MHPCA Legislative Update 3.3.17
Jane Moore
COMMITTEE HEARINGS OF INTEREST
Subcommittee on Scope of Practice
The speaker’s Subcommittee for Scope of Service meet this week to discuss allowing advanced practice registered nurses (APRN) also known a nurse practitioner to practice at the highest level of their education and certification, making
Missouri a full practice state. Representative Tila Huebrecht lead the discussion before the committee on the importance of improving Missouri’s health care and APRN’s role in that. Missouri has fallen to 36th in the nation on health treatment and ranks 40th
in residents with healthy lives. Currently, there is no license for APRNs, they are only specialized by an accreditation, even though they are required to have a doctorate degree. There are 38 states that are less restrictive than the State of Missouri.
Numerous witnesses from the medical profession came forward to offer informational testimony. Although their testimony was centered around the removal of current guidelines of three APRNs per doctor within 50-mile radius, the big issue seemed to center around
providing adequate healthcare for rural areas. there is no study that shows that a mileage restriction harms or helps healthcare. Missouri is suffering from a shortage of physicians and cannot produce new ones expediently, more specifically psychologists.
In addition, Missouri is losing APRNs to other states that are full practice states.
States that have become full practice states have shown lower cost to care and better health. According to recent studies, the placement of nurse practitioners within nursing homes lead to a reduction of 42 percent in unnecessary transfers and a decrease in
expenses of 66 percent.
Among those offering testimony were the Missouri Association of Nurse Practitioners, Missouri Coalition for Missouri Healthcare, Advocacy for Missouri Nurses Association, United Health Care, Representative Frederick and advanced practice nurse practitioners.
One person spoke in opposition stating that they do not see the other side, where mileage restriction and record review saved lives. He ended his testimony by stating they respect the relationship between Physicians and APRN.
House Appropriations for Health, Mental Health and Social Services.
On Wednesday, Rep. David Wood’s committee met to make their recommendations for HBs 10 & 11 to full budget committee. Major changes included 2% reduction in administrative lines across divisions in DMH, DHSS and DSS, decreases to new dollars toward MMIS, reductions for dual eligibles under the MORX program, physician services and hospitals lines to help fund increased dollars toward home and community-based programs and nursing homes to bring the equity point changed back down from 27 points to 24, and the addition of the foster care outdoor program.
The committee is expected to present their changes to the full budget committee next week.
House Health and Mental Health Policy
This week the House Committee for Health and Mental Health met to hear public testimony on four bills. The first bill presented was House Bill 435, sponsored by Representative Neely. This legislation would legalize medical marijuana to
treat epilepsy or irreversible debilitating diseases, in which will be determined and published by the department. This is the eighth year the General Assembly has taken up legislation in efforts to legalize medical marijuana. Those testifying in favor include
Dr. Adrianne R. Poe, Heidi Rayl, Jim Tabor, Josh Schisler with The Abigail Alliance For Better Access To Developmental Drugs, Kathryn Kwalski, Mike Sharp and Wayne Lee. Those testifying in opposition include Eric Zahnd with Association of Prosecuting Attorneys,
Jason Grellner with Missouri Narcotics Officer Association, Kurt Wilkens, LCSW and Angela Bonine with Act Missouri.
COMING UP…
On Monday, the House Budget Committee will be hearing public testimony on HCB 3 relating to funds for vulnerable senior citizens and to discuss the elimination of the Senior Citizen Property Tax Credit.
On Wednesday the Senate Appropriations Committee will walk through the Governor’s recommendations for the Department of Social Services.
