SS/SCS/SBs 70 & 128 - This act modifies several provisions relating to the administration of health care services, including: (1) qualifications of the Director of the Department of Health and Senior Services; (2) infection control data reporting; (3) hospital inspectors and surveyors; (4) certified nursing assistant training requirements; (5) personal care assistance vendors; (6) an interactive assessment tool for certain home and community-based services; (7) the suspension of MO HealthNet benefits for certain offenders; (8) nursing home administrator licenses; and (9) unanticipated out-of-network health care services. QUALIFICATIONS OF THE DIRECTOR OF THE DEPARTMENT OF HEALTH AND SENIOR SERVICES (Section 192.007) This act requires the Director of the Department of Health and Senior Services to have specified qualifications regarding education and experience. This provision is identical to provisions in SB 177 (2019). INFECTION CONTROL DATA REPORTING (Section 192.667) Under this act, hospitals and the Department of Health and Senior Services shall not be required to comply with infection data reporting requirements of current law applying to hospitals if the Centers for Medicare and Medicaid Services (CMS) also requires the submission of such data, except that the Department shall post a link on its website to the publicly reported data on CMS's website. Additionally, hospitals that have established antimicrobial stewardship programs, as required under current law, shall meet the National Healthcare Safety Network requirements for reporting antimicrobial usage or resistance when CMS's conditions of participation requiring such reporting become effective. Nothing shall prohibit a hospital from voluntarily reporting the data prior to the effective date of the conditions of participation. This provision is identical to SB 435 (2019). HOSPITAL INSPECTORS AND SURVEYORS (Section 197.108) This act prohibits the Department of Health and Senior Services from assigning an individual to inspect or survey a hospital if the inspector or surveyor was an employee of such hospital or another hospital within its organization within the previous 2 years. The Department shall require inspectors or surveyors to disclose the name of every hospital in which he or she was employed in the previous 10 years, the length of service, and the job title held, as well as the same information for any immediate family member employed at a hospital. Such information shall be considered a public record. If any person has reason to believe that an inspector or surveyor has any personal or business affiliation that would result in a conflict of interest, he or she may notify the Department. If the Department has reason to believe the information to be true, the Department shall not assign the inspector or surveyor to the hospital or any hospital within its organization. This provision is identical to SB 415 (2019) and substantially similar to HB 758 (2019). CERTIFIED NURSING ASSISTANT TRAINING REQUIREMENTS (Section 198.082) This act requires certified nursing assistant training programs to be offered at skilled nursing or intermediate care facility units in Missouri veterans homes and hospitals. Certified nursing assistants shall include certain employees at such units and hospitals who have completed the training and passed the certification examination. Training shall include on-the-job training at certain locations and the act repeals language pertaining to continuing in-service training. Persons who have completed the required hours of classroom instruction and clinical practicum for unlicensed assistive personnel under state regulations shall be allowed to take the certified nursing assistant examination and shall be deemed to have fulfilled the classroom and clinical standards requirements for designation as a certified nursing assistant. Finally, the Department of Health and Senior Services may offer additional training programs and certifications to students already certified as nursing assistants as specified in the act. This provision is identical to SB 490 (2019) and HB 817 (2019) and similar to SB 1062 (2018) and HB 2597 (2018). PERSONAL CARE ASSISTANCE VENDORS (Sections 208.909, 208.918, and 208.924) Under current law, vendors of consumer-directed services shall monitor the performance of personal care assistance service plans. This act requires the consumer to permit the vendor to comply with its quality assurance and supervision process, including bi-annual face-to-face home visits and monthly case management activities. During the home visits, the vendor shall document if the attendant was present and providing services as set forth in the plan of care and report the Department if the attendant is not present or providing services, which may result in a suspension of services to the consumer. This act repeals language permitting the Department of Health and Senior Services to establish certain pilot projects for telephone tracking systems. This act also requires vendors to notify consumers during orientation that falsification of personal care attendant time sheets shall be considered and reported to the Department as fraud. Under this act, a vendor shall submit an annual financial statement audit or annual financial statement review performed by a certified public accountant to the Department upon request. The Department shall require the vendor to maintain a business location in compliance with any and all city, county, state, and federal requirements. Additionally, this act requires the Department to create a consumer-directed services division provider certification manager course. No state or federal funds shall be authorized or expended if the owner, primary operator, certified manager, or any direct employee of the consumer-directed services vendor is also the personal care attendant, unless such person provides services solely on a temporary basis for no more than three days in a thirty-day period. Currently, a consumer's services may be discontinued if the consumer has falsified records. This act adds language to include providing false information of his or her condition, functional capacity, or level of care needs. These provisions are substantially similar to provisions in HCS/HB 1885 (2018) and HB 2500 (2018) and similar to SB 969 (2018) and provisions of SB 526 (2017). INTERACTIVE ASSESSMENT TOOL FOR CERTAIN HOME AND COMMUNITY-BASED SERVICES (Section 208.935) Finally, the Department shall, subject to appropriations, develop an interactive assessment tool for utilization by the Division of Senior and Disability Services when implementing the assessment and authorization process for home and community-based services authorized by the Division. This provision is substantially similar to language in SB 441 (2019). SUSPENSION OF MO HEALTHNET BENEFITS FOR CERTAIN OFFENDERS (Sections 217.930 and 221.125) Under this act, MO HealthNet benefits shall be suspended, rather than cancelled or terminated, for offenders entering into a correctional facility or jail if the Department of Social Services is notified of the person's entry into the correctional center or jail, the person was currently enrolled in MO HealthNet, and the person is otherwise eligible for MO HealthNet benefits but for his or her incarcerated status. Upon release from incarceration, the suspension shall end and the person shall continue to be eligible for MO HealthNet benefits until such time as he or she is otherwise ineligible. The Department of Corrections shall notify the Department of Social Services within 20 days of receiving information that person receiving MO HealthNet benefits is or will become an offender in a correctional center or jail and within 45 days prior to the release of such person whose benefits have been suspended under this act. City, county, and private jails shall notify the Department of Social Services within 10 days of receiving information that person receiving MO HealthNet benefits is or will become an offender in the jail. These provisions are identical to SB 393 (2019). NURSING HOME ADMINISTRATOR LICENSES (Section 344.030) Under current law, an applicant for a nursing home administrator license must have a minimum of three years of experience or two years of postsecondary education in health care administration or have satisfactorily completed a course of instruction prescribed by the Missouri Board or Nursing Home Administrators and passed the examination administered by the Board. Under this act, such applicant may meet this requirement if he or she has an associate degree or higher from an accredited academic institution. Currently law allows the Boar to issue a temporary emergency license for a period of 90 days to a person 21 years of age or older. This act permits the Board to issue such license for a period of 120 days to a person 18 years of age or older. Additionally, this act repeals the provisions relating to the renewal of a temporary emergency license. This provision is substantially similar to SB 375 (2019). UNANTICIPATED OUT-OF-NETWORK HEALTH CARE SERVICES (Section 376.690) This act specifies that health care professionals shall, rather than may, utilize the process outlined in statute for claims for unanticipated out-of-network care. This provision is identical to the perfected SB 103 (2019). SARAH HASKINS
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