COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 0379-07
Bill No.: SCS for SB 112
Subject: Children and Minors; Education, Elementary and Secondary; Health Care; Health Department; Health, Public; Medical Procedures and Personnel
Type: Original
Date: February 3, 2003
FISCAL SUMMARY
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| General Revenue | ($45,000) | ($47,794) | ($49,228) |
| Total Estimated
Net Effect on General Revenue Fund |
($45,000) | ($47,794) | ($49,228) |
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Total Estimated
Net Effect on Other State Funds |
$0 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 5 pages.
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Local Government | $0 | $0 | $0 |
ASSUMPTION
Officials from the Department of Transportation, the Department of Public Safety - Missouri State Highway Patrol, the Department of Insurance, the Missouri Department of Conservation and the Department of Elementary and Secondary Education assume this proposal would not fiscally impact their agencies.
Officials from the Department of Social Services (DOS) state allowing an exemption due to "philosophical beliefs" may cause fewer children to be vaccinated, but it is not possible to estimate an increase in medical costs that may result from an increase in the spread of childhood diseases. DOS assumes no fiscal impact as a result of this proposal.
Officials from the Missouri Consolidated Health Care Plan (HCP) state that this proposal removes the "religious beliefs or medical contraindications" and allows parents the right to determine if their child will be immunized. The parents must submit an annual statement from the physician to the school administrator. Since the childhood immunizations are covered at
100%, HCP assumes most parents will still immunize their children and therefore, there would be no fiscal impact.
ASSUMPTION (continued)
Officials from the Secretary of State Office (SOS) assume this legislation would require the Department of Health and Senior Services, the Department of Elementary and Secondary Education, the Missouri Consolidated Health Care Plan, and the Department of Insurance to promulgate rules and regulations as they pertain to allowing parents to refuse to immunize their children without providing certain justifications. Based on prior rulemakings for these agencies, rules and forms could require as many as 29 pages in the Code of State Regulations. Because rules in their proposed version are also published in the Missouri Register, one-half again as many pages will be required to be published in this publication because of cost statements, fiscal notes, etc., which are not republished in Code. These costs are estimated. The cost per page in the Missouri Register if $23.00; the cost per page in the Code of State Regulations is $27.00. Actual costs may vary depending on the department and the number of rulemakings promulgated. The SOS estimates total costs to be $1,783 in FY 2004 [(29 pages x $27) + (43.5 pages x $23)].
Oversight assumes the SOS could absorb the costs of printing and distributing regulations related to this proposal. If multiple bills pass which require the printing and distribution of regulations at substantial costs, the SOS could request funding through the appropriation process. Any decisions to raise fees to defray costs would likely be made in subsequent fiscal years.
Officials from the Department of Health and Senior Services (DOH) state this proposal would require DOH to develop an exemption form and materials on vaccinations. DOH states the division responsible for implementation of this legislation has downsized due to current budget restraints. Remaining staff are stretched and therefore DOH states it is necessary to request additional staffing resources for the increase in workload
DOH assumes 75, 000 children are born in Missouri each year, therefore there are 900,000 (75,000 x 12) school children. DOH assumes 1% or 9,000 (900,000 x 1%) will object to vaccination under this proposal. DOH assumes it will provide materials on the vaccines, risks associated with not being vaccinated, and the objection form itself to the parent/guardian of each of the 9,000 children. DOH assumes the bulk of the request for an objection form will occur over about two months each year. DOH assumes a .2 FTE hourly employee would be needed to receive requests, log requests into a database, etc. Oversight assumes DOH could absorb these duties. DOH assumes the cost of exemption forms and materials would be $45,000 in FY 04; $47,794 in FY 05; and $49,228 in FY 06.
| FISCAL IMPACT - State Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| GENERAL REVENUE | |||
| Costs - Department of Health and Senior Services | |||
| Exemption forms and brochures | ($45,000) | ($47,794) | ($49,228) |
| ESTIMATED NET EFFECT ON GENERAL REVENUE |
($45,000) |
($47,794) |
($49,228) |
| FISCAL IMPACT - Local Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| $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 parents to refuse to vaccinate their children for religious, philosophical, or medical reasons.
This proposal allows a parent to exempt their school-age child from vaccination by providing a written objection citing religious beliefs, philosophical beliefs, or medical reasons prior to the first day of the child attending school. For religious or philosophical reasons, a parent must file a written objection with the superintendent. The Department of Health and Senior Services (DOH) shall provide exemption forms for a parent to file with the superintendent.
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 Elementary and Secondary Education
Department of Transportation
Department of Health and Senior Services
Department of Social Services
Missouri Consolidated Health Care Plan
Department of Insurance
Missouri Department of Conservation
Department of Public Safety -
Missouri State Highway Patrol
Secretary of State
Mickey Wilson, CPA
Director
February 3, 2003