COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:0512H.02C Bill No.:HCS for HB 271 Subject:Nurses; Health Care; Drugs and Controlled Substances; Professional Registration
and Licensing
Type:Original Date:March 28, 2023Bill Summary:This proposal modifies provisions relating to nurses.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2024FY 2025FY 2026Total Estimated Net
Effect on General
Revenue $0$0$0
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. 0512H.02C
Bill No. HCS for HB 271
Page 2 of
March 28, 2023
KC: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 2026Total Estimated Net
Effect on FTE 000
☐ 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. 0512H.02C
Bill No. HCS for HB 271
Page 3 of
March 28, 2023
KC:LR:OD
FISCAL ANALYSIS
ASSUMPTION
Sections 335.036 and 335.066 - APRN
Officials from the Department of Commerce and Insurance (DCI) state it is estimated that to
fully investigate and prosecute complaints, the board may need additional resources. An
unknown cost of up to $100,000 from the Board of Nursing Fund may be necessary, depending
on the number of cases and legal expenses that occur.
Oversight assumes because the potential for litigation is speculative that the Department of
Commerce and Insurance will not incur significant cost related to this proposal. If a fiscal impact
were to result, the DCI may request additional funding through the appropriation process.
Oversight contacted DCI officials and learned there are currently 14,673 registered APRNs in
Missouri. APRNs are required to pay a one-time fee of $150 for recognition of their APRN
status. DCI officials state this proposal does not change the fee structure or requirements related
to APRNs. The proposal instead changes the current APRN recognition model to a licensure
model.
Officials from the Department of Health and Senior Services assume the proposal will have no
fiscal impact on their organization. Oversight does not have any information to the contrary.
Therefore, Oversight will reflect a zero impact in the fiscal note.
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) notes 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 the 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 hospitals 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. 0512H.02C
Bill No. HCS for HB 271
Page 4 of
March 28, 2023
KC:LR:OD
FISCAL IMPACT – State GovernmentFY 2024
(10 Mo.)
FY 2025FY 2026$0$0$0FISCAL IMPACT – Local GovernmentFY 2024
(10 Mo.)
FY 2025FY 2026$0$0$0
FISCAL IMPACT – Small Business
No direct fiscal impact to small businesses would be expected as a result of this proposal.
FISCAL DESCRIPTION
The proposed legislation appears to have no direct fiscal impact.
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 Commerce and Insurance
Department of Health and Senior Services
Office of the Secretary of State
Joint Committee on Administrative Rules
Julie MorffRoss StropeDirectorAssistant DirectorMarch 28, 2023March 28, 2023