LIFE-SUSTAINING TREATMENT POLICIES (Section 191.250)

This act establishes "Simon's Law" prohibiting any health care facility or health care professional from instituting a do-not-resuscitate or similar order without the written or oral consent of at least one parent or legal guardian of a non-emancipated minor patient or resident. If oral consent is granted, at least 2 witnesses other than the parent, guardian, or physician shall be present and willing to attest to the consent. Such consent shall immediately be recorded in the patient's medical record. Consent granted under the provisions of this act may be revoked orally or in writing by the grantor and shall take precedence over any previous granted consent. These requirements shall not apply if a reasonably diligent effort has been made over a 48-hour period to contact and inform a known parent or guardian without success.

In cases of a child under the jurisdiction of a juvenile court, a juvenile or family court may issue an end-of-life medical decision order, a physician's order, or any other medical decision order, or appoint a guardian for that purpose. The Children's Division shall not be appointed as a guardian for such purposes. If a child under the custody of a juvenile court is returned to his or her parent or guardian, the parent or guardian may revoke consent, orally or in writing, for end-of-life medical decisions ordered by the court.

Nothing in this act shall require health care providers to provide or continue any treatment that would be medically inappropriate because, in their reasonable medical judgment, providing such treatment would either create a greater risk of causing or hastening the patient's death or would be potentially harmful or cause unnecessary pain, suffering, or injury to the patient. Additionally, nothing in this act shall require health care providers to continue cardiopulmonary resuscitation or manual ventilation beyond a time in which, in their reasonable medical judgment, there is no further benefit to the patient or likely recovery of the patient.

This provision is identical to SB 406 (2019) and substantially similar to HB 138 (2019).

CHILD CARE FACILITIES (Sections 208.044, 210.025, 210.201, 210.211, 210.221, 210.245, 210.252, 210.254, 210.1080, 566.147, and Section B)

This act modifies the laws regarding licensing child care facilities in several ways. First, the requirement to have a child care facility license shall not apply to any person caring for six or fewer related or unrelated children, including a maximum of three children under age two, at the same physical address. Children who live in the caregiver's home and who are eligible for enrollment in a public kindergarten, elementary, or high school shall not be included in the total.

Additionally, this act increases the criminal penalties for persons who violate the child care licensure statutes from an infraction with fine not to exceed two hundred dollars for the first offense to a Class C misdemeanor and a fine not to exceed seven hundred fifty dollars and from a Class A misdemeanor and a fine of up to two hundred dollars per day for subsequent offenses to a Class A misdemeanor and a fine of up to two thousand dollars per day.

The Department of Health and Senior Services may file suit for injunctive relief for cases of imminent bodily harm to a child in the care of an unlicensed, nonexempt child care facility. The Department shall not be subject to liability for failing to file suit under this provision.

This act creates a civil penalty, enforceable by the Department, for any person who operates an unlicensed, nonexempt child care facility. The Department shall send a written notice to such person of the Department's findings, along with educational materials about child care facility laws and the ways to become compliant with such laws, including attaining exempt status or becoming licensed. The person shall have 30 days to become compliant and if such person fails to do so, he or she shall be liable for a civil penalty of not less than $750 and not more than $2,000. The Department, or the Attorney General on the Department's behalf, may bring a civil action in Cole County against such person. The Department shall not be subject to liability for failing to file suit under this provision.

Finally, this act creates the "Family Child Care Provider Fund", which shall consist of appropriated funds. The Fund shall be used by the Department for the dissemination of information concerning compliance with child care facility laws, educational initiatives, and the provision of financial assistance, based on need as determined by the Department and available funds, for family child care homes to become licensed.

These provisions are identical to SB 336 (2019) and similar to SB 712 (2018), SCS/SB 115 (2017), SB 850 (2016), SB 482 (2015), and HB 2097 (2014).

Additionally, this act permits the Department of Health and Senior Services to deny an application for a child care facility license if the facility's proposed location is within 1,000 feet of any location where a person required to register as a sexual offender resides or regularly receives treatment or services. This act also modifies the definition of "resides" in a certain provision of law.

This provision has an emergency clause.

This provision is substantially similar to SCS/SB 386 (2019) and HB 826 (2019).

MO HEALTHNET BENEFITS FOR FORMER FOSTER YOUTH (Section 208.151)

Under this act, persons who reside in Missouri, are at least 18 years of age and under 26, and who have received foster care for at least six months in another state shall be eligible for MO HealthNet benefits.

This provision is identical to SB 514 (2019).

CHILD FATALITY REVIEW PANELS (Sections 210.192, 210.194, and 210.195)

This act modifies the law regarding the confidentiality of records made and maintained by entities under the child fatality review panel statutes. Current law requires all meetings, reports, and records to be confidential and not open to the public. Under this act, all meetings and work product shall be confidential, while the state technical assistance team shall make non-identifiable aggregate data on child fatalities public and the Director of the Department of Social Services shall have the discretion to release certain identifiable data. The state technical assistance team shall make an annual report on child fatalities that shall include a summary on the county level of compliance with the child fatality review panel statutes.

