COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:3513H.03C Bill No.:HCS for HB 1490 Subject:Veterans; Merchandising Practices Type:Original Date:March 6, 2024Bill Summary:This proposal creates provisions relating to veterans.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2025FY 2026FY 2027General Revenue$0 to (Exceeding
$427,799)
$0 to (Exceeding
$413,420)
$0 to (Exceeding
$419,487)
Total Estimated Net
Effect on General
Revenue
$0 to (Exceeding
$427,799)
$0 to (Exceeding
$413,420)
$0 to (Exceeding
$419,487)
* Subject to appropriations. The amounts above reflect only administrative costs of the DPS-
MVC (4 FTE) and the DHSS ($50,000 for research and reporting). Not included in the amounts
above are reimbursements to health care facilities for hyperbaric oxygen therapy nor
reimbursements for these costs by the U.S. Department of Defense or the U.S. Food and Drug
Administration.
ESTIMATED NET EFFECT ON OTHER STATE FUNDSFUND AFFECTEDFY 2025FY 2026FY 2027Veterans Traumatic
Brain Injury
Treatment and
Recovery* $0$0$0
Veterans Commission
Capital Improvements
Project
Less than ($73,000)Less than ($73,000)Less than ($73,000)
Total Estimated Net
Effect on Other State
FundsLess than ($73,000)Less than ($73,000)Less than ($73,000)
* Assumes transfers-in/appropriations, gifts, bequests, donations and costs net to $0.
Numbers within parentheses: () indicate costs or losses. L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 2 of
March 6, 2024
HWC:LR:OD
ESTIMATED NET EFFECT ON FEDERAL FUNDSFUND AFFECTEDFY 2025FY 2026FY 2027Total Estimated Net
Effect on All Federal
Funds $0$0$0
ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)FUND AFFECTEDFY 2025FY 2026FY 2027Veterans Traumatic
Brain Injury
Treatment and
Recovery 4 FTE4 FTE4 FTE
Total Estimated Net
Effect on FTE4 FTE4 FTE4 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 2025FY 2026FY 2027Local Government$0$0$0 L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 3 of
March 6, 2024
HWC:LR:OD
FISCAL ANALYSIS
ASSUMPTION
§42.022 – Missouri Veterans Commission
Officials from the Department of Mental Health, the Department of Public Safety –
Director’s Office and the Missouri Veterans Commission (MVC), the Missouri National
Guard, the Missouri House of Representatives and the Missouri Senate 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 notes per the MVC, in the FY 2024 budget, MVC requested and received an
appropriation of $120,000 ($80,000 PS; $40,000 E&E) for a prevention coordinator and the
operation of a Veteran Suicide Awareness program. This was a new program within MVC,
designed to oversee the statewide policy development, implementation, and operation of Veteran
Suicide prevention, awareness, and education. The program includes coordinating with the
Department of Veterans Affairs (VA), state agencies and community programs to ensure the
stakeholders have access to timely, quality services. The FTE will administer national grants and
represent the MVC as a subject matter expert on a national platform to inform program policy.
The program will utilize data analysis to develop strategies to decrease Veteran suicide in this
state.
Per discussion with MVC officials, it is assumed the funding for the program authorized last year
will cover any fiscal impact the provisions of this proposal may have on the MVC. Therefore,
Oversight will not reflect an additional fiscal impact from this part of the proposal.
§42.028 – Compensation for assisting with veterans benefits
Officials from the Missouri Office of Prosecution Services (MOPS) assume the proposal will
have no measurable fiscal impact on MOPS. The enactment of a new crime (§42.028.11) creates
additional responsibilities for county prosecutors and the circuit attorney which may, in turn,
result in additional costs, which are difficult to determine.
Officials from the Department of Commerce and Insurance, the Department of Public
Safety - Missouri Highway Patrol and Missouri Veterans Commission, the Missouri
National Guard and the Office of the State Public Defender
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. L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 4 of
March 6, 2024
HWC:LR:OD
Officials from the Office of the State Courts Administrator assume the proposal would have
no fiscal impact on their organization.
