COMMITTEE ON LEGISLATIVE RESEARCH

OVERSIGHT DIVISION

FISCAL NOTE

L.R. No.: 0368-01

Bill No.: HB 59

Subject: Corrections Dept.; Health Dept.; Mental Health; Mental Health Dept.; Social Services Dept.

Type: Original

Date: January 21, 2003

FISCAL SUMMARY

* Excludes unknown costs for the Department of Higher Education and potential costs to universities and colleges.

Numbers within parentheses: ( ) indicate costs or losses.

This fiscal note contains 6 pages.

* Excludes unknown costs for the Department of Higher Education and potential costs to universities and colleges.

ASSUMPTION

Officials from the Department of Social Services, Department of Elementary and Secondary Education, Truman State University and University of Missouri assume the proposal would have no fiscal impact on their organizations.

Officials from the Department of Health and Senior Services (DOH) state the DOH assumes the Department of Mental Health will have the lead for the plan and will incur the cost. DOH staff will provide support in designing, coordinating and implementing the state plan with existing resources.

Officials from the Department of Mental Health (DMH) state this fiscal note proposes a low cost, on-going approach. No additional DMH staff is requested; existing staff would manage and support this initiative. The amount of funding requested is sufficient to design and coordinate the required state suicide prevention plan. However, an immediate full implementation of the training and technical assistance components of such a plan is not being recommended. Rather the proposed approach would continue indefinitely. Training would begin at selected sites across the state in FY 2005. Training would continue in other locations across the state each year on an on-going basis.

ASSUMPTION (continued)

In FY 2004 existing resources and staff will be utilized for the curriculum development, coordination and scheduling of training sessions which will begin in FY 2005.

There will be two components:

I. Training and Awareness. The DMH currently has a Suicide Prevention Program that focuses primarily on children and the elderly in some, but not all, Missouri counties. It provides a comprehensive array of suicide prevention services including primary prevention by decreasing risk factors and increasing protective factors, gatekeeper training for early identification and intervention with suicidal persons and comprehensive site specific suicide prevention planning.

A. Expansion of the target population of the current suicide prevention grants would occur through gatekeeper training (group training) for health care providers, local agency health staff, community based professionals and employers. The cost for this expansion would be $30,000 ($7,500 per suicide prevention grant X 4 grants = $30,000).

B. Two more gatekeeper instructor trainings (train-the-trainer) are proposed. The cost for the train-the-trainer sessions would be $20,000 ($200 per person X 100 persons = $20,000).

II. Planning and Evaluation. This component will provide an Oversight Committee to assist the Department in state plan development and evaluations as required by the proposal. It is assumed there would be quarterly meetings, three of which would be for two days and one for one day. There would be ten members including five state agency representatives and five consumers. DMH would staff the committee, produce and revise the plan, and perform the annual evaluations with the assistance of the Department of Health and Senior Services.

Oversight Committee

10 members (5 members State Employees)

Lodging (5 people, 3 meetings) 15@ $65 = $975

Meals (5 people, 7 meetings) 35 @ $26 = $910

Mileage (5 people, 4 meetings) 20 @ $75 = $1,500

Misc. Expenses (5 people, 4 meetings) 20 @ $5 = $100

Total for Oversight Committee $3,485

Training and Awareness - $50,000

Total - $53,485

ASSUMPTION (continued)

The DMH proposes total costs for implementation of the proposal of $55,089 in FY 2005 and $56,741 in FY 2006.

Officials from the Department of Higher Education (DHE) stated the DHE's expected involvement is not defined in the proposal and therefore, the cost is unknown.

Officials from the Department of Corrections (DOC) did not respond to our request for a statement of fiscal impact. However, in response to similar legislation from the prior session, DOC officials stated it is unknown what plans may be decided on for implementation. The DOC is unsure what potential fiscal impact could result due to possible programs for employees as well as incarcerated offenders. Program development, implementation and the monitoring thereof, could result in costs as well as the need for staff. Therefore, the potential cost to the DOC is unknown at this time.

Oversight assumes potential costs to the DOC would be minimal and could be absorbed within existing resources based on the Departments of Mental Health, Elementary and Secondary Education, Health and Senior Services, and Social Services responses,.

Officials from Missouri Southern State College did not respond to our request for a statement of fiscal impact.

* Excludes unknown costs for the Department of Higher Education and potential costs to universities and colleges.

FISCAL IMPACT - Small Business

No direct fiscal impact to small businesses would be expected as a result of this proposal.

DESCRIPTION

This proposal requires the Department of Mental Health to design and implement a state suicide prevention plan in collaboration with the departments of Social Services, Health and Senior Services, Elementary and Secondary Education, Higher Education, and Corrections. The director is required to: (1) Promote the use of employee assistance and workplace programs to support employees experiencing depression or other psychiatric illnesses; (2) Promote the use of student assistance and educational programs to support students with depression and other psychiatric illnesses and substance abuse disorders; (3) Provide training and technical assistance to local public health and other community-based professionals on the best practices to prevent suicides; (4) Coordinate with federal, state, and local agencies in order to collect and analyze data on suicides and suicidal behaviors in Missouri and annually issue a public report; and (5) Conduct periodic evaluations of the effect of the implementation of the suicide prevention program.

By July 1, 2004, and each July 1 of even-numbered years thereafter, the director is required to report the results of the evaluation to the chairs of the House Children, Families and Health Committee and the Senate Aging, Families and Mental Health Committee, or their successor committees.

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 Higher Education

Department of Elementary and Secondary Education

Department of Mental Health

Department of Health and Senior Services

Department of Social Services

Truman State University

University of Missouri

NOT RESPONDING: Department of Corrections and Missouri Southern State College

Mickey Wilson, CPA

Director

January 21, 2003