As I told you in my previous Report, my legislative assistant, Joyce Bush, lost her husband John last week. At the funeral parlor, I was glad to see that she was surrounded by loving family and friends from whom she undoubtedly derived much comfort. Our prayers remain with her during this difficult time. She tells me she plans to return to her duties with me here in the Capitol just after our spring break next week. I am very grateful for the assistance of many of her friends here at the Capitol who have helped me stay on schedule during a very busy time here. In particular MaryBeth Bruns, Meghan Travis, Amy Volkart, and Liz McCrory have done a terrific job while Joyce was away.
You will notice the lack of photos in this week’s report. I usually like to add a number of photos to break up the sometimes lengthy detailed descriptions. This week, some things went to the back burner and photos were one of those. Next report, back to some photojournalism. In fact Liz McCrory, the intern from Mizzou who is working with me is a journalism major and in future editions we plan to include some video to embed in this report. It won’t work well for reprints but for those of you reading this at your computer, you might find it a nice break from continual paragraphs.
Another week has flown by, the snow has melted and one can imagine spring is just around the corner. This week was again a busy one. On Monday we heard from our State Auditor Tom Schweich. He spoke to us about his office and how he is directing things to assure that our government agencies are being operated in an honest and efficient manner. I won’t bore you with many details he imparted to us about the Auditor’s activities. However, I found one aspect of his presentation particularly interesting. He was talking about indicators in an organization that embezzlement may be occurring. He named three conditions or observations that if all were present would indicate a high suspicion for shady activity, and a high risk for embezzlement. The first red flag is that if one person handles all aspects of the monetary flow in the organization. If the same person takes in the money, records its receipt, makes the deposit, and pays the bills, with no one else involved in these transactions, which is a red flag. The second indicator involved vacation time. Yes, if an employee does not take vacation time, which is an indicator that something could be amiss. Upon reflection, this makes sense, if you are away, then someone else will be looking over the books, entries, etc., and an irregularity previously undiscovered could see the light of day. The third indicator is that if this person who is in control of the financial flow of the organization and who does not take vacation has a tendency to provide expensive gifts to the other members of the organization. Apparently if these three indicators are present, frequently there is embezzlement of funds going on.
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HOUSE FLOOR ACTIVITY
This week on the floor the body heard a multitude of important bills pertinent to the personal freedoms of the citizens of the state of Missouri. Speaker Tim Jones led this charge with his bill, HCS HB 457, a shield for medical professionals to exercise their conscience rights. The bill serves to protect them from participation in medical procedures or research that violates their religious, moral or ethical beliefs. Major advances in the medical field and the looming encroachment of Obama Care, are forcing health care providers to face the daunting task of providing the best care possible while preserving their right to follow their beliefs that they hold sacred. HCS HB 457 was Third Read and Passed with an overwhelming bi-partisan vote of 116-41 and now moves to the Senate.
Best Practices for our Rural Counties and Schools
Too often our schools and other public facilities face tough decisions on whether or not to authorize spending on maintenance costs. It would seem simple enough, but Missouri’s existing law requires that even simple maintenance like painting is subject to prevailing wage laws. Moreover, our rural areas are often bound to prevailing wage rates that more accurately reflect urban rates. Should your local elementary school be forced to pay $35 an hour to paint a wall? Would they? They likely wouldn’t until the problems are so severe that they demand action.
This is the heart of the problem we’ve attempted to address this week: allowing public entities to maintain their facilities on a timelier basis. The end goal is to increase workplace safety for our public employees and students and to also minimize the distraction to our students that crumbling infrastructure causes. In our reforms, we’ve also included new construction so that local school districts and public entities can get more “bang for the buck”, which will add value to your hard-earned tax dollars. This is a common sense reform and I’m glad to see the conversation move from the House and now to the Senate for action.
Giving You the Choice on Your Paycheck
Each pay period, our union members have dues deducted from their paycheck. These dues fund a variety of purposes, but they often find their way into partisan politics. With Missouri being a “closed shop” state – meaning you must join the union to be employed if there is a union – employees have absolutely zero choice in their money being spent on political activity. This is wrong.
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HB 64, sponsored by Rep. Eric Burlison, proposes a simple solution – if an employee consents annually in writing for their dues to be utilized for political purposes then that amount can be deducted from their paycheck. This is the same process that many of us utilize to help fund charitable institutions that perform work we care about. We feel that a simple acknowledgment from the employee should be asked and received before a portion of their paycheck is redirected from their pocket to a partisan political cause. This legislation must move forward in the Senate, and I look forward to it becoming the law of the land.
