HCS SCS SB 500 -- MISSOURI PART C EARLY INTERVENTION SYSTEM

SPONSOR:  Gibbons (Lager)

COMMITTEE ACTION:  Voted "do pass" by the Special Committee on
General Laws by a vote of 7 to 0.

This substitute establishes the Part C Early Intervention System,
administered by a lead state agency designated by the Governor,
to provide early intervention services to eligible infants and
toddlers as determined by state regulations.  The system will
include a comprehensive, child-find system and public awareness
program to ensure that eligible children are identified, located,
referred, and evaluated for eligibility.  The lead agency will
establish a State Interagency Coordinating Council to assist in
the implementation of the program.

The delivery of program services will be organized on a regional
basis with the lead agency establishing a bidding process for
determining regional offices across the state.  The bidding
process will include criteria for allowing regions to implement
models that will serve the unique needs of their community.  The
bidding process will encourage agreements between organizations
and other state and local governmental entities providing similar
services to infants and toddlers, including the Department of
Mental Health's Division of Mental Retardation and Developmental
Disabilities regional centers and local Senate Bill 40 boards.

Each regional office will include in their proposal assurances
and documentation of their plan to provide for those functions
that are specifically identified under state and federal
regulations and implement a system of provider oversight to
ensure all services are available and accessible.  The program
services will emphasize the family's central role by using
coaching approaches and focusing on implementing the child's
developmental goals.

No general revenue funds appropriated to the lead agency for the
system can be used to satisfy financial commitments for services
that should be paid from another public or private source.
Federal funds received by the system can be used to prevent the
delay of early intervention services; however, the system will
seek recovery from public or private sources that have ultimate
responsibility for the payment.

Beginning October 1, 2005, families with incomes that are above
the Missouri Medicaid Program eligibility level will pay a family
cost participation fee on a sliding scale of $5 to $100 a month.
Moneys collected from the fee and insurance reimbursements will
be used to fund the program.

The Part C Early Intervention System Review Commission is
established to examine the operation, implementation, and funding
of the system.  The commission will have nine members consisting
of three individuals appointed by the Governor, three members
from the House of Representatives appointed by the Speaker of the
House of Representatives, and three members from the Senate
appointed by the President Pro Tem of the Senate.  The commission
will report annually to the General Assembly beginning no later
than March 1, 2006.

Currently, school districts may coordinate with public, private,
and private not-for-profit agencies for the delivery of special
education and related services for children three to four years
of age with handicaps.  The substitute requires school districts
to coordinate with these agencies.

School districts providing early childhood special education will
give consideration to the value of continuing services with Part
C early intervention system providers for the remainder of the
school year when developing an individualized education program
for a student who has previously received these services and
reaches age three during a regular school year.

Two million dollars will be transferred from the Department of
Insurance Dedicated Fund to the Part C Early Intervention System
Fund.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of $50,000
to Unknown in FY 2006, $1,650,000 to Unknown in FY 2007, and
$1,650,000 to Unknown in FY 2008.  Estimated Effect on Other
State Funds of a Cost of $2,000,000 in FY 2006, an Income of $0
in FY 2007, and an Income of $0 in FY 2008.

PROPONENTS:  Supporters say that it is very important to the
state to keep the First Steps Program in operation and better
manage the available funds.  Early intervention is the key to
getting these children in programs that will help them to grow
and prosper.  Families will not have a problem making the
co-payments.  Insurance companies should be required to pay their
fair share.  In other states, private insurance pays
approximately 40% of the program costs.

Testifying for the bill were Senator Gibbons; Triality,
Incorporated; Missouri State Teachers Association; First Steps of
Southwest Missouri; Citizens for Missouri's Children; Regional
Interagency Coordinating Council for First Steps; and
Developmental Services of Franklin County.

OPPONENTS:  Those who oppose the bill say that the First Steps
Program is very helpful to families.  The cost-sharing portion
could be a problem for those families that are on the border line
of being eligible for Missouri Medicaid Program benefits and may
choose not to participate in this valuable program.

Testifying against the bill was Tom Newport.

OTHERS:  Others testifying on the bill say that if the bill is
passed in its current form, the cost to purchase health insurance
will increase.  Larger companies will be affected less because
they can spread the risk across their entire book of business;
however, it may affect smaller companies more.  Mandated coverage
is never a good idea.

Others testifying on the bill were Group Health Plan; United
Healthcare; America's Health Insurance Plans; and Missouri
Association of Health Plans.

Marc Webb, Legislative Analyst

Missouri House of Representatives
93rd General Assembly, 1st Regular Session
Last Updated August 25, 2005 at 1:21 pm