Missouri State Capitol

The Missouri state capital in Jefferson City.

(The Center Square) – Missouri has received, or will receive, billions in federal pandemic aid dollars and infrastructure funding.

When lawmakers convene their 2022 legislative session on Jan. 5, much of the action in Jefferson City will involve spending that money on one-time allocations that don’t induce recurring costs.

First, however, state agencies must make their annual pre-session committee rounds, presenting preliminary budget requests and signaling the start of a process that ends when next fiscal year’s spending plan goes into effect on July 1.

But this year, with the state, local governments and school districts weighing proposals for “one-time-plugs of once-in-a-lifetime money” to kick off the Fiscal Year 23 (FY23) budget cycle, many agencies are thinking big and long-term.

The Missouri Department of Administration is seeking $84 million to modernize the state’s IT infrastructure.

Health care providers, state electric cooperatives, Internet service providers, school districts, and the Missouri Farm Bureau have appeared before panels requesting to tap into a $400 million loan program for broadband development that the state will finance, in turn, by tapping into its federal allocations from the American Rescue Plan Act (ARPA) and proposed Build Back Better plan – when, or if, passed.

MO HealthNet Division Director Todd Richardson outlined the parameters of his FY23 pitch before a Senate panel.

His bottom line: With Missouri’s Medicaid program projected to enroll up to 275,000 more people by July 1, the agency’s “data-rich and information-poor.” IT systems and data management programs need modernization and muscle.

Richardson said one of MO HealthNet’s priorities is creating a multi-sourced central data cache – an “enterprise data warehouse” – to streamline reporting processes for health care providers as well as the state. The efficiencies will save downstream operating costs for all, he said.

“We’re not talking about one system – we’re talking about a collection of systems that all have to work together to provide the program we want to deliver,” he said. “It’s not just a new system to house the data, but also a system focused on data governance so we know what our data means. The enterprise data warehouse is going to allow us to have a single source of truth for our Medicaid data.”

MO HealthNet is studying similar state systems to determine how to proceed, Richardson said, without offering cost outlines for the pending proposal, concluding his presentation before the Senate Interim Committee on Medicaid Accountability & Taxpayer Protection.

Chair Sen. Bill White, R-Joplin. said the committee would recommend investing in across-the-board updates for MO HealthNet’s digital infrastructure, which will undoubtedly be stressed by the Missouri Supreme Court’s decision upholding Amendment 2, the August 2020 ballot measure state voters approved to expand Medicaid for as many as 275,000 low-income adults.

Wednesday’s hearing was the 10-member panel’s fourth since Senate Republican leadership created it after the chamber adjourned from special session without considering a House-adopted bill defunding Medicaid providers that directly, or through affiliates, provide abortion services.

The committee was commissioned to assuage Pro-Life conservatives and “take definitive action” in advancing proposals outlined in that measure, House Bill 2.

During its September meeting, the committee approved its own report detailing proposed regulatory and statutory changes to the state’s Medicaid system.

“Emergency” Medicaid regulations crafted by the panel were implemented last month by Missouri’s Department of Health & Senior Services (DHSS) and Department of Social Services (DSS).

Under them, DHSS can turn over inspection records to DSS’s Medicaid Audit & Compliance Unit to “increase further compliance with state and federal laws and regulations governing abortion facilities.”

The committee’s draft recommendations will be presented to lawmakers in 2022. They are now being reviewed by the federal Centers for Medicare & Medicaid Services (CMS).