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HCS/SS/SB 644 - This act modifies several provisions relating to public health. LUPUS AWARENESS DAY AND MONTH (Section 9.245) This act establishes May as "Lupus Awareness Month" and May 10 as "Lupus Awareness Day". This provision is identical to HB 1353 (2020). TRAUMA BLOOD LOSS PROTOCOLS FOR PUBLIC SCHOOLS (Section 160.485) By January 1, 2021, the Department of Elementary and Secondary Education shall develop a traumatic blood loss protocol for public school personnel to follow in the event of an injury involving traumatic blood loss, as specified in the act. School personnel shall receive annual training in the use of bleeding control kits. This provision is identical to HCS/HB 1991 (2020). MEDICAL MARIJUANA PATIENT INFORMATION (Section 191.255) Under this act, no state agency or employee thereof shall disclose to the federal government or an unauthorized third party the statewide list or any individual information of persons who have applied for or obtained a medical marijuana card. Any violation of this provision is a Class E felony. This provision is identical to a provision in HCS/SS/SB 580 (2020) and HCS/HB 1896 (2020). THE "21ST CENTURY MISSOURI PATIENT EDUCATION TASK FORCE" (Section 191.1160) This act establishes the "21st Century Missouri Patient Education Task Force" consisting of 22 members who shall evaluate the condition of the state's patient education system and make recommendations to improve health care delivery and outcomes in Missouri. The task force shall submit a report of its activities and recommendations by August 28, 2021 and terminate on January 1, 2022. This provision is identical to provisions in HCS/SS/SB 580 (2020) and HB 2288 (2020). MEDICAL MARIJUANA BACKGROUND CHECKS (Section 195.815) The Department shall require all officers, managers, contractors, employees, and other support staff of licensed or certified medical marijuana facilities, and all owners of such facilities who will have access to the facilities or the facilities' supply of medical marijuana, to submit fingerprints to the Highway Patrol for a state and federal criminal background check. The Highway Patrol shall notify the Department of any criminal history record information or lack thereof discovered on the individual. All such records shall be accessible and available to the Department. This provision is identical to a provision in HCS/SS/SB 580 (2020) and similar to a provision in SCS/HCS#2/HB 1896 (2020) and SCS/SB 764 (2020). This provision has an emergency clause. CERTIFICATE OF NEED (Section 197.305 and 197.318) This act modifies several provisions relating to the occupancy rate of health care facilities for purposes of certificates of need. First, this act removes the phrase "nonapplicability review" from the definition of "new institutional health service" regarding changes in licensed bed capacity. Additionally, current law requires maintenance of a 90% average occupancy rate for the previous six quarters when determining whether a long-term care facility may increase its licensed bed capacity. This act changes that rate to 85%. Under current law, long-term care facilities may transfer or sell individual licensed beds to qualifying facilities. The selling facility shall not expand its licensed bed capacity in that licensure category for 5 years. Under this act, the licensed bed transferred or sold to qualifying facilities shall be "licensed and available". Additionally, the selling facility may not expand its bed capacity either for 5 years or until the average occupancy of licensed and available beds in that licensure category within a 15-mile radius is 85% for the previous six quarters. Any facility that transfers or sells licensed and available beds shall have an average occupancy rate of less than 70% for the previous six quarters. This act is identical to provisions in HCS/SS/SB 580 (2020) and HB 2093 (2020) and substantially similar to SB 898 (2020). MO HEALTHNET BENEFITS (Section 208.057) Under this act, any MO HealthNet recipient who becomes ineligible for MO HealthNet benefits due to increased income from employment may remain eligible for such benefits if the recipient pays a premium, as specified in the act. This provision is identical to HCS/HB 2552 (2020). DRUG UTILIZATION REVIEW BOARD (Section 208.175) This act modifies the membership of the MO HealthNet Drug Utilization Review Board. This provision is identical to provisions in HCS/SS/SB 580 (2020) and HCS/HB 2035 (2020). SERVICE ANIMALS (Sections 209.150, 209.200, and 209.204) This act modifies the definition of a "service dog" to be a dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability. Additionally, this act adds "mental health service dog" to the definition of a service dog. A mental health service dog, or a psychiatric service dog, is a dog that has been individually trained for an owner who has a psychiatric disability, medical condition, or developmental disability. The dog is trained to perform tasks to mitigate or assist the owner with difficulties directly related to the disability. These provisions are identical to provisions in HCS/HB 1319 (2020), substantially similar to provisions in HB 750 (2020), and similar to provisions in HCS/HB 