HCS/SCS/SB 538 - This act modifies provisions relating to long-term care facilities and fire marshal regulation. FIRE SAFETY STANDARDS This act specifies that any section of a facility in which a major renovation has been completed on or after August 28, 2007, shall install and maintain an approved sprinkler system in accordance with National Fire Protection Association (NFPA) 13. The act also specifies when the requirements for sprinklers shall be NFPA 13R (residential) or NFPA 13 (commercial). This act removes a fire sprinkler exemption for skilled nursing and intermediate care facilities that pertains to the Chapter 33 of existing residential board and care occupancies of NFPA life safety code. Fire safety inspections of skilled nursing and intermediate care facilities shall be conducted annually by the department. Fire safety inspections of residential care and assisted living facilities shall be conducted annually by the State Fire Marshal. The provisions as to fire safety shall be enforced by the department or the State Fire Marshal depending on which entity conducted the inspection. If a facility submits a plan of compliance for installation of a sprinkler system required under state law, such facility shall install a complete fire alarm system that complies with NFPA 72 upon installation of the sprinkler system. Until such time that the sprinkler system is installed in the facility which has submitted a plan of compliance, each resident room or any room designated for sleeping in the facility shall be equipped with at least one battery-powered smoke alarm installed, tested, and maintained in accordance with NFPA 72. In addition, any such facility shall be equipped with heat detectors interconnected to the fire alarm system which are installed, tested, and maintained in accordance with NFPA 72 in all areas subject to nuisances alarms, including but not limited to, kitchens, laundries, bathrooms, mechanical air handling rooms, and attic spaces. This act removes the requirement that the interconnected smoke detectors be in place throughout the facility. A substantial step for obtaining a loan from the Fire Safety Standards Loan Fund shall be as specified for certain residential care and assisted living facilities and all skilled nursing and intermediate care facilities. The Fire Safety Standards Loan Fund was modified to provide that the loans may be for implementing the sprinkler requirements for certain qualifying residential care and assisted living facilities and all types of qualifying skilled nursing and intermediate care facilities. The loan fund shall be administered by the State Treasurer's Office rather than the Department of Health and Senior Services as in current law. These provisions are substantially similar to provisions in SS/SCS/SB 89 (2009) and CCS/SS/SCS/HB 395 (2009). SECTIONS 198.074 and 198.075 FAMILY CONFERENCES IN LONG-TERM CARE FACILITIES This act requires the Department of Health and Senior Services to strongly encourage long-term care facilities to institute policies to encourage familial involvement in the well-being and support of residents in long-term care facilities including family conferences and meetings. SECTION 198.089 This act is identical to HB 935 (2009) and CCS/SS/SCS/HB 395 (2009). BONDS FOR LONG-TERM CARE RESIDENTS' PROPERTY IN TRUST This act modifies the current provision in law regarding a bond required for holding a resident's property in trust by specifying that the bond shall be obtained and filed with the department for the preceding twelve months rather than for the preceding calendar year. This provision is identical to a provision in SS/SCS/SB 89 (2009). SECTION 198.096 CRIMINAL BACKGROUND CHECKS Any licensed long-term care facility may request criminal background checks of a resident in a facility. This provision is identical to a provision in SS/SCS/SB 89 (2009) and CCS/SS/SCS/HB 395 (2009). SECTION 198.187 INSPECTORS AND SURVEYORS Under this act, the Department of Health and Senior Services shall not assign an individual to inspect or survey a long-term care facility in which the surveyor was an employee of such facility within the preceding two years. The department shall require disclosure statements by newly hired and currently employed inspectors and surveyors of long-term care facilities regarding his or her past employment in long-term care facilities and the current or past employment of immediate family members in long-term care facilities. Any person may notify the department if facts exist that would lead a reasonable person to conclude that any inspector or surveyor has any personal or business affiliation that would result in a conflict of interest in conducting an inspection or survey of a facility. Upon receiving that notice, the department, when assigning an inspector or surveyor to inspect or survey a facility, for any purpose, shall take steps to verify the