Nixon urges lawmakers to wrap up special session

KANSAS CITY, MO (KCUR) - Missouri governor Jay Nixon reiterated his push today for lawmakers to wrap up their more than three week Special session that’s cost tax payers more than $100,000 dollars.

"You know it’s just time for the house and senate to resolve their differences and get a fisc responsible bill to my desk, or bring the special session to a close,” the governor said.

Nixon also said he’s taking a double look at the revised social networking bill lawmakers recently passed. It overturns a previously enacted law limiting teacher interaction with students through online forums like Facebook … but lawmakers added a clause to the new bill requiring schools to come up with their own policies on such matters.

"I’m not taking a double look at it to try to figure out when to sign it or not sign it, that’s not releveant, it’s just making sure that having an individual school district do a narrower type of policy is an acceptable alternative here," Nixon said.

Nixon spoke in Kansas City Thursday, touting a new $20 million dollar federal grant the state recently got to bring new health service training opportunities to thousands of underemployed residents throughout the state.

Elana Gordon, KCUR

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Missouri receives $20M health worker training grant

KANSAS CITY, MO (KCUR) - Missouri has received a $20 million grant from the U.S. Department of Labor to train more than four thousand underemployed adults in the health services sector.

Governor Jay Nixon led the effort to bring the funds to the state’s twelve or so community colleges. Deborah Goodall is with Metropolitan Community College in Kansas City and says the grant will help equip adults with high demand health care skills.

"As health care records become digitalized, you need a different type of worker – someone who not only understands medical terminology and health care side, you also need someone who understands IT systems," Goodall said.

Goodall says among other things, the grant will help schools expand their curriculums, create training opportunities that better cater to working adults, and provide residents with academic scholarships.

Elana Gordon, KCUR

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State Housing Commission approves plan to reduce homelessness

KANSAS CITY, MO (KCUR) - Missouri’s Housing Commission has approved the use of more than $100 million in tax credits to create long-term housing for people with special needs.

Francie Broderick, with Places for People in St. Louis, attended the commission vote in Kansas City. She says for organizations like hers, which provides services for people with mental illnesses, the commission’s new policy is historic.

"I’ve been working in this field for almost 40 years and there’s still mentally ill people homeless in my parking lot and that’s just horrible," Broderick says. "So this is going to make a real difference, this will create a pool of money that wasn’t available to us before to supported housing."

Broderick says in the past, it’s been difficult to compete with large developers to get funds from the commission for projects geared towards people with special needs.

Her organization was one of just three special needs housing projects that did get funding from the housing commission last year. But she says this new policy will expand those opportunities across the state.

Elana Gordon, KCUR

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Smoking rates down in Missouri

KANSAS CITY, MO (KCUR) - A recent survey finds fewer Missourians are lighting up.

A decade ago more than one in four Missourians smoked. Now it’s down to one in five. That’s according to the Centers for Disease Control’s latest annual phone survey.

Kendre Israel, with the state’s tobacco prevention coalition, says Missouri’s decline has outpaced a lot of other states – falling from the third to the eleventh highest smoking rate in the nation since 2004. She says a big increase in smoke-free work place laws across the state partly accounts for this drop.

"You know, those protect people from dangers of second-hand smoke exposure, but they also increase the likelihood people never start people smoking, helps people quit, it helps change social norm in their environment," Israel says.

Israel says other services to help people stop smoking, like Missouri’s quit line, also play a role. Missouri’s smoking rate is still higher than the national average, and Israel says more could be done, including raising the state’s cigarette tax, enacting a state-wide smoking ban, and funding state prevention programs.

Elana Gordon, KCUR

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First health insurance exchange hearing held in Kansas City

KANSAS CITY, MO (KCUR) - A Missouri Senate committee tasked with drafting recommendations for a state health exchange held the first of at least three statewide hearings in Kansas City on Tuesday.

Exchanges are new organizations under the federal health law, intended to provide a more organized and competitive market for buying health insurance.

But yesterday’s hearing wrestled with the very notion of developing one in Missouri.

The eight-member committee focused the majority of the nearly four and a half hour, packed hearing, on asking the state’s Insurance Director and Attorney General about the legalities of an exchange, what kind of role the federal government would have in one, and how an exchange would actually work.

