A New Day is Dawning in Jefferson City

House Floor Activity  Voter Photo ID
This week we passed a Resolution that will send to a vote of the people the question of whether the Missouri Constitution should be amended so that before voting, an individual would have to show a photo ID.  Seems pretty straightforward to me.  If you don’t have an ID, you would still be able to cast a provisional vote, to be verified by the clerk before your vote is counted.  If you cannot afford to get such an ID, one would be provided for you by the state free of charge.  To me it seems a quite reasonable requirement.  The right to vote is not universal, and there are those who cannot vote due to previous felony convictions, illegal status in the country, or if they are too young.  One must show a photo ID to do lots of things in our society now, and if requiring a photo ID before voting will prevent voter fraud we should do it.  Since this is a Resolution to put this to the vote of the people, one does not even have to favor the proposal necessarily to favor allowing the people to decide the matter.  In fact whenever there is doubt about what is in the best interest of the people or what the people would want, I believe it makes very good sense to bring it to a vote of the people for them to decide.  That is especially the case when considering such a fundamental and important issue as who gets to vote.

On Wednesday we were in session on three different occasions, from 10 am till noon, then from 4 till about 6 pm, and then we came back into session at 7:30 pm at which time we finally voted and passed this Resolution by a wide margin.  Therefore you, the citizens of the state of Missouri will have the chance to say whether you believe an individual should have to show a photo ID and prove who they are before voting.   I want to share something with you that happened on the House floor last night that I found interesting and you may as well.  Toward the end of the debate many of my democrat colleagues asserted that this will suppress votes, which I do not believe will be the case at all, unless you mean fraudulent votes, which of course will be suppressed, but that is the intention.  However, there was one Representative from the minority party, and I believe I will allow her to remain anonymous, who asserted several times in a row the accusation “ How Dare You!”, “How Dare You!” when referring to the offering of the Resolution in question about Photo ID.  I knew we were getting close to the final vote, and I knew that it would carry by a wide margin, but I just didn’t want those words to go unanswered, so I went to the microphone to be recognized.  I wanted to ask her a simple question, “If this issue goes to the voters and if they pass it by a wide margin, as I expect they will, will you then say to the voters “How Dare You?, how dare you make this decision with which I disagree?  Will you do that?  Alas however, I never got the chance, as a motion for the “Previous Question” was made and when that motion passed, debate ceased and we went right to the vote.  I am sure all of you reading this have had instances after a discussion with other folks when you later on said to yourself, oh I should have said this or that, and it would have been so fitting or appropriate.  That happens here too, but in the end, this Resolution was passed and providing the Senate passes the same Resolution, the citizens will get to decide this issue. When you cast your vote on this issue, remember there is at least one elected Representative out there who is saying, “How Dare You Put This To A Vote of The People”.

UPDATE:  I have just returned from the House floor on this Thursday morning.  We took up HJR 5 and HB 48, the voter Photo ID proposal for third reading and so I had the opportunity after all to address the “How Dare You” comment.  I pointed out to the body (that’s often how we refer to all of the Reps in the chamber) that the state of Indiana passed a Voter Photo ID provision that was decided by the Supreme Court to be Constitutional just a few years ago.  I also reminded the body of the “How Dare You” repeated comments by a member of the minority party.   I pointed out that this comment actually literally meant “How Dare You Let the People Decide If They Want Photo ID”, and I then followed that with my own statement “How Dare You Say ‘How Dare You Let the People Decide’ ”, and I closed.   We then third read and passed the measure. I want to be fair to those who have the opposing opinion on this matter but I cannot understand why anyone would say that it is wrong to put this or any other substantial question to the people.  Cost is perhaps a valid issue.  If you put every question to be decided to a vote of the people, it would bankrupt us eventually.  However, a fundamental issue related to preserving the fundamental cornerstone of our democracy, I believe that is worthy of going to the people for a vote.
Presentation to the Columbia Chamber of Commerce

Last week, I traveled to Columbia to make a presentation to the Columbia Chamber of Commerce about my position on the expansion of our state Medicaid program.   Favoring the expansion were representatives of the Missouri Hospital Association.  The Chamber was gathering information to try to make a decision about whether to support or oppose such expansion.  I made the presentation and listened to the opposing point of view.  Another interesting aspect of this job as your state Rep is that on this issue I was on the opposite side as those representing the Missouri Hospital Association.  However, the individual who made the presentation for MHA, Mr. Daniel Landon is a man who I know and have worked with quite a bit on an issue that we agree very much on.  Even before I was elected in 2010, I found that the process of licensing hospitals was very onerous, and repetitive and needed reform.  Those of you who have followed me previously know quite a bit about that issue. I like Daniel very much, and I believe the feeling is mutual.  When I arrived at the Chamber office, after brief introductions with staff, they were prepared to lead me off to a small annex type of room where they explained that I would remain until the presentation in favor of the expansion was completed by Mr. Landon and his associate.  Their fear, I believe was that this is a contentious issue and they did not want any ‘fur flying’.  From my perspective however, I was making a sacrifice in coming to make such a presentation, delaying my return to Rolla, and preparing such a presentation to assist them.  I let them know that I felt it was not necessary that I be sequestered and I assured them that if they inquired with Mr. Landon, since he knew me, he would have no objections to my presence, nor would I have to his during my presentation.  After brief discussions, all was settled, I thought, until Mr. Landon arose and was introduced and I was asked to leave the room.  However, the Chairman was brought up to date, I stayed, and all went very well.  While this is not a policy update for you, I thought you might like to hear about it as an ‘inside baseball’ account of what transpires in the day to day course of being your Representative.
NPR/ KBIA Interview & Round Table Discussion On Medicaid Expansion

