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 votes unanimously for child sexual abuse victims to have more time to sue

      A measure to give victims of child sexual abuse more time to sue those responsible for their abuse was given a unanimous vote of support in the House last week.  The bill reached the floor too late to become law this year, but its sponsor hopes that vote will give it momentum for future sessions. 

Representative Brian Seitz (Photo: Tim Bommel, Missouri House Communications)

      In 2018 state law was changed to lift the statute of limitations on criminal prosecution of child sexual abuse, but in civil law a victim of childhood sexual abuse can only sue their abusers until they turn 31 or within three years of discovering that an injury or illness was the result of childhood sexual abuse, whichever occurs later.  House Bill 367 would have extended that age limit to 41, and expand the scope of who can be sued to include anyone who enabled abuse or allowed it to continue, or who created a circumstance in which it could occur.

“Through no fault of their own, children who have been abused in the past are being victimized again by not being allowed to hold their perpetrators to account in civil actions,” said the bill’s sponsor, Representative Brian Seitz (R-Branson). 

      He said when the bill was heard by the House Judiciary Committee, people who experienced abuse as children in Missouri came from all over the state and as far away as Florida and Texas, to testify. 

“Many came from my own district to testify to the atrocities committed against them as children but it’s too late for them to face those involved in a civil action because the statute of limitations had run out before they came to terms with their abuse,” said Seitz.  “House Bill 376 cannot stop these past events but will allow for these children, now adults, to call the people – and I use that term loosely – to be held to account, and creates a path for civil actions to benefit the survivors and provide some form of restitution and accountability.”

Seitz refers to abuse that happened at Kanakuk Summer Camp at Branson, which in 2010 resulted in a former counselor there receiving two life sentences in Missouri prison.

      “I bring forward House Bill 367 to the House Floor for Evan; for Elizabeth, whose brother, Trey, committed suicide in 2019 because of the abuse; for Keith; for Jody; for Jessica; and for Ashton.”

      The House voted 150-0 for the bill’s perfection, or initial passage, which normally would be one step in the process toward it being sent to the Senate.  In this case, said Seitz, it is a symbolic vote and one he hopes will lead to this change in Missouri law eventually being made.

      One of the bill’s co-sponsors, Representative Raychel Proudie (D-Ferguson), called the bill, “incredible.  It is one of the proudest things I’ve been able to look at this year … this is probably the best bill we’re going to hear on this floor this year.  I ask the body’s unanimous support.”

      With this year’s session ending on Friday, Seitz plans to pre-file the language of HB 367 again for the 2024 legislative session.

Ban of invasive medical exams without consent sent to governor

      The legislature has voted to ensure that Missouri patients can no longer have invasive medical examinations performed while they’re unconscious and without prior knowledge or consent.

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

      Legislators were told that medical students and residents have been allowed and even directed to perform anal, prostate, or pelvic examinations on unconscious patients as part of their instruction, sometimes without those patients’ consent. 

      House Bill 402 contains several provisions regarding healthcare.  One of those would specify that such exams on unconscious patients may only be conducted when that patient or their authorized representative has given consent; the examination is necessary for medical purposes; or when such an exam is necessary to gather evidence of a sexual assault.  The legislature voted last week to send HB 402 to Governor Mike Parson (R) for his action.

      Representative Hannah Kelly (R-Mountain Grove) sponsored that provision.  She told House Communications, “The patient has the right to know what’s going on.”

      She said her first concern regarding that issue was for survivors of sexual assault, some of whom she knows personally.

      “If you talk to sexual assault survivors, often times they’re very hesitant, especially if they’re younger, to go seek healthcare and to have confidence to get the proper healthcare that they need.  This was brought to me out of the concern that we make it abundantly clear in statute that if you’re going to put somebody under anesthesia in regards to any kind of female exam that they have full disclosure of what’s happening before you go under,” said Kelly.  “I think anybody likes that, right?  But especially if you’re a sexual assault survivor that’s something that is of utmost importance to make sure that you’re getting what you need from your healthcare provider because you’re hesitant, because you’re not secure and you’re not feeling confident of the process.”

      The patient examination issue was an important one for legislators in both parties, and as a standalone bill, was voted out of the House 157-0.

      Representative Patty Lewis (D-Kansas City) was glad to see it achieve final passage this year.

Representative Patty Lewis (Photo: Tim Bommel, Missouri House Representatives)

      “I’m a nurse by background.  I worked in academic, teaching hospitals.  I worked with residents and med students all the time and when I first learned about this issue I was shocked.  I couldn’t believe that intimate examinations were happening to people without their consent.”

