LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION March 30, 2025 TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB1188 by Kolkhorst (Relating to electronic health record requirements; authorizing a civil penalty.), Committee Report 1st House, Substituted Estimated Two-year Net Impact to General Revenue Related Funds for SB1188, Committee Report 1st House, Substituted: a negative impact of ($1,570,240) through the biennium ending August 31, 2027. 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 Funds2026($809,309)2027($760,931)2028($762,031)2029($762,946)2030($763,881)All Funds, Five-Year Impact: Fiscal Year Probable Savings/(Cost) fromGeneral Revenue Fund1 Change in Number of State Employees from FY 20252026($809,309)5.02027($760,931)5.02028($762,031)5.02029($762,946)5.02030($763,881)5.0 Fiscal AnalysisThis bill amends the Health and Safety Code to require covered entities, as defined, to store all electronic health records (EHR) information of Texas residents at a location within the United States, accessible only to people who need it within the scope of their work, and that the data is otherwise protected. This bill would take effect on September 1, 2026.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION
March 30, 2025
TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB1188 by Kolkhorst (Relating to electronic health record requirements; authorizing a civil penalty.), Committee Report 1st House, Substituted
TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: SB1188 by Kolkhorst (Relating to electronic health record requirements; authorizing a civil penalty.), Committee Report 1st House, Substituted
Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
SB1188 by Kolkhorst (Relating to electronic health record requirements; authorizing a civil penalty.), Committee Report 1st House, Substituted
SB1188 by Kolkhorst (Relating to electronic health record requirements; authorizing a civil penalty.), Committee Report 1st House, Substituted
Estimated Two-year Net Impact to General Revenue Related Funds for SB1188, Committee Report 1st House, Substituted: a negative impact of ($1,570,240) through the biennium ending August 31, 2027. 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 SB1188, Committee Report 1st House, Substituted: a negative impact of ($1,570,240) through the biennium ending August 31, 2027. 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:
2026 ($809,309)
2027 ($760,931)
2028 ($762,031)
2029 ($762,946)
2030 ($763,881)
All Funds, Five-Year Impact:
2026 ($809,309) 5.0
2027 ($760,931) 5.0
2028 ($762,031) 5.0
2029 ($762,946) 5.0
2030 ($763,881) 5.0
Fiscal Analysis
This bill amends the Health and Safety Code to require covered entities, as defined, to store all electronic health records (EHR) information of Texas residents at a location within the United States, accessible only to people who need it within the scope of their work, and that the data is otherwise protected. This bill would take effect on September 1, 2026.
Methodology
The Health and Human Services Commission (HHSC) assumes the implementation of the EHR provisions of this bill will be operational with the agency's new EHR vendor by September 2026 and the agency will prioritize modifying the Clinical Management for Behavioral Health Services system, allowing for technology changes to be completed within existing agency resources. Additionally, HHSC anticipates additional workload for the agency's Regulatory Services Division, specifically the Long-term Care Regulatory team would require $809,309 from the General Revenue Fund ($809,309 from All Funds) and 5.0 full-time-equivalents (FTEs) in fiscal year 2026 and $760,931 from the General Revenue Fund ($760,931 from All Funds) and 5.0 FTEs in fiscal year 2027 to conduct the additional survey requirements and review the additional enforcement cases as required by the provisions of this bill. This analysis assumes the Article II system assessment only for the Department of State Heath Services and does not include an assessment for the Department of Family and Protective Services ($1,118 from the General Revenue Fund in fiscal year 2026 and $916 from the General Revenue Fund in fiscal year 2027).Included in the amounts above are assumed FTE costs totaling $809,309 from the General Revenue Fund ($809,309 from All Funds) and 5.0 FTEs in fiscal year 2026 and $760,931 from the General Revenue Fund ($760,931 from All Funds) and 5.0 FTEs in fiscal year 2027. This includes $49,970 from the General Revenue Fund ($49,970 from All Funds) in fiscal year 2026 for one-time costs related to the implementation of provisions of this bill.According to the Comptroller of Public Accounts, the number of violations that would result in civil penalty revenue is unknown; therefore, the related fiscal impact on the state cannot be estimated. This estimate assumes all other agencies can accomplish the implementation of the provisions of this bill within existing agency resources.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies: b > td > 302 Office of the Attorney General, 304 Comptroller of Public Accounts, 452 Department of Licensing and Regulation, 454 Department of Insurance, 503 Texas Medical Board, 529 Health and Human Services Commission, 537 State Health Services, Department of, 644 Juvenile Justice Department, 696 Department of Criminal Justice, 701 Texas Education Agency, 710 Texas A&M University System Administrative and General Offices, 720 The University of Texas System Administration
302 Office of the Attorney General, 304 Comptroller of Public Accounts, 452 Department of Licensing and Regulation, 454 Department of Insurance, 503 Texas Medical Board, 529 Health and Human Services Commission, 537 State Health Services, Department of, 644 Juvenile Justice Department, 696 Department of Criminal Justice, 701 Texas Education Agency, 710 Texas A&M University System Administrative and General Offices, 720 The University of Texas System Administration
LBB Staff: b > td > JMc, NPe, ER, NV, LBl
JMc, NPe, ER, NV, LBl