Committee votes to let pharmacists dispense opioid relapse fighting medication

      A drug that would help former and recovering addicts fight off relapses would be more available under a bill being considered in the House.

Representative Jonathan Patterson (Photo: Tim Bommel, Missouri House Communications)

      House Bill 2603 would allow pharmacists to sell and distribute naltrexone hydrochloride, a drug that helps stem the desire to use opioids or related substances.

      Bill sponsor Jonathon Patterson (R-Lee’s Summit) told the House Committee on Health and Mental Health Policy, “I think it would help and maybe even stop a few of the deaths that we see here in this state every year.”

      “If you had a person that was getting off opioids and they had this craving for the drug they could go to a pharmacy, the pharmacist could give them that drug and they could take it so that they don’t go and find heroin or any other, fentanyl; drugs that they use that they could overdose on.”

      Patterson explained that his legislation would expand upon a bill passed out of the legislature and signed into law in 2016 which allows pharmacists to sell Narcan, a drug that counteracts overdoses.

      Percy Menzies is the President of the Assisted Recovery Centers of America.  He told the committee that naltrexone is extremely effective and unlike Narcan, which is administered at the time of an overdose, it is preventative.  A person can take it to stave off a relapse.

“They can use it as a way to protect the neurons, the brain, from accidentally or impulsively using opioids.  Narcan’s half-life is only 30 to 45 minutes.  Naltrexone lasts for 24 hours, so you have a drug-free zone within your brain for a 24 hour period.”

      The committee heard that pharmacists would be able to give a person enough naltrexone to last several days.  Licensed clinical social worker Aaron Laxton explained this could then help bridge the time between when a person realizes they are about to relapse and when they can get into a treatment program.

“This is a stop-gap to allow us to get to the next week, until we can get to that open bed, until we can get to that clinical setting and we can start to make some strides.”

      Henrio Thelmaque with Assisted Recovery Centers of America and the Missouri Pharmacy Association also testified in support of the bill, saying, “The idea is to say, ‘Hey, if you are at risk of relapsing here is a preventative measure.”

      Thelmaque said relapses can often be triggered by stressful events such as the loss of a job or a breakup.  He said there have been greater instances of relapses in the last two years, likely due to the COVID pandemic.  He said last year there were 1,842 deaths in Missouri related to opioid overdoses.

      He said this bill could help significantly to reduce that number.

      “There shouldn’t even be one death regarding opioid overdoses, especially with the tools that we have now,” said Thelmaque.

      The committee voted 12-0 to advance Patterson’s bill.  Another favorable committee vote would send it to the full House.

House approves ‘No Patient Left Alone Act’

      The House has approved the easing of restrictions on visitors in hospitals and nursing homes such as those experienced during the COVID-19 pandemic. 

Representative Rusty Black (Photo: Tim Bommel, Missouri House Communications)

Representatives who backed the proposal cited instances of Missourians going for days or more and even dying without loved ones being allowed to see them.  Opponents said it should be up to facilities how best to place restrictions for the good of patients and residents.

      Called the “No Patient Left Alone Act,” House Bill 2116 was the combination of four pieces of legislation.  The sponsor of HB 2116 is Chillicothe Republican Rusty Black.

      “The overall bill would – I’m going to use the word ‘force’ – healthcare providers to allow a patient to list up to four people that could come visit them while they’re in the hospital,” Black explained. 

      The plan drew an impassioned speech from Majority Floor Leader Dean Plocher (R-St. Louis) who spoke about his late father-in-law’s stay in a hospital that lasted more than 20 days, during most of which he was not allowed visitors.  Plocher said for much of this his family was not updated on his condition; his call light was not answered, and they were denied an explanation on the administering of unusual medications.  He complained of improper care and was at one point found to have a fork embedded in his skin and to be suffering from mouth sores.

      He said what happened to his father-in-law in the days before his death was not unique.

