This Fiscal Note is not an official copy and should not be quoted or cited.
Fiscal Note - SB 0604 - Education for Psychologists; Provisional Counselor Licensure
L.R. NO. 2435-04
BILL NO. HCS for SCS for SB Nos. 604, 666 & 816
SUBJECT: Licenses-Professional: Medical Personnel
TYPE: Original
DATE: May 9, 1996
FISCAL SUMMARY
ESTIMATED NET EFFECT ON STATE FUNDS
FUND AFFECTED FY 1997 FY 1998 FY 1999
Healing Arts $14,337 $15,574 $16,898
Respiratory Care
Practitioners $122,830 ($74,613) $76,047
State Committee of
Psychologists ($7,488) ($5,839) ($5,950)
PR Fees $0 $0 $0
Health Care
Providers ($146,671) $146,671 $0
Total Estimated
Net Effect on All
State Funds ($16,992) $81,793 $86,995
ESTIMATED NET EFFECT ON FEDERAL FUNDS
FUND AFFECTED FY 1997 FY 1998 FY 1999
None $0 $0 $0
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 Economic Development-Professional
Registration (DPR) assume the proposal would result in licensure and annual
renewals of approximately 1,500 physical therapist assistants (PTAs). The
initial license/examination fee would be set at $225 and would include an
examination cost of $185, which would be paid directly to the testing service
as a pass-through fee. The annual renewal would be set at $40. Revenue for
FY 97 would result in $337,500. In addition, a 3% annual growth would be
estimated.
For licensure of PTAs, DPR assumes they would need an additional Licensure
Technician I (1 FTE at $16,164 per year) to provide clerical and technical
support to the Board to process applications for examination/ licensure and
to handle daily correspondence. It is also assumed there would be a one-time
cost to design, program and implement a computer licensing program to
accommodate physical therapist assistants for a total of $7,440 (240 hours @
$31 per hour).
DPR assumes the start-up costs for the PTA licensure program would be covered
by the existing fund balance of the State Board of Registration for the
Healing Arts.
The General Revenue transfer amount for PTAs is estimated to be $27,512 per
year and is based on the transfer amount for the Real Estate Appraisers
Commission which has a similar licensee count.
Since the licensure requirements for PTAs would be effective after January 1,
1997, costs for FY 97 were computed for only six months.
Officials from DPR assume the proposed legislation would result in Committee
members dedicating an additional .5 day per quarterly Committee meeting to
review the recommendations of the Credentialing Subcommittee in regard to
applications for continuing education (CE) course approval for a cost of
$800. ($25 per diem (for 1/2 day) x 8 members x 4 meetings)
It is assumed the State Committee of Psychologists would utilize a
Credentialing Subcommittee, of at least three members, to review the
applications for continuing education course approval. It is estimated that
each subcommittee member would dedicate at least one additional day per
quarter, prior to the full Committee meeting, to review the requests for a
cost of $600. ($50 per diem x 3 members x 4)
DPR is requesting an additional .2 Licensure Technician I (.2 FTE at $16,164
per year) to process applications for continuing education course approval,
to enter and track CE credits in the computer licensing system and to process
daily correspondence in regard to continuing education. As a standard for
continuing education, it is estimated that for every 1,000 licensees, an
additional .1 FTE would be necessary. The State Committee of Psychologists
has an estimated 1,800 licensees.
Additionally, DPR assumes the current licensing system for psychologists
would need to be revised so that the continuing education credits could be
accurately recorded and tracked for license renewal. This would result in a
one-time expense of $2,480. ($31 per hour x 80 hours)
Due to the negative impact this proposal would have on the State Committee of
Psychologists Fund, it is possible that licensing fees would need to be
increased in the future.
Based on information from the National Board for Respiratory Care, DPR
officials assume the component of the proposal pertaining to Respiratory
Therapists (RTs) would result in the licensure of approximately 1,398
Registered Respiratory Therapists (RRTs) and 2,956 Certified Respiratory
Therapists (CRTs). Revenue is projected to be $122,830 in FY 97, $224,200 in
FY 98 and $230,950 in FY 99. The initial registration fee would be set at
$35 for RRTs and $25 for CRTs. Both fees would need to be increased to $50
in FY 98 to support the provisions of the legislation. Additionally, DPR
assumed a 3% growth rate. Based on prior actual and estimated future
revenues, there would be a $29,450 loss of revenue annually in the Health
Care Providers Fund and a resulting cost savings of a comparable amount. The
registered therapists currently licensed under the Health Care Providers Fund
would now be licensed under the Respiratory Care Practitioners Fund.
