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NewsBook:  Missouri Government News for the Week of October 13, 2014

Missouri Attorney General Chris Koster announced Friday morning that he had sought a state court order to prevent a hazardous waste disposal facility in north St. Louis from receiving Ebola-contaminated waste.

Stericycle obtained an emergency federal permit from the U.S. Department of Transportation's Pipeline and Hazardous Materials Safety Administration on Oct. 3. The permit allows the company to transfer Ebola-infected materials from Texas.

The permit does not specify a final destination for the waste except that it be the "nearest appropriate disposal facility available at the time."

Koster's court action is similar to one filed in Louisiana's government to stop the waste from landing in their state.

Stericycle, Inc., the international company that owns the St. Louis facility, has "the nation's largest network of medical waste transport vehicles, collection sites, and treatment facilities," according to the company's website.

Stericycle operates several waste management facilities within Texas.

The permit is what spurred Koster to seek a court order. A statement issued by the attorney general's office Friday cited an independent, three-year study that found that there had been "numerous violations" of state law at the St. Louis facility.

"This facility has a history of violations in the handling of medical waste," Koster was quoted as saying in the statement. "We should not allow this company to transport Ebola waste into our state without absolute assurance of safety."

A 2000 study by Health Care Without Harm, an international group promoting ecologically-conscious health care, noted that Stericycle had mishandled medical waste materials in several states, including Missouri.

On Monday Louisiana Attorney General Buddy Caldwell sought a restraining order to block the Dallas Ebola victim's incinerated personal belongings from being dumped in a Louisiana landfill.

"There are too many unknowns at this point, and it is absurd to transport potentially hazardous Ebola waste across state lines," Caldwell was quoted as saying in a release from his office.

However, "Ebola-associated waste that has been appropriately inactivated or incinerated is no longer infectious," according to the Centers for Disease Control and Prevention website.

Neither Koster nor a representative from Stericycle could be reached for immediate comment.

No special actions are being taken by Missouri hospitals to prepare for Ebola, but funding from the state is limiting their preparation efforts, Missouri Hospital Association's Vice-President Dave Dillon said.

Preparing hospitals for Ebola in Missouri is not a unique circumstance, he said. "We actually are not doing anything we wouldn't do for a similar emergency, whether it was Ebola or a pandemic influenza or reacting to an earthquake or another type of disaster," Dillon said.

Missouri hospitals have prepared for similar situations in the past and have been given resources to handle these types of situations.

"This isn't new because this has occurred. In fact, we have been, for over a decade, investing resources in Missouri in equipment and in training in staff at Missouri hospitals so that they have the capacity to respond to something similar to this," Dillon said.

Most Missouri hospitals have protective equipment available to them but Dillon said it is questionable if they have access to higher level equipment.

"Most hospitals already have a certain level of protective equipment for staff and probably have levels that are, access to levels, that are above what the CDC is currently recommending," Dillon said. "What's more, we actually, as an organization, have worked with the hospital community to strategically to locate cashes of equipment and supplies so that if, in fact, we were to have a hospital that had an event, we would be able to support them with additional equipment."

National Nurses United, a national nurses union, conducted a survey and found that nurses across the country are demanding more training to handle the illness and protection from the illness itself. RoseAnn DeMoro, the executive director of National Nurses United says there is no room for error in a situation like this.

“There is no standard short of optimal in protective equipment and hands-on-training that is acceptable,” DeMoro said in a news release. “Nurses and other frontline hospital personnel must have the highest level of protective equipment, such as the Hazmat suits Emery University or the CDC themselves use while transporting patients and hands on training and drills for all registered nurses and other hospital personnel including the practice putting on and taking off the optimal equipment. The time to act is long overdue.”

JEFFERSON CITY - Anti-child abuse groups and attorneys told a special Missouri legislative joint-committee Thursday sexually abused children need better post-abuse care.

The state legislature created "The Task Force on the Prevention of Sexual Abuse of Children" during the 2011 session and is now looking into how the task force performed and improvements members think can be made. Everyone giving testimony agreed the state needs to use more resources to provide evidence-based care to victims of sexual abuse.

