This Fiscal Note is not an official copy and should not be quoted or cited.
Fiscal Note - SB 0763 - Improves Access to Immunization for Children
L.R. NO. 2959-04
BILL NO. HCS SCS SB 763 and 545
SUBJECT: Insurance-Medical, Children and Minors
TYPE: Original
DATE: April 23, 1996
FISCAL SUMMARY
ESTIMATED NET EFFECT ON STATE FUNDS
FUND AFFECTED FY 1997 FY 1998 FY 1999
General Revenue $357,739 $429,304 $429,304
Insurance
Dedicated $40,500
Total Estimated
Net Effect on All
State Funds $398,239 $429,304 $429,304
ESTIMATED NET EFFECT ON FEDERAL FUNDS
FUND AFFECTED FY 1997 FY 1998 FY 1999
Federal $273,566 $328,292 $328,292
Total Estimated
Net Effect on All
Federal Funds $273,566 $328,292 $328,292
ESTIMATED NET EFFECT ON LOCAL FUNDS
FUND AFFECTED FY 1997 FY 1998 FY 1999
Local Government $0 $0 $0
FISCAL ANALYSIS
ASSUMPTION
The Department of Health (DOH) stated the legislation should improve
immunization rates among pre-school population and should ease the burden on
the public health structure by covering more children. The current average
number of annual births is 75,000. DOH serves half of this number or 37,500.
Of the births, 48.1% or 18,038 are insured. It cost $140 in vaccine for each
child. Therefore, 75,000 x 50%=37,500 x 48.1% = 18,038 x $140 = $2,525,320.
Savings were apportioned across five funding sources:
The MCH/PHS Block Grants are 13% of vaccine funding, resulting in $328,292 in
federal savings. General Revenue funds are 17% of vaccine funding, resulting
in $429,304 in General Revenue savings. There will be savings in two other
vaccine funding sources that are direct assistance to the department but are
not reflected in the budget. Vaccines for Children(VFC)Program is 53% of
vaccine funding, resulting in $1,338,420 in federal savings. Title 317
Immunization Grants are 17% of vaccine funding, resulting in $429,304 in
federal savings.
The Department of Insurance(INS) stated it will need .5 FTE, an Insurance
Product Analyst II, and related expense to review all new life and health
form filings caused by changes to insurance policies and plans generated by
this and all other legislation enacted during this session. This FTE would
work full-time for six months a year. INS states that approximately 245
insurers and 25 HMOs are currently writing medical plans. On average each
company offers three plans. The result would be 810 new policy filings needed
to comply with this legislation. A policy filing fee of $50 is required and
based on 810 filings, $40,500 in revenue to the Insurance Dedicated Fund
would be generated in the first fiscal year only.
Oversight assumes the passage of this proposal would not increase cost to
INS; however, revenue of $40,500 in the first fiscal year only would be
realized. In addition, passage of more than one similar proposal could
require the INS to request increased appropriations to cover cumulative
administrative costs.
Officials from the Department of Highway and Transportation (DHT) estimated
this proposal will cost the Highways and Transportation Medical Plan
$488,300. These additional costs will be paid by the participants of the
plan and therefore will not fiscally impact DHT.
The Department of Corrections (DOC), Department of Public Safety (DPS),
Department of Social Services (DOS), Office of Administration (OA),
Consolidated Health Care Plan (HCP), and the Department of Conservation (MDC)
stated that the proposed legislation will have no fiscal impact on their
agency.
FISCAL IMPACT-State Government FY 1997 FY 1998 FY 1999
(10 Months)
GENERAL REVENUE FUND
Savings-Department of Health
Reduced Immunization Payments $357,739 $429,304 $429,304
Estimated Net Effect on General
Revenue Fund $357,739 $429,304 $429,304
INSURANCE DEDICATED FUND
Income - Department of Insurance
Policy Filing Fees $40,500 $0 $0
Estimated Net Effect on Insurance $40,500 $0 $0
Dedicated Fund
FEDERAL FUNDS
Savings-Department of Health
Reduced Immunization Payments $273,566 $328,292 $328,292
Estimated Net Effect on Federal Funds $273,566 $328,292 $328,292
FISCAL IMPACT - Local Government FY 1997 FY 1998 FY 1999
(10 Mo.)
$0 $0 $0
DESCRIPTION
Individual and group health insurance policies, including contracts issued by
health maintenance organizations (HMO's), where not preempted by federal law
will cover routine and necessary immunizations for newly born children of the
insured. These immunizations apply from birth until 60 months of age without
being subject to a deductible, copayment, or coinsurance requirement.
Contracts issued by HMO's may authorize insurance coverage only when services
are given by a designated provider who is affiliated with the HMO. Parents
may delegate authority to consent to immunization of a minor in writing to
any adult with care and control of the minor. The adult who consents to
immunization of the minor must give accurate health information about the
minor for whom the consent is given in order to determine whether the
immunization is advisable. A person may not consent to immunization of a
minor when the parent(s) expressly refuses to give consent, the parent
clearly states that the person not consent, or reasonable efforts were made
to locate the parent for consent and have failed. The person who gives
consent to child immunizations is liable only for acts of willful misconduct
or gross negligence.
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 Public Safety
Department of Conservation
Department of Corrections
Department of Social Services
Office of Administration
Consolidated Health Care Plan
Department of Highway and Transportation
Department of Insurance
Department of Health