SENATE JOURNAL - <p><b>SEVENTY-FIRST DAY--THURSDAY, MAY 15, 1997</b>

Journal of the Senate

FIRST REGULAR SESSION

SEVENTY-FIRST DAY--THURSDAY, MAY 15, 1997

The Senate met pursuant to adjournment.

President Pro Tem McKenna in the Chair.

The Chaplain offered the following prayer:

Our Father in Heaven, the Apostle Paul wrote, "Every man shall receive his own reward according to his own labor." Lord, we pray that You will be with us that our labor not be in vain. Help us to accomplish something worthwhile. We seek Your wisdom, understanding, courage and power. Grant to us what is needed to do the very best job that can be done. Amen.

The Pledge of Allegiance to the Flag was recited.

A quorum being established, the Senate proceeded with its business.

The Journal of the previous day was read and approved.

The following Senators were present during the day's proceedings:

Present--Senators
Banks Bentley Caskey Childers
Clay Curls DePasco Ehlmann
Flotron Goode Graves House
Howard Jacob Johnson Kenney
Kinder Klarich Lybyer Mathewson
Maxwell McKenna Mueller Quick
Rohrbach Russell Schneider Scott
Sims Singleton Staples Westfall
Wiggins Yeckel--34

Absent with leave--Senators--None

RESOLUTIONS

Senator House offered Senate Resolution No. 865, regarding Jeff Pauls, which was adopted.

MESSAGES FROM THE HOUSE

The following messages were received from the House of Representatives through its Chief Clerk:

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has dissolved the conference on SS for SCS for HS for HCS for HB 335 as amended and has adopted the SS for SCS for HS for HCS for HB 335 as amended and has again taken up and passed SS for SCS for HS for HCS for HB 335 as amended.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has adopted SCS for HS for HCS for HB 361 and has again taken up and passed SCS for HS for HCS for HB 361.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has adopted SS for SCS for HS for HB 850 and has again taken up and passed SS for SCS for HS for HB 850.

Emergency clause adopted.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has taken up and adopted the Conference Committee Report on SB 315, as amended, and has taken up and passed CCS for SB 315.

Bill ordered enrolled.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has taken up and adopted the Conference Committee Report on HCS for SB 387 and has taken up and passed CCS for SB 387.

Emergency clause adopted.

Bill ordered enrolled.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has taken up and adopted the Conference Committee Report on HCS for SS for SB 11, as amended, and has taken up and passed CCS for SB 11.

Bill ordered enrolled.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has taken up and passed SCS for HCS for HB 557.

With House Perfecting Amendments Nos. 1 and 2.

HOUSE PERFECTING AMENDMENT NO. 1

Amend Senate Committee Substitute for House Committee Substitute for House Bill No. 557, Page 10, Section 30.810, Line 3, by deleting the number "30.769" and inserting in lieu thereof the number "30.767"; and

Further amend said bill, Page 11, Section 348.015, Line 1, by deleting the number "348.005" and inserting in lieu thereof the following: "[348.005] 348.015"; and

Further amend said bill, Page 14, Section 348.400, Line 22, by inserting immediately before the word "as" the word "Lender"; and

Further amend said bill, Page 17, Section 348.410, Line 5, by deleting the number "7" and inserting in lieu thereof the number "5".

HOUSE PERFECTING AMENDMENT NO. 2

Amend Senate Committee Substitute for House Committee Substitute for House Bill No. 557, Page 19, Section 348.415, Line 9, by adding immediately after said line, the following:

"Section 1. 1. In any action challenging any rule promulgated pursuant to the provisions of this bill, the agency as defined in section 536.010 promulgating such rule shall be required to prove by a preponderance of the evidence that the rule or threatened application of the rule is valid, is authorized by law, is not in conflict with any law and is not arbitrary and capricious.

2. The court shall award reasonable fees and expenses as defined in section 536.085 to any party who prevails in such action.

3. All rules promulgated pursuant to the provisions of this section shall expire on August 28 of the year after the year in which the rule became effective unless the General Assembly extends by statute the rule or set of rules beyond that date to a date specified by the General Assembly.

4. Any rulemaking authority granted pursuant to the provisions of this bill is subject to any rulemaking authority contained in Chapter 536 including any subsequent amendments to Chapter 536.

5. The provisions of this section shall terminate if legislation amending the provisions of section 536.024 has been signed into law prior to the effective date of this Act.

Section 2. Any rule or portion of a rule promulgated pursuant to this bill shall become effective only as provided pursuant to chapter 536, RSMo, including but not limited to section 536.028 RSMo., if applicable, after the effective date of this act. All rulemaking authority delegated prior to the effective date of this act is of no force and effect and repealed. The provisions of this section are nonseverable and if any of the powers vested with the general assembly pursuant to section 536.028, if applicable, to review, to delay the effective date, or to disapprove and annul a rule or portion of a rule are held unconstitutional or invalid, the purported grant of rulemaking authority and any rule so proposed and contained in the order of rulemaking shall be invalid and void.".

And further amend the bill by amending the title and enacting clause accordingly.

In which the concurrence of the Senate is respectfully requested.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has taken up and passed SS for HB 578.

With House Perfecting Amendment No. 1.

HOUSE PERFECTING AMENDMENT NO. 1

Amend Senate Substitute for House Bill No. 578, Page 3, Section 1, Line 96, by adding immediately after said line, the following:

2. The court shall award reasonable fees and expenses as defined in section 536.085 to any party who prevails in such action.

4. Any rulemaking authority granted pursuant to the provisions of this bill is subject to any rulemaking authority contained in Chapter 536 including any subsequent amendments to Chapter 536.

5. The provisions of this section shall terminate if legislation amending the provisions of section 536.024 has been signed into law prior to the effective date of this Act.

And further amend the bill by amending the title and enacting clause accordingly.

In which the concurrence of the Senate is respectfully requested.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House Conference Committee on HS for HCS for HB 472 as amended was dissolved and the House request the Senate recede from Senate Amendment No. 1.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House refuses to adopt SS for HS for HB 811, as amended, and requests the Senate to recede from its position and failing to do so, grant the House a conference thereon.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House refuses to concur in SA 1 to SCA 1; SCA 1, as amended; SSA 1 for SCA 2; SSA 1 for SCA 3; SCA 4; SA 1; SA 2; SA 3; SA 4; SA 1 to SA 5; SA 5 a.a.; SA 6; SA 7; SA 1 to SA 8; SA 8 a.a.; to HCS for HB 288 and request the Senate to recede from its position or, failing to do so, grant the House a conference thereon.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House recedes from its position on HA 2 to SB 128, and has again taken up and passed SB 128 as amended.

Bill ordered enrolled.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House recedes from its position on HA 1, as amended, to SB 67, and has again taken up and passed SB 67 as amended.

Bill ordered enrolled.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has taken up and passed SB 171.

With House Amendments Nos. 1 and 2.

HOUSE AMENDMENT NO. 1

Amend Senate Bill No. 171, Page 1, In the Title, Line 2, by deleting the word "section" and inserting in lieu thereof the following: "sections 327.101 and"; and

Further amend said bill, Page 1, In the Title, Line 3, by deleting the words "one new section" and inserting in lieu thereof the words "two new sections"; and

Further amend said bill, Page 1, Section A, Lines 1 and 2, by deleting all of said lines and inserting in lieu thereof the following:

"Section A. Sections 327.101 and 429.015, RSMo 1994, are repealed and two new sections enacted in lieu thereof, to be known as sections 327.101 and 429.015, to read"; and

Further amend said bill, Page 1, Section A, Line 3, by inserting after all of said line the following:

"327.101. No person shall practice architecture in Missouri as defined in section 327.091 unless and until there is issued to [him] the person a certificate of registration or a certificate of authority certifying that [he] the person has been duly registered as an architect or authorized to practice architecture, in Missouri, and unless such certificate has been renewed as hereinafter specified; provided, however, that nothing in this chapter shall apply to the following persons:

(1) Any person who is an employee of a person holding a currently valid certificate of registration as an architect or who is an employee of any person holding a currently valid certificate of authority [under] pursuant to this chapter, and who performs architectural work under the direction and continuing supervision of and is checked by one holding a currently valid certificate of registration as an architect [under] pursuant to this chapter;

(2) Any person who is a regular full-time employee who performs architectural work for [his] the person's employer if and only if all such work and service so performed is in connection with a facility owned or wholly operated by the employer and which is occupied by the employer of the employee performing such work or service, and if and only if such work and service so performed do not endanger the public health or safety;

(3) Any holder of a currently valid certificate as a registered professional engineer who performs only such architectural work as is incidental and necessary to the completion of engineering work lawfully being performed by such registered professional engineer;

(4) Any person who is a landscape architect, city planner or regional planner who performs work consisting only of consultations concerning and preparation of master plans for parks, land areas or communities, or the preparation of plans for and the supervision of the planting and grading or the construction of walks and paving for parks or land areas and such other minor structural features as fences, steps, walls, small decorative pools and other construction not involving structural design or stability and which is usually and customarily included within the area of work of a landscape architect or planner;

(5) Any person who renders architectural services in connection with the construction, remodeling or repairing of any privately owned building described in paragraphs (a), (b), (c), (d), and (e) which follow, and who indicates on any drawings, specifications, estimates, reports or other documents furnished in connection with such services that [he] the person is not a registered architect:

(a) A dwelling house; or

(b) A multiple family dwelling house, flat or apartment containing not more than two families; or

(c) A commercial or industrial building or structure which provides for the employment, assembly, housing, sleeping or eating of not more than nine persons; or

(d) Any one structure containing less than twenty thousand cubic feet, except as provided in (b) and (c) above, and which is not a part or a portion of a project which contains more than one structure; or

(e) A building or structure used exclusively for farm purposes[.];

(6) Any person who renders architectural services in connection with the remodeling or repairing of any privately owned building described in paragraphs (a), (c), (d) and (e) of subdivision (5) of this section or for a multiple family dwelling house, flat or apartment containing not more than four families, and who indicates on any drawings, specifications, estimates, reports or other documents furnished in connection with such services that the person is not a registered architect.".

HOUSE AMENDMENT NO. 2

Amend Senate Bill No. 171, Page 4, Section 429.015, Line 86, by inserting after said line:

"8) The agreement is in writing".

