FIRST REGULAR SESSION [TRULY AGREED TO AND FINALLY PASSED] CONFERENCE COMMITTEE SUBSTITUTE FOR SENATE COMMITTEE SUBSTITUTE FOR HOUSE COMMITTEE SUBSTITUTE FOR

HOUSE BILL NO. 10 102ND GENERAL ASSEMBLY 0010H.05T 2023

AN ACT To appropriate money for the expenses, grants, refunds, and distributions of the Department of Mental Health, the Department of Health and Senior Services, and the several divisions and programs thereof, and the Missouri Health Facilities Review Committee to be expended only as provided in Article IV, Section 28 of the Constitution of Missouri, and to transfer money among certain funds for the period beginning July 1, 2023, and ending June 30, 2024.

Be it enacted by the General Assembly of the state of Missouri, as follows:

There is appropriated out of the State Treasury, to be expended only as provided in 2 Article IV, Section 28 of the Constitution of Missouri for the purpose of funding each 3 department, division, agency, fund transfer, and program described herein, for the item or items 4 stated, and for no other purpose whatsoever, chargeable to the fund designated for the period 5 beginning July 1, 2023, and ending June 30, 2024, as follows:

PART 1

Section 10.000. Each appropriation in this act shall consist of the item or 2 items in each section of Part 1 of this act, for the amount and 3 purpose and from the fund designated in each section of Part 1, as 4 well as all additional clarifications of purpose in Part 2 of this act 5 that make reference by section to said item or items in Part 1. Any 6 clarification of purpose in Part 2 shall state the section or sections 7 in Part 1 to which it attaches and shall, together with the language 8 of said section(s) in Part 1, form the complete statement of purpose CCS SCS HCS HB 10 2

9 of the appropriation. As such, the provisions of Part 2 of this act 10 shall not be severed from Part 1, and if any clarification of purpose 11 in Part 2 is for any reason held to be invalid, such decision shall 12 invalidate all of the appropriations in this act of which said 13 clarification of purpose is a part. Part 3 of this act shall consist of 14 guidance to the Department of Mental Health and the Department 15 of Health and Senior Services in implementing the appropriations 16 found in Part 1 and Part 2 of this act. An appropriation may be 17 comprised in whole or in part of a one-time amount, and such one- 18 time amount shall be construed to be a component part of, and not 19 in addition to, the stated appropriation amount. Any amount of an 20 appropriation identified as “one-time” in this act shall not be 21 considered an addition to any ongoing core appropriation(s) in 22 future fiscal periods beyond June 30, 2024. Any amount 23 identified as one-time may, however, be requested in any future 24 fiscal period as a new decision item.

Section 10.005. To the Department of Mental Health 2 For the Office of the Director, provided three percent (3%) flexibility is 3 allowed from this section to Section 10.575 4 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $589,982 5 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20,385 6 From General Revenue Fund (0101). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 610,367

7 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89,579 8 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53,711 9 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . 143,290 10 Total (Not to exceed 7.82 F.T.E.) .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $753,657

Section 10.010. To the Department of Mental Health 2 For the Office of the Director 3 For paying overtime to state employees. Nonexempt state employees 4 identified by Section 105.935, RSMo, will be paid first with any 5 remaining funds being used to pay overtime to any other state 6 employees 7 Personal Service 8 From General Revenue Fund (0101). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,340,182 CCS SCS HCS HB 10 3

Section 10.015. To the Department of Mental Health 2 For the Office of the Director 3 For program operations and support, provided three percent (3%) 4 flexibility is allowed from this section to Section 10.575 5 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $5,861,619 6 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359,977 7 From General Revenue Fund (0101). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,221,596

8 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,213,337 9 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 792,009 10 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . . . . . . 2,005,346

11 To procure and implement a multi-year, vendor-hosted, integrated 12 commercial off the shelf electronic health record system for use in 13 all of the department's hospitals and facilities 14 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 591,287 15 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,490,000 16 From General Revenue Fund (0101). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,081,287 17 Total (Not to exceed 126.55 F.T.E.) .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $12,308,229

Section 10.020. To the Department of Mental Health 2 For the Office of the Director 3 For staff training, provided ten percent (10%) flexibility is allowed from 4 personal service to expense and equipment and three percent (3%) 5 flexibility is allowed from this section to Section 10.575 6 Expense and Equipment 7 From General Revenue Fund (0101). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $659,140

8 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221,553 9 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290,361 10 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . . . . . . . 511,914

11 For the Caring for Missourians' Mental Health Initiative 12 Expense and Equipment 13 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . 551,705 14 Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,722,759 CCS SCS HCS HB 10 4

Section 10.025. To the Department of Mental Health 2 For the Office of the Director 3 For funding insurance, private pay, licensure fee, and/or Medicaid refunds 4 by state facilities operated by the Department of Mental Health 5 From General Revenue Fund (0101). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $205,000

6 For refunds 7 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . . . . . . . 250,000 8 From Mental Health Interagency Payments Fund (0109). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 9 From Mental Health Intergovernmental Transfer Fund (0147). . . . . . . . . . . . . . . . . . . . . . . . . . 100 10 From Compulsive Gamblers Fund (0249). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 11 From Health Initiatives Fund (0275). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 12 From Mental Health Earnings Fund (0288). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50,000 13 From Habilitation Center Room and Board Fund (0435).. . . . . . . . . . . . . . . . . . . . . . . . . . 10,000 14 From Inmate Fund (0540). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 15 From Mental Health Trust Fund (0926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25,000 16 From DMH Local Tax Matching Fund (0930). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150,000

