Budget proposal maintains House’s steep cuts to DHSS after dispute over virus data

House and Senate conferees have agreed to a budget that would make significant cuts in the Department of Health and Senior Services’ director’s office.  House members say that department is needlessly withholding information about a virus outbreak that killed two people in Missouri, including one state employee.

House Budget Committee Chairman Scott Fitzpatrick (in foreground, right) and Senate Budget Committee Chairman Dan Brown (foreground, left) speak to Senator Jamilah Nasheed while House Budget Committee Vice Chairman Justin Alferman (top, center) speaks to Senators Dan Hegeman (top left) and Kiki Curls during a break in the conference committee hearing Monday. Those senators had concerns about Reps. Fitzpatrick’s and Alferman’s intentions to cut money that amounts to the salaries of several people in the Department of Health and Senior Services’ Director’s office, including the director. (photo; Mike Lear, Missouri House Communications – click for larger version)

The conference committee agreed to cut money equal to the salaries of eight positions in the director’s office, including the director.

House Budget Committee Vice Chairman Justin Alferman (R-Hermann) is one of several lawmakers who have asked how many people in Missouri have tested positive for the antibodies to the Bourbon virus.  The House has also subpoenaed the Department seeking that information, and the Department still hasn’t provided it.

The Director of the Department of Health and Senior Services, who had not appeared before the House Budget Committee for any of its public hearings, did appear before the conference committee between House and Senate members that met Monday night to agree on a budget proposal for both chambers to vote on this week.  Dr. Randall Williams maintains he can’t release what Alferman and others are asking for.

“Missouri law and HIPAA are very clear that if I provide information that can identify you in a small sample size, [that’s a violation],” said Williams.

The Department’s General Counsel, Nikki Loethen, told the committee, “The issue here is that there is already significant information already available regarding who was tested and with all of that information that’s already available, for us to disclose the information that [lawmakers are asking for] could lead to the identification of individuals.”

Alferman said the Department’s argument that the information could lead to the identification of individuals is “ridiculous.”

Some senators on the conference committee wanted to restore what they called “drastic” cuts to DHSS, but Alferman and House Budget Committee Chairman Scott Fitzpatrick (R-Shell Knob) did not want to back down.  Alferman had already agreed to reverse another of his amendments in response to the situation that shifted control of the state health lab from DHSS to the Department of Public Safety.

“I don’t know how I’m supposed to negotiate with someone who doesn’t come to the table,” said Alferman about the Department.

Fitzpatrick noted that Williams was once before at the center of a controversy with serious implications for public health.

In 2016 Williams, while the public health director for the State of North Carolina, joined another state official in rescinding a “do not drink” notice regarding well water potentially contaminated by coal ash.  The state’s toxicologist at the time said North Carolina was telling people the water was safe when it knew it wasn’t, and went so far as to accuse other state officials of “playing down the risk.”

“It would just seem to indicate that there’s a pattern of behavior that Dr. Williams has made a controversial decision in the past,” said Fitzpatrick.  “I just don’t think that allowing that to continue to happen in Missouri is a good idea.”

Democrats who opposed the cuts to DHSS noted the positions cut in the Director’s office would include the lawyers who interpret for the Department how it must act to comply with state and federal laws.

“I do find it concerning that when we ask the Department to interpret laws, both federal and state, and then they interpret it, if we disagree with their interpretation that we’re then going to cut their funding, of the very people who makes those interpretations,” said Springfield representative Crystal Quade (D)“We’re dealing with very sensitive information and very dangerous, life-threatening things, often, with these viruses, and it’s important that we are following the law accordingly so that we can make sure people are protected, so it was concerning to me that was the decision of the committee.”

Fitzpatrick noted that the cuts would remove 8 people from a department of more than 1,700 employees.

“I doubt those eight people are going to make it impossible for the mission of the Department of Health and Senior Services to be met.  I think if anything, several of those people were part of obstructing the General Assembly from finding the information that I think [it’s] entitled to,” said Fitzpatrick.

Backers of the cuts said they are concerned about the safety of the public, and that includes Missourians knowing whether they should be concerned about a bourbon virus outbreak.

