2002-26 RE: Tobacco Tax
(version 2)
| Submitted by: |
Mr. Alex Bartlett
Husch & Eppenberger, LLC
235 East High Street
PO Box 1251
Jefferson City, Missouri 65102-1251 |
Contact person Alex Bartlett can be reached by calling (573) 635-9118.
Petition sample form approved for circulation on March 1, 2002.
Amended official ballot title certified by Secretary of State on March 29, 2002.
THE PROPOSED ACT
Be it enacted by the people of Missouri, as follows:
Section 1. From and after January 1, 2003, in addition to the taxes imposed by sections 149.015, 149.082 and 149.160, RSMo, there are hereby imposed additional taxes upon the sale of cigarettes and tobacco products as provided in this section 1. Such taxes shall be equal to two and three-quarters cents per cigarette and twenty percent of the manufacturer's invoice price before discounts and deals for tobacco products other than cigarettes. The taxes imposed by this section shall be collected in the same manner and at the same time as the taxes imposed, respectively, upon cigarettes by section 149.015, RSMo, and upon tobacco products other than cigarettes by section 149.160, RSMo.
Section 2.1. All of the proceeds from the additional taxes imposed by section 1 shall be credited to and placed in the Healthy Families Trust Fund within the state treasury which is hereby created.
2. All proceeds from the additional taxes imposed by section 1 which are credited to and placed in the Healthy Families Trust Fund prior to July 1, 2003, may be appropriated and used for any of the purposes, programs or services for which monies in the Emergency Preparedness Resource Account, the Health Care Treatment and Access Account, the Life Sciences Research Account, the Early Care and Education Account, and the Tobacco and Addiction Prevention, Education and Cessation Account may be appropriated and used as provided in sections 3, 4, 5, 6 and 7.
3. After June 30, 2003, the state treasurer without legislative action shall credit to and place in the following accounts within the Healthy Families Trust Fund all proceeds from the additional taxes imposed by section 1 as said proceeds are received:
(1) Twenty-nine percent of such proceeds shall be credited to and placed in the Emergency Preparedness Resource Account which is created by section 3.
(2) Forty-three percent of such proceeds shall be credited to and placed in the Health Care Treatment and Access Account which is created by section 4.
(3) Fourteen percent of such proceeds shall be credited to and placed in the Life Sciences Research Account which is created by section 5.
(4) Seven percent of such proceeds shall be credited to and placed in the Early Care and Education Account which is created by section 6.
(5) Seven percent of such proceeds shall be credited to and placed in the Tobacco and Addiction Prevention, Education and Cessation Account which is created by section 7.
4. The use of funds placed into the Healthy Families Trust Fund shall be governed by the restrictions on the use of public funds codified in the Missouri Constitution or in the Revised Statutes of Missouri as of January 1, 2002.
5. Any monies credited to and placed in any account created by sections 3, 4, 5, 6 or 7 shall only be appropriated and used for a program, service or purpose which is authorized for such account as provided in this act and shall not be subject to the provisions of section 33.080, RSMo. The unexpended balances of such monies shall remain in the Healthy Families Trust Fund and in the particular account in which the monies are placed, and such balances shall not revert to general revenue. All interest which accrues upon the funds in any account within the Healthy Families Trust Fund shall be added to such account and shall not be credited to general revenue.
6. Additional accounts may be created within the Healthy Families Trust Fund by statute or executive order; however, no portion of the proceeds from the taxes imposed by section 1 shall be placed in any such additional account.
