March 2, 2008 Missouri legislative up-date

1. Peer Review Legislation. Effort supported by MEMSA, MAA, Mo ACEP, Mo Fire Service Alliance, MDHSS & SAC.  SB 915 (Ridgeway), HB 1454 (Roorda) {has been assigned to Judiciary Committee}.  Would provide protection for Quality Improvement records from plaintiff attorneys.  Almost all health care providers have had this protection for many years.  This has been vigorously opposed by the Missouri Association of Trial Attorneys. Senate Hearing held on Thursday Feb 14. Passed 6-1 in Senate Committee.
2. Increased Medicaid Funding for ambulance services. Effort supported by MEMSA & MAA. We have already testified before two committees and met with some senior committee members.  Currently ground ambulance services only get 40% of what Medicare pays and air ambulances get only 26% of Medicare payments for Medicaid patients.  We are seeking to have the air and ground ambulance Medicaid rates set the same as the physician Medicaid rates which appears to be moving up to 65% of the federal Medicare rates.
3. Death Benefit for EMS, Fire & Law Enforcement. HB 1630 (Bruns), SB 966 (Dempsey). State Council of Firefighters is leading the effort, also supported by MEMSA, MAA & SAC.  This bill is the same as last year’s effort.  $100,000 death benefit and $10,000 burial contribution. SB 966 hearing will be March 4^th at 1 pm in Senate Committee Room 1.
4. Cell Phone 9-1-1 funding. We expect a bill to be filed soon which would set up a state-side pubic vote to place a monthly tax (50-75 cents) on cell phones which could then pay for the establishment of 9-1-1 in the 15 counties without 9-1-1 and the 80 counties with inadequate cell phone 9-1-1 services. No Primary Bill Filed as of today.  SB 1118 is current law but 25 cents, HB 1712 is an addressing bill which would allow for some additional taxation.
5. Stroke / STEMI Legislation. HB 1790 (Cooper) SB 1233 (Shields).  The effort is led by Dept of Health and is supported by MEMSA, MAA, ACEP, AHA, Mo Hospital Association and SAC.  This bill would create stroke and STEMI centers like we presently have trauma centers.  We expect Senator Shields to file a similar bill in the Senate.  Hearing held Tuesday Feb 26^th and the house committee voted 7-0 on 2-28-08.  The Chair of the Committee has announced that this is his priority bill for this year.  
6. Recall of Ambulance District Board Members. SB 978 (Griesheimer), HB 1936 (Joe Smith) {assigned to Local Government Committee}.  This effort is supported by State Council of Firefighters, SAC, MEMSA and MAA.  We do not know of any other elected officials who can not be recalled by the voters.  The bill closely follows the present law allowing for recall of board members of fire protection districts.  SB 978 has already passed in the Senate and is now waiting for a hearing in the House. This is a Consent bill which means that there is no opposition to the bill thus it may move more easily through the legislature. 
7. Legal Protection of Health Care providers during a large scale disaster.  HB 1609 (Cooper) {assigned to Health Policy}.  The effort is being led by DHSS with support from SAC, MAA & MEMSA.  One of the lessons learned in New Orleans is that lawyers will sue the medical professionals based on the “standard of care” related to a normal world and not the world in crisis.  This bill would recognize that the standard of care is different and thus help protect health care workers from lawsuits during a time of major crisis.  No hearing date set.
8. Volunteer Ambulance Staffing.  SB 1044 (Stouffer), HB 2000 (McGhee). SB 1044 has had a hearing in the Senate. The bill is to adjust staffing requirements for volunteer ambulance services. Senate Hearing held.