COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 1215-01
Bill No.: SB 273
Subject: Health Care; Health Care Professionals; Medical Procedures & Personnel; Physicians
Type: Original
Date: February 12, 2001
FISCAL SUMMARY
| FUND AFFECTED | FY 2002 | FY 2003 | FY 2004 |
| Healing Arts Fund | ($24,999) | ($26,464) | ($27,125) |
| Total Estimated
et Effect on All State Funds |
($24,999) |
($26,464) |
($27,125) |
| FUND AFFECTED | FY 2002 | FY 2003 | FY 2004 |
| None | $0 | $0 | $0 |
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2002 | FY 2003 | FY 2004 |
| Local Government | $0 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 3 pages.
ASSUMPTION
Officials from the Department of Economic Development-Division of Professional Registration (DPR) assume the proposed legislation would result in an increase in workload due to approximately 240 supervision agreements submitted annually for review by the Board of Healing Arts. DPR assumes the need for a .5 Investigator II (.5 FTE at $37,488 per year) to routinely audit and review each physician agreement and the documentation of the joint review of practice. It is estimated that each review will take approximately 6 - 8 hours each (240 licensees x 6 hours = 1,440 hours). It is assumed that the audits and reviews can be conducted in the board office. However, if travel is required, additional expense and equipment costs will be needed.
The associated costs will be paid from the Board of Registration for the Healing Arts fund. NOTE: A license fee increase for physician assistants may be necessary to cover the costs associated with this proposal.
Officials from the Department of Health Department of Social Services (DOS) assume the proposed legislation would have no fiscal impact on its agency.
| FISCAL IMPACT - State Government | FY 2002
(10 Mo.) |
FY 2003 | FY 2004 |
| HEALING ARTS FUND | |||
| Costs-DPR
Personal Service |
($16,011) |
($19,693) |
($20,185) |
| Fringe Benefits | ($5,336) | ($6,564) | ($6,728) |
| Expense & Equipment | ($3,652) | ($207) | ($212) |
| Total Costs-DPR | ($24,999) | ($26,464) | ($27,125) |
| FISCAL IMPACT - Local Government | FY 2002
(10 Mo.) |
FY 2003 | FY 2004 |
| $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 act modifies the regulation of physician's assistants. Section 334.735 currently regulates physician's assistants (PA). The act modifies the definition of "supervision" to require "direct, on-site" control in the same office where a physician is present. The act prohibits a PA from performing any of the procedures listed in 334.735.3 on a new patient without the prior review of the supervising physician. For the treatment of existing patients, the PA must obtain prior approval through a documented order, signed and dated by the physician. Any PA practicing under a physician supervision agreement must notify the Board of Registration for the Healing Arts in order for the Board to track the agreement and make it available to the public. Language is also added requiring PAs to carry individual liability insurance in an amount no less than one million dollars. Finally, a new subsection 10 is added to state that it will be against public policy to make contracts or agreements that require a physician to supervise a PA without also providing a right to refuse supervision if the PA is not believed to be appropriately competent.
This act is identical to SB 874 (2000).
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 Economic Development
Division of Professional Registration
Department of Social Services
Department of Health
Jeanne Jarrett, CPA
Director
February 12, 2001