In which the concurrence of the Senate is respectfully requested.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House refuses to recede from its position on HS for SCS for SBs 49, 213, 130, 32, 235 and 221, as amended, and grants the Senate a conference thereon.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the Speaker has appointed the following conferees to act with a like committee from the Senate on HS for SCS for SBs 49, 213, 130, 32, 235 and 221, as amended: Representatives: Crump, Leake, Koller, Marble and Lograsso.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House refuses to recede from its position on SB 358, as amended, and grants the Senate a conference thereon.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the Speaker has appointed the following conferees to act with a like committee from the Senate on SB 358, as amended: Representatives: Gratz, Luetkenhaus, Dougherty, Griesheimer and Hartzler (124).

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House refuses to recede from its position on HCS for SS for SCS for SB 165, as amended, and grants the Senate a conference thereon.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the Speaker has appointed the following conferees to act with a like committee from the Senate on HCS for SS for SCS for SB 165, as amended: Representatives: Rizzo, Scheve, Tate, Cooper and Pouche.

Also,

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has taken up and passed SS for SB 275.

Bill ordered enrolled.

CONFERENCE COMMITTEE APPOINTMENTS

President Pro Tem McKenna appointed the following conference committee to act with a like committee from the House on SB 358, as amended: Senators Curls, Howard, Jacob, Rohrbach and Sims.

President Pro Tem McKenna appointed the following conference committee to act with a like committee from the House on HS for SCS for SBs 49, 213, 130, 32, 235 and 221, as amended: Senators Staples, Kinder, McKenna, DePasco and Yeckel.

PRIVILEGED MOTIONS

Senator Quick moved that the Senate refuse to recede from its position on SS for HS for HB 811, as amended, and grant the House a conference thereon, which motion prevailed.

CONFERENCE COMMITTEE APPOINTMENTS

President Pro Tem McKenna appointed the following conference committee to act with a like committee from the House on SS for HS for HB 811, as amended: Senators Quick, Caskey, Staples, Sims and Yeckel.

Senator Quick announced that photographers from the Senate and the Associated Press had been given permission to take pictures in the Senate Chamber today.

PRIVILEGED MOTIONS

Senator Goode moved that the Senate refuse to recede from its position on SA 1 to SCA 1; SCA 1, as amended; SSA 1 for SCA 2; SSA 1 for SCA 3; SCA 4; SA 1; SA 2; SA 3; SA 4; SA 1 to SA 5; SA 5 a.a.; SA 6; SA 7; SA 1 to SA 8; SA 8 a.a. to HCS for HB 288 and grant the House a conference thereon, which motion prevailed.

Senator Klarich moved that the Senate recede from its position on SA 1 to HS for HCS for HB 472, as amended, which motion prevailed.

On motion of Senator Klarich, HS for HCS for HB 472, as amended, was read the 3rd time and passed by the following vote:
Yeas--Senators
Banks Bentley Caskey Childers
Curls DePasco Ehlmann Goode
Graves House Howard Jacob
Johnson Kenney Kinder Klarich
Lybyer Mathewson Maxwell McKenna
Mueller Quick Rohrbach Russell
Schneider Scott Sims Singleton
Staples Westfall Wiggins Yeckel--32

Nays--Senators--None

Absent--Senators--Clay--1

Absent with leave--Senators--Flotron--1

The President Pro Tem declared the bill passed.

On motion of Senator Klarich, title to the bill was agreed to.

Senator Klarich moved that the vote by which the bill passed be reconsidered.

Senator Quick moved that motion lay on the table, which motion prevailed.

HOUSE BILLS ON THIRD READING

Senator Banks moved that HB 32, with SCS and SA 4 (pending), be called from the Informal Calendar and again taken up for 3rd reading and final passage, which motion prevailed.

SA 4 was again taken up.

At the request of Senator Maxwell, the above amendment was withdrawn.

Senator Banks offered SS for SCS for HB 32, entitled:

SENATE SUBSTITUTE FOR

SENATE COMMITTEE SUBSTITUTE FOR

HOUSE BILL NO. 32

An Act relating to certain health care providers.

Senator Banks moved that SS for SCS for HB 32 be adopted.

Senator Wiggins offered SA 1:

SENATE AMENDMENT NO. 1

Amend Senate Committee Substitute for House Bill No. 32, Page 4, Section 6, Line 4, by inserting after all of said line the following:

"Section 7. No physician shall perform an abortion unless the physician first obtains a medical malpractice insurance policy covering personal injury or death to the physician's abortion patients arising out of the rendering of or the failure to render health care services by the physician while performing abortions. The insurance policy shall be sufficient to satisfy a damage award of five hundred thousand dollars.".

Senator Wiggins moved that the above amendment be adopted.

Senator Banks raised the point of order that SA 1 is out of order in that it goes beyond the subject matter of the bill.

The point of order was referred to the President Pro Tem.

Senator Jacob raised the point of order that SA 1 is out of order in that it is incorrectly drafted.

The point of order was referred to the President Pro Tem.

President Wilson assumed the Chair.

President McKenna resumed the Chair.

The President Pro Tem ruled the point of order raised by Senator Banks well taken and the point of order raised by Senator Jacob well taken.

Senator Mueller offered SA 2:

SENATE AMENDMENT NO. 2

Amend Senate Substitute for Senate Committee Substitute for House Bill No. 32, Page 3, Section 2, Line 22, by deleting all of said line; and

Further amend said bill, page 4, Section 2, lines 1-13, by deleting all of said lines and place in lieu thereof:

"(9) Meet the following quality standards in accordance with guidelines established by the Missouri Board of Healing Arts.".

Senator Mueller moved that the above amendment be adopted, which motion prevailed.

Senator Kenney offered SA 3:

SENATE AMENDMENT NO. 3

Amend Senate Substitute for Senate Committee Substitute for House Bill No. 32, Page 1, In the Title, Line 2, by striking all of said line and inserting in lieu thereof the following:

"To repeal section 191.227, RSMo 1994, relating to certain health care providers, and to enact in lieu thereof seven new sections relating to the same subject."; and

Further amend said bill, Page 1, Section 1, Line 1, by inserting immediately before all of said line the following:

"Section A. Section 191.227, RSMo 1994, is repealed and seven new sections enacted in lieu thereof, to be known as sections 191.227, 1, 2, 3, 4, 5 and 6, to read as follows:

191.227. 1. All physicians, chiropractors, hospitals, dentists, and other duly licensed practitioners in this state, herein called "providers", shall, upon written request of a patient, or guardian or legally authorized representative of a patient, furnish a copy of his record of that patient's health history and treatment rendered to the person submitting a written request, except that such right shall be limited to access consistent with the patient's condition and sound therapeutic treatment as determined by the provider. [Beginning August 28, 1994,] Such record shall be furnished within a reasonable time of the receipt of the request therefor and upon payment of a handling fee of [fifteen] twenty-five dollars plus a fee of thirty-five cents per page for copies of documents made on a standard photocopy machine.

2. Notwithstanding provisions of this section to the contrary, providers may charge for the reasonable cost of all duplications of medical record material or information which cannot routinely be copied or duplicated on a standard commercial photocopy machine.

3. The transfer of the patient's record done in good faith shall not render the provider liable to the patient or any other person for any consequences which resulted or may result from disclosure of the patient's record as required by this section.".

Senator Kenney moved that the above amendment be adopted, which motion prevailed.

Senator Jacob offered SA 4:

SENATE AMENDMENT NO. 4

Amend Senate Substitute for Senate Committee Substitute for House Bill No. 32, at the end, by inserting after all of said line the following:

"334.253. 1. A physician may not make a referral to an entity for the furnishing of any physical therapy services with whom the physician, physician's employer, or immediate family member of such referring physician has a financial relationship. A financial relationship exists if the referring physician, the referring physician's employer, or immediate family member:

(1) Has a direct or indirect ownership or investment interest in the entity whether through equity, debt, or other means; or

(2) Receives remuneration from a compensation arrangement from the entity for the referral.

2. The following financial arrangements shall be exempt from disciplinary action under this section:

(1) When the entity with whom the referring physician has an ownership or investment interest is the sole provider of the physical therapy service within a rural area;

(2) When the referring physician owns registered securities issued by a publicly held corporation or publicly traded limited partnership, the shares of which are traded on a national exchange or the over-the-counter market, provided that such referring physician's interest in the publicly held corporation or publicly traded limited partnership is less than five percent and the referring physician does not receive any compensation from such publicly held corporation or publicly traded limited partnership other than as any other owner of the shares of such publicly held corporation or publicly traded limited partnership;

(3) When the referring physician has an interest in real property resulting in a landlord-tenant relationship between the physician and the entity in which the equity interest is held, unless the rent is determined, in whole or in part, by the business volume or profitability of the tenant or is otherwise unrelated to fair market value;

(4) When the indirect ownership in the entity is by means of a bona fide debt incurred in the purchase or acquisition of the entity for a price which does not in any manner reflect the potential source of referrals from the physician with the indirect interest in the entity and the terms of the debt are fair market value, and neither the amount or the terms of the debt in any manner, directly or indirectly, constitutes a form of compensating such physician for the source of his business;

(5) When such physician's employer is a health maintenance organization as defined in subdivision (6) of section 376.960, RSMo, and such health maintenance organization owns or controls other organizations which furnish physical therapy services so long as the referral is to such owned or controlled organization and the physician does not also have a direct or indirect ownership or investment interest in such organization, physical therapy services or the health maintenance organization and the referring physician does not receive any remuneration as the result of the referral;

(6) When such physician's employer is a hospital defined in section 197.020, RSMo, and such hospital owns or controls other organizations which furnish physical therapy services so long as the referral is to such owned or controlled organization and the physician does not also have a direct or indirect ownership or investment interest in such organization, physical therapy service, or the hospital and the referring physician does not receive any remuneration as the result of the referral.

3. [The provisions of sections 334.252 and 334.253 shall become effective January 1, 1995] The provisions of this section shall not apply to physiatrists."; and

Further amend the title and enacting clause accordingly.

Senator Jacob moved that the above amendment be adopted.

Seantor Caskey raised the point of order that SA 4 is out of order in that the amendment goes beyond the scope and purpose of the original bill.

President Pro Tem McKenna ruled the point of order well taken.

