Journal of the House

First Regular Session, 94th General Assembly

SEVENTY-SEVENTH DAY, Thursday, May 17, 2007

The House met pursuant to adjournment.

            Speaker Jetton in the Chair.

            Prayer by Msgr. Donald W. Lammers.

              Almighty God, in these last days of the 2007 Session of this body, we ask that Your grace sustain us in the zeal with which we began in January. Help us to give to each topic still on our agenda the attention it deserves. Hold us in the virtue of great integrity, so that our judgments and decisions this week flow from the best of our wisdom and study.

              May the work we are accomplishing this Session be like the spring planting, destined to bear fruit aplenty, meeting the needs of the people.

              We pray for those who have suffered from the flood waters; we give thanks that not many were harmed and that the waters are returning to their banks. We praise You for these signs of Your care for us.

              We pray to You Almighty God, living and reigning forever and ever. Amen.

            The Pledge of Allegiance to the flag was recited.

            The Speaker appointed the following to act as Honorary Pages for the Day, to serve without compensation: Peyton Elizabeth Bowman, Lisa Mitchell, Mark Mitchell, Molly Mitchell, Lilly Mitchell and Dalton Tate.

            The Journal of the seventy-sixth day was approved as printed.

SPECIAL RECOGNITION

            Jerry Oligschlaeger, Doorman for the Missouri House of Representatives, was introduced by Representative Villa and recognized for twenty-two years of service with the House.

COMMITTEE REPORTS

            Committee on Fiscal Review, Chairman Guest reporting:

            Mr. Speaker: Your Committee on Fiscal Review, to which was referred HCS SS#2 SCS SB 161 (Fiscal Note), begs leave to report it has examined the same and recommends that it Do Pass.

            Mr. Speaker: Your Committee on Fiscal Review, to which was referred HCS SCS SB 328 (Fiscal Note), begs leave to report it has examined the same and recommends that it Do Pass.

            Mr. Speaker: Your Committee on Fiscal Review, to which was referred HCS SS SB 358 (Fiscal Note), begs leave to report it has examined the same and recommends that it Do Pass.

            Mr. Speaker: Your Committee on Fiscal Review, to which was referred HCS SB 419 (Fiscal Note), begs leave to report it has examined the same and recommends that it Do Pass.

THIRD READING OF SENATE BILLS

            HCS SS SCS SB 320, relating to veterinary student loan assistance, was taken up by Representative Quinn (7).

            Representative Pratt assumed the Chair.

            Representative Lampe offered House Amendment No. 1.

House Amendment No. 1

AMEND House Committee Substitute for Senate Substitute for Senate Committee Substitute for Senate Bill No. 320, Page 1, Section A, Line 5, by inserting immediately after said line the following:

              "261.020. The state director of the department of agriculture is hereby constituted the official who has supervision of all the legalized departments of the state which are of a regulatory nature for the advancement of horticulture and agriculture, except after January 1, 1996, he or she shall not have direct supervision of the state fair. He or she shall cooperate with the college of agriculture of the University of Missouri in all ways beneficial to the horticultural and agricultural interests of the state, without duplicating research, extension or educational work conducted by said college, but nothing herein shall be construed as to subordinate the state department of agriculture to the said college of agriculture. The director has charge of the veterinary service of the state, the appointment of the state veterinarian, and, with the advice of the veterinarian, of deputy veterinarians, and other assistants. The director has the power of reasonable quarantine in relation to the regulatory laws of the state department of agriculture, and the power of quarantine in relation to livestock diseases includes poultry. It is the duty of the director to gather and compile helpful statistics and information, singly or in cooperation with the federal government, relating to horticulture and agriculture, and he or she may publish bulletins not duplicating available educational bulletins of the college of agriculture and the United States Department of Agriculture. He or she may charge a reasonable amount for any publication distributed by the department of agriculture. Any funds received from the amounts so charged shall be deposited to the credit of the general revenue fund. The director shall make a biennial report to the governor and the general assembly, including the essential information relating to horticulture and agriculture, especially crops and livestock, also data concerning the agricultural organizations of the state, accompanied by recommendations relating to the state department of agriculture and the advancement of agricultural education."; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            On motion of Representative Lampe, House Amendment No. 1 was adopted by the following vote:

            Representative Dempsey moved the previous question.

