HCS HB 1620 -- ASSISTED LIVING FACILITIES

SPONSOR:  Schaaf (Sutherland)

COMMITTEE ACTION:  Voted "do pass" by the Special Committee on
Healthcare Facilities by a vote of 9 to 2.

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

(1)  Defines "assisted living facility" as any premises other
than a residential care facility, intermediate care facility, or
skilled nursing facility that provides or coordinates 24-hour
care and protective oversight to three or more residents.  Care
may include the provision of shelter, board, and assistance with
any activities of daily living or supervision of health care
under the direction of a licensed physician;

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

(3)  Requires an assisted living facility to provide for or
coordinate oversight and services to meet the needs of a resident
as provided for in a written contract signed by the resident or
other responsible party;

(4)  Prohibits an assisted living facility from accepting an
individual who is a danger to self or others, requires physical
or chemical restraint, requires more than one person to
simultaneously assist the resident in daily activities, or is
bed-bound;

(5)  Requires an assisted living facility to provide staff in
appropriate numbers and with appropriate skills to provide
24-hour care to residents;

(6)  Requires an assisted living facility to keep a written plan
for the protection of all residents in the event of a disaster;

(7)  Requires an assisted living facility to complete a resident
assessment upon admission, at least semi-annually, and whenever a
significant change has occurred in the resident's condition;

(8)  Requires the use of a personal electronic monitoring device
for any resident of an assisted living facility whose physician
recommends its use;

(9)  Prohibits any facility from naming or advertising itself as
an assisted living facility without obtaining a license from the
Department of Health and Senior Services; and

(10)  Requires the department to develop rules to ensure the
compliance of the provisions of the substitute.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of Unknown,
greater than $100,000 in FY 2007, FY 2008, and FY 2009.  No
impact on Other State Funds.

PROPONENTS:  Supporters say the bill is long overdue in
redefining residential care facilities to assisted living
facilities, expanding options, and creating choices for older
Missourians.  Residents with diminished capacity will be allowed
to remain at the assisted living facility with certain
protections in place, rather than transferred to a skilled
nursing facility when they are unable to exit safely in an
emergency.  Those living with dementia can continue to live a
dignified and meaningful life if surrounded by competent and
caring staff.

Testifying for the bill were Representative Sutherland;
Lieutenant Governor; Missouri Alzheimer's Coalition; AARP;
Missouri Association of Homes for the Aging; Department of Health
and Senior Services; Bethesda Health Group, Incorporated;
Lutheran Senior Services; Missouri Association of Long-Term Care
Physicians; Missouri Aging Federation; Missouri Coalition for
Quality Care; Missouri Long-Term Care Ombudsman Program; Missouri
Alliance of Area Agencies on Aging; Kathy Ray-Smith, Missouri
Association of Regional Long-Term Care Ombudsman; Central
Missouri Area Agency on Aging; OWL, the Voice of Mid-Life and
Older Women; and Sunrise and Mary LePage.

OPPONENTS:  Those who oppose the bill say that in its current
form the bill is inconsistent with current regulations and
practices and unsafe for residents.  There is a need for fair and
proper enforcement of the regulations.  Currently, inspectors are
punitive; therefore, the Department of Health and Senior Services
should be properly hiring and training their personnel to improve
the education, attitude, and success of the people working in
long-term care facilities.

Testifying against the bill were Missouri Health Care
Association; and Larus Corporation.

Dominic Lackey, Legislative Analyst

Missouri House of Representatives
93rd General Assembly, 2nd Regular Session
Last Updated November 29, 2006 at 9:44 am