Section 3.1. The Emergency Preparedness Resource Account is hereby created within the Healthy Families Trust Fund. Monies placed in the Emergency Preparedness Resource Account shall be appropriated and used solely for the following purposes, programs or services:
(1) The department of social services shall administer the following programs or services:
(a) Providing supplemental Medicaid payments to hospitals for trauma services. Such payments shall be in addition to the hospital's Medicaid per diem reimbursement rate. The reimbursement methodology and criteria shall be formulated by the department of social services;
(b) Providing supplemental payments to hospitals for uncompensated trauma treatment services not covered by Medicaid. The reimbursement methodology and criteria shall be formulated by the department of social services;
(c) Providing supplemental Medicaid payments to hospitals for uncompensated and Medicaid emergency room treatment services;
(d) Providing supplemental Medicaid payments to physicians:
a. For trauma treatment services delivered by a physician in a hospital trauma center. Such payments shall increase the Medicaid reimbursement rate for a particular service to a level equal to three hundred percent of the Medicare reimbursement rate for such service. For follow-up treatment services by trauma specialists and other physicians for trauma injuries initially treated in a trauma center, the Medicaid reimbursement rate for a particular service shall increase to a level equal to one hundred fifty percent of the Medicare reimbursement rate for such service;
b. For physician services delivered in a hospital emergency department. Such payments shall increase the Medicaid reimbursement rate for a particular service to a level equal to the Medicare reimbursement rate for such service;
c. For pediatric and adult primary care services and treatment services provided by specialists as authorized by appropriation and rules promulgated by the department of social services. Such payments shall increase the Medicaid reimbursement rate for a particular service to a level equal to one hundred percent of the Medicare reimbursement rate for such service;
(e) Providing supplemental Medicaid payments to emergency medical services providers, including but not limited to public or private ambulance services;
(f) Providing supplemental Medicaid payments to dentists;
(g) Providing supplemental Medicaid payments to other noninstitutional Medicaid providers;
(h) Establishing quantifiable health status outcome standards that measure the incidence of health conditions such as but not limited to diabetes, obesity, heart disease and low birth-weight infants among Medicaid recipients who are women or ethnic minorities and to develop strategies to reduce the incidence of such health conditions among Medicaid recipients who are women or ethnic minorities. Such standards shall be created and implemented in collaboration with hospitals, physicians and managed care organizations; and
(i) Evaluating the availability and use of primary care services and hospital emergency room utilization among Medicaid recipients; and
(2) The department of health and senior services shall administer the following programs or services:
(a) Grants to enhance disease surveillance and detection activities as they relate to emergency preparedness; and
(b) A comprehensive study of the causes for Missouri's elevated death rate due to traumatic injuries compared to other states. Funds shall be made available through grants administered by the department to promote programs, including educational programs, to reduce the incidence and severity of traumatic injuries as indicated in the study; and
(c) A computerized comprehensive trauma registry to improve the state's ability to analyze the efficiency and effectiveness of the trauma care system.
2. Hospitals and physicians who receive moneys from the Emergency Preparedness Resource Account shall collaborate in the development of an emergency preparedness plan to enhance access to treatment services in the event of an emergency, as defined in section 44.010, RSMo.
3. Particular programs or services authorized by this section 3 will be funded only to the extent that funds are available from within the Emergency Preparedness Resource Account.
Section 4. The Health Care Treatment and Access Account is hereby created within the Healthy Families Trust Fund. Monies placed in the Health Care Treatment and Access Account shall be appropriated and used solely for the following purposes, programs and services:
(1) For prescription drug costs for senior citizens;
(2) For medical, mental and other health care assistance coverage to low-income adults and children who may otherwise be uninsured;
(3) For initiatives to improve the health of women and minorities; and
(4) To fund costs for health care programs or services.
Section 5.1. The Life Sciences Research Account is hereby created within the Healthy Families Trust Fund. Monies placed in the Life Sciences Research Account shall be appropriated and used solely for increasing the capacity for quality life sciences research in the state of Missouri as provided in this section 5.
2. Monies in the Life Sciences Research Account shall be used strategically, in cooperation with other governmental and not-for-profit private entities, to enhance the capacity of the state of Missouri's ability to perform research so as better to serve the health and welfare of the residents of Missouri as a center of life sciences research and development by building on the success of research institutions located in Missouri and enhancing their capacity to carry out their respective missions.
3. The management, governance and control of monies appropriated from the Life Sciences Research Account shall be vested in the Life Sciences Research Board which is hereby created and which shall consist of seven members. The board is assigned to the office of administration as a type III division. The following provisions shall apply with respect to the Life Sciences Research Board and its members:
(1) Each member shall be appointed by the governor with the advice and consent of the senate pursuant to the procedures herein set forth, for a term of four years, except that the terms of the members first appointed shall be for terms as hereinafter described. The governor shall appoint the chairperson of the Board.
