Honorable James B. Frank, Chair, House Committee on Human Services
FROM:
Jerry McGinty, Director, Legislative Budget Board
IN RE:
HB465 by Thierry (Relating to a pilot program to provide Medicaid coverage of doula services.), As Introduced
Estimated Two-year Net Impact to General Revenue Related Funds for HB465, As Introduced : a negative impact of ($963,934) through the biennium ending August 31, 2025.
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
2024
($598,464)
2025
($365,470)
2026
($365,559)
2027
($365,649)
2028
($365,740)
All Funds, Five-Year Impact:
Fiscal Year
Probable Savings/(Cost) from GR Match For Medicaid 758
Probable Savings/(Cost) from Federal Funds 555
Change in Number of State Employees from FY 2023
2024
($598,464)
($598,464)
2.0
2025
($365,470)
($365,470)
2.0
2026
($365,559)
($365,559)
2.0
2027
($365,649)
($365,649)
2.0
2028
($365,740)
($365,740)
2.0
Fiscal Analysis
The bill would require the Health and Human Services Commission to establish and implement a pilot program not later than September 1, 2024 to provide medical assistance reimbursement for doula services, including nonmedical childbirth education, coaching, and support services provided during pregnancy, labor, delivery, and the postpartum period.
Methodology
The analysis assumes necessary technology changes will be completed during fiscal year 2024 and will cost $0.9 million in All Funds, with related ongoing costs estimated to be $0.4 million in All Funds in each subsequent fiscal year. It is assumed costs associated with technology changes will receive a 50 percent federal match.
According to HHSC, the agency would require 2.0 additional full-time equivalents (FTEs) each fiscal year to conduct the evaluation study required by the bill. The estimated cost of the additional FTEs is $0.3 million in All Funds each fiscal year.
The analysis assumes Medicaid coverage for doula service will begin on September 1, 2024. It is assumed the cost of providing doula services can be accomplished by utilizing existing agency resources and may be offset, in whole or in part, by decreased costs primarily related to reduced needs for clinical procedures.
The analysis assumes the remaining duties and responsibilities associated with implementing provisions of the bill could be accomplished by utilizing existing agency resources.
Technology
Technology costs are estimated to total $900,113 in fiscal year 2024 for system upgrades to the Texas Medicaid and Health Partnership Provider Enrollment Management System and auxiliary technology services. FTE-related technology costs are estimated to be $6,427 in fiscal year 2024 and $1,047 in each subsequent year.
Local Government Impact
No fiscal implication to units of local government is anticipated.