            Which motion was adopted by the following vote:

            On motion of Representative Quinn (7), HCS SS SCS SB 320, as amended, was adopted.

            On motion of Representative Quinn (7), HCS SS SCS SB 320, as amended, was read the third time and passed by the following vote:

            Representative Pratt declared the bill passed.

            HCS SCS SB 299 & SS SCS SB 616, as amended, relating to liquor control, was taken up by Representative Cooper (120).

            Representative Dixon offered House Amendment No. 3.

House Amendment No. 3

AMEND House Committee Substitute for Senate Committee Substitute for Senate Bill No. 299 and Senate Substitute for Senate Committee Substitute for Senate Bill No. 616, Page 19, Section 311.489, Line 60, by inserting immediately after said line the following:

              "311.685. 1. Any retail licensee selling intoxicating liquor or nonintoxicating beer under this chapter or chapter 312, RSMo, and aggrieved by official action of the supervisor affecting the licensee, may bring a civil action against any person who is the proximate cause of such official action by the supervisor, if the violation occurred on or about the premises of the retail licensee. If a judgment is entered in favor of the licensee, the court shall award the retail licensee civil damages up to an amount of five thousand dollars and shall award reasonable court costs and attorney fees.

              2. No civil action shall be brought under this section against any employee of the supervisor of alcohol and tobacco control or any law enforcement officer."; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            On motion of Representative Dixon, House Amendment No. 3 was adopted.

            Representative Davis offered House Amendment No. 4.

House Amendment No. 4

AMEND House Committee Substitute for Senate Committee Substitute for Senate Bill No. 299 and Senate Substitute for Senate Committee Substitute for Senate Bill No. 616, Section 311.489, Page 18, Line 19, by inserting after "3." the following:

              "(1) Except as otherwise provided in subdivision (2) of this subsection,"; and

              Further amend said section and page, Line 25, by inserting after "However," the following:

              "except as otherwise provided in subdivision (2) of this subsection,"; and

              Further amend said section and page, Line 32, by inserting the following after all of said line:

              "(2) Notwithstanding any provision of this subsection to the contrary, the governing municipality may approve the plan with more restrictive hours of operation."; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            Representative Davis moved that House Amendment No. 4 be adopted.

            Which motion was defeated.

            Representative Schad offered House Amendment No. 5.

            Representative Skaggs raised a point of order that House Amendment No. 5 goes beyond the scope of the bill.

            Representative Pratt requested a parliamentary ruling.

            The Parliamentary Committee ruled the point of order well taken.

            Representative Nolte offered House Amendment No. 6.

            Representative Frame raised a point of order that House Amendment No. 6 goes beyond the scope of the bill.

            Representative Pratt requested a parliamentary ruling.

            The Parliamentary Committee ruled the point of order well taken.

            Representative Dempsey moved the previous question.

            Which motion was adopted by the following vote:

            On motion of Representative Cooper (120), HCS SCS SB 299 & SS SCS SB 616, as amended, was adopted.

            On motion of Representative Cooper (120), HCS SCS SB 299 & SS SCS SB 616, as amended, was read the third time and passed by the following vote:

            Representative Pratt declared the bill passed.

            SS SCS SB 225, relating to hunting heritage protection, was taken up by Representative Munzlinger.

            On motion of Representative Munzlinger, SS SCS SB 225 was truly agreed to and finally passed by the following vote:

            Representative Pratt declared the bill passed.

BILL IN CONFERENCE

            CCR SS SCS HCS HB 780, as amended, relating to professional registration, was taken up by Representative Wasson.

            On motion of Representative Wasson, CCR SS SCS HCS HB 780, as amended, was adopted by the following vote:

            On motion of Representative Wasson, CCS SS SCS HCS HB 780 was read the third time and passed by the following vote:

            Representative Pratt declared the bill passed.

