Politics

Missouri governor candidates say higher pay, improved tech needed to fix ailing safety net

Published

1 year ago

August 1, 2024

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In just the last three months, Missouri has come under fire from two federal agencies and a U.S. district court judge over how it administers programs designed to help the most vulnerable.The state’s dysfunctional call centers serve to deny low-income residents food aid that is guaranteed to them by federal law, a judge ruled in May.Missouri funnels mentally ill people into nursing homes, the Department of Justice concluded in June, rather than providing resources that could help them live in their communities.And delays processing Medicaid applications, among the worst in the nation, violate federal rules — which pediatricians say is causing chronically ill kids to miss medications.The issues are years in the making — a product of decades of underinvestment and workforce cuts, advocates say.And they’re not in isolation: There are also foster kids being housed in hospitals, people waiting for months in jailto be transferred to psychiatric facilities, daycares struggling to remain open because of state payment delaysand staffing issues that have caused backlogged child welfare investigations.On Aug. 6, Missouri will hold primaries to nominate the next governor. Three Republicans are considered the frontrunners for gubernatorial nomination: Lt. Gov. Mike Kehoe, Secretary of State Jay Ashcroft and state Sen. Bill Eigel.

From left: Missouri’s GOP candidates for governor Lt. Gov. Mike Kehoe, Secretary of State Jay Ashcroft and state Sen. Bill Eigel.

The two leading Democrats running are House Minority Leader Crystal Quade and businessman Mike Hamra.The Independent asked each candidate what they would do about the various crises within the state’s fragile safety net.Most agree that two broad issues lie at the root of these problems, particularly within the Missouri Department of Social Services: the fact that state workers aren’t paid enough and that the state has lagged in modernizing its technology.The leading Republican candidates said they would invest more in workforce or technology, though at the same time all three want to slash the income tax.Democrats want to make similar investments without that cut to state revenue.“Regardless of who the governor is,” said Casey Hanson, deputy director of Kids Win Missouri, a coalition of organizations that advocate for children and families’ wellbeing, “we hope that they will come in with that mentality that we need to have systems that work in our state, so that when families need to access the safety net, they’re able to.”Workforce considerationOn the Republican side, both Kehoe and Eigel said they’d be open to supporting raises for state workers.The laundry list of safety-net issues is “not an acceptable situation,” Eigel said.Broadly, Eigel said, more government spending has led to worse outcomes.But asked about whether more money would be needed to, for instance, ensure child welfare workers have reasonable caseloads — which St. Louis Public Radio has most recently reported on — Eigel said: “No question and nobody’s proposing zero government.”Eigel would support raising salaries of child welfare workers “up to $80,000 or $90,000 per person so we can really recruit at a level where we’re getting quality individuals to investigate child abuse.”“…And to do that is a fractional line item in a multi tens of billions of dollar budget.”Entry level child welfare workers start at salaries of just over $44,000, DSS spokesperson Baylee Watts said.Eigel said several of the issues “may require more direct resources” but that he would also prioritize “getting rid of bureaucracy.”In terms of state pay, Kehoe said Missouri has come a long way in the last few years. But the state must continue to remain competitive with the private sector.Kehoe has lived in Jefferson City for more than 30 years, and he says he’s seen firsthand how some state employees struggle to get by.“I’ve been at Schnucks and watched someone take out a SNAP or food stamp card to buy groceries,” he said, “And I knew that person had worked for the state for 25 years.“Now, we shouldn’t have somebody work for the state of Missouri for 25 years and have to use an assistance card to buy bread at Schnucks,” Kehoe said.

The primary in August, where Crystal Quade and Mike Hamra will appear on the ballot, will be the first significant Democratic nomination contest for governor since 2004.

