COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 3186-01
Bill No.: SB 749
Subject: Nurses; Health Care; Health Care Professionals; Medical Procedures and Personnel; Licenses - Professional
Type: Original
Date: January 30, 2004
FISCAL SUMMARY
| FUND AFFECTED | FY 2005 | FY 2006 | FY 2007 |
| Total Estimated
Net Effect on General Revenue Fund |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2005 | FY 2006 | FY 2007 |
| Nursing Fund | $0 | $15,000 | $225 |
| Total Estimated
Net Effect on All State Funds |
$0 | $15,000 | $225 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 4 pages.
| FUND AFFECTED | FY 2005 | FY 2006 | FY 2007 |
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2005 | FY 2006 | FY 2007 |
| Local Government | $0 | $0 | $0 |
ASSUMPTION
Officials from the Department of Insurance assume the proposal will have no fiscal impact on their organization.
Officials from the Office of Administration - Division of Budget and Planning (BAP) state the proposed legislation should not result in additional costs or savings to the BAP. The proposal would increase total state revenue.
Officials from the Department of Economic Development (DED) - Division of Professional Registration (PR) state the proposal requires the State Board of Nursing to promulgate rules to establish a licensure category for registered nurse first assistants (RNFAs).
The Missouri Association of RNFAs estimates there are approximately 100 RFNAs in Missouri. It is estimated that a $150 biennial fee will be charged (100 X $150 = $15,000). A 3% growth rate has also been calculated (100 RFNAs X 3% = 3 new RFNAs in FY 07). Start-up costs for implementation of this proposal include four (4) telephone conference calls of the Practice Committee of the board to review certifying agency criteria and approve rules ($100 X4 = $400, includes per diem for board members, conference call costs and board member charges for phone calls). It is also assumed that existing staff will design, program and implement a computer licensing program (8 hours X $21.65/hour = $173). This will be a one-time set-up cost through a ASSUMPTION (continued)
PR transfer (total start-up costs = $573). It is further assumed that there will be on-going expenses for printing application forms and renewals (on-going costs approximately $106 annually). It is assumed that all other costs can be covered by the board's current appropriation.
Oversight assumes DED-PR will be able to absorb the minimal costs associated with implementing this proposal with current appropriations.
Officials from the Office of the Secretary of State (SOS) state this proposal recognizes "registered nurse first assistants" and authorizes the board of Nursing to certify such practitioners. The Missouri State Board of Nursing may promulgate rules to implement this legislation. Based on experience with other divisions, the rules, regulations and forms issued by the Missouri State Board of Nursing could require as many as 10 pages in the Code of State Regulations. For any given rule, roughly one-half again as many pages are published in the Missouri Register as are published in the Code because cost statements, fiscal notes and notices are not published in the Code. The estimated cost of a page in the Missouri Register is $23.00. The estimated cost of a page in the Code of State Regulations is $27.00. The actual costs could be more or less than the numbers given. The fiscal impact of this legislation in future years is unknown and depends upon the frequency and length of rules filed, amended, rescinded and withdrawn. The SOS estimates the cost of this legislation to be $615 [(10 pp x $27) + (15 pp x $23)].
Oversight assumes the SOS could absorb the costs of printing and distributing regulations related to this proposal. If multiple bills 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.
This proposal will increase Total State Revenue.
| FISCAL IMPACT - State Government | FY 2005
(10 Mo.) |
FY 2006 | FY 2007 |
| NURSING FUND | |||
| Income - Department of Economic Development - Professional Registration | |||
| Biennial Licensing Fees | $0 | $15,000 | $225 |
| ESTIMATED NET EFFECT ON NURSING FUND |
$0 |
$15,000 |
$225 |
| FISCAL IMPACT - Local Government | FY 2005
(10 Mo.) |
FY 2006 | FY 2007 |
| $0 | $0 | $0 |
FISCAL IMPACT - Small Business
Small businesses which are owned by or could employ registered nurse first assistants could be fiscally impacted by this proposal.
DESCRIPTION
This proposal defines the term "registered nurse first assistants" and authorizes the Missouri State Board of Nursing to promulgate rules for their certification. A "registered nurse first assistant" (RNFA) is defined as a registered nurse, licensed in Missouri, who has received additional certification through a nationally-recognized professional organization to become a RNFA or who meets the criteria for RNFAs establishes by the Missouri State Board of Nursing.
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
Office of Administration -
Division of Budget and Planning
Department of Economic Development -
Division of Professional Registration
Department of Insurance
Office of Secretary of State
Mickey Wilson, CPA
Director
January 30, 2004