This Fiscal Note is not an official copy and should not be quoted or cited.
Fiscal Note - SB 0726 - Dept. of Health to Promote Core Functions of Public Health
L.R. NO. 2146-03
BILL NO. SCS for SB 726 w/ HCA 1
SUBJECT: Health; Health Professional, Department of Health; Public Health;
Department of Natural Resources
TYPE: Original
DATE: May 13, 1996
FISCAL SUMMARY
ESTIMATED NET EFFECT ON STATE FUNDS
FUND AFFECTED FY 1997 FY 1998 FY 1999
None
Total Estimated
Net Effect on All
State Funds $0 $0 $0
ESTIMATED NET EFFECT ON FEDERAL FUNDS
FUND AFFECTED FY 1997 FY 1998 FY 1999
None
Total Estimated
Net Effect on All
Federal Funds $0 $0 $0
ESTIMATED NET EFFECT ON LOCAL FUNDS
FUND AFFECTED FY 1997 FY 1998 FY 1999
Local Government $0 $0 $0
FISCAL ANALYSIS
ASSUMPTION
Officials from the Department of Social Services, the Department of Mental
Health, the Office of Lieutenant Governor, the Office of Secretary of State,
the Office of Attorney General, the Office of State Courts Administrator, the
Department of Insurance, the Office of State Auditor, the Department of
Elementary and Secondary Education, the Department of Agriculture, the
Department of Natural Resources, St. Louis County, and the City of
Springfield assume this proposal would not fiscally impact their agencies.
The Department of Natural Resources (DNR) assumes this proposal does not
conflict with the Missouri Constitution which states that DNR is responsible
for administering the programs of the state as provided by law relating to
environmental control and the conservation and management of natural
resources. Therefore, DNR assumes this proposal would not fiscally impact
their agency.
Officials from the Department of Health (DOH) assume that the definition of
abortion facility would require it to inspect physicians offices and other
abortion facilities, resulting in a potential 100 to 1,500 facilities which
would have to be inspected. In order to conduct a comprehensive review of
these facilities, DOH assumes that a survey team comprised of, at a minimum,
2 Health Facility Nursing Consultants and a Health Facility Consultant I,
would be required. The Health Facility Nursing consultants would evaluate
the care provided while the Health Facility Consultant I would evaluate the
construction, fire safety requirements and infection control. In addition, a
Health Facility Consultant II would be needed to manage the program and
develop rules and regulations. Clerical support would be needed as well.
This would be the minimum needed to inspect 100 facilities. Therefore, DOH
has ranged the costs for the staff from the inspections of 100 to 1,500
facilities to be $303,959 to $4,009,160 annually.
Section 192.038 requires abortion facilities as defined in section 188.015,
which holds itself out to the public as providing abortions and which are not
required to be licensed as an ambulatory surgical center, shall be inspected,
at least annually, by the DOH. Similar language was previously contested and
per a decision by the Oversight Subcommittee on April 10, 1996, any costs
related to licensure and inspection were eliminated.
Officials from Jackson County, Clay County, St. Charles County, Franklin
County, Jefferson County, Greene County, City of Kansas City, and City of St.
Louis did not respond to our fiscal impact request.
FISCAL IMPACT - State Government FY 1997 FY 1998 FY 1999
(10 Mo.)
$0 $0 $0
FISCAL IMPACT - Local Government FY 1997 FY 1998 FY 1999
(10 Mo.)
$0 $0 $0
DESCRIPTION
This proposal would encourage cooperation between county, city, and
city/county public health agencies to provide prevention and health
promotion. It would require the Director of the Department of Health (DOH)
to set public health minimum standards and to be responsible for the ten core
functions of public health described in this proposal.
An abortion facility as defined under chapter 188.015 (i.e., clinic,
physician's office or any other place or facility in which abortions are
performed other than a hospital) would not be required to be licensed as an
ambulatory surgical center, but shall be inspected at least annually, or any
time for good cause, by the Department of Health (DOH). DOH would promulgate
rules necessary for the operation of unlicensed abortion facilities. Twenty
day written notice would be given to the facility when DOH has reasonable
grounds to believe a violation is occurring. Failure on the part of the
facility to correct the violation could result in DOH seeking injunctive
relief and any other relief under the law.
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 Agriculture
Department of Health
Department of Social Services
Department of Mental Health
Office of Lieutenant Governor
Office of Secretary of State
Office of Attorney General
Office of State Auditor
Department of Elementary and Secondary Education
Department of Natural Resources
Department of Insurance
Office of State Courts Administrator
City of Springfield
St. Louis County
NOT RESPONDING: Jackson County, Clay County, St. Charles County, Franklin
County, Jefferson County, Greene County, City of Kansas City, and City of St.
Louis