Senator Maxwell offered SA 5:

SENATE AMENDMENT NO. 5

Amend Senate Substitute for Senate Committee Substitute for House Bill No. 32, Page 7, Section 6, Line 6, by inserting immediately after said line the following:

"Section B. Sections 376.1399 and 536.028 from senate substitute for senate committee substitute for house substitute for house committee substitute for house bill no. 335 as truly agreed to and finally passed by the first regular session of the eighty-ninth general assembly and section 14 from senate amendment no. 26 to senate substitute for senate committee substitute for house substitute for house committee substitute for house bill no. 335 as truly agreed to and finally passed by the first regular session of the eighty-ninth general assembly are repealed and two new sections enacted in lieu thereof, to be known as sections 376.1399 and 14, to read as follows:

376.1399. The director may, after notice and hearing, promulgate reasonable rules to carry out the provisions of sections 376.1350 to 376.1390. Any rule or portion of a rule promulgated shall become effective only as provided in chapter 536, RSMo.

[376.1399. 1. The director may, after notice and hearing, promulgated reasonable rules to carry out the provisions of sections 376.1350 to 376.1390. The director shall have the authority to promulgate rules to accomplish the following purposes:

(1) To regulate the internal affairs of the department of insurance;

(2) To prescribe forms and procedures to be followed in proceedings before the department of insurance; and

(3) To effectuate or aid in the interpretation of any law of this state pertaining to the subject matters of sections 376.1350 to 376.1390.

2. Any rule that has the effect of creating or substantially modifying a legal right, liability, obligation or sanction shall be considered substantive. The director may only promulgate substantive rules on subject matters specifically authorized pursuant to sections 376.1350 to 376.1390 and any substantive rule or portion of a rule shall become effective only as provided pursuant to chapter 536, RSMo, including, but not limited to, section 536.028, after the effective date of this act. All such substantive rules and all substantive rulemaking authority granted pursuant to sections 376.1350 to 376.1390 shall expire on August 31, 1998. Any act by the general assembly that serves to extend or postpone the expiration of any rule or rulemaking authority shall not constitute legislative approval of the rule or authority nor be admissible in any court as evidence of legislative intent. The provisions of this section are nonseverable and if any of the powers vested with the general assembly pursuant to section 536.028 to review, to delay the effective date or to disapprove and annul a rule, or portion of a rule, are held unconstitutional or invalid, the purported grant of rulemaking authority and any rule so proposed and contained in the order of rulemaking shall be invalid and void.]

[536.028. 1. The delegation of authority to any state agency to propose to the general assembly rules as provided under this section is contingent upon the agency complying with the provisions of this section and this delegation of legislative power to the agency to propose an order of rulemaking containing a rule or portion thereof that has the effect of substantive law, other than a rule relating to the agency's organization and internal management, is contingent and dependent upon the power of the general assembly to review such proposed order of rulemaking, to delay the effective date of such proposed order of rulemaking until the expiration of at least thirty legislative days of a regular session after such order is filed with the general assembly and the secretary of state, and to disapprove and annul any rule or portion thereof contained in such order of rulemaking.

2. No rule or portion of a rule that has the effect of substantive law shall become effective until the order of rulemaking, in which such rule or portion thereof is contained, has been reviewed by the general assembly in accordance with the procedures provided herein and the agency's authority to propose an order of rulemaking is dependent upon the power of the general assembly to disapprove and annul any such proposed rule or portion thereof as provided herein.

3. In order for the general assembly to have an effective opportunity to be advised of rules proposed by any state agency under the authority of this section, an agency may propose a rule by complying with the procedures provided in section 536.021, except that the notice of proposed rulemaking shall first be filed with the general assembly by providing a copy thereof to the joint committee on administrative rules which may hold hearings upon any proposed rule or portion thereof at any time. The agency shall cooperate with the joint committee on administrative rules by providing any witnesses, documents or information within the control of the agency as may be requested.

4. In order to propose an order of rulemaking to the general assembly, the agency shall comply with the provisions of section 536.021, except that the agency may file a proposed order of rulemaking with the secretary of state only by first filing such proposed order with the general assembly by providing a copy thereof to the secretary of the senate and the clerk of the house of representatives. The president pro tem of the senate shall direct that a copy of the proposed order of rulemaking be delivered to the joint committee on administrative rules which may hold hearings thereon. The agency shall cooperate with the committee by providing any witnesses, documents or information within the control of the agency as may be requested.

5. Such proposed order of rulemaking shall not become effective prior to the expiration of thirty legislative days of a regular session after such order is filed with the secretary of state and the general assembly.

6. The committee may, by majority vote of its members, recommend that the general assembly disapprove and annul any rule or portion thereof contained in an order of rulemaking after hearings thereon and, upon a finding that such rule or portion thereof should be disapproved and annulled upon the following grounds:

(1) Such rule is substantive in nature in that it creates rights or liabilities or provides for sanctions as to any person, corporation or other legal entity; and

(2) Such rule or portion thereof is not in the public interest or is not authorized by the general assembly for one or more of the following grounds:

(a) An absence of statutory authority for the proposed rule;

(b) The proposed rule is in conflict with state law;

(d) The rule exceeds the purpose, or is more restrictive than is necessary to carry out the purpose, of the statute granting rulemaking authority;

(e) A substantial change in circumstance has occurred since enactment of the law upon which the proposed rule is based as to result in a conflict between the purpose of the law and the proposed rule, or as to create a substantial danger to public health and welfare;

(f) The proposed rule is so arbitrary and capricious as to create such substantial inequity as to be unreasonably burdensome on persons affected.

7. Any recommendation or report issued by the committee pursuant to subsection 6 of this section shall be admissible as evidence in any judicial proceeding and entitled to judicial notice without further proof.

8. The general assembly may adopt a concurrent resolution in accordance with the provisions of article IV, section 8 of the Missouri constitution to disapprove and annul any rule or portion thereof upon one or more of the grounds stated in subsection 6 of this section.

9. Any rule or portion thereof not disapproved within thirty legislative days of a regular session pursuant to subsection 8 of this section shall be deemed approved by the general assembly and the secretary of state may publish such order of rulemaking as soon as practicable upon the expiration of thirty legislative days of a regular session after the order of rulemaking was filed with the secretary of state and the general assembly.

10. Upon adoption of such concurrent resolution as provided in subsection 8 of this section, the secretary of state shall not publish the order of rulemaking until the expiration of time necessary for such resolution to be signed by the governor, or vetoed and subsequently acted upon by the general assembly pursuant to article III, section 32 of the Missouri Constitution. If such concurrent resolution is adopted and signed by the governor or reconsidered pursuant to article III, section 32, the secretary of state shall publish in the Missouri Register, as soon as practicable, the order of rulemaking along with notice of the proposed rules or portions thereof which are disapproved and annulled by the general assembly.

11. Notwithstanding the provisions of section 1.140, RSMo, the provisions of this section are nonseverable and the delegation of legislative authority to an agency to propose orders of rulemaking is essentially dependent upon the powers vested with the general assembly as provided herein. If any of the powers vested with the general assembly to review, to delay the effective date or to disapprove and annul a rule or portion of a rule contained in an order of rulemaking, are held unconstitutional or invalid, the purported grant of rulemaking authority and any rule so proposed and contained in the order of rulemaking pursuant thereto shall be invalid and void.

12. Nothing in this section shall prevent the general assembly from adopting by bill within thirty legislative days of a regular session the rules or portions thereof, or as the same may be amended, as contained in a proposed order of rulemaking. In that event, the proposed order of rulemaking shall have been superseded and any rule proposed therein shall be void and only such rules adopted by the general assembly and submitted to the governor may become effective. Rules so adopted shall be published by the secretary of state as soon as practicable. In that event, the secretary of state shall not publish the proposed order of rulemaking and such proposed order of rulemaking shall be invalid and void.

13. Upon adoption of any rule now in effect or hereafter promulgated, any such rule or portion thereof may be revoked by the general assembly either by bill, or by concurrent resolution pursuant to article IV, section 8 of the constitution on recommendation of the committee on administrative rules upon the grounds listed in subsection 6 of this section. The secretary of state shall publish in the Missouri Register, as soon as practicable, notice of the revocation.]

Section 14. The director may, after notice and hearing, promulgate reasonable rules to carry out the provisions of sections 1 to 11. Any rule or portion of a rule promulgated shall become effective only as provided in chapter 536, RSMo.

[Section 14. 1. The director may, after notice and hearing, promulgate reasonable rules to carry out the provisions of sections 1 to 11. The director shall have the authority to promulgate rules to accomplish the following purposes:

(1) To regulate the internal affairs of the department of insurance;

(2) To prescribe forms and procedures to be followed in proceedings before the department of insurance; and

(3) To effectuate or aid in the interpretation of any law of this state pertaining to the subject matters of sections 1 to 11.

2. Any rule that has the effect of creating or substantially modifying a legal right, liability, obligation or sanction shall be considered substantive. The director may only promulgate substantive rules on subject matters specifically authorized pursuant to sections 1 to 11 and any substantive rule or portion of a rule shall become effective only as provided pursuant to chapter 536, RSMo, including, but not limited to, section 536.028, after the effective date of this act. All such substantive rules and all substantive rulemaking authority granted pursuant to sections 1 to 11 shall expire on August 31, 1998. Any act by the general assembly that serves to extend or postpone the expiration of any rule or rulemaking authority shall not constitute legislative approval of the rule or authority nor be admissible in any court as evidence of legislative intent. The provisions of this section are nonseverable and if any of the powers vested with the general assembly pursuant to section 536.028 to review, to delay the effective date or to disapprove and annul a rule, or portion of a rule, are held unconstitutional or invalid, the purported grant of rulemaking authority and any rule so proposed and contained in the order of rulemaking shall be invalid and void.]"; and

Further amend the title and enacting clause accordingly.

Senator Maxwell moved that the above amendment be adopted.

Senator Rohrbach raised the point of order that SA 5 is out of order in that it goes beyond the scope of the bill.

The point of order was referred to the President Pro Tem, who ruled it not well taken.

At the request of Senator Maxwell, SA 5 was withdrawn.

Senator Jacob offered SA 6:

SENATE AMENDMENT NO. 6

Amend Senate Substitute for Senate Committee Substitute for House Bill No. 32, at the end, by inserting after all of said line the following:

(1) Has a direct or indirect ownership or investment interest in the entity whether through equity, debt, or other means; or

(2) Receives remuneration from a compensation arrangement from the entity for the referral.

