Colorado Legislative Council Staff

STATE

REVISED CONDITIONAL FISCAL NOTE

(replaces Fiscal Note dated February 7, 1998)

Cash Funds Exempt Revenue and Expenditure Impact

TITLE:            CONCERNING THE CREATION OF A STATEWIDE GULF WAR SYNDROME REGISTRY.

Summary of Legislation

*    Reflects the cost to implement the registry. The bill requires that the registry shall not be implemented until adequate moneys are received through grants, donations, and in-kind gifts. Expenditures will occur when moneys are available to implement the program. That may occur in FY 1999-00 or later.

            The fiscal note is revised only to note the creation of the Gulf War Syndrome Registry Fund, and the fact that grants, donation and gifts will be credited to the fund and moneys therein shall be subject to annual appropriation by the General Assembly. Costs to implement the registry remain unchanged.

            The reengrossed bill directs the Department of Public Health and Environment (DPHE) to establish and maintain a statewide registry to collect names and medical information regarding veterans and family members of veterans who have been affected by Gulf War Syndrome. The bill also:

            •   requires physicians, health care professionals, hospitals, or medical facilities believing a veteran who may have been exposed to a causative agent while serving in the Gulf War to submit a report (including the incidence of the syndrome, diagnosis, method of treatment, and treatment outcomes) to DPHE, with the consent of the veteran or affected family member;

            •   requires DPHE to contact the families of any children born after August 2, 1990, who are on the State Cancer Registry or have been reported as having birth defects to determine whether either of the two biological parents served in the Gulf War;

            •   provides that if a parent did serve, DPHE shall inform the families about the registry and their option to have the child's name, symptoms, and diagnoses listed in the registry;

            •   creates a Gulf War Syndrome Advisory Committee;

            •   directs the advisory committee to compile and evaluate registry information and submit an annual report with its findings, conclusions, and recommendations to the Governor, State Board of Health, and the Health, Environment, Welfare, and Institutions Committees of the General Assembly;

            •   requires that all information concerning persons on the registry is confidential, except that it may be compiled for statistical purposes;

            •   protects physicians, health care professionals, hospitals, or medical facilities from civil or criminal liability for reporting information;

            •   allows DPHE to accept and expend grants, donations, and gifts-in-kind for the purpose of maintaining and publicizing the registry, and provides that the registry shall not be implemented until there are sufficient grants, donations, and gifts-in-kind to support its implementation; and

            •   as amended, creates the Gulf War Syndrome Registry Fund, wherein grants, donations and gifts shall be credited to the fund and moneys in the fund shall be subject to annual appropriation by the General Assembly.

            The bill is effective upon signature of the Governor.

State Revenues

            To the extent that DPHE receives grants, donations, and gifts for the Statewide Gulf War Syndrome Registry, there will be additional cash funds exempt revenue available to implement the registry. The level of revenue provided by grants, donations, and gifts cannot be quantified at this time. 

State Expenditures

            Department of Public Health and Environment. The bill authorizes the department to accept and expend grants, donations and gifts from private and public sources to maintain and publicize the registry. It additionally requires that the registry shall not be implemented until sufficient grants, donations and gifts are obtained. This fiscal note assumes a minimum period of one year is required to access adequate moneys to support the registry. Thus, no expenditures are identified for FY 1998-99. The bill is assessed as having a conditional fiscal impact for FY 1999-00 and beyond, contingent upon the receipt of adequate moneys to support the registry. Because the level of revenue anticipated through grants, donations, and gifts cannot be quantified, the year in which expenditures may occur cannot be identified. The following paragraph identifies the resources DPHE will require to implement the registry once adequate moneys are available.

            Based on its experience in maintaining a Cancer Registry and a Birth Defects Registry, combined with information from Iowa and its experience in establishing and maintaining a Gulf War Syndrome Registry, the department will need 3.5 FTE and $197,477 to implement a registry in Colorado. Staff responsibilities would include the provision of:

            •   medical and epidemiological oversight of the program;

            •   education and outreach functions to health care providers and Gulf War veterans;

            •   medical records review and quality control prior to data entry into the registry;

            •   statistical analysis;

            •   computer programming; and

            •   toxicological/epidemiological consultation.

            Personal services and associated operating costs are estimated at $190,869, and meeting costs for the advisory committee are estimated at $6,608 (8 meetings annually at a cost of $826 per meeting = $6,608).

NOTE:   The bill requires that the Gulf War Syndrome Advisory Committee members serve without compensation. This fiscal note assumes that the committee will not be convened until adequate moneys are available to implement the registry.

Spending Authority

            The bill does not require additional spending authority for FY 1998-99.

Departments Contacted

            Public Health and Environment