Summary of the Perfected Version of the Bill

HS HB 349 -- ELDER ABUSE (Hosmer)

This substitute modifies the law relating to protection of the
elderly.  In its major provisions, the substitute:

(1)  Creates a new chapter on protection of the elderly and
transfers several existing statutory sections to this chapter;

(2)  Expands the list of persons required to report suspected
elder abuse to the Department of Social Services and mandates
that suspected abuse be reported within 24 hours;

(3)  Requires reports of suspected elder abuse to be referred to
the appropriate law enforcement agency.  Current law requires
only substantiated reports to be referred.  The Division of
Aging is also required to investigate immediately any report of
elder abuse or neglect that involves a threat of imminent harm;

(4)  Requires the division and law enforcement agencies to
cross-train personnel in investigating cases of suspected elder
abuse;

(5)  Makes it a class A misdemeanor for a health care provider
to knowingly hire an applicant whose name appears on the
Division of Family Services' central registry for child abuse
and neglect; who has had a foster care license refused,
suspended, or revoked; or who has been disqualified from
employment by the Department of Mental Health;

(5)  Allows the Attorney General to handle Medicare fraud
investigations.  The substitute also allows the Attorney General
to obtain investigative subpoenas and search warrants in
connection with investigations of abuse cases;

(6)  Authorizes the Division of Aging, when confronted with
violations or deficiencies related to staffing, to implement
corrective actions such as staffing ratios, training plans, or
plans related to staff supervision;

(7)  Requires facilities to meet or exceed federal requirements
concerning the posting of deficiencies;

(8)  Makes it a class A misdemeanor for a division employee to
knowingly disclose the time of an unannounced inspection of a
facility licensed by the division and requires the division to
terminate his or her employment;

(9)  Raises the public assistance and Medicaid eligibility asset
limit from $1,000 to $3,000 for an individual and from $2,000 to
$5,000 for a couple.  The substitute also allows the elderly and
persons qualifying for total disability benefits with incomes up
to 100% of the federal poverty level to qualify for Medicaid;

(10)  Requires the Division of Medical Services to remit
Medicaid payments to long-term care facilities for newly
admitted residents within 45 days of admission;

(11)  Adds 2 new centers to the list of Regional Child
Assessment Centers to be funded by the Department of Social
Services;

(12)  Adds felony stalking, as well as any prostitution,
robbery, arson, or firearms offense, to the list of state and
federal funds disqualifiers for in-home child care providers;

(13)  Clarifies certain definitions in the Family Care Safety
Act and expands the information available on the Family Care
Safety Registry and Access Line;

(14)  Increases the categories of employee disqualification for
elder and child care workers;

(15)  Requires elder care providers to access the Family Care
Safety Registry for all employee disqualification checks after
January 1, 2001;

(16)  Creates a hearsay exception for elderly and disabled
persons in certain cases;

(17)  Makes it a class B misdemeanor for an owner or employee of
a long-term care facility or of an in-home services provider
agency to have sexual contact with a resident of the facility or
with a client in his or her care.  Second or subsequent
violations are class A misdemeanors.  In addition, sexual
intercourse or deviant sexual intercourse in these cases is a
class D felony.  Second or subsequent violations are class C
felonies.  An employee who is married to a resident or client
and engages in this activity with his or her spouse is exempt
from prosecution.  Consent of the victim is no defense to
prosecution;

(18)  Allows the Director of the Department of Social Services
to contract with and provide funding for federally-qualified
health centers for certain purposes;

(19)  Prohibits persons from claiming any legal privilege as a
defense for failing to report suspected elder abuse, except that
the attorney-client privilege may still be claimed;

(20)  Grants the Department of Social Services access to the
financial, medical, and mental health records of any elderly
person when any action regarding the care and protection of that
elderly person is brought;

(21)  Requires the Division of Aging to provide certain
information and certain links regarding long-term care
facilities and facility surveys on its web site;

(22)  Makes the elderly caregiver tax credit refundable;

(23)  Requires the Division of Aging to publish a list of older
adult service providers in Missouri;

(24)  Requires the division to consider compliance history in
renewing licenses for certain elderly care facilities;

(25)  Mandates the inclusion of certain access and training
requirements in all Medicaid participation agreements with
in-home services providers and long-term care facilities;

(26)  Requires the division to restructure the adult day care
program by examining the program's requirements, offering
additional reimbursement for transportation to services, and
streamlining regulations governing long-term care facilities
that offer adult day care services;

(27)  Moves the state ombudsman for long-term care facilities
from the division to the Lieutenant Governor's office,
establishes an ombudsman advisory commission, and allows the
regional ombudsman coordinator to report suspected elder abuse
in certain cases;

(28)  Allows any person who prevails on an appeal from a denial
or removal of certain public assistance benefits to petition for
attorney's fees and costs when the state was substantially
unjustified in its decision;

(29)  Requires a joint report from the departments of Social
Services, Health, and Mental Health on the consolidation of
their employee disqualification lists; and

(30)  Requires all payments by long-term care facilities to
vendors of essential services to be made within 120 days.

FISCAL NOTE:  Estimated Net Cost to Healthy Families Trust Fund
- Health Care Treatment and Access Account of $0 to $5,000,000
in FY 2002, FY 2003, and FY 2004.  Estimated Net Cost to General
Revenue Fund of $17,978,556 to $18,354,433 in FY 2002,
$25,273,278 to $25,853,060 in FY 2003, and $27,236,453 to
$27,866,020 in FY 2004.  Cost does not include unknown costs for
expansion of the Shared Care Tax Credit.


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Last Updated November 26, 2001 at 11:43 am