FIRST REGULAR SESSION

SENATE COMMITTEE SUBSTITUTE FOR

HOUSE SUBSTITUTE FOR

HOUSE BILL NO. 11

92ND GENERAL ASSEMBLY



0011S.04C


AN ACT

To appropriate money for the expenses, grants, and distributions of the Department of Social Services and the several divisions and programs thereof 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 11.005. To the Department of Social Services

For the Office of the Director

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 603,097



Personal Service 12,133

Expense and Equipment 1,500

From Federal Funds 13,633



Personal Service 41,764

Expense and Equipment 17,300

From Child Support Collections Fund 59,064

Total (Not to exceed 10.58 F.T.E.) $675,794



Section 11.010. To the Department of Social Services

For the Office of the Director

For the purpose of funding contractual services with Legal Services Corporations in Missouri which provide legal services to low-income Missouri citizens. Funds shall be allocated according to the most recent national census data for the population of poor persons living in Missouri and in the same manner as current allocation from the Legal Services Corporation. Funding shall not be allocated if the provisions of Section 504(a)(7) and Section 508(b)(2)(B) of the Omnibus 1996 Appropriations Bill have not been met by the Legal Services Corporation. Contracts for services should provide low-income Missouri citizens equal access to the civil justice system, with high priority on families and children, domestic violence, the elderly, and qualification for benefits under the Social Security Act and the Work Opportunity Reconciliation Act of 1996. Contractors shall provide to the department a report of services rendered, including the number of low-income citizens served, the types of services provided, the cost per case, and the amount of free and reduced-fee legal services which have been provided; and shall include a full accounting of all expenditures made by or on behalf of Legal Services Corporations in Missouri which shall include expenditures of all federal, state, and other funds. An accounting shall be made for the first six months from July 1, 2003 through December 31, 2003 and a final accounting for the year through June 30, 2004, and these reports shall include a comparison with all expenditures for Fiscal Year 2003. The accountings shall be delivered to the General Assembly, including the House Budget Committee Chair, the House Appropriations Committee - Social Services Chair, the Senate Appropriations Committee Chair, and also to all current House Appropriations Committee - Social Services members, no later than January 31, 2004, and July 31, 2004 respectively

From Legal Services for Low-Income People Fund $5,290,610E



Section 11.015. There is transferred out of the State Treasury, chargeable to the Basic Civil Legal Services Fund, Five Million, Two Hundred Ninety Thousand, Six Hundred Ten Dollars ($5,290,610) to the Legal Services for Low-Income People Fund

From Basic Civil Legal Services Fund $5,290,610E



Section 11.020. To the Department of Social Services

For the Office of the Director

For the purpose of receiving and expending donations and federal funds provided that the General Assembly shall be notified of the source of any new funds and the purpose for which they shall be expended, in writing, prior to the use of said funds

From Federal and Other Funds $12,429,000



Section 11.025. To the Department of Social Services

For Administrative Services

For the Division of General Services

For the purpose of funding operating maintenance and repair

From Facilities Maintenance Reserve Fund $30,708

From Federal Funds 10,138



For the Division of Youth Services

For the purpose of funding operating maintenance and repair

From Facilities Maintenance Reserve Fund 78,794

From Federal Funds 138,243

Total $257,883



Section 11.030. To the Department of Social Services

For the Office of Director

For the Human Resources Center

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 452,765



Personal Service 190,653

Expense and Equipment 41,089

From Federal Funds 231,742

Total (Not to exceed 18.23 F.T.E.) $684,507



Section 11.035. To the Department of Social Services

For Administrative Services

For the Division of Budget and Finance

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 1,989,785



Personal Service 422,380

Expense and Equipment 116,518

From Federal Funds 538,898

Total (Not to exceed 68.38 F.T.E.) $2,528,683



Section 11.040. To the Department of Social Services

For Administrative Services

For the Division of Budget and Finance

For the payment of fees to contractors who engage in revenue maximization projects on behalf of the Department of Social Services

From Federal Funds $1,000,000E



Section 11.045. To the Department of Social Services

For Administrative Services

For the Division of Budget and Finance

For the purpose of funding the receipt and disbursement of refunds and incorrectly deposited receipts to allow the over-collection of accounts receivables to be paid back to the recipient

From Federal and Other Funds $2,500,000E



Section 11.050. To the Department of Social Services

For Administrative Services

For the Division of Budget and Finance

For the purpose of funding payments to counties toward the care and maintenance of each delinquent or dependent child as provided in Chapter 211.156, RSMo

