AGP Executive Report

Food safety alert: The CDC says the cyclosporiasis outbreak tied to iceberg lettuce has spread to 47 states, with nearly 23,000 suspected/confirmed cases and two deaths in Michigan; Missouri is among the hardest-hit states, and officials keep urging people to watch recalls and prep produce carefully. Another outbreak, another recall: A separate salmonella outbreak linked to Mexican jalapeños has sickened at least 345 people across 27 states, with 36 hospitalizations; Chipotle and Qdoba pulled the ingredient after the investigation. Local health access: CoxHealth is partnering with Oscar Health to bring ACA Marketplace coverage to eight Missouri counties (including Greene) for the 2027 plan year, after CoxHealthPlans exits direct Marketplace coverage in parts of its region. Healthcare business/legal: Boone Health sued cardiologists and their Pulsepoint practice over alleged noncompete violations. Missouri policy & public health: Missouri AG Catherine Hanaway reached an agreement barring a St. Louis kratom seller from 7-OH products as federal restrictions loom. Community health workforce: Future health professionals took part in a Rural Immersion Program. Public safety (health-adjacent): Jackson County prosecutors charged a man in the Aug. 1 Kansas City shooting death of a woman, with children inside the home.

Food Safety: CDC says the multistate salmonella outbreak tied to Mexican jalapeños has sickened at least 345 people across 27 states, with 36 hospitalizations; Chipotle and Qdoba pulled the peppers after investigators linked the source to jalapeños distributed by Coast Citrus Distributors. Local Health: Missouri’s cyclosporiasis numbers keep climbing, with the state reporting 1,095 cases as of Aug. 2 and warning that the outbreak is tied to contaminated produce as the CDC expands the lettuce-linked investigation to more states. Health Policy: Missouri and Kansas residents using the ACA marketplace could see double-digit premium hikes again in 2027, as insurers file requests averaging roughly 10–35% increases. Care Access: A Jackson County court ruling has helped drive a surge in Missourians getting medication abortions via out-of-state telehealth, with Guttmacher data showing a quadrupling since 2023. Community Health: Joplin City Council will consider expanding its trolley routes to improve access to medical providers and offices, with the plan expected to cost about $307,100. Public Health Milestone: Missouri marked 60 years since Medicare and Medicaid were signed into law in 1965, a reminder of how the programs have shaped care for millions.

Cyclospora Update (Missouri): MU Health Care says it has treated 96 cyclosporiasis cases since the outbreak began, with most managed outpatient; Missouri health officials report 1,095 confirmed cases statewide as of Sunday, nearly double the prior week, and infectious-disease doctors note symptoms can take weeks to appear. CDC Outbreak Watch: The lettuce-linked cyclosporiasis outbreak is now tied to 15 states, with Ohio and Michigan reporting the highest totals as cases and related ER visits continue to be tracked. Salmonella Food Safety (Missouri): Chipotle and Qdoba removed jalapeños after a multistate Salmonella outbreak tied to Mexican peppers sickened at least 345 people across 27 states; Missouri is among the states reporting cases, though officials say there’s no ongoing risk from the restaurants. Local Health & Environment: Missouri DNR says it’s responding to E. coli contamination in the Big River after problems at the Leadwood wastewater treatment facility, with temporary repairs underway. Medicaid Fraud Push: Missouri’s AG joined a national push urging Congress to pass the STOP FRAUD in Medicaid Act to expand states’ ability to investigate Medicaid recipient fraud. Community Health Access: Chiro One is offering sports physicals at select St. Louis and Kansas City clinics as families prep for the school sports season.

Cyclospora in Missouri: Missouri health officials report nearly 600 cyclospora cases as of late July, with state figures cited at 1,095 confirmed illnesses—part of a fast-growing national outbreak tied to iceberg lettuce. The CDC says the lettuce-linked outbreak now spans 15 states (including Missouri), with thousands of cases and hospitalizations expected to keep rising as diagnoses catch up. Food safety—salmonella: Qdoba joined Chipotle in removing jalapeños after a salmonella outbreak linked to recalled peppers spread to 27 states, with 345 illnesses and 36 hospitalizations reported. Local healthcare access: Marathon Health says it partners with Missouri unions to provide worker-centered care through union-covered health centers, aiming to boost prevention and lower overall costs. New cardiology care: Essentia Health-St. Joseph’s Medical Center welcomed cardiologist Dr. Priscilla Ababio. Public health reminders: CDC also flagged a small but serious tetanus cluster—four unvaccinated children in four states (including Missouri) with long hospital stays.