This act also removes the requirement that the Department of Health and Senior Services analyze the child fatality review panel reports and prepare epidemiological reports regarding childhood deaths.

These provisions are substantially similar to SB 305 (2019).

FOSTER HOME PLACEMENT (Section 210.565)

This act requires the Children's Division to make diligent efforts to locate the adult siblings and parents of siblings of a child when seeking foster home placement with a relative of the child. Adult siblings or parents of siblings shall have preference for placement only after grandparent placement and above other blood or affinity relatives.

This provision is identical to SB 440 (2019).

AMBER ALERT SYSTEM (Section 210.1014)

This act requires the Amber Alert System Oversight Committee to meet at least annually to discuss potential improvements to the system. The committee membership may include a representative of the outdoor advertising industry, a representative of the Missouri Broadcasters Association, and a representative of the public at large.

Additionally, Amber Alerts issued in Missouri may include an embedded Uniform Resource Locator (URL) referencing additional resources available on the Internet.

This act establishes "HAILEY'S Law" ("Honing Alerts Issued by Law Enforcement for Youth Safety Act") and requires the Amber Alert System to be integrated into the Missouri Uniform Law Enforcement System (MULES) and Regional Justice Information Services (REJIS) to expedite the reporting of child abductions.

Finally, this act requires the committee to submit a report to the General Assembly by January 1, 2020, and annually thereafter, regarding information specified in the act.

This provision is identical to the perfected SS/SB 145 (2019), substantially similar to HCS/HB 185 (2019), and similar to HB 1378 (2018) and HB 697 (2017).

CHILD RELOCATION (Section 452.377)

This act requires a party intending to relocate a child subject to a custody or visitation agreement to notify any other parties entitled to custody or visitation of their right to file a motion seeking an order to prevent the relocation and an accompanying affidavit setting forth the specific good faith factual basis for opposing the relocation within 30 days of receipt of the notice.

This provision is identical to the perfected SCS/SB 83 (2019).

CHILD SUPPORT ENFORCEMENT (Sections 454.507, 454.600, 454.603, and 513.430)

This act modifies several provisions relating to child support enforcement. First, this act modifies the definition of "account" with reference to accounts in financial institutions maintained by a non-custodial parent to include traditional individual retirement accounts (IRAs) and Roth IRAs. Additionally, traditional IRAs and Roth IRAs shall not be exempt from attachment or execution for child support enforcement.

This act requires the Family Support Division within the Department of Social Services to enter into an agreement with each financial institution within the state to develop and operate a data match system for child support enforcement, unless such institution does business in 2 or more states and enters into an agreement with the federal Office of Child Support Enforcement for a data match.

Current law requires the Division or IV-D agency to notify by mail a non-custodial parent account holder of the issuance of a lien on the account at a financial institution. This act provides that if the account is jointly owned, such interests are presumed equal unless proven otherwise within 30 days of the mailing of the notice to the non-custodial parent.

These provisions are identical to SB 277 (2019).

Additionally, this act modifies the definition of a "health benefit plan" to include public assistance programs when referring to the provision of health care to a child through a child support order. The court or Children's Division shall require the child to be covered by a health benefit plan in any IV-D case. The plan may be private whenever such a plan is available through a parent's employer or union. If a private plan is not available at a reasonable cost, the court may require a parent to otherwise provide coverage for the child.

This provision is identical to SB 448 (2019).

SEX TRAFFICKING (Section 567.020, 578.421, 578.423, and 610.131)

Currently, there is an affirmative defense to the offense of prostitution if the defendant is under 18 years of age and acting under coercion of an agent. Under this act, if the defendant is under 18 years of age, the defendant shall be classified as a victim of abuse and subject to current child abuse reporting requirements.

This act modifies the definition of "pattern of criminal street gang activity" by adding a number of offenses relating to prostitution, sexual trafficking, and abuse and neglect of a child.

Provisions of current law regarding juveniles involved in criminal street gang activity that authorized a prosecuting attorney to transfer the case to a court of general jurisdiction are repealed.

Finally, a court may order the expungement of records relating to the offense of prostitution if the defendant was under 18 years of age or acting under the coercion of an agent.

These provisions are substantially similar to SB 361 (2019).

THE OFFENSE OF PROMOTING PROSTITUTION (Section 567.050)

This act modifies the offense of promoting prostitution in the first degree. A person may be found guilty of such offense if he or she owns, manages, or operates an interactive computer service with the intent to promote or facilitate the prostitution of another. Such offense shall be a Class A felony if the person, in addition to operating an interactive computer service with the intent to promote prostitution while using a facility affecting commerce, acts in reckless disregard of the fact that such conduct contributed to the offense of trafficking for the purposes of sexual exploitation. A person injured by such actions may recover civil damages and restitution.

This provision is identical to a provision in SS/SCS/SB 37 (2019) and SCS/SB 60 (2019).

SARAH HASKINS