Senate committee member Jane Cunningham worried that creating an exchange would weaken Missouri’s and other state’s legal challenges to the federal health law, and its requirement that people buy health insurance. But Attorney General Chris Koster said, "I don’t think that however the legislature decides to move will affect the outcome of the case."

Koster also said if an exchange does not require people to buy coverage in it, then it doesn’t appear to violate proposition C – that’s the legislation that prohibits insurance mandates in the state. At least two others hearings are scheduled next month for Columbia and Jefferson City.

Elana Gordon, KCUR

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Missouri receives $21M grant to set up insurance exchange

KANSAS CITY, MO (KCUR) - Missouri has received a $21 million federal grant to build an online health insurance exchange, or marketplace.

Travis Ford with the Missouri Department of Insurance says if set up correctly, an exchange would enable Missourians to view multiple insurance plans online at once, to more easily compare policies and prices.

Under the federal health law, states can either develop their own exchanges, or opt out and have the federal government step in and create one instead. Ford says the grant allows Missouri to get a head start on the process.

"If Missouri’s leaders elect to build, create and operate a state-run online market place like this, then we need to be ready," Ford says. "This grant money allows us to do the work and put the IT structure in place necessary for us to be ready."

The federal health law requires the exchanges to be up and running by 2014.

The Missouri house unanimously passed exchange legislation last session, but it never made it to a vote in the Senate.

The Senate’s insurance committee, meanwhile, is preparing to hold hearings across the state this month and next on whether and how to set one up.

Elana Gordon, KCUR

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Missouri again cuts premiums for pre-existing condition program

KANSAS CITY, MO (KCUR) - A state health insurance option for people with pre-existing health conditions has once again gotten cheaper. In what state insurance officials are calling a significant reduction, Missouri's high risk insurance pool is cutting premiums by nearly 25 percent.

The federally funded program is designed for people with chronic diseases who've either been flat-out denied health coverage or charged an extremely high rate.

So far, about 550 people have enrolled in the program, but it has the capacity to ensure up to 2500.

Travis Ford, with the Missouri Department of Insurance, says cost may be a factor in whether people sign up.

"This is not free insurance, it's not cheap insurance, it's for people who can pay a full premium," says Ford. "But at least it's the right to buy insurance."

Ford says the program's premiums, or what people pay for a policy on a monthly basis, are based on a combination of federal rules and private health insurance trends in the state. He says determining these premium rates and ensuring they're as affordable as possible is an ongoing and challenging process.

"That means continual number crunching and analysis," says Ford. "And that's difficult in Missouri because health insurance rates are not regulated. And so health insurance companies are not required to file rates with the state."

Ford says in an effort to make coverage more accessible, the high risk program recently got federal approval to cut premiums by 23 percent. That's on top of a 25 percent rate reduction in February.

Ford says the latest cut could save a person an estimated $500 to $2000 a year, depending on one's age and deductible.

To be eligible for the program, a person must be without insurance for at least six months and have a pre-existing health condition.

The program was created under the federal health law last year, and is slated to phase out once insurance companies can no longer deny people coverage in 2014.

Elana Gordon, KCUR
Photo: Carolen Collins looks over the application to Missouri's new high risk insurance pool. Denied coverage in the private market, she recently enrolled in the program.

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Child care facilities must place infants on backs for naps

KANSAS CITY, MO (KCUR) - Licensed child care facilities in Missouri must now place infants on their backs during nap time. The new law, effective this month, aims to reduce the number of infant deaths in the state.

The change has been a long-time coming.

The American Academy of Pediatrics recommended fifteen years ago, that babies sleep on their backs to reduce the risk of sudden infant death syndrome, or SIDS. Since then, the rate of SIDS has gone down by more than 50 percent nationwide.

Cheryl Herzog Arneill, with the Missouri organization SIDS resources, says that's because placing infants on their backs ensures they have an open airway.

"When a baby is not positioned on their backs for sleep, they have less ability to lift their head and get out of threatening positions," Arneill said. "If any type of loose bedding or soft fluffy material – even a bumper pad in the crip – would get too close to infant airway, the buildup of carbon dioxide or exhaled air could actually trigger a sids episode."

