HCS HB 1422, 1199, 1411, 1754 & 1947 -- PUBLIC HEALTH PROGRAMS

SPONSOR:  Ladd Stokan

COMMITTEE ACTION:  Voted "do pass" by the Committee on Public
Health by a vote of 13 to 0 with 2 present.

This substitute creates various programs relating to public
health and safety.

ORGAN TRANSPLANT PROGRAM

The substitute establishes a separate organ transplant program
to be administered by the Missouri Kidney Program in the
University of Missouri.  This program will provide assistance
for immunosuppressive medications.  If other funds are available
through the transplant program, other services for other organ
transplant patients may be provided.

The Missouri Kidney Program will establish program guidelines
and eligibility requirements and will coordinate its efforts
with the divisions of Family Services and Medical Services in
the Department of Social Services for the effective operation of
the organ transplant program.

ASSISTIVE TECHNOLOGY

The substitute authorizes the Missouri Assistive Technology
Advisory Council to establish a loan program for the purchase of
assistive technology devices and services.  After July 1, 2001,
upon appropriations for the loan program and matching grant
moneys received by the state as specified by the federal
Assistive Technology Act of 1998, such moneys will be regulated
and dispersed according to the provisions of the substitute.

The Assistive Technology Loan Revolving Fund is established.  It
will be administered by the Missouri Assistive Technology
Advisory Council and the State Treasurer.  The council can
approve the receipt of federal, state, public, and private
moneys or loans to finance the fund.  The moneys and
appropriations will be used to maintain the assistive technology
loan program and will not revert to the General Revenue Fund at
the end of the biennium.

LEAD ABATEMENT LOAN PROGRAM

The substitute requires the Department of Health to develop an
administrative plan by July 1, 2001, for implementing a new loan
program for owners of dwellings or child-occupied facilities for
the performance of lead abatement projects.

Owners who apply for such loans are required to conduct lead
abatement projects consistent with Sections 701.300 to 701.338,
RSMo, provisions pertaining to Lead Abatement and Prevention of
Lead Poisoning, and rules created under those provisions.

The department is required to evaluate lead abatement project
plans developed by loan applicants; to provide loans for the
cost of performing lead abatement projects as stated in the
substitute; and to establish rules pertaining to the dispersal
and repayment of each loan.  Applicants are required to comply
with  payment, lead abatement provisions, data requests, and
inspection requirements as specified in the substitute.
Preference will be given to loan applicants who conduct a lead
abatement project that will have the most significant impact in
protecting the health of the occupants of a dwelling or child-
occupied facility.

The substitute also establishes a Missouri Lead Abatement Loan
Fund in the state treasury.  The fund will be financed from
appropriations, loan repayments, interest, gifts, bequests,
donations, and other public or private funds.  The State
Treasurer is required to administer the fund according to the
provisions of the substitute.

Moneys in the fund are used only for the purpose of performing
lead abatement projects.  Moneys in the fund will not revert to
the credit of the General Revenue Fund at the end of the
biennium.

BLINDNESS EDUCATION, SCREENING, AND TREATMENT

The substitute establishes the Blindness Education, Screening
and Treatment Program Fund in the state treasury.

The fund is financed from a voluntary $1 contribution from
applicants who renew their motor vehicle registration and from a
voluntary $1 contribution from driver's license applicants.
Moneys in the fund can be used for the purpose of financing a
Blindness Education, Screening and Treatment Program.
Unexpended balances in the fund will not revert to the credit of
general revenue or any other fund at the end of any fiscal year.

Subject to the availability of funding, the Department of Health
is required to develop a Blindness Education, Screening and
Treatment Program for the purposes of providing blindness
prevention education, screening, and treatment for persons who
do not have adequate coverage under their health benefit plan.
The substitute requires the department to develop regulations
governing eligibility requirements for the program and specifies
the services provided by the program.

DONATED DENTAL SERVICES

The substitute allows the Department of Health to contract with
the Missouri Dental Board to establish a Donated Dental Services
Program in conjunction with the provisions of Section 332.323.

Licensed volunteer dentists will provide comprehensive dental
care for needy, disabled, elderly, and medically compromised
persons.  Dental care can be provided to such persons in a
licensed volunteer dentist's office.  Eligible persons are
required to pay for dental laboratory costs.

The department is required to contract with the Missouri Dental
Board, its designee, or other qualified organizations to
administer the program.

The substitute also contains provisions specifying the
contractual responsibilities of the organization administering
the program.

