|
March 2, 2007
The General Assembly is still in a “slow moving” mode of operation. Three weeks remain before the legislative break and this Thursday is the last day to file Senate bills.
News this week includes:
House Bill 788
On Tuesday at noon Representative Wayne Cooper heard House Bill 788.
HB 788 changes the laws regarding public health emergency preparedness. The bill:
- Defines "emergency plan," "responder," and "volunteer";
- Specifies that health care professionals and emergency responders deployed during an emergency are exempt from civil penalty unless the act or omission is intentional or careless;
- Specifies that the Governor, in a state of emergency, can issue an executive order requiring medical care be given at temporary facilities if the number of seriously ill or injured persons exceeds hospital capacity;
- Allows the Governor to waive or suspend administrative rules that would hinder or delay the ability of the Department of Health and Senior Services to respond to a declared emergency;
- Specifies that the department can recruit, train, and accept the services of citizen volunteers to dispense medication; and
- Requires the department to provide volunteers with access to professional staff for training and oversight, develop written rules, and make sure volunteers understand their responsibilities.
DOH Director Jane Drummond presented initial testimony for the department. This Governor’s priority was supported by a multitude of supporters including Ambulance Association, independent living centers, ER doctors, St. Louis County, EMTs and others.
Sharon Lynch presented testimony on behalf of MoALPHA and did a great job!
The Missouri Association of Trial Attorneys as expected presented opposition testimony based on legal interpretations of malicious acts and gross negligence. They contend the bill exempts standards of care. The bill was voted “DO PASS” on Wednesday.
Animal Law
House Bill 46 was given initial approval by the House.
Currently, any neglected or abused animal may be impounded. This bill prohibits a farm animal weighing more than 50 pounds from being impounded until the district state veterinarian of the Department of Agriculture has examined the animal and determined the animal to be in imminent danger of loss of life or has determined that the condition or conditions deemed to be in violation cannot reasonably be rectified before the disposition hearing. If before the disposition hearing, reasonable attempts to correct the condition have not been made and approved by the veterinarian during a required follow-up visit, the animal may be impounded or destroyed.
If an abused or neglected farm animal in the possession of a caregiver is impounded, the authority having custody of the animal is required to make a diligent effort to notify the owner in writing that the animal has been impounded.
FISCAL NOTE: Estimated Cost on General Revenue Fund of $87,022 in FY 2008, $82,706 in FY 2009, and $85,187 in FY 2010. No impact on Other State Funds in FY 2008, FY 2009, and FY 2010.
PROPONENTS: Supporters say that caring for an animal that has been seized from its owner can be very expensive, and often the animal is determined to be safe and the abuse case is not pursued. The bill changes the laws to permit the owner to continue to care for the animal while the state veterinarian examines the animal and investigates the case. Owners should have an opportunity to rectify the situation before their animals are taken from them.
Testifying for the bill were Representative Viebrock; Missouri Farm Bureau; and Missouri Federation of Animal Owners.
OPPONENTS: Those who oppose the bill say that they are concerned about the exacerbation and suffering by animals that need better care. A one-day delay by the state veterinarian in checking on the animals could mean life or death for the animals. Testifying against the bill were Missouri Alliance for Animal Legislation; and Humane Society of Missouri. OTHERS: Others testifying on the bill say that there are currently only four state district veterinarians and four federal veterinarians in the state who are able to examine the animals. Due to a statewide veterinarian workforce shortage, they feel that it is critically important to have an unbiased expert to evaluate the animals.
Others testifying on the bill was Department of Agriculture.
Farm Protection' controversy headed to committee, Senate Bill 364
Wednesday night was a hot one for members of the Missouri Senate's Agriculture, Conservation, Parks and Natural Resources Committee.
That's when the eight-member panel heard testimony on the proposed “Missouri Farm and Food Preservation Act” backed by Gov. Matt Blunt, the Missouri Farm Bureau and a number of other groups.
It's the plan that would cancel local counties' health ordinances limiting agricultural expansions, instead regulating farms with state and federal rules.
Opponents and supporters alike say the changes would make it easier for the expansion of confined animal feeding operations, known as CAFOs.
“My personal view, as a fourth generation farmer, is that this is the most important legislation that we have ever taken on in this state,” Farm Bureau President Charles Kruse told members at the annual Legislative briefing last week. “Are we going to see agriculture, five or 10 years down the road, still being a viable, successful industry, the largest and most important industry in our state?”
Kruse grows soybeans on a family farm near Dexter, in southeast Missouri.
