HS HB 1615 -- PROTECTION OF THE ELDERLY (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)  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
(Section 187.020.5, RSMo);

(3)  Requires the division and law enforcement agencies to
cross-train personnel in investigating cases of suspected elder
abuse (Section 187.030.2);

(4)  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.  This provision
has an emergency clause (Section 187.084.7);

(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 (Sections 191.100,
191.900, and 191.910);

(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.  The division may require
corrective action for up to one year regardless of whether the
deficiency or violation is corrected.  If corrective action is
required with regard to staffing ratios, facilities may request
a rate adjustment increase to adjust the staffing ratio (Section
198.026.3);

(7)  Requires facilities to meet or exceed federal requirements
concerning the posting of deficiencies (Section 198.030);

(8)  Requires the division to terminate the employment of a
division employee who knowingly discloses the time of an
unannounced inspection of a facility licensed by the division
(Section 198.526);

(9)  Raises the public assistance and Medicaid eligibility asset
limits from $1,000 to $5,000 for an individual, and from $2,000
to $7,000 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 (Sections 208.010.2 and 208.151);

(10)  Requires the Division of Medical Services to remit to
long-term care facilities Medicaid payments for newly admitted
residents within 45 days of admission.  The substitute also
requires all drugs and medicines on the Medicaid pharmacy prior
authorization list to be first approved by the Joint Committee
on Administrative Rules (Section 208.152);

(11)  Allows a statement made by an elderly or disabled person
near the time of an alleged crime to be admitted as evidence in
civil, criminal, or administrative proceedings if the person is
unavailable as a witness due to the person's physical or mental
condition and the court believes the person's statement to be
reliable (Section 491.076);

(12)  Requires the Division of Aging to restructure the adult
day care program by examining the program's requirements,
offering additional reimbursement for transportation to such
services, and streamlining regulations governing long-term care
facilities that offer adult day care services (Section 660.401);

(13)  Requires all deaths of skilled, intermediate care, or
residential care facility residents to be reported to the
medical examiner or coroner, as well as the deaths of facility
residents who have been in the care of a hospital for less than
5 days.  If there is reasonable cause to suspect that the death
was the result of abuse, sexual abuse, or negligence, the
medical examiner or coroner must report the findings to the
police and prosecuting attorney; and

(14)  Establishes the Pharmacy Relief for the Elderly Fund,
which assists persons over the age of 62 who do not have health
insurance and require prescription medications.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
$28,520,706 in FY 2001, $44,883,488 in FY 2002, and $48,354,868
in FY 2003.

HB 1615 -- PROTECTION OF THE ELDERLY

CO-SPONSORS:  Hosmer, Ladd Stokan, Gaw, Barnett, Crawford,
McKenna, Britt, Selby, Cierpiot, Backer, Kelly (27), Dougherty

COMMITTEE ACTION:  Voted "do pass" by the Committee on Criminal
Law by a vote of 18 to 0.

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)  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
(Section 187.020.5, RSMo);

(3)  Requires the division and law enforcement agencies to
cross-train personnel in investigating cases of suspected elder
abuse (Section 187.030.2);

(4)  Requires the division to establish in one area of the state
a pilot project using a telephone check-in system to monitor the
arrival and departure of staff providing in-home services
(Section 187.100);

(5)  Allows the Attorney General to obtain investigative
subpoenas and search warrants in connection with investigations
of abuse cases (Sections 191.100 and 191.910);

(6)  Authorizes the division, 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.  The division may require
corrective action regardless of whether the deficiency or
violation is corrected (Section 198.026.3);

(7)  Requires the division to terminate the employment of a
division employee who knowingly discloses the time of an
unannounced inspection of a facility licensed by the division
(Section 198.526);

(8)  Requires the Department of Social Services to increase the
current asset and income limits for Medicaid eligibility
(Section 208.225);

(9)  Allows a statement made by an elderly or disabled person
near the time of an alleged crime to be admitted as evidence in
criminal proceedings if the person is unavailable as a witness
due to the person's physical or mental condition and the court
believes the person's statement to be reliable (Section 491.076);

(10)  Authorizes staff of the department, in any action brought
by the department relating to the care and protection of an
eligible adult, to have access to all medical and mental health
records of the eligible adult (Section 660.030); and

(11)  Requires training on elder abuse and neglect for all
employees providing in-home services through contracts with the
department (Section 660.252).

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund exceeds
$230,912 in FY 2001, exceeds $235,315 in FY 2002, and exceeds
$236,230 in FY 2003.

PROPONENTS:  Supporters say that the bill fosters coordination
between the Division of Aging and law enforcement, promotes home
health care, and emphasizes quality of patient care in facility
and home care settings.

Testifying for the bill were Representatives Hosmer and Ladd
Stokan; AARP; Silver Haired Legislature; Missouri Alliance for
Home Care; Missouri Coalition for Quality Care; Office of the
Attorney General; Service Employees Union International; Phil
Melugin, home health care provider; State Highway Patrol;
Derrick Potts, attorney; and Missouri Assisted Living
Association.

OPPONENTS:  There was no opposition voiced to the committee.

Sarah Madden, Legislative Analyst

HB 1615 -- Protection of the Elderly

Co-Sponsors:  Hosmer, Ladd Stokan, Gaw, Barnett, Crawford,
McKenna, Britt, Selby, Cierpiot, Backer, Kelly (27), Dougherty

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)  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
(Section 187.020.5);

(3)  Requires the division and law enforcement agencies to
cross-train personnel in investigating cases of suspected elder
abuse (Section 187.030.2);

(4)  Requires the division to establish in one area of the state
a pilot project using a telephone check-in system to monitor the
arrival and departure of staff providing in-home services
(Section 187.100);

(5)  Allows the Attorney General to obtain investigative
subpoenas and search warrants in connection with investigations
of abuse cases (Sections 191.100 and 191.910);

(6)  Authorizes the division, 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.  The division may require
corrective action regardless of whether the deficiency or
violation is corrected (Section 198.026.3);

(7)  Requires the division to terminate the employment of a
division employee who knowingly discloses the time of an
unannounced inspection of a facility licensed by the division
(Section 198.526);

(8)  Requires the Department of Social Services to increase the
current asset and income limits for Medicaid eligibility
(Section 208.225);

(9)  Allows a statement made by an elderly or disabled person
near the time of an alleged crime to be admitted as evidence in
criminal proceedings if the person is unavailable as a witness
due to the person's physical or mental condition and the court
believes the person's statement to be reliable (Section 491.076);

(10)  Authorizes staff of the department, in any action brought
by the department relating to the care and protection of an
eligible adult, to have access to all medical and mental health
records of the eligible adult (Section 660.030); and

(11)  Requires training on elder abuse and neglect for all
employees providing in-home services through contracts with the
department (Section 660.252).