107 (2019), HB 1369 (2019), HB 262 (2017), HCS/HB 1907 (2018), HCS/SS/SCS/SB 918 (2018), and SB 335 (2017), HCS/HB 1428 (2016), HB 787 (2015), and HB 142 (2015). Under this act, any person knowingly misrepresenting a dog as a service dog, as described in the act, for the purposes of receiving accommodations regarding service dogs under the Americans with Disabilities Act shall be guilty of a Class C misdemeanor for the first offense and a Class B misdemeanor for each subsequent offense. Additionally, any person knowingly misrepresenting any animal as an assistance animal, as described in the act, for the purposes of receiving accommodations regarding assistance animals under the Fair Housing Act or the Rehabilitation Act shall be guilty of a Class C misdemeanor for the first offense and a Class B misdemeanor for each subsequent offense. The Governor's Council on Disability shall prepare and make available online a placard for posting in a front window or door of a business stating that service dogs are welcome and that misrepresenting a service dog is a violation of Missouri law. The Council shall also prepare and make available a brochure detailing guidelines regarding service dogs and assistance animals. These provisions are substantially similar to provisions in HCS/HB 1319 (2020) and SB 750 (2020) and similar to provisions in HCS/HB 107 (2019), SCS/SB 107 (2019), HCS/HB 2031 (2018), and HCS/SS/SCS/SB 918 (2018). OFFENSE OF UNLAWFUL USE OF UNMANNED AIRCRAFT OVER A CORRECTIONAL CENTER (Section 217.850) Under this act, a person commits the offense of unlawful use of unmanned aircraft over a correctional center if he or she purposely: • Operates an unmanned aircraft within a vertical distance of 400 feet over a correctional center's secure perimeter fence; or • Allows an unmanned aircraft to make contact with a correctional center, including any person or object on the premises of or within the facility. The act sets forth exceptions to when use of an unmanned aircraft over a correctional center shall not be prohibited. The offense of unlawful use of an unmanned aircraft over a correctional center is punishable as an infraction unless the person using the unmanned aircraft is: • Delivering a gun, knife, weapon, or other article that can be used to endanger the life of an offender or correctional center employee, in which case the offense is a class B felony; • Facilitating an escape from confinement, in which case the offense is a Class C felony; or • Delivering a controlled substance, in which case the offense is a Class D felony. These provisions are identical to SS/SCS/HB 1450 (2020) and HCS/HB 1898 (2020) and substantially similar to SCS/SB 602 (2020). CERTAIN AGRICULTURAL INSPECTIONS (Section 261.099) This act specifies that the Missouri Department of Agriculture, the Missouri Department of Natural Resources, the county sheriff for the county in which the facility is located, the United States Department of Agriculture, and any other federal or Missouri state agency with statutory or regulatory authority shall have exclusive authority to inspect the grounds or facilities located in Missouri for the production of eggs, milk or other dairy products, the raising of livestock or poultry, or the production or raising of dogs or other animals that are not used to produce any food product. Unless requested by the owner of the grounds or facilities, no other entity may inspect the grounds or facilities to enforce or carry out the laws or administrative rules of another state. This provision shall not apply to inspections performed in charter counties or the city of St. Louis or to inspections performed on any manufacturing component of any production agriculture farm. This provision is identical to SCS/SB 699 (2020) and similar to HB 1583 (2020) and the perfected HCS/HB 951 (2019). WORKING ANIMALS (Section 262.760) Under this act, the right to utilize working animals, as defined in the act, is guaranteed. No law, ordinance, or rule shall be enacted by any political subdivision of the state that terminates, bans, or effectively bans, by creating undue financial hardship, the job or use of working animals or an enterprise employing working animals. Nothing in the act shall prevent the establishment of or alter the laws, ordinances, or rules of a political subdivision regarding animal care, public health, or public safety; unless such law, ordinance, or rule is in violation of the act, in which case, the act shall supercede such law, ordinance, or rule. This act is identical to SB 979 (2020), HCS/HB 1752 (2020) and similar to SB 416 (2019), SCS/HB 559 (2019), and HB 1021 (2019). POWDERED ALCOHOL (Section 311.020) This act adds powdered alcohol to the definition of "intoxicating liquor". This provision is identical to HB 1285 (2020). REIMBURSEMENT OF HEALTH CARE CLAIMS (Section 376.383) Currently, a health carrier that has not paid a claimant on or before the 45th processing day from the date of receipt of the claim shall pay the claimant interest and a penalty based on the unpaid balance of the claim as of the 45th processing day. On claims exceeding $35,000 on the unpaid balance of the claim, the health carrier under this act shall pay the claimant 1% interest per month and a penalty in