Food Safety Alert: Qdoba removed jalapeños from all locations as a Salmonella Javiana outbreak tied to jalapeños has sickened at least 345 people across 27 states, with 36 hospitalizations and no deaths reported; Chipotle also pulled jalapeños, and a recall is underway. Water & Wastewater Watch: Missouri’s Department of Natural Resources is stepping in at Leadwood’s failing wastewater treatment facility after tests found high E. coli levels in the Big River, with officials working on short- and long-term fixes. Parasite Outbreak: Cyclosporiasis linked to iceberg lettuce has expanded to 15 states; Missouri health officials say the state is now included, with more than 1,000 cases reported and Jefferson County alone reporting 62 cases since early July. Local Care Access: Western Missouri Medical Center brought rehabilitation services back in-house, rebranding it as Western Missouri Sport and Rehab starting July 31. Health-Related Research: University of Missouri researchers report that consistent daily routines may help reduce pain and depression in older adults, even among people with insomnia. Policy & Affordability: Missouri voters rejected Amendment 5, which would have phased out the state income tax in favor of higher sales taxes.

Medicaid Integrity Push: Missouri Attorney General Marty Jackley joined a coalition urging Congress to pass the STOP FRAUD in Medicaid Act, aiming to expand states’ ability to investigate and prosecute beneficiary fraud. Rural Health Workforce: Nineteen future healthcare professionals took a rural immersion tour across five Missouri counties, visiting hospitals and public safety sites to learn how agriculture, behavioral health, and local access shape care. Opioid Overdose Response: Springfield fire stations are expanding Naloxone access with new distribution boxes, partnering with the county health department and the state’s addiction science team. Public Health Safety Alerts: The CDC says the Cyclospora outbreak now involves 15 states, with Missouri cases continuing to rise. Community Health Infrastructure: Lincoln University unveiled a $45.5 million Health and Security Sciences Institute, expanding training capacity for health careers. Health Care Access & Costs: Missouri’s Medicaid renewals are set to get harder, with advocates warning paperwork changes could end coverage for people who remain eligible. Election Results, Health Policy Stakes: Missouri voters rejected Amendments 4 and 5, a decision that could affect how constitutional changes move forward—important for future health and welfare policy debates.

Food Safety: The CDC is expanding the largest known cyclosporiasis outbreak to 15 states, adding Missouri (1,095 cases) and tracing illnesses to shredded iceberg lettuce linked to Taco Bell and Taylor Farms in central Mexico; officials say the investigation is still looking for other possible sources as symptoms can include severe gastrointestinal illness. Public Health & Community: A Kansas City-area blood drive at Chicken and Pickle in Overland Park was inspired by a 5-year-old leukemia patient, highlighting how families rely on blood products during treatment. Medicaid Watch: Missouri coverage losses are increasingly driven by paperwork problems—procedural terminations—while 2027 changes will require twice-yearly eligibility checks for expansion adults, raising the stakes for families to keep forms processed. Access to Care: Kansas City leaders say Costco has agreed to continue pharmacy services at the Midtown location, after residents raised concerns about losing nearby medication access. Local Wellness Education: MU Extension is taking registrations for its Fall 2026 Master Gardener course in Warrensburg, with training focused on plant health, soils, nutrition, and safe pesticide use.

Medicaid Fraud Push: Missouri Attorney General Catherine Hanaway joined a 16-state coalition urging Congress to pass the STOP FRAUD in Medicaid Act, which would expand what states can investigate and prosecute beyond provider fraud. Post-Hospital Care Scrutiny: Two U.S. senators demanded internal records from major Medicare Advantage insurers on how they decide coverage for post-acute care, including whether denials rely on predictive tools. Food Safety Alert: Walmart-distributed pistachio nut butter (bettergoods brand) is being recalled after salmonella was found in multiple jars, prompting consumers to stop using the product. Public Health Update: Missouri cyclosporiasis cases nearly doubled again, with state and local health departments reporting more than 1,000 illnesses. Local EMS Expansion: Boone Health dedicated a new ambulance station in south Columbia, aiming to cut response times by several minutes. Transportation Safety: MoDOT begins a year-long Route 367 safety project Wednesday to reduce speeding, with a community meeting set for Aug. 13. Health Access Policy: Missouri’s Department of Health and Senior Services proposed rules that could allow curbside pickup at cannabis dispensaries, with public comments due in September.

