Missouri Recovery Network
428 East Capitol, Second Floor Jefferson City, MO 65101
573-635-6669
www.morecovery.org
CAPITOL REPORT #16
April 18, 2007
 DMH/ADA Urges Participation in Strategic Planning ..…………………....……...…...... 1
 Mark Your Calendars for Recovery Day 2007 at Busch Stadium …………………….… 3
 MRN Continues Training on Stigma -Next Session is April 27 …. ……….…….……….. 3
 Seminar on “The Addicted Brain” in Chesterfield……………………………………….. 4
 Spring Training Institute: Strengthening Families – Enhancing Lives ………..………. 4
 Budget Bill Includes 4.5% Increase for ADA Service Providers ………………. ……… 4
 May 18 Deadline Looms for 2007 Legislative Session ………………………….….……. 5
 Which Bills of Interest Are Likely to Pass? ...............................................…….…..……. 5
 Status of Other Bills in Which Readers Have Shown Interest ………………..….……. 9
 Proposal for Internet Meth Registry Raises Concerns …………………..………..……. 12
 Transformation Workgroups Laying the Groundwork …………………….. .....….…. 12
 How Close is Missouri to Meeting the Need for Recovery Services? …………….……. 13
 Betty Ford Institute Panel Looking for Comments on Definition of Recovery ……..… 14
 Good Housekeeping Magazine Focuses on Very Young Alcoholics …………….…..…. 14
 HBO Series on Addiction Gets Attention ……………….. ………….………..…………. 15
 MRN Rally Generates Enthusiasm for Recovery Advocacy …………………………… 15
DMH Division of Alcohol and Drug Abuse
Urges Participation in Strategic Planning
At its April 13 meeting, the MRN Council visited with Mark Stringer, Director of the Division
of Alcohol and Drug Abuse. Mark encouraged members of the Council, as well as the MRN
general membership, to participate in the development of the Division’s new Strategic Plan,
which he would like to finalize before the end of the current fiscal year, i.e. June 30, 2007. The
Council is excited about the direction which the Division is taking and would like readers of the
Capitol Report to share in that excitement. Mark is especially interested in getting feedback on
the top five priorities:
1. Centers of Excellence for Addiction Treatment and Prevention
A Center of Excellence could provide services to general populations, or it could
focus on specialized services to specific populations: women, men, juveniles,
offenders, people with co-occurring disorders, older adults, etc. What should a
Center for Excellence look like? What services should it offer and how should it be
staffed? How can it serve as a model of treatment? In any case, services should be
individualized, since each person has individual needs.
2. Links to Health Care Systems
Each of the Centers of Excellence should be closely associated with one or more of
the major systems of health care or social services and be able to serve as a valuable
“specialty” adjunct to those services. Examples are the Department of Corrections,
Department of Social Services, Federally Qualified Health Centers, local health
clinics, drug courts, hospitals, or family services. How can that be achieved?
3. Prove Our Value!
Addiction services need to be able to prove that they are worth the investment of
public and private dollars. We operate in a competitive environment. Each proposal
for funding can make a claim for its value to society. How can we best make our
case for prevention and treatment services? What arguments can we advance that
will be compelling for policymakers? What can we tell legislators that will show the
impact of alcohol and other drugs on our state and nation? How can we show that
treatment and prevention is cost-effective?
4. Professional Development for Treatment and Prevention Service Providers
Training is being offered on an occasional basis, sponsored by various organizations.
How can they be brought together, and expanded, so that they meet needs for
professional development? How can we best use the available communications
technology? The Division is considering a “Virtual Training Academy,” a uniform
set of trainings which anyone could access at any time. It would further the goal of a
career ladder, which would help those who are in the field stay in the field and also
attract new employees. Workforce development continues to be a great need. How
can we help make that a reality?
5. Treatment on Demand
The existence of waiting lists for treatment is a tragic reality. There is great demand
with a lack of services available. Needs assessments have been conducted, and we
have reliable estimates of the number of Missourians who are impacted by alcohol
and other drug addiction (see page 13, below, for an example). However, the
“supply” of resources is very limited. Mark stated that 85% of those who seek
treatment and do not receive it immediately do NOT come back a second time and
therefore opportunities for treatment and recovery are lost. “Treatment on Demand”
is a goal, a long-range goal articulated by national advocacy organizations for
decades. How can we make it a reality in Missouri? How can we make progress
toward hope and help for those who need it?
Mark asked that anyone who has ideas and suggestions on these priorities, or other important
aspects of strategic planning, contact him via e-mail at mark.stringer@dmh.mo.gov. Feedback
should also be shared with the Division’s new Deputy Director, Barbara Keehn, who can be
e-mailed at barbara.keehn@dmh.mo.gov.
