HB 432
Modifies provisions relating to protection of vulnerable persons
LR Number:
Last Action:
7/14/2021 - Signed by Governor
Journal Page:
Calendar Position:
Effective Date:
Emergency clause
House Handler:

Current Bill Summary

SS/SCS/HS/HB 432 - This act modifies several provisions relating to the protection of vulnerable persons, including: (1) seclusion and restraint policies in public schools; (2) public school policies accommodating nursing mothers; (3) recording of parent meetings; (4) sheltered workshops; (5) the Alzheimer's State Plan Task Force; (6) forensic examinations; (7) the birth match program; (8) nutrition assistance programs; (9)child care benefits; (10) MO HealthNet antipsychotic medication; (11) unaccompanied youth; (12) child care facilities; (13) newborn safety incubators; (14) children in the custody of the state; (15) a child's right to counsel; (16) the Missouri Food Security Task Force; (17) employment leave for victims of certain crimes; (18) child hearing aids; (19) insurance coverage for mental health conditions; (20) step therapy; (21) modification of prior custody orders or visitation; (22) prohibition of certain sex offenders from being near certain properties; and (23) the "Missouri Commission on Autism Spectrum Disorders".


Under this act, school discipline policies required under current law shall reserve confining a student in seclusion for situations or conditions in which there is an imminent danger of physical harm to the student or to another.

Beginning July 1, 2022, no school district, charter school, or publicly contracted private provider shall use any mechanical, physical, or prone restraint technique which cause certain obstructions, impairments, physical pressure, danger, or pain, as listed in the act. A student who primarily uses sign language or an augmentative mode of communication shall be permitted to have his or her hands free for brief periods unless doing so appears likely to result in harm.

Before July 1, 2022, each school district's written policy addressing restrictive behavioral interventions shall be updated to be consistent with the act's prohibitions and limitations related to restraint techniques. The policy shall require students to be removed from seclusion or restraint as soon as the student is determined to no longer be an imminent danger of physical harm, shall require all personnel to annually review policies and procedures related to seclusion and restraint, and to require personnel who use seclusion or restraint to complete an annual training on permitted techniques. The policy shall also require each use of seclusion or restraint to be monitored by a personnel member and for a report containing certain documentary and parental support information to be completed and retained. A copy of the report shall be provided to the parent within 5 days of the incident and to the Department of Elementary and Secondary Education within 30 days. The school shall attempt to notify the parent as soon as possible after the use of seclusion or restraint, but at the latest no later than one hour after the end of the school day.

No public or charter school officer, administrator, or employee shall retaliate against a person for reporting a violation of the school's seclusion and restraint policy or a violation of the act or for providing information regarding a violation of the act. The Department shall compile and maintain all reported seclusion or restraint incidents in its core data system and make such data available on the Missouri Comprehensive Data System, except for personally identifiable data.

By July 1, 2022, the Department shall updates its model policy related to the confinement of students to include the provisions of the act related to the written seclusion and restraint policies.

These provisions are identical to provisions in HCS#2/SS/SB 327 (2021) and HB 387 (2021) and similar to HB 119 (2021), HB 1568 (2020), HB 1569 (2020), provisions in HCS/SS/SCS/SB 528 (2021), and HB 1023 (2019).


This act requires the Department of Elementary and Secondary Education to develop a model policy relating to accommodations for breast-feeding by January 1, 2022. Public school districts must adopt a written policy meeting the requirements of this act by July 1, 2022. The policy shall include provisions to provide certain minimum accommodations to lactating employees, teachers, and students to express or breast-feed in each public school building within the district for at least a year after the birth of a child. School districts must provide a minimum of three opportunities during a school day to express or breast-feed.

This provision is substantially similar to SB 76 (2021), HB 1490 (2020), and HB 1279 (2020).


Under this act, no school district or charter school shall prohibit a parent or legal guardian of a student from audio recording any meeting held under the federal Individuals with Disabilities Education Act (IDEA), or the federal Rehabilitation Act of 1973. Any audio recording make by a parent or legal guardian shall be the property of the parent or guardian, and shall not be considered to be a public record. School districts and charter schools shall not require parents to notify the school district or charter school of such parent's intent to record a meeting more than 24 hours in advance. No school district or charter school employee who reports any violation of this act shall be subject to discharge, retaliation, or any other adverse employment action for making such report.

This provision is identical to a provision in SCS/HCS/HB 228 (2021).


