COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. NO.: 4492-02
BILL NO.: SB 1027
SUBJECT: Children and Minors; Dentists; Medicaid; Health Care; Health Department; Health Care Professionals; Medical Procedures and Personnel
TYPE: Original
DATE: March 7, 2000
FISCAL SUMMARY
| FUND AFFECTED | FY 2001 | FY 2002 | FY 2003 |
| General Revenue | (Unknown) | (Unknown) | (Unknown) |
| Total Estimated
Net Effect on All State Funds* |
(UNKNOWN) | (UNKNOWN) | (UNKNOWN) |
*Expected to exceed $100,000 annually.
| FUND AFFECTED | FY 2001 | FY 2002 | FY 2003 |
| Federal | $0 | $0 | $0 |
| Total Estimated
Net Effect on All Federal Funds* |
$0 | $0 | $0 |
*Unknown revenues and expenditures annually and net to $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 Public Safety - Missouri State Highway Patrol, the Missouri Consolidated Health Care Plan, the Department of Economic Development - Division of Professional Registration, the Department of Conservation, the Department of Transportation, the Department of Health, and the Department of Insurance assume this proposal would not fiscally impact their agencies.
Department of Social Services (DOS) officials state the proposal would allow a physician that is treating a child for immunizations to administer the appropriate fluoride treatment to the child. DOS states a licensed dental hygienist who is practicing in a public health setting may provide fluoride treatments, teeth cleaning, and sealants to Medicaid-eligible children without the supervision of a dentist. DOS states that Medicaid would reimburse any dental hygienist, dentist, or pediatrician who provides fluoride treatments, teeth cleaning, and sealants to Medicaid-eligible children at no less than 75% of the usual and customary cost. DOS assumes the fiscal impact is unknown but expects the fiscal impact to be greater than $100,000.
| FISCAL IMPACT - State Government | FY 2001
(10 Mo.) |
FY 2002 | FY 2003 |
| GENERAL REVENUE FUND | |||
| Costs - Department of Social Services | |||
| Medical assistance payments | (Unknown) | (Unknown) | (Unknown) |
| ESTIMATED NET EFFECT ON GENERAL REVENUE FUND* |
(UNKNOWN) |
(UNKNOWN) |
(UNKNOWN) |
| *Expected to exceed $100,000 annually. | |||
| FEDERAL FUNDS | |||
| Income - Department of Social Services | |||
| Medicaid reimbursements* | Unknown | Unknown | Unknown |
| Costs - Department of Social Services | |||
| Medical assistance payments* | (Unknown) | (Unknown) | (Unknown) |
| ESTIMATED NET EFFECT ON FEDERAL FUNDS |
$0 |
$0 |
$0 |
| *Expected to exceed $100,000 annually. | |||
| FISCAL IMPACT - Local Government | FY 2001
(10 Mo.) |
FY 2002 | FY 2003 |
| $0 | $0 | $0 |
FISCAL IMPACT - Small Business
Small dental offices would expect to be fiscally impacted to the extent they would incur additional revenue and costs as a result of the requirements of this proposal.
DESCRIPTION
This proposal would allow additional persons to provide certain dental treatments to children. Section 167.181 currently requires children to be immunized. New language would state that when a child is receiving an immunization, the physician may also administer the appropriate fluoride treatment to the child. Currently, Section 192.070 requires the Bureau of Child Hygiene to issue educational literature. New language would state that such literature should include the importance of routine dental care for children. Section 332.311 currently prohibits dental hygienists from practicing without the supervision of a dentist. New language would create an exception to this rule by allowing a dental hygienist who is practicing in a public health setting to provide fluoride treatments, teeth cleaning, and sealants, if appropriate, to children who would be eligible for Medicaid. These procedures may be done without the supervision of a dentist. Medicaid would reimburse all dentists, dental hygienists, and pediatricians who provide the above services at seventy-five percent of the usual and customary cost, which would be determined by the Division of Medical Services by rule. This provision would expire on August
28, 2005.
DESCRIPTION (continued)
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
Department of Social Services
Department of Economic Development
Division of Professional Registration
Missouri Consolidated Health Care Plan
Department of Transportation
Department of Conservation
Department of Public Safety
Missouri State Highway Patrol
Department of Insurance
Jeanne Jarrett, CPA
Director
March 7, 2000