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House considers drug-monitoring program

JEFFERSON CITY, Mo. — House lawmakers gave initial approval to a bill that would require the state to implement a Prescription Drug Monitoring Program to track the prescription and sale of all Schedule II through Schedule IV drugs.

Missouri is currently the only state in the nation with no statewide drug-monitoring program, which supporters say is both a tool for law enforcement to track illicit behavior and a valuable resource for doctors to keep from prescribing unnecessary or dangerous medications. The bill’s primary purpose would be to track the distribution of opiate pain relievers and other potentially addictive medicine.

But opponents say the creation of a statewide database with prescription drug and medical information of all Missourians is inviting a breach of privacy and a policy that state government is not equipped to adopt.

“This may well be the most well-intentioned bill we hear all year,” Rep. Jay Barnes, R-Jefferson City, said on the floor during debate. “But there are some serious problems with this well-intentioned bill.”

Missouri lawmakers have weighed the creation of a drug monitoring program for years, with the measure routinely failing to pass through the legislature thanks to vigorous lobbying, particularly from right-wing groups who see the program as a prime example of government overreach.

Many opponents site breaches in 2013 to the state’s DOR CCW permit list — when the list was handed over to investigators in the federal government in violation of state statute — as evidence that Missouri voters cannot trust the government to create such a database.

The legislation, sponsored by Rep. Holly Rehder, a Republican, received enough votes in its initial approval today to advance out of the House after a final vote, but not enough to override a gubernatorial veto. Rehder supports the bill in part after witnessing her own young daughter’s struggle with prescription drugs, which she says may have been prevented by a drug-monitoring program.

The bill is likely to face stiff resistance in the senate, where a similar bill died in committee last year. A staunch opponent of the bill, Sen. Rob Schaaf, is expected to fight the legislation, which he says will jeporadize patient privacy. Schaaf, a physician and a Republican, is known for his penchant for filibusters and slowing down legislation on the floor. Schaaf has frequently questioned the effectiveness of similar programs in other states.

Rehder says her privacy provisions are strictly drawn. Records within the database would be treated as closed records, although a court order or subpoena would make them available to law enforcement. State health officials would also be required to notify law enforcement if they had a “reasonable cause” to believe a violation of the law or professional standards has taken place. That language was a point of contention for several House members who moonlight as lawyers, who said “reasonable cause” is a phrase that doesn’t exist in current case law.

Rehder’s bill is HB130, and still needs another round of votes in the House to pass. The senate version, similar to Rehder’s, is SB63.