THIRD READING OF SENATE BILL

            HCS#2 SCS SB 333, relating to health and senior services, was taken up by Representative Cooper (155).

            Representative Cooper (155) offered House Amendment No. 1.

House Amendment No. 1

AMEND House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Pages 79 to 85, Sections 197.551, 197.554, 197.557, 197.560, 197.563, 197.566, 197.569, 197.572, 197.575, 197.578, 197.581, 197.584, and 197.587, by deleting all of said sections from the bill; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            On motion of Representative Cooper (155), House Amendment No. 1 was adopted.

            Representative Cooper (155) offered House Amendment No. 2.

House Amendment No. 2

AMEND House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Page 77, Section 194.285, Lines 1-3, by deleting all of said lines and inserting in lieu thereof the following:

              “194.285. 1. A person who acts without negligence and in good faith in accordance with sections 194.210 to 194.294 or with the anatomical gift laws of another state or foreign country is not liable for damages in any civil action or subject to prosecution in any criminal proceeding for his or her act. A party claiming another person was negligent shall have the burden of proving the claimed negligence.”; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            On motion of Representative Cooper (155), House Amendment No. 2 was adopted.

            Representative Schad offered House Amendment No. 3.

House Amendment No. 3

AMEND House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Page 112, Section 620.510, Line 2, by deleting the words “economic development” and inserting in lieu thereof the words “health and senior services”; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            On motion of Representative Schad, House Amendment No. 3 was adopted.

            Representative Bruns offered House Amendment No. 4.

House Amendment No. 4

AMEND House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Page 46, Section 192.2175, Lines 114 through 117, by deleting all of said lines and inserting in lieu thereof the following:

              “288.100, RSMo. Any person who is employed in a position for”; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            On motion of Representative Bruns, House Amendment No. 4 was adopted.

            Representative Bruns offered House Amendment No. 5.

House Amendment No. 5

AMEND House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Section 570.145, Page 111, Line 10, by deleting the open bracket "["; and

              Further amend said substitute, said section, said page, Line 11, by deleting the closed bracket "]"; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            On motion of Representative Bruns, House Amendment No. 5 was adopted.

            Representative Cooper (158) offered House Amendment No. 6.

House Amendment No. 6

AMEND House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Page 5, Section 58.451, Line 92, by inserting after the word "on" and before the word "the" the following:

              "the coroner to determine"; and

              Further amend said bill, Page 7, Section 58.570, Line 71, by inserting after the word "on" and before the word "the" the following:

              "The coroner to determine"; and

              Further amend said bill, Page 111, Section 570.145, Line 3, by deleting the "[" before the word "with", inserting an "[" before the word "permanently", removing the "]" after the word "deprive" and inserting a "]" after the word "permanently".

            On motion of Representative Cooper (158), House Amendment No. 6 was adopted.

            Representative Portwood offered House Amendment No. 7.

House Amendment No. 7

AMEND House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Section 58.785, Page 10, Line 59, by inserting after all of said section, the following:

              "191.227. 1. All physicians, chiropractors, hospitals, dentists, and other duly licensed practitioners in this state, herein called "providers", shall, upon written request of a patient, or guardian or legally authorized representative of a patient, furnish a copy of his or her record of that patient's health history and treatment rendered to the person submitting a written request, except that such right shall be limited to access consistent with the patient's condition and sound therapeutic treatment as determined by the provider. [Beginning August 28, 1994,] Such record shall be furnished within a reasonable time of the receipt of the request therefor and upon payment of a fee as provided in this section.

              2. Health care providers may condition the furnishing of the patient's health care records to the patient, the patient's authorized representative or any other person or entity authorized by law to obtain or reproduce such records upon payment of a fee for:

              (1) Copying, in an amount [not more than seventeen] of eighteen dollars and [five] forty-nine cents plus [forty] forty-four cents per page for the cost of supplies and labor;

              (2) Postage, to include packaging and delivery cost; and

              (3) Certification and notary fee[, not to exceed two] of eight dollars, if certification is requested.

