HB 1615 Modifies various provisions relating to protection of the elderly
Current Bill Summary
- Prepared by Senate Research -

SS#2/SCS/HS/HB 1615 - This act modifies the law relating to protection of the elderly. A new Chapter 187 is created and several existing sections are transferred to this chapter.

ABUSE AND NEGLECT SECTION 187.010 - Modifies definitions for elder care terms, including the definition of "abuse" to include "financial" injury.

SECTION 187.020 - Requires certain persons to report suspected abuse or neglect of facility residents. Anyone failing to make a report is guilty of a Class A misdemeanor. The Department of Social Services shall investigate reports within twenty-four hours. Reports involving imminent harm shall be investigated immediately. All reports will be referred to the appropriate law enforcement agency. All reports are confidential, except that family members will be notified, unless they are the alleged abusers. The Department must notify the reporter within five days regarding the initiation of an investigation.

Immunity is given to reporters, unless they act negligently, recklessly, or in bad faith. No reporter may be harassed for making a report. The Division of Aging and a telephone contact line will provide information on a person's rights if this occurs.

It is a Class D felony to abuse or neglect a resident. The Department must maintain an employee disqualification list (EDL) consisting of persons who have been finally determined to have abused or neglected a resident. Sections 187.075 and 187.032 provide similar provisions for in-home care clients and private care clients, respectively. Section 187.078 provides similar provisions for the misappropriation of an individual's property.

SECTION 187.030 - The Department must investigate reports by using the procedures established in Sections 660.250 to 660.295. The Division and law enforcement must require elder abuse training and must develop an investigation checklist.

SECTION 187.034 - Provides immunity from liability to reporters, unless they act in bad faith.

SECTION 187.081 - Any person placed on the EDL must be notified in writing with thirty days to respond or appeal. Based on substantiated reports, any person who intentionally or negligently inflicts serious physical injury or death to another will be automatically listed. No person on the EDL may be employed by anyone receiving the list.

SECTION 187.084 - No later than two days after hiring, providers must request a criminal background check and must check the EDL. Failure to disclose will result in a Class A misdemeanor. Failure to investigate will result in civil penalties. This section only applies to persons hired after the effective date of this section. This section contains an emergency clause.

SECTION 187.087 - Provides that all reports of abuse or neglect will be kept confidential, with specific exceptions.

SECTION 187.102 - Requires the Departments of Social Services, Mental Health, and Health to work cooperatively in the investigation of abuse and neglect, when appropriate.

SECTION 491.076 - This new section allows a statement made by an elderly or disabled person, while still under the stress of excitement caused by the incident, to be admitted into evidence if the statement is made near the time of a crime. In addition, the elderly or disabled must testify or be unavailable and the court must find a sufficient indicia of reliability.

SECTION 660.030 - This new section provides that no legal privilege, with the exception of attorney/client, will excuse a person's failure to report or cooperate with the investigation of abuse or neglect. All Department personnel shall have access to victim's records, unless otherwise prohibited by federal law.

INSPECTIONS AND COMPLIANCE SECTION 191.900 - Includes "financial" in the definition of abuse and redefines "medical assistance" as any federal health care program.

SECTION 191.910 - Allows the Attorney General (AG), with approval of the court, to investigate violations of sections 191.900 to 191.910 or section 187.020.

SECTIONS 197.400 - 197.477 - Revises various provisions regarding the licensure of home health care providers, including the creation of three classifications of home health care.

SECTION 198.012 - Includes the provisions of Section 187.020, RSMo, as non-applicable to certain entities, such as hospitals.

SECTION 198.026 - Currently, this section outlines facility compliance procedures and allows the Department to penalize facilities that do not comply. Provisions are added regarding receivership of non-complying nursing homes.

SECTION 198.030 - Requires every residential care facility I or II to meet or exceed federal requirements for posting deficiencies.

SECTION 198.032 - Includes Section 187.020 in the requirement for confidentiality of resident records.

SECTION 198.090 - Adds a provision to prohibit the payment to any person of the state's cash grant funds to get an elderly or disabled person admitted to any long term care facility.

SECTION 198.526 - Currently, this section deals with facility inspection procedures. New language provides for immediate termination and a Class C misdemeanor for any Division employee who discloses an inspection time to a facility.

FAMILY CARE REGISTRY SECTIONS 210.903-210.936 - Currently, this section establishes the Family Care Safety Registry and Access Line. New language requires the inclusion of the Department of Mental Health's EDL.

MISCELLANEOUS SECTION 190.142 - Restricts the practice of emergency medical technicians to specific situations.

