HCS/SCS/SBs 959 & 598 - This act modifies the reporting of elder abuse and the provision of in-home services.

Sections 197.400 - 197.477 revises various provisions regarding home health care provider licensure, including the creation of three classifications of home health care. This portion is similar to SCS/SB 947.

Section 660.250 adds a definition for "noncompliant client".

Section 660.252 requires the incorporation of an abuse and neglect curriculum into all Medicaid agreements between the Department and in-home services providers.

Section 660.260 deals with the duties of the Department upon receipt of the abuse report. New language requires prompt investigation of reports and investigation within twenty-four hours of reports that indicate clear danger to the client.

Section 660.300 currently lists those persons who are required to report any elder abuse or neglect of in-home services clients. New language adds in-home services providers and employees, volunteers of area agencies on aging, or organized AAA programs. If a physician makes an initial report, then the Department must maintain contact with the physician. In-home services providers may also report any noncompliant client.

Upon notification of noncompliance, the Department nurse shall attempt to resolve the circumstances and shall investigate the case when necessary. The client may also be referred to the Interdisciplinary Case Management Team (ICMT), which will attempt to resolve the problem and, if unable to, will issue a report identifying the client as noncompliant.

The Department must create an ICMT to assist and intervene into certain cases. The ICMT will review all reports of noncompliant clients for evaluation or re-assessment. Membership will be determined on a case by case basis, but the ICMT will at least include the client's case manager, a Department nurse, a provider nurse, a long-term care specialist, and a mental health professional, who may assume the role of co-case manager. If the ICMT believes the client suffers from a mental disorder, then the client should be referred to a mental health coordinator for investigation. The in-home services provider will be reimbursed for its participation on the ICMT.

Local area agencies on aging must provide volunteer training to all mandated reporters regarding the detection and report of elder abuse.

The Department must establish a categorization procedure for in-home services clients, based on their assessed needs. Specific criteria for each category will be determined by rule and some clients may be referred to the ICMT. Each client with non-nursing plans of service will receive at least two provider- nurse visits to assess the client and the client's services. The cost of visits will be reimbursed if such services are pre- authorized by the Department and will not be included in the maximum amount of medical assistance allowed the client.

All clients will be advised of their rights at the initial evaluation, including the right to call the Department for any reason. The Department must establish a method other than the abuse and neglect hotline to receive such calls.

Section 660.302 - requires the Department to refer all suspected cases of elder abuse to law enforcement to jointly determine when protective services are needed. Training of personnel and a checklist will be required.

Section 660.303 requires the Division of Aging to establish a telephone check-in pilot project by July 1, 2001 in a first- class county with a charter form of government. This project will allow in-home services employees to document the actual time they spend with clients by "clocking in" by telephone.

Portions of this act are substantially similar to HB 1615, SB 1081 and SB 1071 (2000).
ERIN MOTLEY