Thursday, March 31, 2016

Post for Week of April 1st


Capitol Report for April 1st

 

The Missouri House returned this week from the annual Spring Break.  To date the House has seen more than 1,500 bills filed with nearly 450 House Bills already receiving committee approval. At this time the House has approved and sent to the Senate more than 150 bills, and so far only one of the bills has received final approval. The number of bills sent to the Senate is a significant increase from last session when the House had approved just more than 90 bills entering the break.  This high volume of bills moving through the process means all legislators will have a heavy workload from now until the end of session.

 

We passed two bills which I feel will have a direct impact on improving health care for all Missourians.  I will share a summary of these two bills from the House communications office.

 

House Approves “Step Therapy” Measure to Improve Access to Vital Medications (HB 2029)

 

Missourians with chronic illnesses would have better access to the medications they need under legislation approved by the Missouri House this week. The legislation is designed to prevent redundant “step therapy” so that patients who switch health insurance benefits are not forced to try medications that have already proven to be ineffective before being allowed to use medication that works.

 

The legislation approved by the House simply ensures that a patient will not have to go through the process of trying multiple medications again simply because of an insurance change. In effect, it makes it so the medicine prescribed by the patient’s doctor is the medicine the patient is allowed to take.

 

The legislation received overwhelming bipartisan support and is now on its way to the Senate for consideration.

 

 

Expanding Access to Health Care (HB 1923)

 

The Missouri House approved legislation this week designed to modernize health care in Missouri, and improve the level of care provided by the state’s system of Medicaid. The legislation brings telehealth services in Missouri into state statute and works to bring greater access to health care to Missourians in rural and underserved areas. 

 

The bill would update Missouri’s laws on Medicaid reimbursement in regard to telehealth services so that more health care professionals could provide telehealth care to Medicaid recipients. Supporters of the bill say it is an important change that will allow patients to receive care without having to travel long distances. They noted the change could also result in a significant cost savings. In 2015 the state’s Medicaid program allocated more than $40 million for use in providing non-emergency medical transportation to take patients in underserved areas to see specialists.

 

 

 

Until Next Week,

Tila

Thursday, March 3, 2016

Legislative Update


Legislation Update for this week...

(This update is specifically related to bills I am sponsoring)

 

HB 1366 "BioSim Bill"--this bill will provide a means for a pharmacist to substitute a BioSimiliar medication for a Biologic medication much in the same manner as a generic medication is substituted for a trade or brand name medication.  This bill is in the Senate,  I am expecting it to be heard in committee in the next few weeks.  The bill has good bipartisan support and will hopefully make it through the Senate without any issues.

 

HB 1558 -- this bill deals with the laws regarding the inspections of certain nursing facilities.  There are situations in which while a facility is being built or remodeled there are duplicative inspections being conducted and not always do the regulations to pass each inspection match.  This bill will remove and clarify this situation.  This will result in less building costs and less red tape while ensuring safety of the patient is where the attention is at.  This bill will receive a hearing next week.  I am excited about this hearing and hope it will go without difficulty.  This bill is filed from last year which has made it much easier this year, I think we worked all the "kinks" out then!

 

HB 2665 -- I filed this bill just this week!   The bill will clarify an issue for EMS while respecting local control.  We are very excited about this bill as a group of constituents, including Darlene Shelton from Dexter, worked with the EMS community to draft the language for this bill.  I will be adding it as an amendment to at least one bill to help this issue be addressed as quickly as possible.  The EMS community has taken all the action they can without this language so we will work to get this language through the process as quickly as possible!

 

HCR 67 -- This resolution deals with encouraging Congress to give States more flexibility in Early Childhood federal funding.  Hopefully this will be just another document reinforcing to Congress that we, as a State, understand best how to allocate resources and emphasize it is much easier for the People to go to and contact the State Agencies compared to reaching a Federal Agency.  It has been referred to committee this week. I will be speaking with the chair to request a hearing as soon as a time is available.  

 

HCR 66 -- This resolution deals with information regarding meningococcal disease and available vaccines.  It was voted out of the first level of committee this week and is on its way to the second committee level!  I should know more next week as to the next hearing date.

 

 

 

 

Other topics of interest....

 

I am working with a group of other legislators to review our current policies in place regarding our State's Infrastructure.  I have been meeting with our local and state transportation individuals including those who work with MODOT, rail and ports.  My intern, Mary, is spending quite a bit of time assisting me with researching what other states do to support and encourage infrastructure maintenance and development.  We are discussing many ideas but I think it is going to take a variety of actions to address our current infrastructure challenges and they certainly won't be addressed overnight.  I will continue to update you from time to time on our progress.

