COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 3668-01
Bill No.: SB 879
Subject: Removes the religious and medical exemption limitations from childhood vaccination requirements.
Type: Original
Date: January 23, 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 4 pages.
ASSUMPTION
Officials from the Missouri Consolidated Health Care Plan (HCP) stated the HCP feels the majority of children insured under the HCP receive their vaccinations and very few claim the exemptions. Therefore, the additional members seeking vaccinations is expected to be very few and will have a very minimal impact on the HCP's premiums.
Officials from the Missouri Highways and Transportation Department, Department of Insurance, Missouri Department of Conservation, and Department of Public Safety - Missouri Highway Patrol assume the proposed legislation will not fiscally impact their organization.
Officials from the Department of Elementary and Secondary Education (DES) assume the proposed legislation will not fiscally impact their organization. However, the proposal would allow parents to exempt their children from vaccination without cause for religious beliefs or medical contraindications. This could cause an increase in the number of children exempted from vaccinations which may expand the level of record-keeping at local schools; however, the Department of Health and Senior Services does not expect this proposal to have a significant impact statewide.
Officials from the Department of Health and Senior Services (DOH) stated this legislation would not be expected to significantly impact the operations of the DOH. If the proposal were to substantially impact the DOH programs, then the DOH would request funding through the legislative process.
The primary responsibility for implementing this law would fall on public and private school nurses.
Oversight assumes the additional responsibility placed on public and private school nurses would be minimal and could be absorbed within existing resources.
Officials from the Department of Social Services (DOS) stated that although this bill could result in fewer vaccinations being administered to children, the savings to Medicaid is not expected to be significant. In addition, it is difficult to attach a cost to increased Medicaid payments for illnesses resulting from unvaccinated children.
Officials from the Office of the Secretary of State (SOS) state this bill would require the Department of Health and Senior Services, the Department of Elementary and Secondary Education, and the Department of Social Services, Family Services to promulgate rules and regulations as they pertain to the removal of religious and medical exemption limitations regarding childhood vaccination requirements. Based on prior rulemakings for these agencies, rules and forms for these agencies could ASSUMPTION (continued)
require as many as 29 pages in the Code of State Regulations. For any given rule, roughly one-half again as many pages are published in the Missouri Register as are published in the Code because cost statements, fiscal notes and notices are not published in the Code. The estimated cost of a page in the Missouri Register is $23.00. The estimated cost of a page in the Code of State Regulations is $27.00. The actual costs could be more or less than the numbers given. The fiscal impact of this legislation in future years is unknown and depends upon the frequency and length of rules filed, amended, rescinded and withdrawn. The SOS estimates the cost of this legislation to be $1,487 [(29 pp x $27) + (43.5 pp x $23)].
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 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 act removes the religious and medical exemption limitations from childhood vaccination requirements. Currently, Section 167.181, RSMo, allows a parent to claim his or her child is exempt from immunization requirements due to religious beliefs or medical contraindications. This act removes those limitations and allows a parent to simply object in writing. New language requires the Department of Health and Senior Services, school districts, and other public entities to inform the public of available exemptions. In addition, this act changes all references to the term "immunization" to "vaccination".
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
Missouri Consolidated Health Care Plan
Missouri Department of Highways and Transportation
Department of Elementary and Secondary Education
Department of Health and Senior Services
Department of Social Services
Department of Insurance
Missouri Department of Conservation
Department of Public Safety - Missouri Highway Patrol
Office of Secretary of State
Mickey Wilson, CPA
Acting Director
January 23, 2002