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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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)
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.
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.
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.
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.
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.
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.
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.
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.
The Missouri House has voted to make it tougher for people to illegally use dealer license plates.
Representative Kevin Engler (photo; Tim Bommel, Missouri House Communications – click for larger version)
House Bill 2122 would limit the issuance of dealer plates based on the number of vehicle sold annually. A dealer selling six vehicles per year could have one plate. Twelve sales per year is enough for a second, 20 per year for a third, and each additional 10 sales per year beyond that would allow a dealer another plate.
The bill’s sponsor, Representative Kevin Engler (R-Farmington), said those plates are being abused, most notably by a dealer’s family members and friends using one daily and avoiding paying taxes on the vehicles those are on.
The bill would also double the bonding requirement for dealers from $25,000 to $50,000. Engler said that requirement hadn’t been increased since 1984, and it needs to be changed to ensure protection for consumers. During debate, Engler learned of a dealership in O’Fallon that folded, and cited that as an example of why dealers should have a greater bonding requirement.
Another provision limits sales events that happen off of a dealer’s premises to two a year, and taking place within a ten-mile radius of the dealer’s licensed location.
Opponents of HB 2122 said it would punish all dealers because of a handful of bad actors in the state.
Representative Delus Johnson (photo; Tim Bommel, Missouri House Communications – click for version)
The legislation also requires dealers to submit regular business hours, a phone number and an e-mail address and maintain the latter two for use by the Department of Revenue and the public; allows discretion for the suspension of dealer licenses for issues in which it is currently mandatory; and allows the use of motor vehicle inspections made within 90 days of an application for registration or transfer by new owners of a vehicle.
The House voted 119-31 to send HB 2122 to the Senate, where it has been referred to that chamber’s Committee on Transportation, Infrastructure, and Public Safety.
A bill that would update Missouri’s sex offender registry has been sent to the state Senate.
Representative Kurt Bahr (photo; Tim Bommel, Missouri House Communications – click for larger version)
House Bill 2042 would classify the registry’s offenders into three tiers based on their offenses: less-serious offenses would land an offender on the first tier, with those on the third tier having committed the most serious offenses. Those on the first tier could petition the courts to be removed from the registry ten years after being placed on it. Those on the second tier could petition after 25 years; those on tier three would remain on the registry for life. Those who commit additional sex crimes or felonies while on the registry also could not petition for removal.
The bill’s sponsor, St. Charles Republican Kurt Bahr, said for some offenders to have the opportunity to come off of the registry will strengthen it, while giving those offenders a better chance at getting quality employment and jobs and put them at less risk of re-offending.
The bill was passed out of the House 144-2. Bahr was surprised at the broad support it received.
The legislation’s supporters include the Missouri Attorney General’s Office, the Missouri Association of Prosecuting Attorneys, and the Missouri Association of Criminal Defense Lawyers.
Bahr is optimistic that HB 2042 will have enough support to get through the Senate if that body chooses to move it before the session ends in May.
Representative Mark Ellebracht (photo; Tim Bommel, Missouri House Communications – click for larger version)
The bill’s broad bipartisan support includes Liberty Democrat Mark Ellebracht, who said lawmakers and the public are seeing now that the registry has been in place for years, what needs to be changed about it.
Ellebracht believes there are potential constitutional issues with the legislation that will have to be addressed in the Senate, but he supports the concepts in the bill, including an amendment that broadens prohibitions on sex offenders participating in Halloween-related events.
The bill also requires anyone on the registry who is convicted of child molestation in the first degree to be electronically monitored if he or she moves to a different county or city not within a county until that move is completed.
The Senate has referred the bill to its committee on Civil and Criminal Jurisprudence.
HB 2042 would also broaden background checks on childcare workers. It includes the same language found in House Bill 2249, which has also been sent to the Senate.
The Missouri House of Representatives has voted to increase protection for children in the state’s childcare facilities by broadening background checks on those facilities’ workers.
Representative David Wood (photo; Tim Bommel, Missouri House Communications – click for larger version)
Versailles Republican David Wood told his House colleagues the state is not conducting background checks including fingerprints of those who come from out of state and apply to be childcare providers.
Wood said his House Bill 2249 would put Missouri in compliance with federal regulations. Missouri is currently operating under a federal waiver, and once that expires on September 30, Missouri will lose about $5-million in federal grant money.
Unless and until it passes, he said parents don’t have much ability to know the background of those workers taking care of their children.
Applicants undergoing background checks would be allowed to work in child care facilities while the check is being conducted, but could not be left with children unsupervised during that time. A worker would have to undergo a new check every five years.
The bill’s requirements would not apply to facilities not getting state or federal money, to those taking care of children within three degrees of relation to themselves, or those who have four or fewer children in their care.
The House voted 131-4 to send HB 2249 to the Senate. The same language is included in another bill, House Bill 2042, which has also been sent to the Senate.
The language of HB 2249 is also found in House Bill 2042, which reforms the sex offender registry.
The House Budget Committee has proposed a state spending plan that would continue to keep state-appropriated funds from going to impaired driving checkpoints.
Representative Kathie Conway (photo; Tim Bommel, Missouri House Communications – click for larger version)
Last year the House proposed that $20-million made available for grants to law enforcement agencies not be allowed for use in checkpoints. That proposal became part of the final budget plan for the fiscal year that began July 1, 2017. Law enforcement agencies can conduct checkpoints but have to find other ways to pay for them.
The idea was controversial but has the backing of House Budget Committee Chairman Scott Fitzpatrick (R-Shell Knob), who cited data from the Department of Transportation showing saturation efforts – periods of increased law enforcement patrols on the roads – result in more arrests per dollar.
Representative Kathie Conway (R-St. Charles) remains adamant in her opposition to the prohibition. She proposed letting $500,000 be used on checkpoints in the Fiscal Year 2019 budget, and argued that checkpoints are effective.
Those who supported barring state-appropriated funds from going to checkpoints last year stood by their decision. Representative Justin Hill (R-Lake St. Louis) said what’s happened in the last year shows it was correct.
Representative Peter Merideth (D-St. Louis) supported the partial opening up of state funds to checkpoints. He said he believes checkpoints are effective, at least when used in conjunction with other things like saturation efforts. He also believes checkpoints are fairer.
Representative Justin Hill (photo; Tim Bommel, Missouri House Communications – click for larger version)
Many backers of the prohibition on state funds being used for checkpoints say checkpoints are unconstitutional because vehicles are stopped without probable cause. Yukon Republican Robert Ross said while he supports law enforcement and knows Conway does too, he said the issue is one of due process.
The committee rejected Conway’s amendment. If that decision stands through the completion of a budget proposal for Fiscal Year 2019, the prohibition on state-appropriated funds being used for checkpoints would continue. Conway said she would continue to try to lift it.
The full House, when lawmakers return from spring break next week, will debate the proposal that was passed out of the chamber’s Budget Committee. The issue could be debated again then.