There was plenty of hot coffee to go with the side orders of biscuits, eggs, bacon and politics at the annual Rolla Area Chamber of Commerce “Eggs and Issues” breakfast, held Tuesday morning at Matt’s Steakhouse.

There was plenty of hot coffee to go with the side orders of biscuits, eggs, bacon and politics at the annual Rolla Area Chamber of Commerce “Eggs and Issues” breakfast, held Tuesday morning at Matt’s Steakhouse. Joining county and city officials, interested citizens and business owners, were speakers Sen. Dan Brown R-16, Rep. Keith Frederick R-121 and Rep. Jason Chipman R-120.
The event was hosted by CenturyLINK with Doug Galloway, director of governmental affairs, Southern Region, handling the introductions with a quick update about broadband internet service in rural Mo.
“This year, we will be spending over $100 million in capital investments in Missouri, alone,” said Galloway. “Here at the Rolla exchange, we are in the final stages of offering broadband under the SEC’s Connect America program, with over 2,080 new locations in these high-cost, underserved areas where broadband was not offered by anyone in Phelps County.” The company also installed 215 miles of fiber optic cable. Galloway said CenturyLINK will be offering broadband to 61,000 new locations across the state by the end of this year, with an additional 92,000 over the next three years. He then introduced Sen. Dan Brown, the first speaker to address the crowd.

Sen. Brown, who is chairman of the Committee of Appropriations, has one more year to legislate due to term limits. He gave the two state representatives credit for helping him stay abreast of the local issues. Brown said uncertainty in Washington is making it hard to legislate.
“Going forward, we don’t know how the federal government is going to send the money we get from them now,” explained Brown. As an example, he said, “Republicans have advocated they wanted Medicaid and these bigger ticket items, slimmed down in the form of block grants.” I told some of my colleagues, be careful what you wish for, because you might get it—and it might come with a 30 percent cut.”
Brown said he tries to be careful to not pass something in Jefferson City that might eventually cost counties and cities more money, “if we’re not willing to fund it as a state.” He added that it’s not a good place to be in (responsibly speaking) because there hasn’t been a federal budget in eight years. He pointed out that Mo.’s budget (Mo. has to have an annual balanced budget by law) is around $27.5 billion and that a third of this comes from the federal government in the form of taxpayer dollars. He alluded that higher education and health care decisions are affected by the strings that bind Mo. to Washington.
A large amount of that goes to the Medicaid program,” he said. “We currently have over 1 million people on Medicaid, while the whole (Mo.) population is about six million. “We (Mo.) pay 40 percent and the fed pays 60 percent—most states, it’s 50/50. “There will probably be a real adjustment if we go to a block grant system, and that means we will have to raise the eligibility requirements to reduce that number [of people on the program], because the state won’t have the money to pay for it.
Sen. Brown said there will probably be another special session called to fund provider rate cuts, both in nursing homes and home care, which experienced hard budget cuts.

Rep. Keith Frederick was the second speaker. He said it was a pleasure to have been serving seven years and wants to make some headway with the scourge of opioid addiction in the state. One initiative he wants to re-introduce this year will have some help due to additional legislation passed this year.
“We’ve established a new physician license category called “Assistant Physicians,” he said.
These are mid-level practitioners that have graduated from medical school. He said there aren’t enough residencies to go around and these students are carrying six-figure debt. Rep. Frederick and others saw this as a way to use the talents of these students that couldn’t find a residency to continue their practice.  
“As we approach this whole opioid addiction epidemic, we need a work force, people out there in the trenches to work with these folks that need addiction services,” he explained. “That’s one way of attracting new health care workers to our state. I’ve encountered a number of these people and they are eager and anxious to come and work with us.”
Rep. Frederick said the second initiative is something called “ECHO”—Enhanced Community Health Outreach. “It was pioneered in Mexico for the treatment of hepatitis in the rural communities,” he shared. “It was a way of getting information in the tertiary care centers out to the rural areas to support child practitioners to be able to diagnose and treat complex problems.” In the case of drug addiction, he said, “our division of mental health has developed an opioid addiction course curriculum, to support opioid addition treatment in our state.”
He also discussed medication assisted treatments that allow a patient to function by controlling the cravings of opioid drug dependency. Rep. Frederick referred to an article in the St. Louis Post-Dispatch concerning the limitations of assisted treatments in Missouri.
His proposal is to use assistant physicians in conjunction with addiction specialists and using the ECHO program to establish clinics in rural areas—perhaps even partnering with private industry.
“If we can provide these treatment options, in all 114 counties in our state, we can then start to make an impact,” he noted. He says it’s just expanding treatment with what is currently working and avoiding the NARCAN cycle—the commercial drug that helps to prevent an opioid overdose—only to be needed again for a repeat overdose, the result of addictive and habitual behavior.
“I’ve been involved in a lot of non-health issues, but I think my forte is . . . as only one of two doctors in the House . . . is to deal with these health issues.
Rep. Frederick said another proposal he is working on is for medicaid reform.
It uses health savings accounts, with the amount of funding available to be based on an individual’s condition. It also involves a mechanism of personal responsibility, to manage the money they have in their account, with some control over the health care provider and cost of a procedure.
The final speaker, Rep. Jason Chipman, wanted to discuss a bill he carried that dealt with minimum wage.
“It shows supply and demand,” he explained. “You raise the cost of labor, all the other costs go up too. History has shown, time and again, you raise the cost of labor and you leave some people out, making it impossible for them to get a foothold in the labor market.” He referred to a study in Seattle that was conducted after the minimum wage was raised in that city. This resulted in workers that had hours cut and jobs were lost for an across the board decrease in take-home wages.
He spoke of other successes such as funding the formula for schools for the first time in the history of the funding process, which is to say the state is fulfilling its financial obligation to public schools.
Rep. Chipman said the legislative process is challenging and encouraged the audience to stay involved, because the more he is informed by his constituents, the better job he can do to help with their concerns.