This Monday, I left early to get to Columbia to KBIA radio station.  I had been invited to participate in a discussion about Medicaid.  Other state Reps from the area had apparently been contacted and suggested that I be contacted since this is an area I have been involved in.  The person providing the case for expansion of the state’s Medicaid system was Dr. Karen Edison, the director of Health Care Policy Research for University of Missouri, and a dermatologist. We had a good discussion, though it was apparent, that both Dr. Edison and the moderator were of the opinion that Medicaid should be expanded.  Each of us made the case for our position and point of view. You can listen to the discussion by clicking this link:
By the way I filed my Medicaid Reform Bill, HB 608 this afternoon, Thursday
Capitol Visits

Rolla Technical Institute and Rolla Technical Center Celebrates Career and Technical Education Month. Student and faculty representatives visited the Capitol this week. Pictured above are Libby Oldham, counselor; Estaban Ortiz, SkillsUSA; Connor Melzer, HOSA; MaKayla McCurdy, DECA; Taylor Strain, FFA; and Stephani Broyles, Director.

Douglas Williams, Executive Director and Becky Wilson, Community Transition Specialist from Tri-County Center for Independent Living came by my office Wednesday. Tri-County Center for Independent Living is a not-for-profit organization designed to assist persons with disabilities achieve and maintain as much independence as they wish in the setting of their choice. Wilson shared with me a story where she had assisted a gentleman that had been living in a nursing home transition to a home of his own. They can assist those that qualify back into their own home, a lease home, or even residential housing with no more than four individuals living in the home. For individuals receiving benefits from MO HealthNet, the program Money Follows the Person (MFP) not only reintroduces the individual back into community living, but saves the state money. When a person no longer requires the support of a nursing home, many supports can be supplied through basic community services, such as home delivered meals and Homemaker/Chore Services, while freeing up dollars from the overstrained system we know as Medicaid. It also places people back into the community where they are generally much happier and healthier.

Freedom of the Road Riders were in the capitol on Tuesday for their Lobby Day. A few from our district visited as well. They are Lobbying on behalf of the helmet bill that was filed again this year.

Health Care Policy Committee  HB 47 & 72

At the first meeting of the Committee on Health Care Policy, I served as chairman of a House Committee for the first time.  We heard two bills related to Tanning beds.  HB 47 introduced by Rep. Gary Cross and Co-Sponsored by me as well, provides that an individual 16 years of age or younger needs to have permission from a parent to go to a tanning bed.  In addition, we heard HB 72 introduced by Rep. Jay Barnes that would make “any person under six years of age who uses a tanning device in violation of this section or any guardian of a person under six years of age who knowingly allows his or her child who is under six years of age to use a tanning device in violation of this section shall be subject to a fine of one thousand dollars for each violation.  Every use of a tanning device in a tanning facility in violation of this section is a separate offense.”

I was very pleased with the hearings and the quality of the testimony was generally quite good.  We heard from a medical student who told her story of her high school years when she tanned at every opportunity and she told us of how during medical school she came to learn the harmful and potential deadly effects of UV rays.  She provided a great deal of evidence and research results regarding the increased risk that comes with increased exposure to UV rays.  Her testimony was then followed by the testimony of a 2nd year resident in Dermatology at Washington University School of Medicine.  Her testimony was also very astute, and I told the committee members that I felt like I was back in medical school when we joked about trying to learn all the info was like trying to drink from a fire hose.  Next Dr. McEwen, a Dermatologist testified and in my opinion did a wonderful job of distilling all this information down to an understandable summary.  He also added his personal experience that this week already he had removed 4 malignant melanomas from the skin of patients in his dermatology office.  We learned that the rate of skin cancers is increasing at an alarming rate in young women aged 19-27.

We then heard extensive testimony from the opposing side, which as you might expect were representatives of and owners of tanning facilities.  While they had much to say to refute some of the medical evidence, they stated that they were not really opposed to the requirement that consent be obtained from parents for teenagers age 16 or less.  Their main concern was that they did not want the form that is to be developed by the department of health to misrepresent any facts and scare people from what they consider to be reasonable use of tanning facilities.

To put these bills in context, I believe the bill to require consent from a parent for a person age 16 or younger will have broad support in the House.  While I of course see no need for a 6 year old to use a tanning bed, I am not as certain that the provisions of this bill will be as broadly supported.  Imposing a misdemeanor charge on a 6 year old as well as the parent, and imposing a $1,000 fine for each violation would be a large amount of money.

