Allergy safety in child care facilities the subject of House plan with bipartisan backing

        Legislation that stems from the tragic death of a boy in Harlem in 2017 is back before the Missouri House. 

Elijah-Alavi Silvera
(Photo courtesy of Thomas Silvera)

      Though the operators of 3-year-old Elijah-Alavi Silvera’s daycare had been told he had a severe dairy allergy, he was given a grilled cheese sandwich.  He went into severe anaphylactic shock and died.  His death prompted his father to spearhead an effort that became known as “Elijah’s Law,” which was passed in the State of New York in 2019.

Since then it has also become law in Illinois and Virginia and as an ordinance in Kansas City. Missouri is one of five states in which it is proposed this year.

      It is found in House Bill 2552, which would allow doctors to prescribe epinephrine auto-injectors, more commonly known as “epi-pens,” to childcare facilities.  It would also require licensed childcare providers to adopt a policy on allergy prevention and response, with a special emphasis on deadly food-borne allergies. 

      The bill’s sponsor, Representative Jim Schulte (R-New Bloomfield), presented it last week to the House Committee on Healthcare Reform.

Representative Jim Schulte (Photo: Tim Bommel, Missouri House Communications)

      “It pertains to a young boy who had a [dairy]* allergy.  His mother was aware of it and she had told the daycare provider about it and even provided an epi-pen for them, however, they had no training and by the time they realized what was going on and called an ambulance, he had already passed away.  His family is leading this.  I think they’re in seven states now, with this bill,” Schulte told his fellow legislators.

     There are some concerns among lawmakers, including a question of cost.  Epi-pens are expensive, and the bill does not address how the cost for them might be covered.  Schulte said grant programs are available and could apply. 

      Legislators also questioned a provision that would have the Department of Elementary and Secondary Education develop a model policy for allergy prevention and response and a guide for childcare providers.  Some legislators suggest that would be better handled by a different agency.

      Representative Anthony Ealy (D-Grandview) said it doesn’t matter to him from where the policy comes, as long as it is exhaustive.

Representative Anthony Ealy (Photo: Tim Bommel, Missouri House Communications)

      “I think that DESE because childcare facilities fall under DESE, they should have a part to play in it, but it does make sense for the Department of Health to also have a voice in it.  I just want the best professionals to be able to create a model,” Ealy said. 

      Committee Chairman Kent Haden (R-Mexico) said those are fair concerns, but at the heart of the bill is a serious issue that deserves attention.

      “It’s a catch-22 sometimes we need to be aware of.  I had a neighbor, a young lady that went on a float trip and ate muffins that had sesame seeds on them and died on the float trip … an allergy is a very severe, death threatening event,” Haden said.

      Also sponsoring the same language is Representative Emily Weber (D-Kansas City), who said regardless of whether this bill becomes law, she hopes it raises awareness among the state’s childcare facilities. 

Representative Emily Weber (Photo: Tim Bommel, Missouri House Communications)

      “I would hope that daycare centers would hear a bill like this and start working on their procedures, on what happens if they accept a child who has horrible, maybe peanut allergies, which is like the most common one.  I would hope that they would kind of move together and figure out their solution and their procedures on what to do,” Weber said. 

      “When something like [what happened to Elijah] happens, it can happen in an instant, and it’s all about timing at that point.  Making sure you have the procedure:  okay, the child’s going into anaphylactic shock, what do we do next?  Where’s the epi-pen?  Who do we call?  Things like that.”

      Similar proposals were filed by Weber and Ealy last year but neither was the subject of a hearing.  Both say they are just glad to see the language getting traction, with Schulte’s version.

      “I’m super excited about that.  I’m so happy that Representative Schulte had a hearing … Representative Haden is a huge supporter of this bill.  I talked to him last session about it … he read my bill and said this is a really good bill,” Weber said.

      The Healthcare Reform Committee has not voted on Schulte’s bill. Weber’s version is House Bill 2036, and Ealy’s version is House Bill 2364.

Radio stations note: “Alavi” in Elijah-Alavi Silvera is pronounced like “Allah-vee”

Note to reporters: though sometimes reported otherwise, Elijah-Alavi Silvera had an allergy to dairy, not peanuts. This was confirmed by his father, Thomas.

Expansion of adoption tax credit sent to governor

      Missouri legislators hope one of the bills they’ve sent to the governor will lead to more children being adopted into loving homes. 

Representative Hannah Kelly (Photo: Tim Bommel, Missouri House Communications)

      One of the provisions in Senate Bill 24 would expand Missouri’s adoption tax credit, which offers a nonrefundable tax credit for one-time adoption-related expenses such as attorney fees, up to $10,000 per child.  That credit is capped at $6-million a year.  SB 24 would remove that cap, makes the tax credit refundable, and would have the per-child limit adjust with inflation.