Quade served as House minority leader, and said her experience in that job gives her insight into the issues plaguing Missouri’s social services. She led hearings looking into people being kicked off Medicaid, and says she has met with numerous frontline DSS staff to hear concerns.“Year after year,” Quade said, “I have led the fight to increase funding, not only for staff, but also things like our call centers…I can’t count how many hearings I’ve been in where agency directors have begged for adequate funding so they can successfully help Missourians but have been ignored or disregarded,” she added.Quade said if elected, she’d meet with frontline workers and families who “have been left behind to ensure our state is doing all we can.”Hamra called the situation “unacceptable” and reflective of a lack of leadership.“I will both provide staff the resources they need to do their jobs, and in return, demand that they provide the level of service Missourians deserve,” Hamra said. “I have a 20-year track record of running a large organization where I have put this approach into practice and would bring this same mindset to state government as governor.”Elsewhere in Missouri’s social services agency, benefits program workers in the Family Support Division start at just under $39,000 and youth services workers at the Division of Youth Services start at $42,000, Watts said. There are currently 252 job openings in the Family Support Division, 126 in the Division of Youth Services and 8 in Children’s Division, as of late May, Watts said.And even if the agency could fill all its positions, it’d still be operating at a level far below where it used to be. Fifteen years ago, there were over 1,000 more staff members in the Department of Social Services than there are today, according to state budget documents — in part a result of substantial cuts under Democratic Gov. Jay Nixon.Around one-fifth of the state’s population is on Medicaid. One-third of Missourians will interact with the Department of Social Services, according to agency leaders.Watts said agency leaders “remain committed to advocating for higher pay” for staff.The impacts of low staffing in the Family Support Division include delays for Missourians to access needed health and food assistance. A lack of benefits’ staff means various programs compete for resources, Missouri told the federal government.And a decline in staff has coincided with shifts away from person-to-person interaction.The agency several years ago moved from assigning caseworkers to each benefits participant and toward a call center model, said Sarah Owsley, advocacy director for the anti-poverty nonprofit Empower Missouri, which she argues hasn’t proven successful in other states.“We would love to see some resources put back into local offices where families can have a personal contact, a person they’ve built a relationship with,” she said, adding that data shows the person-to-person model helps families secure benefits and move toward self sufficiency, rather than simply being denied access.In Missouri, call center wait times can be hours long, and the remaining in-person offices sometimes direct clients back to the phones.The agency is working toward “innovative ways to provide 24/7 self-service options for the public’s convenience,” Watts said.She added that the agency is “actively monitoring and adjusting staffing to meet the demands of managing the call center and processing applications,” and has seen a reduction in wait times in recent weeks.DSS “faces a challenge of increased workloads and call volumes while maintaining staffing levels for Medicaid applications and the call center,” Watts said.Technology modernizationAshcroft and Kehoe said technology is another area they think could be improved to help these safety net issues.“The state needs to do a better job with information. The state needs to do a better job of making it easier for individuals to communicate and have their say,” Ashcroft said.He would also undertake a broader reevaluation of state resources, he said — a “reset of government departments.”Kehoe said Missouri hasn’t been able to keep up with technology compared to other states.“We have to do that,” he said, “and I think we have to make sure we get to a point where the right people are getting the right help. eliminate as much of the fraud as we can and the people who actually are able to go to work, get them opportunities in the workforce.”There have been longstanding tech problems within Missouri’s social services department, including antiquated software systems.

Clara Bates

Missouri Independent A family enters the Missouri Department of Social Services resource center in Columbia.