"The things I have heard, the things I have seen, there is no human being on earth that can experience that and not have some very long term health issues if the trauma is not addressed," said Emily van Schenkhof, deputy director of Missouri KidsFirst. "So one of the things the task force is really trying to promote is that any child that has been sexually abused or any child that has been traumatized that they have the ability to be part of an appropriate mental health intervention, and we spend some time trying to heal that child."

Schenkhof said the state needs to spend a higher proportion of sexual abuse money on the victims, rather than on the perpetrators of sexual abuse. She said little-to-no evidence has shown it is possible to change the behavior of a sex offender older than 30.

Several guardians ad litem, or state attorneys representing children, said a program to better treat psychological issues of the sexually abused should be a top priority in revamping state funding on the issue.

"You watch the forensic interview, you hear the child speak, and that changes you," Missouri attorney Nicholas Mebruer said. "You know that that will permeate every aspect, every relationship that child will ever have [without adequate interventions]."

Liberal watchdog group Progress Missouri has filed an ethics complaint alleging lobbyists broke the law when providing more than $3,000 worth of food and beverages.

At issue is a loophole in Missouri ethics laws that allow lobbyists to not disclose who they are when they provide gifts to lawmakers.

The alleged violation occurred in Dallas at an American Legislative Exchange Council, or ALEC, meeting in August.

The complaint also alleges not all members of the General Assembly were invited, which Executive Director Sean Nicholson says is required by law.

He also says there is no way all lawmakers could've gotten to Dallas that night for dinner.

"When lobbyists file reports and say the entire General Assembly was at a Dallas steakhouse in August, we know and basic common sense tells us that's not true," Nicholson said.

House Speaker Tim Jones said he didn't know much about the complaint, but he did caution the public not to read much into it.

"I don't think that anybody should presume that buying somebody a dinner buys preference in any way," Jones said.

House Speaker Tim Jones, R-St. Louis County, said Wednesday Ferguson would be helped if Missouri became the 25th right-to-work state in the nation.

"Missouri is now an oasis of big labor influence and power," Jones said. "If you look at a map of the country, we're nearly surrounded by states that have gone to worker freedom states."

Jones also said the education establishment is too powerful and unwilling to change and that is a detriment to communities like Ferguson.

"While people continue to toe the line from what their superintendents want and simply vote lock-step with the superintendents, with the education establishment, we're not going to be able to make these big changes," Jones said.

Jones' ideas come just days after St. Louis Mayor Francis Slay pleaded for help for Ferguson and the entire St. Louis area.

Missouri's state health department held an Ebola training session on Tuesday, Oct. 7, to prepare the state's health officials should there be an Ebola case in the state.

More than 150 first responders, public health officials and hospital officials attended the meeting, said Ryan Hobart, Missouri Department of Health and Senior Services director of public information.

Hobart said they discussed the symptoms of Ebola and what to do with a patient who has Ebola-like symptoms.

"I think we're doing all we can to prepare," Hobart said.

While there is not a lead official on Ebola preparedness at the health department, Hobart said multiple officials in the health department's Communicable Diseases department are working on the issue, and that hospitals can contact the department "24/7" to report a case.

Because Ebola can be transmitted even after death, funeral directors must also take precautions.

For now, the National Funeral Directors Association has directed funeral homes and funeral directors to guidelines published by the Centers for Disease Control and Prevention, said Jessica Koth, NFDA public relations manager.

"The CDC will be there to help guide the funeral directors," Koth said.

The Missouri Nurses Association is also trying to educate and inform nurses around the state to be prepared for Ebola.

"Nurses are often times the first point of triage when these patients come in and it's critically important they're asking the right questions and being educated," Missouri Nurses Association CEO Jill Kliethermes said.

Kliethermes said nurses also attended the state health department's meeting.

So far the Governor's office has remained silent in response to St. Louis Mayor Francis Slay's plea for the government's help in addressing racial challenges and violence within the city.

