LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 83RD LEGISLATIVE REGULAR SESSION March 5, 2013 TO: Honorable Lois W. Kolkhorst, Chair, House Committee On Public Health FROM: Ursula Parks, Director, Legislative Budget Board IN RE:HB915 by Kolkhorst (Relating to the administration and monitoring of certain medications provided to foster children.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB915, As Introduced: a negative impact of ($2,413,462) through the biennium ending August 31, 2015. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 83RD LEGISLATIVE REGULAR SESSION
March 5, 2013
TO: Honorable Lois W. Kolkhorst, Chair, House Committee On Public Health FROM: Ursula Parks, Director, Legislative Budget Board IN RE:HB915 by Kolkhorst (Relating to the administration and monitoring of certain medications provided to foster children.), As Introduced
TO: Honorable Lois W. Kolkhorst, Chair, House Committee On Public Health
FROM: Ursula Parks, Director, Legislative Budget Board
IN RE: HB915 by Kolkhorst (Relating to the administration and monitoring of certain medications provided to foster children.), As Introduced
Honorable Lois W. Kolkhorst, Chair, House Committee On Public Health
Honorable Lois W. Kolkhorst, Chair, House Committee On Public Health
Ursula Parks, Director, Legislative Budget Board
Ursula Parks, Director, Legislative Budget Board
HB915 by Kolkhorst (Relating to the administration and monitoring of certain medications provided to foster children.), As Introduced
HB915 by Kolkhorst (Relating to the administration and monitoring of certain medications provided to foster children.), As Introduced
Estimated Two-year Net Impact to General Revenue Related Funds for HB915, As Introduced: a negative impact of ($2,413,462) through the biennium ending August 31, 2015. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
Estimated Two-year Net Impact to General Revenue Related Funds for HB915, As Introduced: a negative impact of ($2,413,462) through the biennium ending August 31, 2015.
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 2014 ($1,277,759) 2015 ($1,135,703) 2016 ($1,138,466) 2017 ($1,141,339) 2018 ($1,144,277)
2014 ($1,277,759)
2015 ($1,135,703)
2016 ($1,138,466)
2017 ($1,141,339)
2018 ($1,144,277)
All Funds, Five-Year Impact: Fiscal Year Probable Savings/(Cost) fromGeneral Revenue Fund1 Probable Savings/(Cost) fromGR Match For Medicaid758 Probable Savings/(Cost) fromFederal Funds555 Change in Number of State Employees from FY 2013 2014 ($1,266,898) ($10,861) ($182,813) 25.0 2015 ($1,126,404) ($9,299) ($158,741) 25.0 2016 ($1,129,144) ($9,322) ($159,128) 25.0 2017 ($1,131,993) ($9,346) ($159,529) 25.0 2018 ($1,134,907) ($9,370) ($159,940) 25.0
Fiscal Year Probable Savings/(Cost) fromGeneral Revenue Fund1 Probable Savings/(Cost) fromGR Match For Medicaid758 Probable Savings/(Cost) fromFederal Funds555 Change in Number of State Employees from FY 2013 2014 ($1,266,898) ($10,861) ($182,813) 25.0 2015 ($1,126,404) ($9,299) ($158,741) 25.0 2016 ($1,129,144) ($9,322) ($159,128) 25.0 2017 ($1,131,993) ($9,346) ($159,529) 25.0 2018 ($1,134,907) ($9,370) ($159,940) 25.0
2014 ($1,266,898) ($10,861) ($182,813) 25.0
2015 ($1,126,404) ($9,299) ($158,741) 25.0
2016 ($1,129,144) ($9,322) ($159,128) 25.0
2017 ($1,131,993) ($9,346) ($159,529) 25.0
2018 ($1,134,907) ($9,370) ($159,940) 25.0
Fiscal Analysis
The bill would amend the Family Code and Government Code as it relates to the administration and monitoring of certain medication provided to foster children. The bill would make administration of a psychotropic drug valid only if it is provided in the manner provided by Section 576.025b, Health and Safety Code. It would also allow evidence of consent to be included in the foster childs health passport. The bill would expand the monitoring of the prescriptions of psychotropic drugs to include children under the supervision of the Department of Family and Protective Services (DFPS) through an agreement under the Interstate Compact on the Placement of Children and those who are eligible for both Medicaid and Medicare.
Methodology
In order to provide consent in accordance with the provisions of the bill, DFPS has assumed that the medical consenter, provider, and child would all have to be present in a face-to-face health care visit. DFPS reports that currently 75 percent of caseworkers are unable to do face-to-face appointments and instead participate via phone call and/or teleconferencing, and that child protective services (CPS) caseworkers serve as a medical consenter for 2,000 children. On average, DFPS reports that each child prescribed psychotropic medications has an estimated 5 visits per year to ensure that the proper dosage is prescribed. It is assumed that each visit would require 3.5 hours (including the visit with the physician, waiting to be seen, and travel to and from the appointment with the child) resulting in the need for an additional 17 CPS caseworkers. Each caseworker would need supporting staff so it is assumed that an additional 8 full-time equivalents would also be needed. The estimated cost for these FTEs is $1,416,491 in FY14, $1,294,445 in FY15, $1,297,594 in FY16, $1,300,867 in FY17, and $1,304,216 in FY18 in All Funds. These costs include salaries, benefits and other related costs. Presumably not all 2,000 children would be prescribed psychotropic drugs; therefore, costs associated with the provisions of the bill could be less. DFPS also estimates that there would be a cost to modify the Information Management Protecting Adults and Children in Texas (IMPACT) system, which is the agencys automated casework system so that data can be provided to the Health and Human Services Commission. The agencys estimated cost for this system change is $44,081 (430 hours X $102.51 per hour) in All Funds for FY14, bringing the overall cost to $1,460,572 in FY14. DFPS does not anticipate any significant fiscal impact as a result of complying with the other sections of the bill. The Health and Human Services Commission and the Office of Court Administration do not anticipate any significant fiscal impacts as a result of complying with any of the provisions of the bill.
Technology
DFPS indicates that additional devices and software and changes to the IMPACT system, at a cost of $67,455 in All Funds in FY14 and $23,374 each fiscal year thereafter, would be required. These costs are included above.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies: 212 Office of Court Administration, Texas Judicial Council, 530 Family and Protective Services, Department of
212 Office of Court Administration, Texas Judicial Council, 530 Family and Protective Services, Department of
LBB Staff: UP, CL, MB, SJ, VJC
UP, CL, MB, SJ, VJC