FIRST REGULAR SESSION
[PERFECTED]
HOUSE SUBSTITUTE FOR
92ND GENERAL ASSEMBLY
Taken up for Perfection March 18, 2003. House Substitute for House Bill No. 10 ordered Perfected and printed.
STEPHEN S. DAVIS, Chief Clerk
AN ACT
To appropriate money for the expenses, grants, refunds, and distributions of the Department of Mental Health, the Board of Public Buildings, the Department of Health and Senior Services, and the several divisions and programs thereof, the Missouri Health Facilities Review Committee and the Commission for the Missouri Senior Rx Program to be expended only as provided in Article IV, Section 28 of the Constitution of Missouri, for the period beginning July 1, 2003 and ending June 30, 2004.
Be it enacted by the General Assembly of the state of Missouri, as follows:
There is appropriated out of the State Treasury, to be expended only as provided in Article IV, Section 28 of the Constitution of Missouri, for the purpose of funding each department, division, agency, and program enumerated in each section for the item or items stated, and for no other purpose whatsoever chargeable to the fund designated for the period beginning July 1, 2003 and ending June 30, 2004, as follows:
Section 10. 002. To the Department of Mental Health
For the purpose of funding Personal Service, Expense and Equipment, grants, refunds and distributions of the department
From General Revenue Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$509,234,658
From Federal Funds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .136,243,848E
From Mental Health Interagency Payments Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,322,098
From Facilities Maintenance Reserve Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1,197,230
From Mental Health Intergovernmental Transfer Fund. . . . . . . . . . . . . . . . . . . . . . .10,000,000
From General Revenue Reimbursements Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4,544,329
From Compulsive Gamblers Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 452,988
From Health Initiatives Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4,935,195
From Family Support Loan Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291,305
From Mental Health Earnings Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3,711,600
From Healthy Families Trust Fund-Health Care Account. . . . . . . . . . . . . . . . . . . . . .2,077,681
From Healthy Families Trust Fund-Tobacco Prevention Account. . . . . . . . . . . . . . . . .300,000
From Debt Offset Escrow Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70,000
From Mental Health Trust Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,273,223
Section 10.003. To the Department of Mental Health
There is transferred out of the State Treasury such amounts as may be necessary to transfer money among certain funds for the several divisions and programs of the department
From Department of Mental Health-Federal Fund. . . . . . . . . . . . . . . . . . . . . . . . . $19,811,800
From General Revenue Reimbursements Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2,700,000
From Escheats Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50,000
DEPARTMENT OF MENTAL HEALTH TOTALS
General Revenue Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$509,234,658
Federal Funds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .136,243,848
Other Funds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34,586,321
Total (Not to exceed 9,625.98 F.T.E.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$680,064,827
Section 10.004. To the Department of Health and Senior Services
For the purpose of funding Personal Service, Expense and Equipment, grants, refunds and distributions of the department provided: 1. For the purpose of funding family planning services, pregnancy testing and follow-up services, that none of these funds appropriated herein may be expended to directly or indirectly subsidize abortion services or administrative expenses. Abortion services include performing, assisting with, or directly referring for abortions, or encouraging or counseling patients to have abortions. Family planning services are preconception services that limit or enhance fertility, including contraception methods, the management of infertility, preconception counseling, education, and general reproductive health care. Follow-up services are services that supplement initial consultations for family planning services and pregnancy testing but do not include pregnancy or childbirth care. Nondirective counseling is defined as providing patients with a list of health care and social service providers that provide pregnancy, prenatal, delivery, infant care, foster care, adoption, alternative to abortion and abortion services and nondirective, non-marketing information in regard to such providers. Such list may categorize the providers by the service or services they provide. An organization that receives these funds may not directly refer patients who seek abortion services to any organization that provides abortion services, including its own independent affiliate. Nondirective counseling relating to pregnancy may be provided. None of these funds may be paid or granted to an organization or an affiliate of an organization that provides abortion services. An organization that receives these funds may not display or distribute marketing materials about abortion services to patients. An otherwise qualified organization shall not be disqualified from receipt of these funds because of its affiliation with an organization that provides abortion services, provided that the affiliated organization that provides abortion services is independent as determined by the conditions set forth in this section. To ensure that the state does not lend its imprimatur to abortion services, and to ensure that an organization that provides abortion services does not receive a direct or indirect economic or marketing benefit from these funds, an organization that receives these funds and its independent affiliate that provides abortion services may not share any of the following:
(a) The same or similar name;
(b) Medical or non-medical facilities, including but not limited to
business offices, treatment, consultation, examination, and waiting rooms;
(c) Expenses;
(d) Employee wages or salaries; or
(e) Equipment or supplies, including but not limited to computers,
telephone systems, telecommunications equipment and office supplies.