17 For the transfer payment of refunds set off against debts as required by 18 Section 143.786, RSMo 19 From Debt Offset Escrow Fund (0753). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25,000 20 Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $715,500

Section 10.030. To the Department of Mental Health 2 Funds are to be transferred out of the State Treasury to the Mental 3 Health Trust Fund 4 From Abandoned Fund Account (0863).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $100,000

Section 10.035. To the Department of Mental Health 2 For the Office of the Director 3 For receipt and disbursement of donations and gifts which may become 4 available to the Department of Mental Health during the year 5 (excluding federal grants and funds) 6 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $563,436 7 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,925,000 8 From Mental Health Trust Fund (0926) (Not to exceed 7.50 F.T.E.) . . . . . . . . . . . . . . $2,488,436 CCS SCS HCS HB 10 5

Section 10.040. To the Department of Mental Health 2 For the Office of the Director 3 For receiving and expending grants, donations, contracts, and payments 4 from private, federal, and other governmental agencies which may 5 become available between sessions of the General Assembly 6 provided the General Assembly shall be notified of the source of 7 any new funds and the purpose for which they shall be expended, 8 in writing, prior to the use of said funds 9 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $146,767 10 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,462,390 11 From Department of Mental Health Federal Fund (0148) (Not to exceed 12 2.00 F.T.E.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $2,609,157

Section 10.045. To the Department of Mental Health 2 For Medicaid payments related to intergovernmental payments 3 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . . . . $11,900,000 4 From Mental Health Intergovernmental Transfer Fund (0147). . . . . . . . . . . . . . . . 6,600,000 5 Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $18,500,000

Section 10.050. To the Department of Mental Health 2 Funds are to be transferred out of the State Treasury to the 3 Department of Social Services Intergovernmental Transfer Fund 4 for providing the state match for the Department of Mental Health 5 payments 6 From General Revenue Fund (0101). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $283,849,564

Section 10.055. To the Department of Mental Health 2 Funds are to be transferred out of the State Treasury to the General 3 Revenue Fund to provide the state match for the Department of 4 Mental Health payments 5 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . . . $201,393,308

Section 10.060. To the Department of Mental Health 2 Funds are to be transferred out of the State Treasury to the General 3 Revenue Fund for Disproportionate Share Hospital funds 4 leveraged by the Department of Mental Health - Institution of 5 Mental Disease facilities 6 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . . . . $50,000,000 CCS SCS HCS HB 10 6

Section 10.098. To the Department of Mental Health 2 For the purpose of providing matching grant to a not-for-profit 3 organization with two physical locations in any county with more 4 than one million inhabitants with at least 150 F.T.E.’s and 5 experience in adult day service for the renovation of a community 6 facility located in any city with more than forty-six thousand but 7 fewer than fifty-one thousand inhabitants, providing adult day care 8 services, child day care services, recreational services and support 9 for the local community 10 From General Revenue Fund (0101) (one-time). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $2,000,000

Section 10.099. To the Department of Mental Health 2 For the construction of a 200 bed mental health hospital in conjunction 3 with a non-state governmental acute care hospital operating 4 inpatient behavioral health beds in a state-owned facility 5 From Federal Earnings Fund (0558) (one-time). . . . . . . . . . . . . . . . . . . . . . . . . . . . $135,000,000 6 From Budget Stabilization Fund (0522) (one-time). . . . . . . . . . . . . . . . . . . . . . . . . . . 135,000,000 7 From Department of Mental Health Federal Fund (0148) (one-time). . . . . . . . . . . . 30,000,000 8 Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $300,000,000

Section 10.100. To the Department of Mental Health 2 For the Division of Behavioral Health 3 For the administration of statewide comprehensive psychiatric services 4 and alcohol and drug abuse prevention and treatment programs, 5 provided three percent (3%) flexibility is allowed from this section 6 to Section 10.575 7 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $2,523,649 8 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80,459 9 From General Revenue Fund (0101). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,604,108

10 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,687,804 11 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,885,533 12 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . . . . . . 3,573,337

13 Personal Service 14 From Health Initiatives Fund (0275). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58,526 15 Total (Not to exceed 59.92 F.T.E.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $6,235,971 CCS SCS HCS HB 10 7

Section 10.105. To the Department of Mental Health 2 For the Division of Behavioral Health 3 For prevention and education services, provided three percent (3%) 4 flexibility is allowed from this section to Section 10.575 5 Expense and Equipment 6 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . . . . $17,655,365 7 From Health Initiatives Fund (0275). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82,148 8 From Mental Health Earnings Fund (0288). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475,024 9 From Department of Mental Health Federal Stimulus - 2021 Fund 10 (2455). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,198,535

11 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106,695 12 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,372,959 13 From General Revenue Fund (0101). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,479,654

14 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155,232 15 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 396,585 16 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . . . . . . . 551,817

17 For enabling enforcement of the provisions of the Family Smoking 18 Prevention and Tobacco Control Act of 2009, in collaboration with 19 the Department of Public Safety, Division of Alcohol and Tobacco 20 Control 21 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 338,402 22 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194,743 23 From Department of Mental Health Federal Fund (0148). . . . . . . . . . . . . . . . . . . . . . . . . 533,145

24 For suicide prevention initiatives 25 Personal Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,855 26 Expense and Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 829,797 27 F