2. The following financial arrangements shall be exempt from disciplinary action under this section:

(1) When the entity with whom the referring physician has an ownership or investment interest is the sole provider of the physical therapy service within a rural area;

3. [The provisions of sections 334.252 and 334.253 shall become effective January 1, 1995] The provisions of this section shall not apply to physiatrists or to any essential community provider."; and

Further amend the title and enacting clause accordingly.

Senator Jacob moved that the above amendment be adopted, which motion prevailed.

Senator Westfall offered SA 7:

SENATE AMENDMENT NO. 7

Amend Senate Substitute for Senate Committee Substitute for House Bill No. 32, Page 5, Section 4, Line 19, by inserting following said line:

"No healthcare insurer shall be required to offer a provider contract to an essential community provider.".

Senator Westfall moved that the above amendment be adopted, which motion prevailed.

President Wilson resumed the Chair.

Senator Banks moved that SS for SCS for HB 32, as amended, be adopted, which motion prevailed.

On motion of Senator Banks, SS for SCS for HB 32, as amended, was read the 3rd time and passed by the following vote:
Yeas--Senators
Banks Caskey Childers Clay
Curls DePasco Ehlmann Goode
Graves House Howard Jacob
Johnson Kenney Klarich Lybyer
Mathewson Maxwell Quick Rohrbach
Russell Schneider Scott Sims
Singleton Staples Westfall Wiggins
Yeckel--29

Nays--Senators
Kinder Mueller--2

Absent--Senators
Bentley McKenna--2

Absent with leave--Senators--Flotron--1

The President declared the bill passed.

On motion of Senator Banks, title to the bill was agreed to.

Senator Banks moved that the vote by which the bill passed be reconsidered.

Senator Quick moved that motion lay on the table, which motion prevailed.

PRIVILEGED MOTIONS

Having voted on the prevailing side, Senator Maxwell moved that the vote to lay on the table the motion to reconsider the vote by which HJR 11 passed be reconsidered, which motion prevailed by the following vote:
Yeas--Senators
Banks Bentley Caskey Childers
Curls DePasco Ehlmann Goode
Graves Howard Jacob Johnson
Kenney Kinder Klarich Lybyer
Mathewson Maxwell Mueller Quick
Rohrbach Russell Schneider Scott
Sims Singleton Staples Westfall
Wiggins Yeckel--30

Nays--Senators
Clay House--2

Absent--Senators--McKenna--1

Absent with leave--Senators--Flotron--1

Having voted on the prevailing side, Senator Maxwell moved that the vote by which the title to HJR 11 was agreed to be reconsidered, which motion prevailed by the following vote:
Yeas--Senators
Banks Caskey Childers Curls
DePasco Ehlmann Goode Graves
Howard Jacob Johnson Kenney
Kinder Klarich Lybyer Maxwell
McKenna Mueller Quick Rohrbach
Russell Schneider Scott Sims
Singleton Westfall Wiggins Yeckel--28

Nays--Senators
Clay House--2

Absent--Senators
Bentley Mathewson Staples--3

Absent with leave--Senators--Flotron--1

Having voted on the prevailing side, Senator Maxwell moved that the vote by which HJR 11 was read the third time and finally passed be reconsidered, which motion prevailed by the following vote:
Yeas--Senators
Banks Bentley Caskey Childers
Clay DePasco Ehlmann Goode
Graves Howard Jacob Johnson
Kenney Kinder Lybyer Mathewson
Maxwell McKenna Mueller Quick
Rohrbach Russell Schneider Scott
Sims Singleton Staples Westfall
Wiggins Yeckel--30

Nays--Senators--House--1

Absent--Senators
Curls Klarich--2

Absent with leave--Senators--Flotron--1

Having voted on the prevailing side, Senator Maxwell moved that the vote by which SA 1 was adopted be reconsidered, which motion prevailed by the following vote:
Yeas--Senators
Banks Bentley Caskey Childers
Clay Curls DePasco Ehlmann
Goode Graves Howard Jacob
Johnson Kenney Klarich Lybyer
Mathewson Maxwell Mueller Quick
Rohrbach Russell Schneider Sims
Singleton Staples Westfall Wiggins
Yeckel--29

Nays--Senators--House--1

Absent--Senators
Kinder McKenna Scott--3

Absent with leave--Senators--Flotron--1

SA 1 was again taken up.

Senator Maxwell offered SSA 1 for SA 1:

SENATE SUBSTITUTE AMENDMENT NO. 1 FOR SENATE AMENDMENT NO. 1

Amend House Joint Resolution No. 11, Page 1, In the Title, Line 3, by striking the following: "joint municipal utility commission revenue bonds" and inserting in lieu thereof the following: "the provisions of certain public services"; and

Further amend said bill and page, the preamble, line 4, by striking the following: "the following amendment" and inserting in lieu thereof the following: "by two separate questions, the following amendments"; and

Further amend said bill, page 2, section 27, line 22, by inserting immediately after all of said line the following:

"Section B. Article VI, Constitution of Missouri, is amended by adding thereto one new section, to be known as section 30(c), to read as follows:

Section 30(c). Any entity created pursuant to Article VI, Section 30(a) of this Constitution which adopts or has adopted a charter for its own government, shall have all powers which the general assembly of the state of Missouri has authority to confer upon such entity, provided such powers are consistent with the constitution of this state and are not limited or denied either by the charter so adopted or by statute."; and

Further amend the title and enacting clause accordingly.

Senator Maxwell moved that the above substitute amendment be adopted, which motion prevailed.

On motion of Senator Maxwell, HJR 11, as amended, was read the 3rd time and passed by the following vote:
Yeas--Senators
Banks Bentley Caskey Childers
Clay DePasco Ehlmann Flotron
Goode Graves House Howard
Jacob Johnson Kenney Kinder
Klarich Lybyer Mathewson Maxwell
McKenna Mueller Quick Rohrbach
Russell Schneider Scott Sims
Singleton Westfall Wiggins Yeckel--32

Nays--Senators--None

Absent--Senators
Curls Staples--2

Absent with leave--Senators--None

The President declared the bill passed.

On motion of Senator Maxwell, title to the bill was agreed to.

Senator Maxwell moved that the vote by which the bill passed be reconsidered.

Senator Quick moved that motion lay on the table, which motion prevailed.

REPORTS OF STANDING COMMITTEES

Senator Scott, Chairman of the Committee on State Budget Control, submitted the following report:

Mr. President: Your Committee on State Budget Control, to which was referred HCS for HB 411, begs leave to report that it has considered the same and recommends that the bill do pass.

HOUSE BILLS ON THIRD READING

HCS for HB 411, entitled:

An Act to repeal sections 193.085, 193.087, 193.145, 193.215, 210.822, 210.832, 210.834, 210.839, 210.841, 210.842, 285.300, 285.302, 285.304, 288.250, 451.040, 452.305, 452.315, 452.345, 452.350, 452.370, 454.410, 454.415, 454.425, 454.440, 454.500, 454.455, 454.460, 454.465, 454.470, 454.475, 454.476, 454.485, 454.490, 454.495, 454.496, 454.505, 454.512, 454.513, 454.514, 454.515, 454.516, 454.517, 454.518, 454.519, 454.603, 454.808, 486.225 and 620.145, RSMo 1994, and sections 210.842, 452.345, 454.400, 454.850, 454.855, 454.860, 454.862, 454.867, 454.869, 454.871, 454.877, 454.880, 454.882, 454.885, 454.887, 454.890, 454.895, 454.897, 454.900, 454.902, 454.905, 454.907, 454.910, 454.912, 454.915, 454.917, 454.927, 454.930, 454.932, 454.935, 454.937, 454.940, 454.942, 454.945, 454.947, 454.950, 454.952, 454.955, 454.957, 454.960, 454.962, 454.965, 454.967, 454.970, 454.972, 454.975, 454.977, 454.979, and 454.980, RSMo Supp. 1996, and to enact in lieu thereof one hundred twenty-nine new sections for the purpose of complying with federal mandates for child support enforcement, with penalty provisions, an effective date for certain sections and an emergency clause.

Was taken up by Senator Caskey.

Senator Caskey offered SS for HCS for HB 411, entitled:

SENATE SUBSTITUTE FOR

HOUSE COMMITTEE SUBSTITUTE FOR

HOUSE BILL NO. 411

An Act to repeal sections 193.085, 193.087, 193.145, 193.215, 210.822, 210.832, 210.834, 210.839, 210.841, 210.842, 285.300, 285.302, 285.304, 288.250, 301.020, 301.190, 379.116, 451.040, 452.305, 452.315, 452.345, 452.350, 452.370, 454.410, 454.415, 454.425, 454.440, 454.500, 454.455, 454.460, 454.465, 454.470, 454.475, 454.476, 454.485, 454.490, 454.495, 454.496, 454.505, 454.512, 454.513, 454.514, 454.515, 454.516, 454.517, 454.518, 454.519, 454.603, 454.808, 486.225 and 620.145, RSMo 1994, and sections 210.842, 452.340, 452.345, 454.400, 454.850, 454.855, 454.860, 454.862, 454.867, 454.869, 454.871, 454.877, 454.880, 454.882, 454.885, 454.887, 454.890, 454.895, 454.897, 454.900, 454.902, 454.905, 454.907, 454.910, 454.912, 454.915, 454.917, 454.927, 454.930, 454.932, 454.935, 454.937, 454.940, 454.942, 454.945, 454.947, 454.950, 454.952, 454.955, 454.957, 454.960, 454.962, 454.965, 454.967, 454.970, 454.972, 454.975, 454.977, 454.979, and 454.980, RSMo Supp. 1996, and to enact in lieu thereof one hundred thirty-eight new sections for the purpose of complying with federal mandates for child support enforcement, with penalty provisions, an effective date for certain sections and an emergency clause.

Senator Caskey moved that SS for HCS for HB 411 be adopted.

Senator Maxwell offered SA 1:

SENATE AMENDMENT NO. 1

Amend Senate Substitute for House Committee Substitute for House Bill No. 411, Page 3, Section A, Line 4 of said page, by inserting immediately after all of said line the following:

"30.255. Beginning July 1, 1998, the state treasurer shall, when making a new deposit of state funds, continuing an existing demand deposit of state funds, or renewing an existing time deposit of state funds beyond the expiration date of the deposit in any financial institution, review and consider the depository institutions' lending record, giving consideration to, among other factors, whether:

(1) The institution has been given by the appropriate federal regulatory agency a written evaluation of the institution's record of meeting the credit needs of its entire community, including low and moderate income neighborhoods, pursuant to the federal Community Reinvestment Act of 1977, as amended, 12 U.S.C. 2905; and

(2) The most recent evaluation of the institution includes a rating of "needs to improve record of meeting community credit needs" or "substantial noncompliance of meeting community credit needs", or categories substantially comparable if said federal law is amended.

