April 22, 2005

The Senate will finalize its deliberations on the budget and it will proceed to the House and Senate conference committee. Both the House and Senate will be working vigorously to pass their chambers legislation in hopes that they can move their proposals to the other chamber in time for approval by the May 13 th end of session.

News this week includes:

Primarily Seat Belt Enforcement Bill Heard in the House
The House Committee on Transportation held a hearing on SCS/SB’s 221, 250 and 256, sponsored by Sen. Jon Dolan (R-Lake St. Louis). This bill makes modifications to several provisions relating to the operation of motor vehicles. Provisions of interest include: Primary Seat Belt Enforcement, Child Booster Seats, Airbags, Use of left lane by trucks, yellow stripe violations, and alcohol related traffic offenses.

Testifying in support were MoDOT, Midwest Trauma Society, Children’s Mercy Hospital, MADD of Missouri, Missouri Highway Patrol, Missouri Hospital Association, Missouri Alliance of Automobile Manufacturers, the St. Charles County Sheriff, Missouri Safety Council, DaimlerChrysler, General Motors, State Farm Insurance, Missouri Insurance Coalition, and the Missouri State Medical Association.

There were no witnesses to testify in opposition and the committee took no action.

House Health Policy
The House Health Care Policy Committee held a hearing on several bills. One would require health care providers to give medical and laboratory test results to patients within five business days of receipt. Another is a bill advanced by nursing unions that would require hospitals to post, for each shift and unit, nurse-patient staffing ratios and the hospital’s method for setting and adjusting staffing levels. A third bill would prohibit the withholding of artificially administered food and water from a patient unless he or she has specifically authorized that withholding in a written advance directive.

Seat Belts
The omnibus transportation bill, HB 518, was heard in the Senate Transportation Committee.

House Bill 518 This substitute changes the laws regarding highway safety.

CHILD PASSENGER RESTRAINTS

The substitute:

1. Requires children less than four years of age to be secured in a child passenger restraint system appropriate for the child;
   
2. Requires children four through five years of age to be secured in a child passenger restraint system or booster seat;
   
3. Requires children at least six years of age to be secured by a vehicle safety belt, child passenger restraint system, or booster seat;
   
4. Allows children weighing more than 40 pounds, who would otherwise be required to be secured in a booster seat, to be transported in the back seat of a vehicle while wearing only a lap belt if the back seat of the motor vehicle is not equipped with a combination lap and shoulder belt for booster seat installation;
   
5. Requires car rental agencies doing business in Missouri to inform customers of the requirements of the substitute and to provide for the rental of an appropriate child passenger restraint system;
   
6. Exempts public carriers for hire or school buses; and
   
7. Requires the Department of Public Safety to develop a public information program to ensure compliance with the child passengerrestraint laws.

A violation of the child passenger restraint and safety belt provisions is an infraction and punishable by a fine of not more than $25 plus court costs with no points assessed against the person. The charges against any person receiving a citation for a child restraint violation will be dismissed or withdrawn if the person provides prior to or at a hearing evidence of the acquisition of a child passenger restraint system or child booster seat which is satisfactory to the court or the prosecutor.

ABANDONED VEHICLES

Law enforcement officers may authorize a towing company to immediately move any vehicle left unattended on any interstate highway or freeway in an urbanized area. Currently, a vehicle must be abandoned for at least four hours.

The substitute has an effective date of January 1, 2006.

FISCAL NOTE: Estimated Effect on General Revenue Fund of a Cost of Less than $100,000 to an Income of Unknown in FY 2006, FY 2007, and FY 2008. Estimated Effect on Other State Funds of an Income of $0 to a Cost of $147,546 in FY 2006, an Income of $0 in FY 2007, and an Income of $0 in FY 2008.

Committee Approves Traffic Safety/Motorcycle Helmet Bill
The House Transportation Committee has approved a House Committee Substitute for Senate Bills 221, 250 and 256. The new bill juxtaposes changes expected to both reduce and increase traumatic injuries and deaths from traffic accidents.

