COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. NO.: 3937-01
BILL NO.: SB 889
SUBJECT: Drugs and Controlled Substances; Nurses; Health Care; Health Care Professionals; Medical Procedures and Personnel
TYPE: Original
DATE: February 15, 2000
FISCAL SUMMARY
| FUND AFFECTED | FY 2001 | FY 2002 | FY 2003 |
| General Revenue | $30,000 | $30,000 | $30,000 |
| Total Estimated
Net Effect on All State Funds |
$30,000 | $30,000 | $30,000 |
| FUND AFFECTED | FY 2001 | FY 2002 | FY 2003 |
| None | |||
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2001 | FY 2002 | FY 2003 |
| Local Government | $0 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 4 pages.
ASSUMPTION
Officials from the Department of Social Services - Division of Medical Services, the Department of Economic Development - Division of Professional Registration, the Department of Transportation, the Department of Public Safety - Missouri State Highway Patrol, the Department of Insurance, the Department of Conservation, and the Missouri Consolidated Health Care Plan assume this proposal would not fiscally impact their agencies.
The Department of Health (DOH) states that certified registered nurse anesthetists (CRNA) could independently order the administration of a controlled substance for a patient. This would require that any CRNA doing so, register with the Department of Health. Registration requires an annual fee of $30. There are approximately 1,000 CRNAs, therefore, this proposal could generate $30,000 in General Revenue per year.
DOH further states there are approximately 1,000 CRNAs in Missouri who would potentially be eligible to register with the Bureau of Narcotics and Dangerous Drugs (BNDD), Department of Health for controlled substance authority. This would increase DOH registration and monitoring workload by approximately 5%. The BNDD currently has 8 investigators. DOH assumes that an additional caseload of 5% would require 1 Investigator II ($36,468) or equivalent budget for contractual investigators. The Investigator II position would inspect and monitor records and security required by law and any possible diversion or theft of controlled substances. All complains received would be investigated.
Oversight assumes a 5% increase in workload would not require additional FTE.
| FISCAL IMPACT - State Government | FY 2001
(10 Mo.) |
FY 2002 | FY 2003 |
| GENERAL REVENUE FUND | |||
| Income - Department of Health | |||
| Registration fees | $30,000 | $30,000 | $30,000 |
| ESTIMATED NET EFFECT ON GENERAL REVENUE FUND |
$30,000 |
$30,000 |
$30,000 |
| FISCAL IMPACT - Local Government | FY 2001
(10 Mo.) |
FY 2002 | FY 2003 |
| $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 would allow registered professional nurses (RPN)who are registered nurse anesthetists to dispense controlled substances to their patients. Current law allows physicians,
podiatrists, dentists, optometrists and veterinarians to prescribe, administer, and dispense controlled substances to their patients. They may all allow nurses or graduate physicians under their supervision to do so as well. New language would add RPNs who are recognized as nurse anesthetists to the list. Such persons, however, may only allow nurses under their supervision
to administer or dispense controlled substances. This proposal would also add a new Section 335.098, which would allow RPNs who are recognized as registered nurse anesthetists to prescribe and administer those drugs and devices, including controlled substances, that would be customarily used in their profession during the time surrounding an operation. They would allow others authorized under this section to do the same.
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 Insurance
Missouri Consolidated Health Care Plan
Department of Social Services
Department of Conservation
Department of Transportation
Department of Public Safety
Missouri State Highway Patrol
Department of Health
Department of Economic Development
Division of Professional Registration
Jeanne Jarrett, CPA
Director
February 15, 2000