From General Revenue Fund $3,192,000



Section 11.055. To the Department of Social Services

For the Information Services and Technology Division

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 6,120,456



Personal Service 4,540,503

Expense and Equipment 25,547,990

From Federal Funds 30,088,493



Personal Service 241,055

Expense and Equipment 2,779,477

From Child Support Enforcement Collections Fund 3,020,532



Personal Service 36,524

Expense and Equipment 403,289

From Administrative Trust Fund 439,813



Expense and Equipment

From Education Improvement Fund 127,238



Personal Service 7,331

Expense and Equipment 43,271

From Third Party Liability Collections Fund 50,602

Total (Not to exceed 185.89 F.T.E.) $39,847,134



Section 11.060. To the Department of Social Services

For Administrative Services

For the purpose of funding the Division of General Services

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 2,213,429



Personal Service 242,488

Expense and Equipment 83,672

From Federal Funds 326,160



Personal Service

From Child Support Enforcement Fund 95,627



For the purpose of funding the centralized inventory system

Expense and Equipment

From Administrative Trust Fund 5,750,000

Total (Not to exceed 77.76 F.T.E.) $8,385,216



Section 11.065. To the Department of Social Services

For Administrative Services

For the purpose of funding the Division of Legal Services

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 2,095,591



Personal Service 2,823,231

Expense and Equipment 779,092

From Federal Funds 3,602,323



Personal Service 488,298

Expense and Equipment 318,163

From Third Party Liability Collections Fund 806,461



Personal Service

From Child Support Enforcement Fund 147,745

Total (Not to exceed 149.74 F.T.E.) $6,652,120



Section 11.100. To the Department of Social Services

For the Family Support Division

For the purpose of funding division administration, provided that this appropriation may be used to support the administration of the Children's Division

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 1,787,659



Personal Service 6,068,410

Expense and Equipment 6,363,452

From Federal Funds 12,431,862



Expense and Equipment

From Third Party Liability Collections Fund 134,577



Personal Service 1,346,002

Expense and Equipment 134,847

From Child Support Enforcement Collections Fund 1,480,849



Expense and Equipment

From Administrative Trust Fund 39,690



Expense and Equipment

From Blind Pension Fund 62,417

Total (Not to exceed 237.66 F.T.E.) $15,937,054



Section 11.105. To the Department of Social Services

For the Family Support Division

For the income maintenance field staff and operations, provided that this appropriation may be used to support Children's Division Field Staff and Operations

Personal Service and/or Expense and Equipment, provided that not more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund $27,948,342



Personal Service 60,734,831

Expense and Equipment 4,398,163

From Federal Funds 65,132,994



Personal Service 663,295

Expense and Equipment 28,252

From Health Initiatives Fund 691,547

Total (Not to exceed 3,050.77 F.T.E.) $93,772,883



Section 11.110. To the Department of Social Services

For the Family Support Division

For the income maintenance staff training, provided that this appropriation may be used to support Children's Division staff training

From General Revenue Fund $545,999

From Federal Funds 164,591

Total $710,590



Section 11.115. To the Department of Social Services

For the Family Support Division

For the purpose of funding the electronic benefit transfers (EBT) system to reduce fraud, waste, and abuse

Expense and Equipment

From General Revenue Fund $3,259,735

From Federal Funds 2,564,886

Total $5,824,621



Section 11.120. To the Department of Social Services

For the Family Support Division

For the purpose of funding the receipt of funds from the Polk County and Bolivar Charitable Trust for the exclusive benefit and use of the Polk County Office

From Charitable Trust Account $10,000



Section 11.125. To the Department of Social Services

For the Family Support Division

For the purpose of funding contractor, hardware, and other costs associated with planning, development, and implementation of a Family Assistance Management Information System (FAMIS)

From General Revenue Fund $2,451,822

From Federal Funds 3,789,073

Total $6,240,895



Section 11.130. To the Department of Social Services

For the Family Support Division

For the purpose of funding Community Partnerships

Personal Service

From General Revenue Fund $161,956



For grants and contracts to Community Partnerships and other community initiatives and related expenses

From General Revenue Fund 2,890,268

From Federal Funds 7,483,799



For Missouri Mentoring Partnership

From General Revenue Fund 495,715

From Federal Funds 778,143





For Missouri Mentoring Partnership, contingent upon the availability of

additional new revenue for fiscal year 2004 as authorized in

legislation in 2003 by the 92nd General Assembly and approved

by the Governor and/or voters

From General Revenue Fund 705,142

Total (Not to exceed 5.38 F.T.E.) $12,515,023



Section 11.135. To the Department of Social Services

For the Family Support Division

For the purpose of funding Food Stamp work training-related expenses

From General Revenue Fund $82,000

From Federal Funds 5,300,000

Total $5,382,000



Section 11.140. To the Department of Social Services

For the Family Support Division

For the purpose of funding the payment of Temporary Assistance for Needy Families benefits

