CCS/HCS#2/SB 710 - This act modifies several provisions relating to health care, including: (1) sickle cell; (2) Biliary Atresia Awareness Day; (3) Will's Law; (4) administration of epinephrine auto syringes; (5) the Alzheimer's State Plan Task Force; (6) medical student loan programs; (7) health care facility visitation; (8) the Older Americans Act; (9) oversight of health care facilities; (10) organ donation; (11) home health licensing; (12) supplemental health care services agencies; (13) the Missouri RX Plan; (14) consumer-directed services; (15) prepaid dental plans; (16) Black Maternal Health Week; and (17) the repeal of certain Department of Health and Senior Services statutes.SICKLE CELL (Sections 9.236 and 208.184)
This act establishes the third full week in September each year as "Sickle Cell Awareness Week".
This provision is identical to provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 2627 (2022), the truly agreed to and finally passed SS/SCS/HB 1738 (2022), CCS/HCS/SS/SB 690 (2022), SB 1145 (2022), HCS/HB 2462 (2022), HB 2559 (2022), HB 2653 (2022), HCS/HB 2658 (2022), HCS/SS/SCS/SB 46 (2021), and CCS#2/HCS/SS/SB 64 (2021).
Under this act, the Advisory Council on Rare Diseases and Personalized Medicine within the MO HealthNet Division shall annually review specified issues relating to sickle cell disease, including medications and treatment options. After each annual review, the Division may develop a report of the review to be made available to the public.
This provision is identical to a provision in CCS/HCS/SS/SB 690 (2022), HCS/HB 2658 (2022), and HB 2653 (2022) and similar to a provision in SB 1147 (2022) and HB 2559 (2022).
BILIARY ATRESIA AWARENESS DAY (Section 9.350)
This act establishes October 1 each year as "Biliary Atresia Awareness Day".
This act is identical to provisions in HB 2356 (2022), HS/HB 2310 (2022), and HCS/HB 2462 (2022).
WILL'S LAW (Sections 167.625 and B)
This act establishes "Will's Law," requiring individualized health care plans to be developed by school nurses in public schools and charter schools. Such plans shall be developed in consultation with a student's parent or guardian and appropriate medical professionals that address procedural guidelines and specific directions for particular emergency situations relating to the student's epilepsy or seizure disorder. Plans are to be updated at the beginning of each school year and as necessary. Notice must be given to any school employee that may interact with the student, including symptoms of the epilepsy or seizure disorder and any medical and treatment issues that may affect the educational process.
All school employees shall be trained every two years in the care of students with epilepsy and seizure disorders. Training shall include an online or in-person course of instruction approved by the Department of Health and Senior Services. School personnel shall obtain a release from a student’s parent to authorize the sharing of medical information with other school employees as necessary.
This act protects school employees from being held liable for any good faith act or omission while performing their duties.
This provision contains an emergency clause.
This provision is identical to provisions in the truly agreed to and finally passed CCS#2/HCS/SS/SCS/SBs 681 & 662 (2022), CCS/HCS/SS/SB 690 (2022), SCS/SB 187 (2021), and HCS/SS/SCS 152 (2021) and is substantially similar to HB 2588 (2020).
ADMINISTRATION OF EPINEPHRINE AUTO SYRINGES (Section 167.630)
This act authorizes school contracted agents trained by a nurse to administer an epinephrine auto syringe on any student who is having a life-threatening anaphylactic reaction. This act also provides that trained contracted agents shall be immune from civil liability in the administration of a prefilled auto syringe.
This provision is identical to SS/SCS/HCS/HB 2151 (2022), SB 1210 (2022), HCS/SS#2/SB 823 (2022), and SB 1170 (2022) and similar to a provision in SCS/HCS/HB 2304 (2022).
ALZHEIMER'S STATE PLAN TASK FORCE (Sections 172.800 and 191.116)
This act repeals an obsolete reference to the Alzheimer's Disease and Related Disorders Task Force. Additionally, the act changes the date that the Alzheimer's State Plan Task Force shall submit a report of recommendations from June 1, 2022, to January 1, 2023, and extends the task force expiration date from December 31, 2026, to December 31, 2027.
This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HB 2331 (2022), CCS/HCS/SS/SB 690 (2022), and SCS/SB 1045 (2022).
MEDICAL STUDENT LOAN PROGRAMS (Sections 191.500, 191.515, 191.520, 191.525, 335.230, and 335.257)
This act modifies provisions of current law relating to the medical student loan program administered by the Department of Health and Senior Services by adding psychiatry, dental surgery, dental medicine, or dental hygiene students to the list of eligible students in the program, as well as adding psychiatric care, dental practice, and dental hygienists to the definition of "primary care". Additionally, this act modifies the loan amount students may be eligible to receive from $7,500 each academic year to $25,000 each academic year.