Director Stringer also announced several other changes in Division staff assignments and
appointments. Barbara Keehn is Deputy Director but retains her title as Eastern District Administrator. The lineup of senior managers now looks like this:
2















Western District Administrator – Dave Fleming
Central District Administrator – Debbie McBaine
Eastern District Administrator – Barbara Keehn
Clinical Director – Terry Morris
Clinical review & Compulsive Gambling – Nora Bock
Certification and Safety – Pat Veltrop
SATOP – Steve Deets
Faith & Community Services – George Norman
Director of Administration – Laurie Epple
Director of Operations – Sue Leutwyler
Director of Policy and Development – Marsha Buckner
Director of Prevention – Angie Stuckenschneider
Research & Statistics – Jodi Haupt
Staff Development – Bianca Arrington-Madison
Director of Prevention – Angie Stuckenschneider
Contact information for staff can be found at http://www.dmh.missouri.gov/ada/org/senior.htm.
Mark Your Calendars for Recovery Day 2007 at Busch Stadium!
In recognition of National Alcohol and Drug Addiction Recovery Month, MRN will once
again CELEBRATE recovery at Busch Stadium in St. Louis. The date has been set for Sunday,
September 23, when the St. Louis Cardinals host the Houston Astros at 1:15 p.m. MRN hopes
to sell 600 tickets for the game. We invite you to come celebrate recovery with MRN! Details
will follow in the next Capitol Report and MRN newsletters, which can be accessed at
http://www.morecovery.org/newsletter.asp.
MRN Continues Training on Stigma – Next Session April 27
The fourth in a series of workshops, “The Stigma Stops Here: Confronting Stigma Where
You Find It,” will be conducted on Friday, April 27, 2007 at Provident, Inc. in St. Louis, from
9:00 a.m. to 3:00 p.m.. Previous workshops were conducted in Jefferson City, Springfield and
Kansas City. More than 30 people have already signed up for the St. Louis session, and interest
in this important subject is strong. Five CEU’s will be awarded to participants. The cost is
$20.00,
which
includes
lunch.
Registration
can
be
done
online,
at
http://morecovery.org/events.asp or by calling the MRN office at 573-635-6669.
The workshop addresses perceptions of addiction and recovery and how they have been
shaped by our personal environment and by the media. The training focuses on our response to
stigma, how we can confront stigma and discrimination on a daily basis, as well as on a planned
level through public education, policy shaping efforts, and joining with other groups and
3
organizations to make a difference. Resource materials and examples of successful events are
given throughout the presentation. It is also a great networking opportunity!
Seminar on “The Addicted Brain” Offered in Chesterfield
MRN is co-sponsoring “The Addicted Brain” seminar to be conducted on Friday, April 20,
2007, from 7:30 a.m. to Noon, at the Doubletree Hotel and Conference Center in
Chesterfield, MO. The event, held in recognition of Alcohol Awareness Month, is sponsored
by CenterPointe Hospital. Other co-sponsors are the National Council on Alcoholism-St. Louis
Area (NCADA), the Missouri Nurses Association (MONA), and Employee Assistance
Professionals Association-St. Louis Chapter (EAPA). The presenter is David L. Ohlms, M.D.,
medical director of chemical dependency services at CenterPointe. Learning objectives include
improving the understanding of the biochemistry of addiction; the reward pathway of addiction;
dopamine’s role, and the role of endogenous opiates in addiction. Continuing education credit
has been approved for social workers, counselors, psychologists, nurses and physicians through
UM-SL and the St. Louis Metropolitan Medical Society. For more information, contact the
MRN office at 573-635-6669.
Spring Training Institute: Strengthening Families –Enhancing Lives
The Department of Mental Health’s 2007 Spring Training Institute will once again be held at
Tan-Tar-A Resort and Conference Center, Osage Beach, Missouri. The dates are May 16-18,
and this year’s theme is “Strengthening Families – Enhancing Lives”. The Institute is designed
for consumers, providers, and staff of the Department’s three divisions. It also attracts staff from
other state agencies and private, voluntary organizations. The Institute provides opportunities to
learn about the latest research, evidence-based treatment and other issues related to the people
served by the Department. For an informative “Conference at a Glance” and registration
materials, visit http://dmh.missouri.gov/ada/provider/springtrain.htm.
Budget Bill for FY2008 DMH/ADA Operations
Approved by the House, Makes Progress in the Senate
The budget picture for Fiscal Year 2008, which begins on July 1, 2007, looks a bit brighter as
the Senate Appropriations Committee has recommended a 4.5% cost-of-living increase for the
treatment and prevention services provided by the Division of Alcohol and Drug Abuse. This
amounts to about $4.1 million. On the other hand, the Senate Committee has rejected the House
of Representatives’ recommendation for a $1 million allocation for treatment of adolescents with
co-occurring addiction and mental illness, and $300,000 for meth counseling. Prospects seem to
be dim for three other items requested by the Department: the $2.75 million for expansion of
recovery support services, the Opportunities to Succeed program (DOC), the public inebriate
program in St. Louis, and expansion of the school-based SPIRIT program to other sites.
Readers are reminded that these are only recommendations at this point. The bill still needs
to be approved by the full Senate, and discrepancies between House and Senate versions will
have to be negotiated by a conference committee, approved by both chambers, and then the
“truly agree to and finally passed” version is subject to approval or veto by the Governor. By
4
law, appropriations (budget) bills must be on the Governor’s desk two weeks before the close of
session, i.e. on May 11th this year.
