SENATE JOURNAL - THIRD DAY--FRIDAY, SEPTEMBER 7, 2001

Journal of the Senate

FIRST REGULAR SESSION

FIRST EXTRA SESSION

THIRD DAY--FRIDAY, SEPTEMBER 7, 2001

The Senate met pursuant to adjournment.

Senator Klarich in the Chair.

Reverend Carl Gauck offered the following prayer:

Oswald Chambers stated: "It is not so true that 'prayer changes things' as that prayer changes me and I change things."

Heavenly Father, as we pray this morning let us be mindful that prayer can and will change us. If we take serious what we pray for and allow Your Spirit to change us we may well allow our actions to follow the path that You would have us take both here and among the people You have given us to love. Lord let it be so among us. Amen.

The Pledge of Allegiance to the Flag was recited.

A quorum being established, the Senate proceeded with its business.

The Journal of the previous day was read and approved.

Photographers from KY3 and KOMU-TV were given permission to take pictures in the Senate Chamber today.

The following Senators were present during the day's proceedings:

Present--Senators

Bentley Bland Caskey Cauthorn

Childers DePasco Dougherty Gibbons

Goode Gross Jacob Johnson

Kenney Kinder Klarich Klindt

Loudon Mathewson Quick Rohrbach

Russell Schneider Scott Singleton

Steelman Stoll Wiggins Yeckel--28

Absent with leave--Senators

Carter Foster House Sims

Staples Westfall--6

The Lieutenant Governor was present.

REPORTS OF STANDING COMMITTEES

Senator Kenney, Chairman of the Committee on Rules, Joint Rules, Resolutions and Ethics, submitted the following report:

Mr. President: Your Committee on Rules, Joint Rules, Resolutions and Ethics, to which was referred SCS for SBs 3, 8 and 9, begs leave to report that it has examined the same and finds that the bill has been truly perfected and that the printed copies furnished the Senators are correct.

REFERRALS

President Pro Tem Kinder referred SCS for SBs 3, 8 and 9 to the Committee on State Budget Control.

SENATE BILLS FOR PERFECTION

Senator Singleton moved that SB 4, SB 1, SB 5 and SB 6, with SCS, be taken up for perfection, which motion prevailed.

SCS for SBs 4, 1, 5 and 6, entitled:

SENATE COMMITTEE SUBSTITUTE FOR

SENATE BILLS NOS. 4, 1, 5 and 6

An Act to repeal section 135.095, RSMo, relating to a Missouri Senior Rx Program, and to enact in lieu thereof ten new sections relating to the same subject, with a contingent effective date for a certain section and an emergency clause.

Was taken up.

Senator Singleton moved that SCS for SBs 4, 1, 5 and 6 be adopted.

Senator Singleton offered SA 1:

SENATE AMENDMENT NO. 1

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 3, Section 208.550, Line 18, by inserting after all of said line the following:

""(8) Generic drugs", a chemically equivalent copy of a brand-name drug whose patent has expired and there must be three sources of the product. Drug formulations must be of identical composition with respect to the active ingredient and meet official standards of identity, purity, and quality of active ingredient;"; and

Further amend said bill and section, Page 4, Lines 59 to 62, by striking all of said lines; and further amend said section by renumbering all subdivisions accordingly.

Senator Singleton moved that the above amendment be adopted, which motion prevailed.

Senator Singleton offered SA 2:

SENATE AMENDMENT NO. 2

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 6, Section 208.553, Line 32, by inserting at the beginning of said line the following:

"In making the initial appointment to the committee, the governor, president pro tem, and speaker shall stagger the terms of the appointees so that four members serve initial terms of two years, four members serve initial terms of three years, four members serve initial terms of four years and one member serves an initial term of one year. All members appointed thereafter shall serve three-year terms. All members shall be eligible for reappointment.".

Senator Singleton moved that the above amendment be adopted, which motion prevailed.

Senator Singleton offered SA 3:

SENATE AMENDMENT NO. 3

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 6, Section 208.553, Line 47, by adding after all of said line, the following:

(5) Shall have rulemaking authority for the implementation and administration of the program."; and

Further amend the title and enacting clause accordingly.

Senator Singleton moved that the above amendment be adopted, which motion prevailed.

Senator Singleton offered SA 4:

SENATE AMENDMENT NO. 4

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 11, Section 208.565, Line 4, by adding after all of said line, the following:

"A certificate of participation shall remain in effect for an initial period of not less than one year and shall be automatically renewed unless terminated by either the manufacturer or the state with sixty days notification."; and

Further amend the title and enacting clause accordingly.

Senator Singleton moved that the above amendment be adopted, which motion prevailed.

President Maxwell assumed the Chair.

Senator Singleton offered SA 5:

SENATE AMENDMENT NO. 5

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 7, Section 208.556, Line 5, by deleting the word "The"; and

Further amend said section, page 7, lines 6-14, by deleting all of said lines, and renumber the remaining subsections accordingly.

Senator Singleton moved that the above amendment be adopted, which motion prevailed.

Senator Kinder offered SA 6:

SENATE AMENDMENT NO. 6

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 1, In the Title, Line 4, by inserting immediately after the word "section" the following: ", an expiration date"; and

Further amend said bill, Page 13, Section B, Line 5, by inserting immediately after said line the following:

"Section C. This act shall expire on June 30, 2005.".

Senator Kinder moved that the above amendment be adopted, which motion prevailed.

Senator Singleton offered SA 7:

SENATE AMENDMENT NO. 7

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 11, Section 208.565(2), Line 27, by inserting after the word "provided" the following: "and the Division of medical services for rebate administration".

Senator Singleton moved that the above amendment be adopted, which motion prevailed.

Senator Singleton offered SA 8:

SENATE AMENDMENT NO. 8

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 4, Section 208.550, Lines 63-66, by deleting said lines and renumbering the remaining subdivisions accordingly.

Senator Singleton moved that the above amendment be adopted, which motion prevailed.

Senator Goode offered SA 9:

SENATE AMENDMENT NO. 9

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 6, Section 208.553, Line 47, by adding at the end of said line, the following:

(5) The Commission shall utilize the definition of "generic drugs" as defined pursuant to section 208.550 as a general guideline and the Commission may revise such definition, by rule, for the purpose of maximizing the use of generic drugs in the program".

Senator Goode moved that the above amendment be adopted, which motion prevailed.

Senator Steelman offered SA 10:

SENATE AMENDMENT NO. 10

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 3, Section 135.095, Line 18, by inserting after all of said line the following:

"208.010. 1. In determining the eligibility of a claimant for public assistance pursuant to this law, it shall be the duty of the division of family services to consider and take into account all facts and circumstances surrounding the claimant, including his or her living conditions, earning capacity, income and resources, from whatever source received, and if from all the facts and circumstances the claimant is not found to be in need, assistance shall be denied. In determining the need of a claimant, the costs of providing medical treatment which may be furnished pursuant to sections 208.151 to 208.158 and 208.162 shall be disregarded. The amount of benefits, when added to all other income, resources, support, and maintenance shall provide such persons with reasonable subsistence compatible with decency and health in accordance with the standards developed by the division of family services; provided, when a husband and wife are living together, the combined income and resources of both shall be considered in determining the eligibility of either or both. "Living together" for the purpose of this chapter is defined as including a husband and wife separated for the purpose of obtaining medical care or nursing home care, except that the income of a husband or wife separated for such purpose shall be considered in determining the eligibility of his or her spouse, only to the extent that such income exceeds the amount necessary to meet the needs (as defined by rule or regulation of the division) of such husband or wife living separately. In determining the need of a claimant in federally aided programs there shall be disregarded such amounts per month of earned income in making such determination as shall be required for federal participation by the provisions of the federal Social Security Act (42 U.S.C.A. 301 et seq.), or any amendments thereto. When federal law or regulations require the exemption of other income or resources, the division of family services may provide by rule or regulation the amount of income or resources to be disregarded.