135.240. The provisions of subdivision (3) of section 135.225 and section 135.230 shall apply to employees determined to:

(1) Be difficult to employ. For the purpose of this section, "a person difficult to employ" shall mean a person who was unemployed for at least three months immediately prior to being employed at the new business facility in the enterprise zone; or

(2) Be eligible for public assistance in accordance with eligibility standards for aid to families with dependent children in effect on July 16, 1996 or be eligible for funds from the temporary assistance for needy families block grant program or general relief programs.

167.260. 1. Any local school district offering to all pupils who are eligible by age pursuant to section 163.017, RSMo a full day of kindergarten within the school calendar as prepared pursuant to section 171.031, RSMo, shall be eligible for state aid for a program for developmentally delayed and free reduced price lunch eligible children ages three and four as defined in section 178.691, RSMo, and for children from at-risk families as defined in section 167.273. State aid shall be provided for no more than a half-day program within the district's school calendar. At a minimum such eligible child shall reach the age of three before the first day of [October] August prior to the start of the school year. Such program shall emphasize social skills, physical development and preparation for kindergarten.

2. Any school district offering instruction to children ages three and four shall receive subject to appropriations additional state aid based on the count of children ages three and four enrolled in the district's program and eligible for free and reduced price lunch divided by two multiplied by the guaranteed tax base as defined in subsection (7) of section 163.011, RSMo, multiplied by the operation levy for school purposes as defined in subsection (9) of section 163.011, RSMo.

[2.] 3. The state board of education shall approve such programs and distribute state aid."; and

Further amend said bill, Page 12, Section 193.215, Line 25 of said page, by inserting immediately after all of said line the following:

"205.770. 1. In any county of the second class in this state there may be created and established by order of the county commission of any such county a board which shall be styled "The Social Welfare Board of the County of .........".

2. [All powers and duties connected with and incident to the betterment of social and physical causes of dependency, the relief and care of the indigent, and the care of sick dependents, with the exception of the mentally ill and those suffering with contagious, infectious and transmissible diseases shall be exclusively invested in and exercised by the board.

3.] The board shall have power to receive and expend donations for social welfare and medical purposes and shall have [exclusive] control over the distribution and expenditure of any public funds set aside and appropriated by such counties and by any city located in any such county for the relief of the temporarily dependent. The board shall have power to promote the general welfare of the poor within the limits of such counties by [social and sanitary reforms, by industrial instruction, by the inculcation of habits of providence and self-dependence, and by the establishment and maintenance of any activities to these ends] providing medical care and emergency assistance. The board shall have power to sue and be sued, complain and defend in all courts, to assume the care of or take, by gift, grant, devise, bequest or otherwise, any money, real estate, personal property, right of property, or other valuable things, and may use, enjoy, control, sell or convey the same for charitable purposes, to have and to use a common seal and alter the same at pleasure.

[4.] 3. The board may make bylaws for its own guidance, rules and regulations for the government of its agents, servants and employees, and for the distribution of the funds under its control.

[5.] 4. If any second class county which has established a social welfare board pursuant to the provisions of this section, subsequently becomes a first class or a third class county, such county may retain its social welfare board and continue to function pursuant to the provisions of sections 205.770 to 205.840.

205.780. [Said] This board shall have the [exclusive] power to make [all suitable provisions for the relief, maintenance and support of all indigent persons within said county and within any city in said county who may appropriate for the support of said board, and to make suitable provisions for the care and maintenance to the sick dependents and those who are unable to support themselves; to enforce the laws of the state, the ordinances of such cities located within said county, in regard to the indigent, and to make] such rules and regulations in the conduct of its business not inconsistent with the laws of the state of Missouri and the ordinances of such cities[; to have exclusive control, care and management of all public hospitals owned or operated by said counties or said cities, except those for the care of the insane and those suffering with contagious, infectious and transmissible diseases; to recommend to the common council of said city the passage of such ordinances as said board may deem necessary for the welfare of the indigent of said city; to]. This board will have the power to appoint competent physicians and surgeons, who shall hold their office at the pleasure of said board, at a salary to be fixed by said board, and said physicians and surgeons shall perform such duties as may be prescribed by said board, and shall render medical attendance to all those who may come within the provisions of this law; [said] this board shall have the power and it shall be the duty of [said] this board to employ and discharge all persons or officers in their judgment necessary to carry out the matters over which [said] this board is given jurisdiction or control.

205.790. 1. [Said] This board shall be nonpartisan and nonsectarian in character, and the members and officers thereof shall receive no compensation as such.

2. [Said] This board shall consist of the mayor of such cities and the presiding commissioner of the county commission of such counties, who shall be ex officio members thereof, and six other members, three of whom shall be appointed by the county commission of such counties, who shall hold office, one for one year, one for two years and one for three years, whose terms of office shall be designated by such county commission, three by the mayor and common council of such cities, who shall hold office, one for one year, one for two years and one for three years, whose terms of office shall be designated by the mayor.

3. Whenever the term of office of any member so appointed expires, the appointment of his successor shall be for three years. All such appointments shall date from the first of June following their appointment.

4. Vacancies from any causes shall be filled in like manner as original appointment. The mayor may, for misconduct or neglect of duty, remove any member appointed by him in the manner required for removal of officers of such cities. The county commission may, by a majority vote, for misconduct or neglect of duty, remove any member appointed by them.

205.820. It shall be the duty of said board to keep a record of its proceedings and of its receipts, expenditures and operations, and shall annually render a full and complete itemized report, stating the condition of their trust, together with such other suggestions as they may deem of general interest to the mayor and [common] city council of said cities and the county commission of said counties; provided, said board shall render reports concerning receipts, expenditures, operations, etc., whenever called for by the [common] city council of said cities or the county commission of said counties.

205.830. 1. It shall be the duty of said board, when any person by himself, herself, or another apply for relief to make immediate inquiry [into the state and circumstances of the applicant, and if it shall appear that he or she is in such indigent circumstances as to require temporary relief, the said board shall furnish, out of the funds in their hands, such relief as the circumstances of the case may require; provided, that in all cases where the applicant for aid may be found dependent and said applicant or member of said applicant's family is an able-bodied male person capable of performing manual labor, said board shall require such person to perform work to the value of the aid given, and the city engineer and the street commissioners of such cities in their respective departments are required to utilize the services of such able-bodied persons upon receiving notice from said board that such person has received or is entitled to such aid. Where the applicant or a member of the applicant's family is an able-bodied female, said board shall, whenever practicable, require that labor to the value of the aid given be performed. They shall make investigations of cases of dependence for individuals or other charitable organizations and furnish such reports upon the same as in their judgment seems advisable.

2. Their office shall be a center of intercommunication between the various charitable agencies in the city. They shall foster harmonious cooperation between them and endeavor to eradicate the evils of overlapping relief, and for this purpose shall maintain a confidential registration bureau.

3. When it is impossible to repress mendicancy by the above means they shall prosecute imposters. They shall carefully work out such plans for helping families to self-dependence as may seem most practicable. They shall make concentrated attack on social causes of hardship, such as unsanitary housing, child labor, extortionate charges by pawnshops, salary loan and chattel mortgage agreements] to determine if such person is eligible for such relief.

207.010. The [division of family services is an integral part of the] department of social services [and] shall have and exercise all the powers and duties necessary to carry out fully and effectively the purposes assigned to it by law and shall be the state agency to:

(1) Administer state plans and laws involving [aid to dependent children] the Missouri families work program and any program established subsequent to the passage of The Personal Responsibility and Work Opportunity Reconciliation Act of 1996, as amended;

(2) Aid or relief in case of public calamity;

(3) Aid for direct relief;

(4) Child welfare services;

(5) Social services to families and adults;

(6) Pensions and services for the blind; and

(7) Any other duties relating to public assistance and social services which may be imposed upon the department of social services.

208.010. 1. In determining the eligibility of a claimant for public assistance [under this law] pursuant to this chapter, it shall be the duty of the division of family services to consider and take into account all facts and circumstances surrounding the claimant, including [his] the claimant's living conditions, earning capacity, income and resources, from whatever source received, and if from all the facts and circumstances the claimant is not found to be in need, assistance shall be denied. In determining the need of a claimant, the costs of providing medical treatment which may be furnished under sections 208.151 to 208.158 and 208.162 shall be disregarded. The amount of benefits, when added to all other income, resources, support, and maintenance shall provide such persons with reasonable subsistence compatible with decency and health in accordance with the standards developed by the division of family services; provided, when a husband and wife are living together, the combined income and resources of both shall be considered in determining the eligibility of either or both. "Living together" for the purpose of this chapter is defined as including a husband and wife separated for the purpose of obtaining medical care or nursing home care, except that the income of a husband or wife separated for such purpose shall be considered in determining the eligibility of his or her spouse, only to the extent that such income exceeds the amount necessary to meet the needs (as defined by rule or regulation of the division) of such husband or wife living separately. In determining the need of a claimant in federally aided programs there shall be disregarded such amounts per month of earned income in making such determination as shall be required for federal participation by the provisions of the federal Social Security Act (42 U.S.C.A. 301 et seq.), or any amendments thereto. When federal law or regulations require the exemption of other income or resources, the division of family services may provide by rule or regulation the amount of income or resources to be disregarded. In determining the eligibility of a claimant pursuant to this section, the division of family services shall make all appropriate inquiries with the division of employment security, department of revenue and other such agencies and divisions prior to the issuance of such public assistance benefits. Should benefits be awarded on a temporary or emergency basis, such eligibility for benefits shall be terminated within thirty days unless the determining division has reverified and substantiated a continued need.