      Those proposed changes are now awaiting action by Governor Mike Parson (R), and their House sponsor, Hannah Kelly (R-Mountain Grove), couldn’t be happier. 

      “I just think we did something really good today.  I honestly had given up on it and then it passed.  I couldn’t hardly believe it.  Now it’s on the governor’s desk.  I’m very thankful,” said Kelly.  “We’re just saying, ‘Hey, we’re here to make sure that we invest in these kids and these families, help them get across the line, get them out of the system, get them building their futures together as a family.’”

      More than 2,200 Missouri children are awaiting adoption.  Representative Keri Ingle (D-Lee’s Summit) once worked as an adoption specialist with the state Children’s Division, and said most of the families who would adopt those children see the system as complicated and laced with prohibitive expenses.

      “They know it costs a lot of money, they know it’s hard, they know that they have to jump through a lot of bureaucratic hurdles, but they don’t know that there’s support on the other end of it.  They don’t know that they’ll be eligible, perhaps, for a subsidy and tax credits and things like that, that will help them complete their family and get kids out of foster care and make it affordable and not cost prohibitive.”

      Ingle said this bill could make a huge difference.

“We have kids that linger in care indefinitely and unnecessarily, because there are so many families out there that want to adopt kids, that want to create forever homes for these kids, but they just feel like it’s beyond their fiscal ability to do so.  Anything we can do to help them through that process and create that forever family and get these kids out of [state] care … there are way too many people that would love to expand their families and adopt.”

      The bill is especially personal for Kelly, who talks often to her colleagues and in public settings about her own experience adopting her then-teenage daughter. 

      “My daughter is building her own life and celebrating her impending wedding coming soon and going to college and doing all the things that you hope to see your children do, not because of me but because she simply had the opportunity to know she had a forever home base to come back to.  To be a part of that is a privilege and to get to be a part of helping Missouri families provide that for children who otherwise would not have that, is a privilege.”

Representative Keri Ingle (Photo: Tim Bommel, Missouri House Communications)

      Ingle said even as other issues have caused tension between her party and Republicans there has been a lot of cooperation on issues like this one, and she’s been glad to be a part of it.

      “We’ve been really, really lucky to have a specific group of people in my tenure that have really placed children and child welfare at the forefront of what we work on and placed partisan ship at the very, very back when it comes to those things.  Politics has nothing to do with child welfare and it shouldn’t have anything to do with that.  We should all come together and do what’s right for the kids of this state, and so I’m always really proud to see the work that my colleagues do, on both sides of the aisle, when it pertains to that.”

      Kelly added, “If any Missouri family wants to give a child who does not have a forever home a home we need to back up and support them, and that is what this credit is about.”

      The House’s final vote on SB 24 was 139-5.  It now awaits the governor’s decision to either sign it into law, veto it, or allow it to become law without his action.

House members frustrated by Department after report on missing foster children

      Missouri House members aren’t pleased with a lack of answers from the Department of Social Services in the wake of a federal report slamming its lack of response when children in foster care go missing.

Representative Mary Elizabeth Coleman (Photo: Tim Bommel, Missouri House Communications)

      The U.S. Department of Health and Senior Services’ Office of the Inspector General report is based on 2019 data and was released last week.  It said the state does not properly report when children are missing and doesn’t do enough to keep them from going missing again, if they are found.

      “I was shocked by the scope of the report but I was not surprised by the content,” said Representative Mary Elizabeth Coleman (R-Arnold), Chairman of the House Committee on Children and Families, which met Tuesday in response to that report.

      That study found that 978 children went missing from state care at some point during 2019.  In looking closely at the handling of 59 cases of children missing from foster care, it found that in nearly half there was no evidence that the state had reported those children missing as required by law.

Department of Social Services Acting Director Jennifer Tidball and Children’s Division Interim Director Joanie Rogers testify to the House Committee on Children and Families (Photo: Tim Bommel, Missouri House Communications)

      The Committee heard testimony from Department of Social Services Acting Director Jennifer Tidball, who said many of the policy issues cited in the report stemmed from a previous administration.  She produced a 2016 memo from then-director Tim Decker that allowed caseworkers to quit some practices and documentation, some of which she says has been resumed since 2019.

      Coleman and other lawmakers were frustrated by what they saw as a “passing of the buck,” trying to blame that earlier administration, and a failure to follow the law and to implement programs the legislature has authorized to help the Division keep foster kids safe.

      “If the tools that have been given by the legislature have not been utilized and if the state and federal laws are not being followed because it’s the policy of the department, what enforcement mechanism could the legislature use to induce you to follow state and federal statute?”

      The top Democrat on the committee, Keri Ingle (D-Lee’s Summit), said Tuesday’s hearing was beyond frustrating.