May 18 Deadline Looms for 2007 Legislative Session
There are only about 20 legislative days remain in the current Regular Session of the Missouri
General Assembly, which ends at 6:00 p.m. on May 18. Of the more than 1,300 bills introduced
in the House of Representatives, 139 have been third read, passed and sent to the Senate. Of the
more than 750 bills and resolutions introduced in the Senate, 156 have been passed and sent to
the House. All bills that have not been ”truly agreed on and finally passed,” i.e. approved by both
chambers at the deadline, fail at that point and proponents will have to start again in 2008. The
Governor could call for a Special Session, which could focus only on specific legislation
identified in that call. Governors are generally reluctant to do so, due to the extra cost involved,
but it may happen if his priority legislation does not succeed in the regular session.
Of greatest concern to Governor Blunt and legislative leaders is the Medicaid reform
legislation, which must pass in some form – or the deadline must be extended beyond June 30,
2008, the date by which the Medicaid program is to end, as agreed by the legislature two years
ago. The terms of SB 577, the “Missouri Health Improvement Act of 2007,” sponsored by Sen.
Charlie Shields (R-St. Joseph), which replaces Medicaid with Missouri HealthNet, would go into
effect immediately on passage, though implementation would extend over three years.. That bill
was approved by the Senate by a vote of 26-7 on April 4. It is likely to get extensive debate in
House Committee and on the House floor, and then the differences between House and Senate
versions will have to be negotiated by a conference committee. Meanwhile, two bills introduced
– one by a Republican and one by a Democrat -- would extend that “sunset” deadline to 2009
and 2010 if legislators and the Governor are unable to reach an agreement.
The next issue of the MRN Capitol Report will look more closely at SB 577. The text of the
bill already covers 75 pages. Responding to critics, Senator Shields said that legislators are
trying the reach an appropriate balance of general and detailed guidance for MO HealthNet. He
suggested that the bill could become a 1,000-page document if it contained all of the details
requested by its detractors!
Which Bills of Interest Are Likely to Pass in 2007?
Among the bills passed by the Senate and sent to the House, in addition to SB 577 (Shields)
are the following. Please note that these bills can still be amended. Readers with special
interests in the subject matter are encouraged to review the full texts of the bills.
Among the bills passed by the Senate and sent to the House are the following:
SB 3 (Gibbons) – The “mental health reform” bill. It provides for (a) new fire safety
standards, including sprinklers, (b) a definition of “vulnerable person,” (b) sex offender
notification, (c) abuse and neglect investigations, (d) civil immunity and penalties under certain
conditions, and (e) a mental health facility review panel. The bill is in the House’s Health Care
Policy Review Committee, which has not yet scheduled a public hearing.
5
SB 46 (Mayer) – The “Faith-Based Organization Liaison Act” [see MRN Capitol Report #15].
provides that the Director of the Department of Social Services designate regional departmental
employees to serve as liaisons to faith-based organizations in their regions. The liaison's primary
function will be to communicate with and promote faith-based organizations as a means of
providing private community services to benefit persons in need of assistance who would
otherwise require financial or other assistance under public programs administered by the
department. The bill has been approved by the House Committee on Family Services and sent to
the Rules Committee, which voted to advance the bill on April 16. An identical bill, HB 888
(Grisamore) was given a “do pass” recommendation by the House Committee on General Laws,
but that committee has not yet reported the bill to the House floor.
SB 85 (Champion) – Establishes a prescription drug monitoring program in the Dept. of
Health and Senior Services and modifies existing record keeping for controlled substances and
pseudoephedrine products. Includes: “The department shall, when appropriate: (1) work with
associations for impaired professionals to ensure intervention, treatment, and ongoing
monitoring and follow up; (2) encourage individual patients who are identified and who
have become addicted to substances monitored …. to receive addiction treatment. The
department…. Shall consult with the department of mental health in developing and
implementing patient intervention and referrals. The Senate Bill was first read in the House on
April 12. It is scheduled for second reading and referral to committee.
SB 107 (Wilson) – Creates the crime of distribution of a controlled substance to a person in or
on, or within 2,000 feet of a public or private state, county or municipal park – a Class A
felony. In the House Committee on Crime Prevention & Public Safety.
SB 158 (Engler) – Bars state and local agencies, including school districts, from discriminating
between Licensed Professional Counselors. Voted “do pass -- consent” by the House Committee on Professional Registration and Licensing.
SB 159 (Engler) -- Revises the complaint procedures against a Licensed Professional
Counselor or Licensed Clinical Social Worker by an inmate. Voted “do pass -- consent” by the
House Committee on Professional Registration and Licensing.