House Majority Floor Leader Dean Plocher (Photo: Tim Bommel, Missouri House Communications)

      “Health care facilities were allowed to arbitrarily set rules for visitation all while staff could come and go on a daily basis, and I guess they could, in fact, bring in viruses too.  Health care facilities essentially became prisons for our loved ones.  People were admitted.  One day you could have visitors, the next day you couldn’t.  People were confined without access to an advocate from those that knew them.  It was arbitrary and there was no recourse if you were locked away by a health care facility without access to visitors,” said Plocher.  “This bill protects all Missourians and all of our loved ones.  This bill is necessary and should be a right for of those receiving care, to have a visitor and an advocate by their side.”

      Several Republicans called the legislation perhaps the most important bill they could handle this year.

      “I truly believe that this bill will prevent a loss of life in many situations,” said Neosho representative Ben Baker (R), who chaired the committee that handled HB 2116.  “When you are in that situation where you have no one to turn to, no one that you know, no one that you have that personal relationship with, it’s extremely important for the mental well-being, the physical well-being of those patients in those situations to have that.  I can’t imagine what it would be like if I was in that situation where I had no one to advocate for me.”

      Some Democrats spoke against the measure saying health care facilities should be able to determine what practices are the safest for their staff and those in their care, particularly during a pandemic.

      “We all have rights and we all have freedoms and while your loved one is potentially needing support in one room, somebody else’s loved one is down the hall and they don’t need to be exposed to whatever it is that folks are bringing into that care facility,” said Representative Ashley Aune (D-Kansas City).

Representatives Ashley Aune (left) and Bridge Walsh Moore (Photos: Tim Bommel, Missouri House Communications)

      “I can respect this is a horrible situation.  It was a horrible situation we were put in.  No one wants to keep family members from their loved ones in the hospital when they are sick.  No one wants to do that, but a lot of times it’s what has to be done,” said Representative Bridget Walsh Moore.

      “We all have high emotions about not being able to be with our loved ones at the end of their life , but I’m wondering if the policy, the legislation … takes the work and takes the authority, really, away from the people who are closest to the situation, working with their patients, to make a determination as to how safe, or not, it is for others to come in when people are sick,” said Representative Yolanda Young (D-Kansas City)

      Republicans maintained that they worked with health care industry representatives in creating a bill that would answer their concerns while not jeopardizing safety in health care facilities. 

      “It’s done in a very prudent way.  It does not open up visitation in a free-for-all manner.  It’s thoughtful to where there’s only a handful of people that can get in off of a list and only a couple at a time, the facility can screen those folks, and so we can have the best of both worlds.  We can have the safety that’s required but we can also have those visitation rights that is so important to the folks who need us to come in to hold their hand, to be with them, to help them with their mental health and physical health by being there for them in person,” said Representative J. Eggleston (R-Maysville).

      The bill specifies that a patient’s list of visitors would include a spouse, or parents or guardians in the case of a child.  Facilities could still deny access to patients under specified circumstances including at the request of the patient or law enforcement; when a person has signs and symptoms of a transmissible infection; or when the attending physician believes the presence of visitors would be detrimental to the patient.  The bill’s provisions do not grant visitors access to restricted areas like operating rooms or behavioral health units. 

      The House voted 120-27 to send the bill to the Senate.

House gives initial approval to nurseries in Missouri prisons

      Fueled by emotional testimony from several lawmakers, a proposal to let women in prison have their babies with them has received initial approval in the Missouri House.

Representative Bruce DeGroot pauses to collect himself during emotional comments while presenting his HB 1897. (Photo: Tim Bommel, Missouri House Communications)

      House Bill 1897 would let incarcerated women in Missouri live with their infants for up to 18 months if they meet certain criteria. 

House members have heard that in other states such programs have been beneficial to mothers, children, and those states.  Recidivism among participants has been minimal and children have benefitted from bonding with their mothers and being less likely to enter foster care.  States, meanwhile, have saved money due to reduced recidivism and need for foster care, among other factors.

      The bill is sponsored by Representative Bruce DeGroot (R-Ellisville)

      “When we [legislators] first got up here, I think to a person we all wanted to come up here for the same reason.  We all wanted to make Missouri a better place for our kids.  This bill makes Missouri a better place for our kids,” said DeGroot.  

