FIRSTREGULARSESSION
HOUSEBILLNO.539
102NDGENERALASSEMBLY
INTRODUCEDBYREPRESENTATIVESCHWADRON.
1585H.01I DANARADEMANMILLER,ChiefClerk
ANACT
Toamendchapter190,RSMo,byaddingtheretotwonewsectionsrelatingtofirstresponders.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Chapter190,RSMo,isamendedbyaddingtheretotwonewsections,tobe
2knownassections190.1010and190.1015,toreadasfollows:
190.1010.1.Thissectionandsection190.1015shallbeknownandmaybecited
2asthe"MissouriFirstResponderMentalHealthInitiativeAct".
3 2.Asusedinthissection,thefollowingtermsmean:
4 (1)"Behavioralhealth"or"behavioralhealthcare",treatmentformental
5health,substanceusedisorder,orbothoccurringtogether;
6 (2)"Emergencyservicespersonnel",anyemployeeofanemergencyservices
7providerwhoisengagedinprovidingservicesasafirstresponder;
8 (3)"Emergencyservicesprovider",anypublicemployerthatemployspersons
9toprovidefire-fightingservices;
10 (4)"Employee",afirstresponderemployedbyaunitofstateorlocal
11government,byapublichospitalorambulanceservice,orbya911dispatchingagency;
12 (5)"Employer",thestate,aunitoflocalgovernment,a911dispatchingagency,
13orapublichospitalorambulanceservicethatemploysfirstresponders;
14 (6)"Firstresponder",alawenforcementofficer,911dispatcher,paramedic,
15emergencymedicaltechnician,oravolunteerorfull-timepaidfirefighteremployedbya
16unitofstateorlocalgovernment,a911dispatchingagency,orapublichospitalor
17ambulanceservicethatemploysfirstresponders;
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 18 (7)"Lawenforcementagency",anycountysheriff,municipalpolice
19department,policedepartmentestablishedbyauniversityorcollege,thedepartment
20ofpublicsafety,thedepartmentofcorrections,andanyotherstate,local,orcounty
21agencycomposedofcountyprobationofficers,correctionsemployees,or911
22telecommunicatorsoremergencymedicaldispatchers;
23 (8)"Peersupportadvisor",anemployeeapprovedbythelawenforcement
24agencyoremergencyservicesproviderwhovoluntarilyprovidesconfidentialsupport
25andassistancetofellowemployeesexperiencingpersonalorprofessionalproblems.An
26emergencyservicesproviderorlawenforcementagencyshallprovidepeersupport
27advisorswithanappropriateleveloftrainingincounselingtoprovideemotionaland
28moralsupport;
29 (9)"Peersupportcounselingprogram",aprogramestablishedbyanemergency
30servicesprovider,alawenforcementagency,stateorlocalpolice,orafirefighter
31organizationtotrainemployeestoserveaspeersupportadvisorsinordertoconduct
32peersupportcounselingsessions;
33 (10)"Peersupportcounselingsession",communicationwithapeersupport
34advisordesignatedbyanemergencyservicesproviderorlawenforcementagency.A
35peersupportcounselingsessionisaccomplishedprimarilythroughlistening,assessing,
36assistingwithproblemsolving,makingreferralstoaprofessionalwhennecessary,and
37conductingfollow-upasneeded;
38 (11)"Posttraumaticstressdisorder",anypsychologicalorbehavioralhealth
39injurysufferedbyafirstresponderbyandthroughthefirstresponder'semployment
40duetothefirstresponder'sexposuretostressfulandlife-threateningsituationsand
41rigorsofthejob,excludingaposttraumaticstressinjurythatarisessolelyasaresultofa
42legitimatepersonnelactionbytheemployersuchastransfer,promotion,demotion,or
43termination,whichshallnotbeconsideredacompensableinjuryunderthissection;
44 (12)"Record",anyrecordkeptbyatherapistorbyanagencyinthecourseof
45providingbehavioralhealthcaretoafirstresponderconcerningthefirstresponderand
46theservicesprovided.Theterm"record"includesthepersonalnotesofthetherapistor
47agency,aswellasallrecordsmaintainedbyacourtthathavebeencreatedinconnection
48with,inpreparationfor,orasaresultofthefilingofanypetition.Theterm"record"
49doesnotincludeinformationthathasbeende-identifiedinaccordancewiththefederal
50HealthInsurancePortabilityandAccountabilityAct(HIPAA)anddoesnotincludea
51referencetothereceiptofbehavioralhealthcarenotedduringapatienthistoryand
52physicalorothersummaryofcare.
