February 3, 2006

The Missouri General Assembly continued to focus on committee hearings this week as they began to direct their focus on legislation. News of interest this week include:

Immunizations

House Bill 1071 was heard this week in the House Children and Families Committee.

Representative Phillips's bill allows the Department of Health and Senior Services to develop rules and regulations changing the manner and frequency of certain immunizations for children.

The Department of Health's Susan Jenkins and Andrew Wankum testified against the legislation testifying that the current system works. I entered testimony on behalf of MOALPHA in opposition.

Ron Calzone of "Missouri First" testified in favor of the bill citing that current regulations violate due process.

HB 1071 sponsored by Representative Phillips and Faith made the following changes to DHSS's ability to require immunizations through the rule making process for school and childcare attendance:

1. HB 1071 would remove the ability to DHS to add immunizations required for school attendance through the rule-making process. Instead, if adopted, the law would only allow DHSS to modify the frequency and manner of administering the immunizations specifically listed in Section 167.181 RSMo; and
2. HB 1071 would eliminate the authority for DHSS to add immunizations required for childcare attendance through the rule-making process. Instead, if adopted, the law would only allow DHSS to require those vaccinations required under 167.181 RSMo for school attendance.

Please see the attached .pdf document here.

Nurse Disciplinary Standards are Reviewed

The House Professional Registration and Licensing Committee held a hearing this week on House Bill 982. The bill allows the State Board of Nursing to expunge complaints against a nurse if the board’s investigation concludes the matter is not grounds for disciplinary action against the nurse's license. Currently, records would be expunged only for unsubstantiated complaints filed against a nurse by state prisoners.

Under current law, hospitals and ambulatory surgical centers must report final disciplinary actions taken against a practitioner on staff. The reports go to the appropriate licensure board. House Bill 982 would require nurse staffing agencies and other "employers of nurses" to file similar reports with the licensure boards.

If the bill advances, it is expected to be modified to require reporting only of incidents which constitute a violation of the appropriate licensure board's disciplinary standards.

Association Health Plan Bill Leads to Health Reform Plan

This week, the Senate Pensions, Veterans' Affairs, and General Laws Committee reviewed Senate Bill 663. The measure would authorize employer purchasing alliances to purchase health insurance coverage. These alliances would be not-for-profit corporations created for the purpose of purchasing health insurance for groups of employers. Current law restricts the sale of group health coverage to groups that are forming solely for the purpose of buying coverage.

In presenting the bill to the committee, bill sponsor Sen. Jason Crowell, R-Cape Girardeau, described how his proposal to authorize association health plans at the state level was part of a broader vision for reforming the health care insurance system. Arguing the present delivery and financing system is unsustainable, Crowell would propose a shift from employer-sponsored coverage to a focus on individual coverage that is portable as workers change jobs. Association health plans and commercial insurers would serve much of the employed, lower-risk population, while higher-risk Missourians would have access to coverage through a large insurance purchasing pool that also would include governmental employees and Medicaid recipients. The purchasing pool would be open to all, with premium subsidies available for lower-income recipients. Coverage under the purchasing pool would be provided through private insurers submitting bids to cover the members of the purchasing pool. Current Medicaid funding would be incorporated into the purchasing pool arrangement.

Committee Reviews Medicaid Whistleblower Protection Bill

House Bill 1401 is designed to prevent employers from firing, demoting, harassing or suing an employee because he or she reported allegations of Medicaid fraud or participated in Medicaid fraud investigations or legal actions. The House Judiciary Committee heard testimony on the bill this week. The whistleblower protections in the bill overlap somewhat with those of a 2000 state law applicable to hospital and ambulatory surgical center employees, but the penalties for violation are more specific and stringent. The bill would not protect those who file frivolous reports or participate in the fraudulent activity. Lawsuits would not be barred if the employee acts negligently, recklessly, maliciously or in bad faith.

