HB 1654 -- Protection of the Elderly

Co-Sponsors:  Hosmer, Kreider, Ladd Baker, Abel, Willoughby,
Johnson (90), Kelly (27), Monaco, Harding, Carnahan, Marsh,
Moore, Smith

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

(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 Health and Senior 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 department is
also required to investigate immediately any report of elder
abuse or neglect that involves a threat of imminent harm;

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

(5)  Requires emergency medical services (EMS) and hospital
employees who abuse, neglect, or financially exploit the elderly
to be placed on the employee disqualification list;

(6)  Requires the department to establish a telephone check-in
pilot project for in-home service employees by July 1, 2003;

(7)  Requires the Department of Health and Senior Services and
the Department of Mental Health to cooperate in abuse and neglect
investigations;

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

(9)  Creates civil penalties for home health agencies;

(10)  Requires disclosure of financial interests of nursing home
owners and operators applying for licensure and renewal of
licensure.  The bill also allows the department to deny licensure
or renewal based on a review of the facility's compliance history
and the owner or operator's compliance history;

(11)  Authorizes the department, 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;

(12)  Requires notice of noncompliance of a licensed facility to
be given to the Attorney General;

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

(14)  Allows for revocation of a facility's license when the
operator has been cited for failure to comply with a class I
standard two times in 24 months or for failure to comply with a
class II or III standard two times in 12 months;

(15)  Allows the Attorney General to bring an action to recover
civil penalties from licensed facilities for violations;

(16)  Requires nursing assistants employed by a skilled nursing
facility or intermediate care facility to complete training
within 120 days of being hired;

(17)  Adds freedom from neglect to the list of rights of
long-term care facility residents and extends the time for filing
a complaint for violations of a resident's right from 180 days to
two years from the date of the alleged deprivation or injury;

(18)  Allows the department to reduce the frequency of
inspections of licensed facilities from twice a year to once a
year based on the facility's compliance record;

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

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

(21)  Requires elder care providers to access the Family Care
Safety Registry for all employee disqualification checks after
January 1, 2004;

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

(23)  Makes it a class B misdemeanor for an owner or employee of
a skilled nursing facility or an Alzheimer's special unit 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;

(24)  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;

(25)  Requires the department to provide certain information and
certain links regarding long-term care facilities and facility
surveys on its web site;

(26)  Requires the department to provide a publication that lists
all public and private organizations in the state that provide
services to the elderly;

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

(28)  Allows investigation reports to be made available without a
court order to certain persons;

(29)  Clarifies when the department can seek an injunction in
connection with an investigation;

(30)  Requires the department 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; and

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

Missouri House of Representatives
Last Updated October 11, 2002 at 9:02 am