Health Workforce & Training: Missouri Southern State University is opening the Roy Blunt Health Science Innovation Center, adding a simulated operating room, simulated hospital, and skills lab to help graduates enter the workforce with more confidence and hands-on readiness. Public Health Watch: Missouri cyclosporiasis cases surged to 1,095 as of Aug. 2, with health officials warning the state may soon appear on the CDC’s outbreak map as new cases keep coming in. Food Safety: Walmart and the FDA issued a recall for bettergoods pistachio nut butter sold in multiple states due to possible Salmonella contamination. Medicaid Oversight: Missouri Attorney General Catherine Hanaway backed federal legislation aimed at cracking down on Medicaid fraud, arguing states need more power to pursue beneficiary and recipient fraud. Health Policy & Costs: Missouri voters are weighing Amendment 5, which would phase out the state income tax and expand sales taxes—raising concerns about whether healthcare and prescription costs could be hit. Behavioral Health Access: A new Behavioral Health Crisis Center in Trenton is offering voluntary, walk-in stabilization to help people avoid ER visits and possible criminal justice involvement.

Medicaid Budget Pressure: Missouri’s Medicaid program is heading into its toughest budget years in at least a decade as a new federal law threatens $1B+ in penalties unless the state cuts its error rate below 3% starting in 2029, while Missouri weighs extending private managed-care contracts to protect coverage for low-income families. Health Coverage Rates: Missouri released preliminary 2027 health insurance rates for the individual and small-group markets, with public comments due Aug. 31 and final rates expected by Oct. 31. Water Safety & Drownings: A man was nearly drowned after an electrical shock at Lake of the Ozarks, and another man drowned at Moonshine Beach on Table Rock Lake—both incidents highlight ongoing summer risks. Crash & Injury Updates: A Morgan County SUV overturned into a creek; a Camden County motorcycle crash sent a rider to a hospital by air; and a Livingston County crash injured three teens after an SUV hit an animal. Food Safety Recall: FDA-linked egg recall includes cartons with specific codes and a sell-by window through Aug. 17, tied to antibiotic-resistant Salmonella illnesses across 17 states. Public Health Policy: A Supreme Court decision shielding Roundup’s maker from failure-to-warn claims is also expected to reshape the fight over another pesticide, paraquat, tied to Parkinson’s disease.

Public Health & Care Access: Freeman Neosho Hospital earned five-star ratings for patient communication, a recognition based on patient feedback. Medicaid & Fraud: An adult day care provider in St. Louis, Agape Love Adult Day Care LLC operator Tony King, was indicted for allegedly submitting $1.47 million in false Missouri Medicaid claims for services not provided. Health Policy Watch: Missouri DSS says federal changes tied to public assistance are coming and urges residents to monitor updates on its H.R.1 site. Community Back-to-School Support: Adair County Health Department and CAPNEMO helped families at a free Back-to-School Fair with backpacks, school supplies, sports physicals, and vision screenings. Safety & Injury Alerts: Dunklin County jail staff found an inmate unresponsive in an apparent suicide; the Missouri State Highway Patrol is investigating. Road Safety: A Stoddard County crash killed a woman and injured eight others; multiple other Missouri crashes reported serious injuries, including a helmetless motorcyclist death in Laclede County. Health System News: Missouri’s preliminary health insurance rates for 2027 were released, adding to ongoing affordability concerns.

Missouri Health Insurance: The Missouri Department of Commerce and Insurance released preliminary 2027 health insurance rates for ACA-compliant individual and small-group plans, with a public review process running through late summer; officials say they’re checking filings for justification and compliance, and early data suggests multiple insurers will offer coverage in every county. Tick-Borne Alerts: Missouri health watchers are keeping an eye on tick-borne illness risk as experts warn about the rare Bourbon virus after a first New York case, with symptoms like fever, fatigue, rash, and headache and no vaccine or specific treatment. Water Safety: Missouri State Highway Patrol reports drownings are up sharply this year, urging life jacket use and safer habits around lakes and rivers as summer continues. Cyclospora Watch: Missouri and Kansas are still dealing with cyclosporiasis cases tied to contaminated food or water, and local shoppers are reconsidering produce choices while health officials work to identify the source. Community Health Access: Missouri families are also navigating affordability pressures, with events like a Kansas City-area back-to-school health fair offering free backpacks, sports physicals, and other services. Housing & Health: In Kansas City, North Lawn Apartment Complex tenants announced a rent strike over claims of unsafe conditions, including sewage issues, infestations, and broken heating/cooling.