      “What do we do if our own departments are telling us that they’re not following state and federal law and they’re not following their own policies and they’re not taking us up on additional resources when we’re offering additional resources?”

Representative Keri Ingle (Photo: Tim Bommel, Missouri House Communications)

      Coleman said she was troubled that the Department did not today provide much information outside of what was in the federal report and even challenged its findings.  She said the next step will be to hold a hearing focused on possible solutions.

      “We’re going to continue to work and see what pressure we can put on the Department to continue to follow state and federal law.  The committee will continue to hold hearings.  We’ll probably have one more and then we’ll have a report with recommendations and I would think that you’ll see legislation that comes out of this process,” said Coleman.

      After Tidball’s testimony the Committee heard from several child welfare advocates, offering their response to the report and possible responses, however Tidball and her staff left the hearing shortly after she spoke.

Extensive Foster Care reforms passed in 2018 session set to become effective

The Missouri legislature this year passed a number of provisions aimed at making life better for children in the state’s foster care system.  Legislation that has become law would help children get an education, proper medical care, and ease their transition out of state care.

Representative Jim Neely carried Senate Bill 819 in the House and chaired a committee tasked with examining issues related to foster care. (photo; Tim Bommel, Missouri House Communications)

House Speaker Todd Richardson (R-Poplar Bluff) in January created the Special Committee to Improve the Care and Well-Being of Young People, to focus on foster care issues.  That committee and its chairman, Representative Jim Neely (R-Cameron), handled many of these provisions and oversaw combining several of them into one bill, House Committee Bill 11.  Many of them later became part of Senate Bill 819 which was passed and has been signed into law.  The provisions in that bill become effective August 28.

The Director of Missouri’s Office of Child Advocate, Kelly Schultz, has been a foster parent to 17 children over the years.  She said both as a foster parent and as the director, this year has been “huge,” for professionals, families, and most importantly children in foster care.

“Just to recognize what the professionals in foster care and what the foster families go through, and that really talking about it and just going through and looking at just everyday decisions that we make – as the legislative body, as the executive branch and policy – what those decisions are and how they impact the children in care,” said Schultz.

She said this year the legislature took steps toward doing the most important thing changes can do for children in Missouri:  to “normalize” their lives relative to those of their peers.

“Normalizing mistakes, normalizing learning, because that’s honestly what the teen years are about a lot of times, is testing boundaries, learning from that, moving forward, taking chances and risks,” said Schultz.

Schultz described some of the changes the legislature approved this year as “low-hanging fruit;” issues that were easily fixed that could have a major impact on the lives of children and those who work with them.

One example is a provision that allows children in state care to get bank accounts in their own name after they turn 16.  That measure was originally found in a bill handled by Representative Don Phillips (R-Kimberling City).

“I think it really gives the foster children some freedom, it gives them some independence, some responsibility, and they don’t have to have a co-signer or anything like that where most would have to have, and I just think it’s a wonderful opportunity for them,” said Phillips.

House Speaker Todd Richardson in January created the Special Committee to Improve the Care and Well-Being of Young People, which spent much of the 2018 session examining foster care issues. Much of its work became law in SB 819. (photo; Tim Bommel, Missouri House Communications)

Schultz said as a foster parent, that provision doesn’t just help children.  She was once “on the hook,” when a child whose account she was a co-signer on overdrew that account.

Another provision will allow fees for birth, death, or marriage certificates to be waived if those documents are requested by certain state agencies on behalf of a child under juvenile court jurisdiction.

The sponsor of the original legislation dealing with that, Representative Mike Kelley (R-Lamar), said the fees for those documents might be considered nominal to most people, but they can seem insurmountable to children trying to gain their independence.

“It’s hard for most citizens to realize that $10 or $15 to someone who doesn’t have a job and has no way to make income is a huge amount of money and a burden upon those citizens that truly are wards of the state that we should be looking out for and doing what we can to help them be successful,” said Kelley.

Also included in SB 819 are provisions to:

– Allow a child who is homeless or in state care and who has not received all his or her required immunizations to enroll in school, daycare, preschool, or nursery for up to 30 days while he or she begins getting caught up on those immunizations.

– Expand assessment and treatment services for children in foster care.  It would require such services for all children in foster care – currently it is required only for those under the age of ten – and would require that those services be completed in accordance with the American Academy of Pediatrics’ periodicity schedule.  Current law requires screenings of children in state custody every six months.

– Allow minors to contract for admission to a rape crisis center if qualified as specified in the act

SB 819 also creates the “Social Innovation Grant Program.”  It will create a state program to fund pilot projects that seek to address social issues such as families in generational child welfare, opioid-addicted pregnant women, or children with behavioral issues who are in residential treatment.  Projects receiving grants should have the potential of being replicated to get the most out of state funds and address such concerns.

Earlier stories:

House prepares extensive foster care reform legislation