              3. Notwithstanding provisions of this section to the contrary, providers may charge for the reasonable cost of all duplications of health care record material or information which cannot routinely be copied or duplicated on a standard commercial photocopy machine.

              4. The transfer of the patient's record done in good faith shall not render the provider liable to the patient or any other person for any consequences which resulted or may result from disclosure of the patient's record as required by this section.

              5. Effective February first of each year, the fees listed in subsection 2 of this section shall be increased or decreased annually based on the annual percentage change in the unadjusted, U.S. city average, annual average inflation rate of the medical care component of the Consumer Price Index for All Urban Consumers (CPI-U). The current reference base of the index, as published by the Bureau of Labor Statistics of the United States Department of Labor, shall be used as the reference base. For purposes of this subsection, the annual average inflation rate shall be based on a twelve-month calendar year beginning in January and ending in December of each preceding calendar year. The department of health and senior services shall report the annual adjustment and the adjusted fees authorized in this section on the department's Internet web site by February first of each year."; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            Representative Darrough raised a point of order that House Amendment No. 7 is not germane to the bill.

            Representative Pratt requested a parliamentary ruling.

            The Parliamentary Committee ruled the point of order not well taken.

            On motion of Representative Portwood, House Amendment No. 7 was adopted.

            Representative Zweifel offered House Amendment No. 8.

            Representative Jones (89) raised a point of order that House Amendment No. 8 goes beyond the scope of the bill.

            Representative Pratt requested a parliamentary ruling.

            The Parliamentary Committee ruled the point of order well taken.

            Representative Silvey offered House Amendment No. 9.

House Amendment No. 9

AMEND House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Page 101, Section 199.051, Line 2, by inserting immediately after said line the following:

              “208.014. 1. There is hereby established the "Medicaid Reform Commission". The commission shall have as its purpose the study and review of recommendations for reforms of the state Medicaid system. The commission shall consist of ten members:

              (1) Five members of the house of representatives appointed by the speaker; and

              (2) Five members of the senate appointed by the pro tem.

No more than three members from each house shall be of the same political party. The directors of the department of social services, the department of health and senior services, and the department of mental health or the directors' designees shall serve as ex officio members of the commission.

              2. Members of the commission shall be reimbursed for the actual and necessary expenses incurred in the discharge of the member's official duties.

              3. A chair of the commission shall be selected by the members of the commission.

              4. The commission shall meet as necessary.

              5. The commission is authorized to contract with a consultant. The compensation of the consultant and other personnel shall be paid from the joint contingent fund or jointly from the senate and house contingent funds until an appropriation is made therefor.

              6. The commission shall make recommendations in a report to the general assembly by January 1, 2006, on reforming, redesigning, and restructuring a new, innovative state Medicaid healthcare delivery system under Title XIX, Public Law 89-97, 1965, amendments to the federal Social Security Act (42 U.S.C. Section 30 et. seq.) as amended, to replace the current state Medicaid system under Title XIX, Public Law 89-97, 1965, amendments to the federal Social Security Act (42 U.S.C. Section 30, et seq.), which shall sunset on June 30, [2008] 2010.

              208.631. 1. Notwithstanding any other provision of law to the contrary, the department of social services shall establish a program to pay for health care for uninsured children. Coverage pursuant to sections 208.631 to 208.660 is subject to appropriation. The provisions of sections 208.631 to 208.657 shall be void and of no effect after June 30, [2008] 2010.

              2. For the purposes of sections 208.631 to 208.657, "children" are persons up to nineteen years of age. "Uninsured children" are persons up to nineteen years of age who are emancipated and do not have access to affordable employer-subsidized health care insurance or other health care coverage or persons whose parent or guardian have not had access to affordable employer-subsidized health care insurance or other health care coverage for their children for six months prior to application, are residents of the state of Missouri, and have parents or guardians who meet the requirements in section 208.636. A child who is eligible for medical assistance as authorized in section 208.151 is not uninsured for the purposes of sections 208.631 to 208.657.”; and

              Further amend said bill, Page 102, Section 208.909, Line 36, by inserting immediately after said section the following:

              “208.930. 1. As used in this section, the term "department" shall mean the department of health and senior services.