2. Benefits shall not be payable to any claimant who:

(1) Has or whose spouse with whom he or she is living has, prior to July 1, 1989, given away or sold a resource within the time and in the manner specified in this subdivision. In determining the resources of an individual, unless prohibited by federal statutes or regulations, there shall be included (but subject to the exclusions pursuant to subdivisions (4) and (5) of this subsection, and subsection 5 of this section) any resource or interest therein owned by such individual or spouse within the twenty-four months preceding the initial investigation, or at any time during which benefits are being drawn, if such individual or spouse gave away or sold such resource or interest within such period of time at less than fair market value of such resource or interest for the purpose of establishing eligibility for benefits, including but not limited to benefits based on December, 1973, eligibility requirements, as follows:

(a) Any transaction described in this subdivision shall be presumed to have been for the purpose of establishing eligibility for benefits or assistance pursuant to this chapter unless such individual furnishes convincing evidence to establish that the transaction was exclusively for some other purpose;

(b) The resource shall be considered in determining eligibility from the date of the transfer for the number of months the uncompensated value of the disposed of resource is divisible by the average monthly grant paid or average Medicaid payment in the state at the time of the investigation to an individual or on his or her behalf under the program for which benefits are claimed, provided that:

a. When the uncompensated value is twelve thousand dollars or less, the resource shall not be used in determining eligibility for more than twenty-four months; or

b. When the uncompensated value exceeds twelve thousand dollars, the resource shall not be used in determining eligibility for more than sixty months;

(2) The provisions of subdivision (1) of subsection 2 of this section shall not apply to a transfer, other than a transfer to claimant's spouse, made prior to March 26, 1981, when the claimant furnishes convincing evidence that the uncompensated value of the disposed of resource or any part thereof is no longer possessed or owned by the person to whom the resource was transferred;

(3) Has received, or whose spouse with whom he or she is living has received, benefits to which he or she was not entitled through misrepresentation or nondisclosure of material facts or failure to report any change in status or correct information with respect to property or income as required by section 208.210. A claimant ineligible pursuant to this subsection shall be ineligible for such period of time from the date of discovery as the division of family services may deem proper; or in the case of overpayment of benefits, future benefits may be decreased, suspended or entirely withdrawn for such period of time as the division may deem proper;

(4) Owns or possesses resources in the sum of one thousand five hundred dollars or more; provided, however, that if such person is married and living with spouse, he or she, or they, individually or jointly, may own resources not to exceed two thousand five hundred dollars; and provided further, that in the case of a temporary assistance for needy families claimant, the provision of this subsection shall not apply;

(5) Prior to October 1, 1989, owns or possesses property of any kind or character, excluding amounts placed in an irrevocable prearranged funeral or burial contract pursuant to subsection 2 of section 436.035, RSMo, and subdivision (5) of subsection 1 of section 436.053, RSMo, or has an interest in property, of which he or she is the record or beneficial owner, the value of such property, as determined by the division of family services, less encumbrances of record, exceeds twenty-nine thousand dollars, or if married and actually living together with husband or wife, if the value of his or her property, or the value of his or her interest in property, together with that of such husband and wife, exceeds such amount;

(6) In the case of temporary assistance for needy families, if the parent, stepparent, and child or children in the home owns or possesses property of any kind or character, or has an interest in property for which he or she is a record or beneficial owner, the value of such property, as determined by the division of family services and as allowed by federal law or regulation, less encumbrances of record, exceeds one thousand dollars, excluding the home occupied by the claimant, amounts placed in an irrevocable prearranged funeral or burial contract pursuant to subsection 2 of section 436.035, RSMo, and subdivision (5) of subsection 1 of section 436.053, RSMo, one automobile which shall not exceed a value set forth by federal law or regulation and for a period not to exceed six months, such other real property which the family is making a good-faith effort to sell, if the family agrees in writing with the division of family services to sell such property and from the net proceeds of the sale repay the amount of assistance received during such period. If the property has not been sold within six months, or if eligibility terminates for any other reason, the entire amount of assistance paid during such period shall be a debt due the state;

(7) Is an inmate of a public institution, except as a patient in a public medical institution.

3. In determining eligibility and the amount of benefits to be granted pursuant to federally aided programs, the income and resources of a relative or other person living in the home shall be taken into account to the extent the income, resources, support and maintenance are allowed by federal law or regulation to be considered.

4. In determining eligibility and the amount of benefits to be granted pursuant to federally aided programs, the value of burial lots or any amounts placed in an irrevocable prearranged funeral or burial contract pursuant to subsection 2 of section 436.035, RSMo, and subdivision (5) of subsection 1 of section 436.053, RSMo, shall not be taken into account or considered an asset of the burial lot owner or the beneficiary of an irrevocable prearranged funeral or funeral contract. For purposes of this section, "burial lots" means any burial space as defined in section 214.270, RSMo, and any memorial, monument, marker, tombstone or letter marking a burial space. If the beneficiary, as defined in chapter 436, RSMo, of an irrevocable prearranged funeral or burial contract receives any public assistance benefits pursuant to this chapter and if the purchaser of such contract or his or her successors in interest cancel or amend the contract so that any person will be entitled to a refund, such refund shall be paid to the state of Missouri up to the amount of public assistance benefits provided pursuant to this chapter with any remainder to be paid to those persons designated in chapter 436, RSMo.

5. In determining the total property owned pursuant to subdivision (5) of subsection 2 of this section, or resources, of any person claiming or for whom public assistance is claimed, there shall be disregarded any life insurance policy, or prearranged funeral or burial contract, or any two or more policies or contracts, or any combination of policies and contracts, which provides for the payment of one thousand five hundred dollars or less upon the death of any of the following:

(1) A claimant or person for whom benefits are claimed; or

(2) The spouse of a claimant or person for whom benefits are claimed with whom he or she is living.

If the value of such policies exceeds one thousand five hundred dollars, then the total value of such policies may be considered in determining resources; except that, in the case of temporary assistance for needy families, there shall be disregarded any prearranged funeral or burial contract, or any two or more contracts, which provides for the payment of one thousand five hundred dollars or less per family member.

