Tag: Kent Haden

House Approves Plan to Reduce Wait Times, Costs for Healthcare

      House lawmakers have voted to decrease the time Missourians must wait for some medical procedures, increase quality of and access to healthcare, and decrease costs.

      Insurance entities require health care providers to seek prior authorization before performing some procedures before they will agree to cover those procedures.  If House Bill 1976 becomes law, health care providers who reach a 90 percent approval rate for a given procedure over a six month period will then not have to seek prior authorization for the following six months.

Representative Melanie Stinnett (Photo: Tim Bommel, Missouri House Communications)

      “Insurance companies and their prior authorization standards are getting in the way of health care for everyday Missourians,” said bill sponsor Melanie Stinnett (R-Springfield).

      She said the passage of HB 1976 would mean “better access to care for patients and, potentially, decreased cost for patients, because the prior authorization process, itself, increases costs within the healthcare system.”

      Stinnett said without knowing it, many patients have likely had a negative experience that involved prior authorization.

      “Often, [patients] feel like it is something that the doctor hasn’t done or needs to do, but in reality it’s something that the health insurers lay over on top of what the health care provider has to do,” said Stinnett.  “It’s a challenge that the health care provider has to deal with, but often the patient doesn’t realize who’s imposing it or where that’s coming from.”

      “As someone who has spent hours and hours and hours trying to get preauthorization for patients that need physical therapy, I cannot support this enough,” St. Louis Representative Jo Doll (D), who has worked as a physical therapist, told her colleagues.  “The process is burdensome, it takes hours and hours of – people that are there to provide patient care – takes them away from patients and makes them calling, writing, submitting countless forms to get visits approved.”

Representative Jo Doll (Photo: Tim Bommel, Missouri House Communications)

      Health care industry workers and those patients who know of the prior authorization process view it as little more than “red tape” that drives up costs and slows care, and Representative Patty Lewis (D-Kansas City) agrees, and said some doctors report that the delays it causes lead to worse outcomes and even deaths.

      “Some of the witnesses who came through committee talked about the additional [workers that must be hired to do prior authorization paperwork].  We know we have a workforce shortage in the State of Missouri, so putting additional workforce just to go through red tape when they end up providing the care that’s needed … this is the right thing to do to increases access to care,” Lewis said.  

      The legislation made its way to the House after being approved by the Committee on Healthcare Reform.  Chairman Kent Haden (R-Mexico) noted that panel gave it a bipartisan, unanimous vote.

      “The only people that testified against it were the insurance people and [pharmacy benefit managers],” Haden said.  “It is really good for all of our clients, all of our constituents.  Not many bills we see effect everybody in the House and all their constituents.  This bill will effect virtually everyone and their constituents immediately.  It’s a great bill.” 

      Stinnett told her fellows the prior authorization process gives power to insurance companies and leaves providers fighting to get the best care and outcomes for their patients.  Her legislation aims to change that, and to allow providers to focus more on patients’ needs rather than what insurers will allow.

      “I think that this bill really puts a highlight on prioritizing the physician and patient relationship, and allowing the physician or the other health care provider and that patient to make their health care decisions.”

      The House voted 146-6 to send that legislation to the Senate.

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.

Legislators to MODOT and Conservation: get dead deer off the roads

      Two House lawmakers say there are too many dead deer on the state’s roads and it’s hurting economic development and tourism.  They say it’s time the legislature steps in and gets the Departments of Conservation and Transportation to do something about it.

Representative Paula Brown (Photo: Tim Bommel, Missouri House Communications)

      Hazelwood Democrat Paula Brown and Mexico Republican Kent Haden have each filed identical legislation that would require the Department of Transportation to move dead deer from roadways and bury them at least three feet deep on Conservation land, and would have the Department of Conservation pay for that removal and burial.

      Both representatives say this is an issue driven by constituent concerns.  Brown shared with the Committee on Transportation Accountability some of the reports she’s gotten from people throughout the state: “There’s 22 deer on this stretch of road … I hit a buzzard because it was eating a deer … then one of my other representatives from my side of the aisle called and said, ‘Have you been hearing about dead deer?’ and I was like, ‘It’s time to do something.’”

      Haden had a similar experience. 

“I was in a Sunday school class right before I filed this bill and without any prompting from me … the subject of deer on the highways came up, and suddenly a quiet, normally, 25-people in a Sunday school class turned into a pitchfork and torches meeting.  Their question was why don’t we do something about these dead deer on the road?”

“We are open to solutions,” said Brown.  “This is not to punish anyone but when constituents call you and tell you how disgusted they are, and they’re from all over the state, it’s time for us to do something.”

“ … the problem’s gotten worse, not better.”

The issue came before a House transportation committee four years ago when its then-chairman, former representative Tim Remole (R-Excello), said he counted 75 deer on Highway 63 in the roughly 30 mile distance between Moberly and Columbia.  Remole filed legislation about the problem then, and Haden said the committee was told by the Departments of Conservation and Transportation that they would work something out and a legislative solution would not be needed. 