Farm Bureau and other agriculture-related groups complain that the 16 different current county health ordinances create what Kruse called “a patchwork of regulations” that will cause “agriculture (to) continue to decline in this state.”
Rhonda Perry, the Missouri Rural Crisis Center's program director, is also a livestock and grain farmer in Howard County, between Fayette and Armstrong.
She said when Missouri adopted “the current state standards that we have now, that Farm Bureau thinks are perfectly adequate for all 115 counties in the state ... in 1996, the Farm Bureau and all the commodity groups complained then, that these state standards ... were going to put all of agriculture out of business and we were all going to be doomed.”
The Rural Crisis Center and others prefer to keep individual counties' control of the health ordinances-closest to the people affected by agricultural changes.
“Who we're talking about protecting here is less than one-half of 1 percent of the farming operations in this state,” Perry said. “That protection for those industrial operations comes at the expense of protection for the rest of us. ...
“(This bill) takes away all local control related to industrial livestock factories, and then it turns around and takes away farmers' and landowners' constitutional rights to legally challenge the operations, even if they infringe on our own property rights.”
Supporters say the new law would prevent “nuisance” lawsuits about farming odors or dust raised by plowing, among other legal issues.
State Sen. Chris Koster, R-Harrisonville, sponsors the proposed law.
“I have developed, over the last six weeks, a real appreciation ... for the notion that it is possible for agriculture to slip from our fingertips, if we don't protect it,” he told the Farm Bureau members. “Our job, with Senate Bill 364, is to make sure that agriculture is always the most important industry in the state of Missouri.”
The Rural Crisis Center has no interest in seeing Farm Bureau's position become law, Perry said.
“In our minds, our definition of what kind of agriculture we would like to see in this state are family farms in which farmers own the livestock, make the management decisions about how that operation is run and provide the majority of the day-to-day labor,” she said.
Missouri's economy will do better with her definition, she said.
House Minority Leader Jeff Harris, D-Columbia, wants lawmakers to prohibit CAFOs within two miles of any state park or historic site, such as Arrow Rock in Saline County.
But, Koster said: “Once you start down the process of identifying which institutions - whether it be state parks or churches or hospitals - have encroachments, you've begun down a slippery slope that I would be highly disinclined to begin down.”
Current setbacks “have been established on a scientific basis through the Department of Natural Resources,” he said, “and my goal would be to remain as closely faithful to those as possible.”
Eva Danner presented testimony on behalf of MAC and CCAM. In addition Skip Elkins presented testimony in opposition. Over 100 witnesses were on record entering testimony. The vote was 6-2 with Senator Shoemyer and Senator Coleman voting NO. This bill has “legs” and a full court press will be needed to stop this bill. Representative Munzlinger has similar legislation in the House.
Legislators Approve Licensure of Midwives
The Senate Pensions, Veterans’ Affairs and General Laws Committee approved a bill this week that would create a system of occupational licensure for “direct-entry midwives” who provide obstetrical and postpartum care for a fee. As previously reported in Advocate, Senate Bill 303 would require that these licensed midwives be recognized as certified professional midwives by the North American Registry of Midwives and registered with a newly created licensure board for direct-entry midwives in the Division of Professional Registration. The bill prohibits direct-entry midwifes from prescribing drugs, using forceps during deliveries, or performing cesarean sections, medical inductions or vacuum deliveries. The bill also limits who may be held liable for a direct-entry midwife’s negligent acts or omissions but does not preclude other providers from being liable for their own negligence in providing follow up treatment.
Legislators Consolidate and Approve Abortion Measures
The Senate Judiciary and Civil and Criminal Jurisprudence Committee consolidated several bill relating to abortion and then approved the resulting Senate Committee Substitute for Senate Bills 370, 375 & 432.
The committee substitute applies current criminal penalties for performing abortions to those inducing abortions. It also includes in the state abortion laws a definition of “medical emergency” used as an affirmative defense to abortion violation allegations.
A facility operated for the purpose of performing or inducing any second or third trimester abortions or at least five or more first trimester abortions per month must be licensed as an ambulatory surgical center.
The bill also creates new standards as to the content of educational programs about contraception and sexually-transmitted disease in public and charter schools, as well as new restrictions on who may offer such programs to students.
Committees Review Pharmacy “Conscience Clause” Bills
Legislators reviewed several bills this week that would enact “conscience clause” protections to allow pharmacists and pharmacy workers to refuse to dispense drugs or devices which cause abortion.