Water Safety: Missouri State Highway Patrol reports an 80% jump in drownings and 36% more water fatalities so far this year, urging life jackets and safer habits around rivers, lakes, and docks. Foodborne Illness: Cyclospora outbreaks are making Missouri and Kansas residents sick, with cases near 600 in Missouri and experts warning the source can be hard to track. Health Coverage: Missouri’s Department of Commerce and Insurance released preliminary 2027 health insurance rates for ACA-compliant plans, with multiple insurers offering coverage across counties. Tick-Borne Alerts: Experts are warning about rare Bourbon virus after a first New York case, noting there’s no vaccine and symptoms can overlap with other illnesses. Local Care Access: A Kansas City-area back-to-school health fair helped families with free backpacks, supplies, and school physicals to ease rising costs. Injury & Emergency Response: Multiple serious incidents hit the region, including a Ripley County crash with two deaths, and Lake of the Ozarks electric shock and truck-pedestrian cases sending people to hospitals. Policy & Politics: Missouri voters face an August ballot fight over citizen-led constitutional amendments, with critics warning it could reshape public participation and court independence.

Workplace health warning: InvestigateTV+ reports Missouri resident Tyler Jordan and others are developing deadly silicosis after cutting engineered-stone countertops, with lung transplants sometimes needed after years of exposure. Foodborne illness update: Missouri health officials say cyclosporiasis cases have climbed to nearly 600, while the CDC outbreak map lags behind; officials say the Missouri cluster appears tied to the same produce source seen in the broader outbreak. Health care fraud: A north St. Louis County adult daycare provider was indicted for allegedly submitting $1.47 million in false Missouri Medicaid claims for care that wasn’t provided. Domestic violence prevention: Kansas City nonprofit Newhouse launched “Fathers for Change,” an early intervention program using therapy sessions to target the roots of violent behavior. Tick-bite fallout: A Missouri woman describes developing alpha-gal syndrome—sudden meat and dairy allergy—after a tick bite, highlighting how symptoms can show up weeks later. Community health access: Adair County’s back-to-school fair offers sports physicals, vision screenings, and supplies for students. Public safety: Missouri State Highway Patrol urges water safety after a sharp rise in drownings and water fatalities this year.

Cyclospora Watch: Missouri health officials report 593 cases of cyclosporiasis as of July 26—nearly 600—while the state still doesn’t show up on the CDC’s official outbreak map, even as experts say the cases may tie back to the same multistate produce-linked source. Water Safety: The Missouri State Highway Patrol says drownings are up sharply this year—an 80% jump in drownings and 36% more water deaths than last year—urging life jackets and safer rescue habits. Tick-Borne Alert: A rare, untreatable tick-borne virus called Bourbon virus was identified in New York for the first time after a Long Island man survived years of illness, raising awareness of how easily rare infections can be missed. Medicare & Skin Cancer Care: Missouri’s Sen. Eric Schmitt is among lawmakers pushing CMS to reverse a major Medicare payment cut affecting office-based image-guided superficial radiation therapy for some skin cancers. Local Health Fraud: A north St. Louis County adult daycare provider was indicted for allegedly submitting $1.47 million in false Medicaid claims for care that wasn’t provided. Heat & Power Reliability: The U.S. Department of Energy issued an emergency order covering Missouri to reduce blackout risk during extreme heat.

Water Safety Watch: Missouri State Highway Patrol reports 27 drownings and 30 total water fatalities from Jan. 1–July 30, up 80% and 36% respectively from last year, urging life jackets, avoiding alcohol, and extra caution around currents and drop-offs. Food & Waterborne Risk: Investigators are still working to trace rising cyclospora cases across Missouri and Kansas through a long, multi-step produce supply chain—making it hard to pinpoint where contamination started. Medicaid Fraud: A federal indictment alleges an adult day care provider, Agape Love Adult Day Care LLC operator Tony King, defrauded Missouri Medicaid of about $1.47 million via false reimbursement claims for care not provided. Healthy Aging Leadership: Northeast Iowa Area Agency on Aging CEO Greg Zars was elected to the USAging Board of Directors, representing Iowa, Kansas, Missouri, and Nebraska. Public Health Leadership in St. Louis: St. Louis Mayor Cara Spencer named Dr. Faisal Khan as city health director, bringing pandemic-era experience and a focus on local health risks. Tick-Borne Alert: Bourbon virus—rare and potentially fatal with no vaccine or widely available test—was confirmed in New York after a lone star tick bite, raising awareness for Missouri-area exposure. Oral Health & Cancer Care: A pediatric dentist highlights how cancer treatment can cause painful mouth complications like mucositis and why pre-treatment dental checks can prevent infections. Ballot Measure Impact: Missouri voters decide Amendment 4, which would make citizen-led constitutional amendments pass in all eight congressional districts instead of by statewide majority. Court System News: Missouri Courts Administrator Kathy Lloyd was appointed president of the National Center for State Courts and vice chair of COSCA.