From General Revenue Fund $17,287,706

From Federal Funds 118,545,760E

Total $135,833,466



Section 11.145. To the Department of Social Services

For the Family Support Division

For the purpose of funding Grandparent Foster Care payments

From General Revenue Fund $7,282,030



Section 11.150. To the Department of Social Services

For the Family Support Division

For the purpose of funding supplemental payments to aged or disabled persons

From General Revenue Fund $210,000



Section 11.155. To the Department of Social Services

For the Family Support Division

For the purpose of funding nursing care payments to aged, blind, or disabled persons, provided a portion of this appropriation may be transferred to the Department of Mental Health for persons removed from the Supplemental Nursing Care Program and placed in the Supported Housing Program, resulting in a reduction of Department of Mental Health supplemental nursing home clients and for personal funds to recipients of Supplemental Nursing Care payments as required by Section 208.030, RSMo

From General Revenue Fund $25,538,684



Section 11.158. To the Department of Social Services

For the Family Support Division

For the purpose of funding General Relief Program payments,

contingent upon the availability of additional new revenue

for fiscal year 2004 as authorized in legislation in 2003 by

the 92nd General Assembly and approved by the Governor

and/or voters

From General Revenue Fund $10,200,000



Section 11.160. To the Department of Social Services

For the Family Support Division

For the purpose of funding receipt and disbursement of Supplemental Security Income Program payments and funding General Relief benefits payable for periods prior to July 1, 2003. Funds appropriated in this section shall not provide for General Relief cash benefits for periods after June 30, 2003

From Federal Funds $4,000,000



Section 11.165. To the Department of Social Services

For the Family Support Division

For the purpose of funding Blind Pension and supplemental payments to blind persons

From Blind Pension Fund $20,580,572



Section 11.170. To the Department of Social Services

For the Family Support Division

For the purpose of funding benefits and services as provided by the Indochina Migration and Refugee Assistance Act of 1975 as amended

From Federal Funds $3,812,553



Section 11.175. To the Department of Social Services

For the Family Support Division

For the purpose of funding community services programs provided by Community Action Agencies, including programs to assist the homeless, under the provisions of the Community Services Block Grant

From Federal Funds $19,144,171



Section 11.180. To the Department of Social Services

For the Family Support Division

For the purpose of funding grants for local initiatives to assist the homeless

From Federal Funds $500,000



Section 11.185. To the Department of Social Services

For the Family Support Division

For the purpose of funding the Emergency Shelter Grant Program

From Federal Funds $1,340,000



Section 11.190. To the Department of Social Services

For the Family Support Division

For the purpose of funding the Surplus Food Distribution Program and the receipt and disbursement of Donated Commodities Program payments

From Federal Funds $1,000,000



Section 11.195. To the Department of Social Services

For the Family Support Division

For the purpose of funding the Low-Income Home Energy Assistance Program

From Federal Funds $40,794,695E



Section 11.200. To the Department of Social Services

For the Family Support Division

For the purpose of funding administration of blind services

Personal Service $3,093,020

Expense and Equipment 893,411

From Federal Funds 3,986,431



Personal Service 854,016

Expense and Equipment 210,637

From Blind Pension Funds 1,064,653

Total (Not to exceed 129.53 F.T.E.) $5,051,084



Section 11.205. To the Department of Social Services

For the Family Support Division

For the purpose of funding services for the visually impaired

From Federal Funds $5,085,000

From Blind Pension Fund 1,549,935

From Donated Funds 100,000

Total $6,734,935



Section 11.210. To the Department of Social Services

For the Family Support Division

For the purpose of funding Child Support Enforcement Field Staff and Operations

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 540,653



Personal Service 22,917,908

Expense and Equipment 7,528,116

From Federal Funds 30,446,024



Personal Service 5,911,198

Expense and Equipment 1,929,481

From Child Support Enforcement Collections Fund 7,840,679



For the purpose of funding mediation services, contingent upon the

availability of additional new revenue for fiscal year 2004 as

authorized in legislation in 2003 by the 92nd General Assembly

and approved by the Governor and/or voters

From General Revenue Fund 100,000

Total $38,927,356



Section 11.215. To the Department of Social Services

For the Family Support Division

For the purpose of funding payments to private agencies collecting child support orders and arrearages

From Child Support Enforcement Collections Fund $510,000

From Federal Funds 990,000

Total $1,500,000



Section 11.220. To the Department of Social Services

For the Family Support Division

For the purpose of funding contractual agreements with local governments in certain paternity establishment and child support enforcement cases

From Child Support Enforcement Collections Fund $653,000

From Federal Funds 1,270,000

Total $1,923,000



Section 11.225. To the Department of Social Services

For the Family Support Division

For the purpose of funding reimbursement to counties and the City of St. Louis providing child support enforcement services

From Federal Funds $8,200,000E



Section 11.230. To the Department of Social Services

For the Family Support Division

For the purpose of funding payment to the federal government for reimbursement of federal Temporary Assistance for Needy Families payments, incentive payments to local governments and other states, refunds of bonds, refunds of support payments or overpayments, and distributions to families

