To repeal section 197.400, RSMo 1994, and section 197.445, RSMo Supp. 1996, relating to the regulation of home health agencies, and to enact in lieu thereof one new section relating to the same subject.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF MISSOURI, AS FOLLOWS:

     Section A. Section 197.400, RSMo 1994, and section 197.445, RSMo Supp. 1996, are repealed and one new section enacted in lieu thereof, to be known as section 197.400, to read as follows:

     197.400. As used in sections 197.400 to 197.475, unless the context otherwise requires, the following terms mean:

     (1) "Council", the home health services advisory council created by sections 197.400 to 197.475;

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

     (3) "Home health agency", a public agency or private organization or a subdivision or subunit of an agency or organization that provides two or more home health services at the residence of a patient according to a physician's written and signed plan of treatment;

     (4) "Home health services", any of the following items and services provided at the residence of the patient on a part-time or intermittent basis: nursing, physical therapy, speech therapy, occupational therapy, home health aid, or medical social service;

     (5) "Part-time or intermittent basis", the providing of home health services in an interrupted interval sequence on the average of not to exceed three hours in any twenty-four-hour period;

     (6) "Patient's residence", the actual place of residence of the person receiving home health services, including institutional residences as well as individual dwelling units;

     (7) "Physician", a person licensed by the state board of registration for the healing arts under the provisions of chapter 334, RSMo, to practice in this state as a physician and surgeon;

     (8) "Plan of treatment", a plan reviewed and signed as often as medically necessary by a physician or when such plan concerns treatment related to podiatric care, a podiatrist, not to exceed sixty days in duration, prescribing items and services for an individual patient's condition;

     (9) "Podiatrist", a person licensed by the state board of podiatry under the provisions of chapter 330, RSMo, to practice in this state as a podiatrist;

     (10) "Subunit" or "subdivision", any organizational unit of a larger organization which can be clearly defined as a separate entity within the larger structure, which can meet all of the requirements of sections 197.400 to 197.475 independent of the larger organization, which can be held accountable for the care of patients it is serving, and which provides to all patients care and services meeting the standards and requirements of sections 197.400 to 197.475.

          [197.445. 1. The department may adopt reasonable rules and standards necessary to carry out the provisions of sections 197.400 to 197.477. The rules and standards adopted shall not be less than the standards established by the federal government for home health agencies under Title XVIII of the Federal Social Security Act. The reasonable rules and standards shall be initially promulgated within one year of September 28, 1983.

          2. The rules and standards adopted by the department under the provisions of sections 197.400 to 197.477 shall apply to all health services covered by sections 197.400 to 197.477 rendered to any patient being served by a home health agency regardless of source of payment for the service, patient's condition, or place of residence, at which the home health services are ordered by the physician. No rule or portion of a rule promulgated under the authority of sections 197.400 to 197.477 shall become effective unless it has been promulgated pursuant to the provisions of section 536.024, RSMo.]