This makes me think of a piece of advice that was offered by a member of the legislature a few years ago who admonished, “You don’t have to go after every barking dog, just the ones that are biting you”.  I don’t think that we have a problem with people taking their 5 year olds to tanning beds, but I think that enacting the requirement that anyone 16 or younger have consent of their parents will go a long way toward raising the level of awareness of the potential harmful effects of excess exposure to UV rays and could possibly prevent some cancers in the future.

I did not take a vote on either of these issues since we just heard them, and I prefer to allow the committee members time to do further research, get more info from the stakeholders and just give the matter some thought.  We will likely vote on this issue next week.

Committee on Professional Registration
HB 314 Nurse Practitioner Expansion of Scope of Practice

I sit on this Committee, but it meets at the same time as my Committee on Health Care Policy, of which I am the Chairman.  This creates conflicts, as you might expect.  This week, I was aware that an important bill would be heard in the Committee on Professional Registration and so I decided to commence my Health Care Policy Committee at 1:00 pm instead of at noon.  Therefore I was able to sit in on the hearing of HB 314, dealing with nurse practitioners and their desire to practice without the current requirements for working closely with a licensed physician.  We heard nurses tell us that they were every bit as qualified and capable to practice medicine as their physician collaborators.  We heard that we will need to expand the scope of practice of Nurse Practitioners due to the effects of ObamaCare and the increased demand for medical care.  We also heard from physicians and medical organizations that pointed out the differences in training, which I knew to be very great.  For instance, the requirements to become a licensed physician, either MD or DO, as it requires 4 years of medical school, followed by 3-7 years further training under more experienced doctors during residency. This compares to 18-24 months of training for a nurse practitioner, after getting his or her nursing degree, much of which can be accomplished online while still working as a regular nurse. There is no requirement for any residency. The amount of time spent in clinical training, taking care of patients for nurse practitioners is from 500-720 hours and for DO’s and MD’s it is 12,000 to 16,000 hours.

I have two children and a son in law that either have completed medical school or are in the process of doing so.  The very difficult nature of these studies is hard to overestimate.  The time commitments are extreme.  In fact it was just in the last few years that the amount of time that a doctor could be required to work per week during residency was limited, and the limit placed was 80 hours per week- it’s like having two full time jobs!  This goes on for years after medical school.  It’s hard, but you learn a lot.  One physician who testified stated that you never learn everything you would like to learn, but you are much better prepared after all of those years than you were when you were first starting out.

I have worked with both Nurse Practitioners and Physician Assistants and value them as members of the health care team.  I believe they can play a significant role in accomplishing our goals of increasing availability and quality of medical care as we go forward.  This is best achieved, however, by working as a team with the most highly trained individual, the physician, acting as captain to coordinate care and serve as a resource not only for patients but for other providers in the team of health care workers working together.  So I am not opposed to working with these individuals, often referred to as physician extenders, I just oppose giving someone the same rights and responsibilities as a physician when they have not gone through 10 % of the rigorous training of a physician.  Patients are better served if they see a NP or PA who is working with a doctor.
We did not vote on this bill during the meeting of the Professional Registration Committee.
Committee on Higher Education

On Tuesday morning, we heard HB 312, introduced by Rep. Mike Thomson which will allow for traffic regulations to be enforced on our college campuses.  Currently there are some of our college campuses where the traffic regulations have no force of law; the campus police have no ability to enforce even stop sign requirements.  This bill would fix that oversight by allowing the campuses of our state colleges and universities to enforce traffic laws the same as if they occurred on our public streets or roads.  
Final Thoughts

That’s all I have for this week.  I want to know your opinions on issues and proposals.  I hear from a lot of people from around the state, but the priority for me is to hear from and be connected with you, the people of the 121st district.  For those of you who are new to my district, the northern half of Pulaski county, please know that I want to hear from you and get to know you and represent your views.  In addition, I have gotten a fair amount of email regarding all of the gun laws that are swirling around this place.  Please know that I will fight to protect your 2nd Amendment rights with fierce tenacity.  Guns are not the problem; bad guys with guns are the problem.  I just became a lifetime member of the NRA, I previously just renewed every year or two, but I knew I would hold beliefs in common with the NRA the rest of my life, so I decided to become a lifetime member.  By the way, the NRA has a promotion right now, till then end of February, which offers a Lifetime Membership (normally $1,000) for $300.  I know that is still a lot of money, but in the past when they have runs specials on Lifetime Membership, I believe the rate has been $600, this is the first time I have seen it available for $300.  Please be aware, I will oppose efforts to infringe on the second amendment and your right to keep and bear arms.  There will be more on this as the session goes on, and I discussed this at length in a previous Capitol Report.

I am saddened by the premature death of my niece Ms. Bridgett Anibal, an absolutely wonderful, sweet person who fought a short battle with lung cancer and passed away last evening (Wednesday).  Your prayers for her parents and family will be much appreciated.

If you know of someone else in the district that would like to get this Capitol Report, please forward this to them and encourage them to email back to me and I will ask my Legislative Assistant, Joyce to get them on the Capitol Report Distribution list.

Visiting the Capitol

I always enjoy it when constituents visit the Capitol. If you ever find yourself in or around Jefferson City at any time during the year, please feel free to visit us.