This Fiscal Note is not an official copy and should not be quoted or cited.
Fiscal Note - SB 0317 - Provides for the regulation and licensing of the practice of naturopathic medicine
SB 317 - Fiscal Note

COMMITTEE ON LEGISLATIVE RESEARCH

OVERSIGHT DIVISION

FISCAL NOTE

L.R. NO. 1412-01

BILL NO. SB 317

SUBJECT: Licenses - Professional: Physicians

TYPE: Original

DATE: February 18, 1999

FISCAL SUMMARY

ESTIMATED NET EFFECT ON STATE FUNDS

FUND AFFECTED FY 2000 FY 2001 FY 2002
General Revenue $1,250 $1,500 $1,500
Board of Registration for the Healing Arts $24,422 $32,888 $33,946
Total Estimated

Net Effect on All

State Funds

 $25,672 $34,388 $35,446



ESTIMATED NET EFFECT ON FEDERAL FUNDS

FUND AFFECTED FY 2000 FY 2001 FY 2002
None
Total Estimated

Net Effect on All

Federal Funds

 $0 $0 $0



ESTIMATED NET EFFECT ON LOCAL FUNDS

FUND AFFECTED FY 2000 FY 2001 FY 2002
Local Government $0 $0 $0

Numbers within parentheses: ( ) indicate costs or losses

This fiscal note contains 5 pages.

FISCAL ANALYSIS

ASSUMPTION

Officials from the Department of Economic Development (DED) - Division of Professional Registration (DPR) assume the proposed legislation would result in the potential licensure of 171 individuals, based on an average licensee count for the 13 states in the nation that have licensure for the practice of naturopathic medicine.

The projected revenue reflects a $250 fee, which is the maximum amount established by statute. Revenue for FY 00 would be $42,750 (71 x $250). In addition, a 3% growth rate has been estimated.

All monies collected will be deposited in the Board of Registration for the Healing Arts Fund and all expenses will be paid out of said fund.

DPR is requesting an additional .25 FTE Licensure Technician II (.25 FTE at $21,948 per year) to carry out duties generated by this proposal. This employee would be responsible for processing applications for licensure, as well as responding to any inquiries relating to the licensure law or rules and regulations.

It is assumed the Board would appoint a subcommittee to promulgate the rules and regulations and develop the application forms. It is estimated the subcommittee would be composed of four board members. The subcommittee would meet approximately five times in Jefferson City, Missouri. Each member of the subcommittee would receive a $50 per day per diem. The costs associated with the subcommittee would be one-time. Associated travel costs (mileage, lodging and meals) are estimated to be $5,596.

DPR estimates first year postage and printing costs for statute and rule mailings to applicants and for first year start up printing of rules and applications to be $1,048. It is estimated that postage and printing costs for subsequent years can be absorbed under existing appropriations for the State Board of Registration for the Healing Arts. However, if this legislation results in a larger increase than expected, additional appropriations will be required.

It is assumed the Office of the Attorney General (AGO) would provide approximately 60 hours of assistance per year with rules, opinions and meetings. Based on an hourly cost of $58.04, the annual total would be $3,482.

It is assumed that existing staff would design, program, and implement a computer licensure program. However, if costs are higher than anticipated, further monies would be required.



ASSUMPTION (continued)

It is assumed a national examination will be utilized for examinations. However, if the Board elects to develop its own examination, the cost is estimated between $10,000 and $50,000.

Officials from the Department of Health (DOH) assume the proposal would result in additional revenue through registration fees. Any person licensed as a "Naturopath" who wishes to utilize controlled substances in their profession would be required to register with DOH. The fee is $30 annually and goes to General Revenue. DOH estimates the number of individuals wishing to register to be minimal (possibly 50 applicants) and estimates the workload associated with this proposal to be minimal. Annual revenue is projected to be $1,500 (50 applicants x $30).

Officials from the Office of the Secretary of State (SOS) assume the proposed legislation would require the printing of additional pages in the Missouri Register and the Code of State Regulations and have estimated a publishing and distribution cost of $1,490.50 for FY 00. Additionally, future costs are unknown and depends upon the frequency and length of rules filed, amended, rescinded or withdrawn.

While this bill alone would not require SOS to acquire additional staff, SOS assumes the

cumulative effect of additional Register and Code publishing duties could, at some point, require additional staff. However, Oversight assumes SOS could increase fees to cover any additional costs, per Section 536.033, RSMo and therefore, has not included associated costs in the fiscal impact specifications below.

Officials from the Office of the Attorney General (AGO), Office of Administration - Administrative Hearing Commission (AHC), Department of Labor and Industrial Relations (DOL) 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 2000 FY 2001 FY 2002
(10 Mo.)
GENERAL REVENUE FUND
Income-Department of Health (DOH)
Registration Fees/Renewals $1,250 $1,500 $1,500

ESTIMATED NET EFFECT TO

GENERAL REVENUE FUND $1,250 $1,500 $1,500
FISCAL IMPACT - State Government FY 2000 FY 2001 FY 2002
(continued) (10 Mo.)
BOARD OF REGISTRATION FOR
THE HEALING ARTS FUND
Income-Division of Professional Registration (DPR)
Licensure Fees/Renewals $42,750 $44,000 $45,250
Costs-DPR
Personal Service (.25 FTE) ($4,687) ($5,765) ($5,909)
Fringe Benefits (1,432) (1,762) (1,806)
Per Diem (Subcommittee) (2,000) 0 0
Expense and Equipment (6,727) (103) (107)
Other Costs/AGO Costs (3,482) (3,482) (3,482)
Total Costs - DPR ($18,328) ($11,112) ($11,304)

ESTIMATED NET EFFECT TO

BOARD OF REGISTRATION FOR
THE HEALING ARTS FUND $24,422 $32,888 $33,946
FISCAL IMPACT - Local Government FY 2000 FY 2001 FY 2002
(10 Mo.)
$0 $0 $0
FISCAL IMPACT - Small Business
No direct fiscal impact to small businesses would be expected as a result of this proposal.



DESCRIPTION

This proposal would establish licensure for the practice of naturopathic medicine in the State of Missouri. The Board of Healing Arts would adopt rules for the regulation of this medical profession.

These rules would include: establishing and depositing fees, conducting licensing exams, prescribing continuing education, initiating naturopathic specialties, determining qualifications of doctors, and screening doctors for competency. The bill would also contain provisions regarding

DESCRIPTION (continued)

the examination which must be taken before receiving a license. The board would also establish reciprocation with states that have an educational program with equivalent standards.

The bill would contain provisions regarding clinical training for naturopathic medical students.

Licensed naturopathic physicians would be allowed to dispense substances and devices as long as they follow certain criteria established by the bill.

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

This proposal would affect Total State Revenues.



SOURCES OF INFORMATION

Department of Economic Development - Division of Professional Registration

Department of Health

Office of the Secretary of State

Office of the Attorney General

Office of Administration - Administrative Hearing Commission

Department of Labor and Industrial Relations

Office of State Courts Administrator







Jeanne Jarrett, CPA

Director

February 18, 1999