Several attempts were made to legislators, including the governor's office, for comment on the mayor's plea but remained silent. This comes after many protests as a result of the actions in Ferguson.

On Tuesday, three people were left dead and one hospitalized after two separate shootings in northern St. Louis bringing the homicide total to one-hundred eight in two thousand fourteen, up from eighty-eight in two thousand thirteen.

Rep. Jay Barnes, R-Jefferson City, says he will introduce legislation that will transfer power from local prosecutors to the state's Attorney General.

The attorney general and a law enforcement agency that is not involved with the case would work together to decide if an officer should be prosecuted in the event of a deadly shooting involving police.

"The point of having the attorney general's office make these charging decisions and handle these cases is that there is no appearance of impropriety," said Barnes.

Barnes said he wants to create a system that gives confidence to a community that has mistrust where a deadly shooting would occur.

Last Week

Federal funding cuts have cost Missouri hospitals jobs and led to the shutdown of two facilities according to some health officials.

The Missouri Healthcare Association reported that by the end of September, hospitals had announced the elimination of 1,800 positions since 2013.

The organization's figure was calculated from reports by local news organizations and, in a few cases, hospital reports.

In addition, according to the Missouri Foundation for Health, federal funding reductions have been cited by two rural hospitals that recently announced their closures -- one in the central part of the state and the other in southwest Missouri.

The cuts are in various federal programs that provide reimbursement to hospitals that care for lower-income patients.

One of the major reductions involves federal funds that are provided to hospitals that comply with the federal requirement to provide care for uninsured patients regardless of ability to pay.

These are patients without private insurance or coverage by Medicaid or Medicare.

The health care plan for Missouri government workers has expanded coverage to include same-sex couples married in other states.

The policy change was announced on the plan's website, dated Oct. 8.

The Missouri Consolidated Health Care Plan said they will begin to accept enrollment applications from same-sex couples with a valid marriage license from another state. The government health care plan covers nearly 100,000 government employees and spouses, along with other government workers, according to their website.

Mia Platz, communication and publication manager for the Missouri Consolidated Health Care Plan, said same-sex spouses will be able to enroll in the program once the details are worked out.

"We're going to have a special enrollment period for folks who, if that situation does apply to them, they will have a time period where they can enroll, their spouses as well as their spouse's dependents," Platz said. "We are still finalizing the details on that, that all of our members will be receiving more information about that here very shortly."

The plan's change follows a decision from Jackson County Circuit Judge J. Dale Youngs, a Gov. Jay Nixon appointee, to require the state of Missouri to recognize same-sex marriages from other states.

"All they do is treat one segment of the population - gay men and lesbians - differently than their same-sex counterparts, for no logical reason," Youngs wrote in his opinion.

Missouri Attorney General Chris Koster announced he would not appeal the decision.

In separate statements, legislative leaders attacked Attorney General Chris Koster for his decision not to appeal a court decision requiring recognition of gay marriages from other states.

"I urge the Attorney General Chris Koster to do his duty as the state's lawyer and defend the law the voters enshrined in our constitution," Senate President Pro Tem Tom Dempsey, R-St. Charles, was quoted as saying in a statement issued by the Senate.

The House speaker used even stronger language in a statement issued two days later that attacked Koster's no-appeal decision.

"He cannot just abandon his duties when they are politically inconvenient, and I think it is disgraceful that he is attempting to do so," wrote House Speaker Tim Jones, R-St. Louis County.

Both statements were in response to a Jackson County circuit court decision that struck down a voter-approved constitutional amendment that prohibits the state from recognizing gay marriage.

Judge J. Dale Youngs wrote there is no government interest in prohibiting recognition of gay marriages that had been performed in other states.

"There is no logical relationship between that interest and laws that discriminate against gay men and lesbians who have been married in jurisdictions in which same-sex marriages are legal," he wrote.

Three days after that decision, Koster issued a brief, three-paragraph statement that he would not appeal the decision.