SECTION 660.085 - Allows the Department to consider the compliance history of a facility or of a facility's operator when issuing or renewing the facility's license.

SECTIONS 1-20 - Creates the "Missouri Law Enforcement District Act". These sections contain an emergency clause.

SECTION 21 - Requires the Joint Committee on Administrative Rules to review all new drugs or medicines before they are placed on the Medicaid pharmacy prior authorization list.

This act contains a termination for Section 210.936, RSMo. Portions of this act are substantially similar to SB 1071, SB 1081, SBs 959 & 598, SB 947, and SB 576.
ERIN MOTLEY

SS #1: SA 1 - DELETES "OR AN ELIGIBLE ADULT" FROM THE LIST OF MANDATED REPORTERS IN SECTION 187.020;

SA 2 - ADDS MISSOURI LAW ENFORCEMENT DISTRICT ACT IN SECTIONS 1-20;

SA 3 - ADDS PROVISIONS TO CREATE AN INTERDISCIPLINARY CASE MANAGEMENT TEAM FOR IN-HOME SERVICES CLIENTS. PROVIDERS WILL NOT BE LIABLE FOR THE CONSEQUENCES OF A NONCOMPLIANT CLIENT'S BEHAVIOR, UNLESS THEY ARE THE RESULT OF THE PROVIDER'S OR EMPLOYEE'S (SSA 1 FOR SA 1 TO SA 3) NEGLIGENT, RECKLESS, WILLFUL OR WANTON BEHAVIOR. THE TEAM MUST INCLUDE A FAMILY MEMBER WHEN APPROPRIATE AND AVAILABLE (SA 2 TO SA 3);

SA 4 - ADDS REQUIREMENT THAT VOLUNTEERS FOR LOCAL AREA AGENCIES ON AGING BE INCLUDED IN TRAINING EFFORTS;

SA 5 - ADDS SECTION 660.083 ALLOWING THE DEPARTMENT TO CONSIDER THE COMPLIANCE HISTORY OF A FACILITY AND FACILITY'S OPERATOR DURING LICENSURE;

SA 6 - IN SECTION 191.910, PAGE 30, LINE 5, REMOVES THE BRACKETS AROUND THE WORD "SHALL" AND DELETES THE NEW LANGUAGE REGARDING THE AG's ABILITY TO COMMENCE A PROSECUTION IN 3RD CLASS COUNTIES WITH LESS THAN FULL-TIME PROSECUTORS;

SA 7 - ADDS FAMILY CARE SAFETY REGISTRY PROVISIONS IN SECTIONS 210.903-210.936 AND ADDS THE DEPT. OF MENTAL HEALTH'S EMPLOYEE DISQUALIFICATION LIST;

SA 8 - PROVIDES THAT CONTINUING CARE RETIREMENT COMMUNITIES WILL NOT BE SUBJECT TO CERTIFICATE OF NEED REQUIREMENTS;

SS #2: SA 1 - ADDS SECTION 208.151 REGARDING MEDICAID SPENDDOWN LEVELS TO ALLOW AN ELDERLY OR DISABLED PERSON TO BE ELIGIBLE AT 100% POVERTY LEVEL;

SSA 1 FOR SA 2 - ADDS SECTION 208.152 WITH BOREN AMENDMENT LANGUAGE REQUIRING, SUBJECT TO APPROPRIATION, THE REIMBURSEMENT OF NURSING FACILITIES BY MEDICAID AT APPROPRIATE LEVELS TO COVER COSTS;

SA 3 - MODIFIES SECTION 190.142 TO DELETE THE WORD "CONTINUED" FROM THE DESCRIPTION OF EMERGENCY CARE DURING WHICH AN EMERGENCY MEDICAL TECHNICIAN MAY PRACTICE;

SA 4 - ADDS A PROVISION TO SECTION 187.084 TO REQUIRE APPLICANTS FOR PATIENT CARE TO ALSO DISCLOSE IF THEY ARE LISTED ON THE CENTRAL REGISTRY FOR CHILD ABUSE, HAVE HAD A FOSTER LICENSE DENIED OR SUSPENDED, OR IF THEY ARE LISTED ON THE DEPARTMENT OF MENTAL HEALTH'S EMPLOYEE DISQUALIFICATION LIST;

SSA 1 FOR SA 5 - ADDS SECTION 208.010 AND 208.151 TO INCREASE, SUBJECT TO APPROPRIATION, MEDICAID ASSET LIMITS TO $2500 FOR A SINGLE PERSON AND $5000 FOR A COUPLE.

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