COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 1516-01
Bill No.: SB 424
Subject: Health Care; Hospitals; Medical Procedures and Personnel; Nurses
Type: Original
Date: April 1, 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 | (Unknown exceeding $100,000) | (Unknown exceeding $100,000) | (Unknown exceeding $100,000) |
ASSUMPTION
Officials from the Department of Mental Health, the Department of Social Services, and the Department of Economic Development - Division of Professional Registration assume this proposal would not fiscally impact their agencies.
Officials from the Department of Health and Senior Services (DOH) state this proposal enacts nurse staffing requirements and procedures for maintaining staffing requirements during non-emergency and emergency situations for all hospitals. DOH states the costs to hospitals is indeterminate because of the varying sizes of hospitals, the varying services offered, and the staffing mix of licensed staff versus non-licensed staff.
DOH states this proposal would not create a fiscal impact for DOH. Staffing needs based on
the patient's needs are presently assessed as part of the regular survey process.
Oversight requested various hospitals in Missouri to respond to this fiscal note request. None of the hospitals responded. However, in a similar proposal from the previous session, various hospitals indicated that there would be unknown costs in developing and maintaining an acuity
ASSUMPTION (continued)
system. Oversight assumes the costs to county hospitals is unknown but greater than $100,000.
| 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 |
| COUNTY HOSPITALS | |||
| Costs - County Hospitals | |||
| Development and maintenance cost of an acuity system | (Unknown exceeding $100,000) | (Unknown exceeding $100,000) | (Unknown exceeding $100,000) |
| ESTIMATED NET EFFECT ON COUNTY HOSPITALS | (Unknown exceeding $100,000) | (Unknown exceeding $100,000) | (Unknown exceeding $100,000) |
FISCAL IMPACT - Small Business
No direct fiscal impact to small businesses would be expected as a result of this proposal.
DESCRIPTION
This proposal establishes nurse staffing plans for licensed hospitals. Hospitals must attempt to fill staffing needs based on the acuity system in order to address staff shortages before requiring a registered nurse or unlicensed personnel to work overtime. Hospitals must not mandate a nurse to work beyond the scheduled shift unless there is a declared national or state emergency.
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 Mental Health
Department of Economic Development -
Division of Professional Registration
Department of Social Services
Department of Health and Senior Services
Mickey Wilson, CPA
Director
April 1, 2003