6. Beginning September 30, 1989, when determining the eligibility of institutionalized spouses, as defined in 42 U.S.C. Section 1396r-5, for medical assistance benefits as provided for in section 208.151 and 42 U.S.C. Sections 1396a et seq., the division of family services shall comply with the provisions of the federal statutes and regulations. As necessary, the division shall by rule or regulation implement the federal law and regulations which shall include but not be limited to the establishment of income and resource standards and limitations. The division shall require:

(1) That at the beginning of a period of continuous institutionalization that is expected to last for thirty days or more, the institutionalized spouse, or the community spouse, may request an assessment by the division of family services of total countable resources owned by either or both spouses;

(2) That the assessed resources of the institutionalized spouse and the community spouse may be allocated so that each receives an equal share;

(3) That upon an initial eligibility determination, if the community spouse's share does not equal at least twelve thousand dollars, the institutionalized spouse may transfer to the community spouse a resource allowance to increase the community spouse's share to twelve thousand dollars;

(4) That in the determination of initial eligibility of the institutionalized spouse, no resources attributed to the community spouse shall be used in determining the eligibility of the institutionalized spouse, except to the extent that the resources attributed to the community spouse do exceed the community spouse's resource allowance as defined in 42 U.S.C. Section 1396r-5;

(5) That beginning in January, 1990, the amount specified in subdivision (3) of this subsection shall be increased by the percentage increase in the consumer price index for all urban consumers between September, 1988, and the September before the calendar year involved; and

(6) That beginning the month after initial eligibility for the institutionalized spouse is determined, the resources of the community spouse shall not be considered available to the institutionalized spouse during that continuous period of institutionalization.

7. Beginning July 1, 1989, institutionalized individuals shall be ineligible for the periods required and for the reasons specified in 42 U.S.C. Section 1396p.

8. The hearings required by 42 U.S.C. Section 1396r-5 shall be conducted pursuant to the provisions of section 208.080.

9. Beginning October 1, 1989, when determining eligibility for assistance pursuant to this chapter there shall be disregarded unless otherwise provided by federal or state statutes, the home of the applicant or recipient when the home is providing shelter to the applicant or recipient, or his or her spouse or dependent child. The division of family services shall establish by rule or regulation in conformance with applicable federal statutes and regulations a definition of the home and when the home shall be considered a resource that shall be considered in determining eligibility.

10. Reimbursement for services provided by an enrolled Medicaid provider to a recipient who is duly entitled to Title XIX Medicaid and Title XVIII Medicare Part B, Supplementary Medical Insurance (SMI) shall include payment in full of deductible and coinsurance amounts as determined due pursuant to the applicable provisions of federal regulations pertaining to Title XVIII Medicare Part B, except the applicable Title XIX cost sharing.

11. A "community spouse" is defined as being the noninstitutionalized spouse.

208.151. 1. For the purpose of paying medical assistance on behalf of needy persons and to comply with Title XIX, Public Law 89-97, 1965 amendments to the federal Social Security Act (42 U.S.C. Section 301 et seq.) as amended, the following needy persons shall be eligible to receive medical assistance to the extent and in the manner hereinafter provided:

(1) All recipients of state supplemental payments for the aged, blind and disabled;

(2) All recipients of aid to families with dependent children benefits, including all persons under nineteen years of age who would be classified as dependent children except for the requirements of subdivision (1) of subsection 1 of section 208.040;

(3) All recipients of blind pension benefits;

(4) All persons who would be determined to be eligible for old age assistance benefits, permanent and total disability benefits, or aid to the blind benefits under the eligibility standards in effect December 31, 1973, or less restrictive standards as established by rule of the division of family services, who are sixty-five years of age or over and are patients in state institutions for mental diseases or tuberculosis;

(5) All persons under the age of twenty-one years who would be eligible for aid to families with dependent children except for the requirements of subdivision (2) of subsection 1 of section 208.040, and who are residing in an intermediate care facility, or receiving active treatment as inpatients in psychiatric facilities or programs, as defined in 42 U.S.C. 1396d, as amended;

(6) All persons under the age of twenty-one years who would be eligible for aid to families with dependent children benefits except for the requirement of deprivation of parental support as provided for in subdivision (2) of subsection 1 of section 208.040;

(7) All persons eligible to receive nursing care benefits;

(8) All recipients of family foster home or nonprofit private child-care institution care, subsidized adoption benefits and parental school care wherein state funds are used as partial or full payment for such care;

(9) All persons who were recipients of old age assistance benefits, aid to the permanently and totally disabled, or aid to the blind benefits on December 31, 1973, and who continue to meet the eligibility requirements, except income, for these assistance categories, but who are no longer receiving such benefits because of the implementation of Title XVI of the federal Social Security Act, as amended;

(10) Pregnant women who meet the requirements for aid to families with dependent children, except for the existence of a dependent child in the home;

(11) Pregnant women who meet the requirements for aid to families with dependent children, except for the existence of a dependent child who is deprived of parental support as provided for in subdivision (2) of subsection 1 of section 208.040;

(12) Pregnant women or infants under one year of age, or both, whose family income does not exceed an income eligibility standard equal to one hundred eighty-five percent of the federal poverty level as established and amended by the federal Department of Health and Human Services, or its successor agency;

(13) Children who have attained one year of age but have not attained six years of age who are eligible for medical assistance under 6401 of P.L. 101-239 (Omnibus Budget Reconciliation Act of 1989). The division of family services shall use an income eligibility standard equal to one hundred thirty-three percent of the federal poverty level established by the Department of Health and Human Services, or its successor agency;

(14) Children who have attained six years of age but have not attained nineteen years of age. For children who have attained six years of age but have not attained nineteen years of age, the division of family services shall use an income assessment methodology which provides for eligibility when family income is equal to or less than equal to one hundred percent of the federal poverty level established by the Department of Health and Human Services, or its successor agency. As necessary to provide Medicaid coverage under this subdivision, the department of social services may revise the state Medicaid plan to extend coverage under 42 U.S.C. 1396a (a)(10)(A)(i)(III) to children who have attained six years of age but have not attained nineteen years of age as permitted by paragraph (2) of subsection (n) of 42 U.S.C. 1396d using a more liberal income assessment methodology as authorized by paragraph (2) of subsection (r) of 42 U.S.C. 1396a;

(15) The following children with family income which does not exceed two hundred percent of the federal poverty guideline for the applicable family size:

(a) Infants who have not attained one year of age with family income greater than one hundred eighty-five percent of the federal poverty guideline for the applicable family size;

(b) Children who have attained one year of age but have not attained six years of age with family income greater than one hundred thirty-three percent of the federal poverty guideline for the applicable family size; and

(c) Children who have attained six years of age but have not attained nineteen years of age with family income greater than one hundred percent of the federal poverty guideline for the applicable family size. Coverage under this subdivision shall be subject to the receipt of notification by the director of the department of social services and the revisor of statutes of approval from the secretary of the U.S. Department of Health and Human Services of applications for waivers of federal requirements necessary to promulgate regulations to implement this subdivision. The director of the department of social services shall apply for such waivers. The regulations may provide for a basic primary and preventive health care services package, not to include all medical services covered by section 208.152, and may also establish co-payment, coinsurance, deductible, or premium requirements for medical assistance under this subdivision. Eligibility for medical assistance under this subdivision shall be available only to those infants and children who do not have or have not been eligible for employer-subsidized health care insurance coverage for the six months prior to application for medical assistance. Children are eligible for employer-subsidized coverage through either parent, including the noncustodial parent. The division of family services may establish a resource eligibility standard in assessing eligibility for persons under this subdivision. The division of medical services shall define the amount and scope of benefits which are available to individuals under this subdivision in accordance with the requirement of federal law and regulations. Coverage under this subdivision shall be subject to appropriation to provide services approved under the provisions of this subdivision;