              2. Subject to appropriations, the department may provide financial assistance for consumer-directed personal care assistance services through eligible vendors, as provided in sections 208.900 through 208.927, to each person who was participating as a non-Medicaid eligible client pursuant to sections 178.661 through 178.673, RSMo, on June 30, 2005, and who:

              (1) Makes application to the department;

              (2) Demonstrates financial need and eligibility under subsection 3 of this section;

              (3) Meets all the criteria set forth in sections 208.900 through 208.927, except for subdivision (5) of subsection 1 of section 208.903;

              (4) Has been found by the department of social services not to be eligible to participate under guidelines established by the Medicaid state plan; and

              (5) Does not have access to affordable employer-sponsored health care insurance or other affordable health care coverage for personal care assistance services as defined in section 208.900. For purposes of this section, "access to affordable employer-sponsored health care insurance or other affordable health care coverage" refers to health insurance requiring a monthly premium less than or equal to one hundred thirty-three percent of the monthly average premium required in the state's current Missouri consolidated health care plan.

Payments made by the department under the provisions of this section shall be made only after all other available sources of payment have been exhausted.

              3. (1) In order to be eligible for financial assistance for consumer-directed personal care assistance services under this section, a person shall demonstrate financial need, which shall be based on the adjusted gross income and the assets of the person seeking financial assistance and such person's spouse.

              (2) In order to demonstrate financial need, a person seeking financial assistance under this section and such person's spouse must have an adjusted gross income, less disability-related medical expenses, as approved by the department, that is equal to or less than three hundred percent of the federal poverty level. The adjusted gross income shall be based on the most recent income tax return.

              (3) No person seeking financial assistance for personal care services under this section and such person's spouse shall have assets in excess of two hundred fifty thousand dollars.

              4. The department shall require applicants and the applicant's spouse, and consumers and the consumer's spouse, to provide documentation for income, assets, and disability-related medical expenses for the purpose of determining financial need and eligibility for the program. In addition to the most recent income tax return, such documentation may include, but shall not be limited to:

              (1) Current wage stubs for the applicant or consumer and the applicant's or consumer's spouse;

              (2) A current W-2 form for the applicant or consumer and the applicant's or consumer's spouse;

              (3) Statements from the applicant's or consumer's and the applicant's or consumer's spouse's employers;

              (4) Wage matches with the division of employment security;

              (5) Bank statements; and

              (6) Evidence of disability-related medical expenses and proof of payment.

              5. A personal care assistance services plan shall be developed by the department pursuant to section 208.906 for each person who is determined to be eligible and in financial need under the provisions of this section. The plan developed by the department shall include the maximum amount of financial assistance allowed by the department, subject to appropriation, for such services.

              6. Each consumer who participates in the program is responsible for a monthly premium equal to the average premium required for the Missouri consolidated health care plan; provided that the total premium described in this section shall not exceed five percent of the consumer's and the consumer's spouse's adjusted gross income for the year involved.

              7. (1) Nonpayment of the premium required in subsection 6 shall result in the denial or termination of assistance, unless the person demonstrates good cause for such nonpayment.

              (2) No person denied services for nonpayment of a premium shall receive services unless such person shows good cause for nonpayment and makes payments for past-due premiums as well as current premiums.

              (3) Any person who is denied services for nonpayment of a premium and who does not make any payments for past-due premiums for sixty consecutive days shall have their enrollment in the program terminated.

              (4) No person whose enrollment in the program is terminated for nonpayment of a premium when such nonpayment exceeds sixty consecutive days shall be reenrolled unless such person pays any past-due premiums as well as current premiums prior to being reenrolled. Nonpayment shall include payment with a returned, refused, or dishonored instrument.

