SECOND REGULAR SESSION
SENATE BILL NO. 959
90TH GENERAL ASSEMBLY
INTRODUCED BY SENATOR HOWARD.
Read 1st time February 3, 2000, and 1,000 copies ordered printed.
TERRY L. SPIELER, Secretary.
4174S.02I
AN ACT
To amend chapters 187 and 660, RSMo, by adding thereto four new sections relating to in-home care for the elderly.
Section A. Chapters 187 and 660, RSMo, are amended by adding thereto four new sections, to be known as sections 187.020, 187.030, 187.100 and 660.252, to read as follows:
187.020. 1. When any physician, dentist, chiropractor, optometrist, podiatrist, intern, nurse, medical examiner, social worker, psychologist, minister, Christian Science practitioner, peace officer, pharmacist, physical therapist, in-home services owner, in-home services provider, in-home services operator, in-home services employee, employee of the department of social services or of the department of health or of the department of mental health or employee or volunteer for a local area agency on aging or for an organized area agency on aging program has reasonable cause to believe that an in-home services client has been abused or neglected, as a result of in-home services, he or she shall immediately report or cause a report to be made to the department. If the report is made by a physician of the in-home services client, then the department shall maintain contact with the physician regarding the progress of the investigation. The department shall also allow any in-home services owner, in-home services provider, in-home services operator, or in-home services employee to report an in-home services client to the department who is not being or has not been compliant with the department's order of in-home services for that client.
2. The department shall establish an interdisciplinary case management team to assist the department, the client's case manager, and the client's in-home services provider by acting as consultants and by intervening in cases where the team's specialized expertise will supplement the plan of service. The team shall review all reports of noncompliant in-home services clients for evaluation or reassessment of the services provided to the in-home services client. The department shall determine membership on the interdisciplinary case management team by rule, pursuant to chapter 536, RSMo. The team shall include at a minimum a department nurse, in-home services provider nurse, mental health professional, and may include a representative of law enforcement, a physician and other local resources.
3. Local area agencies on aging shall provide volunteer training, if requested, to those persons listed in subsection 1 of this section regarding the detection and report of abuse and neglect, pursuant to this section.
4. Any person required in subsection 1 of this section to report or cause a report to be made to the department who fails to do so within a reasonable time after the act of abuse or neglect is guilty of a class A misdemeanor.
5. The report shall contain the names and addresses of the in-home services provider agency, the in-home services employee, the in-home services client, information regarding the nature of the abuse or neglect, the name of the complainant, and any other information which might be helpful in an investigation.
6. In addition to those persons required to report under subsection 1 of this section, any other person having reasonable cause to believe that an in-home services client has been abused or neglected by an in-home services employee may report such information to the department.
7. Upon receipt of a report, the department shall initiate a prompt and thorough investigation within twenty-four hours. The department shall immediately investigate reports which indicate a clear and immediate danger to the in-home services client.
8. If the investigation indicates possible abuse or neglect of an in-home services client, the investigator shall refer the complaint together with his or her report to the department director or his or her designee for appropriate action. If, during the investigation or at its completion, the department has reasonable cause to believe that immediate removal is necessary to protect the in-home services client from abuse or neglect, the department or the local prosecuting attorney may, or the attorney general upon request of the department shall, file a petition for temporary care and protection of the in-home services client in a circuit court of competent jurisdiction. The circuit court in which the petition is filed shall have equitable jurisdiction to issue an ex parte order granting the department authority for the temporary care and protection of the in-home services client, for a period not to exceed thirty days.
9. Reports shall be confidential, as provided under section 660.320.
10. Anyone, except any person who has abused or neglected an in-home services client, who makes a report pursuant to this section or who testifies in any administrative or judicial proceeding arising from the report shall be immune from any civil or criminal liability for making such a report or for testifying except for liability for perjury, unless such person acted negligently, recklessly, in bad faith, or with malicious purpose.
11. Within five working days after a report required to be made under this section is received, the person making the report shall be notified in writing of its receipt and of the initiation of the investigation.
12. No person who directs or exercises any authority in an in-home services provider agency shall harass, dismiss or retaliate against an in-home services client or an in-home services employee because he or any member of his or her family has made a report of any violation or suspected violation of laws, standards or regulations applying to the in-home services provider agency or any in-home services employee which he has reasonable cause to believe has been committed or has occurred.
13. Any person who knowingly abuses or neglects an in-home services client shall be guilty of a class D felony.
14. The department shall maintain the employee disqualification list and place on the employee disqualification list the names of any persons who have been finally determined by the department, pursuant to section 660.315, to have recklessly, knowingly or purposely abused or neglected an in-home services client while employed by an in-home services provider agency.
15. The in-home services provider shall have the authority to enter the home of any in-home services client, with the client's permission, at a random, but reasonable time and in a reasonable manner to ensure the proper provision of services. The department shall establish a procedure by which all in-home services clients will be categorized based on their care needs after the initial qualification assessment. The department shall determine the criteria for each category by rule, pursuant to chapter 536, RSMo. There shall be a category for complex cases and these cases may be referred to the interdisciplinary case management team as necessary. The department, and a nurse licensed in Missouri pursuant to chapter 335, RSMo, who is contracted with the client's in-home services provider to provide evaluation or care on an as-needed basis, shall evaluate the client's condition upon initiation of services and when the client's services are reevaluated and changed, shall determine the care needs of the client and, based on the categorization procedure established by the department, establish a plan of services appropriate to meet the client's needs. After initial assessment of the client, at least one visit to the client's home shall be required by a nurse, registered pursuant to chapter 335, RSMo, who is contracted with the client's in-home services provider. All nurse visits shall be reimbursed to the in-home services provider and shall not be included in the maximum amount of funding allowed the client under Title XIX of the federal Social Security Act, 42 U.S.C. 301, et seq., pursuant to chapter 208, RSMo. In-home services clients shall have the right to request additional nurse visits.
187.030. 1. The department of social services shall investigate incidents and reports of elder abuse using the procedures established in sections 660.250 to 660.295, RSMo, and shall promptly refer all suspected cases of elder abuse to the appropriate law enforcement agency and prosecutor and shall determine whether protective services are required pursuant to sections 660.250 to 660.295, RSMo.
2. The division of aging and law enforcement agencies shall require training and cross-training of personnel regarding the proper handling of cases involving elder abuse. The division of aging, in cooperation with law enforcement agencies, shall, by rule, develop a checklist for division and law enforcement personnel to follow when investigating possible elder abuse.
3. Any rule or portion of a rule, as that term is defined in section 536.010, RSMo, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536, RSMo, and, if applicable, section 536.028, RSMo. This section and chapter 536, RSMo, are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536, RSMo, to review, to delay the effective date or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2000, shall be invalid and void.
187.100. 1. By July 1, 2001, the division of aging shall establish a telephone check-in pilot project in one area of the state to be designated by the division. Such pilot project shall require that a telephone check-in system be established for in-home services employees, as defined in section 660.250, RSMo, to accurately document the actual time that such employees spend in clients' homes by requiring such employees to clock in and out of the client's home by telephone. Such system shall also require in-home services employees to thoroughly document the specific services delivered to clients.
2. The division may promulgate rules to implement the provisions of this section. No rule or portion of a rule promulgated under the authority of this section shall become effective unless it has been promulgated pursuant to chapter 536, RSMo.
660.252. All Medicaid participation agreements entered into between the department of social services and in-home services provider agencies shall include a requirement that all in-home services employees of such agencies receive training on elder abuse and neglect.