In order to prevent the curtailment of employment opportunities for disabled persons working at sheltered workshops, the Department of Elementary and Secondary Education shall permit sheltered workshops to pay such disabled persons commensurate wages, defined as wages based on the disabled person's productivity in proportion to the productivity of an experienced non-disabled person in a similar job and that may be lower than the state minimum wage. The sheltered workshop shall provide written assurance to the Department that such wages shall be reviewed and adjusted periodically and no sheltered workshop shall be permitted to reduce the agreed-upon wage rate for a period of two years after approval without prior authorization from the Department.

This provision is identical to SB 582 (2021).


This act establishes the "Alzheimer's State Plan Task Force" in the Department of Health and Senior Services, which shall consist of 21 members as specified in the act. The task force shall assess and maintain a state plan to overcome the challenges of Alzheimer's disease, including assessing the existing services and resources available for persons with Alzheimer's disease and their families and identifying opportunities for Missouri to coordinate with federal entities. The task force shall deliver a report to the Governor and General Assembly by June 1, 2022, and shall supplement the report annually thereafter. The task force shall expire on December 31, 2026.

This provision is identical to SB 523 (2021) and substantially similar to provisions in SCS/HCS/HB 1683 (2020) and SB 823 (2020).

FORENSIC EXAMINATIONS (Sections 192.2520 and 197.135)

This act requires the statewide coordinator for the telehealth network for forensic examinations of victims of sexual offenses to regularly consult with Missouri-based stakeholders and clinicians regarding the training programs offered by the network, as well as the implementation and operation of the network. Current law permits the training to be offered online or in person and this act requires that the training be made available online and permits it to be offered in person. Providers shall not be required to utilize this training, so long as the training utilized by providers is, at a minimum, equivalent to the network's training.

Current law requires licensed hospitals to perform forensic examinations of victims of sexual offenses beginning January 1, 2023. Under this act, such requirement shall only occur beginning January 1, 2023, or no later than 6 months after the establishment of the telehealth network, whichever is later. Finally, no individual hospital shall be required to comply with these provisions unless and until the Department of Health and Senior Services provides such hospital with access to the network for mentoring and training services without charge.

Finally, victims of sexual offenses who are 14 to 17 years of age may be referred by hospitals to SAFE CARE providers for medical or forensic evaluation and case review.

These provisions are identical to SCS/SB 550 (2021).

BIRTH MATCH PROGRAM (Sections 193.075, 210.150, and 210.156)

Under this act, the Children's Division shall make available to the State Registrar the identifying information of certain individuals, within the previous ten years, whose parental rights have been terminated due to child abuse or neglect, individuals who pled or were found guilty of murder or manslaughter when the victim was a child, and individuals who pled guilty or were found guilty of certain sexual offenses against a child. The State Registrar shall provide to the Division the birth record information of children born to such individuals. The Division shall verify the identity of the parent and if that identity is verified, the Division shall provide the appropriate local office with information regarding the birth of the child. Appropriate local Division personnel, or local providers designated by the Division, shall initiate contact with the family, or make a good faith effort to do so, to determine if the parent or family has a need for services and provide such voluntary and time-limited services as appropriate. The Division shall document the results of such contact and services provided, if any, in the Division's information system. Identifying information and records created and exchanged under this act shall be closed records and shall only be used as specified in the act.

These provisions are identical to provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 429 (2021) and the perfected SS/SB 327 (2021).

NUTRITION ASSISTANCE PROGRAMS (Sections 208.018, 208.285, 208.1060, and 210.251)

The current Supplemental Nutrition Assistance Program (SNAP) farmers' market pilot program expired on October 10, 2020. This act reauthorizes the program until August 28, 2027.

This provision is identical to SB 575 (2021).

This act changes the Missouri Senior Farmers' Market Nutrition Program to the Missouri Farmers' Market Nutrition Program and expands the program to include low-income pregnant and postpartum women, infants, and children under 5 years of age who are at nutritional risk. Additionally, this act removes language in current statute permitting vouchers under the program to be used at roadside stands and community-supported programs (CSAs).

This act modifies voucher distribution to permit eligible individuals to receive program vouchers from distribution sites in their county of residence or a neighboring county.

This provision is substantially similar to HB 652 (2021).

This act requires the Department of Social Services to submit a state plan to the U.S. Department of Agriculture for a "Farm to Food Bank Project" and to contract with any qualified food bank for the purpose of operating the project.

This provision is identical to SB 562 (2021).

Under this act, Missouri shall have no stricter requirements than federal regulations for participants in administering the program for at-risk school children through the federal Child and Adult Care Food Program. Facilities shall not be required to be licensed child care providers to participate in the program, as long as minimum health and safety standards are met and documented.

This provision is identical to a provision in HCS/SCS/SB 457 (2021) and HCS/HB 1337 (2021) and substantially similar to SCS/SB 563 (2021).

