COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 0537-01
Bill No.: SB 176
Subject: Emergencies; Health Care; Health Department; Health, Public; Science and Technology
Type: Original
Date: January 28, 2003
FISCAL SUMMARY
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| General Revenue | (Unknown greater than $100,000) | (Unknown greater than $100,000) | (Unknown greater than $100,000) |
| Total Estimated
Net Effect on General Revenue Fund |
(Unknown greater than $100,000) | (Unknown greater than $100,000) | (Unknown greater than $100,000) |
| 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 Health and Senior Services (DOH) state that there is presently a system in place to assure laboratory testing of suspect bioterrorism agents. This system is a network of laboratories, level A (local public and private hospitals), level B (State Public Health Laboratories, and level C (Federal laboratories). The level of laboratory performing the testing is dependent upon the agent involved and the complexity of laboratory testing. This system is being developed in each state and the State Public Health Laboratories oversee that it is operational. Federal bioterrorism funds support the testing. Unless these funds would be eliminated or significantly decreased, this bill would have no fiscal impact upon the State Public Health Laboratory.
DOH states the Bureau of Communicable Disease (Investigation) would actively monitor public or private epidemiological studies that promote and safeguard the health of the citizens of Missouri from bioterrorism. All reports of suspected bioterrorist agents would be furnished to the local public health agencies.
ASSUMPTION (continued)
DOH assumes since a laboratory testing system for bioterrorism agents is presently in place, no additional state funding is required at this time for the State Public Health Laboratory.
The DOH is unclear in the intention for the DOH to monitor the public and private epidemiological studies. Currently the DOH does have disease reporting requirements and performs follow-up investigations. The DOH shares that information with local public health agencies. If this is the intent, the DOH assumes there would not be increased costs to do the public health epidemiological studies that arise from disease reports to the department or local public health agencies.
However, DOH assumes if studies by universities or private entities (drug companies, for instance) are considered as part of the responsibilities of the legislation, DOH does not currently monitor studies conducted by public or private research universities or private entities. The DOH states to do so would require added expertise and staff. The DOH does not know what this cost would be because the DOH does not have an inventory of research projects. Should studies of universities and private entities be required to be monitored, the DOH assumes the fiscal impact would be unknown and greater than $100,000.
Oversight assumes "...monitor any epidemiological study conducted by any public or private entity..." would require DOH to monitor public or private research universities and private entities. Therefore, based on DOH assumptions of costs for monitoring such entities, the fiscal impact would be unknown and greater than $100,000.
Officials from the Secretary of State (SOS) office assume this proposal authorizes the Bureau of Communicable Diseases to monitor epidemiological studies for bioterrorist agents. The Department of Health and Senior Services will promulgate rules to implement this proposal. These rules will be published in the Missouri Register and the Code of State Regulations. Based on experience with other divisions, the rules, regulations and forms issued by the Department of Health and Senior Services could require as many as 12 pages in the Code of State Regulations. For any given rule, roughly half again as many pages are published in the Missouri Register as in the Code because cost statements, fiscal notes and the like are not repeated in Code. These costs are estimated. The estimated cost of a page in the Missouri Register is $23. The estimated cost of a page in the Code is $27. The actual cost could be more or less than the numbers given. The impact of this legislation in future years is unknown and depends upon the frequency and length of rules filed, amended, rescinded or withdrawn. Officials from the SOS office estimate total cost to be $738 [(12 pages x $27) + (18 pages x $23)].
ASSUMPTION (continued)
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.
| FISCAL IMPACT - State Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| GENERAL REVENUE | |||
| Cost - Department of Health and Senior Services | |||
| Program costs | (Unknown greater than $100,000) | (Unknown greater than $100,000) | (Unknown greater than $100,000) |
| ESTIMATED NET EFFECT ON GENERAL REVENUE FUND | (Unknown greater than $100,000) | (Unknown greater than $100,000) | (Unknown greater than $100,000) |
| 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 authorizes the Bureau of Communicable Diseases within the Department of Health and Senior Services to monitor all epidemiological studies conducted by any public or private entity for suspected bioterrorist agents. Bioterrorist agents are agents which promote or spread bioterrorism and include, but are not limited to, anthrax, botulism, and smallpox.
The Bureau is responsible for notifying the affected local health departments of any suspected DESCRIPTION (continued)
bioterrorist agents. The State Public Health Laboratory must test and report on all samples of
suspected bioterrorist agents. The reports shall include the following:
(1) the name of the disease or condition being reported, (2) the date of onset; the date of diagnosis, (3) the name, address, telephone number, occupation, race/ethnic group, social security number, sex, age, and date of birth for the case or suspected case, (4) the date of death, if death has occurred, (5) and the name, address, and telephone number of the person making the report.
Reports compiled by the State Lab shall be furnished in a timely manner to the affected local health department. The information contained in the reports is confidential and will not be disclosed, except upon the written consent of the affected individual.
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 and Senior Services
Secretary of State
Mickey Wilson, CPA
Director
January 28, 2003