This act also modifies the Nursing Student Loan Program by modifying the amount of financial assistance available to students from $5,000 each academic year for professional nursing programs to $10,000 each academic year and from $2,500 each academic year for practical nursing programs to $5,000 each academic year.
Finally, this act modifies the Nursing Student Loan Repayment Program by removing the June and December deadlines for qualified employment verification while retaining the requirement that such employment be verified twice each year.
These provisions are identical to provisions in the truly agreed to and finally passed SS/SCS/HB 2331 (2022), CCS/HCS/SS/SB 690 (2022), SCS/SB 1045 (2022), and SB 757 (2022) and substantially similar to provisions in HCS/HB 2133 (2022) and HB 2881 (2022).
HEALTH CARE FACILITY VISITATION (Sections 191.1400, 191.2290, and 630.202)
This act establishes the "Compassionate Care Visitation Act". Under this act, a health care facility, defined as a hospital, hospice, or long-term care facility, shall allow a resident, patient, or guardian of such, to permit in-person contact with a compassionate care visitor during visiting hours. A compassionate care visitor may be the patient's or resident's friend, family member, or other person requested by the patient or resident. The compassionate care visitation is a visit necessary to meet the physical or mental needs of the patient or resident, including end-of-life care, assistance with hearing and speaking, emotional support, assistance with eating or drinking, or social support.
A health care facility shall allow a resident to permit at least 2 compassionate care visitors simultaneously to have in-person contact with the resident during visitation hours. Visitation hours shall include evenings, weekends, and holidays, and shall be no less than 6 hours daily. 24-hour visitation may be allowed when reasonably appropriate. Visitors may leave and return during visitor hours. Visitors may be restricted within the facility to the patient or resident's room or common areas and may be restricted entirely for reasons specified in the act.
By January 1, 2023, the Department of Health and Senior Services shall develop informational materials for patients, residents, and their legal guardians regarding the provisions of this act. Health care facilities shall make these informational materials accessible upon admission or registration and on the primary website of the facility.
A compassionate care visitor may report any violation of the Compassionate Care Visitation Act by a health care facility to the Department of Health and Senior Services, as specified in the act. The Department shall investigate any such complaint within thirty-six hours of receipt.
No health care facility shall be held liable for damages in an action involving a liability claim against the facility arising from compliance with the provisions of this act; provided no recklessness or willful misconduct on the part of the facility, employees, or contractors has occurred.
The provisions of this act shall not be terminated, suspended, or waived except by a declaration by the Governor of a state of emergency, in which case the provisions of the "Essential Caregiver Program Act" shall apply.
Additionally, this act establishes the "Essential Caregiver Program Act". During a governor-declared state of emergency, a hospital, long-term care facility, or facility operated, licensed, or certified by the Department of Mental Health shall allow a resident of such facility, or the resident's guardian or legal representative, to designate an essential caregiver for in-person contact with the resident in accordance with the standards and guidelines developed under this act. An "essential caregiver" is defined as a family member, friend, guardian, or other individual selected by a resident, or the guardian or legal representative of the resident. Essential caregivers shall be considered a part of the patient's care team, along with the resident's health care providers and facility staff.
The Department of Health and Senior Services and the Department of Mental Health shall develop the program's standards and guidelines, including: (1) allowing the resident to select at least two caregivers, although the facility may limit in-person contact to one at a time; (2) establishing an in-person contact schedule allowing for at least four hours each day; and (3) establishing procedures enabling physical contact between the caregiver and resident. The facility may require the caregiver to follow infection control and safety measures; provided that such measures are no more stringent than required for facility employees. Caregiver in-person contact may be restricted or revoked for caregivers who do not follow such measures.
A facility may request a suspension of in-person contact for a period not to extend seven days. The suspension may be extended, but not for more than fourteen consecutive days in a twelve-month period or more than forty-five days in a twelve-month period. The Department shall suspend in-person contact by essential caregivers under this act if it determines that doing so is required under federal law, including a determination that federal law requires a suspension of in-person contact by members of the resident's care team.
The provisions of this act shall not apply to those residents whose condition necessitates limited visitation for reasons unrelated to the stated reason for the declared state of emergency.
A facility, its employees, and its contractors shall be immune from civil liability for (1) an injury or harm caused by or resulting from exposure of a contagious disease or harmful agent or (2) acts or omissions by essential caregivers who are present in the facility, as a result of the implementation of the caregiver program. This immunity shall not apply to any act or omission of the facility, its employees, or its contractors that constitutes recklessness or willful misconduct.
