HCS HB 671 -- ASSISTED LIVING FACILITIES

SPONSOR:  Cooper, 155 (Sutherland)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Health
Care Policy by a vote of 10 to 0.

This substitute changes the laws regarding assisted living
facilities.  The term "residential care facility I" as it applies
to long-term care provided to the elderly and disabled is changed
to "assisted living facility I," and "residential care facility
II" is changed to "assisted living facility II."  The substitute:

(1)  Defines "assisted living facility I" as a state licensed
facility that provides 24-hour care and protective oversight with
shelter and board to three or more residents.  This care may
include the administration of medication during a short-term
illness or recuperation;

(2)  Defines "assisted living facility II" as having the same
requirements as an assisted living facility I but which also
provides assistance to the residents with daily-living activities
and instrumental activities of daily living;

(3)  Defines the terms "dementia," "appropriately trained
individual," "community based assessment," "shared responsibility
agreement," "social model of care," "activities of daily living,"
and "instrumental activities of daily living";

(4)  Requires assisted living facilities I and II to provide
24-hour staff in the appropriate numbers and with adequate skill
to care for the needs of the residents and to have an evacuation
plan for residents in case of a disaster;

(5)  Requires a resident assessment by an appropriately trained
professional upon admission, at least annually, and whenever a
resident's condition has required a change;

(6)  Prohibits a facility from accepting an individual who is a
danger to self or others, has a risk of elopement, requires
physical or chemical restraint, requires more than one person to
simultaneously assist in daily activities, or is bed-bound;

(7)  Requires a facility to take the necessary precautions to
ensure those individuals with a physical, cognitive, or other
impairment can be safely evacuated during an emergency;

(8)  Requires assisted living facilities I and assisted living
facilities II to disclose the services they are able to provide
and the conditions that will require discharge or transfer to a
prospective resident or the legal representative of the resident;
and

(9)  Requires the Department of Health and Senior Services to
develop rules to ensure compliance with the substitute.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of Unknown,
greater than $100,000 in FY 2006, FY 2007, and FY 2008.  No
impact on Other State Funds in FY 2006, FY 2007, and FY 2008.

PROPONENTS:  Supporters say that the bill will help alleviate the
confusion of consumers about the different types of long-term
care facilities available to the public.  It also requires
assisted living facilities to implement a social model of care,
which focuses on keeping people in the least restrictive
environment possible and includes care plans for individuals
focused on the individual's needs.  The social model of care is
especially appropriate for dementia patients.  The bill will
allow the provider to conduct an assessment of a resident and
determine what the resident's needs are and how the facility can
meet those needs.

Testifying for the bill were Representative Sutherland; Missouri
Coalition of Alzheimers' Association Chapters; Mary LePage; Dolan
Residential Care; Missouri Association of Homes for the Aging;
Lutheran Senior Services; and Office of the Lieutenant Governor.

OPPONENTS:  Those who oppose the bill say that it goes beyond
changing the name "residential care facility" to "assisted living
facility."  There aren't any limits on the care that an assisted
living facility can provide, as long as it agrees to provide the
care.  The bill will increase staffing requirements, which will
exacerbate the current staffing shortage.  The change of the name
to "assisted living facility" should also include what the change
means for residents.

Testifying against the bill were Missouri Healthcare Association;
and AARP.

Amy Woods, Senior Legislative Analyst

Missouri House of Representatives
93rd General Assembly, 1st Regular Session
Last Updated August 25, 2005 at 1:20 pm