§42.312 – Operation Enduring Freedom, Operation Freedom’s Sentinel and Operation Allies
Refuge Program
Officials from the Missouri National Guard (MONG) estimates there are 73,000 veterans
eligible to receive this award. HB 1490 will have an approximate $1,000 - $1,095,000 fiscal
impact to the Veterans Recognition program, which is funded by the Veterans Commission
Capital Improvement Trust Fund (0304). The wide range of estimated fiscal impact is due to the
uncertainty of how many veterans will apply and be approved for the award. The estimated cost
per award (medal, medallion, and certificate), including postage, is $15. The total estimated cost
would be an accumulated cost, spanning future fiscal years over the life of the program.
There are several other programs currently in place to recognize veterans of previous conflicts. A
summary of program activity is contained in the table below:
Oversight contacted the MNG to inquire how many personnel deployed to Operation Enduring
Freedom, Operation Freedom’s Sentinel, and Operation Allies Refuge Program. However,
Oversight did not received that information. Therefore, using MNG’s estimate of 73,000 current
Missouri veterans, Oversight will assume approximately 40 percent of those veterans served
during this timeframe (10/7/2001 – 8/30/2021). Oversight also assumes approximately half or
14,600 (73,000 * 0.40 * 50%) service members and registered veterans will apply for the medal.
14,600 x $15 = $219,000.
Based on the implementation of other similar programs, Oversight will reflect this cost spread
over the three years ($219,000 / 3 = $73,000) of the fiscal note to the Veterans Commission
Capital Improvement Trust Fund. Oversight notes the ending balance in the Veterans
Commission Capital Improvement Trust Fund (0304) as of February 29, 2024, was $25,909,949.
Officials from the Missouri Veterans Commission (MVC) defer to the MONG regarding the
fiscal impact of the provisions of §42.312. L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 5 of
March 6, 2024
HWC:LR:OD
Officials from the Office of Administration 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.
§§191.2600 to 191.2630 – Alternative therapies for veterans with PTSD and traumatic brain
injuries
Officials from the Department of Public Safety (DPS) - Missouri Veterans Commission
(MVC) state this proposal would have a significant fiscal impact on the Missouri Veterans
Commission.
This would be a new program owned by the Missouri Veterans Commission as defined in
§191.2600 (2) definition of Commission. Section 191.2610 provides compliance and eligibility
under the program which is increased responsibilities of MVC, outside of its existing operational
structure. Section 191.2615 creates the new fund “Veterans Traumatic Brain Injury Treatment
and Recovery fund” and further defines how monies are granted and reimbursed. Section
191.2620 defines responsibility of the recipient and the oversight, data analysis, and reporting
responsibility of MVC.
The MVC assumes this bill would require MVC to review, preapprove, obligate, pay, report, and
audit the program on behalf of the Veterans in any authorized facility throughout the state. This
work would require the creation of a new section within the Missouri Veterans Commission
consisting of technicians with medical knowledge and staff familiar with accounting that does
not currently exist.
The MVC makes the following assumptions:
currently have available - $103,000
MVC is not certain how many of these therapies exist today and defer to the Department of
Health and Senior Services regarding these therapies and related information.
Since the provisions of this proposal would be effective January 1, 2025, the MVC anticipates a
6-month impact for 2025 of $363,293; an impact of $363,420 for FY 2026; and an impact of
$369,487 for FY 2027. L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 6 of
March 6, 2024
HWC:LR:OD
Oversight has no information to the contrary. Therefore, Oversight will present the fiscal impact
of this proposal as provided by DPS-MVC. Oversight assumes all costs incurred by the MVC
and the DHSS, plus reimbursements for therapy/treatment will be paid for through the Veterans
Traumatic Brain Injury Treatment and Recovery Fund authorized by §191.2615. Funding for this
program will consist of any appropriation, gifts, bequests and donations. Therefore, Oversight
assumes, for fiscal note purposes, total funding and expenditures will net to $0.