      He became tearful as he said the bill makes him think of his own mother and her reaction to this and other bills he’s worked on. 

      “She’s not proud I’m a state rep.  You know what she’s proud of?  She gets proud of debtor prison bills.  She gets proud of bills that make it so women don’t have to pay for feminine hygiene products in prison.  She gets proud when babies can be with their mom in prison.”

      Several representatives thanked DeGroot and Representative Curtis Trent (R-Springfield), who filed the same bill, for bringing the proposal forward. 

      “Gentlemen, don’t sell yourself short.  This bill is remarkable and it’s going to change not just the lives for people who have unfortunately experienced going to jail but the lives of those children who are going to get to experience their mother,” said Representative Raychel Proudie (D-Ferguson).

      Trent marveled at the widespread support this proposal has garnered from within and outside the legislature.

      “When all these kinds of people can come together, when all these different perspectives can be taken into account, when that process can yield something like this bill, which has the tremendous bipartisan support … which has the tremendous support of the communities that are most effected all around this state, has the support of families, to me that is when this body and when this general assembly is at its proudest, is at its finest,” said Trent.  “These children that are being born that will benefit from this program are children who will be our friends and neighbors and family for the rest of their lives and we can’t measure the impact that this will have on them.”

      “What an amazing bill this is,” said Representative Rasheen Aldridge (D-St. Louis)“This is more than just a feel good bill.  This is one of these pieces of legislation that I know when I walk away I’m going to be happy to say, you know, Missouri did something really great.  We did something historic.  We did something that when other states look at criminal justice reform, when they look at legislation that is being passed, they’re going to look at Missouri and say we did something right.”

      Aldridge encouraged other members to add their names to the list of the bill’s co-sponsors to send a strong message of support to the Senate if and when the measure is sent there.  By Friday afternoon the list of co-sponsors had grown to 27 House members.

      If HB 1897 becomes law it would be up to the Department of Corrections to administer the nursery program and determine which women could participate.  Potential participants would be screened for mental health issues and could have no record of violent offenses or child abuse. 

      Another favorable vote would send the proposal to the Senate.

Local rehab centers would benefit from proposed new tax credit

      A proposed new tax credit would give a boost to community-based drug treatment programs throughout the state.  The plan’s sponsor says these programs do a lot of good and give back to their communities but some are facing financial challenges and she wants to see them get more support.

Representative Cheri Toalson Reisch (Photo: Tim Bommel, Missouri House Communications)

      Under House Bill 2527 a taxpayer who makes a donation to a faith-based organization, peer- or community-based organization, or recovery or community center or outreach that offers addiction recovery services could claim a tax credit for an amount equal to half of that donation.  Up to $2.5-million in tax credits could be awarded in one year, subject to the legislature appropriating the money for them.

      Sponsor Cheri Toalson Reisch (R-Hallsville) says she has such rehab organizations in her district and she’s seen how they benefit individuals and the overall community. 

      “I see what [program participants] do on a daily basis.  They get jobs.  They help their communities out.  We don’t want people to recidivate.  We want them to be able to pay their child support, to pay their bills, and support themselves, so it’s a win-win.”

      “I have Primrose Hill, which is part of Team Challenge, in my district.  It helps women with babies and children to get over addictions.  I also have In2Action that helps people with addiction and recovery and felons coming out of prison,” said Toalson Reisch.  “If you’d have heard the testimony [from program participants] from a year ago, I was bawling my eyes out.  This is that important to people.”

      Toalson Reisch said some of these programs are struggling, and others are looking to expand.  She said in either case, this legislation could give them the help they need and thereby help more Missourians.

      “Especially, I think, during COVID and a lot of stressful times in their lives [some Missourians] need this help and to know that a resource is there for them locally that they can utilize and be put into a program and help them overcome their addictions.”

Mission Gate Prison Ministry works with more than 300 men, women, and families each hear.  Program Director Stephen Hunt told the House Committee on Ways and Means this bill would encourage more contributions to his organization.

      “We support this bill because two-thirds of our annual budget is funded by private donations,” said Hunt.