(2) The members of the Board shall be generally familiar with the life sciences and current research trends and developments, with either technical or scientific expertise in life sciences, and with an understanding of the application of the results of life sciences research. The appointment of a person to the Life Sciences Research Committee heretofore created by Executive Order 01-10 issued by the governor on July 23, 2001, shall not disqualify a person from serving as a member, either contemporaneously or later, on the Life Sciences Research Board.
(3) Three of the first appointees as members of the Life Sciences Research Board shall be appointed to two-year terms, and the remaining four initial appointees as members of the Board shall be appointed to four-year terms.
(4) No member of the Life Sciences Research Board shall serve more than two consecutive full four-year terms on the Board.
(5) The members of the Life Sciences Research Board shall receive no salary or other compensation for their services as members, but shall receive their necessary traveling and other expenses incurred while actually engaged in the discharge of their official duties.
4. Centers for Excellence for Life Sciences Research shall be established and be subject to the following provisions:
(1) A Center for Excellence for Life Sciences Research means a system or regional consortium of public and/or private not-for-profit academic, research or health care institutions or organizations engaged in competitive research in targeted fields consistent with the strategic purposes of Life Sciences Research as provided in this section 5.
(2) The Life Sciences Research Board shall monitor and adopt such regulations as are necessary to assure quality and accountability in the operations of the Centers for Excellence for Life Sciences Research.
(3) One St. Louis Area Center for Excellence may be established within the geographical area encompassing the City of St. Louis and St. Louis, St. Charles, Jefferson and Franklin counties. In the event any part of a municipality is located within any one of these counties and also encompasses a part of another Missouri county, the entire area encompassed within the city limits of such municipality shall be a part of the geographical area of the St. Louis Area Center for Excellence.
(4) One Kansas City Area Center for Excellence may be established within the geographical area encompassing Jackson, Clay and Platte counties. In the event any part of a municipality is located within any one of these counties and also encompasses a part of another Missouri county, the entire area encompassed within the city limits of such municipality shall be a part of the geographic area of the Kansas City Area Center for Excellence.
(5) A University of Missouri System Center for Excellence may be established which shall encompass the institutions and campuses within the University of Missouri system. The board of curators of the University of Missouri may determine which institutions and campuses will participate in the University of Missouri System Center for Excellence and the extent and nature of such participation. Institutions and campuses of the University of Missouri system which are within the geographical area of another Center for Excellence may participate in such Center for Excellence unless prohibited from doing so by the board of curators.
(6) The Life Sciences Research Board shall receive and review suggestions for the formation and composition of the initial Centers for Excellence for Life Sciences Research within the St. Louis Area and the Kansas City Area. After receiving and reviewing such suggestions, the Life Sciences Research Board shall determine the initial composition and consider and approve the organizational plan and structure of the Centers for Excellence within the St. Louis Area and the Kansas City Area. The Life Sciences Research Board shall also review, consider and approve the organization plan and structure of the University of Missouri System Center for Excellence before such Center for Excellence shall be considered as a Center for Excellence under the provisions of this section 5.
(7) The Life Sciences Research Board may establish additional geographical areas within the state of Missouri within which a Center for Excellence for Life Sciences Research may be established. Prior to establishing such a geographical area within which a new Center for Excellence may be established, the Life Sciences Research Board shall first find and determine (i) that a new Center for Excellence within such geographical area is needed, (ii) that resources are available for a new Center for Excellence within such geographical area and (iii) that the establishment of a new Center for Excellence within such geographical area will not adversely affect any existing Center for Excellence.
(8) Before any Center for Excellence is considered to be a Center for Excellence for Life Sciences Research under the provisions of this section 5, its composition and organizational structure shall be approved by the Life Sciences Research Board.
(9) The geographical areas specified herein for a St. Louis Area Center for Excellence and a Kansas City Area Center for Excellence or which are hereinafter established by the Life Sciences Research Board for a Center for Excellence as herein provided may be expanded by the Life Sciences Research Board to include additional contiguous geographical areas within the State of Missouri.
