This Fiscal Note is not an official copy and should not be quoted or cited.
Fiscal Note - SB 0861 - MO Bd. of Respiratory Care To License Respiratory Therapists
L.R. NO.  3051-01
BILL NO.  SB 861
SUBJECT:  Licenses - Professional: Medical Procedures and Personnel
TYPE:     Original
DATE:     February 5, 1996



                              FISCAL SUMMARY
                    ESTIMATED NET EFFECT ON STATE FUNDS


FUND AFFECTED              FY 1997             FY 1998           FY 1999
General Revenue           ($5,041)            ($6,233)          ($6,420)

Respiratory Care
Practitioners             $122,830           ($74,613)           $76,047

Health Care
Providers               ($146,671)            $146,671                $0

PR Fees                         $0                  $0                $0

Total Estimated
Net Effect on All
State Funds              ($28,882)             $65,825           $69,627


                   ESTIMATED NET EFFECT ON FEDERAL FUNDS

FUND AFFECTED              FY 1997             FY 1998           FY 1999
None                            $0                  $0                $0

Total Estimated
Net Effect on All
Federal Funds                   $0                  $0                $0


                   ESTIMATED NET EFFECT ON LOCAL FUNDS


FUND AFFECTED              FY 1997             FY 1998           FY 1999
Local Government                $0                  $0                $0


                              FISCAL ANALYSIS

ASSUMPTION
Based on information from the National Board for Respiratory Care, Missouri
has 1,398 Registered Respiratory Therapists (RRTs) and 2,956 Certified
Respiratory Therapists (CRTs).  Therefore, officials from the Department of
Economic Development- Professional Registration (DPR) based projected
revenues upon this licensee count.  Revenue is projected to be $122,830 in FY
97, $224,200 in FY 98 and $230,950 in FY 99.  The initial registration fee
would be set at $35 for RRTs and $25 for CRTs.  Both fees would need to be
increased to $50 in FY 98 to support the provisions of the legislation.
Additionally, DPR assumed a 3% growth rate.  Based on prior actual and
estimated future revenues, there would be a $29,450 loss of revenue annually
in the Health Care Providers Fund and a resulting cost savings of a
comparable amount. The registered therapists currently licensed under the
Health Care Providers Fund would now be licensed under the Respiratory Care
Practitioners Fund.


It is assumed the Respiratory Care Practitioners Fund would reimburse the
Health Care Providers Fund in FY 98 for the start-up costs incurred in FY 97.

To administer the provisions of this legislation, DPR assumes they would need
a .5 Executive Director II (.5 FTE at $34,694 per year) to serve as the
senior executive officer of the Board and to be responsible for overseeing
the registration and regulation of respiratory care practitioners.  In
addition, DPR asserts they would need one Licensure Technician I (1 FTE at
$16,164 per year) to provide clerical and technical support directly to the
Executive Director and to the Board.

Due to the total number of estimated licensees, DPR also asserts the need for
two additional employees for the Division-Administration support and
investigative pools.  DPR would request one Clerk Typist II (1 FTE at $15,624
per year) and one Investigator II (1 FTE at $25,020 per year).  The new
standard used by DPR would be an additional FTE for every 3,000 licensees.

DPR included per diem costs for the Board members to meet eight days per year
and has included associated travel expenses, i.e., mileage, hotel, and meals.

The General Revenue Transfer amount is estimated at $40,320 per year and is
based on the transfer amount for the Advisory Committee for Licensed Clinical
Social Workers, which is a Board of similar size.

Officials from the Office of State Secretary of State (SOS) assume the
proposal would result in the promulgation of new rules.  The actual number of
Missouri Register and Code of State Regulations pages this proposal would
generate is unknown; however, a conservative estimate of 247 pages was used
to compute the associated printing and distribution costs.

Officials from the Department of Revenue (DOR), Office of Secretary of State
Treasurer (STO), Administrative Hearing Commission and the Office of State
Courts Administrator (CTS) assume the proposed legislation would have either
minimal or no fiscal impact on their agencies.


FISCAL IMPACT - State Government        FY 1997    FY 1998    FY 1999
                                       (10 mo.)