2. Benefits shall not be payable to any claimant who:

(1) Has or whose spouse with whom [he] the claimant is living has, prior to July 1, 1989, given away or sold a resource within the time and in the manner specified in this subdivision. In determining the resources of an individual, unless prohibited by federal statutes or regulations, there shall be included (but subject to the exclusions [under] pursuant to subdivisions (4) and (5) of this subsection, and subsection 4 of this section) any resource or interest therein owned by such individual or spouse within the twenty-four months preceding the initial investigation, or at any time during which benefits are being drawn, if such individual or spouse gave away or sold such resource or interest within such period of time at less than fair market value of such resource or interest for the purpose of establishing eligibility for benefits, including but not limited to benefits based on December, 1973, eligibility requirements, as follows:

(a) Any transaction described in this subdivision shall be presumed to have been for the purpose of establishing eligibility for benefits or assistance [under] pursuant to this chapter unless such individual furnishes convincing evidence to establish that the transaction was exclusively for some other purpose;

(b) The resource shall be considered in determining eligibility from the date of the transfer for the number of months the uncompensated value of the disposed of resource is divisible by the average monthly grant paid or average medicaid payment in the state at the time of the investigation to an individual or on his or her behalf [under] pursuant to the program for which benefits are claimed, provided that:

a. When the uncompensated value is twelve thousand dollars or less, the resource shall not be used in determining eligibility for more than twenty-four months; or

b. When the uncompensated value exceeds twelve thousand dollars, the resource shall not be used in determining eligibility for more than sixty months;

(2) The provisions of subdivision (1) of this subsection [2 of this section] shall not apply to a transfer, other than a transfer to claimant's spouse, made prior to March 26, 1981, when the claimant furnishes convincing evidence that the uncompensated value of the disposed of resource or any part thereof is no longer possessed or owned by the person to whom the resource was transferred;

(3) Has received, or whose spouse with whom [he] the claimant is living has received, benefits to which [he] the claimant was not entitled through misrepresentation or nondisclosure of material facts or failure to report any change in status or correct information with respect to property or income as required by section 208.210. A claimant ineligible [under] pursuant to this subsection shall be ineligible for such period of time from the date of discovery as the division of family services may deem proper; or in the case of overpayment of benefits, future benefits may be decreased, suspended or entirely withdrawn for such period of time as the division may deem proper;

(4) Owns or possesses resources in the sum of one thousand dollars or more; provided, however, that if such person is married and living with spouse, he or she or they, individually or jointly, may own resources not to exceed two thousand dollars; and provided further, that in the case of an [aid to families with dependent children claimant] individuals receiving benefits through the work first program, the provision of this subsection shall not apply;

(5) Prior to October 1, 1989, owns or possesses property of any kind or character, excluding amounts placed in an irrevocable prearranged funeral or burial contract pursuant to subsection 2 of section 436.035, RSMo, and subdivision (5) of subsection 1 of section 436.053, RSMo, or has an interest in property, of which [he] the claimant is the record or beneficial owner, the value of such property, as determined by the division of family services, less encumbrances of record, exceeds twenty-nine thousand dollars, or if married and actually living together with husband or wife, if the value of his or her property, or the value of his or her interest in property, together with that of such husband and wife, exceeds such amount;

(6) In the case of [aid to families with dependent children] individuals receiving benefits through the work first program, if the parent, stepparent, and child or children in the home owns or possesses property of any kind or character, or has an interest in property for which he or she is a record or beneficial owner, the value of such property, less encumbrances of record and excluding the home occupied by the claimant, as determined by the division of family services [and as allowed by federal law or regulation, less encumbrances of record, exceeds one thousand dollars, excluding the home occupied by the claimant, amounts placed in an irrevocable prearranged funeral or burial contract pursuant to subsection 2 of section 436.035, RSMo, and subdivision (5) of subsection 1 of section 436.053, RSMo, one automobile which shall not exceed a value set forth by federal law or regulation and for a period not to exceed six months, such other real property which the family is making a good-faith effort to sell, if the family agrees in writing with the division of family services to sell such property and from the net proceeds of the sale repay the amount of assistance received during such period. If the property has not been sold within six months, or if eligibility terminates for any other reason, the entire amount of assistance paid during such period shall be a debt due the state] exceeds the maximum amount established through regulation by the department of social services, division of family services. This maximum shall not be less than one thousand dollars. Each individual participating in the work first program shall be allowed to exclude one automobile from this determination;

(7) Is an inmate of a public institution, except as a patient in a public medical institution.

3. In determining eligibility and the amount of benefits to be granted [under] pursuant to federally aided programs, the income and resources of a relative or other person living in the home shall be taken into account to the extent the income, resources, support and maintenance are allowed by federal law or regulation to be considered.

4. In determining the total property owned [under] pursuant to subdivision (5) of subsection 2 of this section, or resources, of any person claiming or for whom public assistance is claimed, there shall be disregarded any life insurance policy, or prearranged funeral or burial contract, or any two or more policies or contracts, or any combination of policies and contracts, which provides for the payment of one thousand five hundred dollars or less upon the death of any of the following:

(1) A claimant or person for whom benefits are claimed; or

(2) The spouse of a claimant or person for whom benefits are claimed with whom [he] the claimant is living. If the value of such policies exceeds one thousand five hundred dollars, then the total value of such policies may be considered in determining resources; [except that, in the case of aid to families with dependent children, there shall be disregarded any prearranged funeral or burial contract, or any two or more contracts, which provides for the payment of one thousand five hundred dollars or less per family member] and provided further that in the case of individuals receiving work first program benefits the provision of this subsection shall not apply.

5. Beginning September 30, 1989, when determining the eligibility of institutionalized spouses, as defined in 42 USC section 1396r-5, for medical assistance benefits as provided for in section 208.151 and 42 USC sections 1396a et seq., the division of family services shall comply with the provisions of the federal statutes and regulations. As necessary, the division shall by rule or regulation implement the federal law and regulations which shall include but not be limited to the establishment of income and resource standards and limitations. The division shall require:

(1) That at the beginning of a period of continuous institutionalization that is expected to last for thirty days or more, the institutionalized spouse, or the community spouse, may request an assessment by the division of family services of total countable resources owned by either or both spouses;

(2) That the assessed resources of the institutionalized spouse and the community spouse may be allocated so that each receives an equal share;

(3) That upon an initial eligibility determination, if the community spouse's share does not equal at least twelve thousand dollars, the institutionalized spouse may transfer to the community spouse a resource allowance to increase the community spouse's share to twelve thousand dollars;

(4) That in the determination of initial eligibility of the institutionalized spouse, no resources attributed to the community spouse shall be used in determining the eligibility of the institutionalized spouse, except to the extent that the resources attributed to the community spouse do exceed the community spouse's resource allowance as defined in 42 USC section 1396r-5;

(5) That beginning in January, 1990, the amount specified in subdivision (3) of this subsection shall be increased by the percentage increase in the consumer price index for all urban consumers between September, 1988, and the September before the calendar year involved; and

(6) That beginning the month after initial eligibility for the institutionalized spouse is determined, the resources of the community spouse shall not be considered available to the institutionalized spouse during that continuous period of institutionalization.

6. Beginning July 1, 1989, institutionalized individuals shall be ineligible for the periods required and for the reasons specified in 42 USC section 1396p.

7. The hearings required by 42 USC section 1396r-5 shall be conducted [under] pursuant to the provisions of section 208.080.

8. Beginning October 1, 1989, when determining eligibility for assistance [under] pursuant to this chapter there shall be disregarded unless otherwise provided by federal or state statutes, the home of the applicant or recipient when the home is providing shelter to the applicant or recipient, or his or her spouse or dependent child. The division of family services shall establish by rule or regulation in conformance with applicable federal statutes and regulations a definition of the home and when the home shall be considered a resource that shall be considered in determining eligibility.

9. Reimbursement for services provided by an enrolled medicaid provider to a recipient who is duly entitled to Title XIX Medicaid and Title XVIII Medicare Part B, Supplementary Medical Insurance (SMI) shall include payment in full of deductible and coinsurance amounts as determined due [under] pursuant to the applicable provisions of federal regulations pertaining to Title XVIII Medicare Part B, except the applicable Title XIX cost sharing.

10. A "community spouse" is defined as being the noninstitutionalized spouse.

208.015. 1. The division of family services shall grant general relief benefits to those persons determined to be eligible [under] pursuant to this chapter and the applicable rules of the division. The director may adopt such additional requirements for eligibility for general relief, not inconsistent with this chapter, which [he] the director deems appropriate.

2. General relief shall not be granted to any person:

(1) Who has been approved for federal supplemental security income and was not on the general relief rolls in December, 1973; or

(2) Who is a recipient of:

(a) [Aid to families with dependent children] Benefits funded through the work first program;

(b) Aid to the blind benefits;

(d) Supplemental aid to the blind benefits.

3. A person shall not be considered unemployable, [under] pursuant to this section, if unemployability is due to school attendance.

4. Persons receiving general relief in December, 1973, and who qualify for supplemental security income shall continue to receive a general relief grant if necessary to prevent a reduction in the total cash income received by such person in December, 1973, which general relief grant shall not exceed the amount of general relief provided by law.

5. In providing benefits to persons applying for or receiving general relief, benefits shall not be provided to any member of a household if the claimant is employable as defined by rule of the division of family services; or if certain specified relatives living in the household of the claimant are employed and have income sufficient to support themselves and their legal dependents and to meet the needs of the claimant as defined by rule of the division. "Specified relatives" shall be defined as the spouse, mother, father, sister, brother, son, daughter, and grandparents of the claimant, as well as the spouses of these relatives, if living in the home.

6. General relief paid to an unemployable person shall not exceed one hundred dollars a month.

208.044. 1. The division of family services shall provide child day care services [to any person who meets the qualifications set forth at sections 301 and 302 of the Family Support Act of 1988 (P.L. 100-485)] in accordance with Title VI of The Personal Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, known as the Child Care and Development Block Grant Amendments of 1996.

2. The division of family services shall purchase the child day care services required by this section by making payments, in accordance with the Child Care and Development Block Grant Amendments of 1996, and payments made directly to any providers of day care services licensed pursuant to chapter 210, RSMo, or to providers of day care services who are not required by chapter 210, RSMo, to be licensed [because they are providing care to relative children or no more than four children] or by reimbursement to parents for services rendered by such providers.

