Missouri WIC recipients to get farmers’ markets vouchers under new law

      A new law could soon have more Missourians on nutrition assistance going to farmers’ markets.

Representative Martha Stevens (Photo: Tim Bommel, Missouri House Communications)

      Language in House Bill 432 will bring the Farmers’ Market Nutrition Program (FMNP) within the Women, Infants, and Children (WIC) program back to Missouri.  This will allow those receiving WIC assistance to use vouchers at farmers markets. 

      Missouri previously participated in the program up until more than a decade ago. 

      The FMNP language was from a standalone bill (House Bill 652) filed by Representative Martha Stevens (D-Columbia), whose background is in social work. 

      “It’s a way to address food insecurity, which is a significant issue in our state for low-income families.  It’s a way to support new moms and young children that are at nutritional risk.  It’s a way to draw down federal dollars to be distributed in our local economy, and it’s a way to support local farmers, but also for some families, potentially this might be their first introduction to a community farmers’ market, so the hope is that they’ll continue to use those markets going further even when they don’t potentially qualify for WIC benefits.”

      She said initially it will be couched in the existing Seniors’ Farmers’ Market Nutrition Program in the counties that offer it.

      “The hope is that after this is established that this is a program that can grow across the state.  We could even, potentially, receive more of the grant money from the USDA to grow that program,” said Stevens.

      The program will be maintained by the state Department of Agriculture, which must submit to the USDA by November an implementation plan.   Stevens said it will likely be next year before WIC recipients in Missouri can get vouchers, as the program funding is grant based.

House prepares extensive foster care reform legislation

An increased focus on issues concerning foster care in Missouri has resulted in a bill containing 11 different reforms meant to make life better for children who are in, and who leave, that care.

Representative Jim Neely chairs the House Special Committee to Improve the Care and Well-Being of Young People and sponsors HCB 11, a comprehensive foster care reform bill. (photo; Tim Bommel, Missouri House Communications – click for larger version)

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 improving the state’s child welfare system.  That committee is chaired by Cameron Representative Jim Neely (R), who selected 11 of the bills assigned to it to be combined into House Committee Bill 11.

Neely, a doctor, said improving the lives of children has been his priority since a young girl who’d been abused came into his office about ten years ago.

“This young lady said a lot of adults had let her down, and so I chewed on that and thought about life and what I needed to do, and that was probably the seed that caused me to run for office a few years later,” said Neely.

Neely said some of the things HCB 11 would change in Missouri law are “quick” or “simple” fixes that could have significant impacts, especially in situations in which foster children have been described as, “falling through the cracks.”

“There’s an incident in the Kansas City area where a child was over in Kansas and if we’d been able to share information with the State of Kansas we might have been able to prevent a horrid situation over there,” said Neely.  “We’re just trying to make [things] a little more user friendly and get the foster parents a little more safety net.”

HCB 11 includes language that would update background checks on foster families so that the Children’s Division would know immediately if a foster parent is charged with a crime that would disqualify him or her from being a foster parent.  Current law only allows checks every two years.

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

That portion of the bill came from House Bill 1944 sponsored by Representative Sonya Anderson (R-Springfield).

“House Bill 1944 would allow the Department of Social Services to utilize the RAPBACK program, which is the Record of Arrest and Prosecution, and so it’s a more instant update if a foster care parent or someone who resides in the house has been charged with a crime,” said Anderson.  “We want to make sure that [foster] children are in the safest environment as possible.”

HCB 11 would also 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.  Currently children are screened every two years.

The original sponsor of that language is Representative Lauren Arthur (D-Kansas City), who said it would ensure that children in foster care receive more appropriate care, and the comprehensive screenings will in turn save the state money by catching medical conditions earlier and aiding in preventative care.

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

“This would change the requirements so that every child in foster care is receiving these kinds of screenings, not just children under the age of ten.  Additionally it means that they’ll receive more appropriate care, so according to the experts – the American Academy of Pediatrics – our children in foster care will go to the doctor according to their recommendations and that schedule as opposed to the legislature saying they have to go every two years,” said Arthur.  “For older kids in foster care, often when they are pulled out of school more than their peers it adds to a feeling of stigma – they feel like they’re different from their classmates – and we certainly don’t want them to feel different or have to go to the doctor more than anyone else just because they’re in foster care.”

Another portion of HCB 11 comes from House Bill 1862 sponsored by Representative Phil Christofanelli (R-St. Peters).  It would enable investigations of abuse of children in foster care in Missouri when it happens outside of the state.