After the state launched a new eligibility verification system for Medicaid in 2018, it saw a huge drop in Medicaid enrollees. Officials largely attributed the decline in participation to improved economic conditions, but there turned out to be significant system glitches. Quade called for an investigation of those drop-offs at the time.A report published in 2019 found Missouri’s Medicaid data system has around 70 components and was partially developed in a system that dates from 1979 — which is “not positioned to meet both current and future needs.” A 2020 report concluded that for participants trying to enroll in benefits, “the system feels like a secret and no one has the answer.”Lately, the state has seen significant improvements in the number of Medicaid renewals it processes using existing data rather than requiring participant response, which it had long struggled with, called ex-parte renewals. Yet the remaining individuals who still need to send in their forms for processing and the advocates who assist them have reported a huge number of paperwork and tech issues, such as uploaded information being lost in the state’s online portal.“To address children losing coverage,” Watts said, “we continue to educate community partners and participants on how to connect with FSD to apply, renew, and use the MyDSS portal, along with looking at ways to improve our ex-parte rates which will in turn decrease the numbers of renewal forms that must be sent out.”Watts said one tool that is in the works would automate more data entry “to streamline processes and allow staff to focus on processing [applications] rather than manual entry.” The full benefits from this are expected by late fall, she added.And the agency leadership are committed to continuing to advocate for tech upgrades, she said.Late last year director Robert Knodell told the American Public Human Services Association that some of the problems that had plagued the agency included “decades of underinvestment,” legacy technology systems, and the challenges of bringing new participants onto Medicaid after the voters approved expansion.Advocates say they’re not just interested in governors’ policy proposals but what candidates think the purpose of these programs is.They say one goal of public assistance is to help people become self-sufficient and the way to do that is to eliminate barriers to their getting help.“When those systems aren’t functioning properly, it puts more stress on families, but it also puts more stress on the state and state workers,” Hanson said, pointing to the case of the education department’s child care subsidy system’s issues since late last year when it moved from the social services department. Those issues have caused day cares to struggle to stay afloat, and daycares to submit more and more payment dispute forms to the state.“And then that creates a backlog, and then the already overburdened state staff are then faced with that backlog in addition to their regular work,” Hanson said.And for families, she said, “we hear about parents who have to turn down work or turn down jobs because their subsidy wasn’t approved in time.”Others have to wait hours on hold to access food benefits, sometimes missing work to do so.Owsley said she hopes lawmakers think about what purpose it serves to impose barriers for people to access these programs.“Families in poverty in Missouri needs support,” she said. “They don’t need more burden, and when they’re reaching out for that assistance, it’s because they need it.”This story was originally published by The Missouri Independent. Jason Hancock and Rudi Keller contributed reporting.

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Poll: Support for Missouri abortion rights amendment growing

Published

1 year ago

August 29, 2024

Natural Bridge

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A proposed constitutional amendment legalizing abortion in Missouri received support from more than half of respondents in a new poll from St. Louis University and YouGov.That’s a boost from a poll earlier this year, which could mean what’s known as Amendment 3 is in a solid position to pass in November.SLU/YouGov’s poll of 900 likely Missouri voters from Aug. 8-16 found that 52% of respondents would vote for Amendment 3, which would place constitutional protections for abortion up to fetal viability. Thirty-four percent would vote against the measure, while 14% aren’t sure.By comparison, the SLU/YouGov poll from February found that 44% of voters would back the abortion legalization amendment.St. Louis University political science professor Steven Rogers said 32% of Republicans and 53% of independents would vote for the amendment. That’s in addition to nearly 80% of Democratic respondents who would approve the measure. In the previous poll, 24% of Republicans supported the amendment.Rogers noted that neither Amendment 3 nor a separate ballot item raising the state’s minimum wage is helping Democratic candidates. GOP contenders for U.S. Senate, governor, lieutenant governor, treasurer and secretary of state all hold comfortable leads.“We are seeing this kind of crossover voting, a little bit, where there are voters who are basically saying, ‘I am going to the polls and I’m going to support a Republican candidate, but I’m also going to go to the polls and then I’m also going to try to expand abortion access and then raise the minimum wage,’” Rogers said.Republican gubernatorial nominee Mike Kehoe has a 51%-41% lead over Democrat Crystal Quade. And U.S. Sen. Josh Hawley is leading Democrat Lucas Kunce by 53% to 42%. Some GOP candidates for attorney general, secretary of state and treasurer have even larger leads over their Democratic rivals.

Brian Munoz

St. Louis Public RadioHundreds of demonstrators pack into a parking lot at Planned Parenthood of St. Louis and Southwest Missouri on June 24, 2022, during a demonstration following the Supreme Court’s reversal of a case that guaranteed the constitutional right to an abortion.

