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EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
and is intended to be omitted in the law.
SECOND REGULAR SESSION
SENATE BILL NO. 844
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR HOUGH.
5628S.01I KRISTINA MARTIN, Secretary
AN ACT
To repeal section 105.711, RSMo, and to enact in lieu thereof one new section relating to the state
legal expense fund.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Section 105.711, RSMo, is repealed and one new 1
section enacted in lieu thereof, to be known as section 105.711, 2
to read as follows:3
105.711. 1. There is hereby created a "State Legal 1
Expense Fund" which shall consist of moneys appropriated to 2
the fund by the general assembly and moneys otherwise 3
credited to such fund pursuant to section 105.716. 4
2. Moneys in the state legal expense fund shall be 5
available for the payment of any claim or any amount 6
required by any final judgment rendered by a court of 7
competent jurisdiction against: 8
(1) The state of Missouri, or any agency of the state, 9
pursuant to section 536.050 or 536.087 or section 537.600; 10
(2) Any officer or employee of the state of Missouri 11
or any agency of the state, including, without limitation, 12
elected officials, appointees, members of state boards or 13
commissions, and members of the Missouri National Guard upon 14
conduct of such officer or employee arising out of and 15
performed in connection with his or her official duties on 16
behalf of the state, or any agency of the state, provided 17
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that moneys in this fund shall not be available for payment 18
of claims made under chapter 287; 19
(3) (a) Any physician, psychiatrist, pharmacist, 20
podiatrist, dentist, nurse, or other health care provider 21
licensed to practice in Missouri under the provisions of 22
chapter 330, 332, 334, 335, 336, 337 or 338 who is employed 23
by the state of Missouri or any agency of the state under 24
formal contract to conduct disability reviews on behalf of 25
the department of elementary and secondary education or 26
provide services to patients or inmates of state 27
correctional facilities on a part-time basis, and any 28
physician, psychiatrist, pharmacist, podiatrist, dentist, 29
nurse, or other health care provider licensed to practice in 30
Missouri under the provisions of chapter 330, 332, 334, 335, 31
336, 337, or 338 who is under formal contract to provide 32
services to patients or inmates at a county jail on a part- 33
time basis; 34
(b) Any physician licensed to practice medicine in 35
Missouri under the provisions of chapter 334 and his 36
professional corporation organized pursuant to chapter 356 37
who is employed by or under contract with a city or county 38
health department organized under chapter 192 or chapter 39
205, or a city health department operating under a city 40
charter, or a combined city-county health department to 41
provide services to patients for medical care caused by 42
pregnancy, delivery, and child care, if such medical 43
services are provided by the physician pursuant to the 44
contract without compensation or the physician is paid from 45
no other source than a governmental agency except for 46
patient co-payments required by federal or state law or 47
local ordinance; 48
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(c) Any physician licensed to practice medicine in 49
Missouri under the provisions of chapter 334 who is employed 50
by or under contract with a federally funded community 51
health center organized under Section 315, 329, 330 or 340 52
of the Public Health Services Act (42 U.S.C. Section 216, 53
254c) to provide services to patients for medical care 54
caused by pregnancy, delivery, and child care, if such 55
medical services are provided by the physician pursuant to 56
the contract or employment agreement without compensation or 57
the physician is paid from no other source than a 58
governmental agency or such a federally funded community 59
health center except for patient co-payments required by 60
federal or state law or local ordinance. In the case of any 61
claim or judgment that arises under this paragraph, the 62
aggregate of payments from the state legal expense fund 63
shall be limited to a maximum of one million dollars for all 64
claims arising out of and judgments based upon the same act 65
or acts alleged in a single cause against any such 66
physician, and shall not exceed one million dollars for any 67
one claimant; 68
(d) Any physician licensed pursuant to chapter 334 who 69
is affiliated with and receives no compensation from a 70
nonprofit entity qualified as exempt from federal taxation 71
under Section 501(c)(3) of the Internal Revenue Code of 72
1986, as amended, which offers a free health screening in 73
any setting or any physician, nurse, physician assistant, 74
dental hygienist, dentist, or other health care professional 75
licensed or registered under chapter 330, 331, 332, 334, 76
335, 336, 337, or 338 who provides health care services 77
within the scope of his or her license or registration at a 78
city or county health department organized under chapter 192 79
or chapter 205, a city health department operating under a 80
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city charter, or a combined city-county health department, 81
or a nonprofit community health center qualified as exempt 82
from federal taxation under Section 501(c)(3) of the 83
Internal Revenue Code of 1986, as amended, excluding 84
federally funded community health centers as specified in 85