“I can’t go home and confidently tell my constituents that I believe that the state department of health is working on their behalf when they shut me out and shut all the members of the House out completely,” said Alferman.

The House and Senate are expected to vote Wednesday on the budget proposal for the fiscal year that begins July 1.  The deadline for the legislature to submit a budget proposal to the governor is at the close of business on Friday.

Fitzpatrick said he would consider restoring the money for those positions if the Department gives the House the information it has asked for, but the next opportunity to do that would likely not come until work begins on a supplemental budget bill in January of 2019.

Earlier story:  House Budget Committee adopts stiff cuts to DHSS over Bourbon virus data dispute

House budget committee adopts stiff cuts to DHSS over Bourbon virus data dispute

House Budget Committee leaders have proposed deep cuts to the office of the Department of Health and Senior Services’ director because the Department has not provided data on a recent virus outbreak that left a state employee dead.

Representative Justin Alferman (photo; Tim Bommel, Missouri House communications – click for larger version)

Committee Vice-Chairman Justin Alferman (R-Hermann) said prior to last week’s budget markup hearing that he would make such cuts if the information was not provided.  The Department continued to stand by its argument that it cannot release the requested data without violating the Health Insurance Portability and Accountability Act (HIPAA).

Alferman’s proposal would cut more than $239-thousand in state revenue and another $925-thousand in federal funds from the director’s office.  That represents the salaries of seven attorneys in the director’s office, the director, the assistant director, and the legislative liaison.

“We have very little resources at our disposal in order to put checks in with some of these departments, and one of the checks and balances is the power of the purse, and we are absolutely using it right here to get information for the six million Missourians who live in the state,” said Alferman.

Alferman and House Budget Committee Chairman Scott Fitzpatrick (R-Shell Knob) say the information they want – the number of people in Missouri who tested positive for the antibodies to the Bourbon virus, indicating they have had it – would not include specific patient information that would violate HIPAA.

A department spokesperson on Wednesday night told the House Budget Committee two people in Missouri have tested positive for Bourbon virus, but did not offer information on how many have tested positive for the antibodies.  The superintendent of eastern Missouri’s Meramec State Park died last year after contracting the virus from a tick bite.  Alferman said he wants to know whether there is a risk to public health from the tick-borne illness.

“All of the released information up until this point, 40-percent of all cases of the Bourbon virus have happened in Missouri, so for a state parks worker to pass away from this disease, I don’t think it’s an unrealistic expectation for us … we know testing was done.  We want the results of that testing to know … we’re policy makers.  Do we need to make a policy change in the state of Missouri to combat this virus?  We don’t know because we’re not getting any information back from the Department,” said Alferman.

He said the Department’s rationale is that releasing the number of people tested could allow someone to question park employees about whether they were screened and use a process of elimination to identify who was and was not tested – something Alferman called a “ridiculous” interpretation.

Representative Peter Merideth (photo; Tim Bommel, Missouri House Communications – click for larger version)

Democrats on the budget committee said while they might agree with Alferman about whether the Department should release that data, they don’t agree with cutting the department’s funding.

St. Louis Democrat Peter Merideth said the proposed cut could result in the firing of people in positions which work to enforce laws protecting Missouri’s seniors.

Merideth told a DHSS spokesperson, “I know that [Representative Alferman] has said that he is not trying to be punitive with this but it strikes me as that is all this is.  It is punishing you for something that you did that you shouldn’t have done … Maybe there is a very real complaint here that we should have gotten more information from you on a timely basis, but I don’t see how this cut to your budget actually helps address the problem and it looks to me like all it actually does is hurts the people of our state.”

Other Republicans, however, agreed with Alferman.  Representative Don Rone (R-Portageville) told the DHSS spokesperson that with as long as this issue has been developing, the DHSS’ director should have been in front of the committee and not a spokesperson.  The director was instead in the nation’s capital that night.

“There’s nothing can be, in Washington D.C., any more important than letting the citizens of this state know that if there is a problem … we’ve got a job to do here and that is protect the people of the state of Missouri, and it’s not right that the director is not here, sitting here, taking these questions,” said Rone.

Alferman’s proposed cut was adopted as part of the committee’s budget proposal, which the committee has voted to send to the House floor.  It will be debated there next week when lawmakers return from spring break.