COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:1870H.01I Bill No.:HB 869 Subject:Department of Health and Senior Services; Health Care; Drugs and Controlled
Substances
Type:Original Date:February 27, 2023Bill Summary:This proposal creates provisions relating to natural medicine.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2024FY 2025FY 2026General Revenue($11,902)$0$0Total Estimated Net
Effect on General
Revenue($11,902)$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. 1870H.01I
Bill No. HB 869
Page 2 of
February 27, 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 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. 1870H.01I
Bill No. HB 869
Page 3 of
February 27, 2023
HWC:LR:OD
FISCAL ANALYSIS
ASSUMPTION
§§191.478 and 579.015 – Natural medicine
Officials from the Department of Health and Senior Services (DHSS) state §191.478.5 of the
proposed legislation allows the use of psilocybin mushrooms (Schedule 1) in Residential Care
Facilities (RCFs) for persons with certain medical conditions. Regulations will need to be written
pertaining to the control and distribution for RCFs and complaints may be received. The Section
for Long Term Care Regulation (SLCR) anticipates being able to address the regulation changes
and any additional complaints as part of the normal course of business. It is unknown the number
of RCFs who may participate in administration to residents, due to the fact it is a Schedule I
drug.
It is assumed it will take a Regulatory Compliance Manager (average salary $74,038) a total of
approximately 40 hours to amend regulations and make a new application and category of
registrants. Based on 2,080 working hours per year, this would require 0.02 FTE (40 ÷ 2,080
hours per year) to accomplish these duties for a total personal service cost of $1,481 ($74,038 X
.02) in FY2024.
The provisions outlined in the proposed legislation will require the Bureau of Narcotic and
Dangerous Drugs (BNDD), in consultation with the Information Technology Services Division
(ITSD) to update MOHWORX to accept applications from select practitioners that are not
registered and licensed with Professional Registration (PR) to prescribe select Schedule 1 drugs.
This requires an additional application path and modifications to the application logic to not
require a license match with PR. The estimated cost is $11,902 (125.28 consultant hours at the
contract consultant rate of $95/hr). It is likely that regulatory requirements will also need to be
updated by BNDD as a result of the proposed legislation.
It is assumed it will take a Regulatory Compliance Manager (salary $74,038) approximately 40
hours to make the required changes to state rules. Based on 2,080 working hours per year, this
would require 0.02 FTE to assume these duties (40 hours ÷ 2,080 hours per year = 0.02) for a
total personal service cost of $1,481 ($74,038 X 0.02) in FY2024.
The Department anticipates being able to absorb the FTE costs of this bill
($1,481+$1,481=$2,962) with current resources. However, if the workload significantly
increased or other legislation was enacted, additional resources would be requested through the
appropriation process. However, until the FY 2024 budget is final, the Department cannot
identify specific funding sources. L.R. No. 1870H.01I
Bill No. HB 869
Page 4 of
February 27, 2023
HWC:LR:OD
Oversight does not have any information to the contrary. Therefore, Oversight will reflect one-
time ITSD costs as the fiscal impact to General Revenue for FY 2024 for DHSS.
Officials from the Department of Commerce and Insurance, the Department of Corrections
the Department of Public Safety - Missouri Highway Patrol, the Department of Social
ServicesMissouri Department of Conservation, the Missouri Department of
Transportation, the Office of the State Public Defender, the Missouri Consolidated Health
Care Plan and the Missouri Office of Prosecution Services 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.
Officials from the Office of the State Courts Administrator did not respond to Oversight’s
request for fiscal impact for this proposal.
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. L.R. No. 1870H.01I
Bill No. HB 869
Page 5 of
February 27, 2023
HWC:LR:OD
FISCAL IMPACT – State GovernmentFY 2024
(10 Mo.)
FY 2025FY 2026GENERAL REVENUE FUNDCosts – DHSS (§§191.478 and
579.015) – ITSD costs to update
MOHWORX application($11,902)$0$0
ESTIMATED NET EFFECT ON
THE GENERAL REVENUE FUND($11,902)$0$0
FISCAL IMPACT – Local GovernmentFY 2024
(10 Mo.)
FY 2025FY 2026$0$0$0
FISCAL IMPACT – Small Business
This proposal may impact small business that provide natural medicine and related items.
(§191.478)
FISCAL DESCRIPTION
This proposal creates provisions relating to natural medicine.
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
Department of Corrections
Missouri Department of Transportation
Department of Public Safety - Missouri Highway Patrol
Department of Social Services
Missouri Department of Conservation L.R. No. 1870H.01I
Bill No. HB 869
Page 6 of
February 27, 2023
HWC:LR:OD
Office of the Secretary of State
Office of the State Public Defender
Joint Committee on Administrative Rules
Missouri Consolidated Health Care Plan
Missouri Office of Prosecution Services
NOT RESPONDING
Office of the State Courts Administrator
Julie MorffRoss StropeDirectorAssistant DirectorFebruary 27, 2023February 27, 2023