COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:3165H.01I Bill No.:HB 1561 Subject:Hospitals; Department of Health and Senior Services Type:Original Date:March 11, 2025Bill Summary:This proposal specifies that the Department of Health and Senior Services
shall not deny trauma center status to a hospital based on its distance from
another trauma center.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2026FY 2027FY 2028General($237,796)($280,921)($285,907)Total Estimated Net
Effect on General
Revenue($237,796)($280,921)($285,907)
ESTIMATED NET EFFECT ON OTHER STATE FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on Other State
Funds $0$0$0
Numbers within parentheses: () indicate costs or losses. L.R. No. 3165H.01I
Bill No. HB 1561
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ESTIMATED NET EFFECT ON FEDERAL FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on All Federal
Funds $0$0$0
ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)FUND AFFECTEDFY 2026FY 2027FY 2028General Revenue2 FTE2 FTE2 FTETotal Estimated Net
Effect on FTE2 FTE2 FTE2 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 2026FY 2027FY 2028Local Government$0 or (Unknown)$0 or (Unknown)$0 or (Unknown) L.R. No. 3165H.01I
Bill No. HB 1561
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FISCAL ANALYSIS
ASSUMPTION
§ 190.241 - Trauma center designations
Officials from the Department of Health and Senior Services (DHSS) state § 190.241.1 of the
proposed legislation prohibits the DHSS, Division of Regulation and Licensure (DRL), Time
Critical Diagnosis (TCD) program from denying a qualified hospital designation of a level I, II,
or III trauma center based solely on the distance or mileage between trauma centers.
As a result of the proposed legislation, TCD anticipates the addition of approximately 20 new
program participants. This would require two (2) full-time Registered Nurses (annual salary of
$78,792) to process the additional applications and conduct the required inspections. The
Registered Nurses will be remote and are expected to travel extensively; therefore, it is assumed
travel will be double the standard cost at $10,262.
Oversight does not have information to the contrary and therefore, Oversight will reflect the
estimates as provided by the DHSS.
In response to a similar proposal, HB 984 (2025), officials from the Cass Regional Medical
Center stated, for those who are already invested in the trauma program, this bill could be
financial detrimental to the investments that have already been made and dedicated to trauma to
include trauma coordinator, trauma registry, medical director, equipment, etc. Annual cost of
these items alone for a Level III center is $250,000. Need for additional trauma center should be
based on geography to avoid diluting the program due to numbers and geographical locations.
Oversight does not have any information to the contrary. Therefore, Oversight will reflect a
potential unknown loss to local regional medical centers and hospitals.
Oversight notes 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. L.R. No. 3165H.01I
Bill No. HB 1561
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FISCAL IMPACT – State GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028GENERAL REVENUECosts – DHSS, TCD (§ 190.241) p. 3 Personal service($131,320)($160,736)($163,950) Fringe benefits($78,953)($96,007)($97,295) Equipment and expense($27,523)($24,178)($24,662)Total Costs - DHSS, TCD($237,796)($280,921)($285,907) FTE Changes2 FTE2 FTE2 FTEESTIMATED NET EFFECT ON
GENERAL REVENUE($237,796)($280,921)($285,907)
Estimated Net FTE Change on the
General Revenue Fund2 FTE2 FTE2 FTE
FISCAL IMPACT – Local GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028LOCAL POLITICAL
SUBDIVISIONS
Cost - regional medical centers and
hospitals - duplicative services
$0 or
(Unknown)
$0 or
(Unknown)
$0 or
(Unknown)
ESTIMATED NET EFFECT ON
LOCAL POLITICAL
SUBDIVISIONS
$0 or
(Unknown)
$0 or
(Unknown)
$0 or
(Unknown)
FISCAL IMPACT – Small Business
No direct fiscal impact to small businesses would be expected as a result of this proposal.
FISCAL DESCRIPTION
The bill specifies that the Department of Health and Senior Services will not deny trauma center
status to a hospital based on its distance from another trauma center. (§ 190.241) L.R. No. 3165H.01I
Bill No. HB 1561
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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 Health and Senior Services
Cass Regional Medical Center
Julie MorffJessica HarrisDirectorAssistant DirectorMarch 11, 2025March 11, 2025