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.Copyright (c) Missouri House of Representatives