"Our national government is founded upon principles of federalism -- a system that empowers Missouri to set policy for itself, but also obligates us to honor contracts entered into in other states," Koster wrote.

In 2004, Missouri voters approved by a margin of greater than 70 percent a constitutional amendment proposed by the legislature that prohibits Missouri government from recognizing gay marriages.

In 2013, Gov. Jay Nixon issued an order requiring the state Revenue Department to accept joint tax returns filed by married gay couples if they had filed joint federal returns.

A new study by The Safety Institute, a non-profit organization that looks at product safety, determined that a type of guardrail used on Missouri highways can cause serious injury and even death upon impact.

The ET-Plus guardrails with a blunt end do not absorb impact properly and can act like a spear and impale cars that hit them.

Safety Institute president Sean Kane said these rails are far more dangerous than older models.

"What we learned is that the ET-Plus was showing a three-times greater fatality rate in impacts and almost a two-times greater increase in injury rates in the impacts compared to the predecessor," Kane said.

A statement by the Missouri Department of Transportation said the rails will not be used in future projects, and they are looking into existing rails on the highways.

They do not know exactly how many rails are in use and where they are located.

Kane said he thinks federal and state governments should investigate further.

"The study was really a response to the lack of response from the feds and also from the states," Kane said. "We wanted to be a catalyst to get them to examine how these end terminals are really performing."

Police Training Session

Police officers who fired rubber bullets and tear gas canisters two months earlier in Ferguson received training from a required state program.

The Department of Public Safety administers the Peace Officer Standards and Training, or POST, program, which oversees police officer standards and training in Missouri.

When it comes to specific policies, however, local police departments get the final say.

"Use of force policies are determined by local police departments, not POST," said Mike O'Connell, communications director for the Missouri Department of Public Safety.

Although specific rules and standards may vary throughout the state, all Missouri police officers are required to complete 48 hours of training every three years, and must be trained in legal studies, interpersonal communication, technical studies and skill development, including defensive tactics.

On Wednesday, Oct. 1, 23 students attended the Law Enforcement Training Institute in the Hearnes Center field house at the University of Missouri- Columbia, one of several POST-approved training academies throughout the state.

"You gotta manage your force," Adam Duncan, the institute's academy coordinator and chief defensive tactics instructor, told students as they began practicing take downs.

Norm White, associate professor of criminology and criminal justice at St. Louis University, said the nature of the job makes the issue of force more complex, as policing methods over the years have led to deteriorating community relations.

"They take on these jobs where they wind up having to be at odds all the time," White said. "So they're at war, as opposed to being a part of the community."

Senate Leader Tom Dempsey, R-St. Charles, said he's in favor of restoring the state Senate chamber to its original construction as long as the committees in charge of the restoration spend state funds wisely.

The Senate's Administration Committee consented to the restoration of the Senate's upper gallery to its original state by removing offices that were added in the 1970s.

Senators were interested in completing the restoration as the Capitol's 100-year anniversary approaches.

"The construction will allow us not only to restore the Senate Chamber to its original grandeur, but it will also help us create more meeting spaces," Dempsey was quoted as saying in a press release. "This will provide the public with additional space to access their senators."

In the press release, Dempsey also said he expects the Office of Administration to prioritize their work accordingly.

"The project is more of an issue of historical restoration than it is a face-lift," Dempsey said. "While there are many areas of repair needed at the Capitol, I trust the Office of Administration to make the best decisions in terms of timing and priority."

State Auditor Tom Schweich has recommended more training of government officials about the legal requirements for government meetings and records be open to the public.

His recommendation came after his release of nearly two decades of audits of how well state and local governments have complied with the state's Sunshine Law.

The various audits found numerous violations. But Schweich said that in many cases he thought it was confusion and misunderstanding about the requirements for openness in government.

"I would say that the vast majority of the violations that we find are just people don't understand the law," Schweich said.

One major area of criticism was occasions when government agencies held closed meetings without fully documenting the reasons for closing a meeting or recording minutes of the closed meeting as required by law.