information , and if the department has probable cause to believe that it is correct, shall not assign the inspector or surveyor to the facility in order to avoid an appearance of prejudice or favor to the facility or bias on the part of the inspector or surveyor. These provisions are substantially similar to provisions in CCS/SS/SCS/HB 395 (2009) and SS/SCS/SB 89 (2009). SECTION 198.525 DISPUTE RESOLUTION PROCESS This act enacts the Missouri Informal Dispute Resolution Act, requiring the Department of Health and Senior Services to contract with the federally designated Medicare Quality Improvement Organization in the state to conduct informal dispute resolutions (IDR)for licensed long-term care facilities. The IDR process shall constitute an informal administrative process but cannot be a formal evidentiary hearing and must be used to determine if a cited deficiency of a facility should be upheld. Use of the IDR process under the act shall not waive the facility's right to pursue further or additional legal actions. The details and timeline for the IDR process are included in the act. SECTION 198.527 AND 198.545 These provisions are substantially similar to provisions in HCS/HB 966 and CCS/SS/SCS/HB 395(2009). PERSONAL NEEDS ALLOWANCE This act codifies the current practice of granting a monthly personal needs allowance for residents in long-term care facilities, as such practice is permitted under federal law. Currently, the allowance is set annually by appropriation at thirty dollars a year. This act creates a formula for increasing the allowance yearly, starting in January 1, 2010, by no more than five dollars a year until such time as the allowance reaches fifty dollars a year. At that time, only upon annual appropriation may the allowance be increased beyond fifty dollars a year. The formula provides that the allowance shall be increased by an amount equal to the product of the Social Security benefit cost of living adjustment and the average amount that MO HealthNet participants are required to contribute to the cost of institutionalized care. This provision is identical to SCS/SB 538 (2009)and CCS/SS/SCS/HB 395 (2009). SECTION 208.016 NURSING HOME TRANSITION GRANTS This act modifies provisions regarding the assistance provided to nursing home residents who transition back into their homes and in the community. Subject to appropriations, nursing home residents eligible for MO HealthNet benefits will receive a one-time transition grant up to $2,400, administered by the Division of Senior and Disability Services within the Department of Health and Senior Services. The funds shall be used on initial down payments, setup costs and other expenditures associated with moving a nursing home resident back into the community. The division will work with the Department of Social Services to generate additional private and federal funding for the transition grants. The Department of Health and Senior Services and the Department of Mental Health shall work in cooperation to develop community-based services for persons who are moving out of nursing homes and back into their communities and promulgate rules as needed. These provisions are substantially similar to HB 1656 (2008) and CCS/SS/SCS/HB 395 (2009). SECTION 208.819 BLASTER'S LICENSE This act adds individuals using explosives along with a well screen cleaning device for the purpose of unblocking clogged agriculture irrigation well screens to the list of individuals who are exempt from obtaining a blaster's license. SECTIONS 319.306 AND 319.321 This provision is contained in HCS/HB 707 (2009) and HB 197 (2009). FEDERAL REIMBURSEMENT ALLOWANCE TAXES This act extends the sunsets for the Medicaid Managed Care Organization reimbursement allowance, the Pharmacy Tax, and the intermediate care facility for the mentally retarded assessment from June 30, 2009 to September 30, 2011. The sunsets for the Federal Reimbursement Allowance assessment and Nursing Facility Reimbursement Allowance are extended from September 30, 2009 to September 30, 2011. SECTIONS 208.437, 208.480, 338.535, 338.550, and 633.401 These provisions are substantially similar to SB 378 (2009) and HB 470 (2009) and CCS/SS/SCS/HB 395 (2009). These provisions as to the provider taxes contain an emergency clause. HOME AND COMMUNITY-BASED CARE ASSESSMENTS This act prescribes procedures for home and community-based services and details the reimbursement for in-home providers who provide assessments to prospective recipients of MO HealthNet-funded home and community-based care. This act provides that the in-home provider shall be reimbursed for one authorized nurse visit to complete the nurse assessment and then a minimum of one and no more than two additional authorized nurse visits to make a properly completed referral. SECTION 1 This provision is similar to a provision in SCS/HCS/HB 10 (2009) and CCS/SS/SCS/HB 395 (2009). ADRIANE CROUSE