COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 2034-01
Bill No.: SB 673
Subject: Health Department; Medical Procedures and Personnel
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 5 pages.
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Federal | $0 | $0 | $0 |
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
Income and expenses of approximately $20,000,000 in FY 04 and $8,000,000 annually would net to $0.
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Local Government | $0 | $0 | $0 |
ASSUMPTION
Officials from the Department of Public Safety, the Springfield Police Department, and the Missouri State Highway Patrol, assume this proposal would not fiscally impact their agencies.
Officials from the Department of Health and Senior Services (DOH) assume this proposal requires a vaccination program for first responders would be implemented to include, but not limited to: hepatitis A, hepatitis B, diphtheria-tetanus, influenza, pneumococcal and other vaccinations as recommended by the United Public Health Service. The DOH states implementation of this proposal would have an impact on the DOH's immunization program, the Center for Emergency Response and Terrorism (CERT), and would affect some operations of the Division of Health Standard and Licensure. Given experience with other vaccination programs, the DOH states a program such as this would have a substantial impact on DOH resources and manpower on a permanent basis.
The DOH states there are 114 local public health agencies (LPHA) in Missouri that the DOH would contract with the actually do the immunizations. The DOH assumes that the contracts with the LPHAs would be $50 for each person being vaccinated. Of the 150,000 first responders it is estimated that 100,000 of them would consent/be able to take the vaccinations. Costs of contracts would be: 100,000 people × $50/person for the LPHAs = $5,000,000 annual.
ASSUMPTION (continued)
The DOH assumes the costs of the vaccinations would be:
Hep A: 2 doses @ $17.75 each = $35.50/vac × 100,000 people = $3,550,000
Hep B: 3 doses @ $24.25 each = $72.75/vac × 100,000 people = $7,275,000
Pneumococcal: $13.08/vac × 100,000 = $1,308,000 (assuming only one dose would be required during working years)
First year costs of "one-time" vaccinations = 3,550,000+7,275,000+1,308,000=$12,133,000
The DOH states assuming a 10% turnover rate would mean the ongoing costs would be $1,213,300 ($12,133,000 x 10%) per year
Additional Costs of Annual Vaccinations:
Influenza: $5.25/dose × 100,000 = $525,000 annually
Costs of Vaccination needed every 10 years:
Tetanus-Diphtheria, assume that 10% of the first responders need to get the booster every year:
Year 1: $6.41 x 100,000 = $641,000
Every year after: $6.41 × 10,000 = $64,100
Costs of Vaccination needed every 5 years:
Smallpox, assume that 10% of the first responders need to get the booster every year.
Year 1: $15 × 100,000 = $1,500,000
Every year after: $15 × 10,000 = $150,000
Personnel Costs-The DOH assumes it would need 1 FTE Clerk Typist III, 3 FTE CHN IVs, 6 FTE Health Program Representatives II, 2 FTE Data Entry Operators, and 1 FTE Program Coordinator.
Oversight has, for fiscal note purposes only, changed the starting salary for the above mentioned personnel to correspond to the second step above minimum for comparable positions in the state's merit system pay grid. This decision reflects a study of actual starting salaries for new state employees for a six month period and the policy of the Oversight Subcommittee of the Joint Committee on Legislative Research.
Oversight assumes that this program will not become effective unless the DOH receives federal funds.
| FISCAL IMPACT - State Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| FEDERAL | |||
| Income - Department of Health and Senior Services | |||
| Federal assistance | $19,722,790 | $7,859,655 | $8,136,566 |
| Costs - Department of Health and Senior Services | |||
| Personal Service (14 FTE) | ($400,586) | ($410,601) | ($420,866) |
| Fringe Benefits | ($162,117) | ($166,170) | ($170,324) |
| Expense and Equipment | ($19,160,087) | ($7,282,884) | ($7,545,376) |
| Total Costs - Department of Health and Senior Services |
($19,722,790) |
($7,859,655) |
($8,136,566) |
| ESTIMATED NET EFFECT ON FEDERAL FUNDS |
$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 requires the Department of Health and Senior Services to offer a vaccination program for first responders. Participation in most cases is voluntary, and authorized exceptions exist. The program will become effective upon receipt of federal funds
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 Health and Senior Services
Department of Public Safety
Springfield Police Department
NOT RESPONDING: Cooper County Hospital, Kansas City Police Department, Greene County Sheriff, Pemiscot Hospital, St. Louis County Police Department, and Taney County Ambulance District
Mickey Wilson, CPA
Director
March 11, 2003