Under Missouri’s new law, the state’s more than 3,000 licensed child-cares must place infants less than 12 months old on their backs to sleep. Arneill says that’s significant because SIDS deaths are disproportionately high in child-care settings.

She says Missouri's new law is critical, even though it doesn't apply to the state's thousands of legal but unlicensed child cares.

"We're hopeful, though, that this news will really spread within the child-care community and most people will know and understand the importance of back-to-sleep," Arneill said.

Between 2006 and 2009, there were 187 SIDS deaths in the state. Nationwide, the number of SIDS deaths dropped by more than fifty percent, after the U.S. launched a Back to Sleep Campaign in the early nineties.

Elana Gordon, KCUR

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Doctors in short supply in rural Missouri, report says

KANSAS CITY, MO (KCUR) - A new report finds that rural Missouri is on track to face greater health care challenges than its urban counterpart.

Herb Kuhn heads the Missouri Hospital Association, which issued the new analysis of state population and physician data.

Kuhn says rural areas are experiencing greater doctor shortages. And, it’s on track to get worse.

"About 55 percent of all physicians in the state are age 50 and over. But in rural areas it’s much higher – 62 percent. So what this means is that we’re going to have physicians in the rural areas in the state retiring earlier than in the urban areas. And, since we have so many fewer physicians in the rural areas, it does raise some issues in terms of access to care in the future," Kuhn says.

Kuhn says this will be an even bigger problem come 2014: that’s when another half million Missourians are expected to gain health coverage through provisions under the federal health law.

The report recommends the state look into new ways to avert the crisis – Kuhn says that could include better use of information technology, revamping student loan-assistance programs, and improving secondary science education and med school preparation in rural areas.

Myra Evans heads a critical access hospital in Fairfax, Missouri, about 100 miles north of Kansas City. She says the new report really resonates with the situation in her region.

"Three years ago a physician that was 57 left to be closer to his grandchildren, and then we had two physicians that were over 80 years old still practicing that retired. So we actually are down to three physicians and we’re trying recruit at least two to our area. And that’s been kind of difficult right now," Evans said.

Evans says her hospital is the only one serving about 11,000 people in the two-county area. She says one way they’ve dealt with the shortage of doctors is by bringing in more nurse practitioners. The Missouri Hospital Association reviewed population and health data, as well as existing workforce studies, for the new report.

Elana Gordon, KCUR

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Ninety percent of Missouri hospitals now have E-records

A growing number of Missouri hospitals are using electronic health records. The Missouri Hospital Association recently assessed the electronic capabilities of 145 hospitals in the state, using both internal and state-health data.

The group found that 90 percent of hospitals now have some sort of electronic system in place, up six percent from last year.

Dave Dillon, with the Hospital Association, says at a minimum, those hospitals are able to electronically collect certain health information about patients. But he says really effective electronic systems are able to integrate their records with those of neighboring doctors’ offices and pharmacies.

“And those are probably the biggest challenges because of the history of everyone having own records, maybe not using common platforms and just the fragmented system we’ve operated under historically,” Dillon says.

Dillon says implementing such electronic systems can also be expensive, especially for smaller hospitals. But he says new federal and state incentive programs, clearer HHS guidelines for how systems should be designed, and reduced Medicare reimbursements to places which aren’t electronic in the future, are bringing more hospitals on board.

Already, about one fifth of Missouri hospitals now have advanced electronic systems in place.

Elana Gordon, KCUR

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New petition would raise Missouri cigarette tax

A new petition aimed at raising Missouri’s cigarette tax has been approved for circulation. The measure would need about 90,000 signatures by next May to be on the ballot in 2012. Missouri’s cigarette tax currently stands at seventeen cents a pack, the lowest in the nation.

Public health advocates and long-time supporters of a tax-hike say it would significantly reduce the number of smokers in Missouri, curb health costs, and raise needed money for the state.

But, many are not on board with the new petition. Amy Blouin, director of the Missouri Budget Project, says it’s misleading.

“It brings in very little revenue and it’s designed to take something there’s strong public sentiment for, and skewing it so it benefits big tobacco,” Blouin said.

Blouin says that’s because the petition’s dollar tax increase would only apply to smaller, generic cigarette brands - but not the larger ones like Philip Morris. The petition’s sponsor is not taking calls about the initiative.

Elana Gordon, KCUR

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