"We can't really tell from looking at paper minutes whether they really didn't want the public to know they were talking about these subjects or whether they just didn't understand what's allowable and what's not allowable," Schweich said of some government meetings that had been closed in apparent violation of the law.

The state auditor said that much of the problem could be solved by just one hour of training of government officials about the requirements of the state's Sunshine Law.

His report had just two recommendations for legislative change. One was that the legislature clearly define that the records of individual legislators are covered by the law assuring public access.

The other legislative recommendation was for lawmakers to clarify where a quasi-governmental insurance program for employers is or is not covered by the Sunshine Law.

JEFFERSON CITY - A judicial candidate in Jefferson City has received $100,000 from a national Republican group.

The Republican State Leadership Committee based in Washington, D.C., donated the money on October 4 to Republican Brian Stumpe, according to a Missouri Ethics Commission contribution receipt.

Stumpe, a municipal prosecutor in Jefferson City, is running against incumbent Cole County Circuit Judge Pat Joyce, a democrat seeking her third six-year term in office.

In 2012, Joyce blocked a Republican-supported proposal that would require a photo I.D. to vote.

The Republican State Leadership Committee help Republican candidates get elected to government offices, according to its website.

"The Republican State Leadership Committee is the largest caucus of Republican state leaders in the country and the only national organization whose mission is to elect down-ballot, state-level Republican officeholders," the webite says. "Since 2002, the RSLC has been working to elect candidates to the office of lieutenant governor, secretary of state and state legislator. The RSLC has more than 100,000 donors in all 50 states."

The website also says that they monitor elections to determine who to contribute to.

"The RSLC closely monitors all state elections by gathering intelligence, working with candidates and party organizations, to determine the best use of RSLC resources to ensure victory for Republican candidates for state office," the committee's website says.

Neither of the treasurers for Joyce or Stumpe were available to comment.

Attorney General Chris Koster released a statement Monday saying he will not appeal a Jackson County Circuit Court ruling saying Missouri must recognize same-sex marriages performed outside the state.

"Our national government is founded upon principles of federalism – a system that empowers Missouri to set policy for itself, but also obligates us to honor contracts entered into in other states," Koster said in the statement.

The decision comes after a Friday ruling from Judge J. Dale Youngs, a Gov. Jay Nixon appointee, saying Missouri must recognize same-sex marriages performed in states where it is legal.

"All they do is treat one segment of the population — gay men and lesbians — differently than their same-sex counterparts, for no logical reason," Youngs wrote in his opinion.

The decision not to appeal also coincides with the Supreme Court deciding Monday not to hear appeals from five states that asked the Court to keep their gay marriage bans in place.

This could open the door to gay marriage being legal in 30 states.

Koster said that was a factor in his decision not to appeal.

"A consequence of this morning’s ruling by the United States Supreme Court is that gay marriage will soon be legal in as many as 30 states," Koster said. "At a time when Missouri is competing to attract the nation’s premier businesses and most talented employees, we should not demand that certain individuals surrender their marriage licenses in order to live and work among us."

"Missouri's future will be one of inclusion, not exclusion," Koster's statement concluded.

The Missouri Club for Growth launched a campaign in support of a constitutional amendment that would allow state lawmakers to override a governor's budget withholdings Monday.

Amendment 10 will appear on the November ballot. Rep. Todd Richardson, R-Poplar Bluff, proposed the amendment in January.

"For years, Governor Nixon has repeatedly held the state budget hostage for political purposes, negatively affecting our public schools and causing unnecessary funding delays for much needed projects and services throughout the state," MOCFG Chairman Bev Randles was quoted as saying in a press release.

The amendment would also bar the governor from proposing a budget based off revenue that has not yet been approved by the General Assembly.

According to an audit released by State Auditor Tom Schweich in September, Democratic Gov. Jay Nixon withheld $53 million in 2012. In 2013, Nixon withheld $82 million, but the funds were later released, according to the audit.

Under the Missouri constitution, a governor cannot restrict spending if actual revenue exceeds estimated revenue, as it did in 2012, according to the audit.