From Federal Funds $36,000,000E

From Alternative Care Trust Fund 167,000

From Debt Offset Escrow Fund 9,000,000E

Total $45,167,000



Section 11.235. To the Department of Social Services

For the Children's Division

For division administration provided this appropriation may be used to support administration of the Family Support Division

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 1,211,548



Personal Service 3,227,622

Expense and Equipment 2,837,427

From Federal Funds 6,065,049



Personal Service 40,716

Expense and Equipment 11,856

From Early Childhood Trust Fund 52,572



Expense and Equipment

From Third Party Liability Collections Fund 163,323

Total (Not to exceed 119.01 F.T.E.) $7,492,492



Section 11.240. To the Department of Social Services

For the Children's Division

For the Children's Field Staff and Operations, provided that this appropriation may be used to support Family Support Division Income Maintenance Field Staff and Operations

Personal Service and/or Expense and Equipment, provided that not more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund $25,022,787



Personal Service 38,515,828

Expense and Equipment 4,461,573

From Federal Funds 42,977,401



Personal Service 49,718

Expense and Equipment 28,209

From Health Initiatives Fund 77,927

Total (Not to exceed 2,013.24 F.T.E.) $68,078,115



Section 11.245. To the Department of Social Services

For the Children's Division

For Children's Staff Training, provided that this appropriation may be used to support Family Support Division Income Maintenance Staff Training

From General Revenue Fund $1,274,001

From Federal Funds 384,041

Total $1,658,042



Section 11.250. To the Department of Social Services

For the Children's Division

For the purpose of funding children's treatment services, including, but not limited to, home-based services, day treatment services, preventive services, child care, family reunification services, or intensive in-home services

From General Revenue Fund $8,329,815

From Federal Funds 5,486,047

Total $13,815,862



Section 11.255. To the Department of Social Services

For the Children's Division

For the purpose of funding placement costs including Foster Care payments, related services, expenses related to training of foster parents, Residential Treatment placements and therapeutic treatment services, and for the diversion of children from inpatient psychiatric treatment and services provided through comprehensive, expedited permanency systems of care for children and families

From General Revenue Fund $56,261,647

From Federal Funds 52,503,972



For the purpose of enhancing current foster care case management

contracts to increase service delivery to children and families.

The purpose of these services shall be to help children who

are at risk of being removed from their family because of

abuse or neglect. Services may also be provided to children

and families to expedite reunifications. Services eligible

under this provision may include Intensive In-Home

Services, Family Reunification Services, and specialized

recruitment and training of foster care families. Funding

may also be used for limited emergency resources for

families.

From Federal Funds 5,000,000

Total $113,765,619



Section 11.260. To the Department of Social Services

For the Children's Division

For the purpose of funding Adoption and Guardianship subsidy payments and related services

From General Revenue Fund $42,039,634

From Federal Funds 18,084,646

Total $60,124,280



Section 11.265. To the Department of Social Services

For the Children's Division

For the purpose of funding independent living placements and transitional living payment services

From Federal Funds $3,393,228



Section 11.270. To the Department of Social Services

For the Children's Division

For the purpose of funding appropriations for children's treatment services, alternative care placement services, adoption subsidy services, independent living services, and services provided through comprehensive, expedited permanency systems of care for children and families

From General Revenue Fund $9,678,918

From Federal Funds 9,273,261

Total $18,952,179



Section 11.275. To the Department of Social Services

For the Children's Division

For the purpose of funding Regional Child Assessment Centers

From General Revenue Fund $1,749,583



Section 11.280. To the Department of Social Services

For the Children's Division

For the purpose of funding diversion of children from inpatient psychiatric treatment and to provide services to reduce the number of children's inpatient medical hospitalization days

From General Revenue Fund $6,561,278

From Federal Funds 9,691,373

Total $16,252,651



Section 11.285. To the Department of Social Services

For the Children's Division

For the purpose of funding residential placement payments to counties for children in the custody of juvenile courts

From Federal Funds $700,000



Section 11.290. To the Department of Social Services

For the Children's Division

For the purpose of funding services and programs to assist victims of domestic violence

From General Revenue Fund $3,655,000

From Federal Funds 1,687,653



For the purpose of funding services and programs to assist victims

of domestic violence, contingent upon the availability of

additional new revenue for fiscal year 2004 as authorized in

legislation in 2003 by the 92nd General Assembly and approved

by the Governor and/or voters

From General Revenue Fund 645,000

Total $5,987,653



Section 11.295. To the Department of Social Services

For the Children's Division

For the purpose of funding the Child Abuse and Neglect Prevention Grant and Children Justice Act Grant

From Federal Funds $1,000,000



Section 11.300. To the Department of Social Services

For the Children's Division

For the purpose of funding transactions involving personal funds of children in the custody of the Children's Division or the Division of Youth Services

