SCS SB 60 -- Health Care Services for the Elderly

Sponsor:  Steelman

ALZHEIMER'S DISEASE AND RELATED DEMENTIAS

This substitute designates the first Tuesday of March as
"Alzheimer's Awareness Day" to promote activities to increase
awareness of Alzheimer's disease and related dementias.  The
Division of Aging is required to provide technical assistance
about Alzheimer's disease and related dementias, including
dementia-specific training materials and trainers.  The division
is also required to establish minimum dementia-specific training
requirements by January 1, 2002.  These training requirements
are to be incorporated into new employee orientation and
in-services.

COVERAGE FOR BREAST AND CERVICAL CANCER

The substitute provides Medicaid coverage for breast and
cervical cancer patients who meet certain requirements and
provides for a period of presumptive eligibility during the
eligibility determination.  Insurance companies may not impose
time limits on individuals for the receipt of a prosthetic
device or reconstructive surgery after a mastectomy.  If an
individual changes his or her insurance, coverage for these
procedures must transfer to the new policy.

ELDER ABUSE AND NEGLECT

The substitute requires Medicaid agreements between in-home
service providers and the Department of Social Services to
include a requirement that workers receive training about abuse
and neglect identification, prevention, and reporting as part of
the current initial training requirement.  Local area agencies
on aging are required to provide volunteer training to all
mandated reporters concerning the detection and report of elder
abuse.

Reports of abuse are required to be investigated promptly, and
those that indicate a clear danger to the client are required to
be investigated within 24 hours.  Funeral directors, embalmers,
in-home service providers, and employees of area agencies on
aging or organized areas on aging are included in the listing of
mandated reporters of abuse.  When a physician is a reporter of
abuse or neglect, the Department of Social Services is required
to maintain contact with the physician concerning the progress
of the investigation.  When a report of abuse or neglect of an
in-home services client is received, the client's case manager
and the department nurse must investigate and immediately report
the results to the department nurse.  The department may allow
the provider's nurse to assist the case manager.  The department
is required to refer all suspected cases of elder abuse to law
enforcement to jointly determine when protective services are
needed.  Both the department and law enforcement personnel are
required to have training concerning the handling of elder abuse
cases.

The substitute allows administrative penalties of up to $1,000
per violation for the in-home services provider if an employee
is found guilty of a violation and if the provider willfully and
knowingly failed to report the abuse to the department.
Providers are allowed to seek administrative review of the
decision.  Violation is defined as a determination of guilt by a
court.  The department is required to establish a quality
assurance and supervision process.  In-home services providers
who knowingly employ a person who is on the employee
disqualification list, who refuse to register with the Family
Care Safety Registry, or who are listed on any of the background
check lists in the registry are guilty of a class A misdemeanor.

The substitute requires the department to conduct a "Safe at
Home" evaluation once a client is assessed for level of care.
The plan of service for each client should be authorized by a
nurse and the in-home services provider nurse may conduct the
assessment.  The department may consult other departments on a
case-by-case basis, and may also refer any client to a mental
health professional if necessary.  All clients are to be advised
of their rights at the initial evaluation, including the right
to call the department for any reason.

Current aging-in-place pilot projects are exempted from the
certificate of need law.

Missouri House of Representatives
Last Updated September 13, 2001 at 2:05 pm