Officials from the Department of Health and Senior Services (DHSS) state §§191.2600 to
191.2630 of the proposed legislation, establishes the “Veterans Traumatic Brain Injury
Treatment and Recovery Act” and the “Veterans Traumatic Brain Injury Treatment and
Recovery Fund” creating provisions relating to alternative therapies (including, but not limited,
to hyperbaric oxygen therapy) for veterans with Post Traumatic Stress Disorder (PTSD) or
Traumatic Brain Injuries (TBI). The Veteran’s Commission would determine if entities are
eligible for reimbursement for providing alternative therapies to veterans diagnosed with PTSD
or TBI and reimbursing those entities from the fund. Under section 191.2615 subsection 7, the
DHSS would be responsible for awarding funds (via contract(s)) to entities to conduct research
on the effectiveness of the therapies as treatment. DHSS would also be responsible for analyzing
the report prepared by the Commission, as well as information from the studies and research
conducted by the entities contracted by DHSS. This information would be used by DHSS to
prepare a report outlining findings, efficacies of alternative treatment, and recommendations on
budgetary, legislative, or regulatory changes required to expand access to alternative treatment
for the target population. Per section 191.2625 subsection 3 of the proposed legislation, the
DHSS report would be submitted to the Governor before January thirtieth each year. Section
191.2630 of the proposed legislation, states that DHSS and the Veteran’s Commission will
jointly promulgate rules and regulations related to the legislation.
The estimated fiscal impact of the research and reporting responsibilities assigned to DHSS as
set forth in the proposed legislation (Sections 191.2615 subsection 7 and 191.2625 subsection 3)
is $50,000 annually. This is based on a research contract quote from one of DHSS’ current
partners.
The legislation proposes to fund these costs from the newly established Veterans Traumatic
Brain Injury Treatment and Recovery Fund. The Veterans Traumatic Brain Injury Treatment and
Recovery Fund would consist of any appropriations, gifts, bequests, or public or private
donations. This fiscal note assumes all costs would be made from the Veterans Traumatic Brain
Injury Treatment and Recovery Fund and an equivalent General Revenue transfer would be
necessary to support the new fund.
Section 191.2605(3) defines facility as “a public or private health clinic, outpatient health clinic,
community health center, hospital, or other facility authorized under rules of the department of
health and senior services to provide hyperbaric oxygen therapy under sections 191.2600 to
191.2615.” As a result of the proposed legislation, DHSS’ Division of Regulation and Licensure,
Section for Health Standards and Licensure may experience minor additional work in terms of
receiving and processing complaints regarding this program and whether a hospital is carrying L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 7 of
March 6, 2024
HWC:LR:OD
out all of the requirements properly.
It is assumed that the DHSS duties listed above will be performed by current DHSS staff.
Therefore, no additional FTE will be required or requested. However, if the workload
significantly increased or other legislation was enacted, additional resources would be requested
through the appropriation process.
Oversight has no information to the contrary. Therefore, Oversight will present the fiscal
impact of this proposal to the Veterans Traumatic Brain Injury Treatment and Recover Fund as
provided by DHSS.
In response to similar legislation from the current session (HB 2215), officials from the
University of Missouri Health Care (MU Health) stated they had reviewed this proposed
legislation and has determined that, as written, it should not create expenses in excess of
$100,000 annually.
Oversight has no information to the contrary. Oversight assumes the additional expenses that
may be incurred as a result of this proposal is absorbable within the current funding levels MU
Health and will present no fiscal impact for this organization.
Officials from the Department of Commerce and Insurance, DPS – Division of Fire Safety,
the Department of Social Services and the Missouri National Guard 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 Treasurer assumed the proposal would have no fiscal
impact on their organization.
