May 8, 2009

As expected the legislature focused primarily on finishing the budget this week with the deadline of May 8th at 6pm.

Wednesday was of the most contentious days in recent legislative history.

At stake, was the Governor and Senate’s plan to extend MO HealthNet (Medicaid) to an additional 35,000 working poor up to 50% of the federal poverty level of $8,500.

The funding paid by a hospital tax and matching federal funds at no cost to the state was defeated Wednesday evening in a party line vote in the House. A massive lobbying effort was unsuccessful against the philosophical mindset of House Republicans.

The majority of Republicans in the House said they made the tough cuts in 2005 and did not want to allow working poor to be readmitted to the MO HealthNet system even if there was no cost and funding was guaranteed in the future by contract.

However, late Wednesday night a compromise was reached by conference negotiators.

House conferees agreed to the working poor being covered. However, they added 10,000 uninsurable people at an undetermined cost to the state budget and with no guaranteed funding for the future. Go figure!

House Bill 11, containing this package, was passed on a party line vote 89-72 by the Republicans. This arrangement is all contingent upon the passage Monday of SB 306 statutorily authorizing the package.

Insurance language dictating terms of contracts by the insurance industry to providers must be deleted or the plan will be dropped.

This all made for entertaining debate on the House floor with the governor being called “sleazy” by the Republicans and the Democrats calling the Republicans non-Christian. Needless to say this made for drama.

News this week includes:

Sunshine Law
House Bill 316, the Sunshine Law bill promoted by Schnuck’s and Dierbergs grocery stores in St. Louis as well as the Missouri Press Association, was heard in the Senate General Laws Committee on Wednesday.

Cities, Counties and others opposed the penalty provisions as well as notice of zoning changes.

Senator Goodman is making changes to the proposal. These include changing the $8000 penalty for “purposely” violating the law to the requirement of having “clear and convincing” proof that the law was violated.

In addition, the notice of zoning hearing will be changed to 3 days notice rather than 4 days.

Nursing Loans
HB 247 received approval and is now on its way to conference before final approval.

The bill modifies the requirements for collaborative practice arrangements between advanced practice registered nurses and collaborating physicians. Advanced practice registered nurses are required to submit a minimum of ten percent of the charts documenting their delivery of health care services to the physician for review every fourteen days. The collaborating physician shall review twenty percent of the charts in which the advanced practice registered nurse wrote a prescription for controlled substances every fourteen days. The charts reviewed for prescription of controlled substances may be counted in the number of charts required to be reviewed for prescribing practices.
The specific rule-making authority granted to the board of healing arts and the board of nursing with respect to collaborative practice arrangements does not extend to collaborative practice arrangements of advanced practice registered nurses and physicians providing certain population-based health services.
This act modifies the definition of eligible student for the nursing student loan program to include doctoral students and to allow full time or part-time doctoral students to be eligible for the loan program.
Provisions of this act are similar to SS/SCS/SB 406 and SCS/SB 509.

Budget
The House and Senate passed HB 22, the federal stimulus capital projects bill, late Thursday evening.

HB 22 included $381 million for one time public projects, general state buildings, colleges, etc. However, the Senate Appropriations Chair Nodler added two $25 million “forgivable” loans to two private companies. Obviously, designed to assist in his congressional race.

$783 million was used to “prop up” the state budget in House bills 1-13.

Late Thursday evening it was decided that the $966 million in stimulus funds unappropriated would be awarded by a Joint Interim Legislative Committee. The committee will hold a hearing throughout the summer to “score” projects for funding in the veto session in September.

These hearings are to be scheduled around the state.

Governor Nixon has other ideas and plans to “shore up” the budget.

As it currently stands the state budget is $1 billion dollars short this current fiscal year ending July 1st.

A great deal of discussion will occur next week and after the session ends next Friday.

Immigration
Representative Jerry Nolte agreed to MOALPHA’s language to have local public health departments E-verify per annum rather than every time a contract is revised.

Representative Nolte attached the amendment to HB 390 in the Senate. Although our language is not controversial, it is very late in the session for the bill to move through the process.

Tobacco
The Senate and House Budget Conference approved $1 million for youth tobacco control programs and another $200,000 was appropriated for youth media literacy programs.

The House recommended $1.2 million, the Senate $1.7 million and the Governor $1.5 million. This was the compromise.

Legislature Passes Newborn Screening Measure
Senate Committee Substitute for House Bill 716 would establish the Brady Alan Cunningham Newborn Screening Act. The bill was given final approval by the House and Senate and now moves to Gov. Nixon for his signature. The bill would require the Missouri Department of Health and Senior Services to expand newborn screening requirements to include certain lysosomal storage diseases such as Krabbe, Pompe, Gaucher, Niemann-Pick or Fabry disease by July 1, 2012. The department is authorized to increase the current fee associated with the screening tests to cover the additional costs of the expanded tests. The bill also includes language that requires the MO HealthNet program and the State Children’s Health Insurance Program to examine and improve hospital discharge and follow-up care procedures for premature infants born earlier than 37 weeks gestational age.

Fair Tax
The Senate Ways and Means Committee met on Wednesday to discuss HJR 37.
The committee continued their hearing from last week to hear from opponents of Rep. Ed Emery's HJR 37, which would establish a "Fair Tax" in Missouri. Opponents included the National Education Association, the Credit Union Association, the Institute on Taxation and Economic Policy, Missouri Association of Social Welfare, Missourians for Tax Justice, the Missouri Budget Project, Catholic Charities, Missourians with Disabilities, the Missouri Press Association, The Whole Person and Services for Independent Living. The committee then adjourned.
Senator Vogel, Chair, indicated that the bill would not move further. Billionaire Rex Singquefield and his lobbying team are pushing the legislation.

Senate-Health Mental Health/ Senior & Families
HB 156 Authorizes the Family Support Division to assist certain elderly individuals who qualify for the federal Food Stamp Program in obtaining supplemental food stamps. - Hearing conducted
This bill would allow Social Services to help those that are 65 and older who already qualify for food stamps to receive supplemental food stamps. The Representative said that this bill specifies 65 and older because this bill is aimed specifically at helping seniors. A representative of The Silver Hair Lobbyists testified in favor of this bill stating that this bill could save the state Medicaid dollars. A representative of AARP testified in favor of t his bill saying that this bill would help people over 65 that have been hurt by the current economic climate. A representative of the Missouri coalition for quality care also testified in favor of HB 156 stating that it is more expensive to purchase healthy food.

Initiatives on Property Tax Rate Ceiling
Rep. Mike Sutherland has amended several bills (S.B. 485 and H.B. 228) to allow an initiative process to reduce the property tax rate ceiling. The bills allow disgruntled citizens to submit petitions signed by 33 percent of the voters to place the lower property tax rate ceiling on the ballot at the next election. If this bill passes, we are certain to see an effort in the near future to reduce the petition requirement.

This is another politically popular attempt to change the property tax system.

Next Week
The legislative session will end next Friday at 6pm. Although the budget has been completed a prime objective of Speaker Richard and the Governor was to pass an economic development bill and this has not been accomplished due to the Senate “gang of five”.

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