Subject: Health Care; Health Care Professionals; Health, Public; Health Department; Physicians

Bill Summary: This legislation requires the Department of Health and Senior Services to establish a program to expand and intensify research to develop innovative advanced imaging technologies for prostate cancer detection.

ESTIMATED NET EFFECT ON GENERAL REVENUE FUND
FUND AFFECTED	FY 2009	FY 2010	FY 2011
General Revenue	(Unknown but Greater than $571,363)	(Unknown but Greater than $609,977)	(Unknown but Greater than $619,275)

Total Estimated Net Effect on General Revenue Fund	(Unknown but Greater than $571,363)	(Unknown but Greater than $609,977)	(Unknown but Greater than $619,275)

ESTIMATED NET EFFECT ON OTHER STATE FUNDS
FUND AFFECTED	FY 2009	FY 2010	FY 2011

Total Estimated Net Effect on Other State Funds	$0	$0	$0

ESTIMATED NET EFFECT ON FEDERAL FUNDS
FUND AFFECTED	FY 2009	FY 2010	FY 2011


Total Estimated Net Effect on All Federal Funds	$0	$0	$0

ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)
FUND AFFECTED	FY 2009	FY 2010	FY 2011
General Revenue	3 FTE	3 FTE	3 FTE

Total Estimated Net Effect on FTE	3 FTE	3 FTE	3 FTE

☐ Estimated Total Net Effect on All funds expected to exceed $100,000 savings or (cost).

☒ Estimated Net Effect on General Revenue Fund expected to exceed $100,000 (cost).

ESTIMATED NET EFFECT ON LOCAL FUNDS
FUND AFFECTED	FY 2009	FY 2010	FY 2011
Local Government	$0	$0	$0

Officials from the Missouri House of Representatives and the Missouri Senate each assume the proposal would have no fiscal impact on their respective agencies.

Officials from the Department of Health and Senior Services (DHSS) estimates that three additional FTE will be needed in order to carry out the provisions of the proposed legislation:

• One Research Manager Band 3 will be responsible for directing the overall planning, development, and administration of the program. Also, the duties include coordination with federal, state, local, and community organizations interested in the project, analysis and evaluation of research data, and development of required reports;

• One Health Program Representative III will be responsible for coordinating the establishment, support, and monitoring of contracts, development of educational materials, and provision of technical assistance regarding contract administration to the contractors;

• One Senior Office Support Assistant will be responsible for correspondence, conference/meeting setup and taking minutes, sending program information to interested organizations, and the public, record keeping, and routine clerical duties for program staff.

Section 191.955.3 requires the Department to implement a statewide campaign to increase the awareness and knowledge of Missourians with respect to the need for prostate cancer screening. This statewide campaign shall include the development and distribution of written education materials as well as the development and placing of public service announcements.

According to data obtained through the Missouri Information for Community Assessment, there are approximately 1,838,972 men in Missouri that are age 25 and older. The Department estimates that written educational materials would be provided to approximately 919,486 men (50 percent). At a cost of $0.09 per brochure, this would result in a cost of $82,754 (919,486 x $0.09). The brochures will be distributed through the contractors for the health education program and would therefore require no funds for postage.

The Department currently pays $43.98 for 201 radio public service announcements on colorectal cancer that run for two weeks in the St. Louis region. It is estimated that four similar campaigns per year would be needed throughout the state. The Department is unsure as to how many public service announcements that this would result in and therefore estimates a cost of unknown > $100,000.

An additional requirement of the statewide campaign includes the establishment of a program to award grants to nonprofit entities to enable the entities to test alternative outreach and education strategies in order to increase the awareness and knowledge of Missourians with respect to the need for prostate cancer screening and improved imaging technologies. DHSS will obtain assistance from the National Cancer Institute's Cancer Information Service to identify potential contractors. The Department assumes that the funding for these grants would be appropriated by the General Assembly and therefore estimates a cost of unknown > $100,000.

The proposed legislation requires the Department to carry out research to develop an improved prostate cancer screening blood test using in-vitro detection. In order to carry out this provision, DHSS will establish contracts with academic research institutions to carry out the research. The Department assumes that the funding for this research would be appropriated by the General Assembly and therefore estimates a cost of unknown > $100,000.

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

The proposed legislation establishes the Prostate Research, Imaging, and Men's Education (PRIME) Act which requires the Department of Health and Senior Services to establish a program to expand and intensify research to develop innovative advanced imaging technologies for prostate cancer detention, diagnosis, and treatment comparable to state-of-the-art mammography technologies.

The Department director must implement a statewide public awareness campaign regarding the need for prostate cancer screening and improved detection technologies and must carry out

research to develop an improved prostate cancer screening blood test using in-vitro detection.

Within six months of the legislation's effective date, the Department director is required to submit a report to the General Assembly regarding the strategy for implementation of the legislation and the status of those efforts. Within one year of the legislation's effective date and annually thereafter, the Department director is required to submit a report to the General Assembly assuring the provisions of the legislation are fully implemented and certifying its compliance or an explanation of any noncompliance.

This legislation is not federally mandated, would not duplicate any other program and would not require additional capital improvements or rental space.

FISCAL IMPACT - State Government	FY 2009 (10 Mo.)	FY 2010	FY 2011

GENERAL REVENUE FUND

Costs - Department of Health and Senior Services
Personal Service	($106,741)	($131,931)	($135,889)
Fringe Benefits	($48,311)	($59,712)	($61,503)
Equipment and Expense	($116,311)	($118,334)	($121,883)
Public Service Announcements	(Unknown but Greater than $100,000)	(Unknown but Greater than $100,000)	(Unknown but Greater than $100,000)
Grants	(Unknown but Greater than $100,000)	(Unknown but Greater than $100,000)	(Unknown but Greater than $100,000)
Research Contracts	(Unknown but Greater than $100,000)	(Unknown but Greater than $100,000)	(Unknown but Greater than $100,000)
Total Costs - DHSS	(Unknown but Greater than $571,363)	(Unknown but Greater than $609,977)	(Unknown but Greater than $619,275)
FTE Change - DHSS	3 FTE	3 FTE	3 FTE

ESTIMATED NET EFFECT ON GENERAL REVENUE FUND	(Unknown but Greater than $571,363)	(Unknown but Greater than $609,977)	(Unknown but Greater than $619,275)

Estimated Net FTE Change for General Revenue Fund	3 FTE	3 FTE	3 FTE