Stan Archie, the Clinical Director of Footprints, Inc. in Kansas City said this bill would also give every Missourian the chance to be a part of someone’s recovery.

“It invites people who can’t get out on the street to be a prat of the solution, and at the same time it also encourages dollars to come into the places where we can demonstrate an effective program,” said Archie.

      David Stoecker, Executive Director of the Springfield Recovery Community Center, told lawmakers these recovery programs save the state money. 

      “It’s over a $20 return for every dollar spent on recovery support, so that $2.5-million equates to the state saving $50-million a year, which to me is a complete no-brainer,” said Stoecker.   

      Toalson Reisch filed this proposal last year but late in the session, so it only cleared one committee.  With it getting traction earlier this year she is optimistic it can become law.  The Ways and Means committee approved HB 2527, sending it on to another committee.

      She proposes that these tax credits be offered for six years, at which time they would expire unless renewed by the legislature.

Missouri House condemns attack on Ukraine in unanimous vote

      The Missouri House voted unanimously today to condemn the Russian attack on Ukraine and to urge the federal government to respond prudently. 

Representative Mike Haffner (Photo: Tim Bommel, Missouri House Communications)

      It approved House Resolution 3658 which says the members of the House, “Stand alongside Ukraine, its people, and its leaders during this horrific and unnecessary war and vow to support Ukraine and hold Russia fully accountable for its catastrophic decision to invade.”

      It was carried by Representative Mike Haffner (R-Pleasant Hill), a decorated combat veteran who retired from the U.S. Navy as a Commander. 

This invasion is not about land.  It’s not about oil.  It’s not about natural resources.  It’s about freedom.  Ukraine has embraced the definition of American freedom as it is defined very clearly in the Declaration of Independence because that freedom results in unprecedented opportunity for all people,” Haffner said.

      Representative Michael O’Donnell (R-St. Louis) is a Lieutenant Commander in the U.S. Navy Reserve.  He said he’s been watching the coverage of Russian forces entering Ukraine equipped not to destroy military targets or equipment, but to kill people.  He’s marveled at the response of the Ukrainian people.

      “We have to look at the bravery of these people.  Would we have behaved any differently?  Would any of us have acted any differently?  Most of us aren’t capable of serving in the military anymore but we would’ve done something.  We would’ve done anything to protect our friends and our families,” said O’Donnell.

      Lee’s Summit representative Keri Ingle (D) said the people of Ukraine are much like the people of Missouri in what they want for themselves and their loved ones.

      “We must support democracy across the world or it will be lost here as well,” said Ingle.

(Photo: Tim Bommel, Missouri House Communications)

      Some representatives said the House’s action today isn’t just about what’s happened in the last week, but what will come if Russia doesn’t stop or isn’t stopped.  Representative David Tyson Smith (D-Columbia) said, “We need to take a stand against oppression and tyranny and we all know that if Russia takes Ukraine it’s not going to stop with Ukraine.” 

      St. Charles Republican and member of the National Guard Adam Schnelting added, “It’s very important that we stand in solidarity with the people of Ukraine not just for Ukraine but also so that Europe does not digress into centuries of darkness.”

      The House voted 143-0 to support the resolution which states, as Rep. Haffner read, “we proudly stand alongside Ukraine, its people, and its leaders during this horrific and unnecessary war and vow to support Ukraine and hold Russia fully accountable for its catastrophic decision to invade this sovereign nation.

      “We condemn Vladimir Putin’s violent attack on the people of Ukraine and we have introduced this legislation to implore the President of the United States and the United States Congress to reaffirm our country’s unwavering support for Ukraine’s freedom and sovereignty.” 

VIDEO: House members urge Missouri response to Russia’s attack on Ukraine

      Missouri House members want to respond to Russia’s Attack on the Ukraine. 

      On Tuesday House Majority Floor Leader Dean Plocher (R-St. Louis) filed House Bill 2913 which would bar all public entities or private entities which receive public funds from contracting with Russia.  The prohibition would extend to any country which occupies or attacks Ukraine, Finland, Sweden, Georgia, or a North Atlantic Treaty Organization (NATO) member.