As passed by the Senate, the bill would create a more expansive law requiring the use of child safety seats. Also, it would authorize a law enforcement officer to enforce the seat belt law if the violation is clearly visible to the officer without stopping the vehicle. Currently, an officer may not stop a vehicle solely for a seat belt violation. The seat belt enforcement change is expected to improve compliance rates and is predicted by federal highway safety officials to save at least 90 lives per year. The House committee retained these proposals, along with a number of other traffic safety changes. It also added language to allow those age 21 and over to ride a motorcycle without wearing a helmet.

Bill Would Revamp Medicaid Dental Services
The House of Representatives gave final approval to a bill requiring the state Medicaid program to contract with a single private entity to manage the delivery of Medicaid dental services. House Bill 400 now moves to the Senate. Proponents argue that it would bring added efficiencies to the delivery system.

Senate Appropriations Committee Advances Budget
The Senate Appropriations Committee has wrapped up its work on the state budget. Regarding Medicaid, the committee adopted a proposed budget designed to emphasize differences with the House version of the budget. Doing so gives more options and flexibility to a conference committee of legislators that will be appointed to negotiate those differences. Key budget issues include the following.

The committee chose to restore Medicaid eligibility standards to exceed the levels set by the House. If the Medicaid budget is not significantly amended during Senate floor debate, the conference committee will negotiate the final eligibility standards in the ranges defined by the House and Senate positions. For parents of Medicaid-eligible children, the House adopted an eligibility cutoff of 23 percent of federal poverty; the Senate Appropriations Committee endorsed 50 percent of the poverty level. For the elderly and disabled, the House passed 80 percent of the federal poverty level, while the Senate committee chose 85 percent. The Senate budget would cover about 31,000 more parents than the House proposal.

Regarding Medicaid’s “rehabilitation and specialty services,” which had earlier been sharply reduced by the governor and then partly restored by the House, the Senate committee allocated the same amount of money for budget restorations as adopted by the House. However, the committee allowed dental and podiatry services to compete with the various rehabilitation and specialty services for a share of that money. The plan for allocating the money to specific services will be decided by the conference committee.

The committee adopted a new plan of graduated premiums for Medicaid coverage of children under the State Children’s Health Insurance Program (SCHIP). The House version of the budget would set a premium cap of 5 percent of household income for those with incomes exceeding 150 percent of the federal poverty level ($29,025 for a family of four). The Senate plan would impose a premium cap of 1 percent of household income for those with incomes between 151-185 percent of federal poverty and 3 percent of household income for those between 186-225 percent of federal poverty. The change is projected to reduce state revenues by $5.7 million.

The Senate agreed with the House stance to restore $9.1 million in spending cuts the governor proposed for community-based mental health treatment. The Senate also agreed with the House in restoring $10.2 million for substance abuse treatment. Both items are included in the Department of Mental Health budget.

The Senate will debate the budget bills next week. The constitution requires the budget to be completed by May 6.

Bill Revamps Licensure Suspensions for Unpaid Taxes
The House Ways and Means Committee held a hearing on House Bill 916 and then approved the bill. The legislation revamps the way the state administers its system of suspending professional and occupational licenses of those who are in arrears on their state tax obligations. The original law was enacted in 2003. House Bill 916 has been developed by state officials to correct various problems of implementation. The bill establishes clearer notification processes, longer deadlines, and new rights of appeal and expungement.

Abortion Regulation Bills Advance
Several bills pertaining to abortion advanced this week. Senate Bill 2 has been amended to include most of the various abortion regulation proposals being considered in the General Assembly. The bill was passed by the Senate and sent to the House. It places new restrictions on the payment of public funds to entities that may be involved or affiliated with abortion services. The bill expands on current data collection requirements and would require physicians performing abortions to have clinical privileges at a hospital providing obstetrical/gynecological care within 30 miles of the location of the abortion procedure. Also, clinics performing more than a certain number of abortions would need to be licensed as an ambulatory surgical center. No abortion, regardless of gestational age, could be performed outside of a physician’s office, outpatient clinic, or licensed ambulatory surgical center or hospital.

House Bill 586 advances to House floor debate after being approved by several House committees. It includes the restrictions on public funding related to abortion services. House Bill 100, which has been passed by the House, was given a hearing by the Senate Judiciary and Civil & Criminal Jurisprudence Committee. It contains a number of abortion regulation changes other than the new standards for public funding.

Next Week:
The May 13 th deadline is approaching rapidly and both chambers will need to conclude final work on the 2006 budget.

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