 

 

I am also working closely with a group of nursing schools, industry stakeholders and the Department of Health and Senior Services to review the current training program for Certified Nursing Assistants (CNAs).  The training program is very out of date in many areas which in turn has a negative impact on those living in nursing facilities because the CNAs are not receiving the best training possible.  We are close to getting this remedied, I am hopeful to see a significant change in this area by the end of the year!

Tuesday, February 23, 2016





Serving the 151st District has been such a great privilege and honor!  The 151st District is one of the best places to live in the world!  During my time as the State Representative for our district, I have learned so much about our area, things I didn't know!!  Today, I am excited to announce I have filed to run for re-election and look forward to the opportunity to serve the 151st District again!

Thursday, February 18, 2016




Legislation Update for this week...
I am happy to report HB 1866, Advanced Practice Registered Nurses, made it out of the first level of committee this week!  This bill is one portion of what I feel is a step towards controlling our health care costs.  APRNs (Advanced Practice Registered Nurses) or better known as Nurse Practitioners, are a valuable member of the healthcare team and in some situations this team member is not able to provide healthcare to patients due to current restrictions and regulations.  I am hoping this bill will continue to progress through the process and by this fall allow Nurse Practitioners to increase access to healthcare for all Missourians.

Capitol Report


“Paycheck Protection” Bill Receives House Approval (HB 1891)

 

The House gave approval this week to legislation meant to give workers the authority to annually opt-in rather than opt-out of paycheck deductions for union fees. Often referred to as “paycheck protection” legislation, the bill would require annual written consent from a public employee before any amount could be withheld from the earnings of the employee for the payment of any portion of dues, agency shop fees, or other fees paid to a public labor organization.

 

The legislation also would require public employee unions to obtain annual written consent in order to spend a portion of the fees on political activities. Unions for first responders, such as police and firefighters, would be exempted from the requirements of the bill.

 

Supporters of the change say it is a matter of protecting the rights of workers and giving them a say in where their money goes. They say unions sometimes support political causes not endorsed by their membership and the bill would give members the authority to prevent their fees from being used for these purposes.

 

Opponents say contributions already are voluntary and requiring this annual authorization will increase costs to public employers and school districts in particular. They believe the authorization requirement is an unnecessary intrusion into the inner workings of a private organization and another administrative burden placed on unions by state government.

 

The General Assembly approved similar legislation two years ago but saw the bill vetoed by the governor. This year’s version of the legislation received 110 votes in the House, which is one more than needed to override a potential veto by the governor.

 

House Approves Legislation to Address Misuse of ASARCO Settlement Dollars (HB 2187)

 

The House approved legislation that would force the Missouri Department of Natural Resources to sell land it had acquired in Oregon County for use as a new state park. Many House members had taken issue with the decision of the executive branch to acquire the Frederick Creek Ranch land with funds that were meant for important remediation efforts such as clean drinking water projects in Missouri’s lead mining district.

 

During the 2015 interim, the House formed a committee to look at what members said was an inappropriate use of settlement funds that were intended to be utilized to remediate the damage done by the ASARCO mining conglomerate at five sites in southeast Missouri’s lead mining district, which includes St. Francois, Reynolds, Iron and Madison counties. Instead, the trustees of the ASARCO settlement determined it was appropriate to use funds to acquire land several counties away and in a different watershed.

 

Now, with the legislation approved by the House, members hope to undo the decision made by executive branch to prioritize the purchase of Frederick Creek Ranch over the remediation projects in areas that were actually impacted by ASARCO’s actions. The bill now moves to the Senate for consideration.

 

House Approves Resolution Encouraging an Audit of the Federal Reserve (HR 71)

 

The members of the Missouri House of Representatives approved a resolution calling on Congress to pass the Federal Reserve Transparency Act to require a complete audit of the Federal Reserve Bank of the United States. As the sponsor of the resolution said on the House floor, the Federal Reserve has loaned trillions of dollars to bail out foreign banks without the consent of Congress, and it refuses to fully disclose the details of its lending practices. He also noted that the Federal Reserve has never received a complete audit.

 

The resolution approved by the House notes that the Federal Reserve has inflated the money supply and manipulated interest rates since its inception in 1913, which has eroded the purchasing power of the dollar by approximately 95 percent, and contributed to boom and bust business cycles. It also points out that Federal Reserve has operated the nation’s monetary system without full disclosure and transparency, which has led to a lower quality of life for the American people and abuse verified by the United States Government Accountability Office in its 2011 Report to Congress.

 

The bill’s sponsor hopes that a complete audit will finally provide the American people with answers about how their money is being spent, where their money is being spent, and at what cost.

 

Promoting Civics Education (HB 1646)

 

The Missouri House approved legislation to promote American history and civics education in Missouri classrooms. The bill would create the Missouri Civics Education Initiative to require students in public, charter, and private high schools to receive a passing grade on a standardized civics test in order to graduate.