Upcoming Dates of Interest
March 20th - 24th - Legislative Spring Break
April 1 - Last day to file House Committee Bills
May 5th - Appropriation bills must be TAFP
May 12th - Final day of session
July 1 - First day of Missouri’s new fiscal year (FY 2018)
Hospice
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Appropriations Bill |
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Track Name(s): |
Hospice |
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Bill History: |
02-23-17 H Referred to House Committee on House-Budget |
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Exempts health care entities registered with the department of health and senior services that distribute hypodermic needles or syringes from the crime of unlawful delivery of drug paraphernalia. |
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Track Name(s): |
Hospice |
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Bill History: |
02-08-17 H Public hearing completed |
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Establishes the Narcotics Control Act. |
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Track Name(s): |
Hospice |
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Bill History: |
03-06-17 H Set on the House Calendar |
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Establishes the "Missouri Right to Shop Act". |
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Track Name(s): |
Hospice |
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Bill History: |
02-22-17 H Public hearing completed |
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Establishes the "Patients First Medicaid Reform Act". |
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Track Name(s): |
Hospice |
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Bill History: |
01-05-17 H Read second time |
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Establishes the "Designated Health Care Decision-Maker Act". |
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Track Name(s): |
Hospice |
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Bill History: |
02-27-17 H Referred to House Committee on House-Rules-Legislative Oversight |
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Modifies provisions relating to expert witnesses. |
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Track Name(s): |
Hospice |
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Bill History: |
03-06-17 S Set on the Senate Calendar |
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Establishes a limit on residential property assessment increases for the elderly and disabled who own and live in their principal residence proportional to the increase of their Social Security benefit. |
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Track Name(s): |
Hospice |
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Bill History: |
03-02-17 H Referred to House Committee on House-Rules-Administrative Oversight |
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Changes the Uniform Arbitration Act regarding agreements between employers and at-will employees. |
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Track Name(s): |
Hospice |
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Bill History: |
03-06-17 H Meeting set for 1:00 PM, HR 6 - House-Litigation Reform |
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Changes provisions relating to advanced practice registered nurses. |
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Track Name(s): |
Hospice |
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Bill History: |
01-25-17 H Referred to House Committee on House-Professional Registration and Licensing |
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Creates the Silver Alert System to aid in identifying and locating a missing endangered person. |
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Track Name(s): |
Hospice |
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Bill History: |
01-24-17 H Public hearing completed |
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Changes provisions relating to the scope of practice for physical therapists. |
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Track Name(s): |
Hospice |
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Bill History: |
02-09-17 H Referred to House Committee on House-Professional Registration and Licensing |
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Modifies the duration of unemployment compensation, modifies the method to pay federal advances, and raises the fund trigger causing contribution rate reductions. |
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Track Name(s): |
Hospice |
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Bill History: |
02-27-17 S Reported to the Senate and first read |
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Requires the Department of Social Services to apply for a global waiver for MO HealthNet. |
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Track Name(s): |
Hospice |
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Bill History: |
02-08-17 H Referred to House Committee on House-Budget |
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Establishes a pilot program to transfer the authority to inspect nursing homes from the Department of Health and Senior Services to local health departments. |
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Track Name(s): |
Hospice |
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Bill History: |
03-07-17 H Meeting set for 12:00 PM or Upon Adj., whichever is later, H - House-Government Efficiency |
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Changes the laws regarding vaccines and disorder monitoring. |
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Track Name(s): |
Hospice |
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Bill History: |
01-05-17 H Read second time |
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Prohibits an employer from taking an adverse employment action based on an employee's reproductive health care decision. |
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Track Name(s): |
Hospice |
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Bill History: |
01-05-17 H Read second time |
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Changes the laws regarding health care records of deceased patients. |
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Track Name(s): |
Hospice |
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Bill History: |
03-06-17 H Set on the House Calendar |
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Establishes the Missouri Freedom to Choose Health Care Act. |
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Track Name(s): |
Hospice |
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Bill History: |
02-16-17 H Referred to House Committee on House-Insurance Policy |
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Requires the Department of Social Services to apply for a global waiver for MO HealthNet. |
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Track Name(s): |
Hospice |
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Bill History: |
02-08-17 H Referred to House Committee on House-Budget |
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Specifies that the county coroner or medical examiner need not be notified and no investigation is necessary for a death that occurs under hospice care. |
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Track Name(s): |
Hospice |
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Bill History: |
02-16-17 H Referred to House Committee on House-Rules-Administrative Oversight |
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Allows persons with certain serious medical conditions to use medical cannabis. |
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Track Name(s): |
Hospice |
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Bill History: |
03-01-17 H Meeting set for 12:00 PM or Upon Adj., HR 7 - House-Health and Mental Health Policy |
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Establishes "Simon's Law", which changes the laws regarding life-sustaining or nonbeneficial treatment policies of health care facilities. |
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Track Name(s): |
Hospice |
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Bill History: |
02-16-17 H Referred to House Committee on House-Health and Mental Health Policy |
