SB 0297 - Fiscal Note

Fiscal Note - SB 0297 - Allows Certified Registered Nurse Anesthetists, to prescribe, administer and dispense controlled substances

COMMITTEE ON LEGISLATIVE RESEARCH

OVERSIGHT DIVISION

FISCAL NOTE

L.R. NO.: 1289-01

BILL NO.: SB 297

SUBJECT: Nurses

TYPE: Original

DATE: February 11, 1999

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FISCAL SUMMARY

ESTIMATED NET EFFECT ON STATE FUNDS
FUND AFFECTED	FY 2000	FY 2001	FY 2002
General Revenue	$30,000	$30,000	$30,000
Total Estimated Net Effect on All State Funds	$30,000	$30,000	$30,000

ESTIMATED NET EFFECT ON FEDERAL FUNDS
FUND AFFECTED	FY 2000	FY 2001	FY 2002
None	$0	$0	$0
Total Estimated Net Effect on All Federal Funds	$0	$0	$0

ESTIMATED NET EFFECT ON LOCAL FUNDS
FUND AFFECTED	FY 2000	FY 2001	FY 2002
Local Government	$0	$0	$0

Numbers within parentheses: ( ) indicate costs or losses

This fiscal note contains 3 pages.

FISCAL ANALYSIS

ASSUMPTION

The Department of Social Services and the Department of Economic Development, Professional Registration assume this proposal would not fiscally impact their agencies.

The Department of Health (DOH) states that certified registered nurse anesthetists, APN certified, could independently order the administration of a controlled substance medication for a patient. This would require that any CRNA doing so, register with the Department of Health. Registration requires an annual fee of $30. There are approximately 1,000 CRNAs, therefore, this proposal could generate $30,000 in General Revenue per year.

DOH further states there are approximately 1,000 CRNAs in Missouri who would potentially be eligible to register with the Bureau of Narcotics and Dangerous Drugs (BNDD), Department of Health for controlled substance authority. This would increase DOH registration and monitoring workload by approximately 5%. The BNDD currently has 8 investigators. DOH assumes that an additional caseload of 5% would require 1 Investigator II ($32,628) or equivalent budget for contractual investigators. The Investigator II position would inspect and monitor records and security required by law and any possible diversion or theft of controlled substances. All complains received would be investigated.

Oversight assumes a 5% increase in workload would not require additional FTE.

FISCAL IMPACT - State Government	FY 2000	FY 2001	FY 2002
	(10 Mo.)
GENERAL REVENUE
Revenue - Department of Health
Registration fees	$30,000	$30,000	$30,000
ESTIMATED NET EFFECT
ON GENERAL REVENUE	$30,000	$30,000	$30,000
FISCAL IMPACT - Local Government	FY 2000	FY 2001	FY 2002
	(10 Mo.)
	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 proposal allows certified registered nurse anesthetists (CRNA), APN titled, to prescribe, administer, and dispense controlled substances. They may allow nurses or graduate physicians under their supervision to do the same. This proposal also provides an exception in that CRNAs may not allow graduate physicians under their supervision to administer or dispense controlled substances. No practitioner specified in this section may accept unused portions of controlled substances or prescribe, administer, or dispense them to himself or herself.

This proposal also adds a new Section 335.097, RSMo, which allows CRNAs to prescribe and administer those drugs and devices, including controlled substances, that are customarily used in their profession within the time surrounding the patient's operation. In addition, they may allow others authorized under this section to do the same.

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 Health

Department of Economic Development

Professional Registration

Department of Social Services

Jeanne Jarrett, CPA

Director

February 11, 1999