SB 195 (Crowell) – Amends laws pertaining to licensing of pharmacists. Also authorizes (but
does not require) the establishment of an impaired licensee committee, to be designated as the
“Well-Being Committee ….. to promote the early identification, intervention, treatment
and rehabilitation of licensees who may be impaired by reasons of illness, substance abuse, or
as a result of any physical or mental condition.” The State Board of Pharmacy may enter into a
contractual agreement with a nonprofit corporation or an association for the purposes of
administering the committee. The Board may require a pharmacist to submit himself or herself
for identification, treatment, or rehabilitation by the committee as a condition to issuing or
renewing the pharmacist's license. The board may also enter into a diversion agreement and
refer the licensee to the committee in lieu of pursuing disciplinary actions. Similar language is in
SB 523 and HB 545 [see below]. The bill was approved by the House Committee on General
laws and Rules Committee, and is ready for House floor debate.
SB 226 (Stouffer) – Requires courts to forward alcohol- or drug-related driving offense
dispositions to the Dept. of Revenue (DOR) within 7 days and requires DOR to then forward the
6
information to the MO State Highway Patrol within 15 days. Second read in the House on
March 7; not yet referred to committee.
SB 239 (Stouffer) – A large “omnibus” bill (a Senate Substitute) that deals with numerous
revisions of motor vehicle related laws. Among the more than 35 issues addressed are two
measures which started out as separate bills: (1) Banning of applicants who have been convicted
of an intoxication-related traffic offense from receiving a school bus endorsement; and (2) the
DWI Memorial Sign Program, which requires MoDOT to place signs at or near the scene of a
crash. Any person may apply to MoDOT to sponsor a drunk driving victim memorial sign in
memory of an immediate family member who died as a result of a motor vehicle accident caused
by a person who was shown to have been operating a motor vehicle in violation of an alcoholrelated traffic law at the time of the accident. MoDOT will charge the sponsoring party a fee to
cover the costs involved. Signs are to remain in place for a period of ten years. After such date,
the signs may be renewed for another 10 years after payment of appropriate maintenance fees.
The signs developed by the department are to resemble a Missouri license plate and feature the
words "Drunk Driving Victim!” the initials of the deceased victim and the month and year in
which the victim of the drunk driving accident was killed. All private roadside memorials or
markers commemorating the death of a drunk driving victim are prohibited. The language of this
bill has been changed. The original bill (SB 185) also added the words “Who’s Next?” to the
sign, but that language was eliminated from the latest version of the bill. SB 239 is in the
House Special Committee on Tax Reform, which has scheduled a hearing for April 17.
SB 272 (Scott) – A bill which deals with various areas of professional licensing. It includes
provisions that would (a) ban discrimination between Licensed Professional Counselors, as in
SB 158, above; and (b) reciprocity requirements for out-of-state applicants as Licensed
Professional Counselors, as in SB 498, below. SB 272 is on the House Calendar of Senate Bills –
Consent.
SB 299 (Purgason) – Extends the expiration date from 2007 to 2010 for certain allowing
issuance of special permits by the Division of Alcohol and Tobacco Control for extended
operating hours to resorts serving alcohol to overnight guests. In House Committee on Local
Government.
SB 308 (Crowell; House Handler: Wasson) – An omnibus bill dealing with various professional
licenses. Included in the House Committee Substitute (HCS) for the bill are provisions for an
Impaired Nurses Program. See HB 914, below. The HCS was approved by the House
Committee on Professional Registration & Licensing and the Rules Committee, and is now on
the House Calendar of Senate Bills for Third Reading.
SB 334 (Griesheimer) – A brewer or importer who assigns brand extension for beer products
to a wholesaler, shall offer to assign such brand extension to the appointed wholesaler. “Brand”
and “brand extensions” are defined in the bill. In House Committee on Local Government.
SB 498 (Scott) – Amends reciprocity requirements for Licensed Professional Counselors.
Requires out-of-state licenses to be 18, of good moral character, a U.S. citizen or lawfully
present in the U.S. in order to be eligible for licensure in Missouri. In House Special Committee
on Professional Registration & Licensing. This provision is also included in HB 780 (Wasson),
which was passed by the House and is currently on the Senate Consent Calendar.
7
Among the bills passed by the House and sent to the Senate are the following:
HB 39 (Portwood) – The “Ticket to Work” bill. Requires the Dept. of Social Services to
determine the eligibility of an employed disabled person requesting medical assistance whose
family gross income is less than 350% of the federal poverty level. Would restore benefits to
some persons who lost them as a result of previous legislation. Cost to the General Revenue
Fund is estimated at $11.7 million in FY2008. The Senate Committee on Health & Mental
Health reported out a Senate Committee Substitute (SCS) for the bill on April 12.
HB 364 (Erwin) – Income tax deduction for health insurance premiums. Authorizes 100%
of the amount paid for nonreimbursed qualified health insurance premiums to be deducted from a
taxpayer’s Missouri taxable income to the extent the amount is not already included in itemized
deductions. Estimated cost to the General Revenue Fund is $2.4 million to $11.2 million in
FY2008. In Senate Health & Mental Health Committee.
HB 444 (Jetton) – Authorizes an income tax deduction for Social Security benefits, SS
disability benefits, or benefits received from a retirement system, regardless of income.
Estimated cost to the General Revenue Fund is more than $285.7 million in FY2008. In Senate
Ways & Means Committee, which conducted a public hearing on March 12. No further action.