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Modifies definitions of 'employee' and 'physician employee' in actions against health care providers for personal injury or death. |
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Track Name(s): |
Hospice |
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Bill History: |
03-06-17 H Set on the House Calendar |
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Allows structured family caregiving as a covered service under MO HealthNet, subject to the approval of federal waivers. |
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Track Name(s): |
Hospice |
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Bill History: |
02-22-17 H Public hearing completed |
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Changes the laws regarding MO HealthNet services. |
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Track Name(s): |
Hospice |
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Bill History: |
01-10-17 H Read second time |
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Establishes the Death with Dignity Act to allow patients with terminal illnesses to end their life in a humane and dignified manner. |
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Track Name(s): |
Hospice |
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Bill History: |
01-10-17 H Read second time |
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Creates standards for predetermination of health care benefits requests and responses. |
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Track Name(s): |
Hospice |
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Bill History: |
01-11-17 H Read second time |
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Changes the laws regarding the Missouri Human Rights Act and employment discrimination. |
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Track Name(s): |
Hospice |
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Bill History: |
02-13-17 H Public hearing completed |
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Changes the laws regarding dispensations of maintenance medications. |
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Track Name(s): |
Hospice |
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Bill History: |
03-08-17 H Meeting set for 12:00 PM or Upon Adj., HR 7 - House-Health and Mental Health Policy |
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Changes the law relating to short term medical policies sold in the state of Missouri. |
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Track Name(s): |
Hospice |
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Bill History: |
02-22-17 H Referred to House Committee on House-Rules-Legislative Oversight |
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Establishes a Prescription Abuse Registry. |
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Track Name(s): |
Hospice |
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Bill History: |
02-21-17 H Public hearing completed |
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Establishes requirements for authorized entities to stock epinephrine auto-injectors for use in emergencies. |
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Track Name(s): |
Hospice |
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Bill History: |
02-16-17 H Referred to House Committee on House-General Laws |
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Establishes a state innovation waiver task force to develop a health care reform plan. |
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Track Name(s): |
Hospice |
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Bill History: |
02-28-17 H Public hearing completed |
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Allows certain assistant physicians, advanced practice registered nurses, and physician assistants to prescribe certain Schedule II medications. |
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Track Name(s): |
Hospice |
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Bill History: |
02-16-17 H Referred to House Committee on House-Professional Registration and Licensing |
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Allows health care providers to contract with the Department of Health and Senior Services to provide volunteer health care services to uninsured and underserved individuals. |
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Track Name(s): |
Hospice |
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Bill History: |
02-22-17 H Meeting set for 12:00 PM or Upon conclusion of morning sessi - House-Health and Mental Health Policy |
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Prohibits law enforcement from releasing records containing personally identifiable health information, unless such information is redacted or a court orders disclosure. |
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Track Name(s): |
Hospice |
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Bill History: |
02-28-17 H Public hearing completed |
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Authorizes the next-of-kin of a deceased person to delegate control of the final disposition of the remains. |
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Track Name(s): |
Hospice |
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Bill History: |
03-07-17 H Meeting set for 8:00 AM, HR 4 - House-Consent and House Procedure |
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Establishes a legislative task force on advanced practice nursing. |
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Track Name(s): |
Hospice |
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Bill History: |
02-16-17 H Read second time |
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Requires a health carrier provider to pay identical benefits to similarly licensed nonparticipating or nonpreferred providers who meet the necessary requirements. |
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Track Name(s): |
Hospice |
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Bill History: |
02-22-17 H Read second time |
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Modifies and creates provisions relating to the MO HealthNet pharmacy program. |
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Track Name(s): |
Hospice |
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Bill History: |
02-22-17 H Read second time |
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Changes the laws regarding rates charged by health care providers. |
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Track Name(s): |
Hospice |
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Bill History: |
02-23-17 H Read second time |
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Changes the laws regarding health care for persons with disabilities. |
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Track Name(s): |
Hospice |
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Bill History: |
02-23-17 H Read second time |
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Modifies provisions relating to coroners. |
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Track Name(s): |
Hospice |
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Bill History: |
02-28-17 H Read second time |
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Changes the laws regarding hospital licensure. |
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Track Name(s): |
Hospice |
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Bill History: |
03-01-17 H Read second time |
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Changes provisions relating to acts that may be performed by a licensed practical nurse and modifies provisions relating to the Missouri State Board of Nursing. |
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Track Name(s): |
Hospice |
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Bill History: |
03-01-17 H Read second time |
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Establishes the "Prescription Drug Monitoring Program Act". |
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Track Name(s): |
Hospice |
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Bill History: |
03-01-17 H Read second time |
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Modifies provisions relating to the Missouri Rx Prescription Drug Program. |