Senate Bill 285 was presented to the Senate Judiciary and Civil and Criminal Jurisprudence Committee. The original version of the bill created a new set of employment laws specific to pharmacy workers and included ambiguities that potentially would affect hospitals’ ability to deliver medical care unrelated to abortion. Missouri Hospital Association worked to promote a new version that would simply add pharmacy workers and abortifacients to a 34-year-old law providing conscience clause rights and protections for hospitals, physicians, and nurses that refuse to provide abortion services. The legislative sponsor offered the committee a revised bill to that effect.
House Bill 412 would protect licensed pharmacies from liability if they refuse to provide or recommend abortifacient drugs or devices, which are defined to include both the RU486 abortion drug and “Plan B” emergency contraception drugs. The sponsor indicated that his intent is to provide liability protection for the business but not the individual pharmacy workers. The bill was given a hearing by the House Special Committee on Small Business.
As in previous years, legislators are considering various conscience clause bills this session. Some narrowly focus on pharmacists and abortion-related drugs; others would make sweeping changes to employment laws affecting all health care workers.
Senate Bill Seeks to Guarantee Health Insurance Access, Enrollment and Portability to Missouri Uninsured
Senate Committee Substitute for Senate Bill 556, sponsored by Senator John Loudon, R-Ballwin, was heard this week in the Senate Health and Mental Health Committee. This bill seeks to guarantee health insurance access, enrollment and portability to all uninsured individuals in Missouri. According to the bill’s sponsor, the legislation is considered a “work-in-progress” (as evidenced by the bill language presented at the hearing — the twelfth version of the Senate Committee Substitute in two weeks, evolving to look very different from the originally filed bill). Senator Loudon claims this is the first major attempt at eliminating the estimated 700,000 to 800,000 uninsured in Missouri.
The bill would establish the Missouri Health Insurance Exchange (or “connector”) and the "Direct Payment Stop Loss Fund". The sponsor also is interested in providing a subsidy for the working poor, although details regarding funding and eligibility have not yet been determined.
Testifying for the bill were Vic Turvey, a former health insurance executive with United Healthcare Corp. and the Missouri Budget Project. Testifying against the bill were individuals representing most of Missouri’s insurance industry: the Missouri Insurance Coalition, Anthem Blue Cross, Blue Cross Kansas City, United Healthcare and American Family Insurance.
This bill shares some common elements with House Bill 818, which will be heard in a House committee next week.
Long-Term Care Partnership Proposal Wins House Approval
The House of Representatives this week gave first-round approval to House Bill 40. The bill would revise current state laws allowing those applying for Medicaid coverage of long-term care to exempt assets equal to the value of benefits paid under a private long-term care insurance policy. The program is called the Missouri Long-Term Care Partnership. Similar language is included in Senate Bill 577, which is legislation to redesign the Medicaid program and rename it as MO HealthNet.
The bill also provides for full state income tax deductibility of unreimbursed premiums paid for long-term care insurance coverage. Currently, 50 percent of such premiums may be claimed as a state income tax deduction.
Bill Denies Public Aid to Illegal Immigrants
The House Special Committee on Immigration voted to approve a House Committee Substitute for House Bill 889 this week. The bill prohibits illegal aliens from receiving any public benefits or assistance exempted as mandated by federal law. It also requires applicants for public benefits to demonstrate their citizenship status as part of their applications. Processes are established for allowing temporary benefits while citizenship information is being verified.
Public Health's Financial Health
The people who run public health departments in our cities and counties think it's time the legislature quit piling on the responsibilities without adding some money.
Local public health agencies are in charge of preventing and controlling communicable disease, providing immunization, making sure schools and child care centers are clean and safe, and assuring a safe food supply--and more.
Spokesman Jerene Huff with the Missouri Association of Local Public Health Agencies has told the Senate Appropriations Committee her and other public health officials also are on the front lines in dealing with chronic diseases and preparing for emerging infectious diseases, such as bird flu.
Huff says Missouri is a leader in so many ways but is 44th in in public health spending. She says local public health agencies are asked to meet their core functions with level or less funding while being asked to address new challenges of chronic and infectious diseases. She says state funding for state health agencies has remained level or decreased for the past seven years.
She says public health agencies are serving a rising population and an aging population. And she says a 28 percent increase in immigration since 2000 presents even more new challenges to public health agencies.
She says the core function public health dollar has been stretched to the limit. For example--she says flu vaccine that used to cost three-dollars now costs fifteen.
Huff says the state spends one-dollar-42 cents per person on public health in Missouri. She says agencies are losing ground.
[top of page]
|