OBESITY AWARENESS AND PREVENTION

The substitute requires the Department of Health to examine the
incidence of obesity in the state of Missouri and to issue a
statewide report on obesity by December 31, 2000, to the
Governor, the Speaker of the House of Representatives, and the
President Pro Tem of the Senate.  The content of the report is
specified in the substitute.

The department is allowed to establish and maintain obesity
awareness prevention and education activities in order to
promote public awareness on the causes, risk factors, and
treatment options associated with obesity.

Eligible persons who receive medical assistance under Section
208.151 are authorized to receive outpatient prescription drug
coverage of non-systemic FDA-approved anti-obesity drug
therapies according to appropriate criteria established by the
department.  The drug coverage may be subject to a prior
authorization and/or a retrospective drug utilization process.
The criteria must include a body mass index as stated and the
presence of a specified risk factor which includes diabetes or
hypertension.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
$237,142 to $44,570,382 in FY 2001, $251,061 to $53,620,949 in
FY 2002, and $255,234 to $53,125,122 in FY 2003.  Subject to
appropriation.  Estimated Net Income to Blindness Education,
Screening and Treatment Program Fund of $62,645 in FY 2001, and
$0 in FY 2002 and FY 2003.  Estimated Net Effect on Highway
Funds of a cost of $121,867 in FY 2001, an income of $1,305 in
FY 2002, and an income of $1,345 in FY 2003.  Estimated Net
Effect on Assistive Technology Loan Revolving Fund of $0 in FY
2001, FY 2002, and FY 2003.  Estimated Net Effect on Missouri
Lead Abatement Loan Fund of $0 in FY 2001, FY 2002, and FY 2003.

PROPONENTS:  Supporters of HB 1199 state that often transplant
patients cannot afford the expensive immunosuppressive
medications which facilitate a transplant recipient's recovery.
This bill would create a separate program which would provide
assistance to eligible persons for the purchase of
immunosuppressive medications at a reduced cost.

Supporters of HB 1411 state that this bill would create a loan
program which could receive federal funds and other moneys that
would allow eligible disabled Missourians to purchase assistive
technology devices and other services.

Supporters of HB 1754 state that subject to funding, an
educational and screening and treatment program would be created
for the purposes of educating the public about blindness and
other eye conditions and providing eye examinations and
treatments for eligible persons.

Supporters for HB 1947 state that this bill would provide much
needed dental services to eligible persons in Missouri.  Similar
programs exist in 28 other states.

Supporters of HB 1422 state that the presence of lead in older
structures is a major cause of lead poisoning in children.
Exposure to lead can also cause nervous system disorders, blood
problems, and digestive tract problems in children and older
persons.

Testifying for HB 1199 were Representative Hosmer; Missouri
Kidney Program; and University of Missouri System.  Testifying
for HB 1411 were Representative Stokan; and Missouri Assistive
Technology Council.  Testifying for HB 1754 were Representative
Froelker; Missouri Council for the Blind; National Federation of
the Blind of Missouri; and Paraquad Center for Independent
Living.  Testifying for HB 1947 were Representative Holand; and
Missouri Dental Association.  Testifying for HB 1422 were
Representative Dougherty; Department of Health; Missouri
Coalition for the Environment; and Missouri Apartment
Association.

OPPONENTS:  There was no opposition voiced to the committee.

Joseph Deering, Legislative Analyst

HB 1422 -- Lead Abatement Loan Program

Co-Sponsors:  Dougherty, Selby, Luetkenhaus, Boucher

This bill requires the Department of Health to develop an
administrative plan by July 1, 2001, for implementing a new loan
program for owners of dwellings or child-occupied facilities for
the performance of lead abatement projects.

Owners who apply for such loans are required to conduct lead
abatement projects consistent with Sections 701.300 to 701.338,
RSMo, provisions pertaining to Lead Abatement and Prevention of
Lead Poisoning, and rules created under these provisions.

The department is required to evaluate lead abatement project
plans developed by loan applicants; to provide loans for the
cost of performing lead abatement projects as stated in the
bill; and to establish rules pertaining to the dispersal and
repayment of each loan.  Applicants are required to comply with
payment, lead abatement provisions, data requests, and
inspection requirements as specified in the bill.

The bill also establishes a Missouri Lead Abatement Loan Fund in
the state treasury.  The fund will be financed from
appropriations, loan repayments, interest, gifts, bequests,
donations, and other public or private funds.  The State
Treasurer is required to administer the fund according to the
provisions of the bill.

Moneys in the fund are used only for the purpose of performing
lead abatement projects.  Moneys in the fund will not revert to
the credit of the General Revenue Fund at the end of the
biennium.