LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 85TH LEGISLATIVE REGULAR SESSION April 2, 2017 TO: 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 licensing and regulation of physician assistants.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB2525, As Introduced: a positive impact of $55,080 through the biennium ending August 31, 2019. LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 85TH LEGISLATIVE REGULAR SESSION April 2, 2017 TO: 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 licensing and regulation of physician assistants.), As Introduced TO: 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 licensing and regulation of physician assistants.), As Introduced Honorable John Kuempel, Chair, House Committee on Licensing & Administrative Procedures Honorable John Kuempel, Chair, House Committee on Licensing & Administrative Procedures Ursula Parks, Director, Legislative Budget Board Ursula Parks, Director, Legislative Budget Board HB2525 by Zerwas (Relating to the licensing and regulation of physician assistants.), As Introduced HB2525 by Zerwas (Relating to the licensing and regulation of physician assistants.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB2525, As Introduced: a positive impact of $55,080 through the biennium ending August 31, 2019. Estimated Two-year Net Impact to General Revenue Related Funds for HB2525, As Introduced: a positive impact of $55,080 through the biennium ending August 31, 2019. General Revenue-Related Funds, Five-Year Impact: 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 2018 $49,690 2019 $5,390 2020 $12,390 2021 $18,390 2022 $25,390 All Funds, Five-Year Impact: Fiscal Year Probable Savings/(Cost) fromGeneral Revenue Fund1 Probable Revenue Gain/(Loss) fromGeneral Revenue Fund1 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 Year Probable Savings/(Cost) fromGeneral Revenue Fund1 Probable Revenue Gain/(Loss) fromGeneral Revenue Fund1 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 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 licensing and regulation of physician assistants. The bill would add individuals who complete certain education requirements as an Anesthesiologist Assistant (AA) to be eligible for licensure under Chapter 204, Physician Assistants of the Occupations Code. The bill would require that an AA be supervised by a physician who is an anesthesiologist and maintains a physical proximity that enables the supervising anesthesiologist to be immediately available if needed. The bill requires the Physician Assistant Board or the Texas Medical Board (TMB) to adopt rules to implement the provisions of the bill. The bill would take effect on September 1, 2017. Methodology TMB estimates one licensing full time equivalent (FTE) will be needed for the licensing and renewal of the 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 304 Comptroller of Public Accounts, 503 Texas Medical Board LBB Staff: UP, CL, EH, EK UP, CL, EH, EK