NOTE: Reducing the General Revenue Fund means less money available
to fund vital services, both in FY2008 and in the years ahead.
HB 469 (Wallace) – Amends laws pertaining to school employee liability, safety practices, and
reporting acts of violence. References to medication and medical services. SCS reported out by
the Senate Education Committee on April 12.
HB 545 (Wasson) – Similar to SB 195 (above), including authorization of a Well-Being
Committee for pharmacists and procedures for intervention, treatment and rehabilitation by
the State Board of Pharmacy. The Senate Committee on Financial, Governmental Organizations
and Elections conducted a public hearing on April 2.
HB 554 (W. Cooper) – Identical to SB 158 (above). Discrimination between Licensed
Professional Counselors. Reported “do pass-consent” by the Senate Committee on Financial,
Governmental Organizations and Elections. On the Senate Calendar of Consent Bills.
HB 555 (W. Cooper) – Revises the complaint procedures against a Licensed Professional
Counselor or Licensed Clinical Social Worker by an inmate. Reported “do pass-consent” by the
Senate Committee on Financial, Governmental Organizations and Elections. It is on the Senate
Calendar of Consent Bills.
HB 914 (Dougherty, Wasson) -- This omnibus bill relating to various licensed professionals
includes language [added in committee] which authorizes the State Board of Nursing to establish
an impaired nurses program “to promote the early identification, intervention, treatment
and rehabilitation of nurses who may be impaired by reasons of illness, substance abuse, or as
a result of any mental condition. This program shall be available to anyone holding a current
nursing license and may be entered voluntarily …. or as a condition of a disciplinary order
8
entered by the board of nursing.” Includes provisions for record-keeping, confidentiality of
information, and other procedural matters. The House Committee Substitute (HCS) for the bill
was approved by the House by a vote of 147-6 and sent to the Senate. It is in the Senate
Committee on Financial, Governmental Organizations and Elections.
Status of Other Bills of Interest
Ready for Third Reading and a final vote in the Senate:
SB 616 (McKenna) – This omnibus “liquor control” bill proposes changes in laws dealing with
various issues advanced by the three-tiered beverage alcohol industry (producers, wholesalers,
retailers), e.g. “point-of-sale” advertising materials; gifts to permit holders; sweepstakes /
contests on licensed retail premises; payments or donations for training on preventive sales
to minors and intoxicated persons; permission to allow producers to sell or give permanent
outdoor signs to retailers; permission for contributions to fraternal, civic, service, veterans,
charitable and religious organizations; limits of 6 licenses to wineries to sell at retail;
permission to make contributions to special events; liberalized hours of sale in Kansas City and
Jackson County convention trade area (may stay open until 6:00 a.m. rather than the current 3:00
a.m.); wineries that serve on the premises may open on Sundays at 9:00 a.m. instead of 11:00
a.m.; late charges for license applications, not to exceed $300; samples for tasting purposes;
license to festival district promotional associations to allow consumption in common areas (if
minors are allowed to enter, they must be easily distinguishable from persons of legal age).
An interesting feature of the bill is the addition of a policy statement at the beginning of the
chapter which contains the liquor control statutes:
“Alcohol is, by law, an age-restricted product that is regulated differently than
other products. The provisions of this chapter establish vital state regulation of
the sale and distribution of alcohol beverages in order to promote responsible
consumption, combat illegal underage drinking, and achieve other important
state policy goals such as maintaining an orderly marketplace composed of
state-licensed alcohol producers, importers, distributors and retailers.”
Ed. Note: It is common for the alcohol industry to include something in their bill which sounds
reasonably attractive to health and safety advocates. In this instance it is the reference to “age”
as the distinguishing feature. Other reasons for regulation could be added: the effects of
intoxicating characteristics of the product, the effects of increased accessibility to the product;
the range of harmful consequences, including addiction, etc. Instead, the industry relies on
promotion of “responsible consumption,” which is not defined. This bill was debated and
“perfected” on April 16. It is on the Senate Calendar of Bills for Third Reading.
Bills Approved by Committee and Ready for Floor Action:
SB 555 (Gibbons) – Combined bill (SCS) with new underage drinking law provisions and
banning of alcohol vaporizers (Alcohol Without Liquid (AWOL). On Senate Formal Calendar
SB 250 (Ridgway) -- Boating While Intoxicated – laws parallel to those for DUI
9
HB 913 (Schneider) – Liquor control: merchandising regulations, longer serving hours for
certain resorts and wineries, wine samples for tasting purposes, special licenses for festival
district promotional associations
SB 644 (Griesheimer) – Direct wine sales (new licenses) of up to two cases per month to
Missouri residents who are at least 21 years of age for personal use.
HB 944 (S. Cooper) – Direct wine sales -- Same as above.
Bills Remaining in Committee:
NOTE: these bills are probably “dead” for the year, though they could show up as amendments to bills that are still “alive.” Nothing is certain until 6:00 pm. on May 18, 2007.