§§301.3181 and 301.3182 – License plates for certain veterans
Officials from the Department of Revenue (DOR) assume the following regarding this
proposal:
A $15.00 fee will be collected at the time of application and registration. The new design would
include both stock and personalized for specialty plates. There will be a $125 design fee and an
additional $45 fee when creating a new plate design. L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 8 of
March 6, 2024
HWC:LR:OD
Administrative Impact
To implement the proposed legislation, the Department will be required to:
• Update charts, procedures and the Department website;
• Update the Application for Missouri Personalized and Special License Plate (DOR-1716, and
DOR-4601); and
• Complete programming and user acceptance testing for identified systems.
FY 2025 – Motor Vehicle Bureau
Associate Research/Data Analyst 53 hrs. @ $25.22 per hr. = $1,337
Research/Data Analyst 13 hrs. @ $27.00 per hr. = $351
Administrative Manager 7 hrs. @ $29.31 per hr. = $205
FY 2025– Strategy and Communications Office
Associate Research/Data Analyst 40 hrs. @ $21.64 per hr. = $865
Total = $2,758
The department will absorb the cost; however, if several bills pass, they will seek appropriations
through the budget process.
Oversight assumes DOR is provided with core funding to handle a certain amount of activity
each year. Oversight assumes DOR could absorb the costs related to this proposal. If multiple
bills pass which require additional staffing and duties at substantial costs, DOR could request
funding through the appropriation process.
DOR notes OA-ITSD services will be required at a cost of $14,506 in FY 2025 (138.15 hours x
$105 per hour).
Oversight does not have any information to the contrary in regards to DOR’s assumptions;
therefore, Oversight will reflect DOR’s OA-ITSD costs on the fiscal note.
Officials from the Missouri Veterans Commission and the Missouri Department of
Transportation 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.
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. L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 9 of
March 6, 2024
HWC:LR:OD
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 hospitals were requested to respond to this proposed legislation but did not. A
listing of political subdivisions included in the Missouri Legislative Information System
(MOLIS) database is available upon request.
FISCAL IMPACT – State GovernmentFY 2025
(10 Mo.)
FY 2026FY 2027GENERAL REVENUE FUNDTransfer-Out – Appropriations to the
Veterans Traumatic Brain Injury
Treatment and Recovery Fund
(§191.2615) p.5-6
$0 to
(Exceeding
$413,293)
$0 to
(Exceeding
$413,420)
$0 to
(Exceeding
$419,487)
Cost – DOR – OA-ITSD services
(§§301.3181 & 301.3182) p. 7-8($14,506)$0$0ESTIMATED NET EFFECT ON
THE GENERAL REVENUE FUND
$0 to
(Exceeding
$427,799)
$0 to
(Exceeding
$413,420)
$0 to
(Exceeding
$419,487) L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 10 of 13
March 6, 2024
HWC:LR:OD
FISCAL IMPACT – State GovernmentFY 2025
(10 Mo.)
FY 2026FY 2027VETERANS COMMISSION
CAPITAL IMPROVEMENTS
TRUST FUND (0304)
Cost – MONG - New medallion
program (§43.212) p. 7
Less than
($73,000)
Less than
($73,000)
Less than
($73,000)
ESTIMATED NET EFFECT ON
THE VETERANS COMMISSION
CAPITAL IMPROVEMENTS
TRUST FUND
Less than
($73,000)
Less than
($73,000)
Less than
($73,000)
VETERANS TRAUMATIC BRAIN
INJURY TREATMENT AND
RECOVERY FUND
Transfer-In – Appropriations from
General Revenue (§191.2615) p.5-6
$0 to
Exceeding
$413,293
$0 to
Exceeding
$413,420
$0 to
Exceeding
$419,487
Income – Reimbursements, gifts,
bequests, & donations (§191.2615)
p. 5-6$0 to Unknown$0 to Unknown$0 to Unknown
Costs – DPS-MVC (§§191.2610 to
191.2630) Personal service (4 FTE),
fringe benefits and equipment and
expenses p. 5-6($363,293)($363,420)($369,487)
FTE Change - MVC4 FTE4 FTE4 FTECosts – DPS-MVC – reimbursement to
health care facility for providing
hyperbaric oxygen therapy to veterans
p. 5-6(Unknown)(Unknown)(Unknown) L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 11 of 13
March 6, 2024
HWC:LR:OD
FISCAL IMPACT – State GovernmentFY 2025
(10 Mo.)
