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

This bill 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 its proposal assurances and
documentation of its 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 may be used to satisfy financial commitments for services
that should be paid from another public or private source.
Federal funds received by the system may 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.

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 bill 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.

The Department of Social Services must recognize the system
established under the bill and will pay all claims for
reimbursement for Medicaid-eligible children to the system.  The
department will seek insurance reimbursement for those eligible
children having other private insurance.

Every health carrier or health benefit plan that offers or issues
health benefit plans, other than Medicaid health benefit plans,
which are issued on or after January 1, 2006, will provide
coverage for medically necessary early intervention services for
children in the program.  The coverage will be limited to $3,000
per covered child, per policy, per calendar year, with a maximum
of $9,000 per child.  In the event a health benefit plan is not
required to provide coverage because of preemption by a federal
law, the lead agency will be responsible for the payment and for
providing any required benefit.

Health benefit plans cannot charge any greater deductibles,
copayments, or coinsurance than other similar health care
services provided.  The benefits paid cannot apply to the maximum
lifetime benefits payable under the contract.  Health benefit
plans will be billed and paid at the applicable Medicaid rate at
the time the covered benefit is delivered.

Payments made by a health carrier for these services will not
exceed 0.5% of the direct written premium for health benefit
plans on the health carrier's most recently filed annual
financial statement.  In lieu of reimbursing claims under these
provisions, a carrier may directly pay to the system by January
31 of the calendar year an amount equal to 0.5% of the direct
written premium or $500,000, whichever is less.  The payment will
constitute full and complete satisfaction of the health benefit
plan's obligation for the calendar year.

The Department of Insurance will collect data related to the
number of children receiving private insurance coverage and the
total amount of moneys paid on behalf of these children by
private health insurance carriers.  The department will report to
the General Assembly regarding the findings no later than January
30, 2007, and annually thereafter.

The provisions of the bill will expire two years after the
effective date unless reauthorized by the General Assembly.  If
the program is reauthorized, it will expire after 12 years.

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