LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION April 9, 2023 TO: Honorable Sam Harless, Chair, House Committee on Health Care Reform, Select FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1575 by Hull (relating to improving health outcomes for pregnant women under Medicaid and certain other public benefits programs.), Committee Report 1st House, Substituted Estimated Two-year Net Impact to General Revenue Related Funds for HB1575, Committee Report 1st House, Substituted : a negative impact of ($4,188,534) through the biennium ending August 31, 2025. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2024($3,216,118)2025($972,416)2026($972,892)2027($973,373)2028($973,860)All Funds, Five-Year Impact: Fiscal Year Probable (Cost) fromGeneral Revenue Fund1 Probable (Cost) fromGR Match For Medicaid758 Probable (Cost) fromFederal Funds555 Change in Number of State Employees from FY 20232024($2,239,640)($976,478)($976,478)6.02025($853,690)($118,726)($118,726)6.02026($854,108)($118,784)($118,784)6.02027($854,530)($118,843)($118,843)6.02028($854,958)($118,902)($118,902)6.0 Fiscal AnalysisThe bill would require the Health and Human Services Commission (HHSC) to adopt standardized assessment questions to screen for, identify, and aggregate data regarding the nonmedical health related needs of pregnant women eligible for Medicaid and the Alternatives to Abortion program.The bill would require managed care organizations (MCO) and other providers to provide HHSC with the data collected.The bill would establish provider qualifications and require that program services may be provided only by a provider who completes the standardized case management training required by HHSC.The bill would require HHSC to require a provider to complete training that meets the provisions of the bill.The bill would require an MCO to conduct a health needs and nonmedical health needs screening of each eligible pregnant recipient or enrollee.The bill would require that HHSC establish a separate provider type for community health workers and doulas.The bill would require HHSC to submit a status report in fiscal year 2025 on the implementation of case management services provider to pregnant women and subsequent reporting every even-numbered year summarizing the data collected.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION
April 9, 2023
TO: Honorable Sam Harless, Chair, House Committee on Health Care Reform, Select FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1575 by Hull (relating to improving health outcomes for pregnant women under Medicaid and certain other public benefits programs.), Committee Report 1st House, Substituted
TO: Honorable Sam Harless, Chair, House Committee on Health Care Reform, Select
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: HB1575 by Hull (relating to improving health outcomes for pregnant women under Medicaid and certain other public benefits programs.), Committee Report 1st House, Substituted
Honorable Sam Harless, Chair, House Committee on Health Care Reform, Select
Honorable Sam Harless, Chair, House Committee on Health Care Reform, Select
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
HB1575 by Hull (relating to improving health outcomes for pregnant women under Medicaid and certain other public benefits programs.), Committee Report 1st House, Substituted
HB1575 by Hull (relating to improving health outcomes for pregnant women under Medicaid and certain other public benefits programs.), Committee Report 1st House, Substituted
Estimated Two-year Net Impact to General Revenue Related Funds for HB1575, Committee Report 1st House, Substituted : a negative impact of ($4,188,534) through the biennium ending August 31, 2025.
Estimated Two-year Net Impact to General Revenue Related Funds for HB1575, Committee Report 1st House, Substituted : a negative impact of ($4,188,534) through the biennium ending August 31, 2025.
General Revenue-Related Funds, Five- Year Impact:
2024 ($3,216,118)
2025 ($972,416)
2026 ($972,892)
2027 ($973,373)
2028 ($973,860)
All Funds, Five-Year Impact:
2024 ($2,239,640) ($976,478) ($976,478) 6.0
2025 ($853,690) ($118,726) ($118,726) 6.0
2026 ($854,108) ($118,784) ($118,784) 6.0
2027 ($854,530) ($118,843) ($118,843) 6.0
2028 ($854,958) ($118,902) ($118,902) 6.0
Fiscal Analysis
The bill would require the Health and Human Services Commission (HHSC) to adopt standardized assessment questions to screen for, identify, and aggregate data regarding the nonmedical health related needs of pregnant women eligible for Medicaid and the Alternatives to Abortion program.The bill would require managed care organizations (MCO) and other providers to provide HHSC with the data collected.The bill would establish provider qualifications and require that program services may be provided only by a provider who completes the standardized case management training required by HHSC.The bill would require HHSC to require a provider to complete training that meets the provisions of the bill.The bill would require an MCO to conduct a health needs and nonmedical health needs screening of each eligible pregnant recipient or enrollee.The bill would require that HHSC establish a separate provider type for community health workers and doulas.The bill would require HHSC to submit a status report in fiscal year 2025 on the implementation of case management services provider to pregnant women and subsequent reporting every even-numbered year summarizing the data collected.
Methodology
This analysis assumes HHSC would be required to develop a database to collect, aggregate, and report on the nonmedical health related needs of eligible pregnant women. This analysis assumes HHSC would require an additional 6.0 Full-time Equivalent (FTE) positions to develop the database. This analysis assumes one Project Manager III, one Information Technology Business Analyst III, two Programmer IVs, one Systems Analyst IV, and one Database Administrator III would manage the implementation and development of a program database to collect and aggregate the required data and support on-going maintenance.In addition to FTE-related costs, the system development of the database is estimated to be $1.8 million in All Funds in fiscal year 2024. Additional costs related to Data Center Services (DCS) infrastructure are estimated to be $0.3 million in All Funds in each fiscal year. System upgrades to the Texas Medicaid and Health Partnership (TMHP) to create new provider types for community health workers and doulas is estimated to cost $1.3 million in All Funds in fiscal year 2024.According to HHSC, costs related to client services, developing the assessment questions, reporting requirements, and updating provider training materials can be accomplished with existing resources.
Technology
Technology costs related to database development, DCS, and TMHP updates total $3.7 million in All Funds for the biennium. Additional FTE-related technology costs are estimated to be $19,283 in fiscal year 2024 and $3,143 in each subsequent year.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: b > td > 529 Health and Human Services Commission
529 Health and Human Services Commission
LBB Staff: b > td > JMc, NPe, ER, CST, NV
JMc, NPe, ER, CST, NV