an amount equal to 1% of the claim per day for a maximum of 100 days and thereafter shall pay the claimant 2% interest per month. Currently, any claim or portion of a claim that has been properly denied before the 45th processing day shall not be subject to interest or penalties. Under this act, denied claims before the 45th processing day shall begin to accrue interest and penalties during the claimant's appeal with the health carrier until such claim is paid, if the claim is approved. If the appeal does not result in an approved claim and a petition is filed with a court of competent jurisdiction to recover payment of the claim, interest and penalties shall continue to accrue for no more than 100 days from the day the first appeal was filed with the health carrier and continue to accrue until ten days after the court finds that the claim shall be paid to the claimant. BREAST CANCER SCREENING AND EVALUATION COVERAGE (Section 376.782) This act modifies an insurance mandate relating to breast cancer screening and evaluation. In addition to existing coverage requirements, the act adds "detectors" to the X-ray equipment specifically listed as being covered under the mandate. The act also specifies that coverage for certain breast cancer screening and evaluation services shall be provided to any woman deemed by her physician to have an above-average risk for breast cancer in accordance with American College of Radiology (ACR) guidelines, rather than specifically to women with a personal or family history of breast cancer. The act also requires coverage of any additional or supplemental imaging, such as breast MRI or ultrasound, deemed medically necessary by a treating physician for proper screening or evaluation in accordance with applicable ACR guidelines. Furthermore, the act requires coverage of ultrasound or MRI services when determined by a treating physician to be medically necessary for the screening or evaluation of breast cancer for any woman deemed by the treating physician to have an above-average risk of breast cancer in accordance with ACR guidelines for breast cancer screening. Lastly, provisions relating to out-of-pocket expenditures are modified to apply to the additional modalities required to be covered under the act. This provision is identical to SB 841 (2020). HEALTH CARE PRACTITIONER CREDENTIALING (Section 376.1578) This act provides that if a health carrier receives a credentialing application, the carrier shall have ten days from sending notice of the application's receipt to request additional information from the practitioner. The application shall be deemed complete upon receipt of the additional information. Within two working days of receipt of the additional information, the carrier shall send notice to the practitioner that the practitioner has submitted a completed application. If the carrier does not request additional information, the application shall be deemed completed as of the date the notice of receipt was sent by the carrier to the practitioner. The act specifies that the carrier's credentialing decision and notification to the practitioner of such decision shall be made within 60 days of receipt of the "completed credentialing application", rather than 60 "business" days of receiving the practitioner's "credentialing information". If a practitioner's application is approved, the carrier shall provide payments for covered health services performed by the practitioner during the credentialing period if the services were on behalf of an entity that had a contract with the carrier during the credentialing period. The contract entity shall submit to the carrier all claims for services provided by the practitioner during the credentialing period within six months after the carrier has approved the practitioner's credentialing application. Claims submitted for reimbursement under this provision shall be sent to the carrier by the provider in a single request or as few requests as practical. A health carrier shall not require a practitioner to be credentialed to receive payments for covered health services if the practitioner is providing coverage for an absent credentialed practitioner during a temporary period not exceed 60 days. Any practitioner authorized to receive payments for covered services under this provision shall provide notice to the carrier as described in the act. A carrier may deny payments if the practitioner providing services in lieu of the credentialed provider meets one of the conditions described in the act. All claims eligible for payment under these provisions shall be subject to the prompt payment statute. These provisions are similar to SB 938 (2020). OFFENSE OF UNLAWFUL USE OF UNMANNED AIRCRAFT OVER AN OPEN AIR FACILITY (Section 577.800) A person commits the offense of unlawful use of unmanned aircraft over an open air facility if he or she: • Operates an unmanned aircraft within a vertical distance of 400 feet from the ground and within the property line of an open air facility; or • Uses an unmanned aircraft with the purpose of delivering to a person within an open air facility a gun, knife, weapon, or other dangerous article or a controlled substance. The act sets forth exceptions to when use of an unmanned aircraft over an