An independent affiliate that provides abortion services must be separately incorporated from any organization that receives these funds. An organization that receives these funds must maintain financial records that demonstrate strict compliance with this section and that demonstrate that its independent affiliate that provides abortion services receives no direct or indirect economic or marketing benefit from these funds. An independent audit shall be conducted at least once every three years to ensure compliance with this section. If the organization is an affiliate of an organization which provides abortion services, the independent audit shall be conducted at least annually. The audit shall be conducted by either an independent auditing firm retained by the department of health or by an independent auditing firm approved by the department and retained by an organization receiving these funds. Any organization receiving federal funds pursuant to Title X of the federal Public Health Services Act may perform services which are required under the federal act, but otherwise prohibited pursuant to this section if:
1) Specifically directed by United States Secretary of Health and Human Services to perform such services by written order directed to the organization; and
2) Such order is final and no longer subject to appeal, and
3) The refusal to perform such required services will result in the withholding of federal funds to said organization.
Federal statutory or regulatory provisions or guidelines of general application shall not constitute such written order as described herein.
2. If any provision of subsection 1 of this section is held invalid, the provision shall be severed from subsection 1 of this section and the remainder of subsection 1 of this section shall be enforced. If the entirety of subsection 1 of this section is held invalid, then this appropriation shall be in accordance with subsection 3 of this section; otherwise subsections 3 and 5 of this section shall have no effect.
3. For the purpose of funding family planning services, pregnancy testing, and follow-up services that are provided directly by the department of health or provided directly by government agencies of this state or provided directly by any political subdivision of this state or provided directly by community mental health centers organized pursuant to sections 205.975 to 205.990, RSMo, or provided directly by community action agencies organized pursuant to sections 660.370 to 660.374, RSMo, through contractual agreement with the department, provided that none of the funds appropriated herein may be expended to directly or indirectly subsidize abortion services or administrative expenses. Abortion services include performing, assisting with, or directly referring for abortions, or encouraging or counseling patients to have abortions. Family planning services are preconception services that limit or enhance fertility, including contraception methods, the management of infertility, preconception counseling, education, and general reproductive health care. Follow-up services are services that supplement initial consultations for family planning services and pregnancy testing but do not include pregnancy or childbirth care. Nondirective counseling is defined as providing patients with a list of health care and social service providers that provide pregnancy, prenatal, delivery, infant care, foster care, adoption, alternative to abortion and abortion services and nondirective, non-marketing information in regard to such providers. Such list may categorize the providers by the service or services they provide. An entity that receives funds pursuant to this subsection may not directly refer patients who seek abortion services to any organization that provides abortion services. Nondirective counseling relating to pregnancy may be provided. None of the funds provided pursuant to this subsection may be paid or granted to an entity that provides abortion services. Any entity receiving funds pursuant to this subsection may not display or distribute marketing materials about abortion services to patients. An independent audit shall be conducted at least once every three years to ensure compliance with this section. The audit shall be conducted by either an independent auditing firm retained by the department of health or by an independent auditing firm approved by the department and retained by the entity receiving these funds. Any entity receiving federal funds pursuant to Title X of the federal Public Health Services Act may perform services which are required under the federal act, but otherwise prohibited pursuant to this section if:
1) Specifically directed by the United States Secretary of Health and Human Services to perform such services by written order directed to the entity; and
2) Such order is final and no longer subject to appeal, and
3) The refusal to perform such required services will result in the withholding of federal funds to said entity.
Federal statutory or regulatory provisions or guidelines of general application shall not constitute such written order as described herein.
4. If the entirety of subsection 1 of this section is held invalid and any provision of subsection 3 of this section is held invalid, then this appropriation shall be in accordance with subsection 5; otherwise subsection 5 shall have no effect.