              8. (1) Consumers determined eligible for personal care assistance services under the provisions of this section shall be reevaluated annually to verify their continued eligibility and financial need. The amount of financial assistance for consumer-directed personal care assistance services received by the consumer shall be adjusted or eliminated based on the outcome of the reevaluation. Any adjustments made shall be recorded in the consumer's personal care assistance services plan.

              (2) In performing the annual reevaluation of financial need, the department shall annually send a reverification eligibility form letter to the consumer requiring the consumer to respond within ten days of receiving the letter and to provide income and disability-related medical expense verification documentation. If the department does not receive the consumer's response and documentation within the ten-day period, the department shall send a letter notifying the consumer that he or she has ten days to file an appeal or the case will be closed.

              (3) The department shall require the consumer and the consumer's spouse to provide documentation for income and disability-related medical expense verification for purposes of the eligibility review. Such documentation may include but shall not be limited to the documentation listed in subsection 4 of this section.

              9. (1) Applicants for personal care assistance services and consumers receiving such services pursuant to this section are entitled to a hearing with the department of social services if eligibility for personal care assistance services is denied, if the type or amount of services is set at a level less than the consumer believes is necessary, if disputes arise after preparation of the personal care assistance plan concerning the provision of such services, or if services are discontinued as provided in section 208.924. Services provided under the provisions of this section shall continue during the appeal process.

              (2) A request for such hearing shall be made to the department of social services in writing in the form prescribed by the department of social services within ninety days after the mailing or delivery of the written decision of the department of health and senior services. The procedures for such requests and for the hearings shall be as set forth in section 208.080.

              10. Unless otherwise provided in this section, all other provisions of sections 208.900 through 208.927 shall apply to individuals who are eligible for financial assistance for personal care assistance services under this section.

              11. The department may promulgate rules and regulations, including emergency rules, to implement the provisions of this section. 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. Any provisions of the existing rules regarding the personal care assistance program promulgated by the department of elementary and secondary education in title 5, code of state regulations, division 90, chapter 7, which are inconsistent with the provisions of this section are void and of no force and effect.

              12. The provisions of this section shall expire on June 30, [2008] 2010.”; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            Representative Baker (25) offered House Amendment No. 1 to House Amendment No. 9.

House Amendment No. 1

to

House Amendment No. 9

AMEND House Amendment No. 9 to House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Page 1, Line 21, by deleting the number "2006" and inserting in lieu thereof the following "[2006,] 2008, and biannually thereafter,"; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            On motion of Representative Baker (25), House Amendment No. 1 to House Amendment No. 9 was adopted.

            On motion of Representative Silvey, House Amendment No. 9, as amended, was adopted.

            Representative Oxford offered House Amendment No. 10.

House Amendment No. 10

AMEND House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Page 10, Section 58.785, Line 59, by inserting after all of said section and line the following:

              "192.331. For the purposes of sections 192.331 to 192.334, the following terms mean:

              (1) "Caseload standards", the minimum and maximum number of cases that an employee can reasonably be expected to perform in a normal work month based on the number of cases handled by the employee or the number of different job functions performed by the employee;

              (2) "Department", the department of health and senior services;

              (3) "Director", the director of the department of health and senior services;

              (4) "Professional caseload standards", caseload standards that are established by the director, after consideration of caseload standards established by national setting authorities or caseload standards used in other states which have similar job titles.

              192.332. 1. The director shall develop caseload standards based on the actual duties of employees in each program area of the department, after considering recommendations of the caseload standards advisory committee, established in section 192.333, and consistent with existing professional caseload standards.

              2. In establishing standards under sections 192.331 to 192.333, the director shall:

              (1) Ensure the standards are based on the actual duties of the employee;

              (2) Ensure the standards are consistent with existing professional caseload standards; and

              (3) Consider standards developed by other states for workers in similar positions of employment.

              3. Such standards shall be used by the director as the basis of the department's personnel budget request to the governor.