[3. When a person who has been eligible and receiving day care services under this section becomes ineligible due to the end of the twelve-month period of transitional day care, as defined in section 208.400, such person may receive day care services from the division of family services if otherwise eligible for such services. Until October 1, 1992, participants eligible for income eligible day care services, as defined by the division of family services, will continue to receive such services in the same proportion as that provided in fiscal year 1989, subject to appropriation.]"; and

Further amend said bill, Page 14, Section 208.055, Line 8 of said page, by inserting immediately after all of said line the following:

"208.060. Application for any benefits [under] pursuant to any law of this state administered by the division of family services acting as a state agency shall be filed in the county office. Application for [aid to dependent children] benefits through the work first program shall be made by the person with whom the child will live while receiving aid. All applications shall be in writing, or reduced to writing, upon blank forms furnished by the division of family services, and shall contain such information as may be required by the division of family services or by any federal authority [under] pursuant to the social security law and amendments thereto. The term "benefits" as used herein or in this law shall be construed to mean:

(1) [Aid to dependent children] Benefits funded through the work first program;

(2) Aid or public relief to individuals in cases of public calamity;

(3) Money or services available for child welfare services;

(4) Any other grant, aid, pension or assistance administered by the division of family services.

208.075. 1. When an application is made for [aid to dependent children] families work program or aid to the permanently and totally disabled benefits because of the physical or mental condition of a person the division of family services shall require the person to be examined by competent medical or other appropriate authority designated by the division of family services. If benefits are paid because of the physical or mental condition of a person the division of family services may, as often as it deems necessary, require such person to be reexamined by competent medical or other appropriate authority designated by the division of family services. Written reports of examinations and reexaminations shall be required and evaluated by the division of family services in determining eligibility to receive benefits or to continue to receive benefits.

2. In any appeal hearing as provided for by section 208.080 and the question at issue involves the physical or mental incapacity of a person, regardless of whether assistance has been denied or a recipient has been removed from the assistance rolls, the written reports of the examination or reexamination made by competent medical or other appropriate authority designated by the division of family services, and any written medical reports by other physicians or clinics submitted by claimant, are hereby declared to be competent evidence and admissible as such at the appeal hearing to be considered by the director with any other evidence submitted. Any written medical report purporting to be executed and signed by the medical or other appropriate authority, its agents, or employees shall be prima facie evidence of it being properly executed and signed without further proof of identification.

208.080. 1. Any applicant for or recipient of benefits or services provided by law by the division of family services may appeal to the director of the division of family services from a decision of a county office of the division of family services in any of the following cases:

(1) If [his] the applicant's or recipient's right to make application for any such benefits or services is denied; or

(2) If [his] the applicant's or recipient's application is disallowed in whole or in part, or is not acted upon within a reasonable time after it is filed; or

(3) If it is proposed to cancel or modify benefits or services; or

(4) If [he] the applicant or recipient is adversely affected by any determination of a county office of the division of family services in its administration of the programs administered by it; or

(5) If a determination is made pursuant to subsection 2 of section 208.180 that payment of benefits on behalf of a dependent child shall not be made to the relative with whom [he] such child lives.

2. If the division proposes to terminate or modify the payment of benefits or the providing of services to the recipient or the division has terminated or modified the payment of benefits or providing of services to the recipient and the recipient appeals, the decision of the director as to the eligibility of the recipient at the time such action was proposed or taken shall be based on the facts shown by the evidence presented at the hearing of the appeal to have existed at the time such action to terminate or modify was proposed or was taken.

3. In the case of a proposed action by the county office of the division of family services to reduce, modify, or discontinue benefits or services to a recipient, the recipient of such benefits or services shall have ten days from the date of the mailing of notice of the proposed action to reduce, modify, or discontinue benefits or services within which to request an appeal to the director of the division of family services. In the notice to the recipient of such proposed action, the county office of the division of family services shall notify the recipient of all [his] the recipient's rights of appeal [under] pursuant to this section. Proper blank forms for appeal to the director of the division of family services shall be furnished by the county office to any aggrieved recipient. Every such appeal to the director of the division of family services shall be transmitted by the county office to the director of the division of family services immediately upon the same being filed with the county office. If an appeal is requested, benefits or services shall continue undiminished or unchanged until such appeal is heard and a decision has been rendered thereon, except that in [an aid to families with dependent children] a work first program case the recipient may request that benefits or services not be continued undiminished or unchanged during the appeal.

4. When a case has been closed or modified and no appeal was requested prior to closing or modification, the recipient shall have ninety days from the date of closing or modification to request an appeal to the director of the division of family services. Each recipient who has not requested an appeal prior to the closing or modification of [his] the recipient's case shall be notified at the time of such closing or modification of [his] the right to request an appeal during this ninety-day period. Proper blank forms for requesting an appeal to the director of the division of family services shall be furnished by the county office to any aggrieved applicant. Every such request made in any manner for an appeal to the director of the division of family services shall be transmitted by the county office to the director of the division of family services immediately upon the same being filed with the county office. If an appeal is requested in the ninety-day period subsequent to the closing or modification, benefits or services shall not be continued at their prior level during the pendency of the appeal.

5. In the case of a rejection of an application for benefits or services, the aggrieved applicant shall have ninety days from the date of the notice of the action in which to request an appeal to the director of the division of family services. In the rejection notice the applicant for benefits or services shall be notified of all of [his] the applicant's rights of appeal [under] pursuant to this section. Proper blank forms for requesting an appeal to the director of the division of family services shall be furnished by the county office to any aggrieved applicant. Any such request made in any manner for an appeal shall be transmitted by the county office to the director of the division of family services, immediately upon the same being filed with the county office.

6. If the division has rejected an application for benefits or services and the applicant appeals, the decision of the director as to the eligibility of the applicant at the time such rejection was made shall be based upon the facts shown by the evidence presented at the hearing of the appeal to have existed at the time the rejection was made.

7. The director of the division of family services shall give the applicant for benefits or services or the recipient of benefits or services reasonable notice of, and an opportunity for, a fair hearing [in the county of his residence at the time the adverse action was taken. The hearing shall be] conducted by the director of the division of family services or [his designee] an authorized designee to include an administrative hearing officer in the administrative hearing unit of the division of legal services. Every applicant or recipient, on appeal to the director of the division of family services, shall be entitled to [be present at the hearing, in person and by attorney or representative] a hearing either in person or by telephone. All in-person hearings shall be held in one of the administrative hearing units regional hearing offices located throughout the state, or as designated by the administrative hearing unit. A person requesting a hearing may appear with or without an attorney or other representative, and shall be entitled to introduce into the record of such hearing any and all evidence, by witnesses or otherwise, pertinent to such applicant's or recipient's eligibility between the time [he applied] application for benefits or services was made and the time the application was denied or the benefits or services were terminated or modified, and all such evidence shall be taken down, preserved, and shall become a part of the applicant's or recipient's appeal record. Upon the record so made, the director of the division of family services shall determine all questions presented by the appeal, and shall make such decision as to the granting of benefits or services as in [his] the director's opinion is justified and is in conformity with the provisions of the law. The director shall clearly state the reasons for [his] the director's decision and shall include a statement of findings of fact and conclusions of law pertinent to the questions in issue.

8. All appeal requests may initially be made orally or in any written form, but all such requests shall be transcribed on forms furnished by the division of family services and signed by the aggrieved applicant or recipient or his or her representative prior to the commencement of the hearing.

208.120. 1. For the protection of applicants and recipients, all officers and employees of the state of Missouri are prohibited, except as hereinafter provided, from disclosing any information obtained by them in the discharge of their official duties relative to the identity of applicants for or recipients of benefits or the contents of any records, files, papers, and communications, except in proceedings or investigations where the eligibility of an applicant to receive benefits, or the amount received or to be received by any recipient, is called into question, or for the purposes directly connected with the administration of public assistance. In any judicial proceedings, except such proceedings as are directly concerned with the administration of these programs, such information obtained in the discharge of official duties relative to the identity of applicants for or recipients of benefits, and records, files, papers, communications and their contents shall be confidential and not admissible in evidence.

2. The division of family services shall in each county welfare office maintain monthly a report showing the name and address of all recipients certified by such county welfare office to receive public assistance benefits, together with the amount paid to each recipient during the preceding month, and each such report and information contained therein shall be open to public inspection at all times during the regular office hours of the county welfare office; provided, however, that all information regarding applicants or recipients other than names, addresses and amounts of grants shall be considered as confidential.

3. It shall be unlawful for any person, association, firm, corporation or other agency to solicit, disclose, receive, make use of or authorize, knowingly permit, participate in or acquiesce in the use of any name or lists of names for commercial or political purposes of any nature; or for any name or list of names of recipients secured from such report in the county welfare office to be published in any manner. Anyone willfully or knowingly violating any provisions of this section shall be guilty of a misdemeanor. If the violation is by other than an individual, the penalty may be adjudged against any officer, agent, employee, servant or other person of the association, firm, corporation or other agency who committed or participated in such violation and is found guilty thereof.

4. Notwithstanding any other provisions of this section to the contrary, the department of social services shall furnish, at least four times annually and upon request of the Immigration and Naturalization Service, the name, address and other identifying information of any individual whom the department knows to be unlawfully in the United States.

208.150. The maximum amount of monthly public assistance money payment benefits payable to or on behalf of a needy person shall not exceed the following:

[(1) Aid to families with a dependent child, or children, and needy eligible relatives caring for a dependent child, or children, in an amount to be computed as follows:

(a) Beginning July 1, 1993, and at least every three years thereafter, the division of family services shall determine by regulation the average need for each such eligible person, which shall include the cost of basic needs required to maintain a child or children in the home at a reasonable and decent low-income standard of living, and shall pay, on a uniform basis, the highest percent of such need as shall be possible within the limits of funds appropriated for that purpose, less available income;

(b) "Available income" means the total income, before taxes or other deductions, of each person residing within the same household, except, to the extent allowed by federal law, the earnings of a student under nineteen years of age enrolled in a secondary school or at the equivalent level of vocational or technical training, plus or minus such credits or deductions as may be prescribed by the division of family services by regulations for the sole purpose of complying with federal laws or regulations relating to this state's eligibility to receive federal funds for aid to families with dependent children payments, and such credits or deductions as may otherwise be prescribed by law;

(d) If the determined need under this subdivision is of an amount less than ten dollars, no cash payment will be made;]

(1) Families work program benefits payable to individuals under the work first program in accordance with requirements established by the department or benefits people qualified for pursuant to aid to families with dependent children under the requirements in effect on June 1, 1995. The department shall not establish benefits payable to be less than those in place on June 1, 1995, and within appropriations authority;

(2) Aid or public relief to an unemployable person not to exceed one hundred dollars.