open air facility shall not be prohibited. The offense of unlawful use of an unmanned aircraft over an open air facility is punishable as an infraction unless the person using the unmanned aircraft is: • Delivering a gun, knife, weapon, or other article that can be used to endanger the life of an employee or guest at such a facility, in which case the offense is a class B felony; or • Delivering a controlled substance, in which case the offense is a Class D felony. These provisions are identical to SS/SCS/HB 1450 (2020) and HB 1898 (2020) and substantially similar to SCS/SB 602 (2020). THE "SEXUAL ASSAULT SURVIVORS' BILL OF RIGHTS" (Section 595.201) This act establishes the "Sexual Assault Survivors' Bill of Rights". Under this act, certain specified rights are provided for survivors of sexual assault during any forensic examination and during any interview by a law enforcement official, prosecuting attorney, or defense attorney, including the right to consult with employees or volunteers of rape crisis centers during any examination or interview, the right to receive notice of these rights prior to an examination or interview, the right to a prompt analysis of the forensic evidence, and other specified rights. This provision is identical to a provision in the perfected SS/SCS/SB 569 (2020) and similar to SB 812 (2020). THE "MISSOURI RIGHTS OF VICTIMS OF SEXUAL ASSAULT TASK FORCE" (Section 595.202) This act creates the "Missouri Rights of Victims of Sexual Assault Task Force" to consist of membership as set forth in the act. The task force shall make certain recommendations as provided in the act. The task force shall collect data regarding sexual assault reporting, arrest, prosecution rates, access to sexual assault victims services, and any other important data, as well as collect feedback from stakeholders, practitioners, and leadership throughout the state and local law enforcement, victim services, forensic science practitioners, and health care communities. The task force shall submit a report on its findings to the Governor and the General Assembly no later than December 31, 2021. The task force shall expire on December 31, 2021. This provision is identical to a provision in the perfected SS/SCS/SB 569 (2020) and similar to SB 812 (2020). EVIDENTIARY COLLECTION KITS (Section 595.220) This act modifies current law regarding procedures for tracking evidentiary collection kits. Currently, the Attorney General shall establish an electronic tracking system for evidentiary collection kits and their components, including individual specimen containers. Additionally, current law requires the Attorney General to permit sexual assault victims or their designees access to the system to monitor the current status of their kits. This act requires such victims to register with the system to track and obtain reports on the status and location of their kits through a secure web-based or similar system. Appropriate medical providers, law enforcement agencies, laboratories, court personnel, persons or entities involved in the final disposition or destruction of the kits, and all other entities and persons having custody of the kits shall participate in the tracking system. The Department of Public Safety, with the advice of the Attorney General and the assistance of the Department of Health and Senior Services, shall develop and retain within the state a central repository for unreported evidentiary collection kits that is temperature-controlled to preserve the integrity of the kits and diminish degradation. Unreported kits shall be retained for 5 years; except in the case of minor victims, the retention period shall be until 5 years after the victim reaches 18 years of age. Finally, records entered into the electronic tracking system shall be confidential and not subject to disclosure under state law. This provision is identical to a provision in the perfected SS/SCS/SB 569 (2020). OFFENSE OF UNLAWFUL USE OF UNMANNED AIRCRAFT OVER A MENTAL HEALTH HOSPITAL (Section 632.460) A person commits the offense of unlawful use of unmanned aircraft over a mental health hospital if he or she purposely; • Operates an unmanned aircraft within a vertical distance of 400 feet over the mental health hospital's property line; or • Uses an unmanned aircraft to deliver to a person confined in a mental health hospital a gun, knife, weapon, or other dangerous article or a controlled substance. The act sets forth exceptions to when use of an unmanned aircraft over a mental health hospital shall not be prohibited. The offense of unlawful use of an unmanned aircraft over a mental health hospital is punishable as an infraction unless the person using the unmanned aircraft is: • Delivering a gun, knife, weapon, or other article that can be used to endanger the life of a patient or mental health center employee, in which case the offense is a Class B felony; • Facilitating an escape from confinement, in which case the offense is a Class C felony; or • Delivering a controlled substance, in which case the offense is a Class D felony. These provisions are identical to SS/SCS/HB 1450 (2020) and HB 1898 (2020) and substantially similar to SCS/SB 602 (2020). SARAH HASKINS
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