LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION April 5, 2023 TO: Honorable Stephanie Klick, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1876 by Guillen (relating to the Rita Littlefield Chronic Kidney Disease Centralized Resource Center established within the Health and Human Services Commission.), Committee Report 1st House, Substituted Estimated Two-year Net Impact to General Revenue Related Funds for HB1876, Committee Report 1st House, Substituted : an impact of $0 through the biennium ending August 31, 2025, as a result of the effective date of the bill. However, there is an estimated fiscal impact of ($5,222,699) to General Revenue for the first biennium of implementation. 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, Seven- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2024$02025$02026($3,759,626)2027($1,463,073)2028($1,463,742)2029($1,463,742)2030($1,463,742)All Funds, Seven-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 20232024$0$0$00.02025$0$0$00.02026($3,361,984)($397,642)($397,642)8.02027($1,344,078)($118,995)($118,995)8.02028($1,344,688)($119,054)($119,054)8.02029($1,344,688)($119,054)($119,054)8.02030($1,344,688)($119,054)($119,054)8.0 Fiscal AnalysisThe bill would require the Health and Human Services Commission (HHSC) to establish the Rita Littlefield Chronic Kidney Disease Centralized Resource Center (the center). HHSC would be required to structure and operate the center and establish and maintain a kidney health clinical trials registry.The bill would also require HHSC to collaborate with the Chronic Kidney Disease Task Force to establish and maintain a website for the center through which individuals can directly communicate and exchange information on chronic kidney disease and related illnesses and register in a kidney health clinical trials registry.HHSC would be able to solicit and accept gifts, grants, and donations from any source to implement the provisions of the bill. The bill would take effect September 1, 2025. LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION April 5, 2023 TO: Honorable Stephanie Klick, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1876 by Guillen (relating to the Rita Littlefield Chronic Kidney Disease Centralized Resource Center established within the Health and Human Services Commission.), Committee Report 1st House, Substituted TO: Honorable Stephanie Klick, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1876 by Guillen (relating to the Rita Littlefield Chronic Kidney Disease Centralized Resource Center established within the Health and Human Services Commission.), Committee Report 1st House, Substituted Honorable Stephanie Klick, Chair, House Committee on Public Health Honorable Stephanie Klick, Chair, House Committee on Public Health Jerry McGinty, Director, Legislative Budget Board Jerry McGinty, Director, Legislative Budget Board HB1876 by Guillen (relating to the Rita Littlefield Chronic Kidney Disease Centralized Resource Center established within the Health and Human Services Commission.), Committee Report 1st House, Substituted HB1876 by Guillen (relating to the Rita Littlefield Chronic Kidney Disease Centralized Resource Center established within the Health and Human Services Commission.), Committee Report 1st House, Substituted Estimated Two-year Net Impact to General Revenue Related Funds for HB1876, Committee Report 1st House, Substituted : an impact of $0 through the biennium ending August 31, 2025, as a result of the effective date of the bill. However, there is an estimated fiscal impact of ($5,222,699) to General Revenue for the first biennium of implementation. 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 HB1876, Committee Report 1st House, Substituted : an impact of $0 through the biennium ending August 31, 2025, as a result of the effective date of the bill. However, there is an estimated fiscal impact of ($5,222,699) to General Revenue for the first biennium of implementation. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. 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, Seven- Year Impact: 2024 $0 2025 $0 2026 ($3,759,626) 2027 ($1,463,073) 2028 ($1,463,742) 2029 ($1,463,742) 2030 ($1,463,742) All Funds, Seven-Year Impact: 2024 $0 $0 $0 0.0 2025 $0 $0 $0 0.0 2026 ($3,361,984) ($397,642) ($397,642) 8.0 2027 ($1,344,078) ($118,995) ($118,995) 8.0 2028 ($1,344,688) ($119,054) ($119,054) 8.0 2029 ($1,344,688) ($119,054) ($119,054) 8.0 2030 ($1,344,688) ($119,054) ($119,054) 8.0 Fiscal Analysis The bill would require the Health and Human Services Commission (HHSC) to establish the Rita Littlefield Chronic Kidney Disease Centralized Resource Center (the center). HHSC would be required to structure and operate the center and establish and maintain a kidney health clinical trials registry.The bill would also require HHSC to collaborate with the Chronic Kidney Disease Task Force to establish and maintain a website for the center through which individuals can directly communicate and exchange information on chronic kidney disease and related illnesses and register in a kidney health clinical trials registry.HHSC would be able to solicit and accept gifts, grants, and donations from any source to implement the provisions of the bill. The bill would take effect September 1, 2025. Methodology The analysis assumes HHSC would require 8.0 full-time equivalents (FTEs) to establish and maintain the center and the related kidney health clinical trials registry beginning in fiscal year 2026. This would include 1.0 database administrator III, 1.0 information specialist IV, 1.0 information technology business analyst III, 1.0 nurse III, 2.0 programmer IVs, 1.0 project manager III, and 1.0 systems analyst IV. The FTE costs would total $1.1 million in fiscal year 2026 and $1.0 million in subsequent fiscal years.The analysis assumes that HHSC would requires $2.5 million in fiscal year 2026 related to technology solution services for system development. In addition, it is assumed HHSC would require $0.3 million each fiscal year to maintain technology infrastructure for the center. Technology The analysis assumes technology costs would include $2.5 million for system development in fiscal year 2026 and $0.3 million to maintain infrastructure in each fiscal year as described above. FTE-related technology costs would total less than $0.1 million each fiscal year. Local Government Impact No fiscal implication to units of local government is anticipated. Source Agencies: b > td > 529 Health and Human Services Commission, 537 State Health Services, Department of 529 Health and Human Services Commission, 537 State Health Services, Department of LBB Staff: b > td > JMc, NPe, ER, NDA, NV, SD JMc, NPe, ER, NDA, NV, SD