February 17 , 2008

The $152 billion federal economic stimulus package might give the economy a much needed infusion of cash, but it could tighten the state budget.

The Center on Budget and Policy Priorities, a think tank in Washington, says a couple of business tax cuts included in the package will cut state income in Missouri by $100 million. House Budget Committee Chairman Allen Icet (R–Wildwood) commented that the federal tax cut will wipe out about one–third of the money lawmakers were counting on to finance increased services for such things as Medicaid and education.

Two business tax cuts included in the package approved by Congress will cost 36 states a total of $2.9 billion in lost income. Concern over the economy led Democrats and Republicans to cooperate and put together the stimulus package. President Bush is expected to sign the legislation this week. Checks totaling $600 per individual and $300 per child could be mailed as soon as May.

News this week includes:

Missouri County Planning Act

Legislation was heard in the House Local Government Committee HB 1832-Cooper and in the Senate Local Government Committee Senator Griesheimer's SB 729.

The Missouri Planning Association Bruce Wiggins, Calloway County Representatives including "Doc" Kritzer for MAC and CCAM along with the St. Louis Homebuilders testified in favor of the legislative proposals. As expected the Missouri Farm Bureau testified against the legislative proposals.

It seems the Missouri Farm Bureau sees "black helicopters" and is worried about farmers' property rights even though this is not a zoning proposal.

This bill establishes the Missouri County Planning Act. In its main provisions, the bill:

1. Allows for the establishment of a county planning commission comprised of appointed members to prepare a comprehensive plan for the county. The planning commission may be established either directly by the county commission or by voter petition and approval;
2. Specifies the powers and duties of the planning commission;
3. Specifies the elements of the comprehensive plan and the procedures for its consideration, hearing, and adoption by the planning commission and the county commission;
4. Authorizes the planning commission to recommend subdivision regulations after a public hearing and authorizes the county commission to adopt the regulations;
5. Authorizes the planning commission to adopt a major street plan for all unincorporated areas of the county in accordance with the transportation element of the comprehensive plan;
6. Authorizes the planning commission to recommend zoning regulations for all unincorporated areas of the county in accordance with the comprehensive plan after a public hearing and authorizes the county commission to adopt the regulations upon voter approval;
7. Requires counties that have adopted zoning regulations under the bill to appoint a county board of zoning adjustment to hear and decide appeals of zoning decisions and applications for variances. The hearing and appeal procedures are specified;
8. Specifies that violations of any regulations adopted under the bill are misdemeanors and authorizes certain counties to impose fines for these violations;
9. Authorizes the grandfathering of actual lawful uses of property in existence on August 28, 2008;
10. Authorizes counties to enter into cooperative agreements with public or private entities for the exercise and performance of the established planning powers, duties, and functions; and
11. Specifies that nothing contained in the bill will affect the existence or validity of a county ordinance or order adopted prior to August 28, 2008.

Helmet Laws

Senator Ridgeway's SB 1067 was heard in the Senate Transportation Committee on Wednesday.

The bill exempts persons 21 years of age or older from wearing protective headgear except when operating or riding motorcycles or motortricycles upon interstate highways. The motorcycle helmet exemption expires on August 28, 2013. This act is substantially similar to SB 252 (2007), SB 635 (2006), SB 12 (2005), SB 744 (2004), SB 226 (2003), SB 646 (2002), SB 18 (2001), SB 610 (2000) and SB 294 (1999).

As usual the "Freedom of the Road" motorcycle group attended in "leather" for the hearing.

Healthcare and the Safety Council testified against the legislation which will reach the floors of the House and Senate.

Legislators Endorse Any Willing Provider Legislation, Add Facility To Provider Definition

This week, the House Special Committee on Healthcare Facilities held a hearing on an "any willing provider" bill for physicians. House Bill 1857 would require that health insurers include in their provider networks any physician or other individual practitioner who is willing to accept the insurer's contractual terms and conditions. Immediately after the hearing, the committee voted to approve House Committee Substitute for House Bill 432. The House Committee Substitute included an amendment adding health care facilities to the provider definition. The sponsor of the bill is Representative Rob Schaaf, M.D., (R–St. Joseph), who chairs the committee.