(16) The division of family services shall not establish a resource eligibility standard in assessing eligibility for persons under subdivision (12), (13) or (14) of this subsection. The division of medical services shall define the amount and scope of benefits which are available to individuals eligible under each of the subdivisions (12), (13), and (14) of this subsection, in accordance with the requirements of federal law and regulations promulgated thereunder except that the scope of benefits shall include case management services;

(17) Notwithstanding any other provisions of law to the contrary, ambulatory prenatal care shall be made available to pregnant women during a period of presumptive eligibility pursuant to 42 U.S.C. Section 1396r-1, as amended;

(18) A child born to a woman eligible for and receiving medical assistance under this section on the date of the child's birth shall be deemed to have applied for medical assistance and to have been found eligible for such assistance under such plan on the date of such birth and to remain eligible for such assistance for a period of time determined in accordance with applicable federal and state law and regulations so long as the child is a member of the woman's household and either the woman remains eligible for such assistance or for children born on or after January 1, 1991, the woman would remain eligible for such assistance if she were still pregnant. Upon notification of such child's birth, the division of family services shall assign a medical assistance eligibility identification number to the child so that claims may be submitted and paid under such child's identification number;

(19) Pregnant women and children eligible for medical assistance pursuant to subdivision (12), (13) or (14) of this subsection shall not as a condition of eligibility for medical assistance benefits be required to apply for aid to families with dependent children. The division of family services shall utilize an application for eligibility for such persons which eliminates information requirements other than those necessary to apply for medical assistance. The division shall provide such application forms to applicants whose preliminary income information indicates that they are ineligible for aid to families with dependent children. Applicants for medical assistance benefits under subdivision (12), (13) or (14) shall be informed of the aid to families with dependent children program and that they are entitled to apply for such benefits. Any forms utilized by the division of family services for assessing eligibility under this chapter shall be as simple as practicable;

(20) Subject to appropriations necessary to recruit and train such staff, the division of family services shall provide one or more full-time, permanent case workers to process applications for medical assistance at the site of a health care provider, if the health care provider requests the placement of such case workers and reimburses the division for the expenses including but not limited to salaries, benefits, travel, training, telephone, supplies, and equipment, of such case workers. The division may provide a health care provider with a part-time or temporary case worker at the site of a health care provider if the health care provider requests the placement of such a case worker and reimburses the division for the expenses, including but not limited to the salary, benefits, travel, training, telephone, supplies, and equipment, of such a case worker. The division may seek to employ such case workers who are otherwise qualified for such positions and who are current or former welfare recipients. The division may consider training such current or former welfare recipients as case workers for this program;

(21) Pregnant women who are eligible for, have applied for and have received medical assistance under subdivision (2), (10), (11) or (12) of this subsection shall continue to be considered eligible for all pregnancy-related and postpartum medical assistance provided under section 208.152 until the end of the sixty-day period beginning on the last day of their pregnancy;

(22) Case management services for pregnant women and young children at risk shall be a covered service. To the greatest extent possible, and in compliance with federal law and regulations, the department of health and senior services shall provide case management services to pregnant women by contract or agreement with the department of social services through local health departments organized under the provisions of chapter 192, RSMo, or chapter 205, RSMo, or a city health department operated under a city charter or a combined city-county health department or other department of health and senior services designees. To the greatest extent possible the department of social services and the department of health and senior services shall mutually coordinate all services for pregnant women and children with the crippled children's program, the prevention of mental retardation program and the prenatal care program administered by the department of health and senior services. The department of social services shall by regulation establish the methodology for reimbursement for case management services provided by the department of health and senior services. For purposes of this section, the term "case management" shall mean those activities of local public health personnel to identify prospective Medicaid-eligible high-risk mothers and enroll them in the state's Medicaid program, refer them to local physicians or local health departments who provide prenatal care under physician protocol and who participate in the Medicaid program for prenatal care and to ensure that said high-risk mothers receive support from all private and public programs for which they are eligible and shall not include involvement in any Medicaid prepaid, case-managed programs;

(23) By January 1, 1988, the department of social services and the department of health and senior services shall study all significant aspects of presumptive eligibility for pregnant women and submit a joint report on the subject, including projected costs and the time needed for implementation, to the general assembly. The department of social services, at the direction of the general assembly, may implement presumptive eligibility by regulation promulgated pursuant to chapter 207, RSMo;

(24) All recipients who would be eligible for aid to families with dependent children benefits except for the requirements of paragraph (d) of subdivision (1) of section 208.150;

(25) All persons who would be determined to be eligible for old age assistance benefits, permanent and total disability benefits, or aid to the blind benefits, under the eligibility standards in effect December 31, 1973[, or those supplemental security income recipients who would be determined eligible for general relief benefits under the eligibility standards in effect December 31, 1973, except income; or less restrictive standards as established by rule of the division of family services]; except that, less restrictive income methodologies, as authorized in 42 U.S.C. Section 1396a (r)(2), shall be used to raise the income limit to one hundred percent of the federal poverty level. If federal law or regulation authorizes the division of family services to, by rule, exclude the income or resources of a parent or parents of a person under the age of eighteen and such exclusion of income or resources can be limited to such parent or parents, then notwithstanding the provisions of section 208.010:

(a) The division may by rule exclude such income or resources in determining such person's eligibility for permanent and total disability benefits; and

(b) Eligibility standards for permanent and total disability benefits shall not be limited by age;

(26) Within thirty days of the effective date of an initial appropriation authorizing medical assistance on behalf of "medically needy" individuals for whom federal reimbursement is available under 42 U.S.C. 1396a (a)(10)(c), the department of social services shall submit an amendment to the Medicaid state plan to provide medical assistance on behalf of, at a minimum, an individual described in subclause (I) or (II) of clause 42 U.S.C. 1396a (a)(10)(C)(ii);

(27) Persons who have been diagnosed with breast or cervical cancer and who are eligible for coverage pursuant to 42 U.S.C. 1396a (a)(10)(A)(ii)(XVIII). Such persons shall be eligible during a period of presumptive eligibility in accordance with 42 U.S.C. 1396r-1.

2. Rules and regulations to implement this section shall be promulgated in accordance with section 431.064, RSMo, and chapter 536, RSMo. [No rule or portion of a rule promulgated under the authority of this chapter shall become effective unless it has been promulgated pursuant to the provisions of section 536.024, RSMo.] Any rule or portion of a rule, as that term is defined in section 536.010, RSMo, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536, RSMo, and, if applicable, section 536.028, RSMo. This section and chapter 536, RSMo, are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536, RSMo, to review, to delay the effective date or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2002, shall be invalid and void.

3. After December 31, 1973, and before April 1, 1990, any family eligible for assistance pursuant to 42 U.S.C. 601 et seq., as amended, in at least three of the last six months immediately preceding the month in which such family became ineligible for such assistance because of increased income from employment shall, while a member of such family is employed, remain eligible for medical assistance for four calendar months following the month in which such family would otherwise be determined to be ineligible for such assistance because of income and resource limitation. After April 1, 1990, any family receiving aid pursuant to 42 U.S.C. 601 et seq., as amended, in at least three of the six months immediately preceding the month in which such family becomes ineligible for such aid, because of hours of employment or income from employment of the caretaker relative, shall remain eligible for medical assistance for six calendar months following the month of such ineligibility as long as such family includes a child as provided in 42 U.S.C. 1396r-6. Each family which has received such medical assistance during the entire six-month period described in this section and which meets reporting requirements and income tests established by the division and continues to include a child as provided in 42 U.S.C. 1396r-6 shall receive medical assistance without fee for an additional six months. The division of medical services may provide by rule the scope of medical assistance coverage to be granted to such families.

