HCS SCS SB 616 -- ASSISTED LIVING FACILITIES

SPONSOR:  Stouffer (Bruns)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Senior
Citizen Advocacy by a vote of 10 to 1.

This substitute changes the laws regarding assisted living
facilities.  "Residential care facility I" as it applies to
long-term care provided to the elderly and disabled is changed to
"residential care facility" and "residential care facility II" is
changed to "assisted living facility."  In its main provisions,
the substitute:

(1)  Defines "assisted living facility" as any premises other
than a residential care facility, intermediate care facility, or
skilled nursing facility that provides or coordinates 24-hour
care and protective oversight to three or more residents.  Care
may include the provision of shelter, board, and assistance with
any activities of daily living or supervision of health care
under the direction of a licensed physician;

(2)  Defines "community based assessment," "dementia,"
"activities of daily living," "instrumental activities of daily
living," "shared responsibility agreement," "appropriately
trained individual," and "social model of care";

(3)  Requires an assisted living facility to provide for or
coordinate oversight and services to meet the needs of a resident
as specified in a written contract signed by the resident or
other responsible party;

(4)  Prohibits an assisted living facility from accepting an
individual who is a danger to self or others, requires physical
or chemical restraint, requires more than one person to
simultaneously assist the resident in daily activities, or is
bed-bound;

(5)  Requires an assisted living facility to provide staff in
appropriate numbers and with appropriate skills to provide
24-hour care to residents;

(6)  Requires that residents with cognitive or physical
limitations preventing timely evacuation be housed on the ground
floor of a facility;

(7)  Requires multilevel facilities or facilities accepting
residents with cognitive or physical impairments to be in
compliance with National Fire Protection Association Code 13 and
the 1997 Life Safety Codes for Existing Health Care Occupancy;

(8)  Requires an assisted living facility to keep a written plan
for the protection of all residents in the event of a disaster;

(9)  Creates a grandfather provision regarding the new licensing
requirements for existing residential care facility II entities;

(10)  Requires an assisted living facility to complete a resident
assessment upon admission, at least semi-annually, and whenever a
significant change has occurred in the resident's condition;

(11)  Requires the use of a personal electronic monitoring device
for any resident of an assisted living facility whose physician
recommends its use;

(12)  Prohibits any facility from naming or advertising itself as
an assisted living facility without obtaining a license from the
Department of Health and Senior Services; and

(13)  Requires the department to develop rules to ensure the
compliance of the provisions of the substitute.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of Unknown,
greater than $100,000 in FY 2007, FY 2008, and FY 2009.  No
impact on Other State Funds in FY 2007, FY 2008, and FY 2009.

PROPONENTS:  Supporters say that the bill is long overdue in
redefining residential care facilities to assisted living
facilities, expanding options, and creating choices for older
Missourians.  Residents with diminished capacity will be allowed
to remain at the assisted living facility with certain
protections in place, rather than transferred to a skilled
nursing facility when they are unable to exit safely in an
emergency.  Those living with dementia can continue to live a
dignified and meaningful life if surrounded by competent and
caring staff.

Testifying for the bill were Senator Stouffer; Lieutenant
Governor; Arthritis Foundation; Missouri Association of Homes for
the Aging; Missouri Alliance of Area Agencies on Aging; Mary Lee
Sharp; Missouri Alzheimer's Coalition; AARP; Missouri Coalition
for Quality Care; and Lutheran Senior Services.

OPPONENTS:  Those who oppose the bill say that in its current
form, the bill is inconsistent with current regulations and
practices and unsafe for residents.  There is a great need for
the proper enforcement of the regulations.  The bill removes a
category of homes and forces facilities to change their mission
and standards.  The standard for "appropriately trained
individual" leads to inappropriate evaluations and assessments.

Testifying against the bill were Missouri Assisted Living
Association; Missouri Health Care Association; Pete Stayton;
Carla Lungren; and Michael Schrappen.

Alex Curchin, Legislative Analyst

Missouri House of Representatives
93rd General Assembly, 2nd Regular Session
Last Updated November 29, 2006 at 9:46 am