From Alternative Care Trust Fund $12,000,000E



Section 11.305. To the Department of Social Services

For the Children's Division

For the purpose of funding Child Care Services and to support the Educare Program not to exceed $3,000,000 expenses

From General Revenue Fund $52,112,362

From Federal Funds 106,628,422

From Early Childhood Development, Education and Care Fund 1,548,152



For the purpose of payments to accredited child care providers pursuant to Chapter 313, RSMo

From Early Childhood Development, Education and Care Fund 3,446,898



For the purpose of funding early childhood start-up and expansion grants pursuant to Chapter 313, RSMo

From Early Childhood Development, Education and Care Fund 4,136,278



For the purpose of funding early childhood development, education, and care programs for low-income families pursuant to Chapter 313, RSMo

From Early Childhood Development, Education and Care Fund 3,446,898



For the purpose of funding certificates to low-income, at-home families for Chapter 313, RSMo

From Early Childhood Development, Education and Care Fund 3,446,898



For the purpose of funding child care services, contingent upon

the availability of additional new revenue

for fiscal year 2004 as authorized in legislation in 2003 by

the 92nd General Assembly and approved by the Governor

and/or voters

From General Revenue Fund 7,200,000

Total $181,965,908



Section 11.315. To the Department of Social Services

For the Division of Youth Services

For the purpose of funding Central Office and Regional Offices

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 2,062,546



Personal Service 543,939

Expense and Equipment 117,846

From Federal Funds 661,785

Total (Not to exceed 61.57 F.T.E.) $2,724,331



Section 11.320. To the Department of Social Services

For the Division of Youth Services

For the purpose of funding treatment services, including foster care and contractual payments

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund 32,529,665



Personal Service 6,627,582

Expense and Equipment 7,073,293

From Federal Funds 13,700,875



Personal Service 2,394,837

Expense and Equipment 3,715,760

From DOSS Educational Improvement Fund 6,110,597



Personal Service 107,219

Expense and Equipment 10,135

From Health Initiatives Fund 117,354

Total (Not to exceed 1,392.00 F.T.E.) $52,458,491



Section 11.325. To the Department of Social Services

For the Division of Youth Services

For the purpose of funding incentive payments to counties for community-based treatment programs for youth. Up to $500,000 from the Gaming Commission Fund appropriated within this

section may be used for funding treatment services, including

foster care and contractual payments

From General Revenue Fund $3,884,412

From Gaming Commission Fund 500,000

Total $4,384,412



Section 11.400. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding administrative services. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

Personal Service and/or Expense and Equipment, provided that not

more than fifteen percent (15%) flexibility is allowed between

each appropriation

From General Revenue Fund $7,057,156



Personal Service 5,358,625

Expense and Equipment 6,754,641

From Federal Funds 12,113,266



Personal Service 16,810

Expense and Equipment 5,110

From Pharmacy Rebates Fund 21,920



Personal Service 266,394

Expense and Equipment 31,385

From Health Initiatives Fund 297,779



Personal Service 71,346

Expense and Equipment 10,281

From Nursing Quality of Care Fund 81,627



Personal Service 250,625

Expense and Equipment 1,414,665

From Third Party Liability Collections Fund 1,665,290

Total (Not to exceed 291.44 F.T.E.) $21,237,038



Section 11.405. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding women and minority health care outreach programs, contingent upon the availability of additional new revenue for fiscal year 2004 as authorized in legislation in 2003 by the 92nd General Assembly and approved by the Governor

and/or voters. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $750,000

From Federal Funds 750,000

Total $1,500,000



Section 11.410. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding a revenue maximization unit in the Division of Medical Services. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

Personal Service $81,000

Expense and Equipment 8,286

From Federal Reimbursement Allowance Fund 89,286



Personal Service 81,000

Expense and Equipment 8,286

From Federal Funds 89,286

Total (Not to exceed 4.00 F.T.E.) $178,572



Section 11.415. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding fees associated with third-party collections and other revenue maximization cost avoidance fees. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From Federal Funds $1,000,000E

From Third Party Liability Collections Fund 1,000,000E

Total $2,000,000



Section 11.420. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding the operation of the information systems. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $6,892,792

From Federal Funds 18,473,731

Total $25,366,523



Section 11.425. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding contractor payments associated with managed care eligibility and enrollment of Medicaid recipients. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $109,586

