May 24, 2013

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Social Services welfare recipient shift scaled back (VIDEO)

April 25, 2013 By

A contract between the Department of Social Services that came under fire from House Republicans has been restructured.

Representatives Sue Allen (left) and Jay Barnes (right) join House Speaker Tim Jones (center) and other House Republicans in announcing changes in a DSS contract the caucus had concerns with. (Photo courtesy; Tim Bommel, Missouri House Communications)

Representatives Sue Allen (left) and Jay Barnes (right) join House Speaker Tim Jones (center) and other House Republicans in announcing changes in a DSS contract the caucus had concerns with. (Photo courtesy; Tim Bommel, Missouri House Communications)

The contract with Boston-based Public Consulting Group outlined how it would look for people receiving state assistance that could be shifted to federal disability payments. Republicans said the original arrangement would have reached out to too many people, including children and those who could still work, and said it would have moved people off of welfare that requires recipients to actively look for jobs to a program where having a job could result in lowered benefits.

Representative Jay Barnes (R-Jefferson City) said documentation of the company’s proposed procedures raised concerns it would use aggressive tactics to get people to switch programs. He’s pleased with the new contract.

“For kids, who should not be in this process, they are no longer part of this contract, PCG will not be making cold calls to individuals, PCG will not be making any threats to those people already categorized as ‘disabled’ if they refuse to cooperate with this and PCG has agreed that they will have all phone calls recorded so that we can spot check what they’re doing.”

The new contract will limit the scope of the company’s search to people with disabilities and serious medical conditions.

The original contract would have also sought to move people whose transfer might have had to go to an appeals process because it would have been less clear the shift would be appropriate.

PCG will make $2,300 for every person moved off of Medicaid.

House Speaker Tim Jones (R-Eureka) commended Governor Jay Nixon and the Department for making these changes.

The situation came to light on a national radio program before PCG’s work began. Jones says it raises a question of whether such contracts need to be subject to legislative review earlier.

“There obviously needs to be some more oversight on these large-scale contracts that do affect thousands, if not millions, of Missourians.”

On the subject of oversight, Representative Sue Allen (R-Town and Country) says she told the Department’s representatives in a recent hearing of her Appropriations Committee she was surprised they didn’t bring the issue up.

“I do expect them to bring these issues to the committee and I had some anxt about that. That is an ongoing issue of trust … but they heard a very strong message and I think we got the good solution.”

See the House Republicans’ media conference below:

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House approves legislation to battle bullying in public schools

April 10, 2013 By

The House has sent the Senate legislation to have school districts add discrimination to anti-bullying policies.

Representative Sue Allen (photo courtesy; Tim Bommel, Missouri House Communications)

Representative Sue Allen (photo courtesy; Tim Bommel, Missouri House Communications)

The proposal sponsored by Representative Sue Allen (R-Town and Country) says those policies should bar bullying on school grounds, at school events and on school buses, and defines cyberbullying. It also lays out what should go into a policy and would require the State Board of Education to develop model policies by September 1.

The debate in recent years in the House has centered on whether an anti-bullying bill should specify who it protects by listing factors for discrimination: things like sexual orientation, race or religion.

Allen’s bill does not. She says a blanket approach means no children will be left out.

“I contend there is no specific profile or picture of any student, girl or boy, who is potentially a victim of bullying.”

Representative Mike Colona (D-St. Louis City) references an unrelated piece of legislation filed last year in the House in arguing that enumeration is needed.

“Fifteen or twenty co-sponsors on a bill that says we can’t say ‘gay’ in school, and I’m supposed to trust school administrators to make sure that LGBT students aren’t bullied? It doesn’t fly. It doesn’t fly.”

Representative Margo McNeil (D-Florissant) says children would be made safer and better able to learn by a bill that includes specifics about who it protects.

“Because it fails to define who or what is considered bullying it leaves huge areas of gray. I maintain that murkiness is one reason why so many children are bullied because of their sexual orientation and religion.”

Representative Jeanie Lauer (R-Blue Springs) says attempting to list all possible factors for discrimination would surely miss some children who also need protection.