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Track Name(s): |
Hospice |
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Bill History: |
03-02-17 H Read second time |
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Changes the laws regarding background check requirements of in-home service providers and personal care attendants. |
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Track Name(s): |
Hospice |
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Bill History: |
03-02-17 H Read second time |
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Appropriates money for the expenses, grants, and distributions of the Department of Social Services. |
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Track Name(s): |
Hospice |
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Bill History: |
03-02-17 H Set on the House Calendar |
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Modifies provisions relating to the collateral source rule and provides that parties may introduce evidence of the actual cost, rather than the value, of the medical care rendered. |
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Track Name(s): |
Hospice |
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Bill History: |
02-06-17 H Read second time |
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Enacts provisions relating to advanced practice registered nurses. |
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Track Name(s): |
Hospice |
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Bill History: |
01-10-17 S Referred to Senate Committee on Senate-Professional Registration |
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Establishes the Advance Health Care Directive Registry. |
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Track Name(s): |
Hospice |
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Bill History: |
03-02-17 H Reported to the House and first read |
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Provides for the expansion of MO HealthNet services beginning January 1, 2018. |
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Track Name(s): |
Hospice |
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Bill History: |
01-10-17 S Referred to Senate Committee on Senate-Health and Pensions |
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Establishes a Prescription Drug Monitoring Act. |
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Track Name(s): |
Hospice |
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Bill History: |
03-02-17 H Reported to the House and first read |
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Requires elder abuse investigators to provide specified written materials to alleged perpetrators. |
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Track Name(s): |
Hospice |
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Bill History: |
03-06-17 S Set on the Senate Calendar |
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Establishes the Senior Services Growth and Development Program. |
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Track Name(s): |
Hospice |
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Bill History: |
02-15-17 S Hearing conducted |
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Modifies provisions relating to expert witnesses. |
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Track Name(s): |
Hospice |
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Bill History: |
03-06-17 S Set on the Senate Calendar |
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Creates the MO HealthNet Buy-In for Workers with Disabilities program. |
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Track Name(s): |
Hospice |
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Bill History: |
03-06-17 S Set on the Senate Calendar |
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Establishes the Narcotics Control Act. |
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Track Name(s): |
Hospice |
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Bill History: |
01-25-17 S Hearing conducted |
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Establishes a workers' compensation claims database. |
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Track Name(s): |
Hospice |
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Bill History: |
01-31-17 S Hearing conducted |
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Modifies definitions of "employee" and "physician employee" in actions against health care providers for personal injury or death. |
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Track Name(s): |
Hospice |
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Bill History: |
02-20-17 H Read second time |
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Requires health carriers and health care providers to establish and participate in shared savings incentive programs. |
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Track Name(s): |
Hospice |
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Bill History: |
02-08-17 S Hearing conducted |
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Establishes the Narcotics Control Act. |
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Track Name(s): |
Hospice |
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Bill History: |
03-06-17 S Set on the Senate Calendar |
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Modifies provisions relating to workers' compensation liability. |
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Track Name(s): |
Hospice |
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Bill History: |
03-06-17 S Set on the Senate Calendar |
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Establishes the Narcotics Control Act. |
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Track Name(s): |
Hospice |
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Bill History: |
02-09-17 S Superseded by - see SB 314 |
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Modifies Universal Service Fund eligibility requirements for wireless telecommunications providers providing lifeline service. |
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Track Name(s): |
Hospice |
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Bill History: |
02-13-17 S Referred to Senate Committee on Senate-Commerce/Consumer Prot./Energy/Environ |
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Removes the termination date for the MO Rx Prescription Drug Program. |
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Track Name(s): |
Hospice |
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Bill History: |
03-08-17 S Meeting set for 8:00 AM, Senate Lounge - Senate-Seniors/Families and Children |
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Requires certain health care professionals to complete two hours of suicide prevention training as a condition of initial licensure and as a condition of license renewal. |
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Track Name(s): |
Hospice |
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Bill History: |
03-02-17 S Referred to Senate Committee on Senate-Professional Registration |
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Authorizes a health care decision-maker to make health care decisions for a incapacitated patient who does not have a person with legal authority to consent for the patient. |
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Track Name(s): |
Hospice |
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Bill History: |
03-02-17 S Referred to Senate Committee on Senate-Judiciary/Civil and Criminal Juris. |
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Modifies a provision relating to maintenance medication filled by pharmacists. |
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Track Name(s): |
Hospice |
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Bill History: |
03-01-17 S Introduced and read first time |
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Modifies membership of the Missouri State Board of Nursing. |
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Track Name(s): |
Hospice |
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Bill History: |
03-01-17 S Introduced and read first time |
Jane Moore
CEO
Missouri Hospice & Palliative Care Assn.
600 Monroe Street
Suite 300
Jefferson City, MO 65101
Phone 573-634-5514
Fax 573-635-0659
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