SB 216 (Crowell) – Creates the crime of driving with any controlled substance in the body
SB 289 (Engler) – Modifies the definition of the practice of professional counseling
SB 621 (Engler) – Changes the name of the DMH Division of Mental Retardation and
Developmental Disabilities (MRDD) to Division of Developmental Disabilities (DD)
SB 622 (Engler) – Requires construction employees to take alcohol and drug tests and test
negative before working on projects on school and state property
SB 676 (Goodman) – Criminalizes prenatal alcohol and other drug use. Child abuse, a Class
C Felony, if the pregnant woman chronically and severely exposes the unborn child and the child
is demonstrably adversely affected.
Second-degree child endangerment, a Class A
Misdemeanor, if there is exposure to the unborn child.
HB 234 (Tilley) – Authorizes Perry County to impose a quarter-cent sales tax for senior
service and youth programs
HB 292 (Roorda) – Creates the crimes of altering or falsifying drug or alcohol test results or
selling or transporting a biological sample or adulterant to falsify test results
HB 438 (Storch) – The 21st Century Scholars Program; students are eligible for scholarships if
they pledge not to drive while intoxicated (no reference to drinking), use drugs, run away, or
become truant. HB 1172 (J. Harris), a similar bill is also in committee.
HB 446 (Deeken) – Creates the Fund for the Reduction of Alcohol-Related Problems and
Underage Drinking, with current proceeds from alcohol excise taxes to be used for prevention,
treatment and recover, and traffic safety
HB 484 (Hughes) – The Missouri Universal Health Insurance Act – single-payer plan
10
HB 737 (Meiners) – Prohibits the Division of Alcohol and Tobacco Control from restricting the
use of any self-service, coin-operated device for selling alcoholic beverages.
HB 885 (K. Wilson) – Impoundment of vehicles, under certain conditions, as part of the
penalty for DWI.
HB 925 (St. Onge). – Requires any person guilty of any intoxication-related traffic offense to use
an ignition interlock device for a period of at least 12 months.
HB 926 (Roorda) – Imposes an excise tax on controlled substances and illicit alcoholic
beverages, defined as “products known as ‘bootleg liquor,’ ‘moonshine,’ ‘nontax-paid liquor,’
and ‘white liquor.’”
HB 972 (Deeken) – Allows persons who have been convicted more than twice of driving while
intoxicated to obtain an ignition interlock restricted license for a one-year period if the person
meets certain requirements, such as successful completion of a DUI monitoring court program or
continuous alcohol monitoring or twice daily breath testing. License may be reinstated if the
device has not prevented operation due to excessive BAC and there is no evidence of tampering.
HB 974 (Silvey) – Prohibits any person under the age of 21 who is not an underage entertainer
from being present in a drinking establishment, which is defined in the bill. Violation is a
class C misdemeanor.
HB 982 (J. Harris) – Additional penalties for conviction of DUI when BAC was at least 0.16%.
HB 984 (J. Harris) – Impoundment of vehicles (similar to HB 885, above)
HB 1032 (Day) – Abolishes the Drug Abuse Educational Assessment and Community
Treatment Program in the Departments of Mental Health and Corrections, and the Correctional
Substance Abuse Earnings Fund.
HB 1138 (Villa) – The medical marijuana bill
HB 1151 (Wilson) – Requires special license plates for persons convicted of DUI, a color that is
easily distinguishable from other plates – must be displayed for one year
HB 1166 (N. Cooper) – Required drug testing for construction workers - same as SB 622, above.
HB 1194 (Schaaf) – Extends expiration date of the MO Medicaid Program to June 30, 2009
HB 1286 (Dixon) – Establishes the Child Abuse Prevention Task Force, with
recommendations to be implemented by state agencies, courts, child welfare, education, faithbased and citizen advocacy
HB 1207 (Davis) – Prohibits use of all tobacco products in the Capitol Building.
HB 1258 (J, Baker) – Extends expiration date of the MO Medicaid Program to June 30, 2010.
11
Meth Registry Proposal Raises Concerns
The MRN Council has expressed concerns about the legislative proposal to establish a
Methamphetamine Offense Registry in the Missouri State Highway Patrol. Such a registry is
patterned after the Sex Offender Registry operated by the Patrol. Questions have arisen about
the appropriateness of associating the public safety aspects of sex offenders and people who
suffer from addiction that need treatment and recovery services. This could add to the stigma
experienced by people who suffer from addiction and contribute to the myth that there is
no hope for recovery.
Key sections of the legislation read as follows:
….. Subject to appropriations, the highway patrol shall maintain a web page on the Internet
which shall be open to the public and shall include a registered methamphetamine offender
search capability. The offender search shall make it possible for any person using the
Internet to search for and find the information specified in subsection 2 of this section, if
known, on methamphetamine offenders registered in this state.
2. (1) Any person who is convicted of …. distributing, delivering, manufacturing, producing
or attempting to distribute, deliver, manufacture or produce methamphetamine, or possessing
with intent to distribute, deliver, manufacture or produce methamphetamine … shall be
included on the methamphetamine offense registry.