From Federal Funds 3,110,113

Total $3,219,699



Section 11.430. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding pharmaceutical payments under the Medicaid fee-for-service and managed care programs and for the purpose of funding professional fees for pharmacists. Prior to the implementation of a preferred drug product list, the Division of Medical Services must submit to the Budget Chairman of the House and the Appropriations Chairman of the Senate a study which outlines the impact of such restrictions on patient care and the entire Medicaid budget. A portion of funding provided within this section, $16,442,080 from the General Revenue Fund and $26,109,887 from Federal Funds, is contingent upon both the passage of legislation authorizing the pharmacy provider tax and the approval of the pharmacy provider tax by the Federal Centers for Medicare and Medicaid Services (CMS), each of which must be in an amount sufficient to provide for Fiscal Year 2004 appropriations made from the Pharmacy Federal Reimbursement Allowance Fund. If these contingencies are not satisfied then the appropriation for the contingent funding noted above is revoked and the base dispensing fee, before any related provider tax adjustment, shall be lesser of $4.09 or the lowest dispensing fee accepted by the pharmacy from any insurer or other third party payer; further, a component in determining ingredient cost reimbursement will include the flat Wholesale Acquisition Cost (WAC). The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $245,925,389

From Federal Funds 575,820,062

From Pharmacy Rebates Fund 59,633,179E

From Pharmacy Reimbursement Allowance Fund 54,255,870

From Health Initiatives Fund 969,293

From Healthy Families Trust Fund-Health Care Account 1,041,034



For the purpose of funding pharmaceutical payments under the Medicaid

fee-for-service and managed care programs and for the purpose

of funding professional fees for pharmacists. Medications will be

available under the state Medicaid plan without restriction/prior

authorization for persons with mental illnesses, except where

generics are available, shall include atypical antipsychotic

medications, conventional antipsychotic medications, anti-

convulsants, and other medications used for the treatment of

mental illnesses. The funding and language within this line item

are contingent upon the availability of additional new revenue

for fiscal year 2004 as authorized in legislation in 2003 by

the 92nd General Assembly and approved by the Governor

and/or voters. The single agency administering the Medicaid

program is only authorized to reimburse for benefits that exceed

a recipient's spend down amount

From General Revenue Fund 7,200,000

From Federal Funds 11,800,000

Total $956,644,827



Section 11.435. There is transferred out of the State Treasury, chargeable to the General Revenue Fund, Thirty Million Dollars ($30,000,000) to the Pharmacy Reimbursement Allowance Fund

From General Revenue Fund $30,000,000E



Section 11.440. There is transferred out of the State Treasury, chargeable to the Pharmacy Reimbursement Allowance Fund, Thirty Million Dollars ($30,000,000) to the General Revenue Fund as a result of recovering the Pharmacy Reimbursement Allowance Fund

From Pharmacy Reimbursement Allowance Fund $30,000,000E



Section 11.445. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding physician services and related services, including, but not limited to, clinic and podiatry services, physician-sponsored services and fees, laboratory and x-ray services, and family planning services under the Medicaid fee-for-service and managed care programs. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $108,792,330

From Federal Funds 182,083,076

From Health Initiatives Fund 1,247,544

From Healthy Families Trust Fund-Health Care Account 1,041,034

Total $293,163,984



Section 11.450. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding dental services for children under the Medicaid fee-for-service and managed care programs. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $2,693,467

From Federal Funds 5,750,170

From Health Initiatives Fund 71,162

From Healthy Families Trust Fund-Health Care Account 848,773

Total $9,363,572



Section 11.455. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding payments to third-party insurers, employers, or policyholders for health insurance. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $31,199,490

From Federal Funds 50,414,133

Total $81,613,623



Section 11.460. To the Department of Social Services

For the Division of Medical Services

For funding long-term care services

For the purpose of funding home health, respite care, homemaker chore, personal care, advanced personal care, adult day care, AIDS, children's waiver services, Program for All-Inclusive Care for the Elderly, and other related services under the Medicaid fee-for-service and managed care programs. Provided that an individual eligible for or receiving nursing home care must be given the opportunity to have those Medicaid dollars follow them to the community to the extent necessary to meet their unmet needs as determined by 13 CSR 15 9.030(5) and further be allowed to choose the personal care program option in the community that best meets the individuals' unmet needs. This includes the Consumer Directed Medicaid State Plan Amendment that is administered by the Division of Vocational Rehabilitation in the Department of Elementary and Secondary Education. And further provided that individuals eligible for the Medicaid Personal Care Option must be allowed to choose, from among all the program options, that option which best meets their unmet need as determined by 13 CSR 15 9.030(5); and also be allowed to have their Medicaid funds follow them to the extent necessary to meet their unmet needs whichever option they choose. This language does not create any entitlements not established by statute. The single state agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $104,484,839

From Federal Funds 167,638,867

From Health Initiatives Fund 159,305



For the purpose of funding care in nursing facilities, Program for All-Inclusive Care for the Elderly, or other long-term care services under the Medicaid fee-for-service and managed care programs. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund 85,896,423

From Federal Funds 261,666,235

From Uncompensated Care Fund 58,516,478

From Intergovernmental Transfer Fund 20,000,000

From Nursing Facility Federal Reimbursement Allowance Fund 7,000,000

From Healthy Families Trust Fund-Health Care Account 17,973

Total $705,380,120



Section 11.465. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding all other non-institutional services, including, but not limited to, rehabilitation, optometry, audiology, ambulance, non-emergency medical transportation, durable medical equipment, and eyeglasses following cataract surgery under the Medicaid fee-for-service and managed care programs. A portion of this funding allows for contracted services related to prior authorization of certain Medicaid services. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $33,639,055