Senate Advances Bill To Expand Prescriptive Authority Of Advanced Practice Nurses

Legislation that would authorize advanced practice nurses to prescribe controlled substances under the auspices of a collaborative practice arrangement with a physician was advanced this week by the full Senate. Senate Committee Substitute for Senate Bill 724 is supported by the hospitals, but opposed by several physician organizations and individual physicians, who argue that APNs lack the expertise to prescribe highly addictive and dangerous drugs.

The bill now awaits final approval by the full Senate.

Senate Advances Bill Adding New Members To MO HealthNet Oversight Panel

This week the Senate Health and Mental Health Committee advanced legislation that would make changes to the MO HealthNet Oversight Committee by adding four new members and one patient advocate. Provisions outlined in Senate Committee Substitute for Senate Bill 821 include the following.

• adding a representative from a rural health clinic
• adding an optometrist
• adding a mental health professional
• adding a licensed nurse

The substitute also specifies that the oversight committee would have three patient advocates rather than two. Of the three advocates, one advocate would represent children, one the disabled, and one the elderly community.

Senate Committee Hears Medicare Advantage Plan Regulation Bills

The Senate Small Business, Insurance and Industrial Relations Committee heard legislation this week to regulate Medicare Advantage Plan insurance products. If passed, Senate Bills 973 and 773 would require that insurance agents allow a two–day waiting period from the date of the solicitation before an applicant could be enrolled in this type of insurance plan. It also requires a disclosure statement be signed by the applicant which includes:

• A statement that Medicare Advantage plans are not Medigap supplement plans
• A statement advising the applicant to confirm with his or her health care providers whether or not the provider has contracted with the Medicare Advantage plan to provide medical services
• A statement advising the applicant to contact either a trusted family member, friend or the state health insurance assistance program

Smoking Cessation Bills Heard In Senate Committee

The Senate Seniors, Families and Public Health Committee reviewed bills this week that would earmark state funds for smoking cessation programs.

Senate Bill 843 would set aside approximately $7 million in tobacco settlement funds for youth smoking prevention programs. The money would be provided by payments to Missouri from smaller tobacco companies that have agreed to abide by the 1998 Master Settlement Agreement between states and the largest tobacco manufacturers. It also creates a commission to review evidence-based youth smoking prevention programs and monitor the progress of prevention efforts.

Senate Bill 946 would create the Tobacco Use Prevention, Cessation and Enforcement Fund. Beginning in fiscal year 2009, payments received from the strategic contribution fund would be deposited into the newly created fund to be used for a comprehensive tobacco control program.

House Committee Proposed Changes To Health Professional Peer Review Law

Senate Bill 915, sponsored by Senator Luann Ridgeway, R–Smithville, was heard in the Senate Seniors, Families and Public Health Committee this week. This act would modify the definition of "health care professional," for purposes of determining who is subject to the protections of the peer review law, to include physical therapists, emergency medical technicians and emergency medical dispatchers.

Insure Missouri Hearings Continue

Rep. Rob Schaaf, R–St. Joseph, committee chair, continued his committee's study of Gov. Matt Blunt's Insure Missouri proposal this week. However, only one hearing was held and only one organization provided testimony at the thirteenth hearing:

•Center for Health Transformation, Missouri Project

Other Bills Advanced In Senate Committees This Week

• Senate Committee Substitute for Senate Bill 778 provides for optional immunization for the human papilloma virus. This bill also received consent bill status.
• Senate Committee Substitute for Senate Bill 1068 establishes the Pharmacy Rebates Fund for the purposes of depositing any revenues received by the state from pharmaceutical manufacturer rebates as required by state or federal law for use in the MO HealthNet pharmacy program.

Next Week

Both the senate and the house will begin full debate next week.

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