208.151. 1. For the purpose of paying medical assistance on behalf of needy persons and to comply with Title XIX, Public Law 89-97, 1965 amendments to the federal Social Security Act (42 U.S.C. section 301 et seq.) as amended, the following needy persons shall be eligible to receive medical assistance to the extent and in the manner hereinafter provided:

(1) All recipients of state supplemental payments for the aged, blind and disabled;

(2) [All recipients of aid to families with dependent children benefits, including all persons under nineteen years of age who would be classified as dependent children except for the requirements of subdivision (1) of subsection 1 of section 208.040] Individuals who meet the July 16, 1996, eligibility requirements for aid to families with dependent children or requirements so established by the department and who are eligible for medical assistance in accordance with rules and regulations promulgated by the department;

(3) All recipients of blind pension benefits;

(4) All persons who would be determined to be eligible for old age assistance benefits, permanent and total disability benefits, or aid to the blind benefits under the eligibility standards in effect December 31, 1973, or less restrictive standards as established by rule of the division of family services, who are sixty-five years of age or over and are patients in state institutions for mental diseases or tuberculosis;

(5) All persons under the age of twenty-one years who [would be eligible for aid to families with dependent children] meet the July 16, 1996, eligibility requirements for aid to families with dependent children or requirements as established by the department, except for the requirements of [subdivision (2) of subsection 1 of section 208.040] deprivation of parental support, and who are residing in an intermediate care facility, or receiving active treatment as inpatients in psychiatric facilities or programs, as defined in 42 U.S.C. 1396d, as amended;

(6) All persons under the age of twenty-one years who would be eligible for aid to families with dependent children benefits [except for the requirement of deprivation of parental support as provided for in subdivision (2) of subsection 1 of section 208.040] pursuant to the July 16, 1996, eligibility requirements or requirements as established by the department except for the requirement of deprivation of parental support;

(7) All persons eligible to receive nursing care benefits;

(8) All recipients of family foster home or nonprofit private child-care institution care, subsidized adoption benefits and parental school care wherein state funds are used as partial or full payment for such care;

(9) All persons who were recipients of old age assistance benefits, aid to the permanently and totally disabled, or aid to the blind benefits on December 31, 1973, and who continue to meet the eligibility requirements, except income, for these assistance categories, but who are no longer receiving such benefits because of the implementation of Title XVI of the federal Social Security Act, as amended;

(10) Pregnant women who meet the requirements for aid to families with dependent children that were in existence as of July 16, 1996, or requirements as established by the department, except for the existence of a dependent child in the home;

(11) Pregnant women who meet the requirements for aid to families with dependent children that were in existence as of July 16, 1996, or requirements as established by the department, except for the existence of a dependent child who is deprived of parental support [as provided for in subdivision (2) of subsection 1 of section 208.040];

(12) Pregnant women or infants under one year of age, or both, whose family income does not exceed an income eligibility standard equal to one hundred eighty-five percent of the federal poverty level as established and amended by the federal Department of Health and Human Services, or its successor agency;

(13) Children who have attained one year of age but have not attained six years of age who are eligible for medical assistance under 6401 of P.L. 101-239 (Omnibus Budget Reconciliation Act of 1989). The division of family services shall use an income eligibility standard equal to one hundred thirty-three percent of the federal poverty level established by the Department of Health and Human Services, or its successor agency;

(14) Children who have attained six years of age but have not attained nineteen years of age. For children who have attained six years of age but have not attained nineteen years of age, the division of family services shall use an income assessment methodology which provides for eligibility when family income is equal to or less than equal to one hundred percent of the federal poverty level established by the Department of Health and Human Services, or its successor agency. As necessary to provide medicaid coverage [under] pursuant to this subdivision, the department of social services may revise the state medicaid plan to extend coverage [under] pursuant to 42 U.S.C. 1396a (a)(10)(A)(i)(III) to children who have attained six years of age but have not attained nineteen years of age as permitted by paragraph (2) of subsection (n) of 42 U.S.C. 1396d using a more liberal income assessment methodology as authorized by paragraph (2) of subsection (r) of 42 U.S.C. 1396a;

(15) The following children with family income which does not exceed two hundred percent of the federal poverty guideline for the applicable family size:

(a) Infants who have not attained one year of age with family income greater than one hundred eighty-five percent of the federal poverty guideline for the applicable family size;

(b) Children who have attained one year of age but have not attained six years of age with family income greater than one hundred thirty-three percent of the federal poverty guideline for the applicable family size; and

(c) Children who have attained six years of age but have not attained nineteen years of age with family income greater than one hundred percent of the federal poverty guideline for the applicable family size. Coverage [under] pursuant to this subdivision shall be subject to the receipt of notification by the director of the department of social services and the revisor of statutes of approval from the secretary of the U.S. Department of Health and Human Services of applications for waivers of federal requirements necessary to promulgate regulations to implement this subdivision. The director of the department of social services shall apply for such waivers. The regulations may provide for a basic primary and preventive health care services package, not to include all medical services covered by section 208.152, and may also establish copayment, coinsurance, deductible, or premium requirements for medical assistance [under] pursuant to this subdivision. Eligibility for medical assistance [under] pursuant to this subdivision shall be available only to those infants and children who do not have or have not been eligible for employer-subsidized health care insurance coverage for the six months prior to application for medical assistance. Children are eligible for employer-subsidized coverage through either parent, including the noncustodial parent. The division of family services may establish a resource eligibility standard in assessing eligibility for persons [under] pursuant to this subdivision. The division of medical services shall define the amount and scope of benefits which are available to individuals [under] pursuant to this subdivision in accordance with the requirement of federal law and regulations. Coverage [under] pursuant to this subdivision shall be subject to appropriation to provide services approved under the provisions of this subdivision;

(16) The division of family services shall not establish a resource eligibility standard in assessing eligibility for persons [under] pursuant to subdivision (12), (13) or (14) of this subsection. The division of medical services shall define the amount and scope of benefits which are available to individuals eligible [under] pursuant to each of the subdivisions (12), (13), and (14) of this subsection, in accordance with the requirements of federal law and regulations promulgated thereunder except that the scope of benefits shall include case management services;

(17) Notwithstanding any other provisions of law to the contrary, ambulatory prenatal care shall be made available to pregnant women during a period of presumptive eligibility pursuant to 42 U.S.C. section 1396r-1, as amended;

(18) A child born to a woman eligible for and receiving medical assistance [under] pursuant to this section on the date of the child's birth shall be deemed to have applied for medical assistance and to have been found eligible for such assistance under such plan on the date of such birth and to remain eligible for such assistance for a period of time determined in accordance with applicable federal and state law and regulations so long as the child is a member of the woman's household and either the woman remains eligible for such assistance or for children born on or after January 1, 1991, the woman would remain eligible for such assistance if she were still pregnant. Upon notification of such child's birth, the division of family services shall assign a medical assistance eligibility identification number to the child so that claims may be submitted and paid under such child's identification number;

(19) Pregnant women and children eligible for medical assistance pursuant to subdivision (12), (13) or (14) of this subsection shall not as a condition of eligibility for medical assistance benefits be required to apply for [aid to families with dependent children] benefits through the work first program. The division of family services shall utilize an application for eligibility for such persons which eliminates information requirements other than those necessary to apply for medical assistance. The division shall provide such application forms to applicants whose preliminary income information indicates that they are ineligible for [aid to families with dependent children] benefits through the work first program. Applicants for medical assistance benefits [under] pursuant to subdivision (12), (13) or (14) shall be informed of the [aid to families with dependent children program] work first program and that they are entitled to apply for such benefits. Any forms utilized by the division of family services for assessing eligibility [under] pursuant to this chapter shall be as simple as practicable;

(20) Subject to appropriations necessary to recruit and train such staff, the division of family services shall provide one or more full-time, permanent case workers to process applications for medical assistance at the site of a health care provider, if the health care provider requests the placement of such case workers and reimburses the division for the expenses including but not limited to salaries, benefits, travel, training, telephone, supplies, and equipment, of such case workers. The division may provide a health care provider with a part-time or temporary case worker at the site of a health care provider if the health care provider requests the placement of such a case worker and reimburses the division for the expenses, including but not limited to the salary, benefits, travel, training, telephone, supplies, and equipment, of such a case worker. The division may seek to employ such case workers who are otherwise qualified for such positions and who are current or former welfare recipients. The division may consider training such current or former welfare recipients as case workers for this program;

(21) Pregnant women who are eligible for, have applied for and have received medical assistance [under] pursuant to subdivision (2), (10), (11) or (12) of this subsection shall continue to be considered eligible for all pregnancy-related and postpartum medical assistance provided [under] pursuant to section 208.152 until the end of the sixty-day period beginning on the last day of their pregnancy;

(22) Case management services for pregnant women and young children at risk shall be a covered service. To the greatest extent possible, and in compliance with federal law and regulations, the department of health shall provide case management services to pregnant women by contract or agreement with the department of social services through local health departments organized [under] pursuant to the provisions of chapter 192, RSMo, or chapter 205, RSMo, or a city health department operated [under] pursuant to a city charter or a combined city-county health department or other department of health designees. To the greatest extent possible the department of social services and the department of health shall mutually coordinate all services for pregnant women and children with the crippled children's program, the prevention of mental retardation program and the prenatal care program administered by the department of health. The department of social services shall by regulation establish the methodology for rei

	Present--Senators
Banks	Bentley	Caskey	Childers
Clay	Curls	DePasco	Ehlmann
Flotron	Goode	Graves	House
Howard	Jacob	Johnson	Kenney
Kinder	Klarich	Lybyer	Mathewson
Maxwell	McKenna	Mueller	Quick
Rohrbach	Russell	Schneider	Scott
Sims	Singleton	Staples	Westfall
Wiggins	Yeckel--34

	Absent with leave--Senators--None

	Yeas--Senators
Banks	Bentley	Caskey	Childers
Curls	DePasco	Ehlmann	Goode
Graves	House	Howard	Jacob
Johnson	Kenney	Kinder	Klarich
Lybyer	Mathewson	Maxwell	McKenna
Mueller	Quick	Rohrbach	Russell
Schneider	Scott	Sims	Singleton
Staples	Westfall	Wiggins	Yeckel--32

	Nays--Senators--None

	Absent--Senators--Clay--1

	Absent with leave--Senators--Flotron--1