COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 0116-02
Bill No.: SB 200
Subject: Boards, Commissions, Committees, Councils; Compacts; Health Care Professionals; Licenses - Professional; Nurses; Uniform Laws
Type: Original
Date: January 16, 2003
FISCAL SUMMARY
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Total Estimated
Net Effect on General Revenue Fund |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Total Estimated
Net Effect on Other State Funds |
$0 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 5 pages.
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Local Government | $0 | $0 | $0 |
ASSUMPTION
Officials from the Department of Corrections, Office of Prosecution Services, Office of the State Courts Administrator and the Office of the State Public Defender assume the proposal would have no fiscal impact on their agencies.
Officials from the Administrative Hearing Commission (AHC) anticipate this proposal will not significantly alter its caseload. AHC notes if other similar proposals also pass, creating more cases or more complex cases, there could be a fiscal impact.
Officials from the Department of Health and Senior Services (DOH) expect the proposal would not significantly impact its operations. DOH officials note if the proposal were to substantially impact its programs, they would request funding through the legislative process. DOH notes the proposal could have a fiscal impact on the Missouri Professional and Practical Nursing Student Loan and Loan Repayment Fund/Programs because nurses may opt not to be licensed in Missouri, therefore reducing the amount of surcharge available for current incentive programs.
ASSUMPTION (continued)
Oversight assumes there could be an indirect effect on the Missouri Professional and Practical Nursing Student Loan and Loan Repayment Fund/Programs; however, there would not be a direct effect on any state funds.
Officials from the Secretary of State's Office (SOS) state this proposal enacts a reciprocal nurse licensure compact. SOS assumes the Department of Economic Development and the Department of Health and Senior Services will promulgate rules to implement the proposal. Based on experience with other divisions, the rules, regulations and forms issued by the Departments could require as many as 27 pages in the Code of State Regulations. SOS notes for any given rule, roughly half again as many pages are published in the Missouri Register as in the Code because cost statements, fiscal notes and the like are not repeated in the Code. SOS estimates the cost of a page in the Missouri Register and the Code of State Regulations to be $23 and $27, respectively. SOS estimates costs of $1,649 for FY 2004. SOS states the impact of this proposal in future years is unknown and depends upon the frequency and length of rules, filed, amended, rescinded or withdrawn.
Oversight assumes the SOS could absorb the costs of printing and distributing regulations related to this proposal. If multiple proposals pass which require the printing and distribution of regulations at substantial costs, the SOS could request funding through the appropriation process. Any decision to raise fees to defray costs would likely be made in subsequent fiscal years.
Officials from the Department of Economic Development - Division of Professional Registration (DPR) assume the proposal would not directly impact their agency. DPR states a nurse would only be required to hold a license in his/her state of residence and then would be able to practice in other states that are part of the nurse license compact. Currently, 1,275 nurses have a Missouri license but reside in a compact state and 1,293 nurses licensed in compact states have a Missouri address. Implementation of the compact would mean there would be a gain of 18 licensees. However, it is anticipated that the increase would be negated as other licensees may not renew or may go inactive. DPR notes there is an annual nurse license compact administrator's fee of $3,000. The revenue loss with the nurse license compact implemented was figured into the revenue projections through fiscal year 2007. Implementation of the nurse license compact will not require a license renewal fee increase assuming the revenue projections are accurate.
| FISCAL IMPACT - State Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| $0 | $0 | $0 | |
| FISCAL IMPACT - Local Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| $0 | $0 | $0 |
FISCAL IMPACT - Small Business
This proposal could result in a cost savings for individuals nurses who currently maintain licenses in more than one state, including Missouri.
DESCRIPTION
This proposal creates two multistate nursing licensure compacts; one for registered nurses and one for advanced practice registered nurses. These compacts allow licensed registered nurses and advanced practice registered nurses to practice nursing in states which participate in one of the nurse licensure compacts. All states wishing to participate in the compacts must adopt articles of authorization listed in the proposal.
This proposal 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
Department of Health and Senior Services
Secretary of State's Office - Administrative Rules
Office of the State Courts Administrator
Department of Corrections
Office of Prosecution Services
Office of the State Public Defender
Office of Administration - Administrative Hearing Commission
Mickey Wilson, CPA
Director
January 16, 2003