To amend chapter 487, RSMo, by adding eleven new sections relating to case managers offering peripregnancy care options.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF MISSOURI,

AS FOLLOWS:

Section A. Chapter 487, RSMo, is amended by adding thereto eleven new sections, to be known as sections 487.195, 487.198, 487.201, 487.204, 487.207, 487.211, 487.214, 487.217, 487.220, 487.223 and 487.226, to read as follows:

487.195. As used in sections 487.195 to 487.226 of this act, the following terms mean:

(1) "Accredited", a public or private post-secondary school or institution which is a public or private community college or four-year college or university located within the state of Missouri;

(2) "Case manager", a peripregnancy caregiver trained and registered to perform services as provided by sections 487.195 to 487.226 who has reached the age of twenty-five;

(3) "Department", the department of health;

(4) "Departments", the departments of health, elementary and secondary education, mental health and social services;

(5) "Facility" or "health facility" includes any licensed hospital, licensed ambulatory surgical center, clinic, or any licensed health professional performing services outside a licensed hospital or clinic;

(6) "Family court", the division of the circuit court known as the family court or in those circuits where there is not a family court, the juvenile division of the circuit court unless otherwise provided by local court rule;

(7) "Peripregnancy" or "peripregnant", during pregnancy or the perinatal period after pregnancy;

(8) "Person", any individual, corporation or other business entity.

487.198. Case manager services shall be provided at no cost to the client and shall include, but not be limited to:

(1) Explaining the value of and encouraging women to obtain prenatal care and advocating and facilitating their access to prenatal care;

(2) Promoting school attendance by minors;

(3) Mentoring services for persons needing encouragement and support;

(4) Promoting adoption and removing obstacles to adoption;

(5) Assuring that a client who is considering abortion is fully informed of the consequences of abortion and that the person's choice is truly and freely made;

(6) Promoting early entry into prenatal care and discussing the socioeconomic factors which may restrict the client from pursuing adequate prenatal care or encourage the client to seek an abortion and referring her to or providing her with services which remove such factors;

(7) Assisting and advocating on behalf of persons to obtain support services such as prenatal care, adoption services, employment services, alternative education, housing, child care or similar services;

(8) Promoting the avoidance of out-of-wedlock conception and referring the client to services to prevent same;

(9) Involving the father or spouse and parents of minors, when appropriate, if approved by the client in writing;

(10) Referring and placing the client with professional counselors and support service agencies.

487.201. The acceptance of case manager services shall be wholly the voluntary choice of the client and the case manager shall so inform the client at the outset. A written verification form must be immediately given to the client upon the client's request. Refusal of a case manager to verify access to case manager services because the client chooses not to accept the offer of services shall be grounds for revocation of the case manager's certification. The verification shall substantially conform to the following language: "I, the undersigned case manager, verify that (client's name) has been offered case management services authorized under sections 487.195 to 487.226, RSMo," and shall be signed immediately by the case manager. In the event a client has met with a case manager and services have been offered to her and rejected by the client and the case manager has refused to immediately sign the verification and deliver it to the client, the client may swear under oath and attest before a notary public to the case manager's refusal to sign and deliver the verification that shall include the name of the case manager who refused. The sworn statements of the client shall serve in lieu of the case manager verification required pursuant to sections 487.195 to 487.226.

487.204. The department shall define minimum standards for training of case managers which are consistent with sections 487.195 to 487.226 of this act but shall not have any other duty not expressly mandated by sections 487.195 to 487.226 of this act. Any accredited public or private post-secondary educational institution may offer training programs designed to meet or exceed the minimum standards. The expense of the training shall be paid by the applicant but the fee charged shall not exceed seventy dollars. The school shall certify all applicants who successfully complete the training program at an accredited public or private post-secondary school. The certificate of training shall expire three years after it is issued.

487.207. 1. Upon certification, case managers shall register with the department. The registration shall include the name, date of birth, address, county and telephone number where the case manager may be contacted for services. Registration shall include a verified statement that the registrant meets the qualifications required pursuant to section 487.204.

2. The local public health department shall maintain a registration list of all case managers who expect to offer case manager services for persons in the county or city. The registration list shall be available, at no charge, to any pregnant woman requiring case manager services. The registration list shall be available to all other persons, at a charge sufficient to cover the cost of copying.

3. The department of health shall maintain a registration list of all case managers. The registration of a case manager shall include the case manager's date of birth. The case manager shall pay to the department a fee of ten dollars at the time of registration. The registration list maintained by the department shall be available by county to any person for public inspection without charge and a copy shall be provided at a charge not to exceed the cost of copying.

4. Nothing in sections 487.195 to 487.226 shall require the department to compensate any person for the performance of case manager services.