(2) The registry information shall consist of the person’s name, date of birth, the nature and
date of all offenses qualifying the offender to register, and any other identifying data the
highway patrol determines is necessary to properly identify the person, but shall not include
the person’s social security number….
The original bill, SB 167 (Bartle) was combined with other bills into a Senate Committee
Substitute for SB’s 660, 553, 557, 167, 258, 114 & 378. It will be referred to by its first number,
SB 660. Other sections of the bill deal with arson, DNA profiling, determination of sex offender
residence, and “explosive weapons,” The bill is on the Senate Calendar of Senate Bills for
Perfection at this time. Key legislators are Senators Matt Bartle (R-Lee’s Summit) and Rob
Mayer (R-Dexter). Since the full Senate will debate the bill, concerned readers may want to
contact the Senator who represents the district in which they reside. It is common for legislators
to reflect their constituents’ concerns during debate.
Transformation Workgroups Laying the Groundwork
for Development of Specific Objectives
Five of the six workgroups formed by the Department of Mental Health’s Office of
Transformation have been meeting regularly since early March [see Capitol Report #15 for an
introduction to the project]. The workgroups have titles which correspond to the project goals:





Mental Health is Essential to Overall Health
Consumer and Family Driven Services
Disparities are Eliminated
Easy, Early Access
Evidence-Based Practice
12
The sixth group, “Technology,” has met once. Each of the groups consists of about 40
members, representing not only DMH staff but also other state agencies, service providers, and
advocacy organizations. In their first three meetings, the groups were given an orientation from
project staff, reviewed the charter, reviewed other planning efforts underway, conducted a
“visioning exercise” and an “environmental scan.” The latter, similar to a “SWOT analysis,”
asks participants to list (a) what is currently working well, (b) what is not working so well, (c)
what opportunities will present themselves in the next five years, and (d) what barriers will
present themselves. The next steps for each group are development of objectives, prioritization
of those objectives, and development of strategies.
Each of the groups has also engaged in “model building,” using Washington University’s
Causal Mapping Exercise. The result has been the generation of “causal maps.” The exercise is
described as follows: “Any major transformation of organizations or service systems requires
developing a shared understanding of the problem and its underlying causes. This can be
difficult as stakeholders are challenged to see the larger whole. Group model building is a
formal approach to mapping the causal structure of a problem. With origins in system dynamics,
group model building uses both qualitative and quantitative modeling techniques.”
The Transformation Project website contains background and contact information, initial
plan, group charters, meeting schedules and locations (all are open meetings), meeting
summaries and agendas. Visit http://www.dmh.missouri.gov/transformation/transformation.htm.
How Close is Missouri to Meeting the Need for Recovery Services?
How Many Missourians Need Treatment for Addiction
But Are Not Getting It – And Why Not?
The “environmental scan” activities launched by the Mental Health Transformation
workgroups, the new emphasis on health and wellness in Medicaid reform proposals, and the
stated long-range goal of “treatment on demand” by the DMH Division of Alcohol and Drug
Abuse have raised questions about assessments of need and the prospects for reducing the tragic
human and economic toll which alcohol and other drug problems take on the state of Missouri.
Last year, Capitol Report #4 (February 27, 2006) included a partial response to such questions.
In case readers missed it, we have reprinted it here and hope that it will serve to advance the
discussion:
In a recent study,* the Institute of Medicine of the National Academy of Sciences addresses
the issue of “failure to treat mental and substance use problems and illnesses.” It cites a
SAMHSA survey (2004) which tried to determine reasons for not receiving treatment they
believe they needed. Reasons given by respondents were: not ready to stop using (41.2
percent), cost or insurance barriers (33.2 percent), stigma (19.6 percent), did not feel the need
for treatment (at the time) or could handle the problem without treatment (17.2 percent), access
barriers other than cost (12.3 percent), did not know where to go for treatment (8.7 percent),
believed treatment would not help (6.3 percent), and did not have time (5.3 percent).
If these percentages were applied to the results of the treatment needs assessment conducted
by the Missouri Division of Alcohol and Drug Abuse, an estimated 491,223 in need of substance
abuse treatment, the estimated numbers of Missourians who responded would be as follows:
13
Not ready to stop using …………................................................................ 202,292
Cost or insurance barriers …………………………..……………..…….…163,012
Stigma ……………………………………………………………………… 96,236
Did not feel the need for treatment or could handle without treatment …… 84,452
Access barriers other than cost ……………………………………….…… 60,393
Did not know where to go …………………………..…………………….. 42,717
Believed treatment would not help ………………………………….…….. 30,933
Did not have the time ……………………………………………….….….. 26,023
Such combinations of numbers may not be scientifically sound, to be sure, but in the absence
of anything more definitive, worth consideration. The actual number treated in programs
funded by the Missouri Division of Alcohol and Drug Abuse in FY2004 was 36,878. The
Institute of Medicine estimates that 25% of the total would enter treatment in the private sector
and 75% in the public sector.
*Improving the Quality of health Care for Mental and Substance-Use Conditions:
Quality Chasm Series (National Academy of Sciences, 2006).