paragraph (c) of this subdivision and rural health clinics 86
under 42 U.S.C. Section 1396d(l)(1), if such services are 87
restricted to primary care and preventive health services, 88
provided that such services shall not include the 89
performance of an abortion, and if such health services are 90
provided by the health care professional licensed or 91
registered under chapter 330, 331, 332, 334, 335, 336, 337, 92
or 338 without compensation. MO HealthNet or Medicare 93
payments for primary care and preventive health services 94
provided by a health care professional licensed or 95
registered under chapter 330, 331, 332, 334, 335, 336, 337, 96
or 338 who volunteers at a community health clinic is not 97
compensation for the purpose of this section if the total 98
payment is assigned to the community health clinic. For the 99
purposes of the section, "community health clinic" means a 100
nonprofit community health center qualified as exempt from 101
federal taxation under Section 501(c)(3) of the Internal 102
Revenue Code of 1987, as amended, that provides primary care 103
and preventive health services to people without health 104
insurance coverage. In the case of any claim or judgment 105
that arises under this paragraph, the aggregate of payments 106
from the state legal expense fund shall be limited to a 107
maximum of five hundred thousand dollars, for all claims 108
arising out of and judgments based upon the same act or acts 109
alleged in a single cause and shall not exceed five hundred 110
thousand dollars for any one claimant, and insurance 111
policies purchased pursuant to the provisions of section 112
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105.721 shall be limited to five hundred thousand dollars. 113
Liability or malpractice insurance obtained and maintained 114
in force by or on behalf of any health care professional 115
licensed or registered under chapter 330, 331, 332, 334, 116
335, 336, 337, or 338 shall not be considered available to 117
pay that portion of a judgment or claim for which the state 118
legal expense fund is liable under this paragraph; 119
(e) Any physician, nurse, physician assistant, dental 120
hygienist, or dentist licensed or registered to practice 121
medicine, nursing, or dentistry or to act as a physician 122
assistant or dental hygienist in Missouri under the 123
provisions of chapter 332, 334, or 335, or lawfully 124
practicing, who provides medical, nursing, or dental 125
treatment within the scope of his license or registration to 126
students of a school whether a public, private, or parochial 127
elementary or secondary school or summer camp, if such 128
physician's treatment is restricted to primary care and 129
preventive health services and if such medical, dental, or 130
nursing services are provided by the physician, dentist, 131
physician assistant, dental hygienist, or nurse without 132
compensation. In the case of any claim or judgment that 133
arises under this paragraph, the aggregate of payments from 134
the state legal expense fund shall be limited to a maximum 135
of five hundred thousand dollars, for all claims arising out 136
of and judgments based upon the same act or acts alleged in 137
a single cause and shall not exceed five hundred thousand 138
dollars for any one claimant, and insurance policies 139
purchased pursuant to the provisions of section 105.721 140
shall be limited to five hundred thousand dollars; or 141
(f) Any physician licensed under chapter 334, or 142
dentist licensed under chapter 332, providing medical care 143
without compensation to an individual referred to his or her 144
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care by a city or county health department organized under 145
chapter 192 or 205, a city health department operating under 146
a city charter, or a combined city-county health department, 147
or nonprofit health center qualified as exempt from federal 148
taxation under Section 501(c)(3) of the Internal Revenue 149
Code of 1986, as amended, or a federally funded community 150
health center organized under Section 315, 329, 330, or 340 151
of the Public Health Services Act, 42 U.S.C. Section 216, 152
254c; provided that such treatment shall not include the 153
performance of an abortion. In the case of any claim or 154
judgment that arises under this paragraph, the aggregate of 155
payments from the state legal expense fund shall be limited 156
to a maximum of one million dollars for all claims arising 157
out of and judgments based upon the same act or acts alleged 158
in a single cause and shall not exceed one million dollars 159
for any one claimant, and insurance policies purchased under 160
the provisions of section 105.721 shall be limited to one 161
million dollars. Liability or malpractice insurance 162
obtained and maintained in force by or on behalf of any 163
physician licensed under chapter 334, or any dentist 164
licensed under chapter 332, shall not be considered 165
available to pay that portion of a judgment or claim for 166
which the state legal expense fund is liable under this 167
paragraph; 168
(4) Staff employed by the juvenile division of any 169
judicial circuit; 170
(5) Any attorney licensed to practice law in the state 171
of Missouri who practices law at or through a nonprofit 172
community social services center qualified as exempt from 173
federal taxation under Section 501(c)(3) of the Internal 174
Revenue Code of 1986, as amended, or through any agency of 175
any federal, state, or local government, if such legal 176
