Legislative update: Drug monitoring program faces showdown

Editor’s Note: Below are articles on recent Missouri General Assembly moves provided to Springfield Business Journal by the Missouri Press Association.

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Showdown looms over prescription drug monitoring program
Even as a Senate committee approved a proposed prescription drug monitoring program, a potential showdown on the bill's fate was playing out behind the scenes.

House Bill 90, sponsored by Rep. Holly Rehder, R-Sikeston, would create an electronic log that monitors prescription drug users through physicians and dispensers.

In an April 6 hearing, Rehder presented her bill to the Senate Transportation, Infrastructure and Public Safety Committee. The committee fast-tracked the bill, passing it 7-0.

The bill passed in the House two weeks ago and will now go to the Senate floor, where it was previously expected to receive strong opposition from Sen. Rob Schaaf, R-St. Joseph. Schaaf has successfully stalled progress on PDMP plans in past sessions, citing privacy concerns over putting people's sensitive medical records into a database that could be hacked.

Schaaf announced in a press conference on April 4 that he would retract his opposition to the bill, but he included a condition: an amendment to the bill mandating that physicians use the program. "I won't block the bill if that amendment is on there," Schaaf said during the hearing.

Sen. Dave Schatz, R-Sullivan, will handle the bill in the Senate. He said he plans to propose an amendment that would create such a mandate.

The April 4 announcement came as a surprise to Rehder, but she hasn't voiced opposition to the potential amendment.

In an interview last week, Rehder said that the wording of a doctor mandate is key.

"We don’t want to get in between our physicians with their patient care," Rehder said. "This is a clinical tool. It does not need to be turned into some form of, you know, ‘Oh well now we’re worried about all the doctors, if they’re checking the database as often as they should.’ We need to allow some of the medical decisions to be in the hands of our doctors."

The mandate has received opposition from the Missouri State Medical Association, which previously testified in favor of the bill.

Lawmakers consider ranking Missouri hospitals for neonatal care
Expectant mothers in Missouri would be able to compare the level of care available at hospitals statewide if lawmakers approve a bill requiring maternal and neonatal rankings.

Under House Bill 58, Missouri hospitals would be given rankings in regard to the ability of the facility to treat varying levels of risk in the maternal and neonatal care they can provide, with Level 1 being the most basic and Level 4 the most specialized in high-risk pregnancies. These levels would be determined by already established risk-level standards set by the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists.

"We’ve done the same with identifying levels of care for stroke patients, for heart patients, trauma centers; why not for prenatal?" said Rep. Marsha Haefner, R-St. Louis, the bill’s sponsor.

Haefner's bill passed the House and now needs Senate approval.

Haefner said Missourians would access this information online and then be able to determine with their physicians which hospital would best meet the needs of the pregnancy. In addition, the bill also cites the ranking processes would not take into account counseling for pregnancy terminations or referrals for pregnancy terminations.

"It was important to me that this process had nothing to do with counseling or referrals for abortion," Haefner said. "That it’s strictly, if you have identified the problem (with a pregnancy), these are your options for levels of care, not to take it a step further and be able to counsel or give referrals for abortions."

After chiding, MU system avoids further cuts in House budget
After a firm scolding, the University of Missouri system escaped further punishment from lawmakers on April 4.

One of the largest lines in the higher education budget is the MU system, which had a bullseye on its back during this tight fiscal year. Many lawmakers nocked their arrows and aimed at the MU system to try and move money to other, smaller programs. They all missed their mark.

As bill amendments were debated on the House floor, many lawmakers voiced their displeasure with the system. They cited a state auditor's report that was critical of $2 million in bonuses and voiced long-simmering frustrations with the system. Despite the complaints, several lawmakers argued cutting money from the system now would be like beating a dead horse.

House Budget Chair Rep. Scott Fitzpatrick, R-Shell Knob, said any more money beyond the $50 million already slated to be cut would be "beyond punitive deductions" and that making additional cuts would create more pressure to raise tuition.

Rep. Mike Moon, R-Ash Grove, proposed two amendments that would have stripped money from the system. One would have moved money to a program meant to attract older adults to Missouri. The other would go toward a program that helps families cover child care costs.

Even though both amendments failed overwhelmingly, they sparked intense reactions from lawmakers across both aisles in the House.

"This nonsense has to stop,” said Rep. Donna Lichtenegger, R-Jackson. “The university has heard what we have said to them. Let’s give them a chance to turn themselves around."