CHILD CARE BENEFITS (Section 208.053)

This act modifies an expired law relating to the "Hand-Up" pilot program, which was designed to ensure that certain participating recipients continued to receive child care subsidy benefits while paying a premium when their income surpassed the eligibility level for full benefits to continue. This act requires the Children's Division, subject to appropriations and by July 1, 2022, to implement a new pilot program in Jackson County, Clay County, and Greene County. The program shall be designed so that applicants may receive transitional child care benefits without first being eligible for full child care benefits, as long as the applicant's income falls within the income limits established through annual appropriations. The Division shall track the number of recipients in the program and the effectiveness of the program in encouraging recipients to secure employment with incomes greater than the maximum for full child care benefits. The report shall be issued to the General Assembly by September 1, 2023, and each September thereafter.

This act repeals provisions relating to the establishment and utilization of a "Hand-Up Premium Fund" in the State Treasury for premiums collected under the previous pilot program.

These provisions will expire on August 28, 2024, unless reauthorized.

These provisions are identical to SB 206 (2021) and SB 584 (2020), substantially similar to HCS/HB 1311 (2018), and similar to SB 965 (2018).


Currently, no restrictions to access shall be imposed that preclude the availability of any individual atypical antipsychotic monotherapy for the treatment of certain disorders in MO HealthNet participants. Under this act, no such restrictions shall be imposed for any individual antipsychotic medication. Additionally, this act modifies current law regarding the MO HealthNet Division's requirements to issue a provider update regarding cost considerations when enumerating treatment and utilization principles, as well as repeals language regarding the Division's adherence to certain principles when implementing new policies and clinical edits for antipsychotic drugs.

This provision is identical to SB 173 (2021), SB 666 (2020), and HB 867 (2019).

UNACCOMPANIED YOUTH (Sections 210.115 and 210.121)

Under this act, for the purposes of providing or accessing supportive services or verifying the status of a youth as unaccompanied or homeless, the fact that a child is an unaccompanied youth, as defined in federal law, is not, in and of itself, a sufficient basis for reporting child abuse or neglect, unless the child is under 16 years of age or is incapacitated.

Additionally, an unaccompanied youth may access supportive services, as defined in the act, so long as the youth is verified as an unaccompanied youth. Acceptable documentation for verification shall include: (1) a statement signed by a licensed mental health professional, licensed social worker, or licensed counselor of a government or nonprofit agency that receives public or private funding to provide services to homeless people; (2) a statement signed by a local educational agency liaison for homeless children and youth or a school social worker or counselor; or (3) a statement signed by an attorney representing the youth in any legal matter.

A person who acts in good faith to accept a statement from a director or designee of a government or nonprofit agency and who is without actual knowledge that such statement is fraudulent or otherwise invalid, shall not be liable in any civil or criminal action for providing shelter or supportive services without having obtained permission from the minor's parent or guardian. The service provider shall not be relieved from liability for negligence or criminal acts on the basis of this act.

These provisions are identical to HCS/HB 1276 (2021) and substantially similar to SCS/SB 536 (2021).

CHILD CARE FACILITIES (Sections 210.201, 210.252, and B)

Under current law, Montessori schools are not required to have a child care facility license to operate in the state. This act modifies the definition of a Montessori school to include programs that are either accredited by, actively seeking accreditation by, or maintain an active school membership with the American Montessori Society, Association Montessori Internationale, the International Montessori Counsel, or the Montessori Educational Programs International.

This provision has an emergency clause.

This provision is identical to the perfected SCS/SB 457 (2021).

This act change the department responsible for certain building and premise health and sanitation inspections for licensed child care facility from the Department of Health and Senior Services to the Department of Elementary and Secondary Education.


This act modifies the "Safe Place for Newborns Act of 2002" by permitting parents to relinquish a child up to 45 days old to a newborn safety incubator, defined as a medical device used to maintain an optimal environment for a newborn infant.

This provision is identical to HB 76 (2021).


Under this act, the Children's Division shall take physical custody of a child who is in the legal custody of the Division and who is hospitalized but no longer in need of medical care. If the Division fails to take physical custody of the child, then the Division shall reimburse the hospital at the same rate the hospital would receive per day for an inpatient admission.

Additionally, if the Division requests transportation of a child to an emergency, the hospital to which the child is transported or any subsequent psychiatric hospital to which the child is transferred shall be allowed to administer emergency psychiatric treatment.

This provision is identical to SB 561 (2021) and substantially similar to HB 1147 (2021).