5. For the purpose of funding family planning services, pregnancy testing, and follow-up services that are provided directly by the department of health or provided by government agencies of this state or provided directly by any political subdivision of this state through contractual agreement with the department, provided that none of these funds appropriated herein may be expended to directly or indirectly subsidize abortion services or administrative expenses. Abortion services include performing, assisting with, or directly referring for abortions, or encouraging or counseling patients to have abortions. Family planning services are preconception services that limit or enhance fertility, including contraception methods, the management of infertility, preconception counseling, education, and general reproductive health care. Follow-up services are services that supplement initial consultations for family planning services and pregnancy testing but do not include pregnancy or childbirth care. Nondirective counseling is defined as providing patients with a list of health care and social service providers that provide pregnancy, prenatal, delivery, infant care, foster care, adoption, alternative to abortion and abortion services and nondirective, non-marketing information in regard to such providers. Such list may categorize the providers by the service or services they provide. The department and any other government entity receiving funds pursuant to this subsection may not directly refer patients who seek abortion services to any organization that provides abortion services. Nondirective counseling relating to pregnancy may be provided. None of the funds provided pursuant to this subsection may be paid or granted to a government entity that provides abortion services. The department and any other government entity receiving funds pursuant to this subsection may not display or distribute marketing materials about abortion services to patients. An independent audit shall be conducted at least once every three years to ensure compliance with this section. The audit shall be conducted by either an independent auditing firm retained by the department of health or by an independent auditing firm approved by the department and retained by the government entity receiving these funds. Any government entity receiving federal funds pursuant to Title X of the federal Public Health Services Act may perform services which are required under the federal act, but otherwise prohibited pursuant to this section if:
1) Specifically directed by the United States Secretary of Health and Human Services to perform such services by written order directed to the government entity; and
2) Such order is final and no longer subject to appeal, and
3) The refusal to perform such required services will result in the withholding of federal funds to said government entity.
Federal statutory or regulatory provisions or guidelines of general application shall not constitute such written order as described herein.
6. For the purpose of funding alternatives to abortion services, consisting of services or counseling offered to a pregnant woman and continuing for one year thereafter, to assist her in carrying her unborn child to term instead of having an abortion, and to assist her in caring for her dependent child or placing her child for adoption, including, but not limited to the following: prenatal care; medical and mental health care; parenting skills; drug and alcohol testing and treatment; child care; newborn or infant care; housing; utilities; educational services; food, clothing and supplies relating to pregnancy, newborn care and parenting; adoption assistance; job training and placement; establishing and promoting responsible paternity; ultrasound services; case management; domestic abuse protection; and transportation. Actual provision and delivery of such services shall be dependent on client needs and not otherwise prioritized by the department. Such services shall be available only during pregnancy and continuing for one year thereafter, and shall exclude any service of the type described in paragraphs 1 through 5. An independent audit shall be conducted annually to ensure compliance with this section. None of these funds shall be expended to perform or induce, assist in the performing or inducing of, or refer for, abortions; and none of these funds shall be granted to organizations or affiliates of organizations that perform or induce, assist in the performing or inducing of, or refer for, abortions
From General Revenue Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$84,552,947
From Federal Funds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .316,923,445E
From Department of Mental Health Interagency Payments Fund. . . . . . . . . . . . . . . . . .520,527
From Division of Aging Donations Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50,000
From Nursing Facility Quality of Care Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3,373,257
From Health Initiatives Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5,406,873
From Health Access Incentive Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,220,482
From Mammography Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70,402
From Division of Aging Elderly Home Delivered Meals Trust Fund. . . . . . . . . . . . . . 430,000
From Missouri Public Health Services Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3,215,501
From Professional & Practical Nursing Student Loan and Nurse Loan
Repayment Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .535,835
From Medical School Loan Repayment Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50,000
From Department of Health Document Services Fund. . . . . . . . . . . . . . . . . . . . . . . . . 815,012
From Workers Compensation Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140,163
From Department of Health-Donated Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4,514,453
From Healthy Families Trust Fund-Senior Catastrophic Prescription Account. . . . . . .980,000
From Hazardous Waste Remedial Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .241,409
From Missouri Senior Rx Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30,786,736
From Debt Offset Escrow Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50,000
From Organ Donation Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357,482
From Early Childhood Development Education and Care Fund. . . . . . . . . . . . . . . . . . 991,998
From Smith Memorial Endowment Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35,000
From Blindness Education Screening and Treatment Fund. . . . . . . . . . . . . . . . . . . . . . 250,000
From Missouri Lead Abatement Loan Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .276,000
From Crippled Children’s Service Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .275,000
Section 10.006. To the Department of Health and Senior Services
There is transferred out of the State Treasury such amounts as may be necessary to transfer money among certain funds for the several divisions and programs of the department
From Health Initiatives Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$4,268,003
From Healthy Families Trust Fund-Senior Catastrophic Prescription Account. . . . 19,199,041
DEPARTMENT OF HEALTH TOTALS
General Revenue Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$84,552,947
Federal Funds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .316,923,445
Other Funds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57,015,603
Total (Not to exceed 2,184.16 F.T.E.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$458,491,995