April 2, 2010

The Missouri Senate Appropriations Committee began their quest to reduce their version of the budget by another $300 million on top of the $200 million cut by the House. In addition Senator Mayer, although he believes an additional $300 million will come to the state, would prefer to use the monies next year.

The Committee worked through Wednesday evening and all day Thursday anticipating finishing the budget next week. After the committee finishes the bills they will go to the Senate floor for debate. Finally, the legislation will go to the House and Senate conference committee to work out the differences.

The Tax Credit debate began this week on Wednesday. As expected, Senator Crowell has slowed the debate by insisting in debate that the tax credits for the state which amount to over $600 million be subject to appropriations rather than allocation as proposed by Senate President Pro Tem Shields. This debate will continue throughout the rest of the session.

News this week includes:

Senate Health/ Mental Health/ Senior & Families
The Senate committee on Health met Tuesday.  

SB 975   Authorizes the use of an electronic death registration system.

This bill opposes losing the option to file and receive death certificates locally until the electronic system is up and running successfully. The physical technology is in place but for now the implementations are not thus eliminating the local option and current turnaround time from 1 max 2 days to 30-60 days by filing with Jefferson city causes the families much hardship because they are not able to receive and type of benefits or access wills, safe deposit boxes, insurances etc. until the death certificate is received. Filing with the state extends turnaround time for such a critical document to unreasonable lengths. As well, it then prolongs the payments of the funeral homes services. The implementation systems major down falls, that are in place in others states, are all Doctors, Funeral Executives and Coroners are not participants and the electronic process cannot work successfully if all do not participate. Time line for implementation is 24 months, recommended currently as amendment is 1 month it is requested that there be a middle ground between the two recommendations. Committee questions why funeral homes cannot print Death certificates currently and it is because they try and limit errors and the faster the turnaround time the more errors that may occur. Three witnesses. Witness: Boone County Funeral Home Owner in favor of the bill Witness: Brad Speak: Independence MO, Funeral Home owner- in favor of the bill. Info Witness: MO. Dept. of Health - will help w/ amendment of time line.

House Ways and Means
The House Ways and Means Committee met on Wednesday. A public hearing was held for three pieces of legislation relating to tax issues.

HB 2302   Requires the Department of Revenue to establish the necessary rules to implement the compliance provisions of the multistate Streamlined Sales and Use Tax Agreement.

Rep. Sutherland, R-Warrenton, introduced House Bill 2302. Known as the Mainstreet Fairness Act in the Senate, this legislation would implement the provisions of the streamlined sales and use tax agreement. Rep. Sutherland said that local businesses are put at a disadvantage to compete with out-of-state sales made over the internet or by phone. This bill would allow businesses to choose whether or not they want to participate in the program.

Twenty-three states have already enacted such legislation. One of those states is Iowa, and speaking on behalf of the legislation was a member of the Iowa General Assembly, Christopher Rants. He spoke on the success of his state when adopting streamlined sales tax.

Also speaking in favor of the bill were: David Overfelt, Missouri Retailer's Association; and Otto Fajen, Missouri National Education Association. Estimates vary between 200-400 million that could be raised on a internet sales tax.

The Senate gave additional debate to the Senate version, SB 905, this week then laid it over.

There were no witnesses speaking in opposition.

HB 2252   Reauthorizes the provisions regarding the tax credit for contributions to pregnancy resource centers and extends the expiration date until August 28, 2022.

The final bill heard was House Bill 2252. The legislation is sponsored by Rep. Faith, R-St. Charles, and would extend the expiration date on the current law regarding tax credits for contributions to pregnancy resource centers. The tax credits are set to be removed in 2012, but this bill changes that to 2022.

Eight witnesses testified in favor of the legislation. Many were from pregnancy resource centers across the state: Terri Hunter, Thrive St. Louis; Cindi Boston, Pregnancy Care Center in Springfield; and Joe Dalton, Pregnancy Resource Center in Rolla.

Also speaking in favor were: Sam Lee, Campaign Life Missouri; Tyler McClay, Missouri Catholic Conference; Susan Klein, Missouri Right to Life, Joe Ortwerth, Missouri Family Policy Council; and Abram Messer, Missouri Family Network.

