COMMITTEE ON LEGISLATIVE RESEARCH

OVERSIGHT DIVISION

FISCAL NOTE

L.R. No.: 4044-07

Bill No.: Truly Agreed to and Finally Passed SCS for HCS for HB 1136

Subject: Abortion; Cemeteries; Health Department

Type: Original

Date: May 20, 2004

FISCAL SUMMARY

Numbers within parentheses: ( ) indicate costs or losses.

This fiscal note contains 5 pages.

ASSUMPTION

Officials from the Department of Social Services, the Office of State Courts Administrator, the Office of Prosecution Services, the Office of Administration - Administrative Hearing Committee, the Department of Economic Development - Division of Professional Registration and the Department of Health and Senior Services assume this proposal would not fiscally impact their agencies.

Officials from the State Public Defender (SPD) did not respond to our fiscal note request. In a similar proposal the SPD assumed the proposal would not fiscally impact their agency.

In a similar proposal, officials from Barton County Memorial Hospital stated costs would be minimal. Oversight assumes the costs to other county hospitals would be minimal.

Officials from the Secretary of State Office (SOS) state this proposal creates the Disposition of Fetal Remains Act. Based on experience with other divisions, the rules, regulations and forms issued by the Department of Health and Senior Services could require as many as 6 pages in the Code of State Regulations. For any given rule, roughly half again as many pages are published in the Missouri Register as in the Code because cost statements, fiscal notes and the like are not ASSUMPTION (continued)

repeated in Code. These costs are estimated. The estimated cost of a page in the Missouri Register is $23. The estimated cost of a page in the Code is $27. The actual cost could be more or less than the numbers given. The impact of this legislation in future years is unknown and depends upon the frequency and length of rules filed, amended, rescinded or withdrawn. The SOS estimates the cost for FY 05 only to be $369.

Oversight assumes the SOS could absorb the costs of printing and distributing regulations related to this proposal. If multiple bills pass which require the printing and distribution of regulations at substantial costs, the SOS could request funding through the appropriation process. Any decisions to raise fees to defray costs would likely be made in subsequent fiscal years.

FISCAL IMPACT - Small Business

Small businesses which are health care facilities would be affected by this proposal.

DESCRIPTION

In the event of a fetal death, either parent may file an application with the state registrar requesting a certificate of birth resulting in stillbirth.

The proposal establishes the Disposition of Fetal Remains Act. The proposal:

(1) Requires that the mother of a dead human fetus determine the final disposition of the remains of the fetus in every instance of fetal death. The mother is allowed to choose any means of final disposition authorized by law or by the Director of the Department of Health and Senior Services; (Section 194.378)

DESCRIPTION (continued)

(2) Authorizes the final disposition of human fetal remains by cremation, burial, incineration in an approved medical waste incinerator, or other means approved by the director. The disposition must be consistent with state law or administrative rules. If the disposition occurs by incineration, the remains must be incinerated separately from medical waste; (Section 194.381)

(3) Does not require a religious service or ceremony to be held; (Section 194.381)

(4) Requires licensed hospitals and other licensed health care facilities to adopt written standards for the disposition of human fetal remains. Licensed health care facilities are required to provide the mother a copy of their written standards; (Section 194.384)

(5) Requires licensed hospitals or other licensed health care facilities to notify the mother within a 24-hour period of her right to determine the final disposition and the methods of final disposition of the fetal remains. The 24-hour notification is required if a miscarriage occurs at the facility (Section 194.387.1); and

(6) Requires the licensed health care facility to provide on-site counseling services to the mother or refer the mother to an appropriate provider of counseling services concerning the death of the fetus. (Section 194.390)

The proposal does not prohibit a woman's ability to obtain a legal abortion.

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 Social Services

Department of Health and Senior Services

Office of State Courts Administrator

Office of Prosecution Services

Office of Administration -

Administrative Hearing Committee

Secretary of State

Department of Economic Development -

Division of Professional Registration

NOT RESPONDING: State Public Defender

Mickey Wilson, CPA

Director

May 20, 2004