OFFICE OF FISCAL ANALYSIS

Legislative Office Building, Room 5200

Hartford, CT 06106 (860) 240-0200

http: //www. cga. ct. gov/ofa

sSB-471

AN ACT EXTENDING THE STATE PHYSICIAN PROFILE TO CERTAIN OTHER HEALTH CARE PROVIDERS.

As Amended by Senate "A" (LCO 3922), Senate "B" (LCO 4103), House "A" (LCO 5155)

House Calendar No. : 452

Senate Calendar No. : 146

OFA Fiscal Note

State Impact:

Agency Affected

Fund-Effect

FY 09 $

FY 10 $

Public Health, Dept.

GF - Cost

None

256,184

Comptroller Misc. Accounts (Fringe Benefits)1

GF - Cost

None

47,348

Public Health, Dept.

GF - Revenue Gain

None

Potential Minimal

Note: GF=General Fund

Municipal Impact: None

Explanation

The bill requires the Department of Public Health (DPH) to expand its current physician profile database system to include dentists, chiropractors, optometrists, podiatrists, naturopaths, dental hygienists, advanced practice registered nurses and physical therapists by 1/1/10. It further specifies that this is to be accomplished within available appropriations.

DPH will incur FY 10 costs of $256,184 to support the salaries of: 1 half-year Office Assistant; 1 full-year Office Assistant; 1 full-year Health Program Assistant; and 1 full-year IT Analyst, as well as associated other expenses and one-time equipment costs. Additional fringe benefits costs of $47,348 would also be incurred.

Should no appropriation be forthcoming for this initiative in FY 10, the requirement that it be undertaken within available appropriations will likely result in one of four outcomes: (1) The Department of Public Health (DPH) will proceed with the development of the database, and will require a deficiency appropriation during FY 10; (2) DPH will delay the implementation pending approval of additional appropriations to meet this mandate in future fiscal years; (3) DPH will shift resources from other department priorities, thereby impacting existing departmental programs; or (4) DPH will not create the database.

Associated FY 11 costs would be $180,383 (DPH) and $97,257 (fringe benefits), as the temporary Office Assistant would no longer be required, and one-time other expenses and equipment costs would not recur.

The bill also makes failure to provide information needed to complete a health care provider's profile a reason for disciplinary action. A minimal revenue gain would ensue to the extent that any civil penalties are imposed. (Section 19a-17 authorizes a civil penalty of up to $10,000. )

It is expected that information concerning each provider's history of medical malpractice or criminal activity will be self-reported. Therefore, no resulting fiscal impact is anticipated for either the Departments of Insurance or Public Safety.

Senate “A” changes the bill's effective date to 1/1/10, which significantly reduces costs of implementation from amounts described in the original fiscal note. This is because the delay will allow the DPH to incorporate the expanded practitioner profile database within a new computer system, currently in development, and thus avert certain significant costs that would have been unavoidable given the original bill's 10/1/08 effective date.

Senate “B” expands the information that must be reported within the practitioner profile database and results in no fiscal impact.

House “A” requires the expanded health care provider profile database to be established within available appropriations. It also makes failure to provide information needed to complete a health care provider's profile a reason for disciplinary action. A minimal revenue gain would ensue to the extent that any civil penalties are imposed.

The Out Years

The annualized ongoing fiscal impact identified above would continue into the future subject to inflation.

1 The fringe benefit costs for state employees are budgeted centrally in the Miscellaneous Accounts administered by the Comptroller. The first year fringe benefit costs for new positions do not include pension costs. The estimated first year fringe benefit rate as a percentage of payroll is 25. 36%. The state's pension contribution is based upon the prior year's certification by the actuary for the State Employees Retirement System (SERS). The SERS fringe benefit rate is 33. 27%, which when combined with the rate for non-pension fringe benefits totals 58. 63%.