COMMITTEE ON LEGISLATIVE RESEARCH OVERSIGHT DIVISION FISCAL NOTE L.R. No.:2584H.01I Bill No.:HB 1245 Subject:Drugs and Controlled Substances; Department of Health and Senior Services; Crimes And Punishment Type:Original Date:April 14, 2023Bill Summary:This proposal exempts entities registered with the Department of Health and Senior Services that distribute hypodermic needles or syringes from the crime of unlawful delivery of drug paraphernalia. FISCAL SUMMARY ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2024FY 2025FY 2026General Revenue($88,018)($94,646)($96,236)Total Estimated Net Effect on General Revenue($88,018)($94,646)($96,236) ESTIMATED NET EFFECT ON OTHER STATE FUNDSFUND AFFECTEDFY 2024FY 2025FY 2026Total Estimated Net Effect on Other State Funds $0$0$0 Numbers within parentheses: () indicate costs or losses. L.R. No. 2584H.01I Bill No. HB 1245 Page 2 of April 14, 2023 HWC:LR:OD ESTIMATED NET EFFECT ON FEDERAL FUNDSFUND AFFECTEDFY 2024FY 2025FY 2026Total Estimated Net Effect on All Federal Funds $0$0$0 ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)FUND AFFECTEDFY 2024FY 2025FY 2026General Revenue1 FTE1 FTE1 FTETotal Estimated Net Effect on FTE1 FTE1 FTE1 FTE ☐ Estimated Net Effect (expenditures or reduced revenues) expected to exceed $250,000 in any of the three fiscal years after implementation of the act or at full implementation of the act. ☐ Estimated Net Effect (savings or increased revenues) expected to exceed $250,000 in any of the three fiscal years after implementation of the act or at full implementation of the act. ESTIMATED NET EFFECT ON LOCAL FUNDSFUND AFFECTEDFY 2024FY 2025FY 2026Local Government$0$0$0 L.R. No. 2584H.01I Bill No. HB 1245 Page 3 of April 14, 2023 HWC:LR:OD FISCAL ANALYSIS ASSUMPTION §§579.040 and 579.076 – Distributors of hypodermic needles Officials from the Department of Health and Senior Services (DHSS) state the proposed legislation would require any entity that possesses, distributes, or delivers hypodermic needles or syringes for the purpose of operating a syringe access program or mitigating health risks that are associated with unsterile drug use to register with the DHSS. The duties associated with the administering of a syringe services program would require one (1.00) additional FTE, a Public Health Program Specialist ($47,616 annually). The duties for this position include, but are not limited to, the following: • Developing, maintaining and implementing the syringe services program rules; • Overseeing the development and implementation of the rules; • Maintaining the registry; • Developing, implementing and coordinating a statewide Syringe Services Program; • Providing consultative, analytical, and administrative technical assistance and capacity building to state staff, local health departments, community-based organizations, public and private universities, private health care providers, local officials, community leaders, and citizens throughout Missouri; • Working with statewide syringe services partners to develop a statewide syringe services strategic plan; • Coordinating and collaborating with partners to identify and arrange training for organizations interested in providing syringe services programs; • Developing and maintaining a directory of syringe service programs; • Provide syringe service education to Local Public Health Agencies (LPHAs) and community groups. Oversight notes, in response to similar legislation from the current session (HB 506), DHSS officials stated that in response to previous fiscal notes, the cost was significantly lower. However, DHSS stated based on a review of available information and technical assistance to ensure the health and safety of Missourians, DHSS has been determined that additional support for this effort is needed beyond just setting up a registry. Oversight does not have any information to the contrary. Oversight assumes DHSS would not need additional rental space for 1 new FTE for this single proposal. However, Oversight notes, depending on the number of proposals passed during the legislative session that, cumulatively, DHSS may need additional rental space or capital improvements as determined by the Office of Administration, Facilities Management, Design and Construction. L.R. No. 2584H.01I Bill No. HB 1245 Page 4 of April 14, 2023 HWC:LR:OD Officials from the Department of Corrections, the Department of Public Safety - Missouri Highway PatrolKansas City Health Department, the Newton County Health Department and the St. Louis County Health Department each assume the proposal will have no fiscal impact on their respective organizations. Oversight does not have any information to the contrary. Therefore, Oversight will reflect a zero impact in the fiscal note for these agencies. In response to similar legislation from the current session (HB 506), officials from the Office of the State Courts Administrator organization. Rule Promulgation Officials from the Joint Committee on Administrative Rules assume this proposal is not anticipated to cause a fiscal impact beyond its current appropriation. Officials from the Office of the Secretary of State (SOS) note many bills considered by the General Assembly include provisions allowing or requiring agencies to submit rules and regulations to implement the act. The SOS is provided with core funding to handle a certain amount of normal activity resulting from each year's legislative session. The fiscal impact for this fiscal note to the SOS for Administrative Rules is less than $5,000. The SOS recognizes that this is a small amount and does not expect that additional funding would be required to meet these costs. However, the SOS also recognizes that many such bills may be passed by the General Assembly in a given year and that collectively the costs may be in excess of what the office can sustain with its core budget. Therefore, the SOS reserves the right to request funding for the cost of supporting administrative rules requirements should the need arise based on a review of the finally approved bills signed by the governor. Oversight only reflects the responses received from state agencies and political subdivisions; however, other local public health agencies were requested to respond to this proposed legislation but did not. A listing of political subdivisions included in the MOLIS database is available upon request. L.R. No. 2584H.01I Bill No. HB 1245 Page 5 of April 14, 2023 HWC:LR:OD FISCAL IMPACT – State GovernmentFY 2024 (10 Mo.) FY 2025FY 2026GENERAL REVENUE FUNDCosts – DHSS (§§579.040 and 579.076) Personal service($43,347)($53,047)($54,118) Fringe benefits($29,204)($35,435)($35,831) Equipment and expense($15,467)($6,164)($6,287)Total Costs - DHSS($88,018)($94,646)($96,236) FTE Change – DHSS1 FTE1 FTE1 FTEESTIMATED NET EFFECT ON THE GENERAL REVENUE FUND ($88,018)($94,646)($96,236) Estimated Net FTE Change on the General Revenue Fund1 FTE1 FTE1 FTE FISCAL IMPACT – Local GovernmentFY 2024 (10 Mo.) FY 2025FY 2026$0$0$0 FISCAL IMPACT – Small Business This proposal may have a minimal administrative fiscal impact on small business organizations if they have to register with the DHSS. (§§579.040 and 579.076) FISCAL DESCRIPTION This bill requires the Department of Health and Senior Services to create a registration process for organizations interested in operating a syringe access program, or similar program intended to mitigate health risks associated with injectable drug use. No entity registered with the Department shall be present within 500 feet of any school building if the school building was established prior to the entity's operation. L.R. No. 2584H.01I Bill No. HB 1245 Page 6 of April 14, 2023 HWC:LR:OD In addition, this bill exempts any entity registered with the Department of Health and Senior Services that possess, distributes, delivers, or manufactures hypodermic needles or syringes for the operation of a syringe exchange program or to otherwise mitigate health risks associated with unsterilized injection drugs from the laws controlling the unlawful distribution, delivery, sale, possession, and manufacturing of drug paraphernalia. (§§579.040 and 579.076) 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 Department of Corrections Department of Public Safety – Missouri Highway Patrol Office of the Secretary of State Kansas City Health Department Newton County Health Department St. Louis County Health Department Office of the State Courts Administrator Julie MorffRoss StropeDirectorAssistant DirectorApril 14, 2023April 14, 2023