Supplement: TX SB1667 | 2023-2024 | 88th Legislature | Fiscal Note (Introduced)
For additional supplements on Texas SB1667 please see the Bill Drafting List
Bill Title: Relating to newborn screening.
Status: 2023-04-26 - Left pending in committee [SB1667 Detail]
Download: Texas-2023-SB1667-Fiscal_Note_Introduced_.html
According to DSHS, 8.0 full-time equivalents (FTEs) would be needed to implement the bill including Molecular Biologist III positions (2.0 FTEs) to perform second-tier testing for DMD, Chemist II (3.0 FTEs), Chemist III (1.0 FTE), and Chemist IV (1.0 FTE) positions to perform different stages of testing with increasing level of authority and complexity, and a Nurse II position (1.0 FTE) to follow-up on abnormal newborn screens to ensure proper diagnostic testing and clinical care coordination. Salaries and benefits total $0.7 million in fiscal year 2025.
Bill Title: Relating to newborn screening.
Status: 2023-04-26 - Left pending in committee [SB1667 Detail]
Download: Texas-2023-SB1667-Fiscal_Note_Introduced_.html
| TO: |
Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services |
| FROM: |
Jerry McGinty, Director, Legislative Budget Board
|
| IN RE: |
SB1667 by Parker (Relating to newborn screening.), As Introduced |
Estimated Two-year Net Impact to General Revenue Related Funds for SB1667, As Introduced : a negative impact of ($3,057,606) 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 to General Revenue Related Funds |
|---|---|
| 2024 | $0 |
| 2025 | ($3,057,606) |
| 2026 | ($3,842,463) |
| 2027 | ($5,439,808) |
| 2028 | ($2,410,474) |
All Funds, Five-Year Impact:
| Fiscal Year | Probable Savings/(Cost) from General Revenue Fund 1 | Probable Savings/(Cost) from GR Match For Medicaid 758 | Probable Savings/(Cost) from Pub Health Svc Fee Acct 524 | Probable Savings/(Cost) from Federal Funds 555 |
|---|---|---|---|---|
| 2024 | $0 | $0 | $0 | $0 |
| 2025 | ($3,057,606) | $0 | $0 | $0 |
| 2026 | ($3,447,914) | ($394,549) | $0 | ($604,839) |
| 2027 | ($3,058,178) | ($2,381,630) | ($524,644) | ($3,651,067) |
| 2028 | $0 | ($2,410,474) | ($1,045,287) | ($3,695,406) |
| Fiscal Year | Probable Savings/(Cost) from Pub Hlth Medicd Reimb 709 | Probable Revenue Gain/(Loss) from Pub Health Svc Fee Acct 524 | Probable Revenue Gain/(Loss) from Pub Hlth Medicd Reimb 709 | Change in Number of State Employees from FY 2023 |
|---|---|---|---|---|
| 2024 | $0 | $0 | $0 | 0.0 |
| 2025 | $0 | $0 | $0 | 8.0 |
| 2026 | $0 | $0 | $999,388 | 8.0 |
| 2027 | $0 | $524,644 | $6,032,698 | 8.0 |
| 2028 | ($2,667,553) | $1,045,287 | $6,105,880 | 8.0 |
Fiscal Analysis
The bill would require Duchenne Muscular Dystrophy (DMD) to be included as part of the Texas Newborn Screening Panel.
Methodology
It is assumed that implementation would only occur once funding is available either through General Revenue appropriation or when a sufficient balance exists in the Newborn Screening Preservation Account.
It is assumed that DMD would be implemented after implementing current screens in the queue to be added to the Newborn Screening Panel. According to the Department of State Health Services (DSHS), the earliest that the first screenings could occur is January 1, 2026.
Capital costs at DSHS include $1.3 million in fiscal year 2025 to retrofit laboratory space to accommodate new instruments. The earliest that construction could begin is March 1, 2025. Additional capital non-IT related costs total less than $0.1 million in fiscal year 2025.
Additional non-IT costs at DSHS include $0.9 million which primarily include supplies, testing kits, and education and training materials in fiscal year 2025. It is assumed that these costs are for a quarter of the fiscal year while costs in subsequent fiscal years would assume a full fiscal year and an increase in testing kits needed.
DSHS would receive revenue gain from reimbursement from private pay insurance. The private pay expected probable revenue gain is estimated at a DMD test cost of $3.87. However, the earliest private pay revenue could begin to generate is January 2027. DSHS estimates $0.5 million in fiscal year 2027 for a partial year and $1.0 million in fiscal year 2028. Funds would be collected in General Revenue-Dedicated Account No. 524, Public Health Services Fee Account.
DSHS would also receive revenue gain from reimbursement from Medicaid and CHIP. The Medicaid and CHIP expected probable revenue gain is estimated at a DMD test cost of $14.46. However, the earliest Medicaid and CHIP revenue is expected to begin is August 2026, for screenings completed in January and February 2026. This analysis assumes a Medicaid and CHIP cost of $1.0 million in All Funds, including $0.4 million in General Revenue, in fiscal year 2026, $6.0 million in All Funds, including $2.4 General Revenue, in fiscal year 2027, and $6.1 million, including $2.4 million in General Revenue, in fiscal year 2028. This analysis assumes this funding would be paid from the Health and Human Services Commission to DSHS and collected in Account 709, Public Health Medicaid Reimbursements, for the tests.
Technology
Technology costs would be $0.1 million in fiscal year 2025 which includes end user security software, end user productivity software and services, Laboratory Information Management Systems (LIMS) Specimen Gate modification, web-based remote system modification, end user workspace hardware, and support services.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
| Source Agencies: | 529 Health and Human Services Commission, 537 State Health Services, Department of |
| LBB Staff: | JMc, NPe, ER, APA, NV, CST |
