COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 3320-01
Bill No.: SB 1145
Subject: Health Care: Health Care Professionals; Medical Procedures and Personnel; Physicians
Type: Original
Date: March 8, 2002
FISCAL SUMMARY
| FUND AFFECTED | FY 2003 | FY 2004 | FY 2005 |
| Total Estimated
Net Effect on All State Funds |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2003 | FY 2004 | FY 2005 |
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2003 | FY 2004 | FY 2005 |
| Local Government | $0 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 3 pages.
ASSUMPTION
Officials from the Department of Social Services and the Department of Economic Development - Division of Professional Registration stated that this proposed legislation would have no fiscal impact on their agencies.
| FISCAL IMPACT - State Government | FY 2003
(10 Mo.) |
FY 2004 | FY 2005 |
| $0 | $0 | $0 |
| FISCAL IMPACT - Local Government | FY 2003
(10 Mo.) |
FY 2004 | FY 2005 |
| $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 proposed legislation redefines the supervision of physician's assistants (PA) by physicians. Section 334.735, RSMo, currently defines the scope of practice of a PA and requires a PA to be supervised by a physician within the same office facility. This proposal provides a new definition for the term "supervision" to require the physician to be immediately available to the PA either
personally or by telecommunications. A supervising physician must be personally present at least twenty percent of the clinic hours if a PA is used. The PA is limited to practice at locations where a physician is no more than thirty miles away and, in health professional shortage areas, fifty miles away. The ability of the Board of Healing Arts to make rules regarding the proximity of
practice between the PA and physician is removed.
This proposal requires all applicants for PA licensure who apply after January 1, 2005, to have a master's degree in a health or medical science related field. A physician is not allowed to supervise more than three full time PAs at one time. This rule does not, however, apply to hospital employees providing in-patient care services. The supervising physician must document the completion of at least one month of practice with a supervising physician continuously present before a PA may practice without the physician continuously present.
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 Social Services
Department of Economic Development
Division of Professional Registration
Mickey Wilson, CPA
Acting Director
March 8, 2002