REFERRALS FOR HOME-AND COMMUNITY-BASED SERVICES (Section 208.895)

Under current law, upon the receipt of a referral for MO HealthNet-funded home-and community-based care containing a nurse assessment or a physician's order, the Department of Health and Senior Services is allowed to reimburse in-home providers for nurse assessments of participants in the in-home and home and community based programs and to contract for home-and community -based assessments through an independent third-party assessor.

Under this act, upon receipt of a referral for services or a physician's order, the department is required to process the referral within 15 business days, arrange for the provision of services by a home- and community-based provider rather than by an in-home provider and notify the referring entity within 5 business days of receiving the referral if additional information is required to process the referral.

The department shall also inform the applicant of:

-The full range of available MO HealthNet home- and community-based services;

-The choice of home- and community-based service providers in the applicant's area; and

- The option to choose more than one home- and community-based service provider to deliver or facilitate the services the applicant is qualified to receive.

This act also requires the department to:

-Prioritize the referrals received, giving the highest priority to referrals for high-risk individuals; and

-Notify the referring entity and the applicant within 10 business days of receiving the referral if it has not scheduled the assessment.

If the department has not complied with the above described requirements, a provider has the option of completing an assessment and care plan recommendation. At such time that the department approves or modifies the assessment and care plan, the care plan shall become effective; such approval or modification shall occur within five business days after receipt of the assessment and care plan from the provider. If such approval, modification, or denial by the department does not occur within five business days the provider's care plan shall be approved and payment shall begin no later than five business days after receipt of the assessment and care plan from the provider.

This act repeals the provision requiring the reassessments and care plan changes to be reviewed and approved by the independent third-party assessor.

The department's auditing of home- and community-based service providers shall include a review of client service and provider choice and communication of home- and community-based service provider service options to individuals seeking MO HealthNet services. The department shall also make publicly available a review of its process for informing participants of service options within MO HealthNet home- and community-based service provider services and information on referrals.

The department shall also:

(1) Develop an automated electronic assessment care plan tool to be used by providers; and

(2) Make recommendations to the general assembly by January 1, 2014, for the implementation of the automated electronic assessment care plan tool.

At the end of the first year of this plan being in effect, the department shall prepare a report for the house appropriation committee for health, mental health and social services or a committee appointed by the speaker of the House of Representatives to review the provisions of this act.

This act removes the August 28, 2013 expiration date.

This provision is identical to a provision contained in HCS/SCS/SB 262 (2013).

CHIROPRACTIC MO HEALTHNET SERVICES (Section 208.960)

This act requires licensed chiropractors to be reimbursed under the MO HealthNet program for providing services currently covered under the MO HealthNet program and within the scope of practice for chiropractors.

This provision is identical to HB 598 (2013).

MODIFIES THE EMPLOYMENT DISQUALIFICATION LIST FOR HOME CARE EMPLOYEES (Section 660.315)

This act provides that any employer or vendor of hospice, home health, long-term care, consumer-directed or in-home care services required to deny employment to an applicant or discharge an employee as a result of information obtained through a portion of the background screening and employment eligibility determination process required under the Family Care Safety Registry provisions shall not be liable in any action brought by the applicant or employee relating to discharge where the employer is required by law to terminate the employee, provisional or otherwise.

Such employer or vendor shall also not be charged for unemployment insurance benefits based on wages paid to the employee or based on an employer making payments in lieu of contributions for work prior to the date of discharge, if the employer terminated the employee because the employee:

(1) Has pled guilty to or nolo contendere or been found guilty in this state or any other state of a crime, which if committed in Missouri would be a class A or B felony violation of certain specified crimes such as offenses against the persons, sexual offenses and robbery or burglary offenses;

(2) Was placed on the employee disqualification list maintained by the Department of Health and Senior Services, after the date of hire;

(3) Was placed on the employee disqualification list maintained by the Department of Mental Health, after the date of hire;

(4) Is listed on any of the background check lists in the Family Care Safety Registry; or

(5) Has a disqualifying finding or was denied a good cause waiver under the employee disqualification list maintained by the Department of Health and Senior Services.

This provision is substantially similar to provisions contained in HCS/HB 1900 (2013) and HCS/SCS/SB 854 (2013).

ADRIANE CROUSE