      Lewis noted that this passage shouldn’t hamper students’ abilities to learn.  She said they have other chances to receive instruction in such examinations.

      “If you go to one of the academic facilities you can opt in to have the med students or residents be part of your care team, or opt out if you don’t want to.”

      Any health care provider who violates the new section of law, or any supervisor of a student or trainee who violates it, would be subject to discipline by their licensing board.

      Kelly, meanwhile, encourages Missourians to ask questions of their healthcare providers and to makes sure they are made fully aware of what will happen if and when they are put under anesthesia.

      The House voted 120-31 to send HB 402 to Governor Parson, who can now sign it into law, veto it, or allow it to become law without his action. 

Legislature votes to incent film productions, touring musicians to come to Missouri

      With the third piece of statutory legislation to reach the governor this year the legislature tries to bring more entertainment industry projects and the dollars that come with them to Missouri.

Representative Kurtis Gregory (Photo: Tim Bommel, Missouri House Communications)

      House lawmakers have for years bemoaned the fact that major motion picture and television productions bypass the Show-Me State for states with better incentive packages – even productions that are set in Missouri. 

Senate Bill 94 would establish tax credits for film projects starting at 20-percent of specified costs, with opportunities for additional credits as other criteria are met.

      Dubbed the “Show MO Act,” House handler Kurtis Gregory (R-Marshall) said the program is well thought out.

      “Investments have to be made inside the state before the credits are handed out,” said Gregory.  “The Department of Economic Development will kind of have the final say in whether or not the credit goes out if it meets the program.”

      Improved film tax credits have been considered by Missouri legislators for years.  They often noted that when the 2014 movie Gone Girl was filmed in Missouri it brought $7.8-million to the state while hiring more than 110 Missourians and more than one thousand more appeared as extras. 

      More often, however, other states have won out on productions of stories that take place in Missouri because they have better incentive packages.  The Netflix series Ozark, even though it unfolded around the Lake of the Ozarks, was filmed in Georgia.  Even scenes taking place in the Missouri Capitol were filmed in Georgia’s capitol.

      Gregory told colleagues, “When film producers call the State of Missouri, call the state film office to say ‘We want to film this movie here,’ and they ask the next question, ‘What’s the incentive program in Missouri look like?” and when our film office has to then say, ‘We’ve got really great locations,’ because they can’t answer the question on whether or not there’s incentives in Missouri, there’s great business leaving this state.”

      SB 94 would allow film productions additional credits when at least half of filming is done in Missouri; at least 15-percent takes place in rural or blighted areas; at least three of a project’s departments hire a Missourian ready to advance in their field; or the project positively portrays the state or something in it.

      The bill also aims to bring more music industry dollars to the state by authorizing credits for rehearsal and tour expenses for live tours and associated rehearsals. 

Representative Steve Butz (Photo: Tim Bommel, Missouri House Communications)

      Legislators laid out limits for these credits as well, as Gregory explained.  “There must be at least $1-million spent with Missouri music vendors, they’ve got to rehearse in a qualified facility for a minimum of ten days, they also have to then do two concerts within the State of Missouri.”

      Those credits would be for 30-percent of tour or rehearsal expenses, capped at $1-million if expenses are less than $4-million.  No taxpayer could get a credit greater than $2-million for expenses between $4- and $8-million; nor greater than $3-million for expenses exceeding $8-million.  Combined credits are limited to $8-million per fiscal year.

      The film tax incentives would expire at the end of 2029 unless the legislature votes to extend them.  The tour and rehearsal credits would expire at the end of 2030 unless extended.

      The bill has broad bipartisan support, with lawmakers in both parties wanting to bring more entertainment industry proceeds to Missouri.  Representative Steve Butz (D-St. Louis) said as has happened with other businesses, the tax credits might get this industry to come to Missouri only to later stay and stand on its own.

      “Here’s another example where we take some help from government to prime that pump, got people willing to do business here,” said Butz.

      “Both of these bills are well-needed.  It’s going to drive industry and economic development to the state,” said Gregory.

      The House voted 113-45 to send that legislation to Governor Mike Parson (R) for his consideration. 

Help for low-income and disabled Missourians a focus in final days of session

      In the House, proposals that would help Missourians with disabilities, those with low incomes, and new mothers on state assistance, are being given every chance to become law before the end of the session next week.  The chamber has voted to add those pieces of legislation to several bills that are still in play in these final days.

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

      Among those is a transitional program meant to help people get off of state assistance gradually as their income increases.  House members say the state’s assistance programs for low-income Missourians trap people in poverty because if they accept a raise that puts them above a program’s limits, they could lose more in state benefits than they gain from a raise. 

      The measure, sponsored by Representative Alex Riley (R-Springfield), would let people incrementally transition off of state assistance, “Trying to create this transitional system that encouraged people to work, that encouraged people to take those raises and to start to work their way up the income ladder and to hopefully, once this goes into effect, actually reduce the number of people receiving benefits in the state.”

      That provision is the product of years of work by members of both parties.  Lee’s Summit Democrat Keri Ingle called it a, “great bill … it’s been a bipartisan effort to essentially wean folks off of assistance, whether it’s TANF or SNAP, and make it easier for Missourians to get what they need to be successful working citizens while at the same time making sure that all of their needs are being met.”

Representative Bridget Walsh Moore (Photo: Tim Bommel, Missouri House Communications)

      The House has voted this week to add that language to two bills.  It did the same for language sponsored by Representative Melanie Stinnett (R-Springfield) that could allow individuals with disabilities to finally be able to advance in their careers without worry of losing state assistance. 

      The changes to the state’s Ticket to Work health insurance program within MO HealthNet would increase the limit to how much a person can earn before they lose benefits, and would not count up to $50,000 of a spouse’s income toward that limit.  It would also direct state agencies to have policies to recruit and keep employees with disabilities and create competitive ways to integrate them into workforces.

      “These are people who are actually begging us to work, who want to work, who want to get promotions, who want to seek new jobs.  What [this] bill does is address the fiscal cliff, making sure that you don’t have to do quite as much of a tap dance that too many people in our state are doing, where you’re allowed to make so much money but only to a certain point,” said St. Louis Democrat Bridget Walsh Moore.

      Walsh Moore, who lives and works with a disability, said the benefits that individuals stand to lose often enable them to have a job in the first place.  Things like, “a personal care attendant, your health insurance your additional services and equipment that you receive through the state that allow you to work.  This would address and allow you to make more money, put that money back into the economy because if you make more money you’re going to spend more money.”

Representative Alex Riley (Photo: Tim Bommel, Missouri House Communications)

      Also supported in the House this week has been a bipartisan plan to extend post-partum coverage under MO HealthNet or Show-Me Healthy Babies from 60 days to a year.

      Stinnett, one of several sponsors of this proposal, said, “In 2019, 75-percent of pregnancy-related deaths in Missouri were determined to be preventable; those deaths that were attributed to things like embolism, hemorrhage, infections, concerns with cardiovascular health, chronic health conditions, and there’s one common denominator that can save these women’s lives, and that’s healthcare access.”

      Several Republicans have cited this as an important pro-life provision.  Representative Darin Chappell (R-Rogersville) said, “We who talk about being pro-life, I don’t know how we do that and then cut off the most vulnerable of our society after 60 days … I believe if we’re ever going to spend money [on benefits programs] it ought to be for those most vulnerable among us.  Those very ones that we fought for them to be able to be born.  We have to take care of them.”

      Representative Tony Lovasco (R-O’Fallon) said even very conservative Republicans like himself could get behind all of these proposals, which don’t expand the state’s assistance programs.

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

 “The reality is we are in a situation where we all, in all of our districts, have employers that are begging for workers.  The number of unfilled positions right now is just astronomical and the idea that we as a state might incentivize people to stay home and not work and not take a promotion, not take a job opportunity because they might just make a slim little bit more money that puts them in a hole when it comes to feeding their family, well that’s just insane.”      

Sponsors are hopeful at least one of the bills containing these provisions will reach the governor’s desk before the session closes at 6pm on May 12.

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.

Dispatchers ask for help dealing with PTSD, seek ‘first responder’ designation

      The state’s 911 dispatchers are urging lawmakers to add them to the state’s legal definition of “first responders,” before the legislative session ends.  Some of them visited the Capitol to share personal stories illustrating why they need the help in dealing with post-traumatic stress that comes with that designation.

Representative Chad Perkins (R-Bowling Green) is among the legislators who has carried legislation aimed at extending mental health services to dispatchers. (Photo: Tim Bommel, Missouri House Communications)

      First responders – which state statute currently defines as firefighters, law enforcement personnel, and emergency medical personnel – are afforded mental health resources, and several legislators say those should also be available to dispatchers.   

      Representative Lane Roberts (R-Joplin) has been Joplin’s Police Chief and the state’s Director of Public Safety, among other things in his career of more than 40 years.  Throughout all of that time he worked with dispatchers and even worked as one at times.

      “We have always underappreciated these folks.  They’re kind of out of sight, out of mind.  They work in a windowless environment, but they are the first of the first responders.  They’re the gateway to public safety,” said Roberts.  “Every time they get an emergency call they get an adrenaline dump just like people who work in the field do.  The difference is, the people in the field get to go somewhere, take action, use those chemicals, while the dispatcher will simply move on to the next call, take those chemicals home at night and go to sleep with them and suffer the health consequences.”

      Independence representative Robert Sauls (D) was a prosecutor in Jackson County and a public defender.

“As a former prosecutor I would regularly listen to 911 calls and what happens in those circumstances and … often times people are contacting 911 operators on their worst day.  Something’s happening, they’re scared, it’s a very stressful situation, and all of these 911 operators are under these stressful environments and the thing of it is, you’ve got to go on to the next one.  You’ve gotten your one situation settled, you hang up the phone, and you’ve got another one.  I think it’s very important to recognize these people as first responders.”

      Polk County 911 Director Sarah Newell said what she and her colleagues do is often dismissed as just answering phones or clerical work.

“It’s not.  We are the first point, so how that call goes is dependent on that dispatcher.  How fast that call gets put out, what information gets put out, resource allocation and knowing and forward thinking to say, ‘they’re probably going to need an ambulance on standby so let’s go ahead and roll one of those,’ so all things that they have to think about out of the box at any given time.”

      J.R. Webb, the Assistant Director of Springfield/Green County 911, said dispatchers, “have to be able to do a lot of things at once.  They have to be able to take that phone call, at the same time they’re typing that information into a computer, at the same time that they may be dealing with first responders on the radio.  The multitasking is incredible in a busy situation, and it takes a special kind of person to be able to do that.  It takes a kind of type ‘A,’ take charge personality to succeed at our job and it’s not meant for everybody.”

      The Chair of the State 911 Board of Governance, Alan Wells, said “Post-traumatic stress is a big, big thing for our 911 telecommunicators, and as of right now they do not have a lot of resources there to help with that.”

“Turnover is a big problem, burnout is a big problem that affects this industry, so we hope to be able to give them all the benefits necessary to sustain a good, long-lasting career,” said Wells.

Representative Robert Sauls also carries legislation intended to include dispatchers in the state’s legal definition of “first responders.” (Photo: Tim Bommel, Missouri House Communications)

      He said it’s not uncommon for dispatchers, especially in the smaller communities throughout Missouri, to know personally the people involved in the incidents they are handling.

      “Sometimes it can be very horrifying for those operators,” said Wells.  “It may be a loved one, a family member, an immediate family member, or in our case it was one of our own 911 call takers who had just left his shift, headed home on his motorcycle and hit a deer and it was a fatality.  The same operators that were just working with him had to take that call and work that incident.”

      Hailey Brunner is in her fourth year as a dispatcher at the Cass Co Sheriff’s Office.  She remembered one week in which her rotation, “worked seven fatalities, whether it be between an accident, people harming themselves, anything of that nature, natural deaths, anything, and it’s just a wide variety, whether it’s young kids to old kids.  My most recent one was a two year-old who died in a fatality car accident.”

      Blake Johnson has been dispatching for five years in Green County.  He said there is one call he’ll always remember. 

“I had taken a call from a family who had lost a child and I can still hear the mom screaming for her kid.  It’s absolutely horrible and it makes it worse when you actually know who those people are.”

      Newell said, “I have a dispatcher who actually worked a motor vehicle accident.  It was a rollover with ejection.  There were four juveniles in the vehicle.  She took the call and … right before she was ready to dispatch, she realized it was her son in the vehicle.”

      Brunner said dispatchers can’t help but imagine the scenes that they are hearing play out over the phone, and that can result in very vivid and very upsetting imagery. 

“You’re hearing all of this stuff that’s going on, on the phone.  You’re hearing the screams and … they’re painting a picture for you, so you have this picture in your mind of what it looks like and it could be completely the opposite of what they actually see on the scene.  It could be better, it could be worse.  We never quite know.”

      Webb said worse still, dispatchers often get no closure at the end of a call.

“You’re sending folks to help these people that are yelling and screaming at you and in their worst day, then you don’t really know for sure when the other first responders go there, and how this call turned out,” said Webb.

Representative Lane Roberts (Photo: Tim Bommel, Missouri House Communications)

      He said an increasing number of suicides in Missouri also directly impacts dispatchers. 

“It could be someone, honestly, wanting an audience while they commit suicide.  That happens way too much.”

      Some call centers, like that at Springfield, have mental health resources that are made available to dispatchers there and in surrounding communities.  Such resources aren’t available to all dispatchers in Missouri, though, especially in many smaller communities. 

      Several bills would address PTSD and mental health resources for dispatchers and other first responders.  These dispatchers and lawmakers are among those who hope at least one of those bills is passed before the session’s end on May 12.