(10) Any Center for Excellence for Life Sciences Research which is established within a geographical area hereinabove specified or a geographical area which is hereafter established by the Life Sciences Research Board shall be comprised of a consortium of public and/or private not-for-profit academic, research or health care institutions or organizations which have collectively at least fifteen million dollars in annual research expenditures in the life sciences, including a collective minimum of two million dollars in basic research in life sciences.
(11) Each Center for Excellence for Life Sciences Research shall appoint a screening committee. The Centers, through their screening committees, shall solicit, collect, prioritize and forward to the Life Sciences Research Board proposed research initiatives for consideration for funding by the Board. Members of each screening committee shall generally be familiar with the life sciences and current trends and developments, with either technical or scientific expertise in the life sciences, with an understanding of life sciences and with an understanding of the application of the results of life sciences research. No member of a screening committee shall be employed by any public or private entity eligible to receive financial support from the Life Sciences Research Account.
(12) The Centers for Excellence for Life Sciences Research shall have any and all powers attendant to carrying out the operations which are not contrary to the provisions of this Act or rules, guidelines or decisions adopted by the Life Sciences Research Board.
5. All monies which are appropriated by the general assembly from the Life Sciences Research Account shall be appropriated to the Life Sciences Research Board to increase the capacity for quality life sciences research in the State of Missouri and to thereby improve the quantity and quality of life sciences research, including but not limited to, basic research (including the discovery of new knowledge), translational research (including translating knowledge into a usable form), developmental research and clinical research (including the literal application of a therapy or intervention to determine its efficacy), to include but not be limited to health research in human development and aging, cancer, endocrine, cardiovascular, neurological, pulmonary and infectious disease, and nutrition and food safety. Funds received by the Board may be used for purposes authorized by this section 5 and subject to the restrictions of this section 5, including but not limited to the costs of personnel, supplies, equipment and renovation or construction of physical facilities, provided that in any single fiscal year no more than ten percent of the funds appropriated may be used for the construction of physical facilities. No funds from the Life Sciences Research Account may be used or expended, either pursuant to a contract, grant or otherwise, to subsidize or fund any program or service which is prohibited by sections 6.1 to 6.4 of Executive Order 01-10 issued by the governor on July 23, 2001.
6. In determining projects to authorize, the Life Sciences Research Board shall consider those proposals endorsed by a Center for Excellence, subject to a process of peer review conducted under the auspices of the Board, and shall also consider the potential of any proposal to bring both health and economic benefit to the people of Missouri. Specifically, at least eighty percent of the funds which are appropriated to the Board in each fiscal year shall be distributed to the institutions or organizations whose programs and proposals have been recommended by a Center for Excellence. Collectively, the institutions or organizations within a single Center for Excellence shall receive in a single fiscal year no more than fifty percent of the funds appropriated to the Board during that fiscal year. Collectively, the institutions or organizations within a single Center for Excellence shall receive in a single fiscal year no less than ten percent of the funds appropriated to the Board during that fiscal year. No single institution or organization shall receive in any consecutive three fiscal year period more than forty percent of the funds appropriated to the Board during that three fiscal year period.
7. The funds appropriated to the Life Sciences Research Board which are not distributed by the Board in any fiscal year to a Center for Excellence or for a Center for Excellence endorsed program pursuant to the provisions of the foregoing subsection 6, if any, shall be held in reserve by the Board or shall be awarded, on the basis of peer review panel recommendations, for capacity building initiatives proposed by public and/or private not-for-profit academic, research or health care institutions or organizations or individuals engaged in competitive research in targeted fields consistent with the provisions of this section 5.
8. The Life Sciences Research Board shall have the authority to award and enter into grants or contracts relating to increasing Missouri's research capacity; to make provision for peer review panels to recommend and review research projects; to contract for administrative and support services; to lease or acquire facilities and equipment; to employ administrative staff; and to receive, retain, hold, invest, disburse and/or administer any funds which it receives from appropriations or from any other source.
