Date Requested:March 04, 2005
Time Requested:01:53 PM
Agency: Health and Human Resources, Department of
CBD Number: Version: Bill Number: Resolution Number:
2005R1241 Intro HB2885
CBD Subject: Updating TB Procedures
FUND(S)
0407 (Central Office General Administrative Fund)
Sources of Revenue
General Fund
Legislation creates:
Neither Program nor Fund

Fiscal Note Summary

Effect this measure will have on costs and revenues of state government.

    The purpose of this article is to bring together the state law governing compulsory testing for tuberculosis (TB) of students and school personnel as well as the statutes pertaining to the treatment, control and commitment of persons with the disease at hospitals, clinics and other health care facilities throughout the state.
    
    The Department of Health and Human Resources (Department) believes this bill will significantly reduce the cost and the burden of repeated TB skin testing for school personnel. The bill also allows a physician or local health officer to seek an individualized course of treatment for persons with TB and thereby reduces the persons risk of developing multidrug resistant TB.
    
    By eliminating the mandate to do tuberculin skin testing (TST) every two years on Boards of Education employees, the Department's TB Control Program estimates that there will be a savings of approximately $53,054 per year in supplies (PPD and safety syringes). The TB Control Program also estimates a savings in the medical evaluation and treatment of the 40 (average) Boards of Education employees found to have positive TST. The cost for evaluation and treatment is approximately $201 per person or $8,040 per year. This will result in an estimated total savings of $61,094 per year.
    
    

Fiscal Note Detail
Over-all effect
Effect of Proposal Fiscal Year
2005
Increase/Decrease
(use"-")
2006
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 -61,094 -61,094
Personal Services 0 0 0
Current Expenses 0 -61,094 -61,094
Repairs and Alterations 0 0 0
Assets 0 0 0
Other 0 0 0
2. Estimated Total Revenues 0 0 0
3. Explanation of above estimates (including long-range effect):
    Cost of supplies to do tuberculin skin testing (TST) on Boards of Education employees (BOE): Number of BOE employees in 2003 = 37,494 (18,747, or half, are tested yearly) Purified Protein Derivative (PPD) $2.28 (per test) x 18,747 = $42,743; Syringes (Safety) $0.55 (per syringe) x 18,747 = $10,311; Total Cost of Supplies/year = $53,054 Cost of medical evaluation and treatment of positive TST reactor: RN time ($77); Chest x-ray ($25); Medical Evaluation ($45); Liver Function Tests ($36); Medications ($18) Total per person - $201 Total cost of medical evaluation and treatment/year for the average of 40 BOE employees = $8,040.
    


Memorandum
Person submitting Fiscal Note:
Martha Yeager Walker
Email Address:
fnbudoff@wvdhhr.org
    The Department is proposing to use the savings realized from this legislation in support of activities such as targeted tuberculin skin testing of high-risk populations as well as to support local health departments to render directly observed therapy (DOT) to all active and high-risk infected individuals in their jurisdictions. When persons are inadequately or only partially treated, it serves to increase the incidence of multi-drug resistant TB (MDRTB), worsen the ability to control the disease, and spread potentially untreatable TB. Treating a patient with DOT greatly reduces the chances of inadequate or partial treatment of these individuals.
    
    The cost of DOT for an active patient with drug-susceptible TB in West Virginia is approximately $2,200 per patient. There were 24 active patients in 2004. An annual estimate cost for the same number of active patients would be $52,800. The cost of treating one patient with MDRTB is estimated to be $150,000, but may range in cost from $90,000 to $700,000 per patient. By supporting DOT, advancing the effective treatment of persons with TB and increasing the State's ability to control the disease, the Department is being proactive in its efforts to prevent and eradicate MDRTB in this state.
    
    The savings realized from this legislation will be used to pay for these treatments.