Tag: Deb Lavender

Physical therapists to no longer require referrals after Governor signs new law

      The first legislation signed into law out of this session will get Missourians in front of the caregivers they need more quickly and with less cost.

Governor Mike Parson signs into law Senate Bill 51, as its sponsor, Senator Karla Eslinger, and its House handler, Representative Brenda Shields, look on. (Photo: the Office of Governor Mike Parson)

      Governor Mike Parson (R) on Thursday signed Senate Bill 51, sponsored by Senator Karla Eslinger (R-Wasola), which will allow people to go to physical therapists without having to first visit another doctor and get a referral. 

“Currently, patients must visit a physician before they can make an appointment with a physical therapist.  This costs the patient additional money and delays in returning to their life before the injury,” said Representative Brenda Shields (R-St. Joseph), who handled the bill in the House.  “It is time for Missourians to choose their own healthcare path and get their lives back.”

Shields has spoken passionately about this proposal largely because of the role physical therapists have played in her own life.

      “I’m excited to be able to carry, I’m honored to be able to carry this bill this year.  If it wasn’t for physical therapists I would not be before this body this year.  When I had my brain bleed stroke almost seven years ago, it took them to give me back my life and I cannot thank them enough.”

      Shields said no matter what she does from here on, she expects the passage of this language will stand as a highlight of her political career.

      “You almost bring me to tears when I think about that … with my experience that I’ve had a physical therapist when I had my stroke seven years ago and the work that they did and the continued support that they gave me through my recovery.  Even when I became depressed or sad, or questioned if I was ever going to return to normal, their continued work and their support … I just really wanted to [get this passed] to thank them for the care that they provided me.”

Shields announced to her colleagues in the chamber on Thursday morning that the bill would be signed, and her physical therapist Dr. Ben Perkins was her guest in the chamber then and at the bill signing.

      Representative Deb Lavender (D-Manchester) is a physical therapist.  She said it’s frustrating to have to turn away people who come to her, knowing she could ease their pain.

“I have actually lost business in my small, private practice physical therapy because when somebody would call me and say, ‘I want to see you,’ I’d say, ‘You have to see the physician first.’”

      The proposal has been around for years in the legislature, with Governor Parson saying he handled it early in his legislative career which began in 2005.

Representative Brenda Shields carried the House version of Senate Bill 51 for multiple years. She said its passage into law will likely always be one of the highlights of her legislative career. (Photo: Tim Bommel, Missouri House Communications)

“I couldn’t be more pleased signing this, being the first bill that we’re really going to sign,” said Parson.  “I think one thing we learned is how important healthcare is no matter where you live in the State of Missouri, and how many opportunities people have to get it.  By doing this bill we’re going to expand that to many more people and cut a lot of bureaucracy out of the way simply to care for people, and I think that’s what we all wanted to do.”

      Under the bill, a physical therapist can refer a patient to another health care provider if they exhibit certain conditions which the physical therapist is unable to treat, or if the patient’s condition doesn’t improve within 30 days or ten visits. 

      The House voted on April 12 to pass SB 51, 146-2.  With its signing, Missouri joins 47 other states who already allowed people to go to physical therapists without first getting a referral.  The bill’s provisions take effect August 28.

House votes to extend insurance coverage for children with developmental disabilities

The House has voted to require insurance companies to cover therapies for developmentally disabled children in Missouri, which would expand on a 2010 law that required coverage for therapy for children with autism.

House Bill 399 would prohibit companies from limiting coverage in fully insured plans for physical, cognitive, emotional, mental, or developmental disabilities.  That is less than one-third of the existing plans in the state, covering somewhere between 1,800 and 6,000 children.

The legislation is sponsored by Rocheport representative Chuck Basye (R).  He said for children to be able to continue treatments when they are young could help them avoid long-term needs and issues later in life.

“Speech therapy can prevent a child from needing a [gastrostomy] tube or from aspirating and getting pneumonia; physical therapy can prevent very expensive orthopedic surgeries and lifelong issues; and occupational therapies can prevent a child from injuries,” said Basye.

One of the driving forces behinds Basye’s interest in the issue is his relationship with a constituent, 9-year-old Nathan, whose mother Basye met during his campaign for reelection.   Nathan is one of the children who could benefit from the passage of HB 399, if only indirectly.