FY 2026FY 2027Reimbursement – DPS-MVC - from the
US Food and Drug Administration or
the US Department of Defense p. 5-6UnknownUnknownUnknown
VETERANS TRAUMATIC BRAIN
INJURY TREATMENT AND
RECOVERY FUND (continued)
Costs – DHSS (§§191.2615 and
191.2625) - research and reporting
requirements p.6 ($50,000)($50,000)($50,000)
ESTIMATED NET EFFECT ON
THE VETERANS TRAUMATIC
BRAIN INJURY TREATMENT
AND RECOVERY FUND$0$0$0
Estimated Net FTE Change on the
Veterans Traumatic Brain Injury
Treatment and Recovery Fund4 FTE4 FTE4 FTE
FISCAL IMPACT – Local GovernmentFY 2025
(10 Mo.)
FY 2026FY 2027$0$0$0
FISCAL IMPACT – Small Business
This proposal may negatively impact certain small business that currently provide services to
veterans for a fee.
FISCAL DESCRIPTION L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 12 of 13
March 6, 2024
HWC:LR:OD
This bill awards medallions, medals, and certificates of appreciation to a veteran that is a resident
of this state, honorably served on active duty in the United States military service at any time
between October 7, 2001, and August 30, 2021, and was honorably separated and discharged
from military service. (§43.212)
This bill establishes the "Veterans Traumatic Brain Injury Treatment and Recovery Act".
The bill creates the "Veterans Traumatic Brain Injury Treatment and Recovery Fund", which will
reimburse facilities that provide hyperbaric oxygen therapy to veterans diagnosed with
posttraumatic stress disorder or traumatic brain injury, and be used to conduct studies on the use
of alternative therapies for such conditions.
The bill specifies the eligibility criteria and requirements for veterans, facilities, and health care
practitioners for reimbursement. The Missouri Veterans Commission must compile an annual
report with data about the treatment of hyperbaric oxygen therapy and its effectiveness. The
information collected for the report is specified in the bill.
The bill grants the Missouri Veterans Commission and the Department of Health and Senior
Services the authority to promulgate rules and regulations for the administration of the Act.
(§§191.2600 to 191.2630)
This bill creates special vehicle license plates for veterans who served in Afghanistan and Iraq.
The bill specifies that any person who was awarded the Afghanistan Campaign medal and the
Iraq Campaign medal, may for vehicle plates by providing proof of service and paying a$15 fee.
The plates can be personalized at no extra cost.
The bill states that there is no limit on the number of plates a person can obtain, as long as he or
she owns the vehicle, and that the plates are not transferable to anyone else. (§§301.3181 and
301.3182)
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 Mental Health
Department of Revenue
Department of Public Safety –
Fire Safety
Director’s Office
Missouri Highway Patrol
Missouri Veterans Commission L.R. No. 3513H.03C
Bill No. HCS for HB 1490
Page 13 of 13
March 6, 2024
HWC:LR:OD
Department of Social Services
Missouri Department of Transportation
Missouri National Guard
Office of the Secretary of State
Office of the State Public Defender
Office of the State Treasurer
MU Health
Joint Committee on Administrative Rules
Missouri House of Representatives
Missouri Senate
Missouri Office of Prosecution Services
Office of the State Courts Administrator
Julie MorffRoss StropeDirectorAssistant DirectorMarch 6, 2024March 6, 2024