analysis
  
The bill would create a pilot treatment program for certain juveniles on
probation.  The bill authorizes the creation of an Assertive Community
Treatment (ACT) Program in Tarrant County for youth who have severe and
persistent mental illness, a history of multiple hospitalizations, poor
school performance, placement in emergency shelters or residential
treatment facilities, are abusing or dependent on chemicals, and are on
probation.

The bill specifies that the ACT team shall consist of degreed or licensed
professionals in the clinical treatment or rehabilitation fields.  It
also specifies that the ACT team will include an RN full-time and a
psychiatrist for at least 10 hrs/wk and directs that the team maintain a
ratio of not less than one staff to 10 youth, with a maximum of 30
targeted youth receiving services at any one time.  The ACT team will
provide psychiatric, substance abuse, and social development services to
targeted youth and will be available during evening and weekend hours to
maintain 24-hour responsibility and availability for covering and
managing a psychiatric crisis.

ACT is an integrated effort to provide intensive community-based care to
high users of the system who have remained unresponsive to previous
therapies.  These are persons who have severe and persistent mental
illness with a history of multiple hospitalizations and involvement with
the criminal justice system, homeless shelters and /or community
residential placements.  Individuals eligible for ACT must also meet case
management criteria for the most intensive level of service.

The Department of Mental Health and Mental Retardation (MHMR) would be
required to submit a report on the effectiveness of the pilot by January
15, 2003.  The bill would be effective September 1, 2001.
  
  
Methodology
  
Tarrant County MHMR Center estimated the average annual number of persons
served to be 50.  The average annual cost per person is estimated to be
$11,500.  Note the additional probability that federal Medicaid funds may
be available for certain ACT services that qualify.

The Department of Mental Health and Mental Retardation assumes that the
pilot project would be operating during fiscal year 2002 only.
  
  
Local Government Impact
  
The bill could have a local impact of $35,000, estimated by Tarrant
County, for the costs of research prior to pilot implementation and
post-pilot evaluation, the latter of which is required by the bill.
  
  
Source Agencies:   655   TX Dept. of Mental Health & Mental Retardation
LBB Staff:         JK, HD, KF, MB