One of the biggest challenges for foes of Amendment 3 could be financial.Typically, Missouri ballot initiatives with well-funded and well-organized campaigns have a better chance of passing — especially if the opposition is underfunded and disorganized. Since the end of July, the campaign committee formed to pass Amendment 3 received more than $3 million in donations of $5,000 or more.That money could be used for television advertisements to improve the proposal’s standing further, Rogers said, as well as point out that Missouri’s current abortion ban doesn’t allow the procedure in the case of rape or incest.“Meanwhile, the anti side won’t have those resources to kind of try to make that counter argument as strongly, and they don’t have public opinion as strongly on their side,” Rogers said.There is precedent of a well-funded initiative almost failing due to opposition from socially conservative voters.In 2006, a measure providing constitutional protections for embryonic stem cell research nearly failed — even though a campaign committee aimed at passing it had a commanding financial advantage.Former state Sen. Bob Onder was part of the opposition campaign to that measure. He said earlier this month it is possible to create a similar dynamic in 2024 against Amendment 3, if social conservatives who oppose abortion rights can band together.“This is not about reproductive rights or care for miscarriages or IVF or anything else,” said Onder, the GOP nominee for Missouri’s 3rd Congressional District seat. “Missourians will learn that out-of-state special interests and dark money from out of state is lying to them and they will reject this amendment.”Quade said earlier this month that Missourians of all political ideologies are ready to roll back the state’s abortion ban.“Regardless of political party, we hear from folks who are tired of politicians being in their doctor’s offices,” Quade said. “They want politicians to mind their own business. So this is going to excite folks all across the political spectrum.”

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Democrat Mark Osmack makes his case for Missouri treasurer

Published

1 year ago

August 29, 2024

Natural Bridge

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Mark Osmack has been out of the electoral fray for awhile, but he never completely abandoned his passion for Missouri politics.Osmack, a Valley Park native and U.S. Army veteran, previously ran for Missouri’s 2nd Congressional District seat and for state Senate. Now he’s the Democratic nominee for state treasurer after receiving a phone call from Missouri Democratic Party Chairman Russ Carnahan asking him to run.“There’s a lot of decision making and processing and evaluation that goes into it, which is something I am very passionate and interested in,” Osmack said this week on an episode of Politically Speaking.Osmack is squaring off against state Treasurer Vivek Malek, who was able to easily win a crowded GOP primary against several veteran lawmakers including House Budget Chairman Cody Smith and state Sen. Andrew Koenig.While Malek was able to attract big donations to his political action committee and pour his own money into the campaign, Osmack isn’t worried that he won’t be able to compete in November. Since Malek was appointed to his post, Osmack contends he hasn’t proven that he’s a formidable opponent in a general election.“His actions and his decision making so far in his roughly two year tenure in that office have been questionable,” Osmack said.Among other things, Osmack was critical of Malek for placing unclaimed property notices on video gaming machines which are usually found in gas stations or convenience stores. The legality of the machines has been questioned for some time.As Malek explained on his own episode of Politically Speaking, he wanted to make sure the unclaimed property program was as widely advertised as possible. But he acknowledged it was a mistake to put the decals close to the machines and ultimately decided to remove them.Osmack said: “This doesn’t even pass the common sense sniff test of, ‘Hey, should I put state stickers claiming you might have a billion dollars on a gambling machine that is not registered with the state of Missouri?’ If we’re gonna give kudos for him acknowledging the wrong thing, it never should have been done in the first place.”Osmack’s platform includes supporting programs providing school meals using Missouri agriculture products and making child care more accessible for the working class.He said the fact that Missouri has such a large surplus shows that it’s possible to create programs to make child care within reach for parents.“It is quite audacious for [Republicans] to brag about $8 billion, with a B, dollars in state surplus, while we offer next to no social services to include pre-K, daycare, or child care,” Osmack said.Here’s are some other topics Osmack discussed on the show:How he would handle managing the state’s pension systems and approving low-income housing tax credits. The state treasurer’s office is on boards overseeing both of those programs.Malek’s decision to cut off investments from Chinese companies. Osmack said that Missouri needs to be cautious about abandoning China as a business partner, especially since they’re a major consumer of the state’s agriculture products. “There’s a way to make this work where we are not supporting communist nations to the detriment of the United States or our allies, while also maintaining strong economic ties that benefit Missouri farmers,” he said.What it was like to witness the skirmish at the Missouri State Fair between U.S. Sen. Josh Hawley and Democratic challenger Lucas Kunce.Whether Kunce can get the support of influential groups like the Democratic Senatorial Campaign Committee, which often channels money and staff to states with competitive Senate elections.

