Honorable John Kuempel, Chair, House Committee on Licensing & Administrative Procedures
FROM:
Ursula Parks, Director, Legislative Budget Board
IN RE:
HB2525 by Zerwas (Relating to the regulation of physician assistants and anesthesiologist assistants.), Committee Report 1st House, Substituted
Estimated Two-year Net Impact to General Revenue Related Funds for HB2525, Committee Report 1st House, Substituted: a positive impact of $55,080 through the biennium ending August 31, 2019.
The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
Fiscal Year
Probable Net Positive/(Negative) Impact to General Revenue Related Funds
2018
$49,690
2019
$5,390
2020
$12,390
2021
$18,390
2022
$25,390
Fiscal Year
Probable Savings/(Cost) from General Revenue Fund 1
Probable Revenue Gain/(Loss) from General Revenue Fund 1
Change in Number of State Employees from FY 2017
2018
($52,310)
$102,000
1.0
2019
($49,610)
$55,000
1.0
2020
($49,610)
$62,000
1.0
2021
($49,610)
$68,000
1.0
2022
($49,610)
$75,000
1.0
Fiscal Analysis
The bill would amend the Occupations Code relating to the regulation of physician assistants and anesthesiologist assistants. The bill would create an anesthesiologist assistant advisory committee and seven committee members would serve without compensation or reimbursements for expenses incurred in the performance of duties as a committee member.
The bill would require the Texas Medical Board (TMB) to adopt rules to regulate anesthesiologist assistants and physician anesthesiologists who supervise assistants. Under the provisions of the bill, an anesthesiologist assistant would not be required to obtain a license and could practice as an assistant under the delegated authority of a licensed physician. The bill would require the physician assistant board to issue an anesthesiologist assistant license to an applicant who meets certain criteria. The bill would amend certain requirements of eligibility for a physician assistant license. The bill would establish eligibility requirements for obtaining an anesthesiologist assistant license.
The bill would take effect on September 1, 2017.
Methodology
Based on the analysis of TMB, it is assumed individuals who are qualified for licensure under the provisions of the bill would apply for licensure. TMB estimates one licensing full time equivalent (FTE) will be needed for the licensing and renewal of the anesthesiology assistant (AAs) as established under the provisions of the bill and tracking of anesthesiologist supervision. The additional FTE would have an estimated cost of $52,310 in fiscal year (FY) 18 and $49,610 each year thereafter. TMB estimates one-time IT equipment costs of $2,700 for the additional FTE and annual costs of $36,312 in salaries and wages and $13,298 in employee benefits and other payroll contribution costs.
This analysis assumes that any increased cost to TMB, which is statutorily required to generate sufficient revenue to cover its costs of operation, would be offset by an increase in fee-generated revenue. Based on information provided by TMB regarding assumed license applicants, fees, and fee schedules, the Comptroller of Public Accounts estimates revenue deposited to the General Revenue Fund of approximately $102,000 in FY18, including 200 initial AA registrations ($496 per registration) and 25 temporary licenses ($107 per license); $55,000 in FY19 including 50 new applicants, 100 renewals ($272 per renewal) and 25 temporary licenses; $62,000 in FY20 including 50 new applicants, 125 renewals and 25 temporary licenses; $68,000 in FY21 including 50 new applicants, 150 renewals and 25 temporary licenses; and $75,000 in FY22 including 50 new applicants, 175 renewals and 25 temporary licenses.
Technology
The costs identified above include estimated one-time information technology costs of $2,700 for equipment for the additional FTE at TMB.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies:
304 Comptroller of Public Accounts, 503 Texas Medical Board