COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:0202S.01I Bill No.:SB 49 Subject:Children and Minors; Health Care Professionals; Medical Procedures and
Personnel; Nurses; Physicians; Professional Registration and Licensing; Civil
Penalties
Type:Original Date:January 23, 2023Bill Summary:This proposal modifies provisions relating to gender reassignment treatment
for children.
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. 0202S.01I
Bill No. SB 49
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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. 0202S.01I
Bill No. SB 49
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FISCAL ANALYSIS
ASSUMPTION
§§191.1720 - "Missouri Save Adolescents from Experimentation (SAFE) Act" and gender
transition procedures
In response to a similar proposal from the 2022 session (HB 2649), officials from the
Attorney General (AGO) assumed any additional litigation costs arising from this proposal can
be absorbed with existing personnel and resources. However, the AGO may seek additional
appropriations if there is a significant increase in litigation.
Oversight does not have any information to the contrary. Therefore, Oversight assumes the
AGO will be able to perform any additional duties required by this proposal with current staff
and resources and will reflect no fiscal impact to the AGO for fiscal note purposes.
Officials from the Office of Administration - Administrative Hearing Commission, the
Department of Commerce and Insurance, the Department of Elementary and Secondary
Education, the Department of Public Safety - Missouri Highway Patrol, the Department of
Social Services, the Missouri Department of Conservation, the Missouri Department of
Transportation, the Missouri Consolidated Health Care Plan and the Office of the State
Courts Administrator
organizations. Oversight does not have any information to the contrary. Therefore, Oversight
will reflect a zero impact in the fiscal note for these agencies.
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 L.R. No. 0202S.01I
Bill No. SB 49
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FISCAL IMPACT – Small Business
Small business health care providers could, under circumstance outlined in the proposal, be
subject to administrative discipline or taken to court 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
Attorney General’s Office
Department of Commerce and Insurance
Department of Elementary and Secondary Education
Department of Public Safety
Missouri Highway Patrol
Department of Social Services
Missouri Department of Conservation
Missouri Department of Transportation
Missouri Consolidated Health Care Plan
Office of the State Courts Administrator
Julie MorffRoss StropeDirectorAssistant DirectorJanuary 23, 2023January 23, 2023