Conscience Rights of Medical Service Providers
On Wednesday the House advanced legislation to recognize and defend our individual freedom of conscience. Our conscience serves as an internal system of self-guidance—a private radar through which only the individual judges and discovers his or her truest thoughts and feelings. Therefore, the ability to abide by one’s conscience must be protected. This week we answered the call of thousands of workers in the medical field who do not want to be forced to perform or participate in procedures or research that infringe upon their beliefs.
HCS HB 457, sponsored by Speaker of the House Tim Jones (R-110), is a shield for medical professionals to exercise their conscience rights. It serves to protect them from participation in medical procedures or research that violates their religious, moral or ethical beliefs. Major advances in the medical field and the looming encroachment of ObamaCare, are forcing health care providers to face the daunting task of providing the best care possible while preserving their right to follow their beliefs that they hold sacred.
HCS HB 457 was Third Read and Passed with an overwhelming bi-partisan vote of 116-41 and now moves to the Senate.
Committee on Higher Education
This week in Committee we heard a bill that would change the name of Linn State Technical College to State
Technical College of Missouri. The bill would become effective July 1, 2014. As an example of being fiscally conservative. The College would use up existing stationery and brochures, etc., and fund any permanent changes needed from private donations. The cost to the state, which we refer to as the fiscal note associated with this bill, is therefore $0. We look closely at bills that spend the taxpayer’s money. We still look closely at those with no fiscal note to assure that no onerous provisions fall on our citizens or have other unintended consequences. I inquired if any alumni would object to the name change and if that could possibly have a negative effect on future donations to the college. The College President assured us that the alumni supported the name change, and that alumni who wanted an updated diploma could, at their own expense, have one created for them with the new name of the institution. This bill was passed unanimously out of Committee “Do Pass” and as a consent status bill.
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Committee on Health Insurance
This week we heard HB 131, and 132 related to eating disorders and health insurance coverage for this condition. We heard from those afflicted and from their family members. The Committee came to understand that all too often this condition ends up with the tragic death of a young lady. We heard from the insurance industry that is striving to keep premiums down so more people can afford health insurance and we heard how difficult it is going to be for people as insurance premiums spike in response to ObamaCare in the very near future. At the conclusion of testimony and deliberations, we ended up requesting an actuarial study of the financial impact of requiring that insurance cover a full scope of treatment for eating disorders. This is actually required in statue before we make a decision on a so called mandate for coverage. There is also a provision in ObamaCare that if we require a mandated coverage in Missouri that is not a part of ObamaCare’s Essential Health Benefits package, and then the state will have to pick up the tab for the excess cost.
Committee on Health Care Policy
This week we heard 4 bills and voted on 5 bills:
We heard HB 400, introduced by Rep Riddle that prevents medication induced abortion when the interaction between the patient and the doctor is only by webcam. This was a potentially very explosive topic to take up in Committee due to the nature of the issue and the passion that flows on both sides. I prefaced the Committee’s deliberations with some remarks that reminded them that the explicit purpose of HB 400 did not deal with the legality of abortion that has been established many years ago. It dealt instead with how such abortions shall be conducted, and especially if we are to permit them to be done when the interaction between the doctor and the patient is only via webcam. We heard testimony on both sides, and everyone was very respectful, measured, and proper decorum was maintained. I gave the Committee, the public present and the witnesses’ accolades for conducting a public hearing in an upstanding fashion even though there was great disagreement on the topic. In the end we voted this bill out of Committee “Do Pass” by a wide margin. We also voted “Do Pass” Rep Koenig’s bill HB 177, and Rep McCaherty’s HB 386 also dealing with abortion. A member of the minority party had previously presented a bill to our Committee that dealt with the use of ultrasound before abortion, HB 298 sponsored by Rep Keith English. Rep English is opposed by a large number of his colleagues in the minority party for his sponsorship of this bill, but it does represent a bipartisan approach in these areas where collaboration has been infrequent. We welcome his involvement and support.
