COMMITTEE ON LEGISLATIVE RESEARCH

OVERSIGHT DIVISION



FISCAL NOTE



L.R. No.: 3966-03

Bill No.: SCS for SB 1142

Subject: Health Care; Health Care Professionals; Health Department; Hospitals

Type: Original

Date: March 9, 2004




FISCAL SUMMARY



ESTIMATED NET EFFECT ON GENERAL REVENUE FUND
FUND AFFECTED FY 2004 FY 2005 FY 2006
Total Estimated

Net Effect on

General Revenue

Fund

$0 $0 $0



ESTIMATED NET EFFECT ON OTHER STATE FUNDS
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.











ESTIMATED NET EFFECT ON FEDERAL FUNDS
FUND AFFECTED FY 2004 FY 2005 FY 2006
Total Estimated

Net Effect on All

Federal Funds

$0 $0 $0



ESTIMATED NET EFFECT ON LOCAL FUNDS
FUND AFFECTED FY 2004 FY 2005 FY 2006
Local Government $0 $0 $0




FISCAL ANALYSIS

ASSUMPTION



Officials from the Department of Social Services, the Office of Administration - Administrative Hearing Committee, the Office of State Courts Administrator, and the Department of Health and Senior Services assume this proposal would not fiscally impact their agencies.



Officials from Barton County Memorial Hospital did not respond to our fiscal note request. In a similar fiscal note from the previous session, Barton County Memorial Hospital assumed the costs would be minimal. Oversight assumes the costs to other county hospitals would be minimal.



Officials from the Secretary of State Office (SOS) state this proposal creates the Disposition of Fetal Remains Act. Based on experience with other divisions, the rules, regulations and forms

issued by the Department of Health and Senior Services could require as many as 6 pages in the

Code of State Regulations. 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 Code. These costs are estimated. The estimated cost of a page in the Missouri

Register is $23. The estimated cost of a page in the Code is $27. The actual cost could be more or less than the numbers given. The impact of this legislation in future years is unknown and



ASSUMPTION (continued)



depends upon the frequency and length of rules filed, amended, rescinded or withdrawn. The

SOS estimates the cost for FY 05 only to be $369.



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.



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



Small businesses which are health care facilities would be affected by this proposal.



DESCRIPTION



This proposal establishes the "Disposition of Fetal Remains Act" and allows the state registrar to issue a "Certificate of Birth Resulting in Stillbirth" for stillborn children.



SECTION 193.255 - The state registrar shall issue a "Certificate of Birth Resulting in Stillbirth" to any applicant having a direct and tangible interest in the record. The information shall be based on information available from the spontaneous fetal death report filed pursuant to Section 193.165, RSMo. The certificate shall include the statement "This is not proof of a live birth". Individuals may file an application for a certificate for any birth that resulted in stillbirth prior to August 28, 2004.



SECTION 194.378 - The mother has a right to determine the final disposition of the fetal

remains, regardless of the duration of a pregnancy. The mother may choose any means of final disposition authorized by law or by the Department.



DESCRIPTION (continued)

SECTION 194.381 - Final disposition of fetal remains may be by cremation, burial, incineration in an approved medical waste incinerator, or other means authorized by the Director of the Department of Health and Senior Services. The final disposition of fetal remains does not require a religious service or ceremony.



SECTION 194.384 - Hospitals and other health care facilities must adopt written standards regarding the final disposition of fetal remains.



SECTION 194.387 - Within twenty-four hours of a miscarriage, hospitals and other health care facilities must notify the mother in writing of her right to determine the final disposition of the fetal remains. Hospitals and other health care facilities must make counseling available to the mother concerning the death of the fetus.



SECTION 194.390 - The "Disposition of Fetal Remains Act" does not prohibit a woman's ability to obtain a legal abortion.



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 -

Administrative Hearing Committee

Office of State Courts Administrator

Department of Health and Senior Services

Department of Social Services

Secretary of State



NOT RESPONDING: Barton County Memorial Hospital









Mickey Wilson, CPA

Director

March 9, 2004