These provisions are substantially similar to provisions in the truly agreed to and finally passed SS/SCS/HCS/HBs 2116, 2097, 1690, & 2221 (2022), CCS/HCS/SS/SB 690 (2022), SCS/SB 671 (2022).
THE OLDER AMERICANS ACT (Sections 192.005, 251.070, and 660.010) This act transfers authority for the implementation of the federal Older Americans Act of 1965 from the Department of Social Services to the Department of Health and Senior Services.
These provisions are identical to provisions in the truly agreed to and finally passed SS/SCS/HB 2331 (2022) and SCS/SB 1045 (2022) and similar to provisions HB 2377 (2022).
OVERSIGHT OF HEALTH CARE FACILITIES (Sections 192.2225, 197.100, 197.256, 197.258, 197.415, 198.006, 198.022, 198.026, 198.036, 198.525, 198.526, and 198.545)
Currently, the Department of Health and Senior Services conducts at least two inspections per year for licensed adult day care programs, at least one of which is unannounced. Under this act, the Department shall be required to conduct at least one unannounced inspection per year.
Currently, the Department conducts an annual inspection of licensed hospitals. Under this act, such inspections shall instead be performed in accordance with the schedule set forth under federal Medicare law.
A hospice currently seeking annual renewal of its certification shall be inspected by the Department of Health and Senior Services. Under this act, the Department may conduct a survey to evaluate the quality of services rendered by the applicant. Additionally, current law requires annual inspections of a certified hospice and this act instead requires such inspections to be performed in accordance with the schedule set forth under federal Medicare law.
Currently, the Department conducts an inspection of licensed home health agencies at least every 1 to 3 years, depending on the number of months the agency has been in operation following the initial inspection. Under this act, such inspections shall instead be performed in accordance with the schedule set forth under federal Medicare law.
This act updates a reference to a Missouri regulation regarding long-term care facility orientation training.
Current law requires the Department to inspect long-term care facilities at least twice a year, one of which shall be unannounced. Under this act, the Department shall be required to conduct at least one unannounced inspection per year. Additionally, current law requires that the Department issue a notice of noncompliance or revocation of a license by certified mail to each person disclosed to be an owner or operator of a long-term care facility. This act instead requires that such notice be sent by a delivery service to the operator or administrator of the facility.
Finally, this act modifies the "Missouri Informal Dispute Resolution Act" relating to informal dispute resolutions between the Department of Health and Senior Services and licensed long-term care facilities. Current law requires the Department to send to a facility by certified mail a statement of deficiencies following an inspection. This act requires that such notice be sent by a delivery service that provides dated receipt of delivery. Additionally, current law provides a facility ten calendar days following receipt of notice to return a plan of correction to the Department. This act changes the ten calendar days to ten working days.
These provisions are identical to provisions in the truly agreed to and finally passed SS/SCS/HB 2331 (2022), CCS/HCS/SS/SB 690 (2022), SCS/SB 1045 (2022), HB 2848 (2022), and SB 1029 (2022) and substantially similar to provisions of SB 342 (2021).
ORGAN DONATION (Sections 194.210, 194.255, 194.265, 194.285, 194.290, 194.297, 194.299, 194.304, 194.321, 301.020, and 302.171)
This act modifies the "Revised Uniform Anatomical Gift Act". Currently, moneys in the Organ Donor Program Fund are limited to use for grants by the Department of Health and Senior Services to certified organ procurement organizations for the development and implementation of organ donation programs, publication of informational booklets, maintenance of an organ donor registry, and implementation of organ donation awareness programs in schools. This act modifies the fund to be used by the Department for educational initiatives, donor family recognition efforts, training, and other initiatives, as well as reimbursement for expenses incurred by the Organ Donation Advisory Committee. The Department shall no longer be required to disperse grants to organ procurement organizations, but shall have the authority to enter into contracts with such organizations or other organizations and individuals for the development and implementation of awareness programs. Additionally, the moneys in the fund shall be invested and interest earned shall be credited to the fund. The fund may seek other sources of moneys, including grants, bequests, and federal funds.
Currently, applicants for motor vehicle registrations and driver's licenses may make a one dollar donation to the organ donor program fund. This act changes that to a donation of not less than one dollar.
Finally, this act makes technical changes to the organ donation statutes.
These provisions are provisions in the truly agreed to and finally passed SS/SCS/HB 2331 (2022), CCS/HCS/SS/SB 690 (2022), SCS/SB 1045 (2022), and SB 1146 (2022).
This act prohibits hospitals, physicians, procurement organizations, or other person from considering COVID-19 vaccination status of a potential organ transplant recipient or potential organ donor in any part of the organ transplant process, except in cases of lung transplants.
This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HB 2331 (2022), CCS/HCS/SS/SB 690 (2022), HB 1861 (2022), and HCS/HBs 2358 & 1485 (2022).