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As Illinois receives praise for its cannabis equity efforts, stakeholders work on system’s flaws

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1 year ago

August 29, 2024

Natural Bridge

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Medical marijuana patients can now purchase cannabis grown by small businesses as part of their allotment, Illinois’ top cannabis regulator said, but smaller, newly licensed cannabis growers are still seeking greater access to the state’s medical marijuana customers.Illinois legalized medicinal marijuana beginning in 2014, then legalized it for recreational use in 2020. While the 2020 law legalized cannabis use for any adult age 21 or older, it did not expand licensing for medical dispensaries.Patients can purchase marijuana as part of the medical cannabis program at dual-purpose dispensaries, which are licensed to serve both medical and recreational customers. But dual-purpose dispensaries are greatly outnumbered by dispensaries only licensed to sell recreationally, and there are no medical-only dispensaries in the state.As another part of the adult-use legalization law, lawmakers created a “craft grow” license category that was designed to give more opportunities to Illinoisans hoping to legally grow and sell marijuana. The smaller-scale grow operations were part of the 2020 law’s efforts to diversify the cannabis industry in Illinois.Prior to that, all cultivation centers in Illinois were large-scale operations dominated by large multi-state operators. The existing cultivators, mostly in operation since 2014, were allowed to grow recreational cannabis beginning in 2019.Until recently, dual-purpose dispensaries have been unsure as to whether craft-grown products, made by social equity licensees — those who have lived in a disproportionately impacted area or have been historically impacted by the war on drugs — can be sold medicinally as part of a patient’s medical allotment.Erin Johnson, the state’s cannabis regulation oversight officer, told Capitol News Illinois last month that her office has “been telling dispensaries, as they have been asking us” they can now sell craft-grown products to medical patients.“There was just a track and trace issue on our end, but never anything statutorily,” she said.

Dilpreet Raju

Capitol News IllinoisThe graphic shows how cannabis grown in Illinois gets from cultivation centers to customers.