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practice is provided by the attorney without compensation. 177
In the case of any claim or judgment that arises under this 178
subdivision, the aggregate of payments from the state legal 179
expense fund shall be limited to a maximum of five hundred 180
thousand dollars for all claims arising out of and judgments 181
based upon the same act or acts alleged in a single cause 182
and shall not exceed five hundred thousand dollars for any 183
one claimant, and insurance policies purchased pursuant to 184
the provisions of section 105.721 shall be limited to five 185
hundred thousand dollars; 186
(6) Any social welfare board created under section 187
205.770 and the members and officers thereof upon conduct of 188
such officer or employee while acting in his or her capacity 189
as a board member or officer, and any physician, nurse, 190
physician assistant, dental hygienist, dentist, or other 191
health care professional licensed or registered under 192
chapter 330, 331, 332, 334, 335, 336, 337, or 338 who is 193
referred to provide medical care without compensation by the 194
board and who provides health care services within the scope 195
of his or her license or registration as prescribed by the 196
board; [or] 197
(7) Any person who is selected or appointed by the 198
state director of revenue under subsection 2 of section 199
136.055 to act as an agent of the department of revenue, to 200
the extent that such agent's actions or inactions upon which 201
such claim or judgment is based were performed in the course 202
of the person's official duties as an agent of the 203
department of revenue and in the manner required by state 204
law or department of revenue rules; or 205
(8) Any entity, including its members, officers, or 206
employees, that provides under contract or subcontract 207
foster care case management services or residential services 208
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pursuant to chapter 210, including but not limited to 209
services under sections 210.112 or 210.119. 210
3. The department of health and senior services shall 211
promulgate rules regarding contract procedures and the 212
documentation of care provided under paragraphs (b), (c), 213
(d), (e), and (f) of subdivision (3) of subsection 2 of this 214
section. The limitation on payments from the state legal 215
expense fund or any policy of insurance procured pursuant to 216
the provisions of section 105.721, provided in subsection 7 217
of this section, shall not apply to any claim or judgment 218
arising under paragraph (a), (b), (c), (d), (e), or (f) of 219
subdivision (3) of subsection 2 of this section. Any claim 220
or judgment arising under paragraph (a), (b), (c), (d), (e), 221
or (f) of subdivision (3) of subsection 2 of this section 222
shall be paid by the state legal expense fund or any policy 223
of insurance procured pursuant to section 105.721, to the 224
extent damages are allowed under sections 538.205 to 225
538.235. Liability or malpractice insurance obtained and 226
maintained in force by any health care professional licensed 227
or registered under chapter 330, 331, 332, 334, 335, 336, 228
337, or 338 for coverage concerning his or her private 229
practice and assets shall not be considered available under 230
subsection 7 of this section to pay that portion of a 231
judgment or claim for which the state legal expense fund is 232
liable under paragraph (a), (b), (c), (d), (e), or (f) of 233
subdivision (3) of subsection 2 of this section. However, a 234
health care professional licensed or registered under 235
chapter 330, 331, 332, 334, 335, 336, 337, or 338 may 236
purchase liability or malpractice insurance for coverage of 237
liability claims or judgments based upon care rendered under 238
paragraphs (c), (d), (e), and (f) of subdivision (3) of 239
subsection 2 of this section which exceed the amount of 240
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liability coverage provided by the state legal expense fund 241
under those paragraphs. Even if paragraph (a), (b), (c), 242
(d), (e), or (f) of subdivision (3) of subsection 2 of this 243
section is repealed or modified, the state legal expense 244
fund shall be available for damages which occur while the 245
pertinent paragraph (a), (b), (c), (d), (e), or (f) of 246
subdivision (3) of subsection 2 of this section is in effect. 247
4. The attorney general shall promulgate rules 248
regarding contract procedures and the documentation of legal 249
practice provided under subdivision (5) of subsection 2 of 250
this section. The limitation on payments from the state 251
legal expense fund or any policy of insurance procured 252
pursuant to section 105.721 as provided in subsection 7 of 253
this section shall not apply to any claim or judgment 254
arising under subdivision (5) of subsection 2 of this 255
section. Any claim or judgment arising under subdivision 256
(5) of subsection 2 of this section shall be paid by the 257
state legal expense fund or any policy of insurance procured 258
pursuant to section 105.721 to the extent damages are 259
allowed under sections 538.205 to 538.235. Liability or 260
malpractice insurance otherwise obtained and maintained in 261
force shall not be considered available under subsection 7 262
of this section to pay that portion of a judgment or claim 263
for which the state legal expense fund is liable under 264
subdivision (5) of subsection 2 of this section. However, 265
an attorney may obtain liability or malpractice insurance 266
for coverage of liability claims or judgments based upon 267