It is assumed the Respiratory Care Practitioners Fund would reimburse the
Health Care Providers Fund in FY 98 for the start-up costs incurred in FY 97.
To administer the component of this legislation relating to Respiratory
Therapists ( RTs), DPR assumes they would need a .5 Executive Director II (.5
FTE at $34,694 per year) to serve as the senior executive officer of the
Board and to be responsible for overseeing the registration and regulation of
respiratory care practitioners. In addition, DPR asserts they would need one
Licensure Technician I (1 FTE at $16,164 per year) to provide clerical and
technical support directly to the Executive Director and to the Board.
Due to the total number of estimated RT licensees, DPR also asserts the need
for two additional employees for the Division-Administration support and
investigative pools. DPR would request one Clerk Typist II (1 FTE at $15,624
per year) and one Investigator II (1 FTE at $25,020 per year). The new
standard used by DPR would be an additional FTE for every 3,000 licensees.
DPR included per diem costs for the Board members to meet eight days per year
and has included associated travel expenses, i.e., mileage, hotel, and meals.
The General Revenue Transfer amount for RTs is estimated at $40,320 per year
and is based on the transfer amount for the Advisory Committee for Licensed
Clinical Social Workers, which is a Board of similar size.
For the component of the proposal relating to the Advisory Commission for
Registered Physician Assistants, DPR has included travel costs (mileage,
hotel, meals) associated with the Commission meetings four times per year for
two days each.
DPR has also requested an additional .25 Clerk Typist II (.25 FTE at $15,624
per year) to handle administrative functions of the Commission. However,
Oversight assumes DPR could absorb the additional work load generated by the
Commission with existing staff and has not included costs associated with the
.25 FTE.
Officials from the Office of State Secretary of State (SOS) assume the
proposal would result in the promulgation of new rules. The actual number of
Missouri Register and Code of State Regulations pages this proposal would
generate is unknown; however, an estimate was made based on a sample of four
agencies within Department of Economic Development. SOS estimates a fiscal
impact of $9,800 for FY 97 for publishing and distribution expenses.
Oversight assumes SOS could increase fees to cover any additional costs, per
Section 536.033 RSMo, and therefore, has not included these costs in the
fiscal impact specifications below.
Officials from the Department of Revenue (DOR), Department of Social Services
(DOS), Department of Mental Health (DMH), Department of Health (DOH),
Department of Elementary and Secondary Education (DES), Office of State
Treasurer (STO), Administrative Hearing Commission, and Office of State
Courts Administrator (CTS) assume the proposed legislation would have either
minimal or no fiscal impact on their agencies.
NOTE: The fiscal impact specifications below reflect six months of costs for
FY 97 for the component of the legislation relating to PTAs and ten months of
costs for FY 97 for the component relating to RTs.
FISCAL IMPACT - State Government FY 1997 FY 1998 FY 1999
HEALING ARTS FUND
Income-Division of Professional Registration (DPR)
Licensing Fees (PAs) $9,025 $9,225 $9,475
Licensing/Testing Fees (PTAs) 337,500 70,125 71,925
Total Income - DPR $346,525 $79,350 $81,400
Costs-DPR
Travel Expense for Commission ($4,267) ($4,534) ($4,670)
Transfer to PR Fees Fund (PTAs) (327,921) (59,242) (59,832)
Total Costs - DPR ($332,188) ($63,776) ($64,502)
ESTIMATED NET EFFECT TO
HEALING ARTS FUND $14,337 $15,574 $16,898
RESPIRATORY CARE PRACTITIONERS FUND
Income-Division of Professional Registration (DPR)
Licensing Fees (RTs) $122,830 $224,200 $230,950
Total Income - DPR $122,830 $224,200 $230,950
Costs-DPR
Transfer to Health Care Providers Fund (RTs) $0 ($146,671) $0
Transfer to PR Fees Fund (RTs) $0 ($152,142) ($154,903)
Total Costs - DPR $0 ($298,813) ($154,903)
ESTIMATED NET EFFECT TO
RESPIRATORY CARE
PRACTITIONERS FUND $122,830 ($74,613) $76,047
STATE COMMITTEE OF
PSYCHOLOGISTS FUND
Costs-Division of Professional Registration (DPR)
Transfer to PR Fees Fund ($7,488) ($5,839) ($5,950)
Total Costs - DPR ($7,488) ($5,839) ($5,950)
ESTIMATED NET EFFECT TO
STATE COMMITTEE OF
PSYCHOLOGISTS FUND ($7,488) ($5,839) ($5,950)
PR FEES FUND
Income-Division of Professional Registration (DPR)
Transfer from Healing Arts Fund (PTAs) $327,921 $59,242 $59,832
Transfer from
