LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION March 4, 2025 TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB513 by Sparks (Relating to a rural community-based care pilot program.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for SB513, As Introduced: a negative impact of ($8,661,457) through the biennium ending August 31, 2027.The fiscal implications related to the establishment of a capitated funding model cannot be determined due to the uncertainty of how costs for the funding model would be calculated. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2026($3,528,281)2027($5,133,176)2028($4,066,714)2029($4,068,262)2030($4,069,844)All Funds, Five-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 20252026($3,504,321)($23,960)($243,161)7.92027($5,090,528)($42,648)($395,083)13.92028($4,028,125)($38,589)($306,666)9.02029($4,029,659)($38,603)($306,765)9.02030($4,031,227)($38,617)($306,866)9.0 Fiscal AnalysisThe bill would require the Department of Family and Protective Services (DFPS) to establish a rural Community-based Care (CBC) pilot program in catchment areas in which DFPS requested, but did not receive bids, proposals, or other applicable expressions of interest to implement CBC.The bill would require the lead entity to establish a collaborative governance structure to provide oversight and guidance. The lead entity would collaborate with DFPS and DFPS would be allowed to advise the lead entity in the implementation of the pilot.The bill would require DFPS to work with the lead entity to develop a capitated funding model and budget.The bill would require DFPS and the lead entity to implement an integrated electronic management system for CBC.The bill would require DFPS, the lead entity and local education institutions to develop and implement a workforce development plan.The bill would require DFPS to contract with an independent evaluator to conduct a comprehensive evaluation of the pilot program.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION
March 4, 2025
TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB513 by Sparks (Relating to a rural community-based care pilot program.), As Introduced
TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: SB513 by Sparks (Relating to a rural community-based care pilot program.), As Introduced
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
SB513 by Sparks (Relating to a rural community-based care pilot program.), As Introduced
SB513 by Sparks (Relating to a rural community-based care pilot program.), As Introduced
Estimated Two-year Net Impact to General Revenue Related Funds for SB513, As Introduced: a negative impact of ($8,661,457) through the biennium ending August 31, 2027.The fiscal implications related to the establishment of a capitated funding model cannot be determined due to the uncertainty of how costs for the funding model would be calculated.
Estimated Two-year Net Impact to General Revenue Related Funds for SB513, As Introduced: a negative impact of ($8,661,457) through the biennium ending August 31, 2027.The fiscal implications related to the establishment of a capitated funding model cannot be determined due to the uncertainty of how costs for the funding model would be calculated.
The fiscal implications related to the establishment of a capitated funding model cannot be determined due to the uncertainty of how costs for the funding model would be calculated.
General Revenue-Related Funds, Five- Year Impact:
2026 ($3,528,281)
2027 ($5,133,176)
2028 ($4,066,714)
2029 ($4,068,262)
2030 ($4,069,844)
All Funds, Five-Year Impact:
2026 ($3,504,321) ($23,960) ($243,161) 7.9
2027 ($5,090,528) ($42,648) ($395,083) 13.9
2028 ($4,028,125) ($38,589) ($306,666) 9.0
2029 ($4,029,659) ($38,603) ($306,765) 9.0
2030 ($4,031,227) ($38,617) ($306,866) 9.0
Fiscal Analysis
The bill would require the Department of Family and Protective Services (DFPS) to establish a rural Community-based Care (CBC) pilot program in catchment areas in which DFPS requested, but did not receive bids, proposals, or other applicable expressions of interest to implement CBC.The bill would require the lead entity to establish a collaborative governance structure to provide oversight and guidance. The lead entity would collaborate with DFPS and DFPS would be allowed to advise the lead entity in the implementation of the pilot.The bill would require DFPS to work with the lead entity to develop a capitated funding model and budget.The bill would require DFPS and the lead entity to implement an integrated electronic management system for CBC.The bill would require DFPS, the lead entity and local education institutions to develop and implement a workforce development plan.The bill would require DFPS to contract with an independent evaluator to conduct a comprehensive evaluation of the pilot program.
Methodology
This analysis assumes the pilot program will be extended past January 2029 and therefore costs are assumed for fiscal years 2029 and 2030. It is also assumed that the pilot program will begin start-up activities in fiscal year 2026 and be fully implemented in fiscal year 2027.To establish the pilot program, manage contracts, provide on-site reviews and provide desk reviews of the subcontractors, it is assumed 1.0 Contract Administration Manager I FTE, 1.0 Program Specialist VI FTE, and 1.0 Director III FTE would be required. Additionally, to provide oversight support, administrative support, subject matter expertise, assistance with federal and state policies, technical assistance with the Information Management Protecting Children and Adults in Texas (IMPACT) system as well as maintaining IMPACT user access, the analysis assumes the following FTEs would be required: 1.0 Case Management Oversight (CMO) Administrative Assistant FTE; 2.0 CMO Worker FTEs; 1.0 CMO Supervisor; 1 Budget Analyst V FTE; 1.0 Program Specialist IV FTE; and 1.0 Management Analyst I. These FTEs would primarily begin in fiscal year 2027 once the pilot program has been implemented.In the current CBC model, the lead entities are provided funding for start-up costs, resource transfer, network support payments, and the Child and Adolescent Needs and Strengths (CANS) assessments. This analysis assumes that funding is also needed for the pilot program. Therefore, $2,958,083 is assumed for the 2026-27 biennium and $2,721,824 in each proceeding fiscal year for these purposes.To implement the integrated electronic management system, this analysis assumes 4.9 Systems Analyst V Contracted FTEs would be needed in fiscal years 2026 and 2027 to upgrade the IMPACT system to allow for real-time case management as well as financial upgrades to allow for the new capitated funding methodology.This analysis assumes $215,000 in each fiscal year to contract with an independent evaluator for the comprehensive evaluation of the CBC pilot program.As noted above, this analysis cannot determine the cost related to the establishment of capitated funding model. The agency indicated that due to the requirement that the capitated funding model account for additional costs of providing services to geographically dispersed populations including increased transportation costs, challenges in achieving economies of scale in the provision of services, recruitment and retaining staff, and building and maintaining provider networks, the agency would not be able to determine these costs since they would be at the discretion of the lead entity to determine.It is assumed any costs for the Health and Human Services Commission can be absorbed within existing appropriations.
It is assumed any costs for the Health and Human Services Commission can be absorbed within existing appropriations.
Technology
Technology related costs including the enhancements to the IMPACT system are estimated to be $1,105,811 in fiscal year 2026 and $1,122,098 in fiscal year 2027.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies: b > td > 529 Health and Human Services Commission, 530 Family and Protective Services, Department of
529 Health and Human Services Commission, 530 Family and Protective Services, Department of
LBB Staff: b > td > JMc, NPe, ER, AN, NV
JMc, NPe, ER, AN, NV