              4. If an employee has failed to satisfactorily complete assignments that are in excess of specified caseload standards, good faith efforts to complete such assignments shall be among the factors considered in the employee's performance evaluation. Any failure to complete assignments that are in excess of specified caseload standards shall not be a factor in determining an employee's eligibility for pay increases.

              5. Subject to appropriations, the department shall use the standards established under sections 192.331 to 192.333 to assign caseloads to individual employees.

              192.333. 1. The director shall convene, at least annually, a caseload standards committee which shall consist of seven nonsupervisory employees of the department and three division directors of the department or their designees. A representative of the employees' certified majority organization shall also serve on the committee in an advisory capacity, but may not vote on any measure before the committee. The caseload standards advisory committee shall include as nearly as possible employees from each program area of the department.

              2. The caseload standards advisory committee shall review professional and other caseload standards and recommendations the committee considers appropriate and recommend to the department minimum and maximum caseloads for each category of workers employed by the department.

              192.334. 1. The director shall submit an annual written report to the general assembly that provides data and statistical information regarding the caseloads of employees of the department. The report shall include the following:

              (1) The established caseload standards for employees in each program area of the department as required in section 192.332;

              (2) The actual caseloads for employees in each program area of the department;

              (3) A description of the methodology used to compute caseloads for employees in each program area of the department;

              (4) Indicate whether the statewide average caseloads of department employees exceed the caseload standards established by the department as required in section 192.332.

              2. The director shall make the report available to the public by posting the report on the department's Internet web site."; and

              Further amend said bill, Page 114, Section 620.510, Line 66, by inserting after all of said section and line the following:

              "630.101. For the purposes of sections 630.101 to 630.104, the following terms mean:

              (1) "Caseload standards", the minimum and maximum number of cases that an employee can reasonably be expected to perform in a normal work month based on the number of cases handled by the employee or the number of different job functions performed by the employee;

              (2) "Department", the department of mental health;

              (3) "Director", the director of the department of mental health;

              (4) "Professional caseload standards", caseload standards that are established by the director, after consideration of caseload standards established by national setting authorities or caseload standards used in other states which have similar job titles.

              630.102. 1. The director shall develop caseload standards based on the actual duties of employees in each program area of the department, after considering recommendations of the caseload standards advisory committee, established under section 630.103, and consistent with existing professional caseload standards.

              2. In establishing standards under sections 630.101 to 630.103, the director shall:

              (1) Ensure the standards are based on the actual duties of the employee;

              (2) Ensure the standards are consistent with existing professional caseload standards; and

              (3) Consider standards developed by other states for workers in similar positions of employment.

              3. Such standards shall be used by the director as the basis of the department's personnel budget request to the governor.

              4. If an employee has failed to satisfactorily complete assignments that are in excess of specified caseload standards, good faith efforts to complete such assignments shall be among the factors considered in the employee's performance evaluation. Any failure to complete assignments that are in excess of specified caseload standards shall not be a factor in determining an employee's eligibility for pay increases.

              5. Subject to appropriations, the department shall use the standards established under sections 630.101 to 630.103 to assign caseloads to individual employees.

              630.103. 1. The director shall convene, at least annually, a caseload standards committee which shall consist of seven nonsupervisory employees of the department and three division directors of the department or their designees. A representative of the employees' certified majority organization shall also serve on the committee in an advisory capacity, but may not vote on any measure before the committee. The caseload standards advisory committee shall include as nearly as possible employees from each program area of the department.

              2. The caseload standards advisory committee shall review professional and other caseload standards and recommendations the committee considers appropriate and recommend to the department minimum and maximum caseloads for each category of workers employed by the department.

              630.104. 1. The director shall submit an annual written report to the general assembly that provides data and statistical information regarding the caseloads of employees of the department. The report shall include the following:

              (1) The established caseload standards for employees in each program area of the department as required in section 630.102;

              (2) The actual caseloads for employees in each program area of the department;

              (3) A description of the methodology used to compute caseloads for employees in each program area of the department;

              (4) Indicate whether the statewide average caseloads of department employees exceed the caseload standards established by the department as required in section 630.102.