4. For purposes of section 1902(1), (10) of Title XIX of the federal Social Security Act, as amended, any individual who, for the month of August, 1972, was eligible for or was receiving aid or assistance pursuant to the provisions of Titles I, X, XIV, or Part A of Title IV of such act and who, for such month, was entitled to monthly insurance benefits under Title II of such act, shall be deemed to be eligible for such aid or assistance for such month thereafter prior to October, 1974, if such individual would have been eligible for such aid or assistance for such month had the increase in monthly insurance benefits under Title II of such act resulting from enactment of Public Law 92-336 amendments to the federal Social Security Act (42 U.S.C. 301 et seq.), as amended, not been applicable to such individual.

5. When any individual has been determined to be eligible for medical assistance, such medical assistance will be made available to him for care and services furnished in or after the third month before the month in which he made application for such assistance if such individual was, or upon application would have been, eligible for such assistance at the time such care and services were furnished; provided, further, that such medical expenses remain unpaid."; and

Further amend the title and enacting clause accordingly.

Senator Steelman moved that the above amendment be adopted.

Senator Rohrbach raised the point of order that SA 10 is out of order under the provisions of Senate Rule 57.

The point of order was referred to the President Pro Tem, who ruled it well taken.

Senator Steelman offered SA 11:

SENATE AMENDMENT NO. 11

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 3, Section 135.095, Line 18, by inserting after all of said line the following:

2. Benefits shall not be payable to any claimant who:

a. When the uncompensated value is twelve thousand dollars or less, the resource shall not be used in determining eligibility for more than twenty-four months; or

b. When the uncompensated value exceeds twelve thousand dollars, the resource shall not be used in determining eligibility for more than sixty months;

(7) Is an inmate of a public institution, except as a patient in a public medical institution.

(1) A claimant or person for whom benefits are claimed; or

(2) The spouse of a claimant or person for whom benefits are claimed with whom he or she is living.

(2) That the assessed resources of the institutionalized spouse and the community spouse may be allocated so that each receives an equal share;

7. Beginning July 1, 1989, institutionalized individuals shall be ineligible for the periods required and for the reasons specified in 42 U.S.C. Section 1396p.

8. The hearings required by 42 U.S.C. Section 1396r-5 shall be conducted pursuant to the provisions of section 208.080.

11. A "community spouse" is defined as being the noninstitutionalized spouse.

(1) All recipients of state supplemental payments for the aged, blind and disabled;

(3) All recipients of blind pension benefits;

(7) All persons eligible to receive nursing care benefits;

(10) Pregnant women who meet the requirements for aid to families with dependent children, except for the existence of a dependent child in the home;

(15) The following children with family income which does not exceed two hundred percent of the federal poverty guideline for the applicable family size:

(a) Infants who have not attained one year of age with family income greater than one hundred eighty-five percent of the federal poverty guideline for the applicable family size;

(24) All recipients who would be eligible for aid to families with dependent children benefits except for the requirements of paragraph (d) of subdivision (1) of section 208.150;

(a) The division may by rule exclude such income or resources in determining such person's eligibility for permanent and total disability benefits; and

(b) Eligibility standards for permanent and total disability benefits shall not be limited by age;

Further amend page 1, title, line 2, by deleting "a Missouri Senior Rx Program" and inserting in lieu thereof "medical assistance"; and

Further amend the title and enacting clause accordingly.

Senator Steelman moved that the above amendment be adopted.

Senator Rohrbach raised the point of order that SA 11 is out of order under the provisions of Senate Rule 57 as it adds an additional subject matter to the bill and, further, that the title cannot be changed for the purpose of making an amendment germane.

The point of order was referred to the President Pro Tem.

Senator Jacob raised the point of order that the point of order raised by Senator Rohrbach is out of order as he failed to state the bill number to which he is raising the point of order.

The point of order was referred to the President Pro Tem.

At the request of Senator Steelman, SA 11 was withdrawn, rendering the points of order moot.

Senator Dougherty offered SA 12:

SENATE AMENDMENT NO. 12

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 1, In the Title, Line 2, by deleting the words "a Missouri Senior Rx Program" and inserting in lieu thereof the following: "medical assistance for the elderly".

Senator Dougherty moved that the above amendment be adopted.

Senator Singleton raised the point of order that SA 12 is out of order under the provisions of Senate Rule 57, as it expands the subject matter of the bill.

The point of order was referred to the President Pro Tem.

Senator Jacob raised the point of order that the point of order raised by Senator Singleton is out of order as it is not specific enough in that he failed to state which title of the four bills he refers to in his point of order.

The point of order was referred to the President Pro Tem.

President Pro Tem Kinder ruled the point of order raised by Senator Jacob not well taken and the point of order raised by Senator Singleton not well taken.

SA 12 was again taken up.

Senator Dougherty moved that the above amendment be adopted, which motion prevailed.

Senator Singleton offered SA 13:

SENATE AMENDMENT NO. 13

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 11, Section 208.565, Line 24, by inserting after the word "division" the following: "or any other state agency or contractor therein".

Senator Singleton moved that the above amendment be adopted, which motion prevailed.

Senator Jacob offered SA 14:

SENATE AMENDMENT NO. 14

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Pages 1-2, Section 135.094, Lines 1-42, by striking all of said section from the bill; and

Further amend said bill, Page 3, Section 208.550, Lines 17-18, by striking all of said lines; and further amend said section by renumbering the remaining subdivisions accordingly; and

Further amend said bill, Pages 6-7, Section 208.553, Lines 52-54, by striking all of said lines; and

Further amend the title and enacting clause accordingly.

Senator Jacob moved that the above amendment be adopted, which motion prevailed.

Senator Gibbons assumed the Chair.

President Maxwell assumed the Chair.

Senator Steelman offered SA 15:

SENATE AMENDMENT NO. 15

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 3, Section 135.095, Line 18, by inserting after all of said line the following:

2. Benefits shall not be payable to any claimant who:

a. When the uncompensated value is twelve thousand dollars or less, the resource shall not be used in determining eligibility for more than twenty-four months; or

b. When the uncompensated value exceeds twelve thousand dollars, the resource shall not be used in determining eligibility for more than sixty months;

(7) Is an inmate of a public institution, except as a patient in a public medical institution.

(1) A claimant or person for whom benefits are claimed; or

(2) The spouse of a claimant or person for whom benefits are claimed with whom he or she is living.

(2) That the assessed resources of the institutionalized spouse and the community spouse may be allocated so that each receives an equal share;

7. Beginning July 1, 1989, institutionalized individuals shall be ineligible for the periods required and for the reasons specified in 42 U.S.C. Section 1396p.

8. The hearings required by 42 U.S.C. Section 1396r-5 shall be conducted pursuant to the provisions of section 208.080.

11. A "community spouse" is defined as being the noninstitutionalized spouse.

(1) All recipients of state supplemental payments for the aged, blind and disabled;

(3) All recipients of blind pension benefits;

(7) All persons eligible to receive nursing care benefits;

(10) Pregnant women who meet the requirements for aid to families with dependent children, except for the existence of a dependent child in the home;

(15) The following children with family income which does not exceed two hundred percent of the federal poverty guideline for the applicable family size:

(a) Infants who have not attained one year of age with family income greater than one hundred eighty-five percent of the federal poverty guideline for the applicable family size;

(24) All recipients who would be eligible for aid to families with dependent children benefits except for the requirements of paragraph (d) of subdivision (1) of section 208.150;

(a) The division may by rule exclude such income or resources in determining such person's eligibility for permanent and total disability benefits; and

(b) Eligibility standards for permanent and total disability benefits shall not be limited by age;

Further amend the title and enacting clause accordingly.