“Nathan and I have this connection through our dogs and he found out I’d lost one of my dogs very unexpectedly last July, and a couple of days later we were at this fundraising event for another candidate and he learned through his mother that I’d lost my dog, and he made an attempt on his own to go get me a little balloon animal dog and came over and gave it to me,” said Basye.  “I thought that was pretty cool.  I’ll never forget that moment.”

Kirkwood representative Deb Lavender (D) is a physical therapist.  She said often, children will start therapy but insurance will cover a limited number of sessions.

“So many complications can occur after that.  They don’t fully maximize their physical ability, mental abilities, capacities, and so being able to extend this therapy is so critical for these children at that time in their life,” said Lavender.

St. Louis Democrat Steve Butz called the bill well-thought-out and a good compromise between parents who were advocating for a change, and the insurance industry.

“These therapies are medicine for these developmentally disabled children.  They are medicines that improve the quality of life, help these children attain goals they could never attain, and the costs of the therapies are quite inexpensive when compared to other experimental drugs and other pharmaceuticals that, say, a child with leukemia might need for his or her survival,” said Butz.

HB 399 would not cost the state anything.  It is projected it would increase premiums for holders of fully insured plans by about 39-cents per member, per month.

The House voted 129-5 to send the bill to the Senate, which last week passed its version of this legislation.

House votes to prevent jailing of Missourians for failing to pay jail bills

The Missouri House has voted to keep judges from putting people back in jail for failing to pay for the costs of keeping them in jail.

Representative Bruce DeGroot (photo; Tim Bommel, Missouri House Communications)

House Bill 192 would keep a person’s failure to pay a jail for housing that person, from resulting in more jail time that would result in additional housing costs.  Instead, a local sheriff could attempt to collect such costs owed through civil proceedings, or a judge could waive those costs.

The legislation is sponsored by Chesterfield Republican Bruce DeGroot, who worked closely with Liberty Democrat Mark Ellebracht.

HB 192 has broad, bipartisan support, as members of both parties agreed that being jailed for failing to pay so-called “board bills” only created a cycle of debt that some Missourians have been trapped in for years.  Legislators gave examples of individuals who had stolen items like makeup or candy, and years later owe tens of thousands of dollars to the local jails that had housed them.

“It just seems so contradictory that I can’t pay a $1000 bill, so you put me back in jail, so that when I get back out of jail now my bill is $1,500.  It just seemed to keep going for forever,” said Representative Deb Lavender (D-Kirkwood).

“In my opinion the goal of the criminal justice system … if you do something wrong, you should be punished.  On the other hand, once you’ve completed your punishment, once you’ve served your time in jail, man, the goal ought to be to get those people back out into society [to] be productive of society, paying for their families, rather than have them in jail dodging warrant servers, and get them back on the tax roll,” said DeGroot.

Ellebracht stressed that these “board bills” are not the same thing as court costs or fines that might be assessed against a defendant.

“When somebody gets thrown in jail, their time is their punishment.  That’s the point of it … but the money that’s accrued for your care – for your food, your clothing, the shelter over your head that the county’s providing – that’s money owed for a service provided incidental to your punishment,” said Ellebracht.  “So, the sheriff has every right to collect that money … they just don’t have a right to keep bringing you back to court and throwing you in jail, thereby accruing more board bills to do so.”

DeGroot said he doesn’t fault the judges in the state who have been jailing individuals over board bills.

Representative Mark Ellebracht (photo; Tim Bommel, House Communications)

“The judges in the counties that practiced this way, I think, are all trying to reform themselves now because they know that not only [the legislature] but the Supreme Court has an appetite right now for curbing this kind of behavior,” said DeGroot, “but they were just, in my opinion, just using the tools that they had available to them.  They didn’t know how else to collect, because the threat of jail time is much more severe than, ‘We’re going to take your stuff.’”

HB 192 would do away with hearings in which the court requires a defendant to show why he or she shouldn’t be jailed for failing to pay board bills.  Lawmakers heard that defendants are often required to appear monthly for such hearings and a warrant is issued for them if they fail to appear.

The bill is supported by a number of groups including the Missouri State Public Defender, the Missouri Association of Criminal Defense Lawyers, and the Missouri Association of Prosecuting Attorneys.