“If I see somebody hurting a child I’m going to be out there taking care of them and protecting them, and I don’t care if it falls in a category or not. That’s not the issue. The issue is that we’re supposed to be here protecting our children.”

The House voted 141-10 to send the proposal to the Senate.

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House budget subcommittee shuns Medicaid expansion, finds mental health money

February 26, 2013 By

A House budget subcommittee has rejected including federal money for Medicaid expansion in the budgets for the Departments of Mental Health, Social Services and Health and Senior Services.

Representative Sue Allen (R-Town and Country)

Representative Sue Allen (R-Town and Country)

Representative Judy Morgan (D-Kansas City) proposed a return to Governor Jay Nixon’s plan to use $1 billion in federal dollars for those departments, freeing up general revenue to use in other areas. Her amendments were defeated in 9-5 partisan votes.

Nixon says if Missouri accepts Medicaid expansion the federal government will pay for it for the first three years, then Missouri will begin picking up a portion of the cost that would eventually grow to ten percent. Democrats say Medicaid expansion will save the state money, extend healthcare to an additional 300,000 Missourians, create jobs and keep rural hospitals from closing.

Chairwoman Sue Allen (R-Town and Country) says Missouri can not afford to accept that plan.

“There will be a time the feds will back off. Missouri is in as good a shape as we are financially because of hard decisions that were made in 2005 to reign in cost, and we have a natural growth of Medicaid which we struggle with every year anyway within the current eligibility.”

The state legislature approved and then-Governor Matt Blunt signed a cut back in Medicaid in 2005. At that time, 100,000 people lost eligibility.

Allen says Medicaid reform would be the more responsible route.

“I would say, first of all, we improve and we correct where you could have greater benefits. You get that taken care of and you move forward, and you do it one step at a time but you don’t jump in a swimming pool without any water in it.”

The plan approved by the committee does shift about $25 million to the Department of Mental Health. Allen says that money came from places in the Fiscal Year 2013 budget where Governor Nixon had withheld money, or where money that was appropriated was not spent.

She says in finding that $25 million, “I don’t know if any services that were cut.”

Allen says she hopes more money can be found for mental health when her committee’s proposal reaches the full budget committee.

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House Republicans to craft budget without $164 million from Medicaid expansion, legislation

January 30, 2013 By

House Republican Budget Leaders say they will begin work on the next state spending plan without including about $164 million dollars found in the Governor’s budget proposal.

House Budget Committee Chairman Rick Stream (Photo courtesy; Tim Bommel, Missouri House Communications)

House Budget Committee Chairman Rick Stream (Photo courtesy; Tim Bommel, Missouri House Communications)

Of that, $46 million is projected new tax revenue and savings resulting from Medicaid expansion and the rest relies on passage of legislation: $52 million from passage of an amnesty period for people to pay overdue taxes, more than $10 million from a proposed law encouraging collection of sales taxes on online purchases and more than $56 million from the elimination of a tax break for low-income renters.

Rep. Sue Allen (R-Town and Country) chairs the budget committee on health, mental health and social services.

“From the perspective of my committee, that [money] may or may not be real,” Allen says. “I’m not going to waste my time incorporating budget recommendations that very likely are not going to be there.”

House Budget Committee Chairman Rick Stream (R-Kirkwood) says if any of those pieces of legislation or policy changes advance, planners can put it back into the budget, but he says banking on it is not fiscally responsible.

“Any country that is borrowing over 40 percent of every dollar it spends is in a disaster mode,” Stream says. “Missouri is not that way. We don’t go into deficit spending like that. We don’t want to contribute to the deficit spending of the government.”

Tax amnesty legislation has cleared the House before but not become law.

Stream says so-called circuit breaker tax credit for renters ”really never passed the House before to my knowledge and certainly not the Senate.”

Rep. Jeanne Kirkton (D-Webster Groves) is the ranking Democrat on the House Budget Committee. She says her caucus will just have to keep working on advancing Medicaid expansion.

