COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:0743S.01I Bill No.:SB 208 Subject:Nurses; Professional Registration and Licensing; Health Care Professionals Type:Original Date:January 9, 2023Bill Summary:This proposal modifies the licensing requirements for Advanced Practice
Registered 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. 0743S.01I
Bill No. SB 208
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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. 0743S.01I
Bill No. SB 208
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January 9, 2023
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FISCAL ANALYSIS
ASSUMPTION
Officials from the Department of Commerce and Insurance (DCI), the Department of
Health and Senior Services and the Department of Social 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.
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 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 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 their 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.
FISCAL IMPACT – State GovernmentFY 2024
(10 Mo.)
FY 2025FY 2026$0$0$0 L.R. No. 0743S.01I
Bill No. SB 208
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FISCAL 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
Department of Social Services
Office of the Secretary of State
Joint Committee on Administrative Rules
Julie MorffRoss StropeDirectorAssistant DirectorJanuary 9, 2023January 9, 2023