This Fiscal Note is not an official copy and should not be quoted or cited.
This Fiscal Note is not an official copy and should not be quoted or cited.
Fiscal Note - SB 0519 - Requires hepatitis B vaccinations of seventh graders beginning in the 2000-2001 school year
COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. NO.: 2191-01
BILL NO.: SB 519
SUBJECT: Requires Hepatitis B Vaccinations of Seventh Graders
TYPE: Original
DATE: March 16, 1999
FISCAL SUMMARY
|
ESTIMATED NET EFFECT ON STATE FUNDS | |||
| FUND AFFECTED | FY 2000 | FY 2001 | FY 2002 |
| General Revenue | $0 | ($44,820) | ($45,736) |
| Total Estimated
Net Effect on All State Funds |
$0 | ($44,820) | ($45,736) |
|
ESTIMATED NET EFFECT ON FEDERAL FUNDS | |||
| FUND AFFECTED | FY 2000 | FY 2001 | FY 2002 |
| Federal Funds | $0 | ($73,620) | ($76,019) |
| Total Estimated
Net Effect on All Federal Funds |
$0 | ($73,620) | ($76,019) |
|
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 5 pages.
FISCAL ANALYSIS
ASSUMPTION
Officials from the Department of Elementary and Secondary Education, Department of Insurance, Department of Conservation, Department of Public Safety - Missouri Highway Patrol, and Department of Transportation assume that this proposal will not fiscally affect their agencies.
Officials from the Missouri Consolidated Health Care Plan (MCHCP) stated that their current contract provides 100 percent coverage preventive services for children's immunizations including Hepatitis B vaccinations. Unless the plans nominally adjust their premium to reflect this additional vaccination, there would be no or a very minimal impact to MCHCP.
Oversight assumes the plans would not increase their costs for preventive services for children.
Officials from the Department of Health (DOH) stated this proposed legislation will not have a fiscal impact for the department. The DOH currently receives state and federal funding for the purchase of Hepatitis B vaccine. Any child under the age of 19 can receive Hepatitis B immunizations at any local public health agency.
Officials from the Department of Corrections (DOC) assumed an unknown cost to the DOC if this proposal was enacted. The DOC stated that they are unsure if incarcerated offenders in the DOC departmental school curriculum at seventh grade level fall under the definition of "student" pursuant to this proposal. If the intent is for DOC inmates to be included, the cost is $75 per Hepatitis B 3-dose vaccine. The average number of DOC students that would meet the criteria of approximate seventh grad level (according to reading and mathematics evaluations) is approximately 3,600 within a year, including turnover. Statistics for ages of the students is not available. The estimated potential fiscal impact for the DOC is $270,000 (3,600 x $75) for the first year if the DOC is intended to be covered by this proposal.
Oversight assumes that inmates in the DOC departmental school curriculum are not intended to be included in this proposal. Oversight notes that Section 167.181 describes children in public, private, parochial or parish schools. Oversight also believes that the rules and regulations required by this proposal would be written to address school children only and not inmates of the DOC.
ASSUMPTION (continued)
Officials from the Department of Social Services - Division of Medical Services (DMS) assume that the DOH would be responsible for the actual cost of the vaccine and that DMS would be responsible for the administration of vaccine for the Medicaid eligible population.
DMS estimates that the current Medicaid population entering the 7th grade in school year 2001 and 2001 will be 16,000. DMS also assumed that 55% of this population would be in managed care and that 4.4% of the current FFS Hepatitis B vaccinations were vaccinations for the population entering the 7th grade.
The DMS provided the following estimate for costs for the current Medicaid population:
Projected 7th Grade Population 16,000
x Non-MC+ percent 45 %
x Number of Doses 3
21,600
Less: Vaccines Already Provided (1,145)
20,455
x Medicaid Reimbursement $ 5.00
Cost for Current Medicaid Population $102,275
Federal Share $ 61,887
General Revenue Share $ 40,338
The DMS assumed that the age distribution of the 1115 Waiver population would mirror the current Medicaid population, which indicates that 4.4% of the eligibles under the age of 19 will enter the 7th grade. The DMS provided the following estimate for costs for the 1115 Waiver population:
FY 2001 FY 2002
Estimate of Population 54,613 65,777
x Non-MC+ Percent 45 % 45%
24,576 29,600
x Percent Entering 7th Grade 4.4% 4.4%
Number of Children 1,081 1,302
x Number of Doses 3 3
x Medicaid Reimbursement $5.00 $5.00
Cost for 1115 Waiver Population $16,215 $19,530
Federal Share $11,733 $14,132
General Revenue Share $ 4,482 $ 5,398
| FISCAL IMPACT - State Government | FY 2000 | FY 2001 | FY 2002 |
| (10 Mo.) | |||
| GENERAL REVENUE FUND | |||
| Costs - Department of Social Services - | |||
| Division of Medical Services | |||
| Increased Assistance Payments | $0 | ($44,820) | ($45,736) |
| ESTIMATED EFFECT ON | |||
| GENERAL REVENUE FUND | $0 | ($44,820) | ($45,736) |
| FEDERAL FUNDS | |||
| Costs - Department of Social Services - | |||
| Division of Medical Services | |||
| Increased Assistance Payments | $0 | ($73,620) | ($76,019) |
| ESTIMATED EFFECT ON | |||
| FEDERAL FUNDS | $0 | ($73,620) | ($76,019) |
| 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 concerns hepatitis B vaccinations. Beginning with the 2000-2001 school year, it requires every student entering the seventh grade to be vaccinated with three doses of hepatitis B vaccine. It will be unlawful for a parent or guardian to neglect to have a child immunized, unless the child is properly exempted.
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 Elementary and Secondary Education
Missouri Consolidated Health Care Plan
Department of Social Services
Department of Insurance
Department of Corrections
Department of Public Safety - Missouri Highway Patrol
Department of Conservation
Department of Transportation
Jeanne Jarrett, CPA
Director
March 16, 1999