LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION March 29, 2023 TO: Honorable Stephanie Klick, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1890 by Jetton (Relating to the operation of a hospital at home program by certain hospitals; authorizing a fee.), Committee Report 1st House, Substituted Estimated Two-year Net Impact to General Revenue Related Funds for HB1890, Committee Report 1st House, Substituted: a negative impact of ($755,835) 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 toGeneral Revenue Related Funds2024($755,835)2025$02026$02027$02028$0All Funds, Five-Year Impact: Fiscal Year Probable (Cost) fromGeneral Revenue Fund1 Probable Savings fromGeneral Revenue Fund1 Change in Number of State Employees from FY 20232024($755,835)$06.02025($730,046)$730,0466.02026($730,580)$730,5806.02027($731,120)$731,1206.02028($731,666)$731,6666.0 Fiscal AnalysisThe bill would require the Health and Human Services Commission (HHSC) to establish standards and approve the operation of a hospital at home program by certain hospitals. The bill would authorize HHSC to establish a fee to be assessed for the approval for the operation of a hospital at home program. LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION March 29, 2023 TO: Honorable Stephanie Klick, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1890 by Jetton (Relating to the operation of a hospital at home program by certain hospitals; authorizing a fee.), Committee Report 1st House, Substituted TO: Honorable Stephanie Klick, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1890 by Jetton (Relating to the operation of a hospital at home program by certain hospitals; authorizing a fee.), 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 HB1890 by Jetton (Relating to the operation of a hospital at home program by certain hospitals; authorizing a fee.), Committee Report 1st House, Substituted HB1890 by Jetton (Relating to the operation of a hospital at home program by certain hospitals; authorizing a fee.), Committee Report 1st House, Substituted Estimated Two-year Net Impact to General Revenue Related Funds for HB1890, Committee Report 1st House, Substituted: a negative impact of ($755,835) 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. Estimated Two-year Net Impact to General Revenue Related Funds for HB1890, Committee Report 1st House, Substituted: a negative impact of ($755,835) 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. 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: 2024 ($755,835) 2025 $0 2026 $0 2027 $0 2028 $0 All Funds, Five-Year Impact: 2024 ($755,835) $0 6.0 2025 ($730,046) $730,046 6.0 2026 ($730,580) $730,580 6.0 2027 ($731,120) $731,120 6.0 2028 ($731,666) $731,666 6.0 Fiscal Analysis The bill would require the Health and Human Services Commission (HHSC) to establish standards and approve the operation of a hospital at home program by certain hospitals. The bill would authorize HHSC to establish a fee to be assessed for the approval for the operation of a hospital at home program. Methodology This analysis assumes HHSC will require 6.0 additional full-time equivalents (FTEs) to implement the provisions of the bill. One Program Specialist VI is assumed to update rules, issue guidance to providers, and review complaints and citations related to the program. Four Nurse III are assumed, including travel expenses, to investigate potential complaints. One Administrative Assistant IV is assumed for support for the compliance nursing staff. Personnel related costs, including salaries and travel, are estimated to be $755,835 in General Revenue in fiscal year 2024 and $730,046 in General Revenue in Fiscal Year 2025.The bill authorizes HHSC to establish a fee for processing hospital at home applications. According to HHSC, an estimated 28 hospitals will continue participating in the program and 28 additional hospitals will participate over the next two years. All 56 hospitals will be subject to the fee authorized by this legislation. This analysis assumes that it will take one year to establish rules and the fee. This analysis assumes the fee amount would cover the costs identified for the FTEs noted above. Technology This analysis assumes there would be FTE related technology costs. The total estimated cost in General Revenue would be $19,283 in fiscal year 2024 and $3,143 in fiscal year 2025. Local Government Impact No fiscal implication to units of local government is anticipated. Source Agencies: b > td > 304 Comptroller of Public Accounts, 529 Health and Human Services Commission 304 Comptroller of Public Accounts, 529 Health and Human Services Commission LBB Staff: b > td > JMc, NPe, ER, CST JMc, NPe, ER, CST