The House voted 156-1 to send the bill to the Senate for its consideration.

House approves ethics reforms for local officials, open records exemption changes

The Missouri House has voted to enact a number of ethics reforms for local  officials, but support for the bill was tempered by an amendment that creates exemptions to the state’s open records, or “Sunshine,” law.

Representatives Nick Schroer (left) offered an amendment adding exemptions to Missouri’s open records law to a bill sponsored by Representative Shamed Dogan that dealt with ethics reform for local officials. (photo; Tim Bommel, Missouri House Communications)

House Bill 445 extends to local officials the ethics policies that state lawmakers and statewide officials are now subject to.  It would bar lobbyists from making expenditures for local government officials, superintendents, or members of school boards or charter school governing boards.  Such expenditures could also not be made for those officials’ staffs or specific members of their families.

The bill would also keep elected or appointed local officials from becoming lobbyists for two years after leaving office.  It would limit to $5 per day the amount a gift to such officials can cost, and cap at $2000 any campaign contributions for municipal, political subdivision, and special district office races.

Bill sponsor Shamed Dogan (R-Ballwin) has proposed that language for several years, based on how he saw local officials being lobbied while he was a city councilman in Ballwin.

“This is simply making sure that that same ethical standard to which we hold ourselves is also going to apply to our local elected officials, who have the same level of public trust, who are also trusted with taxpayer dollars, and who we also expect not to profit from their public service,” said Dogan.

A previous year’s version of Dogan’s bill received 149 votes when the House sent it to the Senate.  This year’s version passed out of the House on Thursday, 103-47.  Democrats said the lessening of support was due to an amendment to Dogan’s bill that they say “guts” Missouri’s open records law that has been in place since 1973.

“I appreciate [Representative Dogan] and his quest to make Missouri a better place and also improve the perception that people have and the confidence that folks have in their elected officials,” said Kansas City Democrat Jon Carpenter.

“But at the same time I’m going to vote against House Bill 445 today because unfortunately it doesn’t just do those things.  It also upends almost five decades of open records and transparency law in this state.  In fact almost unquestionably, when this bill passes it’s going to be the most radical undermining of open records and transparency law in state history,” said Carpenter.

The amendment, offered by Representative Nick Schroer (R-O’Fallon), would add to exemptions from the Sunshine law any personal cell phone numbers, social security numbers or home addresses; records of constituent case files including any correspondence between an elected official and a constituent; and any document or record “received or prepared by or on behalf of” an elected or appointed official “consisting of advice, opinions, and recommendations in connection with the deliberative decision-making process of said body.”

“I took a massive interest in trying to protect the integrity of our positions,” said Schroer.

Schroer discussed with Representative Steve Helms (R-Springfield) incidents in the news that he said are the types of things he wants to prevent.

Representative Jon Carpenter and other Democrats said the changes HB 445 would make to Missouri’s open records law go too far. (photo; Tim Bommel, Missouri House Communications

“The Huffington Post ruined an entire family for one person’s tweets, doxing them,” said Schroer.

“So you mean the Huffington Post printed private, personal information out on social media because they disagreed with a tweet that one of the family members made?” asked Helms.

“Correct,” said Schroer.  “They accessed personal information just like I am trying to protect here.”

Democrats were largely unmoved by the concerns Schroer cited.

“I believe [Representative Schroer] protests way too much,” said Representative Deb Lavender (D-Kirkwood).  “I don’t think the statute we have currently in place allows half of what he’s just told us is sunshineable … I don’t hand out people’s social security numbers.  I won’t give addresses.  I’m covered in the law that we have today.”

Dogan said he felt the provisions offered by Schroer regarding constituent information were necessary.

“I am concerned about people’s e-mail addresses, phone numbers, other personal information being a part of the public disclosure and us not being able to redact that information really is concerning,” said Dogan.  “With that said I’m not sure about the portion that has been the most controversial where it’s talking about all communications.  I think that might have been an unintentional kind of overreach, so I’m a little bit concerned about that section and I would be willing to work on toning that language down somewhat.”

Several Republicans voted against HB 445.  Dogan said most or all of those were likely opposed to campaign finance limits, which many Republicans believe limit free speech.

Today’s vote sends the legislation to the Senate, where several lawmakers in both parties said they expect it will undergo further revisions.