The bill is sponsored by Rep. David Sater, R-Cassville. He is the new chair of the House Appropriations Subcommittee which reviews the budgets of the state Departments of Social Services, Mental Health, and Health and Senior Services.

Volunteers

Senate Bill 889 and House Bill 1118 were heard this week.

SB 889 - Under this act, volunteer licensed health care providers from adjoining states may be deployed to provide health care necessitated by an emergency. Deployed volunteers will not be liable for civil damages for acts or omissions other than damages occasioned by willful or wanton acts or omissions.

The Missouri Hospital Association, Missouri Medical Association, EMS paramedic groups and STARRS were in support.

House Transportation

Three bills were heard in the House Transportation Committee dealing with safety child restraints.

House Bill 1391, House Bill 1043, and House Bill 1165 were proposed.

The bills change the laws regarding child passenger restraints and safety belts. The bill:

1. Requires children younger than four years of age, regardless of weight, or who weigh less than 40 pounds, regardless of age, to be secured in a child passenger restraint system;


2. Requires children four to eight years of age or weighing 40 to 80 pounds or less than four feet nine inches in height to be secured in a child passenger restraint system or booster seat;


3. Requires children at least 80 pounds or more than four feet nine inches in height or eight years of age or older to be secured by a vehicle safety belt;


4. Requires car rental agencies doing business in Missouri to inform customers of the requirements of the bill and to provide an appropriate child passenger restraint system;


5. Exempts public carriers for hire and school buses; and


6. Requires the Department of Public Safety to develop a public information program to ensure compliance with child passenger restraint laws.

The exemption on belt usage of drivers and passengers if there are more persons than safety belts is removed.

The bill becomes effective January 1, 2007.

Senate Transportation

The helmet law hearing for SB 635, Senator Cauthorn, received its hearing on Tuesday. This bill will be voted out of committee as it has in the past. Healthcare groups testified against the legislation.

SB 635 exempts motorcyclists age 21 and older from wearing a helmet when operating a motorcycle or motortricycle. Under current law, everyone operating a motorcycle or motortricycle must wear a helmet.

This act is substantially similar to SB 12 (2005), SB 744 (2004), SB 226 (2003), SB 646 (2002), SB 18 (2001), SB 610 (2000) and SB 294 (1999).

SB 916 was also heard. The bill modifies the law with respect to the use of child passenger safety restraint systems and booster seats. The act requires children of certain ages, weights and heights to be restrained by either a child passenger restraint system, booster seat or safety belt.

AGE/WEIGHT/HEIGHT CLASSIFICATION:

1. LESS THAN 4 YEARS OLD - This act requires children less than four years old, regardless of weight, to use an appropriate child passenger restraint system.


2. LESS THAN 40 POUNDS - The act requires children weighing less than 40 pounds, regardless of age, to be secured in a child passenger restraint system appropriate for the child.


3. LESS THAN 8 YEARS OLD, 80 POUNDS OR UNDER 4'9" - Children (ages 4-7) or children weighing at least 40 pounds but less than 80 pounds, or children less than 4'9" tall must be secured in a child passenger restraint system or booster seat appropriate for that child.


4. GREATER THAN 80 POUNDS OR TALLER THAN 4'9" - Children who are at least 80 pounds or children taller than 4'9" shall be secured by a vehicle safety belt.

A violation of the child passenger restraint provisions is an infraction and the fine is $25 plus court costs. The fine for violating the safety belt provision of the act is $10. Charges for violating the child passenger restraint and booster seat provisions shall be dismissed or withdrawn if the driver provides evidence that he or she acquired a child passenger restraint system or booster seat prior to or at his or her hearing. The act requires car rental agencies to inform its customers of the requirements of the act and provide for the rental of an appropriate child passenger restraint system. The act does not apply to public carriers for hire.

This act is substantially similar to HB 1165 (2006), SS/SCS/HCS/HB 518 (2005), SCS/SB 221 et al (2005), SB 710 (2004), SB 9 (2003), SB 647 (2002) and SB 549 (2001)(sections 307.179 and 476.385).

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