No notice has been posted, but Johnson’s verbal guidance comes almost two years after the first craft grow business went online in Illinois.It allows roughly 150,000 medical patients, who dispensary owners say are the most consistent purchasers of marijuana, to buy products made by social equity businesses without paying recreational taxes. However — even as more dispensaries open — the number available to medical patients has not increased since 2018, something the Cannabis Regulation Oversight Office “desperately” wants to see changed. Johnson said Illinois is a limited license state, meaning “there are caps on everything” to help control the relatively new market.Berwyn Thompkins, who operates two cannabis businesses, said the rules limited options for patients and small businesses.“It’s about access,” Thompkins said. “Why wouldn’t we want all the patients — which the (adult-use) program was initially built around — why wouldn’t we want them to have access? They should have access to any dispensary.”Customers with a medical marijuana card pay a 1% tax on all marijuana products, whereas recreational customers pay retail taxes between roughly 20 and 40% on a given cannabis product, when accounting for local taxes.While Illinois has received praise for its equity-focused cannabis law, including through an independent study that showed more people of color own cannabis licenses than in any other state, some industry operators say they’ve experienced many unnecessary hurdles getting their businesses up and running.The state, in fact, announced last month that it had opened its 100th social equity dispensary.But Steve Olson, purchasing manager at a pair of dispensaries (including one dual-purpose dispensary) near Rockford, said small specialty license holders have been left in the lurch since the first craft grower opened in October 2022.“You would think that this would be something they’re (the government) trying to help out these social equity companies with, but they’re putting handcuffs on them in so many different spots,” he said. “One of them being this medical thing.”Olson said he contacted state agencies, including the Department of Financial and Professional Regulation, months ago about whether craft products can be sold to medical patients at their retail tax rate, but only heard one response: “They all say it was an oversight.”This potentially hurt social equity companies because they sell wholesale to dispensaries and may have been missing out on a consistent customer base through those medical dispensaries.Olson said the state’s attempts to provide licensees with a path to a successful business over the years, such as with corrective lotteries that granted more social equity licenses, have come up short.“It’s like they almost set up the social equity thing to fail so the big guys could come in and swoop up all these licenses,” Olson said. “I hate to feel like that but, if you look at it, it’s pretty black and white.”Olson said craft companies benefit from any type of retail sale.“If we sell it to medical patients or not, it’s a matter of, ‘Are we collecting the proper taxes?’ That’s all it is,” he said.State revenue from cannabis taxes, licensing costs and other fees goes into the Cannabis Regulation Fund, which is used to fund a host of programs, including cannabis offense expungement, the general revenue fund, and the R3 campaign aiming to uplift disinvested communities.For fiscal year 2024, nearly $256 million was paid out from Cannabis Regulation Fund for related initiatives, which includes almost $89 million transferred to the state’s general revenue fund and more than $20 million distributed to local governments, according to the Illinois Department of Revenue.Medical access still limitedThe state’s 55 medical dispensaries that predate the 2020 legalization law, mostly owned by publicly traded multistate operators that had been operating in Illinois since 2014 under the state’s medical marijuana program, were automatically granted a right to licenses to sell recreationally in January 2020. That gave them a dual-purpose license that no new entrants into the market can receive under current law.Since expanding their clientele in 2020, Illinois dispensaries have sold more than $6 billion worth of cannabis products through recreational transactions alone.Nearly two-thirds of dispensaries licensed to sell to medical patients are in the northeast counties of Cook, DuPage, Kane, Lake and Will. Dual-purpose dispensaries only represent about 20 percent of the state’s dispensaries.While the state began offering recreational dispensary licenses since the adult-use legalization law passed, it has not granted a new medical dispensary license since 2018. That has allowed the established players to continue to corner the market on the state’s nearly 150,000 medical marijuana patients.But social equity licensees and advocates say there are more ways to level the playing field, including expanding access to medical sales.Johnson, who became the state’s top cannabis regulator in late 2022, expressed hope for movement during the fall veto session on House Bill 2911, which would expand medical access to all Illinois dispensaries.“We would like every single dispensary in Illinois to be able to serve medical patients,” Johnson said. “It’s something that medical patients have been asking for, for years.”Johnson said the bill would benefit patients and small businesses.“It’s something we desperately want to happen as a state system, because we want to make sure that medical patients are able to easily access what they need,” she said. “We also think it’s good for our social equity dispensaries, as they’re opening, to be able to serve medical patients.”Rep. Bob Morgan, D-Deerfield, who was the first statewide project coordinator for Illinois’ medical cannabis program prior to joining the legislature, wrote in an email to Capitol News Illinois that the state needs to be doing more for its patients.“Illinois is failing the state’s 150,000 medical cannabis patients with debilitating conditions. Too many are still denied the patient protections they deserve, including access to their medicine,” Morgan wrote, adding he would continue to work with stakeholders on further legislation.Capitol News Illinois is a nonprofit, nonpartisan news service covering state government. It is distributed to hundreds of newspapers, radio and TV stations statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation, along with major contributions from the Illinois Broadcasters Foundation and Southern Illinois Editorial Association.

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