GENERAL REVENUE FUND

Costs-Office of Secretary of State (SOS)
   Expense (Printing/Distribution)     ($5,041)   ($6,233)   ($6,420)
Total Costs - SOS                      ($5,041)   ($6,233)   ($6,420)

ESTIMATED NET EFFECT TO
GENERAL REVENUE FUND                   ($5,041)   ($6,233)   ($6,420)


RESPIRATORY CARE PRACTITIONERS FUND

Income-Division of
 Professional Registration (DPR)
   Licensing Fees                      $122,830   $224,200   $230,950
Total Income - DPR                     $122,830   $224,200   $230,950

Costs-DPR
   Transfer to Health Care Providers Fund    $0 ($146,671)         $0
   Transfer to PR Fees Fund                  $0 ($152,142) ($154,903)
Total Costs - DPR                            $0 ($298,813) ($154,903)

ESTIMATED NET EFFECT TO
RESPIRATORY CARE
PRACTITIONERS FUND                     $122,830  ($74,613)    $76,047


FISCAL IMPACT - State Government        FY 1997    FY 1998    FY 1999
(continued)                            (10 mo.)

HEALTH CARE PROVIDERS FUND

Income-Division of Professional Registration (DPR)
   Transfer from Respiratory Care
      Practitioners Fund                     $0   $146,671         $0
Total Income - DPR                           $0   $146,671         $0

Savings-DPR
   Personal Service/Fringe Benefits     $19,935    $19,935    $19,935
   Expense and Equipment                  9,515      9,515      9,515
Total Savings - DPR                     $29,450    $29,450    $29,450

Costs-DPR
   Transfer to PR Fees Fund          ($146,671)         $0         $0
Total Costs - DPR                    ($146,671)         $0         $0

Loss-DPR
   Loss of Registration Fees for
      Respiratory Therapists          ($29,450)  ($29,450)  ($29,450)
Total Loss - DPR                      ($29,450)  ($29,450)  ($29,450)

ESTIMATED NET EFFECT TO
HEALTH CARE PROVIDERS FUND           ($146,671)   $146,671         $0


PR FEES FUND

Income-Division of Professional Registration (DPR)
   Transfer from
   Health Care Providers Fund          $146,671         $0         $0
   Transfer from Respiratory Care
       Practitioners Fund                    $0   $152,142   $154,903
Total Income - DPR                     $146,671   $152,142   $154,903

Costs-DPR
   Personal Service (3.5 FTE)         ($63,315)  ($77,909)  ($79,857)
   Fringe Benefits                     (19,450)   (23,934)   (24,532)
   Board Member Per Diem                (2,800)    (2,800)    (2,800)
   Expense and Equipment               (20,786)    (7,179)    (7,394)
   Other Costs/GR Transfers            (40,320)   (40,320)   (40,320)
Total Costs - DPR                    ($146,671) ($152,142) ($154,903)

ESTIMATED NET EFFECT TO
PR FEES FUND                                 $0         $0         $0


FISCAL IMPACT - Local Government        FY 1997    FY 1998    FY 1999
                                       (10 mo.)

                                              0          0          0

DESCRIPTION
The proposed legislation would establish within the Division of Professional
Registration (DPR) the Missouri Board for Respiratory Care for licensure and
regulation of respiratory therapists.  The Board would be responsible for
adopting rules regarding professional conduct and establishing continuing
education requirements and ethical standards of conduct.  The Board would be
required to hear and investigate complaints, employ investigators, issue
subpoenas and file petitions against certain licensees, as well as discipline
licensees for fraud and other activities and unethical conduct.

DPR would provide the necessary personnel to carry out the legislation and
would be responsible for establishing application and licensure fees.  All
fees collected would be placed in the newly created Respiratory Care
Practitioners Fund. These funds would be used for the operation and
administration of the Board.  The proposal would provide for the issuance of
temporary permits to practice respiratory care for individuals who are
enrolled in approved respiratory care programs.

This legislation is not federally mandated, would not duplicate any other
program and would not require additional capital improvements or rental
space.

SOURCES OF INFORMATION
Department of Economic Development-Professional Registration
Office of Secretary of State
Department of Revenue
Office of State Treasurer
Administrative Hearing Commission
Office of State Courts Administrator