Health Care Providers Fund (RTs) 146,671 0 0
Transfer from State Committee of
Psychologists Fund 7,488 5,839 5,950
Transfer from Respiratory Care (RTs)
Practitioners Fund $0 $152,142 $154,903
Total Income - DPR $482,080 $217,223 $220,685
Costs-DPR
Personal Service (4.7 FTE) ($74,359) ($98,287) ($100,745)
Fringe Benefits (22,843) (30,194) (30,948)
Board Member Per Diem (RTs) (2,800) (2,800) (2,800)
Increase in Per Diem to Review
Continuing Education Course Approval (1,400) (1,400) (1,400)
Equipment and Expense (25,426) (8,385) (8,635)
Examination Fee (PTAs) (277,500) (8,325) (8,325)
One-Time MIS to Revise Existing
Licensure Program (Psychologists) (2,480) 0 0
One-Time MIS (PTAs) (7,440) 0 0
Other Costs/GR Transfers (67,832) (67,832) (67,832)
Total Costs - DPR ($482,080) ($217,223) ($220,685)
ESTIMATED NET EFFECT TO
PR FEES FUND $0 $0 $0
HEALTH CARE PROVIDERS FUND
Income-Division of Professional Registration (DPR)
Transfer from Respiratory Care
Practitioners Fund $0 $146,671 $0
Total Income - DPR $0 $146,671 $0
Savings-DPR
Personal Service/Fringe Benefits $28,960 $29,160 $29,410
Expense and Equipment 9,515 9,515 9,515
Total Savings - DPR $38,475 $38,675 $38,925
Costs-DPR
Transfer to PR Fees Fund (RTs) ($146,671) $0 $0
Total Costs - DPR ($146,671) $0 $0
Loss-DPR
Loss of Licensing Fees for PAs ($9,025) ($9,225) ($9,475)
Loss of Registration Fees for
Respiratory Therapists (29,450) (29,450) (29,450)
Total Loss - DPR ($38,475) ($38,675) ($38,925)
ESTIMATED NET EFFECT TO
HEALTH CARE PROVIDERS FUND ($146,671) $146,671 $0
FISCAL IMPACT - Local Government FY 1997 FY 1998 FY 1999
0 0 0
DESCRIPTION
The proposed legislation would provide for licensure of physical therapist
assistants within the State Board of Registration for the Healing Arts. The
proposal would specify application, examination, licensing, fees,
reciprocation and temporary licensing requirements. Licensure requirements
would be effective after January 1, 1997.
The proposal would create an Advisory Commission for Registered Physician
Assistants to guide, advise and make recommendations to the Board on behalf
of physician assistants in the delivery of health care services.
The proposed legislation would require that at the time of license renewal,
psychologists provide proof of the continuing education requirements of at
least forty hours within the two-year period immediately preceding the date
of the application for renewal. The committee would determine the type and
amount of training or instruction that would qualify as an hour of continuing
education credit.
The proposed legislation would expand the licensing standards for
psychologists. It would require that all psychologist employees hired by
governmental agencies after August 28, 1996, be licensed psychologists or be
in the process of meeting the required hours of supervised professional
experience.
The proposed legislation would establish a provisional license for
professional counselors. Individuals that have met all the requirements of a
licensed professional counselor, except for the supervised counseling
experience, would qualify for licensure.
The proposed legislation would establish within the Division of Professional
Registration (DPR) the Missouri Board for Respiratory Care for licensure and
regulation of respiratory therapists. The Board would be responsible for
adopting rules regarding professional conduct and establishing continuing
education requirements and ethical standards of conduct. The Board would be
required to hear and investigate complaints, employ investigators, issue
subpoenas and file petitions against certain licensees, as well as
discipline licensees for fraud and other activities and unethical conduct.
DPR would provide the necessary personnel to carry out the legislation and
would be responsible for establishing application and licensure fees. All
fees collected would be placed in the newly created Respiratory Care
Practitioners Fund. These funds would be used for the operation and
administration of the Board. The proposal would provide for the issuance of
temporary permits to practice respiratory care for individuals who are
enrolled in approved respiratory care programs.
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-Professional Registration
Office of Secretary of State
Office of Attorney General
Department of Revenue
Office of State Treasurer
Administrative Hearing Commission
Office of State Courts Administrator
Department of Social Services
Department of Mental Health
Department of Health
Department of Elementary and Secondary Education