COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 1046-01
Bill No.: SB 515
Subject: Nurses; Boards, Commissions, Committees, Councils; Economic Development Dept.; Licenses - Professional; Health Care Professionals
Type: Original
Date: March 11, 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 4 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 Economic Development - Division of Professional Registration assume the proposal would have no fiscal impact on their division.
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 Secretary of State's Office (SOS) state the Department of Economic Development, State Board of Nursing (Board) could promulgate rules to implement this proposal. SOS estimates, based on experience with other divisions, the rules, regulations and forms issued by the Board could require as many as 10 pages in the Code of State Regulations (Code). For any given rule, roughly half again as many pages are published in the Missouri Register as in the Code. The estimated cost of a page in the Missouri Register is $23. The estimated cost of a page in the Code is $27. SOS estimates costs of $615 in FY 2004.
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 decisions to raise fees to defray costs would likely be made in subsequent fiscal years.
ASSUMPTION (continued)
Oversight notes advance practice nurses are currently being licensed according to regulations promulgated by the State Board of Nursing (4 CSR 200-4.100) and therefore assumes no fiscal impact related to this proposal.
| 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
No direct fiscal impact to small businesses would be expected as a result of this proposal.
DESCRIPTION
This proposal provides for the licensing of advanced practice registered nurses. The proposal provides definitions for "advanced practice nursing," an "advanced practice registered nurse," and "lapsed license status." The definition of "registered professional nursing" is modified to include acts done without compensation.
Licensed practical nurses are authorized to establish peripheral vascular access for the administration of select intravenous infusion treatment modalities. Currently, licensed practical nurses are authorized to administer intravenous fluid treatment.
DESCRIPTION (continued)
The proposal establishes licensing procedures for applicants to practice as an advanced practice
registered nurse. The applicant must demonstrate completion of certain educational and experience requirements. Applicants are exempt from meeting the educational requirements if they have earned a professional nursing degree and have enrolled in certain accredited programs for advanced practice registered nurses prior September 1, 2003, and have earned an advanced practice registered nurse certificate before December 31, 2005, and have submitted a completed application for licensure to the board before December 31, 2005. The proposal provides for the issuance of a temporary permit (no fee to be charged), under certain conditions, to an applicant while the application is pending.
Registered professional nurses who are recognized by the board to title and practice as an advanced practice nurse before December 31, 2003, and whose recognition is current and active, shall be issued an advanced practice registered nurse license and be exempt from the licensing requirements for advanced practice registered nurses contained in this 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
Office of Administration - Administrative Hearing Commission
Secretary of State's Office - Administrative Rules Division
Mickey Wilson, CPA
Director
March 11, 2003