Transportation Accountability Committee Chairman Don Mayhew (R-Crocker) said he was on the committee then, “I was a participant in that [hearing] and that was four years ago and I can tell you from my own personal experience the problem’s gotten worse, not better.”

      “If the two groups would do what is right for the State of Missouri and not argue over, ‘It’s our money.  You can’t tell us what to do,’ then this wouldn’t be an issue,” said Haden.  “We have two commissions with adequate funding who … have not yet done what is correct for the betterment of the whole State of Missouri, for a relatively small amount of money.”

      Brown agreed, “Conservation carried over roughly $43-million from their budget from last year and we’re asking for, in their estimates, $975,000, give or take.”

      The Departments told lawmakers a combination of things has led to the large number of dead deer remaining along the state’s byways.  One of those has been staffing. 

Department of Transportation Legislative Liaison Jay Wunderlich said the Department is down about 300 maintenance workers.  Also gone are hundreds of incarcerated individuals who, pre-COVID, helped remove carcasses and trash along highways.

“ … right now what we’ve been asked to do is just turn the deer around and to leave it on highway right-of-way … ”

Another factor has been chronic wasting disease (CWD), a fatal neurological disease in deer and other cervids.  Department of Conservation Deputy Director of Resource Management Jason Sumners said the Department is concerned about the movement and disposal of deer carcasses in relation to controlling the spread of that disease.

Representative Kent Haden (Photo: Tim Bommel, Missouri House Communications)

“While not removing the carcass doesn’t deal with that environmental contamination – it’s already there … unless it’s going to a lined landfill, I would prefer (and I think the science would bear out) that just simply leaving that carcass relatively close to where it was … is the best way to mitigate that risk.”

      Wunderlich said Transportation crews have been following Conservation Department guidance on what to do with a dead deer.

      “If it’s alongside the road, right now what we’ve been asked to do is just turn the deer around and to leave it on highway right-of-way so that the deer will decompose as nature deems appropriate.”

      He said between Conservation directions and financial concerns, leaving the deer on the roads made more sense to his Department.

“To make it a priority to go out picking up dead deer our number one focus for the particular day, that’s just not good [use of] taxpayers’ dollars in our minds.  We’ve got to take care of the roads so that people are driving safely,” said Wunderlich.  “Do we have the choice of picking up dead deer for that particular area or do we have to go out and fill potholes, fix a bridge that has a hole in it, put up guardrail, what have you.  We’re doing the best we can with what we’ve got but right now the best that we have is to just go out there to remove the deer as we see them, as it becomes a health or a safety factor.”

      At least one Committee member, Lakeshire Democrat Michael Burton, sympathized with the Transportation Department’s argument.

      “This bill is going to be putting a higher workload on a department that is underfunded and understaffed and I don’t know how you do that without taking employees away from other things that need to be taken care of.”

“ … somebody’s going to have to say, ‘What’s good for the State of Missouri and who’s going to do it?’”

      Haden and Brown insist, though, that the current situation needs to be addressed.  They said in addition to being eyesores, sources of odor, and potential road hazards, the carcasses are threats to economic development and tourism.

“A million dollars could very well be made up with one business settling in our state who could be turned off by the fact of, ‘What is the deal here?’ if they come from a state who does pick up their deer better,” said Haden.  “You also have all the tourists coming through.  How many of them want to look at a decaying, rotten carcass, with odor?  What is that damage to the State of Missouri?  In my opinion it’s very damaging … as Representative Brown said, it is a constituent-driven issue.”

      The Committee’s top Democrat, Michael Johnson, hails from Kansas City which in coming years will host the NFL Draft and the FIFA World Cup soccer tournament.       

“With all of these great events that we’re going to be having throughout our great State of Missouri that are coming up would you say that it would be in the best interests of us to make sure that our highways look as good as they possibly can?”

      Brown agreed, “FIFA, we know that it’s going to impact 250 square miles around the Kansas City city limits.  250 square miles of people coming into our state from everywhere.  We have been trying to attract that kind of business and tourism for years and I don’t want them leaving and saying, ‘I’m not going back there,’ … We can brag about our state parks all day long but if you’re going to pass all the carcasses to get to them, they’re not going to want to come back and we want them to come back.”

      The committee took in the concerns of the two departments but most members commented that something different needs to start happening.  Representative Rudy Veit (R-Wardsville) said he doesn’t think the legislature should be having to deal with this.

      “I just don’t see that this is the type of thing that we should be micromanaging, telling you how to go pick up a deer and where to put it and how deep to put it.  I would appreciate it if you all would … come back [to] us with a simple solution that may not make everybody totally happy but is something in the right direction.”

      Added Haden, “It’s a food fight and somebody’s going to have to say, ‘What’s good for the State of Missouri and who’s going to do it?’”

The legislation is House Bill 501 (Brown) and House Bill 404 (Haden). The committee has not voted on either bill.

Pronunciations:

Remole = REM-oh-lee

Wunderlich = WON-der-lick

Veit = veet