Senator Steelman moved that the above amendment be adopted.

Senator Rohrbach raised the point of order that SA 15 is out of order under the provisions of Senate Rule 57.

The point of order was referred to the President Pro Tem, who took it under advisement. This placed SB 4, SB 1, SB 5, SB 6, with SCS, SA 15 and the point of order (pending) on the Informal Calendar.

On motion of Senator Kenney, the Senate recessed for approximately 45 minutes.

RECESS

The time of recess having expired, the Senate was called to order by President Maxwell.

President Pro Tem Kinder was recognized to rule on the pending point of order on SA 15 to SCS for SBs 4, 1, 5 and 6.

At the request of Senator Rohrbach, the point of order was withdrawn.

SA 15 was again taken up.

Senator Singleton offered SSA 1 for SA 15:

SENATE SUBSTITUTE AMENDMENT NO. 1 FOR SENATE AMENDMENT NO. 15

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 3, Section 135.095, Line 18, by inserting after all of said line the following:

2. Benefits shall not be payable to any claimant who:

a. When the uncompensated value is twelve thousand dollars or less, the resource shall not be used in determining eligibility for more than twenty-four months; or

b. When the uncompensated value exceeds twelve thousand dollars, the resource shall not be used in determining eligibility for more than sixty months;

(4) Owns or possesses resources in the sum of one thousand dollars or more or, for a person sixty-five years old or older, one thousand five hundred dollars or more; provided, however, that if such person is married and living with spouse, he or she, or they, individually or jointly, may own resources not to exceed two thousand dollars or more or, for a person sixty-five years old or older, two thousand five hundred dollars; and provided further, that in the case of a temporary assistance for needy families claimant, the provision of this subsection shall not apply;

(7) Is an inmate of a public institution, except as a patient in a public medical institution.

(1) A claimant or person for whom benefits are claimed; or

(2) The spouse of a claimant or person for whom benefits are claimed with whom he or she is living.

(2) That the assessed resources of the institutionalized spouse and the community spouse may be allocated so that each receives an equal share;

7. Beginning July 1, 1989, institutionalized individuals shall be ineligible for the periods required and for the reasons specified in 42 U.S.C. Section 1396p.

8. The hearings required by 42 U.S.C. Section 1396r-5 shall be conducted pursuant to the provisions of section 208.080.

11. A "community spouse" is defined as being the noninstitutionalized spouse.

(1) All recipients of state supplemental payments for the aged, blind and disabled;

(3) All recipients of blind pension benefits;

(7) All persons eligible to receive nursing care benefits;

(10) Pregnant women who meet the requirements for aid to families with dependent children, except for the existence of a dependent child in the home;

(15) The following children with family income which does not exceed two hundred percent of the federal poverty guideline for the applicable family size:

(a) Infants who have not attained one year of age with family income greater than one hundred eighty-five percent of the federal poverty guideline for the applicable family size;

(24) All recipients who would be eligible for aid to families with dependent children benefits except for the requirements of paragraph (d) of subdivision (1) of section 208.150;

(25) All persons who would be determined to be eligible for old age assistance benefits, permanent and total disability benefits, or aid to the blind benefits, under the eligibility standards in effect December 31, 1973[, or those supplemental security income recipients who would be determined eligible for general relief benefits under the eligibility standards in effect December 31, 1973, except income; or less restrictive standards as established by rule of the division of family services]; except that, for persons sixty-five years old or older, less restrictive income methodologies, as authorized in 42 U.S.C. Section 1396a (r)(2), shall be used to raise the income limit to one hundred percent of the federal poverty level. If federal law or regulation authorizes the division of family services to, by rule, exclude the income or resources of a parent or parents of a person under the age of eighteen and such exclusion of income or resources can be limited to such parent or parents, then notwithstanding the provisions of section 208.010:

(a) The division may by rule exclude such income or resources in determining such person's eligibility for permanent and total disability benefits; and

(b) Eligibility standards for permanent and total disability benefits shall not be limited by age;

Further amend the title and enacting clause accordingly.

Senator Singleton moved that the above substitute amendment be adopted.

Senator Steelman offered SA 1 to SSA 1 for SA 15, which was read:

SENATE AMENDMENT NO. 1 TO

SENATE SUBSTITUTE AMENDMENT NO. 1 FOR SENATE AMENDMENT NO. 15

Amend Senate Substitute Amendment No. 1 for Senate Amendment No. 15 to Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 4, Section 208.010, Line 9, by adding after the word "resources" the following: "on or after July 1, 2002"; and further amend page 17, Section 208.151, line 27, by adding after the word "that" the following: ", on or after July 1, 2002".

Senator Steelman moved that the above amendment be adopted, which motion prevailed.

SSA 1 for SA 15, as amended, was again taken up.

Senator Singleton moved that the above amendment be adopted.

Senator Dougherty requested a roll call vote be taken on the adoption of SSA 1 for SA 15, as amended, and was joined in his request by Senators Bland, Jacob, Steelman and Stoll.

SSA 1 for SA 15, as amended, was adopted by the following vote:

YEAS--Senators

Cauthorn Goode Gross Johnson

Kenney Kinder Klarich Klindt

Loudon Mathewson Quick Rohrbach

Russell Schneider Scott Singleton

Yeckel--17

NAYS--Senators

Bentley Bland Caskey Childers

DePasco Dougherty Gibbons Jacob

Steelman Stoll Wiggins--11

Absent--Senators--None

Absent with leave--Senators

Carter Foster House Sims

Staples Westfall--6

Senator Klarich offered SA 16:

SENATE AMENDMENT NO. 16

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 7, Section 208.556, Lines 31-35, by striking said line; and

Further amend said bill and section, Page 8, Lines 36 to 40, by striking said lines and inserting in lieu thereof the following:

"5. Any senior in the state of Missouri may enroll in the program. After expending twenty-five percent of their annual household income on prescription drugs as a deductible, a senior may qualify for the program provided the amount expended on prescription drugs minus their household income is equal to or less than the limit required to qualify for participation in the program, pursuant to section 208.556."; and further amend line 62, by striking the semi-colon ";" at the end of said line and inserting in lieu thereof a period "."; and further amend lines 63 to 68, by striking said lines; and

Further amend said bill and section, Page 9, Line 76, by striking the word "and" as it appears at the end of said line; and further amend lines 77 to 80, by striking said lines.

Senator Klarich moved that the above amendment be adopted, which motion prevailed.

Senator Rohrbach offered SA 17, which was read:

SENATE AMENDMENT NO. 17

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 6, Section 208.553, Line 23, by deleting all of said line and inserting in lieu thereof the following:

"(c) A person knowledgeable and experienced in the field of pharmacy benefits and pharmacy cost management; and".

Senator Rohrbach moved that the above amendment be adopted.

At the request of Senator Rohrbach, SA 17 was withdrawn.