From Federal Funds 55,862,176

From Healthy Families Trust Fund-Health Care Account 831,745

From Health Initiatives Fund 194,881



For the purpose of funding non-emergency medical transportation. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund 9,576,589

From Federal Funds 11,976,589



For the purpose of funding non-emergency medical transportation,

contingent upon the availability of additional new revenue

for fiscal year 2004 as authorized in legislation in 2003 by

the 92nd General Assembly and approved by the Governor

and/or voters. The single agency administering the Medicaid

program is only authorized to reimburse for benefits that exceed a

recipient's spend down amount

From General Revenue Fund 4,000,000

From Federal Funds 4,000,000

Total $120,081,035



Section 11.470. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding the payment to comprehensive prepaid health care plans or for payments to providers of health care services for persons eligible for medical assistance under the Medicaid fee-for-service programs or State Medical Program as provided by federal or state law or for payments to programs authorized by the Frail Elderly Demonstration Project Waiver as provided by the Omnibus Budget Reconciliation Act of 1990 (P.L. 101-508, Section 4744) and by Section 208.152 (22), RSMo. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $162,875,631

From Federal Funds 459,515,560

From Health Initiatives Fund 8,270,848

From Federal Reimbursement Allowance Fund 107,540,525

From Healthy Families Trust Fund-Health Care Account 4,447,110

Total $742,649,674



Section 11.475. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding hospital care under the Medicaid fee-for-service and managed care programs. The Division of Medical Services may adjust SFY 2004 costs of the uninsured payments to hospitals to reflect the impact on hospitals of the elimination of Medicaid coverage for adults with incomes above 77 percent of the federal poverty level and who were covered through a Section 1931 transfer. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $16,385,660

From Federal Funds 349,336,474

From Uncompensated Care Fund 29,383,522

From Federal Reimbursement Allowance Fund 108,958,465

From Health Initiatives Fund 2,797,179

From Healthy Families Trust Fund-Health Care Account 2,365,987



For Safety Net Payments

From Healthy Families Trust Fund-Health Care Account 30,365,444



For Graduate Medical Education

From Health Families Trust Fund-Health Care Account 10,000,000



For the purpose of funding a community-based care coordinating

program that includes in-home visits and/or phone contact

by a nurse care manager of electronic monitor. The purpose of

such program shall be to ensure that patients are discharged

from hospitals to an appropriate level of care and services

and that targeted Medicaid beneficiaries with chronic illnesses

and high-risk pregnancies receive care in the most cost-

effective setting. Areas of implementation shall include but not

be limited to Greene County. The project shall be contingent

upon adoption of an offsetting increase in the applicable provider

tax and administered by the Division of Medical Services' Disease

Management Program.

From Federal Funds 80,000

From Federal Reimbursement Allowance Fund 80,000



For the purpose of establishing an emergency department diversion

program designed to enhance access to primary care physician

services in lieu of emergency department services. Hospitals

may collaborate with the department to establish an enhanced

fee schedule for physicians identified by such hospitals to

participate in the emergency department diversion programs,

contingent upon adoption of an offsetting increase in the

applicable provider tax.

From Federal Funds $15,000,000

From Federal Reimbursement Fund 10,000,000



For the purpose of funding hospital care under the Medicaid fee-for-

service and managed care programs, and funding for hospital-

employed, Medicaid enrolled physicians in the emergency

department of Level I, II, II Trauma Centers as defined by

the Department of Health & Senior Services and Critical

Access Hospitals as defined by the Department of Social

Services Division of Medical Services, contingent upon

adoption of an offsetting increase in the applicable provider

tax.

From Federal Funds 30,000,000

From Federal Reimbursement Allowance Fund 20,000,000



For the purpose of continuing funding in Southwest Missouri of the

pager project designed to assist those Medicaid recipients with a

high utilization of pharmaceuticals in order to treat chronic

illness. Additionally, such project will be replicated in

metropolitan Kansas City. The project shall be contingent

upon adoption of an offsetting increase in the applicable

provider tax and administered by the Division of Medical

Services' Disease Management Program.

From Federal Funds 60,000

From Federal Reimbursement Fund 60,000

Total $624,872,731



Section 11.476. To the Department of Social Services

For the Division of Medical Services

For payment to Tier 1 Safety Net Hospitals, by maximizing eligible

costs for federal Medicaid funds, utilizing current state and

local funding sources as match for services that are not currently

matched with federal Medicaid payments.