              2. The director shall make the report available to the public by posting the report on the department's Internet web site."; and

              Further amend said bill, Page 115, Section 660.010, Line 51, by inserting after all of said section and line the following:

              "660.020. 1. The director shall develop caseload standards based on the actual duties of employees in each program area of the department, after considering recommendations of the caseload standards advisory committee, established pursuant to section 660.021, and consistent with existing professional caseload standards.

              2. In establishing standards pursuant to sections 660.019 to 660.021, the director shall:

              (1) Ensure the standards are based on the actual duties of the caseworker;

              (2) Ensure the standards are consistent with existing professional caseload standards; and

              (3) Consider standards developed by other states for workers in similar positions of employment.

              3. Such standards shall be used by the director as the basis of the department's personnel budget request to the governor.

              4. If an employee has failed to satisfactorily complete assignments that are in excess of specified caseload standards, good faith efforts to complete such assignments shall be among the factors considered in the employee's performance evaluation. Any failure to complete assignments that are in excess of specified caseload standards shall not be a factor in determining an employee's eligibility for pay increases.

              5. Subject to appropriations, the department shall use the standards established pursuant to sections 660.019 to 660.021 to assign caseloads to individual employees.

              660.021. 1. The director shall convene, at least [biannually] annually, a caseload standards committee which shall consist of seven nonsupervisory employees of the department and three division directors of the department or their designees. A representative of the employees' certified majority organization shall also serve on the committee in an advisory capacity, but may not vote on any measure before the committee. The caseload standards advisory committee shall include as nearly as possible employees from each program area of the department.

              2. The caseload standards advisory committee shall review professional and other caseload standards and recommendations the committee considers appropriate and recommend to the department minimum and maximum caseloads for each category of workers employed by the department.

              660.022. 1. The director shall submit an annual written report to the general assembly that provides data and statistical information regarding the caseloads of employees of the department. The report shall include the following:

              (1) The established caseload standards for employees in each program area of the department as required in section 660.020;

              (2) The actual caseloads for employees in each program area of the department;

              (3) A description of the methodology used to compute caseloads for caseworkers in each program area of the department;

              (4) Indicate whether the statewide average caseloads of department caseworkers exceed the caseload standards established by the department as required in section 660.020.

              2. The director shall make the report available to the public by posting the report on the department's Internet web site."; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            Representative Oxford moved that House Amendment No. 10 be adopted.

            Which motion was defeated.

            Representative Page offered House Amendment No. 11.

House Amendment No. 11

AMEND House Committee Substitute No. 2 for Senate Committee Substitute for Senate Bill No. 333, Section 198.006, Page 89, Line 141, by inserting after all of said line the following:

              “198.069. For any resident of an assisted living facility who is released from a hospital or skilled nursing facility and returns to an assisted living facility as a resident, such resident's assisted living facility shall immediately, upon return, implement physician orders in the hospital or discharge summary, and within twenty-four hours of the patient's return to the facility, review and document such review of any physician orders related to the resident's hospital discharge care plan or the skilled nursing facilities discharge care plan and modify the individual service plan for the resident accordingly. The department of health and senior services may adjust personal care units authorized as described in subsection 14 of section 208.152, RSMo, upon the effective date of the physicians orders to reflect the services required by such orders.”; and

              Further amend said bill by amending the title, enacting clause, and intersectional references accordingly.

            On motion of Representative Page, House Amendment No. 11 was adopted.

            Representative Fallert offered House Amendment No. 12.

            Representative Jones (89) raised a point of order that House Amendment No. 12 goes beyond the scope of the bill.

            Representative Pratt requested a parliamentary ruling.

            The Parliamentary Committee ruled the point of order well taken.

            Representative Dempsey moved the previous question.

            Which motion was adopted by the following vote:

            On motion of Representative Cooper (155), HCS#2 SCS SB 333, as amended, was adopted.

            On motion of Representative Cooper (155), HCS#2 SCS SB 333, as amended, was read the third time and passed by the following vote: