Missouri House considers legalizing medical use of marijuana

The Missouri House is one vote away from proposing that Missouri legalize the medical use of marijuana by people suffering from certain terminal or debilitating conditions.

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

House Bill 1554 would expand on a law passed in 2014 that allows the use of a cannabis extract, cannabidiol (CBD) oil, to treat intractable epilepsy.  If HB 1554 became law, a patient suffering from conditions including cancer, HIV, Parkinson’s disease, multiple sclerosis, and post-traumatic stress disorder could use medical marijuana if a doctor signs a statement saying he or she could benefit from its use and that all options approved by the Food and Drug Administration have been considered.

The bill is sponsored by Representative Jim Neely (R-Cameron), who is also a doctor.

“There’s a lot of people in my world, from the hospice and the long-term care world, that feel that this would be appropriate for people to ease the pain, suffering, and the side-effects of the opioids and this might be the best way to go,” said Neely.  He said the bill would give people, “another option at the end stages of life.”

House members including Travis Fitzwater (R-Holts Summit) spoke about loved ones that might benefit from the legislation, such as his mother and sister who have multiple sclerosis.

Fitzwater said their neurologist, who he knows and trust, has said they should have the option of using marijuana for pain treatment.

“I trust his opinion.  He went to medical school.  He knows what he’s talking about.  He’s spent his career focused on multiple sclerosis and his patients are mainly multiple sclerosis patients,” said Fitzwater.  When he tells me that … [my] mom or [my] sister should have the option to come to their neurologist and discuss treatment options for pain – and this is a gentleman who is as professional as anybody I’ve ever met – they ought to have that opportunity.”

“Patients that have these debilitating diseases ought to have an option … when the doctors agree and there are professionals involved that know more about what’s going on with those patients than we do,” said Fitzwater.

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

Representative Gina Mitten (D-St. Louis) said a colleague of hers who is a practicing attorney must break her oath to uphold the law by using marijuana to treat her epilepsy, rather than use the prescription drugs that caused her to have a psychotic episode among other side effects.

“How is it that it’s okay to have to spend a night, or two nights, or three nights in a hospital due to medication that’s been prescribed and creates all kinds of other side effects, as opposed to something that we know in other states has worked very well for this disease?” asked Mitten.

Pacific Republican Paul Curtman sponsored adding PTSD to the legislation.  He described what he knows some of his fellow comrades in the Marine corps faced, and said leaving this issue facing veterans out of the bill would be a “travesty.”

He spoke about a fellow Marine from Missouri whose experience overseas included having to routinely wash the blood of friends out of the back of a Humvee.  Curtman said the man was prescribed by the Veterans’ Administration drugs that had numerous side effects.  For a time he used marijuana and that worked for him, but he was arrested and forced to return to the drugs prescribed by the VA.

“The VA came by and said if you ever [use marijuana] again you’re jeopardizing your ability to use any of your VA benefits.  So, after being on house arrest for a while with the VA checking up on him to make sure that he was taking the synthetic drugs that the VA wanted him to take, his father came home just a few weeks later only to find that his son had put a gun to his head and pulled the trigger,” said Curtman.

Under the bill the Missouri Department of Health and Senior Services would issue medical cannabis registration cards to approved patients, or to parents in the cases of minor parents.  The bill would only allow the use of smokeless forms of marijuana.  HB 1554 also lays out how marijuana could be legally cultivated by licensed growers under the supervision of the Department of Agriculture.

Another favorable vote would send the legislation to the Senate.  Two years ago the House rejected a bill that would have asked voters whether to legalize the limited, medical use of marijuana.

House approves bill backers say would reduce prescription drug costs

The Missouri House has approved a bill that backers say will save Missourians money on prescription drugs.

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

The sponsor of House Bill 1542, Representative Lynn Morris (R-Nixa), has been working at his pharmacy since 1977.  He said what many don’t know is that pharmacy benefits managers have pharmacists sign agreements that prevent them from telling customers when a drug’s out-of-pocket cost is less than the copay on their insurance plans, unless the customer asks about it.  Morris said that almost never happens because customers assume the cost through their insurance plans or networks will be the cheapest to them.

HB 1542 would eliminate those agreements, which Morris called, “gag orders.”

“Pharmacists want to tell the patient how to save money.  It’s extremely important to pharmacists to help those people,” said Morris.  “We owe it to our customers, we owe it to our patients, to always give them the best price, and these PBMs have forced us not to do that.”

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

The bill was broadly supported, having been sent to the Senate on a 138-7 vote.  Representative Tracy McCreery (D-St. Louis) said there should be nothing keeping pharmacists from being up front with customers.

“This bill is actually one of them that goes straight to the heart of addressing concerns that a lot of our constituents have, which is the rising costs of prescription drugs, and what they need to do in order to use their money most efficiently,” said McCreery.  “Pharmacists are a trusted profession – poll after poll shows that – and I think it’s shameful that pharmacists have been put in a position where there’s a gag order and they’re unable to capitalize on that trusted position.”

Morris said pharmacists agree to these “gag orders” as part of the contracts they sign with those managers.  Without signing such a contract a pharmacist cannot participate in the insurance programs handled by that manager.  He said that’s an issue for any pharmacist, but it’s especially critical for rural pharmacists, for whom the loss of any part of a customer base could mean closing the business.

Other provisions in HB 1542 would bar benefits managers from charging what Morris called “clawback” fees, or any fees related to a claim that has not been disclosed up front.  It would also prohibit benefits managers from keeping pharmacists from making statements to government officials or committees.

HB 1542 has been sent to the Senate.  Morris said similar legislation has been passed in other states or is pending.

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 Speaker: Committee investigating governor will ‘have the time it needs to finish its work’

Missouri’s House Speaker said he doesn’t want to constrain the committee he created to investigate allegations against the state’s governor.

House Speaker Todd Richardson (image center) takes questions from reporters following the House’s adjournment on Thursday, 04/19/2018. (photo; Tim Bommel, Missouri House Communications – click for larger version)

“This committee’s going to have the time it needs to finish its work,” Speaker Todd Richardson (R-Poplar Bluff) said to reporters on Thursday after the House adjourned for the week.

A St. Louis grand jury in February indicted Governor Eric Greitens (R) for felony invasion of privacy.  He is accused of taking, without consent, an intimate photo of a woman with whom he had an affair in 2015.  A circuit judge in St. Louis today declined Greitens’ request to dismiss that case.

Earlier this week Missouri Attorney General Josh Hawley (R) said he has enough evidence for a felony charge against Greitens for violating campaign laws.  Hawley said Greitens took a list of those who donated to his charity for military veterans, The Mission Continues, and transferred it to his political campaign to use in fundraising efforts.

The developments concerning Greitens this week have some calling for the House to take action concerning him now, but Richardson said the chamber will stick to the plan he announced last week.  Preparations are continuing for the House to call itself into special session in case more time is needed for its members to review the recommendations of the Special Investigative Committee on Oversight, when those recommendations are ready.

“The committee didn’t believe, at that point in time, that they would be able to finish their work before the end of session.  I think they still believe that they need additional time to do that work, which is why we have begun the process of calling ourselves into a special session,” said Richardson.  “My point last week and my point this week is, there’s not going to be an artificial timeline or a deadline here.  We’re going to let the committee work, we’re going to let them work as thoroughly as they need to, and when they come back with recommendations we’ll be ready to take them up.”

As for the decision today by Judge Rex Burlison to allow the invasion of privacy case against Greitens to continue, Richardson said it has no bearing on what the House does and it never would have.

“The Missouri legislature is a separate and co-equal branch of government and no matter how that decision had gone today, the House and the Senate would continue to go through our process,” said Richardson.  “Our role and responsibilities here are different than the role of the court in the City of St. Louis so it doesn’t impact it at all.”

Minority Leader Gail McCann Beatty and Representative Gina Mitten, who is the ranking Democrat on the House Special Investigative Committee on Oversight, answer questions from reporters after the House adjourned on Thursday, 04-19-2018. (photo; Tim Bommel, Missouri House Communications – click for larger version)

Richardson and other members of House Republican leadership said this week they believe Greitens should resign.  The President Pro Tem of the Missouri Senate, Ron Richard (R), said this week he also believes Greitens should resign, and if he does not, Richard believes he should be impeached and that effort should begin now.

Richardson said he believes he and the Senate president remain committed to the same process.

“He and I have been in constant contact, and we both want the House committee and the legislature to execute a thorough and fair process, and a process that makes sure that the members of the general assembly – who are going to be tasked with deciding some of those recommendations – that they have the most information that they need in front of them to make a good decision,” Richardson said.

The leader of the House Democrats, Gail McCann Beatty (D-Kansas City), said she thinks Speaker Richardson is handling the situation with caution, but she is anxious to see the chamber take further action regarding Greitens.

“From my perspective I think I have seen enough [to vote on impeachment now].  This is a cloud over our state.  It’s embarrassing, and we need to be moving forward to resolve this sooner than later,” said McCann Beatty.

The investigative committee has continued to meet, and has hearings scheduled for Monday and Tuesday.

House passes proposal to increase access to long-acting birth control, save Missouri money

The state House has again voted for a measure aimed at increasing women’s access to birth control while saving the state money.

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

House Bill 1499 would let health care providers use a long-acting reversible contraceptive (LARC) for a patient other than the one to whom it was initially prescribed.

When a woman in Missouri chooses to have a LARC implanted her doctor must order that device and the woman must return for another office visit to have it implanted.  If the woman changes her mind before the second visit and doesn’t want the device, Missouri law doesn’t allow it to be used for another patient.  It must be returned to its manufacturer and often it is destroyed.

The sponsor of HB 1499, Representative Shamed Dogan (R-Ballwin), said because Medicaid pays for those devices, the passage of his bill would save the state money.

“The State of Missouri currently wastes hundreds of thousands of dollars every year as well as very expensive devices every year, and this bill will allow those devices to be reassigned which will save taxpayer money and will help to save women time and money with extra doctor’s visits,” said Dogan.

Dogan said in Fiscal Year 2017 about 1,800 LARCs were “abandoned” by patients in Missouri.  About 1,000 of those could have been used for other patients and that would’ve saved Missouri about $220-thousand.

The proposal has been sent to the Senate 133-10.  Last year it was passed as an amendment to other legislation, but was not passed in the Senate.

Earlier story:  

Backers say bill to allow reassignment of birth control devices would save money, increase access

House approves bill taking multiple approaches to opioid addiction fight

The Missouri House has voted to take more steps toward fighting opioid addiction, with more such efforts likely to come from the chamber before the session ends in May.

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

House Bill 2105 has been sent to the state Senate for consideration.  The bill has a number of provisions.  Sponsor Keith Frederick (R-Rolla) said the overarching idea behind the bill is to see a shift in the response to opioid addiction from law enforcement and incarceration to treatment availability.

“That’s the thing that’s lacking so much now, is we don’t have enough health care providers to provide access to what’s called, ‘medication assisted therapy,’” said Frederick.  “It is basically using medications like buprenorphine and Suboxone that get rid of the craving for narcotics and it allows people to get back to a useful, functional, rewarding life, but they need the medication on an ongoing basis and for that we need healthcare providers to help provide access to that sort of treatment, and we don’t have enough of those now.”

Frederick said the main provision of HB 2105 would create the “Improved Access to Treatment for Opioid Addictions” Program (IATOA).  It would use assistant physicians – a position created by legislation passed in 2014 – to work in a collaborative way with licensed doctors to provide addiction treatment throughout the state.

Those assistant physicians will be supported by the ECHO program (Extension for Community Healthcare Options) – a program that uses videoconferencing to connect experts with providers statewide to help providers offer specialized care.  Frederick said a module has been created for ECHO that focuses on opioid addiction treatment.

“These assistant physicians will have to become waivered – so they have to take a course on addiction treatment, and then they submit that to the DEA – the DEA can then give them a waiver to prescribe this medication, then they have to work in a collaboration with an experienced addiction treatment specialist, and then they’re also supported by the ongoing education of the ECHO opioid addiction module,” said Frederick.  “It’s a wonderful, collaborative way to bring access to this really life-changing, life-saving treatment to people struggling with addiction instead of their ending up in prison.”

Frederick said this program would be among the first of its kind in the nation, and other states are already taking note of it and considering how to create their own.

Another of HB 2105’s main provisions would limit to a seven-day supply the amount of an opioid drug that could be prescribed to someone for acute pain.  Frederick said this is meant to keep people from becoming addicted while not limiting such drugs to those who rely on them for long-term pain management.

“The difference between somebody who’s addicted and somebody who’s dependent is a pretty big difference,” said Frederick.  “The idea is to prevent people like the high school athlete who has a knee injury and the doc gives him 150 Percocet or whatever – it’s to nip that in the bud; prevent new people from getting addicted, but while acknowledging that there are people in our state that have chronic pain and they’re getting along pretty well, thank you very much.  So, I don’t believe we should be going after that patient that is needing ongoing medication on a regular basis but their life is stable and they’re doing well.”

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

The bill would also create the Prescription Abuse Registry – a registry a person could voluntarily add himself or herself to – for individuals who have struggled with addiction.  The registry would do no more than notify doctors who choose to check it that those on the list have had a substance abuse problem.  That language was added by Representative Jay Barnes (R-Jefferson City).

“I think a lot of times people with substance abuse problems, at some point in their life they try to get clean,” Barnes said.  “At that point in time … they’re in a position when they may want to put themselves on a list like this, but if they have a relapse … being on a list like this would give providers a tool that if they suspect the person of doctor shopping, to check the list and say, ‘What’s going on here?  I know that you’re on this list.  I know that you’ve had a problem with opioids in the past … what are we doing?’”

A person could petition to be removed from the list five years after adding her or his name to it.

Other provisions in HB 2105 would create a drug take-back program for disposal of unused prescriptions; and bar the Department of Corrections from preventing offenders from receiving medication-assisted treatment for substance abuse or dependence.

The bill would also discontinue patient satisfaction scores of doctors, to the extent allowed by federal law.  Frederick said this is to keep doctors from being giving low scores by patients with addiction issues to whom they refused to prescribe opioids.  Such false, punitive low scoring can hurt doctors’ reputations, and hurt them financially.

The House voted 128-4 to send HB 2105 to the Senate.  Representative Frederick is also handling HCB 15 which will also contain multiple provisions aimed at fighting opioid abuse.  That legislation could be coming out of the committee process and ready for debate in the full House in the next few weeks.

House votes to expand definition of ‘service dog,’ criminalize faking a service animal

The Missouri House has voted to expand the state’s legal definition of what qualifies as a “service dog,” and to make illegal the faking of having a service animal.

A service dog, with training that includes waiting patiently for long periods, lays next to its master during a meeting in a hearing room in the Missouri State Capitol. (photo; Tim Bommel, Missouri House Communications – click for larger version)

House Bills 1369 and 2031 are aimed at making life better for those who legitimately have service dogs and service animals, according to sponsor Chrissy Sommer (R-St. Charles).  She said such people make up a growing segment of society, as the list of conditions dogs can help with continues to grow.

“There are a lot of soldiers, there are a lot of seniors who either have, say, PTSD or some ailment or disability that’s not visible that when they go into the public, even though ADA says these are service dogs, entities or businesses or even individuals don’t understand that because you don’t see a disability; it’s not visible,” said Sommer.

HB 1369 changes the definition of “service dog” to include psychiatric service dogs and mental health service dogs.  The definition covers dogs that serve individuals with conditions including panic attacks, anxiety, autism spectrum disorder, epilepsy, Alzheimer’s disease, dementia, and post-traumatic stress disorder (PTSD).

Sommer said the Americans with Disabilities Act (ADA) has left the definition of what is considered a “service dog” in kind of a gray area, so HB 1369 will make clear what animals qualify as service dogs.

HB 2031 would add to Missouri’s law against impersonating a person with a disability the crime of misrepresenting a dog or animal as a service dog or assistance animal.  It would make those misdemeanors punishable by up to fifteen days in jail, or up to 6 months for repeated violations.

Backers of HB 2031 said when people fake having a service animal it casts doubt on individuals who really do have them.  Sommer said such fraud causes other issues as well, when untrained dogs have been, “attacking service dogs in training, them attacking patrons of a restaurant; airplanes are starting to crack down too because what happens is a service dog goes through training – how to handle and airplane, how to handle that pressure, how to handle the different noises, how to handle that small little area they have to be in, whereas a pet, if you try to bring them on a plane and say, ‘Oh, this is a service dog,’ I mean think of what it does to a person.  They’ll freak out,” said Sommer.

St. Louis Democrat Tracy McCreery said she initially thought HB 2031 was not necessary, but has reversed that opinion.

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

“I think a lot of us see now, when we go out to eat or out into social settings, there seem to be a lot more dogs in places where normally animals are not permitted, like restaurants and things like that, so we need to kind of get a handle on things, if you will.  Several states – I think there have been about 19 states that have cracked down on these fake services dogs,” said McCreery.  “What the lady’s bill will do, I think, is help make things more comfortable for those families and people that actually have legitimate service dogs.”

HB 2031 would require the Commission on Human Rights to use its existing complaint hotline to take reports of individuals believed to be faking having a disability or a service animal.

It would also require the Governor’s Council on Disability to design a placard that restaurants and other businesses could display stating that service dogs are welcome and that misrepresentation of a service dog is illegal.  A brochure would also be created to help business owners know what questions are allowed and guidelines on how to behave around service animals.

Each bill received only one “no” in the House’s vote to send them to the Senate for consideration.

Additional audio:

“Because people are taking untrained pets into public areas and telling people, ‘This is a service dog,’ what happens is the dog that’s not trained, in some situations, they’ll panic, they’ll attack the people around them, they’ll go to the bathroom, they’ll bark, they’ll be disruptive,” said Sommer.

 

 

House passes ‘pain capable’ abortion ban

The state House has proposed barring abortions in Missouri of any fetus a doctor determines is capable of feeling pain.

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

House Bill 1266 would prevent such abortions unless they are found to be necessary to avert the mother’s death or if there is a serious risk to the mother of substantial and irreversible physical impairment of a major bodily function.  In such cases a doctor would be required to end the pregnancy in a way that gives the fetus the greatest chance of survival without posing such risks to the mother.

The bill requires reporting of such abortions to the Department of Health and Senior Services, and would make a doctor who performs an abortion in violation of the bill’s provisions subject to discipline.

Sponsor Donna Lichtenegger (R-Cape Girardeau) calls it the “Pain Capable Unborn Child Protection Act.”  She and other backers of the bill argue there is scientific evidence that a fetus can feel pain at 22 weeks.

“The most significant reason that [an abortion after that stage is painful for a fetus] is because at 5-months this child literally needs to be torn apart, limb for limb, in order to be aborted.  It is much safer for the mother and for the fetus to be able to have a C-section and it’s much faster than the abortion,” said Lichtenegger, “so there are other ways that this baby can be delivered without tearing it from limb to limb.”

Representative Cora Faith Walker (D-Ferguson) questioned proponents’ arguments about when a fetus can feel pain, and argued that there is an “abundance” of scientific data to the contrary.

Representative Cora Faith Walker (photo; Tim Bommel, Missouri House Communications – click for larger version)

“The actual pathways – the neurological pathways – that are necessary to feel pain in fetuses is typically not developed until well after the 20-week development state,” said Faith Walker.

St. Louis Democrat Sue Meredith said when the bill was heard by a committee, lawmakers heard from parents who had abortions because their children were not forming properly in the womb and faced short and/or painful lives if brought to term.

“These people weren’t getting these abortions because they were getting rid of an unwanted pregnancy … we are telling people who have these abnormally developing fetuses that you have to carry this fetus full-term.  You have to put that baby through that agony of whatever it is – not being able to breath, not being able to think properly – not being able to do the things that one needs to do to live,” said Meredith.

Harrisonville Republican Rick Brattin said he “begrudgingly” supports HB 1266.  He is frustrated that the legislature is debating at what times during a pregnancy it can be terminated rather than seeking to make abortion illegal altogether.

“It’s just mind boggling to me that we are having to even go with something like this and that there’s even debate on a bill like this,” said Brattin.  “I just look for the time and I pray for the time that people are actually awakened by the egregious act of this horrible procedure and this life-ending act and actually ban abortion, not just pain capable.”

The House voted 117-31 to send HB 1266 to the Senate for consideration.

House budget plan would restore FY ’18 funding levels to colleges, universities

The Missouri House has perfected a budget proposal for the next fiscal year including an agreement to hold down college tuition, while restoring $68-million that Governor Eric Greitens (R) proposed cutting from colleges and universities.

House Budget Committee Chairman Scott Fitzpatrick (photo; Tim Bommel, Missouri House Communications – click for larger version)

The House is proposing putting that money back into the core funding for those institutions, putting them back at the level of state support they are receiving in the current fiscal year.  In exchange, the state’s institutions will increase tuition by no more than one-percent in the fiscal year that begins July 1.

House Budget Committee Chairman Scott Fitzpatrick (R-Shell Knob) proposed an amendment that completed the restoration of that $68-million dollars.

“I think that this is the appropriate thing to do,” said Fitzpatrick.  “I think a one-percent tuition increase is manageable for the folks in this state.”

Under the agreement between Fitzpatrick and the institutions, the schools must receive the money the House has proposed appropriating.  If the appropriations are withheld by the governor or otherwise do not reach them, they can increase tuition based on the Consumer Price Index.

The agreement is supported by Democrats, including the top Democrat on the budget committee, Kip Kendrick (D-Columbia), whose district includes the University of Missouri’s flagship campus.

“I appreciate this and the whole conversation we’ve had in budget committee and working with the chair on reaching an agreement.  I think everyone in here has the intent of … wants to hold tuition increases to a minimum to make sure college remains affordable and accessible for all,” said Kendrick.  “Higher education institutions have taken it on the head in the last few years with some major budget cuts, so glad that we can do all that we can this year.”

Representative Kip Kendrick, the top Democrat on the Missouri House Budget Committee (photo; Tim Bommel, Missouri House Communications – click for larger version)

Until the agreement was reached, Fitzpatrick had proposed putting $30-million of the money that is now going to core funding into the Access Missouri scholarship program, which would have fully funded it.  Kendrick is glad to see that money going back to the core, but he hopes Access Missouri receives additional funding in future years.

“I love Access Missouri.  It is a fantastic, needs-based scholarship program in the State of Missouri.  It is our only needs-based aid program in the state and for a brief moment of time it had 30-million new dollars in it, and I hope that we can do what we can in the future also to make sure that we appropriately fund that line as well,” said Kendrick.

Budget committee member Crystal Quade (D-Springfield) agreed.

“While I wish that we could be funding Access Missouri and I hope that we try to do so in the future, representing Missouri State, one of the institutions who is a big part of this agreement, I was thankful for the budget chair to have the discussion and have everybody at the table and come up with this solution,” said Quade.

The tuition agreement does not extend to Missouri Southern in Joplin.  Fitzpatrick said their financial situation is dire enough that he agreed to let them opt out of the one-percent tuition cap requirement.

The funding for higher education is found in House Bill 2003, which itself appropriates more than $1.17-billion.  The House is expected to vote on that and the rest of the budget bills on Thursday.

If passed, they will go to the Senate, which will spend the coming weeks developing its own budget proposal based on the House’s plan.  The two chambers will then attempt to compromise on a final spending plan to send to the governor in May.

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.