FIRST REGULAR SESSION
92ND GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVES ABEL, SEIGFREID, BARNITZ, WHORTON, WITTE,
KUESSNER, SHOEMYER (9), RANSDALL, BRINGER, HENKE, MERIDETH, SAGER,
HARRIS (110) (Co-sponsors), KRATKY, DAVIS (122), HAMPTON AND KELLY (36).
Read 1st time April 15, 2003, and copies ordered printed.
STEPHEN S. DAVIS, Chief Clerk
AN ACT
To amend chapter 191, RSMo, by adding thereto two new sections relating to the Missouri rural health initiative.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapter 191, RSMo, is amended by adding thereto two new sections, to be known as sections 191.412 and 191.413, to read as follows:
191.412. 1. The director of the department of health and senior services, through the office of rural health and in collaboration with the departments of mental health, social services, economic development, elementary and secondary education, and labor and industrial relations, and other state agencies, shall develop a component of the plan identified in subsection 1 of section 191.411 which shall be known as the "Missouri Rural Health Initiative".
2. The Missouri rural health initiative shall:
(1) Develop a detailed plan that defines a system of coordinated health care services available and accessible to all persons in rural areas of the state;
(2) Develop and administer technical assistance programs to assist rural communities in planning and coordinating the delivery of health care services through community-based systems of care;
(3) Develop recommendations for obtaining financial resources for rural hospitals and clinics in isolated areas of the state that are in danger of closing without financial assistance and have exhausted local sources of support;
(4) Develop recommendations regarding the delivery of health information and health care services in rural areas through telemedicine and telehealth resources;
(5) Coordinate the development of a statewide plan for emergency medical services, in collaboration with the emergency medical services regulatory agencies and representative organizations;
(6) Develop a statewide recruitment and retention strategy for health care professionals;
(7) Develop recommendations in the regulation of rural health care personnel, such as advanced practice nurses, physician assistants, mental health counselors, and dental hygienists, related to scope of practice to address rural health personnel shortages;
(8) Develop recommendations on the coordination and integration of mental health services in primary care settings, hospitals, emergency medical services, trauma services, rehabilitation and other health care services in rural areas;
(9) Evaluate and provide projections on the economic impact of health care services in rural communities;
(10) Develop recommendations to assure access to vulnerable elderly populations in rural areas to health care and social services;
(11) Develop analyses of barriers to health systems development in rural areas, including but not limited to rural facilities, workforce, economies, demographics, transportation systems, and other relevant factors; and
(12) Incorporate the duties of the office of rural health pursuant to section 192.604, RSMo.
191.413. 1. There is hereby established within the department of health and senior services the "Missouri Rural Health Services Commission" which will be responsible for examining the following underlying issues as they relate to preventive, primary, and oral health services in rural Missouri:
(1) Infrastructure issues, including transportation systems, facilities, and workforce;
(2) Economic issues, including education levels, school drop-out rates, continuing education availability and potential, job or workforce development and retraining opportunities, and new employment and economic development; and
(3) Cultural issues, including:
(a) Assessment of the impact of new minority populations increases, especially large increases, in a rural area;
(b) Whether the new minority populations are being incorporated into the rural health care system or are facing isolation through exclusion from such system;
(c) The availability and type of resources in areas with new minority population increases; and
(d) Legal, educational, health care, and social services training for local public and private providers in delivering services to new minority populations in rural areas.
2. The commission shall be comprised of the following ten members:
(1) Two members of the senate, with one member to be appointed by the president pro tem of the senate and one member to be appointed by the minority floor leader of the senate;
(2) Two members of the house of representatives, with one member to be appointed by the speaker of the house and one member to be appointed by the minority floor leader of the house; and
(3) The following six members to be appointed by the governor with the advice and consent of the senate:
(a) Two directors of critical access hospitals; and
(b) Four at-large members.
3. The Missouri rural health services commission shall hold its first meeting no later than sixty days after August 28, 2003, which shall be designated by the governor. After the initial meeting, the commission shall hold at least four regular meetings each year and such additional meetings as the chairperson deems desirable at a place and time to be fixed by the chairperson. Special meetings may be called by five members of the commission upon delivery of written notice to each member of the commission. Reasonable written notice of all meetings shall be given by the chairperson to all members of the commission. Six members of the commission shall constitute a quorum. All actions of the commission shall be taken at meetings open to the public. All meetings of the commission shall be held in the state of Missouri.
4. The commission may make all rules it deems necessary to enable it to conduct its meetings, elect its officers, and set the terms and duties of its officers. The commission shall elect from amongst its members a chairperson and such other officers as it deems necessary.
5. The members of the commission shall serve without compensation but may be reimbursed for all actual and necessary expenses incurred in the performance of their official duties for the commission.
6. The services of the personnel of department of health and senior services shall be made available to the commission at the request of the commission.
7. The commission, by majority vote, may invite individuals representing local and federal agencies or private organizations and the general public to serve as ex officio members of the commission. Such individuals shall not have a vote in commission business and shall serve without compensation but may be reimbursed for all actual and necessary expenses incurred in the performance of their official duties for the commission.
8. The commission shall provide two reports to the governor and the general assembly. The first report to be submitted on or before January 15, 2005, and the final report shall be submitted on or before January 15, 2006.
9. The provisions of this section shall expire on January 15, 2006.