HOME HEALTH LICENSING (Sections 197.400 and 197.445)
Current law limits licensed home health agencies to those that provide two or more home health services at the residence of a patient according to a physician's written and signed plan of treatment. This act permits such licensed entities to provide treatment according to written plans signed by physicians, nurse practitioners, clinical nurse specialists, or physician assistants, as specified in the act.
These provisions are identical to provisions in the truly agreed to and finally passed SS/SCS/HB 2331 (2022), the truly agreed to and finally passed CCS#2/SS/HB 2149 (2022), and CCS/HCS/SS/SB 690 (2022) and substantially similar to SCS/SB 830 (2022), provisions in HCS/HB 2434 (2022), HB 2382 (2022), HB 1565 (2022), and SB 177 (2021).
SUPPLEMENTAL HEALTH CARE SERVICES AGENCIES (Sections 198.640 to 198.648 and 210.921)
Under this act, a person who operates a supplemental health care services agency shall annually register with the Department of Health and Senior Services, as described in the act. A supplemental health care services agency is described as an agency that provides or procures employment for health care personnel in assisted living facilities, intermediate care facilities, residential care facilities, or skilled nursing facilities, or an agency that operates a digital website or smartphone application that facilitates the provision of such personnel.
A supplemental health care services agency shall, as a condition of registration, meet minimum criteria set forth in the act, including licensure and certification of health care personnel, background checks, proof of insurance, not restrict the employment opportunities of the health care personnel, reporting requirements, record maintenance, and liability.
This act modifies provisions of law relating to the release of information from the Family Care Safety Registry by modifying the definition of "employment purposes" to include direct or prospective independent contractor relationships of health care personnel with a supplemental health care services agency.
This act is CCS/HCS/SS/SB 690 (2022) and similar to SB 1011 (2022) and SB 478 (2021).
MISSOURI RX PLAN (Section 208.798)
This act changes the expiration date of the Missouri Rx Plan from August 28, 2022, to August 28, 2029.
This provision is identical to provisions in the truly agreed to and finally passed SS/HB 2400 (2022), CCS/HCS/SS/SB 690 (2022), SB 1179 (2022), and HB 2820 (2022).
CONSUMER-DIRECTED SERVICES (Section 208.909)
A vendor participating in the MO HealthNet consumer-directed services program shall ensure all payroll, employment, and other taxes are timely paid on behalf of the consumer and the vendor shall be liable to the consumer for any garnishment action occurring or that has occurred as a result of the vendor's failure to timely pay such taxes. The vendor may be subject to a $1,000 per occurrence penalty for failure to timely pay such taxes. The vendor shall notify the consumer of any communication or correspondence from any federal, state, or local tax authority of any overdue or unpaid tax obligations, as well as any notice of an impending garnishment.
This provision is substantially similar to provisions in SCS/SB 671 (2022).
PREPAID DENTAL PLANS (Sections 376.427 and 376.1575)
This act adds prepaid dental plans to a statute requiring insurers to pay providers directly if a patient has assigned his or her insurance benefits to the provider.
This provision is identical to CCS/HCS/SS/SB 690 (2022) and SCS/SB 1180 (2022) and similar to HB 2743 (2022).
This act adds prepaid dental plans to the definition of "health carrier" for purposes of statutes regulating the assessment and validation of practitioners' qualifications to provide patient care services and act as a member of the health carrier's provider network.
This provision is identical to SB 1024 (2022), a provision in CCS/HCS/SS/SB 690 (2022), SB 484 (2021), HB 1002 (2021), and a provision in CCS#2/HCS/SS/SB 64 (2021).
BLACK MATERNAL HEALTH Week (Section 1)
This act establishes the week of April 11 through April 17 each year as "Black Maternal Health Week".
This provision is identical to provisions in CCS/HCS/SS/SB 690 (2022).
REPEAL OF CERTAIN DEPARTMENT OF HEALTH AND SENIOR SERVICES STATUTES (Sections 191.743, 196.866, and 196.868)
Currently, physicians or health care providers who are providing services to women with high-risk pregnancies are required to identify such women and report them to the Department of Health and Senior Services within 72 hours for referral for services. The provision authorizing Department services for such women has previously been repealed and this act repeals the reporting requirements for the physicians and health care providers.
Additionally, producers of ice cream, mellorine, or other frozen dessert products are required to be licensed by the Department and pay an associated license fee. This act repeals such requirement and fee.
These provisions are identical to provisions in the truly agreed to and finally passed SS/SCS/HB 2331 (2022), CCS/HCS/SS/SB 690 (2022), SCS/SB 1045 (2022), and SB 1100 (2022).
SARAH HASKINS