Current law prevents Missouri Social Services workers from investigating reports of abuse of Missouri children in foster care if the abuse doesn’t occur in Missouri, and prevents them from communicating with counterparts in other states about abuse or potential abuse.  Christofanelli said his bill would remove those barriers and fix what he called a, “bureaucratic technicality.”

“This is just eliminating some loopholes that have resulted in some unfortunate situations in the past and making sure that we have full communication across state lines to protect kids,” said Christofanelli.

He said HCB 11 is combining a number of efforts to fix situations in which lawmakers are told, all too often, that children are being “left behind.”

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

“It’s one of the most rewarding parts of being in the legislature and it’s such an easy fix.  It’s shocking to me that this hasn’t been done yet because we’ve seen case after case where problems like this arise across state lines,” said Christofanelli.  “Our kids are our greatest asset here in Missouri and if there’s anything that we can do to help keep them safe then we’re going to do it as the legislature, so I’m honored to be a part of that process.”

Some lawmakers expressed concerns with the portion of the bill because other states might release information about abuse claims – particularly unsubstantiated claims – that Missouri would not release.  They expressed a desire to see that concern addressed before the bill could become law.

The House is prepared to vote on whether to send HCB 11 to the Senate.  The bill is broadly supported, including by Columbia Democrat Martha Stevens, who sits on the Special Committee to Improve the Care and Well-Being of Young People.

Stevens said she’s glad to be on the committee but says it has more work to do even if HCB 11 becomes law, “particularly with children aging out of the foster care system, so I’m hopeful that in the interim, with stakeholders and advocates and experts and folks on both sides of the aisle we can bring forward more solutions next year to help address issues around foster care and support the Missouri youth that are aging out of foster care.”

      Other parts of HCB 11 would:

– Provide free birth certificates to children in foster care, making it easier for them to become independent (found in House Bill 1470 sponsored by Representative Mike Kelley, R-Lamar)

– Allow more time for a case management plan to be developed for a child entering foster care (found in House Bill 1637 sponsored by Representative Neely)

– Allow foster children aged 16 years and older to open a checking or savings account with the consent of the Children’s Division or juvenile court, giving them the ability to cash paychecks and better access to jobs  (found in House Bill 1715 sponsored by Representative Don Phillips, R-Kimberling City)

– Make closed under law any records regarding placement of children into foster care or kinship placements, and specify who can access those records and when (found in House Bill 1966 sponsored by Representative Robert Cornejo, R-St. Peters)

– Allow a child who is homeless or in the custody of the Children’s Division, but the whereabouts of his or her immunization records is unknown, to be enrolled in school for up to 30 days while efforts are made to find those records, and if needed, another 30 days after that for the child to get caught up on immunizations (found in House Bill 2139 sponsored by Representative Lynn Morris, R-Nixa)

– Define when juvenile courts have jurisdiction over a child under 21, streamlining situations in which a child is in a safe situation but juvenile court involvement is interfering with the family (found in House Bill 1728 sponsored by Representative Bill Lant, R-Pineville)

– Establish guidelines for educating children in court-ordered group homes or institutions for delinquent or neglected children (found in House Bill 2625 sponsored by Representative Lyle Rowland R, Cedarcreek)

– Create the “Trauma-Informed Care for Children and Families Board” to encourage cooperation between agencies that deal with children and utilize trauma-informed treatment programs (found in House Bill 2217 sponsored by Representative Cora Faith Walker, D-Ferguson)

House approves bipartisan collaborative effort to extend Medicaid coverage for postpartum substance abuse care

A bipartisan, collaborative effort to extend Medicaid benefits for postpartum substance abuse treatment has been approved by the Missouri House.

Representatives Marsha Haefner, Martha Stevens, Cora Faith Walker, and Jay Barnes (photos; Tim Bommel, Missouri House Communications – click for larger version)

House Bill 2280 extends MO HealthNet benefits for pregnant women who are receiving substance abuse treatment within 60 days of giving birth for up to 12 additional months.  Any participating woman must follow the treatment in order to benefit.

Bill sponsor Marsha Haefner (R-St. Louis) said extended treatment has been proven necessary for success.