Michaelle Trupiano, Planned Parenthood Affiliates in Missouri, spoke in opposition to the bill.

Licensure of Clinical Laboratory Personnel
Senator Dan Clemens offered SB 1063 was heard in the Senate Finance Committee.

Clemens bill would create a system of occupational licensure for performing clinical laboratory tests or draw blood for lab tests.

Five new categories of state licensed practitioners would be initiated:

• Clinical lab scientist
• Categorical lab scientist
• Clinical lab tech
• Clinical lab assistant
• Medical lab scientist

Currently federal lab standards apply and in addition is is already difficult to find these practitioners.

I visited with Senator Scott, Chair, and he is not inclined to move the legislation.

House Professional Registration Committee
HB 1449 Allen:  Advanced Practice Registered Nurses
This bill adds an advanced practice registered nurse to the list of approved health care providers who are authorized to write a prescription to refer a patient to a physical therapist.

Witnesses in Support:
Julie Unk: Washington University School of Medicine.  Today nurses cannot prescribe physical therapy, they must find a doctor – who is usually treating patients, in surgery, etc. and it’s difficult to track them down.

Schoemehl: Are there limits on time frames for physical therapy that is prescribed by the dr. or is the time frame determined by insurance companies?

Burlison: How detailed is communication between doctor and patient?

Lyla Pennington: Nurse Practitioner and professor at UMC. Support

Madeline Orr Advanced Practice Registered Nurse at St. Louis Children’s Hospital: Support

John Bardgett: Mo Physical Therapy Association: Support.

Dan Johnson, Nurse Practitioner, Lebanon, MO: Support.

Witnesses in Opposition:  
Bonnie Bowles: MO Association of Osteopathic Physicians and Surgeons: Collaboration with the physician is in the best interest of the patient.

Witnesses for Informational Purposes:  None

- Wasson announced to the committee that he was putting together an Omnibus bill and requested information from committee members in the next 2 weeks.

New Requirements Contain Changes To Social Worker Licensure, Supervision Rules
Changes in the social worker licensure requirements and ethical standards and disciplinary rules were published in the Missouri Code of State Regulations yesterday. Among other things, the new rules create the following requirements for supervised licensed social work experience.

• The supervisor must have been continuously licensed for the past five years.
• Beginning April 30, the supervisor must have a master’s in social work to supervise those seeking clinical or advanced macro licensure or a bachelor’s in social work to supervise those seeking baccalaureate licensure.
• Starting with supervision arrangements registered on or after April 30, the supervisor will be required to submit progress reports on the 12th, 24th and 36th month of supervision.
• All supervision arrangements registered on or after Oct. 1 shall require a supervisor who has completed 16 hours of supervisor training.

The new requirements are effective Friday, April 30.

State Publishes Final Rules Implementing The Nurse Licensure Compact
Rules implementing the Nurse Licensure Compact law enacted in 2009 were published in the Missouri Code of State Regulations yesterday and are effective Friday, April 30. The NLC is an agreement between states to recognize each others’ licensees. Currently, 24 states recognize the NLC.

Downsizing
The Missouri Senate has formed a special 10 member Joint Interim Committee on Reducing the Size of State Government.

This interim committee will be making recommendations on consolidating or eliminating state government functions.

Senator Chuck Purgason is the sponsor of this resolution.

Aid to Local Public Health
As reported earlier our increase from the Governor’s recommendation of $307,000 has been called into question by the Senate Appropriations Committee.

Senator Frank Barnitz prevented the Senate Appropriations Committee which is considering a reduction of $600,000 to aid to local public health from occurring. I visited with Senator Barnitz to stop the reduction prior to the hearing and keep the item open for further debate.

Please make your contacts as per Mahree Skalas’s request. It is absolutely imperative that Senator’s hear from their local public health departments on all their cuts and to at least keep what the health departments had in 2009.

This will be difficult and your contacts are essential.

Mahree will be sending you contacts and I will also. Let’s keep up the pressure. Make contacts!

Next Week
Six Weeks remain in the 2010 legislative session. Legislation is just now making the transition from House to Senate and Senate to House.

The budget will dominate activity next week in the Senate.

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