487.211. It shall be unlawful for anyone to issue or purport to issue a verification of the offer of case manager services unless he has satisfactorily completed the training program and registration as provided in sections 487.195 to 487.226 of this act.

487.214. The department on its own initiative or upon filing of a complaint by any citizen may revoke the training certification of any case manager who fails consistently to comply with the terms of sections 487.195 to 487.226. Whenever any person has cause to believe a case manager has acted in a manner inconsistent with the provisions of sections 487.195 to 487.226, such person may make a complaint, orally or in writing, to the department or the family court.

487.217. 1. The circuit court by local rule shall develop and implement procedures within the family court to refer clients of the family court to case managers where appropriate. The department shall inform all local public health departments and relevant state agencies of case manager services and how to refer clients to case managers. The department of social services shall develop and implement procedures for social workers and other personnel serving clients who may benefit from case manager services, especially personnel investigating claims of child abuse, to make referral to case managers were appropriate. The department of elementary and secondary education shall develop and disseminate to public and private schools for implementation procedures for teachers, counselors and administrators with knowledge of students who may benefit from case manager services to make referral to case managers where appropriate. The department of mental health shall develop and implement procedures for its counselors, treatment personnel and others serving clients who may benefit from case manager services, especially those affected by drug or alcohol addiction, to make referral to case managers where appropriate. If a social worker, teacher, counselor, administrator, person providing treatment or other person knows of a client in need of prenatal care, contemplating an abortion or otherwise needing case manager services, he shall be urged to encourage such clients to seek case manager services. Any city, county or state public health department may provide a place for case managers and clients to meet.

2. The case manager shall use a system of identification codes for record keeping which protects the anonymity of the client. All information concerning an individual's need for case managers' services and records containing any such information held or maintained by any agency, department, political subdivision, and employee thereof or any other person shall be strictly confidential. All such records shall be delivered to the client on demand of the client at any time. If the client makes no demand for the records, such records shall be destroyed within thirty days after a case manager has completed providing services to the client.

3. Disclosure of information without the written consent of the client or failure to deliver or destroy records as required by subsection 2 of this section by a public employee or any other person in violation of this section may be subject to civil actions and shall be grounds for revocation of any state license or certificate held by the public employee or other person who discloses information or fails to destroy records.

487.220. 1. Except as provided in subsection 6 of this section, beginning January 1, 1997, before a facility can perform an induced abortion, it must receive from the client a written verification indicating that the client has been offered case manager services.

2. When a verification is required, a physician who performs an abortion shall acknowledge notice of the verification by signing the verification. The verification shall be made part of the medical record of the client. It is unlawful for any person to perform an induced abortion on a client who does not have a verification. Knowing violation shall be grounds for revocation of the license of the facility and the physician performing the abortion. The attorney general or any taxpayer of this state may seek an injunction against the unlawful action of any facility or of any physician unlawfully performing or about to perform an induced abortion without the client having a verification if such verification is required by sections 487.195 to 487.226 of this act. The court shall assess the reasonable cost of the litigation including the legal expenses of the prevailing party against the nonprevailing party.

3. A verification is not required in the event of a medical emergency threatening the life or long-term physical health of the client as determined by the physician treating the emergency condition. A verification is not required in a nonemergency situation, if the client's attending physician, other than the physician intending to perform the abortion, certifies with reasonable medical certitude that the abortion is medically indicated according to accepted medical standards for preservation of the life or the long-term physical health of the client. The certification shall set forth the medical facts upon which the physician's opinion is based.

4. If no case manager is registered with the department or the circuit court to provide services in the county where the client resides, then no verification shall be required. Recognizing that case manager services will not be immediately available in all areas of the state, if the client contacts a case manager in the county where the client resides for services and the case manager is unable to provide case management services to the client within seventy-two hours of the contact, then the case manager shall immediately give the client a verification. The department may by regulation set a shorter availability period for later stages of pregnancy, if there is medical evidence of significant health risk presented by the seventy-two hour period. The department shall furnish on request a current list of all counties in which no case managers are registered with the department.

5. A list of all case managers registered to provide services in the county in which a facility is located shall be available to clients at the facility.

6. If the pregnancy is a result of rape or incest as reported to a law enforcement agency, no written verification of the offering of case manager services shall be required before the facility performs an induced abortion.

487.223. It shall be unlawful for a person to act as a case manager who has any economic interest in an abortion facility or an organization which promotes a purpose contrary to sections 487.195 to 487.226, including but not limited to employment (including volunteer workers), investment or contractual relationships. It shall also be unlawful for a person to act as a case manager who advocates violence or who has been convicted of a misdemeanor, other than a traffic offense, or felony.

487.226. The policy of this state is to reduce out-of-wedlock conception, inadequate prenatal care, infant mortality, abortion and violence associated with abortion protest activities, and to support childbirth and responsible family planning.