COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:0754H.01I Bill No.:HB 266 Subject:Education, Elementary and Secondary; Emergencies; Department of Elementary
and Secondary Education; Liability
Type:Original Date:January 13, 2025Bill Summary:This proposal requires bleeding control kits in all public school and charter
school classrooms.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2026FY 2027FY 2028
General Revenue*
$0 to (Could exceed
$1,759,700)
$0 or (Could exceed
$100,000)
$0 or (Could exceed
$100,000)
Total Estimated Net
Effect on General
Revenue
$0 to (Could exceed
$1,759,700)
$0 or (Could exceed
$100,000)
$0 or (Could exceed
$100,000)
*Subject to an appropriation by the General Assembly (§160.485.7(2)).
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. 0754H.01I
Bill No. HB 266
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January 13, 2025
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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 2028Total 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 2026FY 2027FY 2028Local Government*$0$0$0
*Transfers in and costs net to zero. L.R. No. 0754H.01I
Bill No. HB 266
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January 13, 2025
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FISCAL ANALYSIS
ASSUMPTION
Section 160.485 - Bleeding Control Kits
Officials from Department of Elementary and Secondary Education (DESE) state, subject to
appropriation, the minimum total cost to provide the bleeding control kits would be $1,759,700
with ongoing costs to replenish/replace used or expired items.
The cost per bleeding control kit is estimated at $100 each (kits from different sources cost
between $40 and $160+). The number of buildings in Missouri that would require kits is 2,406.
The Department estimates a minimum of six kits per building (main hall, auditorium, library,
gymnasiums, science classrooms, and cafeterias) with the number of kits estimated to be around
14,436. Additional kits to be required at the career-technical centers (57) at a minimum of three
per center is estimated to be approximately 171.
The Department assumes that the general assembly will appropriate funds to award
grants/reimbursement to local education agencies for the cost of “Stop the Bleed” kits. 14,607
kits x $100 per kit = $1,460,700 plus an additional five kits for approximately 25% of schools
(598) who have an additional need for high traffic areas or multiple required locations =
$299,000 for a total of $1,759,700.
Once the program has been implemented throughout Missouri materials will need
replaced/restocked as they are used or expire. The Department estimates a minimum cost of
$100,000 with additional potential costs due to inflation.
DESE estimates current staff will develop guidelines as required and administer the
grants/reimbursement, however it will increase the workload on current staff and require
administrative support. If multiple items of legislation are passed that require additional duties,
DESE will seek additional FTE through the appropriation process.
Officials from the Department of Public Safety - Office of the Director 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.
In response to a similar proposal, HB 1487 (2024), officials from the Henry County R-1 School
District assumed the proposal will have a fiscal impact due to monies spent to provide kits.
In response to a similar proposal, HCS HB 1991 (2020), officials from the Maries County R-1
School District assumed the cost would be approximately $69.99 per classroom: $68.99 for the
Curaplex Stop the Bleed Kit and $1.00 for the Emergency Thermal Blanket (10 for $9.95). Fifty L.R. No. 0754H.01I
Bill No. HB 266
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January 13, 2025
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five spaces would need one in their school, it would cost them $3,850 to put them in. They
would have to replace the kits when they expire.
In response to a similar proposal, HCS HB 1722 (2022), DESE used an estimated cost per kit of
$35. However, based on their research this past year, DESE estimated the cost to be closer to
$100 per kit based on the average cost of bleeding control kits. For example, the American Red
Cross offers a Professional Bleeding Control Kit for $122.95. In addition, they indicated some of
the cost increase may be related to inflation and supply chain issues.
Ultimately, Oversight is uncertain what cost would be realized but notes prices ranged from $50
to over $200 per kit based on a brief review. Oversight will show the costs to provide bleeding
control kits at $1,759,700 as estimated by DESE.
Oversight assumes the requirements in this proposal are subject to appropriation by the General
Assembly that would cover all costs. Oversight assumes kits will not be used frequently, so
restocking and annual training costs will be shown as ‘could exceed ($100,000)’ in future years.
FISCAL IMPACT – State GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028GENERAL REVENUETransfer Out - DESE - bleeding control
kits and school personnel training -
§160.485
$0 to (Could
exceed
$1,759,700)
$0 or (Could
exceed
$100,000)
$0 or (Could
exceed
$100,000)
ESTIMATED NET EFFECT ON
GENERAL REVENUE
$0 to (Could
exceed
$1,759,700)
$0 or (Could
exceed
$100,000)
$0 or (Could
exceed
$100,000)
FISCAL IMPACT – Local GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028SCHOOL DISTRICTS
Transfer In - from state General
Revenue - §160.485
$0 to Could
exceed
$1,759,700
$0 or Could
exceed
$100,000
$0 or Could
exceed
$100,000
Cost - for cost of bleeding control kits
and school personnel training -
§160.485
$0 to (Could
exceed
$1,759,700)
$0 or (Could
exceed
$100,000)
$0 or (Could
exceed
$100,000)
ESTIMATED NET EFFECT ON
SCHOOL DISTRICTS$0$0$0 L.R. No. 0754H.01I
Bill No. HB 266
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January 13, 2025
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FISCAL IMPACT – Small Business
No direct fiscal impact to small businesses would be expected as a result of this proposal.
FISCAL DESCRIPTION
This bill establishes the "Stop the Bleed Act", defines "bleeding control kit" and requires the
Department of Elementary and Secondary Education (DESE) to develop a traumatic blood loss
protocol for school personnel by January 1, 2026.
The bill outlines the specific requirements for the blood loss protocol which must include that a
bleeding control kit be placed in areas where there is likely to be high traffic or congregation,
and areas where risk of injury may be elevated.
Additionally, each district must designate a school nurse or school health care provider, or if no
school nurse or school health care provider is available, a school personnel member to receive
annual training on the use of a blood control kit.
The bill requires DESE and each school district and charter school to maintain information
regarding the traumatic blood loss protocol and the Stop the Bleed national awareness campaign
on their respective websites.
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 Elementary and Secondary Education
Department of Public Safety - Office of the Director
Department of Social Services
Henry County R-1 School District
Maries County R-1 School District
Julie MorffJessica HarrisDirectorAssistant DirectorJanuary 13, 2025January 13, 2025