Budget Budget Budget…

 The State of Missouri’s budget situation will continue to dominate discussions during the upcoming legislative session. While current revenue figures are mostly on target, there are several different factors that will be influencing this year’s appropriations process. First there is expected $90-95 million supplemental request for physician and hospital lines in Medicaid and possibly an additional $20-$30 million supplemental request for in-home services. Additionally, tax cuts are also affecting the budget in the current fiscal year.  The first phase of tax cuts passed several years ago is expected to reduce revenues by $80 million in the last six months of the FY2018 and an additional $140 million for the FY2019 budget, which is beginning to be pieced together.

On January 3rd, 2018, Jefferson City, Missouri will once again be buzzing with policy makers, lobbyists, and interested parties jockeying to have their issues at the top of state government's priority list.

This week the Missouri Information Technology Advisory Board (ITAB) held their quarterly meeting. The committee is chaired by the Missouri CIO Rich Kliethermes and its members are made up from the heads of IT from the various state agencies, staff from all of the statewide elected officials, as well as Missouri’s Chief Information Security Officer and State Data Center Director. 

Several years of debate over the proper uses of technology in law enforcement activities brings to light a multitude of issues for legislators to tackle.  From body-cameras to license plate readers; REAL ID compliance and Prescription drug monitoring programs, all these issues conjure frightful thoughts of big brother watching and sacrifice of freedoms. However, technology in law enforcement can be used responsibly and effectively.

The two big terms floating around Missouri politics these days seem to be career politicians and special session.  Both of which nab headlines and conjure up feelings of dysfunctional government. Is one becoming the cause of the other? The constitution, after all, is designed to ensure a citizen legislature. In the Missouri legislature, there are two mechanisms in place to prevent state legislators having their service turn into a career. 

Missouri recently became the last state to implement a prescription drug monitoring program or PDMP as it is more commonly referred. A PDMP is a state run electronic database to track the prescribing and dispensing of certain classes of prescription drugs in order to curb or eliminate abuse. PDMP’s are typically implemented to address the growing opioid abuse crisis in the country, however many legislators, particularly here in Missouri, have serious concerns regarding patient privacy. These concerns are in large part the reason for the stalemate in years past of getting a bill to the Governer’s desk that establishes this type of program. A contingent of Missouri legislators has successfully blocked implementation of PDMP based almost solely on this concern. They argue that a person’s health information, specifically drugs they are prescribed, is information best left to the patient and their doctor and pharmacist. While these legislators have offered some level of compromises including time limited data retention, limited access to the database and/or the scattering of data so that large levels of patient data are not easily hacked into, most of these compromises have been labeled as being too much an impediment to the effectiveness of the program. These opposing forces have clashed year after year ultimately resulting in Missouri being the last state in the union to implement some sort of program. To date the Missouri legislature has not passed a bill for the implementation of a PDMP. However, the state now has begun implementation anyway…

The Governor had pushed hard during regular session for the passage of some version of a PDMP.  After the legislature failed to comply he had threatened something not typically used for these sorts of issues and that is a special session. After one successful special session regarding a time sensitive economic development issue the legislature appears to have slowed the gears to a halt with during the second special session pertaining to issues of abortion. It would seem as though the governors strategy of forcing the legislature to deal with specific issues in the confines of his special calls may have come to an end.  Thus, Governor Greitens has decided to go down a seemingly more popular means of affecting policy by the executive branch by issuing executive order 17-18 (linked here). Governor Greitens ever mindful of putting what he considers wins on the scoreboard sees has raised the ire of the legislature enough that the decision was obviously made to go it alone and enact a broad PDMP of which rules are to be promulgated by the Department of Health and Senior Services.

The legislature has already been reacting to the order from calling out the “Obama style tactics” to digging deeper into the policy flaws that plagued the program while being debated in the legislature. We will all have to wait and see what the concrete response this order will be. Will the legislature pass their own bill next session undoing any work that has been done by the EO? Will someone bring suit as to the constitutionality of the order? Or could the rules promulgated by the department get bogged down and challenged in JCAR? One thing is for certain in American government, when one branch feels as though its authority has been encroached upon the issue at hand has a harder road ahead than it likely would have by going through the traditional procedures.

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The final day of the 2017 session quickly devolved into chaos following one particular senator’s priority legislation dying in the House. This spurred a series of short filibusters in the final hours, and ended with the Senate becoming a complete pandemonium. Previous question motions were made by leadership to end debate on minimum wage legislation and force a vote. At this point, senators were not recognized for motions or comments, and a representative stormed the chamber accusing a senator of literally sentencing him to death for not passing a much-needed organ donor bill, all while Democrats attempted to shut down the Senate by moving for adjournment multiple times. After nearly 30 procedural moves, that were concurrently addressed by more PQ motions, the Senate passed the minimum wage “fix” and adjourned early.

On Thursday, Governor Greitens released his recommendations for the FY 2018 budget that included more than $572 million in spending reductions from last fiscal year. His budget is based of a 3.8% consensus revenue estimate.

Included in his cuts were $73 million reduction from the four year higher educations institutions, a 3% cut to all Medicaid providers,  changes in eligibility requirements for in-home and nursing care,  $31 million reduction in school busing programs and saw the Department of Agriculture’s budget cut by more than half.

On Monday Governor Greitens announced the an expected additional round of budgetary withholds. This comes just a week after he has taken office. Higher education institutions around the state bore the brunt of the cuts, $55 million from the four-year institutions and $11.8 million from community colleges. Other programs that took hits were transportation for K-12 education, the state’s bio-diesel incentives fund, core cuts to the state’s various humanities and cultural partners and Missouri’s tourism advertising budget.