9. The Life Sciences Research Board shall utilize as much of the funds as reasonably possible for building the capacity to do research rather than for administrative expenses. The Board shall not therefore in any fiscal year expend more than two percent of the total monies appropriated to it and of the monies which it has in reserve or which it has received from other sources for its own administrative expenses; provided, however, that the general assembly by appropriation from the Life Sciences Research Account may authorize a limited amount of additional funds to be expended for administrative costs.
10. The Life Sciences Research Board shall make provision for and secure from the state auditor or outside certified public accounting firm an annual audit of its financial affairs and the funds expended from the Life Sciences Research Account. Such shall be performed on a fiscal year basis and the cost of such audit shall not be considered as an administrative expense for purposes of subsection 9 of this section 5. The Board will make copies of each audit publicly available. Every three years the Board with assistance of its staff or independent contractor(s) as determined by the Board shall prepare a comprehensive report assessing the work and progress of the Life Sciences Research program. Such assessment report shall analyze the impact of the Board's programs, grants and contracts performed, shall be provided to the governor and members of the general assembly and shall be publicly available. The cost of such assessment report shall not be considered as an administrative expense for purposes of subsection 9 of this section 5.
11. Grant or contract awards made with funds appropriated from the Life Sciences Research Account shall provide for the reimbursement of costs. Whether reimbursement of particular costs will be allowed depends on the application of a four-part test balancing, which shall include (i) the reasonableness of the cost; (ii) the connection to the grant or contract; (iii) the consistency demonstrated in assigning costs to the grant or contract; and (iv) conformance with the particular terms and conditions of the award or contract. The Life Sciences Research Board may, from time to time, issue regulations and guidelines consistent with this four-part test and shall provide grant and contract recipients with a list or other explanation of regularly allowed costs.
12. Grant and contract recipients have an obligation to preserve research freedom, to ensure timely disclosure of their research findings to the scientific community, including through publications and presentations at scientific meetings, and to promote utilization, commercialization and public availability of their inventions and other intellectual property developed as a general institutional policy. Institutions or organizations receiving grant or contract awards shall retain all right, title and interest, including all intellectual property rights, in and to any and all inventions, ideas, data, improvements, modifications, discoveries, know-how, creations, copyrightable material, trade secrets, methods, processes, discoveries and derivatives, whether patentable or not, which are made in the performance of work under a grant award. The Life Sciences Research Board may, however, adopt reasonable regulations to insure that any such intellectual property rights are utilized reasonably and in a manner which is in the public interest.
13. No member of the Life Sciences Research Board shall be employed by any public or private entity entitled to receive financial support from the Life Sciences Research Account. No member of the Life Sciences Research Board shall participate in the making of any decision by the Board to make any grant to (i) the Board member, (ii) any person who is related to the board member within the fourth degree, by consanguinity or affinity, (iii) any public entity for which the Board member serves as an officer, director, or other member of the entity's governing organ, or (iv) any private entity for which the Board member or the member's spouse is employed, serves as an officer, director, or other member of the entity's governing organ. The Board may, from time to time, issue conflict of interest guidelines and requirements with respect to the administration of the life sciences research program, to govern the actions of its employees and agents and to implement the provisions set forth in this subsection 13.
Section 6. The Early Care and Education Account is hereby created within the Healthy Families Trust Fund. Monies placed in the Early Care and Education Account shall be appropriated and used solely for the purpose of early care and education for children ages 0-6. All monies shall be used for community grants. Appropriations which are made by the general assembly from the Early Childhood Care and Education Account shall be made to the department of social services and shall be used and expended solely for the purpose provided in this section 6.
Section 7. The Tobacco and Addiction Prevention, Education and Cessation Account is hereby created within the Healthy Families Trust Fund. Monies in the Tobacco and Addiction Prevention, Education and Cessation Account shall be appropriated and used solely for the purpose of tobacco and/or addiction prevention, education and/or cessation, including but not limited to, the programs to prevent tobacco usage by minors, to prevent or reduce tobacco usage generally and/or to prevent addiction.
Section 8. All of this provisions of this Act are severable. If any provision of this Act is found by a court of competent jurisdiction to be unconstitutional or unconstitutionally enacted, the remaining provisions of this Act shall be and remain valid.