Senator Jacob offered SA 18:

SENATE AMENDMENT NO. 18

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 12, Section 208.571, Line 7, by striking the words "quasi-public agency created to" and inserting in lieu thereof, the following: "public or private agency. The purpose of the clearinghouse shall include, but not be limited to:"; and

Further amend said page, said section, lines 13-14, by striking all of said lines and inserting in lieu thereof the following:

"2. The administration of the clearinghouse shall include, but not be limited to:

(1) Providing a one-stop-shopping clearinghouse for all information for seniors regarding prescription drug coverage programs and health insurance issues;

(2) Targeting outreach and education including print and media, social service and health care providers to promote the program;

(3) Maintaining a toll free 800-phone number staffed by trained customer service representatives;

(4) Providing the state with measurable data to identify the progress and success of the program, including but not limited to, the number of individuals served, length and type of assistance, follow-up and program evaluation."; and

Further amend pages 12-13, Section 208.571, lines 15-20, by striking all of said lines.

Senator Jacob moved that the above amendment be adopted, which motion prevailed.

Senator Schneider offered SA 19:

SENATE AMENDMENT NO. 19

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 13, Section 208.571, Line 20, by inserting after all of said line the following:

"376.815. No health carrier, as defined in section 376.1350, shall change its drug formulary except pursuant to a United States Department of Health and Human Services Food and Drug Administration recommen-dation or at the beginning of each policy annual anniversary date. A health carrier, however, may add new prescription drugs to its formulary during such period. No health carrier shall increase an enrollee's co-payment, co-insurance or other out-of-pocket expense for formulary drugs except at the beginning of each policy annual anniversary date."; and

Further amend the title and enacting clause accordingly.

Senator Schneider moved that the above amendment be adopted.

Senator Singleton raised the point of order that SA 19 is out of order as it goes beyond the scope of the bill.

The point of order was referred to the President Pro Tem, who ruled it well taken.

Senator Rohrbach offered SA 20, which was read:

SENATE AMENDMENT NO. 20

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 7, Section 208.556, Line 18, by inserting immediately after the "," on said line the following: "therapeutic substitution of pharmaceuticals,".

Senator Rohrbach moved that the above amendment be adopted, which motion prevailed.

Senator Bland offered SA 21:

SENATE AMENDMENT NO. 21

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 6, Section 208.553, Line 19, by striking the word "four" and inserting in lieu thereof the word "six"; and

Further amend said page, said section, line 24, by adding after all of said lines the following:

"; and

(e) Two African-American Legislators; one member of the Senate and one member from the House;"; and

Further amend said page, said section, line 23, by striking the word "and".

Senator Bland moved that the above amendment be adopted.

Senator Childers offered SSA 1 for SA 21, which was read:

SENATE SUBSTITUTE AMENDMENT NO. 1 FOR SENATE AMENDMENT NO. 21

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 6, Section 208.553, Line 19, by striking the word "four" and inserting in lieu thereof, the word "five"; and

Further amend said page, said section, line 24, by adding after all of said lines the following:

"; and

(e) One African-American Legislator from the House or Senate"; and

Further amend said page, said section, line 23, by striking the word "and".

Senator Childers moved that the above substitute amendment be adopted.

At the request of Senator Childers, the above substitute amendment was withdrawn.

SA 21 was again taken up.

Senator Childers offered SSA 2 for SA 21, which was read:

SENATE SUBSTITUTE AMENDMENT NO. 2 FOR SENATE AMENDMENT NO. 21

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 5, Section 208.553, Line 14, by inserting after all of said line the following:

"(3) One of the Legislator members shall be African-American;"; and

Renumber remaining sections accordingly.

Senator Childers moved that the above substitute amendment be adopted.

Senator Bland requested a roll call vote be taken on the adoption of SSA 2 for SA 21 and was joined in her request by Senators Childers, Johnson, Stoll and Wiggins.

SSA 2 for SA 21 failed of adoption by the following vote:

YEAS--Senators

Bentley Cauthorn Childers Gibbons

Johnson Kenney Kinder Klarich

Klindt Loudon Rohrbach Russell

Singleton Steelman--14

NAYS--Senators

Bland Caskey DePasco Dougherty

Goode Gross Jacob Mathewson

Quick Schneider Scott Stoll

Wiggins Yeckel Lt. Gov. Maxwell--15

Absent--Senators--None

Absent with leave--Senators

Carter Foster House Sims

Staples Westfall--6

SA 21 was again taken up.

Senator Kinder requested a roll call vote be taken on the adoption of SA 21 and was joined in his request by Senators Klarich, Kenney, Rohrbach and Russell.

Senator Schneider offered SA 1 to SA 21, which was read:

SENATE AMENDMENT NO. 1 TO

SENATE AMENDMENT NO. 21

Amend Senate Amendment No. 21 to Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Line 6, by striking the words "African-American Legislators" and substitute: "African-Americans".

Senator Schneider moved that the above amendment be adopted, which motion failed.

SA 21 failed of adoption by the following vote:

YEAS--Senators

Bentley Bland Caskey Childers

DePasco Dougherty Goode Jacob

Mathewson Quick Schneider Stoll

Wiggins--13

NAYS--Senators

Cauthorn Gibbons Gross Johnson

Kenney Kinder Klarich Klindt

Loudon Rohrbach Russell Scott

Singleton Steelman Yeckel--15

Absent--Senators--None

Absent with leave--Senators

Carter Foster House Sims

Staples Westfall--6

Senator Singleton offered SA 22:

SENATE AMENDMENT NO. 22

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 10, Section 208.562, Line 7, by deleting the words "pharmaceutical investment" and further amend said page, said section, line 8, by deleting the words "program for seniors" and inserting in lieu thereof, the following: "Missouri Senior Rx Program".

Senator Singleton moved that the above amendment be adopted, which motion prevailed.

Senator Jacob offered SA 23, which was read:

SENATE AMENDMENT NO. 23

Amend Senate Committee Substitute for Senate Bills Nos. 4, 1, 5 and 6, Page 13, Section 208.571, Line 20, by inserting after all of said line the following:

"Section 1. All of the provisions of sections 135.094, 135.095, 208.550, 208.553, 208.556, 208.559, 208.562, 208.565, 208.568 and 208.571 are severable. If any provisions of sections 135.094, 135.095, 208.550, 208.553, 208.556, 208.559, 208.562, 208.565, 208.568 and 208.571 are found by a court of competent jurisdiction to be unconstitutional or unconstitutionally enacted, the remaining provisions shall be and remain valid."; and

Further amend the title and enacting clause accordingly.

Senator Jacob moved that the above amendment be adopted, which motion prevailed.

Senator Singleton moved that SCS for SBs 4, 1, 5 and 6, as amended, be adopted, which motion prevailed.

On motion of Senator Singleton, SCS for SBs 4, 1, 5 and 6, as amended, was declared perfected and ordered printed.

THIRD READING OF SENATE BILLS

SB 2, introduced by Senator Cauthorn, et al, entitled:

An Act to repeal sections 277.203 and 277.212, RSMo, relating to livestock packers, and to enact in lieu thereof three new sections relating to the same subject, with an emergency clause.

Was taken up.

