HCS HB 1574 & 1640 -- REGULATION OF HOSPITALS; REGISTRATION OF
EMBRYO LABORATORIES

SPONSOR:  Ladd Stokan

COMMITTEE ACTION:  Voted "do pass" by the Committee on Public
Health by a vote of 12 to 0.

The substitute requires the Department of Health to use the
following standards for enforcing hospital licensure regulations
as contained in Sections 197.010 to 197.120, RSMo, the Hospital
Licensing Law.  The substitute:

(1)  Requires hospitals to develop and implement a plan of
correction for a deficiency as approved by the Department of
Health when hospitals receive notification of a deficiency in
meeting regulatory standards; and

(2)  Requires the department to direct hospitals to develop and
implement another approved plan of correction for a continuing
deficiency or to require hospitals to implement an approved plan
of correction developed by the department.

If a deficiency in a hospital continues after the department
specifies the corrective order to be taken by the hospital and
the hospital has had the opportunity to correct the deficiency,
the department (in successive order) can:

(1)  Restrict new inpatient admissions or outpatient entrants to
the service or services affected by the deficiency;

(2)  Suspend operations in all or part of the hospital service
or services affected by the deficiency; or

(3)  Deny, suspend, or revoke the hospital's license.

If a hospital deficiency presents a clear and present danger to
patients, the department can restrict access to the service or
services affected based on the scope and severity of the
deficiency until approved corrective actions are taken by a
hospital.  The determination of a deficiency which constitutes a
clear and present danger will be made in accordance with
guidelines established by the department and approved by the
Director of the Bureau of Health Facility Licensing.

A hospital can appeal the corrective measures required by this
substitute to the Administrative Hearing Commission and seek
judicial review.  Appeals on specified corrective actions will
be heard on an expedited basis.

If the hospital and the department agree, prior to the appeal to
the Administrative Hearing Commission, actions can be appealed
to a departmental hearing officer.  The department is required
to establish regulations governing the departmental hearing
process.

The substitute allows the department and hospitals to jointly
design and implement a pilot project to develop an alternative
model for enforcing hospital standards.  The alternative model
can be applied in hospitals or multi-hospital systems.
Components and regulations of the pilot project are stated in
the substitute.

The substitute also authorizes the Department of Health to
develop a registration program for embryo laboratories that
provide assistive reproductive technology (ART) services.  The
purpose of the registration program is to provide consumers
accurate information on fertility resources, practices, and
procedures.

Beginning January 1, 2001, all laboratories that provide ART
procedures and services for the treatment of infertility are
required to register with the department in order to operate in
Missouri.

The substitute specifies the content of the registration
information, type of registration information submitted by
embryo laboratories, and the requirement to provide clients with
information on ART laboratories prepared by the department.  It
also requires the department to provide information on ART
laboratories to consumers, act as an intermediary between a
complainant and an ART laboratory, and prepare a report on the
registration information, success rates, and recommendations.
The report will be submitted to the Speaker of the House of
Representatives, the President Pro Tem of the Senate, and the
chairs of the House and Senate Public Health Committees by
January 1, 2003.

The department can also establish a fee to cover the costs
associated with the registration program.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
$200,480 in FY 2001, $218,719 in FY 2002, and $225,177 in FY
2003.

PROPONENTS:  Supporters of the bill state that there are no
incremental penalty provisions pertaining to the regulation of
hospitals.  Further, the bill would allow for the identification
and registration of embryo laboratories in Missouri which
provide assistive reproductive technology (ART) services.
Currently, such services are not governed by federal or state
statute.

Testifying for the bill were Representative Ladd Stokan;
Department of Health; Missouri Hospital Association; Missouri
Nurses Association; and Missouri Family Network.

OPPONENTS:  There was no opposition voiced to the committee.

Joseph Deering, Legislative Analyst

HB 1574 -- Regulation of Hospitals

Co-Sponsors:  Ladd Stokan, Hosmer, Fraser

This bill requires the Department of Health to use the following
standards for enforcing hospital licensure regulations as
contained in Sections 197.010 to 197.120, RSMo, the Hospital
Licensing Law.  The bill:

(1)  Requires hospitals to develop and implement a plan of
correction for a deficiency as approved by the Department of
Health when hospitals receive notification of a deficiency in
meeting regulatory standards; and

(2)  Requires the department to direct hospitals to develop and
implement another approved plan of correction for a continuing
deficiency or to require hospitals to implement an approved plan
of correction for a continuing deficiency developed by the
department.

If a deficiency in a hospital continues after the department
specifies the corrective order to be taken by the hospital and
the hospital has had the opportunity to correct the deficiency,
the department (in successive order) can:

(1)  Restrict new inpatient admissions or outpatient entrants to
the service or services affected by the deficiency; or

(2)  Suspend operations in all or part of the hospital service
or services affected by the deficiency; or

(3)  Deny, suspend, or revoke the hospital's license.

If a hospital deficiency presents a clear and present danger to
patients, the department can restrict access to the service or
services affected based on the scope and severity of the
deficiency until approved corrective actions are taken by
hospital.

A hospital can appeal the corrective measures required by this
bill to the Administrative Hearing Commission under Section
197.071 and seek judicial review under Section 621.145.  If the
hospital and the department agree, prior to the appeal to the
Administrative Hearing Commission, actions can be appealed to a
departmental hearing officer.

The bill also allows the department and hospitals to jointly
design and implement a pilot project to develop an alternative
model for enforcing hospital standards.  The alternative model
can be applied in hospitals or multi-hospital systems.
Components and regulations of the pilot project are stated in
the bill.