“Opioid and substance abuse during pregnancy is on the rise, with opioid use during pregnancy mirroring that of the general population,” said Haefner.  “The current time offered for substance use disorder treatment, which is 60-days for these new moms, does not allow for enough treatment for most women to experience success with recovery.  If a new mom is doing well then loses support and treatment for her abuse she will often relapse.  Another risk of pulling treatment too soon is after a period of non-use, women experience an increased risk of overdosing because their tolerance is low.”

HB 2280 was combined with similar bills filed by Representatives Cora Faith Walker (D-St. Louis), Martha Stevens (D-Columbia), and Jay Barnes (R-Jefferson City).

Stevens told lawmakers she was glad that the bill will cover a full range of treatments.

She said that one thing that came out of the committee hearing on the bill was that, “new moms need not just substance use disorder treatment.  That we really need to have comprehensive, wrap-around services, and so I’m very pleased that this bill is full Medicaid coverage so that these new moms can get substance use disorder treatment, they can get mental health care, they can go see a primary doctor, and really support them that first year after giving birth.”

Representative Faith Walker commended the lawmakers involved in the legislation for the bipartisan effort that led to its passage.

“It is a very common sense, evidence-based approach to dealing with the opioid epidemic here in the State of Missouri and it will both save taxpayer dollars as well as save lives,” said Faith Walker.  “I want to encourage the body to look at this effort that was put forward by all the bill sponsors moving forward for the rest of the session.”

Representative Keith Frederick (R-Rolla) said the bill represents something the legislature should do to help the most vulnerable in the state.

“The bottom line is that if we have ladies that are pregnant and have the struggle of addiction, they are in a special, vulnerable situation, as is their child,” said Frederick.

The bill’s projected cost is more than $4-million dollars through 2021, but Haefner noted it would save the state money that would have gone to caring for children who could go to state care if their mothers aren’t afforded treatment, and other cost avoidance.  She said the budget the House is debating this week also includes money to pay for the projected costs to extend this coverage.

The bill has been sent to the Senate for its consideration.  If it becomes law, the state will have to seek a waiver from the federal government to allow for the program to be created and implemented.  Missouri would be the first state to seek such a waiver.

Haefner is hopeful the state could get an answer from the federal government by the beginning of 2019.

Democrats propose multi-pronged attack on opioid abuse

Missouri House Democrats say the fight against opioid abuse is about more than passing a statewide prescription drug monitoring program.  They today unveiled a slate of legislation that would attack the problem by addressing a number of other issues.

House Democrat Leader Gail McCann-Beatty and Representative Gina Mitten speak about their caucus’ multi-bill approach to attacking opioid abuse in Missouri. (Photo; Chris Moreland, Missouri House Communications)

“The opioid disorder crisis is multi-faceted,” said House Democrat Leader Gail McCann-Beatty (Kansas City).

Democrats continue to support passage of a statewide prescription drug monitoring program to track the use of prescription narcotics.  Such legislation has advanced farther through the legislative process in each of the past few sessions, but fallen short of passage.  Last year St. Louis Democrat Fred Wessels sponsored such legislation that was combined with a bill sponsored by Sikeston Republican Holly Rehder and fell just short of final passage.  Both representatives will sponsor such legislation again this year.

In addition, Democrats have filed bills that would require pharmacies to post information about methods and locations for the safe disposal of unused medication; require for medical professionals with prescribing authority at least four hours of training on the misuse and abuse of prescription drugs and recognizing addiction in patients; require the Missouri Department of Health and Senior Services to mirror federal regulations for prescribing opioids for chronic pain; require insurance coverage of medication assisted treatment and remove insurer-proposed barriers to addiction services; establish a sterile needle and syringe exchange pilot program; require the Show-Me Healthy Babies program to cover substance abuse treatment for women up to one year post-partum; and expand the use of CBD or hemp oil to include being used as a pain management alternative for those with a history of opioid abuse.

“Substance disorders need to have an all-of-the-above approach and what we’re proposing here is just that.  We’re not only talking about PDMP.  We’re talking about a number of other options; tools that should basically be put in the toolbox of not just the medical community but our entire community,” said Representative Gina Mitten (D-St. Louis).

Mitten is sponsoring the bills that deal with safe disposal of abused prescription medication and additional training for prescribers.

Missouri is the only state in the nation without a statewide prescription drug monitoring program.  Many counties in the state are participating in a program initially launched in the St. Louis region, and Governor Eric Greitens (R) signed an executive order creating a tracking program for some prescription information handled by one benefits provider.

The legislation discussed today by House Democrats is for the 2018 legislative session, which begins January 3.