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We heard HJR 19 which can be reviewed here: 19http://www.house.mo.gov/billtracking/bills131/billpdf/intro/HJR0019I.PDF
This Resolution asserts the rights of citizens of Missouri to purchase health of their own choosing and to be free of mandates from the federal government as it relates to their choices regarding procurement of health care services, and the purchase of health insurance. Anyone who is familiar with my position on the 10th Amendment and states’ rights, and ObamaCare knows I strongly support this bill. A section of the bill is copied below:
Section 35. 1. That the liberty inherent in each citizen includes autonomy in
decisions regarding lawful health care-related services or products and the manner in
which contracting parties may agree for payment to be made for such services or products.
employer, or health care provider to participate in any health care system, or to impose any
sort of direct or indirect penalty, tax, fee, or levy for choosing not to participate in such a
system; nor shall any government official or agency make a citizen's right to offer or accept
direct payment for lawful
The Committee on Health Care Policy, which I Chair, received over 400 witness forms from concerned citizens around the state in support of this bill. We will vote on it after the spring break.
HB 351 Hospital Licensure
I was able to present my bill, HB 351 which I have sponsored for the last two years. This bill seeks to streamline the process by which the state licenses hospitals in Missouri. The process now is often very repetitive since the state and the Federal Government both inspect hospitals. The Center for Medicaid and Medicare Services of the Dept. of Health and Human Services of the federal government inspects hospitals for their participation in the Medicare and Medicaid programs. They accept the accreditation of an organization called the Joint Commission which carries out lengthy and in depth inspections of hospitals. The overlap can mean redundant and non-productive inspections that cause hospitals and our state department of Health and Senior Services to waste critical and scarce resources. HB 351 has been crafted to meet the needs and concerns of all of the stakeholders, including the department in our state responsible for licensing and inspecting hospitals and thereby assuring a high quality of service for patients in our state. This year, after the Committee heard all the testimony, HB 351 was not only unanimously voted “Do Pass”, but was voted “Do Pass by consent”, which is reserved only for issues and bills that are of a non-controversial nature, do not cost the state any money, and have no civil or criminal penalties. While being voted out of committee Do Pass by Consent does not assure that it will make it through the process, it is a good course of events. It now has to be considered by the Senate where negotiations have been underway for some time. I will keep you posted on this bill since it was a bill that I envisioned even before I was elected, as I had observed the need for such reform from my experience in hospitals over the years.
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Of course this continues to be a topic of discussion here at the Capitol One argument that I have heard that is particularly misleading is the assertion that if we don’t take the money from the Federal Government, then some other state will get it. This is to contend that if we do accept the federal money, then as a consequence, another state is going to be deprived of funds that they would have gotten from Missouri. That is simply not the case. In order for funds to be released to a state for their Medicaid program, people have to be enrolled in the program, and then services have to be provided for those individuals. Then the federal government provides money to match what the state spends, at around a 60/40 split with the federal government picking up the larger percentage. If a state enrolls more people than expected, or provides more services to those individuals than projected, they will still get the matching funds from the federal government, whether Missouri participates in the expansion or not. There is no extra bucket of Missouri money that other states will divvy up. In fact since this extra spending is beyond what our federal government takes in as taxes, this money provided to expand Medicaid has to be borrowed. Missouri by not causing the federal government to outlay more money (that it does not have) will lower the amount of money that the federal government will have to borrow, and thereby diminish the amount of the national debt. (currently 16.5 trillion dollars) If all of the states would refuse this money, it would amount to about a half a trillion dollars, not an insignificant amount. The budget put forward in Washington, D.C. by Rep Paul Ryan balances the budget in 10 years, and eliminating the cost explosion of ObamaCare is one tool that helps accomplish that. If we decide not to expand Medicaid in Missouri, in my view it is Missouri’s way of working toward the same goal. I have written much more on this topic and if you want to view it, click on this link :
HB 324- Medical Records
On Wednesday, I also presented HB 324 to the Committee on Health Care Policy. This bill adjusts the allowable cost for reproduction of medical records. It’s a boring topic, but this was a necessary change to update a previous modification that was made to take into account electronic medical records. Two years ago we changed the amount that can be charged to reproduce records, and limited the amount that could be charged for reproducing them in a digital format. Unfortunately the cap on this fee was $25. Facilities actually doing this work found that even though paper is saved, the cost of staff time to reproduce an extensive hospital medical record in digital format was much more than $25. Therefore, they have resorted to producing them in a hard copy format which is reimbursed at a higher level. This defeated the purpose of the original law. We did not vote on this bill, and will take it up after break. No one testified against it.
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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.
For more information regarding any specific piece of legislation, please visit www.house.mo.gov .
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.