      Tuesday night a House committee advanced House Concurrent Resolution 75 filed by Representative Mike Haffner (R-Pleasant Hill). It would urge President Joe Biden (D) to take certain actions in response to the Russian invasion. This resolution could soon be debated by the full House.

      On Wednesday Representatives Plocher and Haffner participated in a media conference with Lieutenant Governor Mike Kehoe (R) and legislative assistant Igor Shalai, a native of Ukraine, who spoke about what his family is experiencing.

House considers further reduction in vehicle safety inspection requirements

      A state representative who several years ago championed an easing of Missouri’s vehicle safety inspection law says it’s time to make more vehicles exempt.

Representative J. Eggleston (Photo: Tim Bommel, Missouri House Communications)

      Senate Bill 89, passed in 2019, rolled back that law.  Since it was enacted, safety inspections have not been required on vehicles that have fewer than 150,000 miles and are up to ten years old.  That portion of SB 89 was proposed by Representative J. Eggleston (R-Maysville)

      He says in the time since that law passed Missouri’s roads have been no less safe.

      “[SB 89] got rid of about half of the cars that needed to be inspected from being inspected … here we are, two or three years later, I’ve looked, I have not found any sudden burst of cars falling apart and causing accidents so I think we’re ready to get rid of [vehicle inspections],” Eggleston told the House Committee on Downsizing State Government.

      Eggleston’s proposal, however, wouldn’t completely eliminate inspections in Missouri.  Under House Bill 2499, all vehicles made since 2012 and having fewer than 150,000 miles would be exempt.

      “I toyed with just doing an all-out, getting rid of it all at once … but because of some of the consternation [about the 2019 proposal], I thought we’ll just ease out of it,” said Eggleston.  “So I basically said, ‘Any car that’s not being inspected today is not ever going to have to be inspected.  Any of them that are inspected today will continue’ … so over time this will just naturally phase itself out.”

      Eggleston’s idea has some support, including from O’Fallon representative Tony Lovasco (R)

      “I do think that ultimately, as technology increases, we’re going to see more and more construction improvements made and what not where [inspections are] really going to be completely superfluous very soon, and I think it does makes sense to have it just drop off naturally rather than us revisiting this every few years,” said Lovasco.

      Representative Michael Burton (D-Lakeshire) doesn’t support extending the 2019 legislation.  He said for him it’s an issue of safety.

      “Let’s talk about a cracked windshield.  That’s something that’s inspected whenever the car goes through an inspection, and I know we have laws where you can’t drive around with a cracked windshield but we also know that police officers right now are generally not pulling people over for that, but I think that can be a safety issue … same thing with seatbelts.  Whenever you get a car inspection they’re checking to make sure all the seatbelts work and what not.  That’s a safety concern of mine.”

      Eggleston said there are 35 states which have no vehicle inspection requirements, and that includes all the states that border Missouri.  He said that hasn’t made their roads less safe than those states who have such a requirement.

      “Their statistics on accidents and deaths are no different than ours.  There’s no correlation between states that have inspection programs and safety at all,” said Eggleston.  “The safety issue you were talking about, it’s perceived but I don’t think it’s actual. There’s no data to back that up.”

      The committee’s top Democrat, Gretchen Bangert (Florrisant), opposed the 2019 legislation and has reservations about taking it further.  She also dislikes that the 2019 law allows vehicles to be sold without an inspection, and wishes this bill would reverse that.

      “So I could have a car that’s a junker and has some sort of issue, and if you don’t know because you don’t get an inspection yourself and just trust me, then the car hasn’t been inspected.  That’s one loophole that I wish we could look at is if you were selling a car to another person that it would have to be inspected regardless of the miles,” said Bangert. 

      Eggleston said it is up to a potential buyer to decide whether to get an inspection on a vehicle they’re considering purchasing.

      His 2019 legislation, as a stand-alone before it was amended onto SB 89, passed out of the House 102-45.

      The committee has not voted on HB 2499.

Previous stories:

Bill rolling back vehicle inspection requirement signed into law

House votes to roll back, rather than eliminate, vehicle inspection requirements