From Federal Funds $23,000,000



Section 11.485. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding payments to hospitals under the Federal Reimbursement Allowance Program and for the expenses of the Poison Control Center in order to provide services to all hospitals within the state. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From Federal Funds $384,999,999E

From Federal Reimbursement Allowance Fund 1E

Total $385,000,000



Section 11.490. To the Department of Social Services

For the Division of Medical Services

For funding programs to enhance access to health care for uninsured adults by using fee-for-service, prepaid health plans, or other alternative service delivery and reimbursement methodology approved by the director of the Department of Social Services. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $2,286,649

From Federal Funds 3,076,630

From Federal Reimbursement Allowance Fund 423,516

From Pharmacy Reimbursement Allowance Fund 89,128



For the purpose of funding health care services provided to uninsured adults through local initiatives for the uninsured. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From Federal and Other Funds 1E

Total $5,875,924



Section 11.495. To the Department of Social Services

For the Division of Medical Services

For funding programs to enhance access to care for uninsured children using fee-for-services, prepaid health plans, or other alternative service delivery and reimbursement methodology approved by the director of the Department of Social Services. In order to be eligible, and pursuant to the provisions of Sections 208.631 to 208.657, RSMo, parents and guardians of uninsured children with incomes between two hundred twenty-six and three hundred percent of the federal poverty level shall submit with their application two health insurance quotes from insurers providing services in their community. Said quotes shall exceed one hundred thirty-three percent of the average monthly premium currently required in the Missouri Consolidated Health Care Plan. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $11,095,939

From Federal Funds 68,489,763

From Federal Reimbursement Allowance Fund 8,300,000

From Health Initiatives Fund 4,999,173

From Pharmacy Rebates Fund 755,579

From Pharmacy Reimbursement Allowance Fund 201,394

From Premium Fund 1,000,000

Total $94,841,848



Section 11.500. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding uncompensated care payments to the St. Louis Regional Disproportionate Share Hospital funding authority

From Federal Funds $25,000,000E



Section 11.505. There is transferred out of the State Treasury, chargeable to the General Revenue Fund, $180,000,000 to the Federal Reimbursement Allowance Fund

From General Revenue Fund $180,000,000E



Section 11.510. There is transferred out of the State Treasury, chargeable to the Federal Reimbursement Allowance Fund, $180,000,000 to the General Revenue Fund as a result of reconciling the Federal Reimbursement Allowance Fund

From Federal Reimbursement Allowance Fund $180,000,000E



Section 11.515. There is transferred out of the State Treasury, chargeable to the General Revenue Fund, $120,000,000 to the Nursing Facility Federal Reimbursement Allowance Fund

From General Revenue Fund $120,000,000E



Section 11.520. There is transferred out of the State Treasury, chargeable to the Nursing Facility Federal Reimbursement Allowance Fund, $120,000,000 to the General Revenue Fund as a result of reconciling the Nursing Facility Federal Reimbursement Allowance Fund

From Nursing Facility Federal Reimbursement Allowance Fund $120,000,000E



Section 11.525. There is transferred out of the State Treasury, chargeable to the Nursing Facility Federal Reimbursement Allowance Fund, $1,500,000 to the Nursing Facility Quality of Care Fund

From Nursing Facility Federal Reimbursement Allowance Fund $1,500,000



Section 11.530. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding Nursing Facility Federal Reimbursement Allowance payments as provided by law. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From Federal Funds $184,999,999E

From Nursing Facility Federal Reimbursement Allowance Fund 1E

Total $185,000,000



Section 11.535. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding Medicaid services for the Department of Elementary and Secondary Education under the Medicaid fee-for-service and managed care programs. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From Federal Funds $33,230,000E



Section 11.545. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding home-delivered meals distributed according to formula to the Area Agencies on Aging in the Department of Health and Senior Services. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From Federal Funds $4,191,968E



Section 11.550. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding medical benefits for recipients of the State Medical Program, including coverage in managed care programs. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From General Revenue Fund $35,726,155

From Health Initiatives Fund 353,437

From Pharmacy Reimbursement Allowance Fund 846,090

Total $36,925,682



Section 11.555. To the Department of Social Services

For the Division of Medical Services

For the purpose of funding appropriations for any medical service under the Medicaid fee-for-service, managed care, or State Medical programs, including related services. The single agency administering the Medicaid program is only authorized to reimburse for benefits that exceed a recipient's spend down amount

From Federal Funds $24,107,486

From Premium Fund 3,837,940

From Third Party Liability Collections 11,399,997

From Uncompensated Care Fund 1

From Pharmacy Rebates Fund 1

From Federal Reimbursement Allowance Fund 1



For the purpose of funding Upper Payment Limit maximization transactions

From Federal Funds 20,500,000

From Intergovernmental Transfer Fund 13,000,000

Total $72,845,426





BILL TOTALS



General Revenue Fund $1,248,960,180

Federal Funds 4,006,831,226

Other Funds 356,359,743

Total $5,612,151,149