“We’re certainly in the minority but I think that we try the best we can to make the case both from an ethical and a financial standpoint and hope that by the end of the day we can sift through all the facts and get this put back in the budget,” Kirkton says.

Kirkton says she hopes this won’t start off the budget process on a bad tone, after the last couple of years have been smooth and marked by bipartisanship.

“I’m hoping that we will still continue to work in a bipartisan manner and I do think that because we are in a minority that we will have a more uphill battle to get things that are near and dear to the Democratic principles into the budget.”

Nixon’s budget is $25.875 billion, more than $1 billion higher than it was last year, most of the increase coming from Medicaid expansion. Stream says he doesn’t know what number House budget makers will be working with.

“We don’t get the budget books until Monday,” Stream says. “Once we get those we’ll start going through them.”

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State of mental health care in Missouri discussed against gun control backdrop

January 22, 2013 By

Among both those for and those against new gun control measures are those who say the quality of mental health care must also be considered when discussing violence prevention.  By several accounts, the system in the state of Missouri is under funded, but there is more than one suggestion about how to fix it.

Representative Sue Allen (R-Town and Country) chairs the House Appropriations Committee on Health, Mental Health and Social Services. She says she has thought that mental health is underfunded for years, not just since recent shooting incidents in Connecticut and Colorado.

“I cannot believe there is not money to better fund mental health, and the key is finding out where it is. Now it may be taking it away from somebody else who maybe is a little more capable of meeting their own needs but they don’t have to because they’re entitled to something.”

Representative Tom Flanigan (R-Carthage) was the chairman of that budget committee last year. He also says the Department of Mental Health has received too little funding for years.

“It’s a very small department, budgetarily, and it probably does more good dollar for dollar than any other department in the state of Missouri.”

Flanigan suspects that stigmas about mental health carry over into funding the department. He hopes this discussion will help to change people’s mindsets.

“It may be that mental health becomes one of those issues that people begin to talk about openly, and to talk about it in terms of positive outcomes. That’s what I would like to see that comes out of this whole situation.”

The National Alliance on Mental Illness gave Missouri a “C” grade for mental health care in a 2009 report.  Missouri Executive Director Cindi Keele says improving awareness and treatment is a matter of funding.

“Public awareness campaigns cost money … community mental health centers need money to have people on staff, perhaps experienced family members, who are hired to be a mentor for these families that are going through these troubling situations.”

Keele isn’t impressed, however, with the idea of just looking elsewhere in the budget for places to pull money for mental health.

“I find that very frustrating … we’ve got to have some more revenue coming into this state, in my opinion.”

Keele says one way to improve the state’s mental health system would be to participate in Medicaid expansion.

“If more people had health insurance we could get mental health issues, to a great extent, detected much earlier and treated much earlier.”

Representative Jeanne Kirkton (D-Webster Groves) is a member of the budget committee on mental health.  She says statistically, expanding Medicaid would reach a large number of people with serious mental health issues.

“If we look at the population of mentally ill and those that are poor, say under 133% of the federal poverty level, 1 out of 6 of those will have severe mental illness. So, if we’re going to talk about gun violence and mental illness, expanding Medicaid to that population is a plus.”

Legislative Republicans don’t support Medcaid expansion however, raising questions about how it will be paid for and whether Congress can be trusted to keep its fiscal promises.  Three House Republicans have been studying the issue of expansion looking for an alternative plan.

Kirkton also expresses concern about stigmas regarding mental health. She says she is worried that ties to discussions of gun violence could further those stigmas.

“You look at the data … the people that are most prone to gun violence are substance abusers and alcoholics … that tend to be more violent than the severely mentally ill. It’s a very small percentage of them who are violent.”

Allen adds, she believes the issue of violence extends beyond guns and mental health to things like violence in movies and video games.

“It’s a very invasive issue … it’s societal. What’s the value of life?”

Lawmakers in both parties say they are not aware of legislative efforts to change any policies or practices in Missouri’s mental health care system.

Allen’s committee on appropriations for health, mental health and social services will hear an overview of the Department of Mental Health at a hearing today at 2:00.

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