COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:2031H.01I Bill No.:HB 803 Subject:Health Care Professionals; Public Health; Children and Minors Type:Original Date:February 24, 2025Bill Summary:This proposal modifies provisions relating to blood tests of pregnant women.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2026FY 2027FY 2028General($18,525)($23,342)($24,509)Total Estimated Net
Effect on General
Revenue($18,525)($23,342)($24,509)
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. 2031H.01I
Bill No. HB 803
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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 L.R. No. 2031H.01I
Bill No. HB 803
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FISCAL ANALYSIS
ASSUMPTION
§ 210.030 - Provisions relating to blood tests of pregnant women
Officials from the Department of Health and Senior Services (DHSS) state § 210.030.1 of the
proposed legislation would increase the number of patient samples that the Missouri State Public
Health Laboratory (MSPHL) would receive for HIV, syphilis, Hepatitis C, and Hepatitis B
testing.
Approximately 4.5 percent of women are pregnant at any one time, so this percentage was used
on the total number of female samples received for HIV and syphilis testing in 2024. An
additional 500 to 800 samples a year would be tested for all conditions if this legislation passed.
The estimated number of pregnant females was used in the calculations for HIV, syphilis,
Hepatitis C, and Hepatitis B expenses for both screening and confirmatory costs. Confirmatory
numbers were based on current trends that are seen for each test. The cost estimates are based
upon the expected number of samples and cost per test with an applied algorithm for testing and
confirmation.
• HIV (765 samples times $6.20 per test plus $327.60 confirmation testing = $5,071)
• Syphilis (675 samples times $3.25 per test plus $1,420.25 confirmation testing = $3,614)
• Hepatitis B (500 samples times $14.93 per test = $7,465)
• Hepatitis C (500 samples times $7.63 per test plus $3,815 confirmation testing = $6,080)
The projected total per year would be $22,230 in additional reagents and kit costs. The cost of
reagents will go up each year with an inflation cost of 5 percent per year. MSPHL cannot absorb
this cost. The workload for performing the additional testing can be absorbed by current staff.
Oversight does not have information to the contrary. Oversight notes this proposal does not have
an emergency clause. Therefore, Oversight will reflect the FY 2026 estimates as provided by the
DHSS as $18,525 ($22,230/12)*10).
Officials from the Department of Public Safety (DPS), Missouri Highway Patrol (MHP)
defer to the Missouri Department of Transportation (MODOT) for the potential fiscal impact of
this proposal.
Oversight notes DPS/MHP’s deferral to MODOT for a statement of fiscal impact; for fiscal note
purposes, Oversight assumes no fiscal impact for DPS/MHP.
Officials from the Department of Commerce and Insurance, the Department of Social
ServicesMissouri Consolidated Health Care Plan, the Missouri Department of L.R. No. 2031H.01I
Bill No. HB 803
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Conservation, the Missouri Department of Transportation, the Oversight Division and the
Newton County Health Department
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 only reflects the responses received from state agencies and political subdivisions;
however, other local public health agencies and 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 2026
(10 Mo.)
FY 2027FY 2028GENERAL REVENUE FUNDCosts – DHSS/MSPHL (§ 210.030)
Additional testing supplies p. 3-4($18,525)($23,342)($24,509)
ESTIMATED NET EFFECT ON
THE GENERAL REVENUE FUND($18,525)($23,342)($24,509)
FISCAL IMPACT – Local GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028$0$0$0
FISCAL IMPACT – Small Business
Certain small medical and laboratory businesses would be impacted by this proposal.
FISCAL DESCRIPTION
This bill requires an additional blood sample to be taken, with the woman's consent, at 28 weeks
of pregnancy, and expands the list of diseases for screening to include hepatitis C and HIV. The
bill also repeals a provision outlining the procedure for a later sample of a woman's blood in any
area of the state designated as a syphilis outbreak area, and provides that if a woman tests
positive for syphilis, hepatitis B or C, or HIV, or a combination thereof, the physician or person
providing care must administer treatment in accordance with the most recent accepted medical
practice to treat such diseases. L.R. No. 2031H.01I
Bill No. HB 803
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The bill additionally repeals a reference to the Missouri Genetic Disease Advisory Committee,
granting the Department the sole authority to make rules pertaining to such tests, provided that
the tests are of the types approved or accepted by the US Food and Drug Administration. The bill
also repeals a requirement that approved and standard tests for these diseases must be made in a
Department approved laboratory. (§ 210.030)
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 Public Safety, Missouri Highway Patrol
Department of Social Services
Missouri Consolidated Health Care Plan
Missouri Department of Conservation
Missouri Department of Transportation
Oversight Division
Newton County Health Department
Julie MorffJessica HarrisDirectorAssistant DirectorFebruary 24, 2025February 24, 2025