House Committee Substitute

HCS/SS/SCS/SB 106 - This act modifies several provisions relating to public health, including: (1) special education records; (2) patient examinations; (3) breast examinations; (4) MO HealthNet for pregnant and postpartum women; (5) mental health coordinators; (6) behavioral health services for certain accused persons; and (7) lead poisoning.


Under this act, a student's special education record shall be deemed a permanent record and shall be maintained as a part of a child's cumulative scholastic record. No school district or pubic school shall destroy a child's student special education record.

This provision is identical to HB 1289 (2023).


Under this act, no health care provider, or any student or trainee under the supervision of a health care provider, shall perform a patient examination, defined as a prostate, anal, or pelvic examination, upon an anesthetized or unconscious patient in a health care facility, unless: (1) the patient or person authorized to make health care decisions for the patient gives specific informed consent for nonmedical purposes, (2) the patient examination is necessary for diagnostic or treatment purposes, (3) the collection of evidence through a forensic examination for a suspected sexual assault is necessary because the evidence will be lost or the patient is unable to give informed consent due to a medical condition, or (4) emergency implied consent, as described in the act, is present. A health care provider shall notify a patient of any such examination performed.

A health care provider who violates the provisions of this act, or who supervises a student or trainee who violates the provisions of this act, shall be subject to disciplinary action by the provider's licensing board.

This provision is substantially similar to SCS/HB 283 (2023), HCS/HB 1742 (2022), and SB 746 (2022).

BREAST EXAMINATIONS (Sections 192.775, 376.782, and 376.1183)

This act prohibits certain mammography facilities from requiring a referral from a primary care provider for a screening mammogram that is consistent with the recommendations in the most recent guidelines established by the U. S. Preventive Services Task Force.

This act prohibits cost-sharing requirements under coverage for certain low-dose mammography screenings if a separate provision of law prohibits cost-sharing requirements with respect to such coverage. The act also prohibits health carriers from requiring a referral from a primary care provider to obtain a low-dose mammography screening required by law to be covered.

This act prohibits cost-sharing requirements under coverage provided for diagnostic breast examinations, supplemental breast examinations, or low-dose mammography screenings. If these provisions would result in health savings account (HSA) ineligibility, these provisions shall apply to HSA-qualified high-deductible health plans only after the deductible has been met.

These provisions are identical to HCS/HBs 575 & 910 (2023) and similar to provisions in SB 461 (2023), SB 1166 (2022), and HB 2427 (2021).


Currently, low-income pregnant and postpartum women receiving benefits through MO HealthNet for Pregnant Women or Show-Me Healthy Babies are eligible for pregnancy-related coverage throughout the pregnancy and for 60 days following the end of the pregnancy. Under this act, MO HealthNet coverage for these low-income women will include full Medicaid benefits for the duration of the pregnancy and for one year following the end of the pregnancy. This coverage shall begin on the effective date of the act and shall continue during any period of time the federal authorization for such coverage is in effect.

These provisions have an emergency clause.

These provisions are substantially similar to HCS/SCS/SBs 45 & 90 (2023), SCS/SBs 698 & 639 (2022) and provisions in HCS/SS#2/SB 823 (2022) and SCS/HCS/HB 2012 (2022).

MENTAL HEALTH COORDINATORS (Sections 441.740, 552.050, 630.045, 630.140, 630.175, 630.120, 631.135, 631.140, 631.150, 631.165, 632.005, 632.150, 632.155, 632.300, 632.305, 632.310, 632.315, 632.320, 632.325, 632.330, 632.335, 632.340, 632.345, 632.350, 632.355, 632.370, 632.375, 632.385, 632.390, 632.392, 632.395, 632.400, 632.410, 632.415, 632.420, 632.430, 632.440, 632.455, and 633.125)

This act repeals references to mental health coordinators throughout statutes regulating civil commitments. Additionally, this act changes the time frame for a designated staff member at a mental health facility to meet with an individual civilly detained at such facility from within 4 days of arrival at the facility to within 48 hours of arrival at the facility.

These provisions are identical to HB 1094 (2023) and SCS/SB 538 (2023).


Currently, a judge may order a pretrial examination of an accused person whom the judge has reasonable cause to believe lacks mental fitness to proceed. The psychiatrist, psychologist, or physician performing the examination shall submit a report with findings, opinions, and recommendations on treatment in suitable hospitals. This act requires the examination report to contain opinions as to the accused's mental fitness to proceed in the reasonably foreseeable future and recommendations as to whether the accused, if found to lack mental fitness to proceed, should be committed to a suitable hospital for treatment or if the treatment can be provided in a county jail or other detention facility approved by the Director of the Department of Mental Health. Additionally, the report shall contain a recommendation as to whether the accused, if found to lack mental fitness to proceed and if not charged with a dangerous felony, murder in the first degree, or rape in the second degree, should be committed to a suitable hospital facility or may be appropriately treated in the community, and whether the accused can comply with bond conditions and treatment conditions.

This provision is substantially similar to SCS/SB 387 (2023).

LEAD POISONING (Sections 701.336, 701.340, 701.342, 701.344, and 701.348)

Currently, the Department of Health and Senior Services, in collaboration with the Department of Social Services and other health care organizations, shall develop an educational strategy to increase the number of children who are tested for lead poisoning under the Medicaid program. This act repeals a provision describing the goals and timelines of the educational strategy.

Under this act, every medical provider serving children shall annually provide education to all parents and guardians of children under 4 years of age regarding lead hazards and provide the option to test every child under 4 years of age with the consent of the parent or guardian. This act repeals the requirement that parents or guardians provide a written statement refusing lead testing.

This act repeals provisions requiring all children less than 6 years of age who reside or spend more than 10 hours a week in a high risk area to be annually tested for lead poisoning. Instead, every child under 6 years of age shall be annually assessed for lead poisoning risk and may be tested with the consent of the child's parent or guardian.

Finally, every child care facility located in a geographic area of high risk for lead poisoning shall, within 30 days of enrollment of a child age 12 months of age or older and under 5 years of age, require the child's parents or guardians to provide evidence of lead poisoning testing or a statement of refusal of such testing.

These provisions are identical to the perfected HCS/HB 906 (2023) and SCS/SB 507 (2023).


Return to Main Bill Page