legal practice rendered under subdivision (5) of subsection 268
2 of this section that exceed the amount of liability 269
coverage provided by the state legal expense fund under 270
subdivision (5) of subsection 2 of this section. Even if 271
subdivision (5) of subsection 2 of this section is repealed 272
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or amended, the state legal expense fund shall be available 273
for damages that occur while the pertinent subdivision (5) 274
of subsection 2 of this section is in effect. 275
5. All payments shall be made from the state legal 276
expense fund by the commissioner of administration with the 277
approval of the attorney general. Payment from the state 278
legal expense fund of a claim or final judgment award 279
against a health care professional licensed or registered 280
under chapter 330, 331, 332, 334, 335, 336, 337, or 338, 281
described in paragraph (a), (b), (c), (d), (e), or (f) of 282
subdivision (3) of subsection 2 of this section, or against 283
an attorney in subdivision (5) of subsection 2 of this 284
section, shall only be made for services rendered in 285
accordance with the conditions of such paragraphs. In the 286
case of any claim or judgment against an officer or employee 287
of the state or any agency of the state based upon conduct 288
of such officer or employee arising out of and performed in 289
connection with his or her official duties on behalf of the 290
state or any agency of the state that would give rise to a 291
cause of action under section 537.600, the state legal 292
expense fund shall be liable, excluding punitive damages, 293
for: 294
(1) Economic damages to any one claimant; and 295
(2) Up to three hundred fifty thousand dollars for 296
noneconomic damages. 297
The state legal expense fund shall be the exclusive remedy 298
and shall preclude any other civil actions or proceedings 299
for money damages arising out of or relating to the same 300
subject matter against the state officer or employee, or the 301
officer's or employee's estate. No officer or employee of 302
the state or any agency of the state shall be individually 303
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liable in his or her personal capacity for conduct of such 304
officer or employee arising out of and performed in 305
connection with his or her official duties on behalf of the 306
state or any agency of the state. The provisions of this 307
subsection shall not apply to any defendant who is not an 308
officer or employee of the state or any agency of the state 309
in any proceeding against an officer or employee of the 310
state or any agency of the state. Nothing in this 311
subsection shall limit the rights and remedies otherwise 312
available to a claimant under state law or common law in 313
proceedings where one or more defendants is not an officer 314
or employee of the state or any agency of the state. 315
6. The limitation on awards for noneconomic damages 316
provided for in this subsection shall be increased or 317
decreased on an annual basis effective January first of each 318
year in accordance with the Implicit Price Deflator for 319
Personal Consumption Expenditures as published by the Bureau 320
of Economic Analysis of the United States Department of 321
Commerce. The current value of the limitation shall be 322
calculated by the director of the department of commerce and 323
insurance, who shall furnish that value to the secretary of 324
state, who shall publish such value in the Missouri Register 325
as soon after each January first as practicable, but it 326
shall otherwise be exempt from the provisions of section 327
536.021. 328
7. Except as provided in subsection 3 of this section, 329
in the case of any claim or judgment that arises under 330
sections 537.600 and 537.610 against the state of Missouri, 331
or an agency of the state, the aggregate of payments from 332
the state legal expense fund and from any policy of 333
insurance procured pursuant to the provisions of section 334
105.721 shall not exceed the limits of liability as provided 335
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in sections 537.600 to 537.610. No payment shall be made 336
from the state legal expense fund or any policy of insurance 337
procured with state funds pursuant to section 105.721 unless 338
and until the benefits provided to pay the claim by any 339
other policy of liability insurance have been exhausted. 340
8. The provisions of section 33.080 notwithstanding, 341
any moneys remaining to the credit of the state legal 342
expense fund at the end of an appropriation period shall not 343
be transferred to general revenue. 344
9. Any rule or portion of a rule, as that term is 345
defined in section 536.010, that is promulgated under the 346
authority delegated in sections 105.711 to 105.726 shall 347
become effective only if it has been promulgated pursuant to 348
the provisions of chapter 536. Nothing in this section 349
shall be interpreted to repeal or affect the validity of any 350
rule filed or adopted prior to August 28, 1999, if it fully 351
complied with the provisions of chapter 536. This section 352
and chapter 536 are nonseverable and if any of the powers 353
vested with the general assembly pursuant to chapter 536 to 354
review, to delay the effective date, or to disapprove and 355
annul a rule are subsequently held unconstitutional, then 356
the grant of rulemaking authority and any rule proposed or 357
adopted after August 28, 1999, shall be invalid and void. 358
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