March 1 , 2008

The Missouri General Assembly completed its eighth week of session this week and several issues are emerging as priorities. Among these leading issues are:

• Property tax reform: This week the Senate perfected SCS/SB 711, the major property tax reform bill, while the House voted out of committee bills relating to property tax relief for seniors;
• Campaign finance reform: The Senate debated and passed SB 1038 (Sen. Shield (R–St. Joseph) which removes limitations on campaign contributions and makes numerous changes to Missouri's campaign finance laws. That bill has been sent to the House for further action.
• Health care reform: Rep. Rob Schaaf (R–St. Joseph) completed his 18th hearing on health care transformation this week. Schaaf has been critical of the Insure Missouri Program initiated by Governor Blunt and is expected to draft an alternative health care reform measure.
• Budget: The House and Senate appropriations committees are in full swing as they attempt to pare down the Governor's recommended budget by $250 million. House Budget Chairman Allen Icet is expected to have a fully marked up House budget by spring break.
• Economic development: Both the House and Senate are working on significant economic development bills relating to the Quality Jobs Act, enterprise zones, angel tax credits and other economic development issues.

Thus far, the House has introduced 986 bills and constitutional amendments and has passed and sent to the Senate 15 measures. The Senate has introduced 482 bills and constitutional amendments and has passed and sent to the House 13 measures.

News this week includes:

House Health Care Policy

HB 1790 Currently, a hospital can be designated as a trauma center, and severely injured patients will be transported to the nearest designated trauma center. This bill changes the laws regarding hospital designation by the Department of Health and Senior Services to include a heart attack center and a stroke center if it meets the department's applicable level of heart attack or stroke center criteria. The bill specifies that patients who suffer a heart attack or stroke will be transported to the nearest heart attack or stroke center.

HB 1546 changes the laws regarding infection control. In its main provisions, the bill:

1. Requires all cases, including non–hospital acquired cases, of methicillin–resistant staphylococcus aureus (MRSA), vancomycin–resistant staphylococcus aureus, and vancomycin–resistant enterococcus to be reported to the Department of Health and Senior Services;
2. Specifies when ventilator–associated pneumonia should be included by the department in quarterly infection incidence rate reports; and
3. Requires every hospital licensed in the state to develop an MRSA control program beginning January 1, 2009. Contacts need to be made Monday on this bill which accomplishes nothing except for more paperwork, time and effort.

Senate moves to fight cervical cancer

The state senate has moved to make sure thousands of parents of sixth–grade girls get information about the availability of a cervical cancer vaccine. The senate has advanced Jolie Justus's bill requiring the state education department to send the information to all sixth–graders in public schools.

Justus says the information will contain information about the link between the Human Papilloma Virus and cervical cancer. But it will be up to the parents or guardians to decide if the girl should get the vaccine.

Justus ran into opposition last year when she tried to make the vaccinations mandatory. Critics argued the mandatory vaccination program would promote promiscuity. This year's proposal makes the vaccinations voluntary.

For those with questions of safety, Justus says the track record is good. She says the vaccine has been approved for use in 80 countries and has been received by more than 11,000 women in the United States since the FDA approved the vaccine's use in 2006. The Senate could send the bill to the House before the end of the week.

Animal Control

Three bills dealing with dog fighting and animal registration were heard in Senate Judiciary this week.

SB 819 – modifies various provisions relating to dog fighting.

SECTION 513.605
This act adds dog fighting to the list of offenses which are subject to the Criminal Activity Forfeiture Act.

SECTION 578.025
This act increases the penalty for being a spectator at a dog fighting event from a Class A misdemeanor to a Class D felony for a second or subsequent offense.

SB 834 – Under this act, a person has an absolute defense against civil liability or criminal prosecution for killing or injuring a dog, if such person's actions were based on the reasonable belief that he or she, or another person, was in imminent danger of being harmed by the dog. It is prima facie evidence that a person considered himself to be in "imminent danger" from a dog if such dog had at least twice previously trespassed onto the person's property, and if the person had notified the county sheriff or local animal control authority on the occasion of each prior trespass. A court shall award all reasonable costs to the defendant in any such suit if evidence shows the defendant is entitled to the absolute defense as described.

SB 1032 – Under current law, certain dangerous wild animals may not be kept unless they are registered with local law enforcement except if the animals are kept in a zoo, circus, scientific or educational institution, research laboratory, veterinary hospital or animal refuge. This act removes the exception for animal refuges. The act also adds the criteria that research laboratories and scientific and educational institutions must be accredited, veterinary hospitals must be permitted by the Missouri Veterinary Medical Board, and zoos must be accredited by the Association of Zoos and Aquariums in order for the exception to apply.

The act specifies that the law enforcement agency responsible for receiving the registrations is the chief law enforcement official in each county or in the City of St. Louis, or his or her designee.

These bills will be combined into a committee substitute.

"Insure Missouri"

Efforts to assure that 54,000 low income working families will have an opportunity for health insurance continue to be complicated as Governor Blunt announced on Friday, February 22nd that the Department of Social Services is withdrawing the Emergency Rule to implement Phase 1 of the Insure Missouri Plan. Although this move means that the immediate implementation of Insure Missouri (that had been scheduled for March) will not happen. There is still the possibility that it can be implemented after July 1, 2008. The General Assembly has a critical opportunity to work in a bi–partisan manner to improve upon the Insure Missouri plan and assure that all Missourians who are living in poverty are included in health care expansion. Democrats and Republicans have been negotiating to reach a compromise.

Panels Discuss Legislation Regulating Psychologists And Professional Counselors

A Senate committee advanced a bill that would authorize the licensure of prescribing psychologists under the State Committee of Psychologists in the Division of Professional Registration. Under Senate Bill 917, individuals licensed as prescribing psychologists would be authorized to prescribe certain Schedule II stimulants and Schedule IV tranquilizers or any other psychological treatment or laboratory test as it relates to the practice of psychology, excluding electrical convulsive therapy.

Prescribing psychologist licenses would only be issued to licensed psychologists who met certain criteria established in the bill. After psychologists receive their license to prescribe, they must enter into a collaborative practice agreement with a licensed physician for a one–year period to diagnose and treat medical problems.

House Bill 2065 was heard in a House committee and would repeal the reciprocity provision which allows a licensed or certified psychologist in another state with similar qualifications to receive a Missouri license without meeting the required criteria.

House Bill 1792 and Senate Bill 1109 were heard in House and Senate committees this week and would significantly expand the definition of "practice of professional counseling" to include individual, group, marriage, and family counseling and psychotherapy.

Health Care Bills Advanced This Week

• Senate Bill 1068 was advanced by the full Senate and 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.
• Senate Bill 974 was advanced in a Senate Committee this week and would modify public safety provisions relating to mental health services including
• changing the good Samaritan statute to allow any person to intervene in an attempted suicide with immunity from liability
• allowing security escort devices to be used on individuals who have been civilly committed when they are transported outside a mental health facility
• allowing mental health coordinators to be contract employees or work for community health providers
• Senate Bill 972 was heard in a Senate Committee this week and would add comprehensive day rehabilitation services under MO HealthNet.
• Senate Bill 1044 was heard in a Senate Committee this week and adds Saline and Lafayette counties to the list of counties that are allowed to have only one licensed individual in attendance when transporting a patient by ground ambulance. Under current law each ground ambulance is required to be staffed with at least two licensed individuals when transporting a patient.

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