On motion of Senator Cauthorn, SB 2 was read the 3rd time and passed by the following vote:

YEAS--Senators

Bentley Bland Caskey Cauthorn

Childers DePasco Dougherty Gibbons

Gross Jacob Johnson Kenney

Kinder Klarich Klindt Loudon

Mathewson Quick Rohrbach Russell

Schneider Scott Singleton Steelman

Stoll Wiggins Yeckel--27

NAYS--Senators--None

Absent--Senator Goode--1

Absent with leave--Senators

Carter Foster House Sims

Staples Westfall--6

The President declared the bill passed.

The emergency clause was adopted by the following vote:

YEAS--Senators

Bentley Caskey Cauthorn Childers

DePasco Dougherty Gibbons Gross

Jacob Johnson Kenney Kinder

Klarich Klindt Loudon Mathewson

Quick Rohrbach Russell Schneider

Scott Singleton Steelman Stoll

Wiggins Yeckel--26

NAYS--Senators--None

Absent--Senators

Bland Goode--2

Absent with leave--Senators

Carter Foster House Sims

Staples Westfall--6

On motion of Senator Cauthorn, title to the bill was agreed to.

Senator Cauthorn moved that the vote by which the bill passed be reconsidered.

Senator Kenney moved that motion lay on the table, which motion prevailed.

REPORTS OF STANDING COMMITTEES

Senator Singleton, Chairman of the Committee on State Budget Control, submitted the following report:

Mr. President: Your Committee on State Budget Control, to which was referred SCS for SBs 3, 8 and 9, begs leave to report that it has considered the same and recommends that the bill do pass.

Senator Kenney requested unanimous consent of the Senate to suspend Senate Rule 52 for the purpose of 3rd reading SCS for SBs 3, 8 and 9, which request was granted.

THIRD READING OF SENATE BILLS

SCS for SBs 3, 8 and 9, entitled:

SENATE COMMITTEE SUBSTITUTE FOR

SENATE BILLS NOS. 3, 8 and 9An Act relating to individual income tax treatment of federal credit or advance refund of federal credit allowed to individual taxpayers under section 6428 of the Internal Revenue Code for tax year 2001, with an emergency clause.

Was taken up by Senator Gibbons.

On motion of Senator Gibbons, SCS for SBs 3, 8 and 9 was read the 3rd time and passed by the following vote:

YEAS--Senators

Bentley Caskey Cauthorn Childers

DePasco Gibbons Gross Jacob

Johnson Kenney Kinder Klarich

Klindt Loudon Mathewson Quick

Rohrbach Russell Scott Singleton

Steelman Stoll Wiggins Yeckel--24

NAYS--Senators

Dougherty Schneider--2

Absent--Senators

Bland Goode--2

Absent with leave--Senators

Carter Foster House Sims

Staples Westfall--6

The President declared the bill passed.

The emergency clause was adopted by the following vote:

	YEAS--Senators
Bentley	Caskey	Cauthorn	Childers
DePasco	Gibbons	Gross	Jacob
Johnson	Kenney	Kinder	Klarich
Klindt	Loudon	Mathewson	Quick
Rohrbach	Russell	Scott	Singleton
Steelman	Stoll	Wiggins	Yeckel--24

	NAYS--Senators
Dougherty	Schneider--2

	Absent--Senators
Bland	Goode--2

	Absent with leave--Senators
Carter	Foster	House	Sims
Staples	Westfall--6

On motion of Senator Gibbons, title to the bill was agreed to.

Senator Gibbons moved that the vote by which the bill passed be reconsidered.

Senator Kenney moved that motion lay on the table, which motion prevailed.

REPORTS OF STANDING COMMITTEES

Senator Kenney, Chairman of the Committee on Rules, Joint Rules, Resolutions and Ethics, submitted the following report:

Mr. President: Your Committee on Rules, Joint Rules, Resolutions and Ethics, to which was referred SCS for SBs 4, 1, 5 and 6, begs leave to report that it has examined the same and finds that the bill has been truly perfected and that the printed copies furnished the Senators are correct.

REFERRALS

President Pro Tem Kinder referred SCS for SBs 4, 1, 5 and 6 to the Committee on State Budget Control.

Senator Singleton requested unanimous consent of the Senate to allow the Committee on State Budget Control to meet while the Senate is in session, which request was granted.

REPORTS OF STANDING COMMITTEES

Senator Singleton, Chairman of the Committee on State Budget Control, submitted the following report:

Mr. President: Your Committee on State Budget Control, to which was referred SCS for SBs 4, 1, 5 and 6, begs leave to report that it has considered the same and recommends that the bill do pass.

Senator Kenney requested unanimous consent of the Senate to suspend Senate Rule 52 for the purpose of 3rd reading SCS for SBs 4, 1, 5 and 6, which request was granted.

THIRD READING OF SENATE BILLS

SCS for SBs 4, 1, 5 and 6, entitled:

SENATE COMMITTEE SUBSTITUTE FOR

SENATE BILLS NOS. 4, 1, 5 and 6An Act to repeal sections 135.095, 208.010 and 208.151, RSMo, relating to medical assistance for the elderly, and to enact in lieu thereof twelve new sections relating to the same subject, with a contingent effective date for a certain section, an expiration date and an emergency clause.

Was taken up by Senator Singleton.

On motion of Senator Singleton, SCS for SBs 4, 1, 5 and 6 was read the 3rd time and passed by the following vote:

YEAS--Senators

Bentley Caskey Cauthorn Childers

DePasco Dougherty Gibbons Gross

Johnson Kenney Kinder Klarich

Klindt Loudon Mathewson Quick

Russell Schneider Scott Singleton

Steelman Stoll Wiggins Yeckel--24

NAYS--Senators

Bland Jacob Rohrbach--3

Absent--Senator Goode--1

Absent with leave--Senators

Carter Foster House Sims

Staples Westfall--6

The President declared the bill passed.

On motion of Senator Singleton, title to the bill was agreed to.

Senator Singleton moved that the vote by which the bill passed be reconsidered.

Senator Kenney moved that motion lay on the table, which motion prevailed.

RESOLUTIONS

Senator Cauthorn offered Senate Resolution No. 14, regarding the Ninetieth Birthday of Cora Velma Brownfield Stegner Geiger, which was adopted.

Senator Bentley offered Senate Resolution No. 15, regarding the Twenty-fifth Anniversary of the History Museum for Springfield-Greene County, which was adopted.

Senator Yeckel offered Senate Resolution No. 16, regarding the Vera Lane Memorial Kitchen and Dining Room at Thomas Jefferson School, St. Louis, which was adopted.

Senator Russell offered Senate Resolution No. 17, regarding the Fiftieth Wedding Anniversary of Mr. and Mrs. Eugene Swanigan, Tunas, which was adopted.

INTRODUCTION OF GUESTS

Senator Rohrbach introduced to the Senate, Beth Rohrbach, California.

On motion of Senator Kenney, the Senate adjourned until 4:00 p.m., Monday, September 10, 2001.

	Present--Senators
Bentley	Bland	Caskey	Cauthorn
Childers	DePasco	Dougherty	Gibbons
Goode	Gross	Jacob	Johnson
Kenney	Kinder	Klarich	Klindt
Loudon	Mathewson	Quick	Rohrbach
Russell	Schneider	Scott	Singleton
Steelman	Stoll	Wiggins	Yeckel--28

	Absent with leave--Senators
Carter	Foster	House	Sims
Staples	Westfall--6

	The Lieutenant Governor was present.