SB 42 - This act modifies various provisions related to elder abuse.

All Medicaid participation agreements must include a requirement for abuse and neglect training (Section 187.085).

The Department must provide certain long-term care information over its website (Section 187.107).

The Department and law enforcement must share resources for training and develop a checklist to guide personnel during elder abuse investigations (Section 187.111).

The Department must promptly refer all cases of suspected abuse to the appropriate law enforcement agency (Section 187.113).

The term "medical assistance" is redefined as any federal health care program. The term "health care provider" is also clarified as one paid to provide services (Section 191.900).

With approval of the court, the Attorney General has authority to investigate violations of 191.900, 191.910, and 198.070 (Section 191.910).

A license will be issued to an applicant that has previously operated facilities, that has a satisfactory compliance history, and that has not had a licensed denied or revoked based on lack of financial capacity (Section 198.022).

The Department may direct a noncompliant facility to take corrective actions related to staffing (Section 198.026).

Every residential care facility I or II, intermediate care facility, or skilled nursing facility must meet or exceed federal requirements for posting deficiencies (Section 198.030).

The use of unsubstantiated inspection reports by insurance carriers for the purpose of underwriting is prohibited (Section 198.032).

The Department may revoke a license if a facility fails to comply with class I standards on two occasions within a twenty- four month period (Section 198.036).

When issuing a decision, the Administrative Hearing Commission must consider conditions as they existed at the time of violation (Section 198.039).

In-home provider agencies must be given administrative appeal rights (Section 198.041).

A skilled nursing facility with private pay residents can receive Medicaid reimbursement if a private pay resident becomes Medicaid eligible without satisfying certificate of need requirements (Section 198.046).

Nurse practitioners, physician's assistants, and facility owners are required to report suspected abuse or neglect of facility residents (Section 198.070).

The pathway to safety law for Alzheimer's residents in residential care facilities is modified (Section 198.073).

Long-term care facilities and residential care facilities I and II must provide immunizations for influenza and pneumonia annually or upon admission. Written consent must be obtained from the resident and the resident's physician. The Department must develop rules for documenting compliance, including the documentation of residents who refuse the immunization. The Department may not impose a violation on a facility for not making an immunization available if a shortage exists (Section 198.074).

The Departments of Health and Senior Services, Social Services, Mental Health, and Elementary and Secondary Education must collaborate on assessment procedures for long-term care services (Section 198.080).

Skilled or intermediate care nursing assistants must complete training within one hundred and twenty days of employment. Training programs can be offered at the facility, provided there has not been a class I violation within twenty- four months. The Department must approve all training (Section 198.082).

Class I standards are divided into three violation categories: class I death violations, class I harm violations, and class I risk violations (Section 198.085).

Residents may file written complaints regarding the deprivation of rights or estates within two years of the alleged violation (Section 198.093).

Nursing home districts are not prohibited from establishing and maintaining senior housing within their corporate limits (Section 198.345).

Facility inspections are required twice per year, unless otherwise provided pursuant to Section 198.526. If a facility is without any class I violations during an eighteen-month period, the facility will be inspected annually for as long as the zero class I violation record is maintained (Section 198.525).

The frequency of inspections will be reduced to once a year, provided that during an eighteen-month period the facility had no class I deficiencies or class II violations and had no substantiated complaints or changes in ownership in the preceding year. Any employee of the Department that discloses an inspection time to a facility will be immediately terminated and guilty of a Class A misdemeanor. The Department has the authority to inspect any facility at any time (Section 198.526).

The Department will monitor the aging-in-place pilot programs and report to the General Assembly by January 1, 2008. The Department will base new licensure categories on the effectiveness of the pilot programs (Section 198.531).

The Department of Health and Senior Services shall promptly report incidents of suspected elder abuse to the appropriate prosecutor and law enforcement (Section 565.186).

The list of mandatory reporters has been expanded and these individuals are required to report suspected abuse and neglect of any person sixty years or older that is unable to protect his or her interests or unable to meet essential human needs (Section 565.188).

Long-term care facilities, mental health facilities, and the Department of Mental Health may disclose information and records relating to suspected elder abuse to the Department of Health and Senior Services (Sections 630.140 and 630.167).

The term "eligible adult" is clarified as a person sixty years of age or older who is unable to protect his or her own interests or is unable to meet his or her essential human needs (Section 660.250).

During an investigation, the Department must provide a referral to the Department of Mental Health for protective intervention and oversight, if necessary (Section 660.260).

Certain reports compiled pursuant to Section 660.250 to Section 660.295 will be available without a court order (Section 660.263).

The Department is allowed to petition the court to enjoin interference with an investigation (Section 660.270).

The list of mandatory reporters, that are required to report suspected abuse and neglect of in-home services clients, has been expanded (Section 660.300).

Penalty provisions are clarified (Section 198.067).

Section 198.088 was modified to be gender-neutral.

Section 197.367 is repealed.

This act is similar to the CCS for SBs 670 & 684 (2002).
LORIE TOWE