 

Supporters said ensuring a thorough knowledge of the country’s history and system of government is a key first step in creating an engaged and active citizenry that will vote and take active roles in the political process.

 

Under HB 1621, exams would consist of the same 100 questions used on the civics portion of the United States Citizenship and Immigration Services’ U.S. Naturalization test that is taken by immigrants looking to gain American citizenship. The questions would cover topics ranging from the United States Constitution to American history to geography. The test could be retaken by the student an unlimited amount of times until a passing grade is obtained.

 

If passed into law, Missouri would join states such as Arizona, North Dakota, South Dakota, Utah, Idaho, Tennessee, South Carolina, Louisiana and Wisconsin, which all passed Civics Education Initiatives earlier in the year.

 

If approved by both chambers and signed by the governor, the Missouri Civics Education Initiative would take effect Aug. 28, 2016, and all students entering ninth grade after July 1, 2017, would be required to receive a passing grade on the civics test.

 

House Approves Returning Heroes’ Education Act (HB 2156)

 

The Missouri House took action this week to fix an issue with the Missouri Returning Heroes’ Education Act that will help veterans to more easily afford the cost of a college education. The bill changes existing law to ensure the tuition benefit created by the act is applied correctly.

 

The Missouri Returning Heroes' Education Act was created by Senate Bill 830 in 2008. The act limits tuition charged to qualified combat veterans to $50 per credit hour for any program leading to a Bachelor's degree.  Under the act, a "combat veteran" is any person who served in armed combat after September 11, 2001, who was a Missouri resident when first entering the military, and who was discharged from military service under honorable conditions.

 

While the program has been beneficial for combat veterans, several filed a lawsuit alleging some state universities were misapplying the benefit. The universities were using the other financial aid available to the veterans to pay for tuition before capping the cost of classes at the $50 limit. The veterans who brought suit said the $50 cap should be applied first so that other financial aid could then be used to cover the other costs associated with attending college, which have increased significantly in recent years.

 

The legislation approved by the House changes the law to require the tuition limitation be provided before all other aid is applied and repeals the provisions prohibiting a veteran from receiving more than the actual cost of attendance when the limitation is combined with other available aid. The bill also will clarify how the law should be interpreted so that every university in Missouri will apply the act in the same way. Supporters said the goal of the legislation is to support veterans in Missouri and to help them to obtain their degrees without accumulating excessive student loan debt.

Thursday, February 4, 2016

Saving Money on Biologic Medicines


Saving Money on Biologic Medicines

By State Representative Tila Hubrecht, 151st District

In recent years, biologic medicines have been at the forefront of cutting edge research in the biomedical field helping us to find new treatments and even cures for chronic conditions like rheumatoid arthritis, multiple sclerosis and even cancer. These medicines have a complex molecular structure grown from living cells. They have become more commonly used as time has gone on. To this point though, biologics have not been able to be substituted with an interchangeable biosimilar medicine in Missouri. Biosimilar medicines have a molecular structure similar to biologics with the same intended goal but are not exactly the same as the original biologic.

Because biosimilar medicines are not identical to their original biologics, a patient could react differently to them. To accurately diagnose patients, doctors want to know exactly what biological drug is dispensed to their patients at the pharmacy. The Missouri Pharmacy Practice Act is being updated to require that prescribers and pharmacists work together to ensure patient records contain exactly what has been prescribed. In order to alleviate the wait time on receiving these prescriptions, this information would not have to be shared until after the prescription is dispensed. Biosimilar medicines would expand the potential patient pool for these treatments exponentially.

Like generic substitutions for prescription pills, these medicines would save patients money while still getting them quality medicines they need. Having established a safe alternative to biologic medicines, the reduction in costs for patients is in the billions. The Rand Corporation projects a reduction of $44.2 billion in spending on brand name biologics between 2014 and 2024. More locally in Missouri, the passage of House Bill 1366 & House Bill 1878 is conservatively estimated to save taxpayers $5.5 million in FY2018, $12.1 million in FY2019 and even more in the future.

Biologic medicines are one of the great recent innovations in the medical field. With the legislation passed from the Missouri House, our state will stay ahead of improvements in medicine as they come in the future. One Democrat on the House floor described the bill as a unicorn bill, one of the mythical few that everyone can get behind. The stakeholders of these medications worked for the past three years to find language that would enable the pharmaceutical companies, pharmacists, insurance groups, physicians and most importantly the patient groups to come together and remove the barriers to life-saving medications facing many chronically and critically ill patients.  I enjoyed working with Representative Solon to ensure bipartisan support of this legislation. Missouri is leading the way on giving taxpayers affordable, high quality medicine and we are proud of it.