Betty Ford Institute Consensus Panel Looking for Comments
on Proposed Definition of Recovery
Judie Didriksen, who serves on the Board of Directors of Faces and Voices of Recovery as
their Mid-American regional representative for that organization and also serves on the MRN
statewide council, has asked for review and comment on a proposed definition of recovery. The
proposed definition is described in a white paper, “What is Recovery? A Working Definition
from the Betty Ford Institute,” issued by the Institute’s Consensus Panel. The panel notes that
“the lack of a standard definition of this term [recovery] has hindered public understanding of
and research on the topic that might foster more and better recovery-oriented interventions.” It is
important to have a definition into which “the recovery community” has had input.
The short definition they propose is: “Recovery from substance dependence is a
voluntarily maintained lifestyle characterized by sobriety, personal health and citizenship.”
The 10-page paper further defines the terms in this definition, provides premises and rationales
for specific elements as well as research implications. To obtain a copy of the paper, or an
update on responses to the request for review, contact Judie at judiedid@mchsi.com.
Good Housekeeping Magazine Focuses on Very Young Alcoholics
The May 2007 issue of Good Housekeeping magazine contains an article that will turn the
heads of some readers. “The Hidden Epidemic of Very Young Alcoholics,” (pages 177-181,
242-245), by Heather Millar, tells the stories of three kids who started drinking before the age of
12, and how they were able to stop drinking after serious consequences. Included are a
description of the “hidden epidemic,” how kids get started, where they were able to get their
alcohol, danger signs, risk factors, and kinds of treatment available. Outpatient is described as
less than adequate, and the “whole-person” approach favored. One of the kids benefited from
Sobriety High West Academy, one of five Sobriety High campuses in the Minneapolis/St. Paul
area. Also included in the report is why treatment is tough, and where to go for information.
14
There is also a graphic display of a lunch box in which the sandwich and carrot sticks are
accompanied by a can of Budweiser. In spite of the apparent ease with which the kids acquired
the alcohol, there is no discussion of environmental influences and no mention of the difficulties
faced by parents who do not have the financial means to send their kids to an upscale treatment
program and do not have access to a specialty school.
HBO “Addiction” Series Gets Attention
The highly-acclaimed HBO series “Addiction” has captured the interest of the media as well
as advocates for recovery. The March 15 debut of the “centerpiece” feature-length documentary
the excellent website, http://www.hbo.com/addiction/, and the kickoff to a multimedia campaign
have provided many valuable resources for people who want to understand addiction, whatever
their motivation. The major broadcast networks have conducted interviews during morning
news broadcasts and Oprah Winfrey devoted an hour to the theme: “Addiction: Why Can’t They
Stop?” on her April 9, 2007 show. Oprah’s audience seemed to be particularly interested in the
descriptions of effects of addiction on the brain by a guest expert, Dr. Anna Rose Childress.
“HBO is using all of its platforms to develop programming directly targeted to
the various needs of the American public on this complex public health issue.
Our resources are committed to illuminating, demystifying and defining
addiction – a problem that is riddled with misconceptions.” – Chris Albrecht,
HBO Chairman and CEO
What makes this series “groundbreaking,” aside from the carefully prepared educational
materials and some of the country’s leading filmmakers, is that it will use all of its digital
platforms, including the HBO main service, multiplex channels, HBO On Demand, pod casts,
web streams, and DVD sales to support a campaign that includes a 14-part series, a book
published by Rodale Press, four independent addiction-themed films, and a national community
grassroots outreach campaign funded by the Robert Wood Johnson Foundation. The
ADDICTION DVD is available for purchase at Barnes and Noble, Best Buy, and Circuit
City.
HBO partners in this venture are the Robert Wood Johnson Foundation, the National Institute
on Drug Abuse (NIAAA), and the National Institute on Alcohol Abuse and Alcoholism
(NIAAA). Join Together described it as “a candid depiction of the emotional, psychological,
social and political toll that addiction takes on the country. The ADDICTION Project
demonstrates conclusively that the disease is treatable and shows that there are millions of
people in long-term recovery.” (Announcement, 01-18-07) MRN Capitol Report will continue
to monitor responses to this exciting development.
MRN Rally Generates Enthusiasm for Recovery Advocacy
The MRN Recovery Rally held in Jefferson City on March 28 used the theme “Silence Hurts
… Step Up … Speak Out!” and many of the 110 people who attended were apparently motivated
to do exactly that! Written evaluations showed that the majority were very satisfied with the
15
rally. Participants appreciated the diversity of the speakers, each of which contributed insights
from their own experience, and practical examples, to amplify the theme. They also showed that
advocacy can be done in many settings and in many ways. Sharing personal recovery stories is
one powerful way to speak out and give others help and hope, and MRN was applauded for
giving advocates the tools and the information to put their passion for the message to good use.
Planning is already underway for the 2008 rally!
Brenda Schell
Project Director, Missouri Recovery Network
April 18, 2007
NOTE: Gerrit L. DenHartog served as advisor and contributor to the content of this report.
[Disclaimer: The content and views expressed in this publication may not reflect the views or
priorities of the agencies and organizations to which reference is made.]
16