CHILD'S RIGHT TO COUNSEL (Section 211.211)

Under this act, when a petition has been filed in a juvenile court under certain provisions of law and a child has waived his or her right to counsel, such waiver may be made in open court and be recorded and in writing. The waiver shall be made knowingly, intelligently, and voluntarily, which shall be determined by the totality of the circumstances, including the child's age, background, experience, emotional stability, and the complexity of the proceedings. Such waiver shall only apply to that proceeding and in any subsequent proceedings, the child shall be informed of his or her right to counsel.

A child's right to counsel shall not be waived in the following proceedings: (1) at a detention hearing, (2) at a certification or dismissal hearing, (3) at an adjudication hearing for any misdemeanor or felony offense, (4) at a dispositional hearing, or (5) at a hearing on a motion to modify or revoke supervision under certain provisions of law.

This provision is identical to provisions in CCS/HCS/SS/SCS/SBs 53 & 60 (2021) and substantially similar to HCS/HB 218 (2021) and to provisions in SB 305 (2021)


This act establishes the Missouri Food Security Task Force, to be comprised of 25 members as set forth in the act. The task force shall report a summary of its activities and recommendations to the Governor and the General Assembly before August 28th of each year, and shall terminate on December 31, 2023, or may be extended until December 31, 2025, as determined necessary by the Department of Agriculture.

This provision is identical to SCS/SB 441 (2021) and similar to HB 597 (2021) and HB 2108 (2020).


Under this act, any person employed by a public or private employer with at least 20 employees is entitled to unpaid leave if the person, or a family or household member, is a victim of domestic or sexual violence. Permissible reasons for taking leave include seeking medical attention, recovering from injury, obtaining victim services, obtaining counseling, participating in safety planning, and seeking legal assistance. Such leave shall be limited to 2 weeks of leave per year if the employer employs at least 50 employees and 1 week per year if the employer employs at least 20 but not more than 49 employees.

Employees are required to give 48 hours notice of the intent to take leave and may be required to provide certification to the employer that the leave is necessary. On return from leave, employees shall be restored to the same or equivalent employment position and shall not lose accrued benefits. Employers are required to maintain health coverage for the employee while on leave but the premium may be recovered if the employee does not return.

Employers are required to post and keep posted a notice summarizing the requirements of this act, which shall be prepared by the Director of the Department of Labor and Industrial Relations.

These provisions are identical to SB 16 (2021), substantially similar to SCS/SB 178 (2019), SB 739 (2018), SB 268 (2017), and SCS/SB 907 (2016), and similar to SB 130 (2015), SB 712 (2014) and SB 367 (2013).

CHILD HEARING AIDS (Section 376.1228)

This act requires health benefit plans delivered, issued, continued, or renewed on or after January 1, 2022, to provide coverage to children under 18 years of age for those hearing aids which are covered for children receiving benefits under MO HealthNet. Any additional costs to the state created under these provisions shall be subject to appropriation. These provisions shall be void if determined by the federal government to be in violation of federal law.

This provision is identical to provisions in HCS/SS/SCS/SB 43 (2021) and similar to HB 289 (2021).


Under this act, each health carrier that offers or issues health benefit plans that are delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2022, and that provider coverage for a mental health condition shall meet certain federal mental health parity requirements.

This provision is identical to a provision in the truly agreed to and finally passed SCS/SB 604 (2021).

STEP THERAPY (Section 376.2034)

Under this act, a step therapy override exception determination for health insurance shall be granted if the patient's treating health care provider attests that coverage of the prescribed prescription drug is necessary to save the life of the patient.


This provision modifies current law relating to the modification of a prior child custody decree by changing and adding intersectional references to current statutory provisions relating to child custody, visitation, and grandparent visitation.

This provision is identical to a provision in HCS/SS/SCS/SB 71 (2021).


This act provides that persons guilty of certain sex crimes cannot be present or loiter within five hundred feet of athletic complexes or athletic fields that exist primarily for use and recreation of children or within five hundred feet of Missouri Department of Conservation Nature or Education Center properties, unless the registered sex offender is the parent of a child participating in an educational program of the Department of Conservation and has permission to be on the property.

This provision is identical to the perfected SCS/SB 91 (2021) and provisions in SB 250 (2021) and similar to SB 638 (2020) and SB 35 (2019).


This act re-establishes the "Missouri Commission on Autism Spectrum Disorders" within the Department of Mental Health. The Commission shall produce an "Autism Roadmap for Missouri" encompassing the lifespan of a person living with autism spectrum disorder. The roadmap shall discuss best practices for care and services within health care, education, vocational support, and community resources, as described in the act. The Commission shall consist of 25 members and shall submit reports to the director of the Department and the Governor, as specified in the act.