53 3.Firstrespondersshallhavethefollowingrightstobehavioralhealthcare:
HB539 2 54 (1)Therightoffullaccesstobehavioralhealthcareservicesandtreatmentthat
55areresponsivetotheneedsoftheindividualandtheprofessionsofpoliceofficers,
56firefighters,emergencymedicaltechnicians,911dispatchers,andparamedics;
57 (2)Therighttoseek,oraccessifrequiredorrequested,servicesandtreatment
58forbehavioralhealthneedswithoutfearofrepercussionsbyhisorheremployeror
59supervisorandwithoutfearofreprisal;
60 (3)Theright,inthecourseofseekingservicesandtreatmentforbehavioral
61health,thatallrecords,notes,andconclusionsbythetreatmentprovidershallnotbe
62sharedwithanemployerunlessotherwisemandatedbylaw.Therightguaranteedby
63thissubdivisionmaybewaivedbytheemployee;
64 (4)Therightoffirstresponderemployeesnottobecompelledbytheiremployer
65underthethreatofdisciplinetoreleaseanyrecordsrelatedtobehavioralhealth;
66 (5)Therighttohavebehavioralhealthrecordsnotbeusedinanydisciplinaryor
67otherproceedingagainstanemployee;
68 (6)Therightofemployeestoseektreatmentinanygeographicareawithout
69restrictionsorlimitationsimposedbytheemployerorinsurancecarrier;
70 (7)Therighttohavebehavioralhealthservicesandtreatmentinamannerthat
71reducesstigmaandbarrierstothoseservicesandtreatment;
72 (8)TherighttoreceiveexpandedFamilyandMedicalLeaveActprotectionsfor
73individualsvoluntarilyseekingpreventivetreatment;
74 (9)Therighttobediagnosedbyalicensedpsychiatrist,psychologist,or
75professionalcounselorspecializinginfirstrespondermentalhealth;
76 (10)Therightofafirstresponderseekingbehavioralhealthserviceswhohas
77beendiagnosed,afterin-networkhealthinsurancehasbeenutilized,tosubmit
78correspondingreceiptsformedicalbillspaidbythefirstrespondertothefirst
79responderbehavioralhealthgrantprogramestablishedunderthissectionfor
80reimbursementtothefirstresponderofout-of-pocketcostsincurredfromthefunds
81specificallyallocatedforfirstresponderbehavioralhealthtreatment.Thefirst
82respondershallpayhisorherout-of-pocketshareforthebehavioralhealthtreatment
83priortosubmittingforreimbursement.Thereshallbeamaximumlimitoftwelve
84monthsbeginningfromthetimeafirstresponderseeksbehavioralhealthtreatmentto
85receivingreimbursementfromtheprogramforthebenefitdescribedinthissubdivision;
86 (11)Therighttoseparatelivingquartersandtreatmentareaswithinbehavioral
87healthanddetoxificationfacilitiesfromotherpatientssoastopreserveanonymityand
88reducetriggeringevents;and
HB539 3 89 (12)Therightforallfirstrespondersretiredfromserviceforaperiodofupto
90thirty-sixmonthstohavefullaccesstobehavioralhealthtreatmentregardlessof
91Medicarerestrictions.
92 4.Therightsguaranteedtofirstrespondersinthissectionshallbejudicially
93enforceable.Anaggrievedemployeemaybringanactionfordamages,attorney'sfees,
94orinjunctivereliefagainstanemployerforviolatingtheprovisionsofthissection.
95 5.(1)Anycommunicationmadebyanemployeeofanemergencyservices
96providerorlawenforcementagencyorpeersupportadvisorinapeersupport
97counselingsession,aswellasanyoralorwritteninformationconveyedinthepeer
98supportcounselingsession,shallbeconfidentialandshallnotbedisclosedbyanyperson
99participatinginthepeersupportcounselingsessionorreleasedtoanypersonorentity.
100Anycommunicationrelatingtoapeersupportcounselingsessionmadeconfidential
101underthissectionthatismadebetweenpeersupportadvisorsandthesupervisorsor
102staffofapeersupportcounselingprogram,orbetweenthesupervisorandstaffofapeer
103supportcounselingprogram,shallbeconfidentialandshallnotbedisclosed.The
104provisionsofthissectionshallnotbeconstruedtoprohibitanycommunications
105betweencounselorswhoconductpeersupportcounselingsessionsorany
106communicationsbetweencounselorsandthesupervisorsorstaffofapeersupport
107counselingprogram.
108 (2)Anycommunicationdescribedinsubdivision(1)ofthissubsectionmaybe
109subjecttoasubpoenaforgoodcauseshown.
110 (3)Theprovisionsofthissubsectionshallnotapplytothefollowing:
111 (a)Anythreatofsuicideorhomicidemadebyaparticipantinapeersupport
112counselingsessionoranyinformationconveyedinapeersupportcounselingsession
113relatedtoathreatofsuicideorhomicide;
114 (b)Anyinformationmandatedbylaworagencypolicytobereportedincluding,
115butnotlimitedto,domesticviolence,childabuseorneglect,orelderabuseorneglect;
116 (c)Anyadmissionofcriminalconduct;or
117 (d)Anyadmissionoractofrefusaltoperformdutiestoprotectothersorthe
118employeeoftheemergencyservicesproviderorlawenforcementagency.
119 (4)Allcommunications,notes,records,andreportsarisingoutofapeersupport
120counselingsessionshallnotbeconsideredpublicrecordssubjecttodisclosureunder
121chapter610.
122 (5)Adepartmentororganizationthatestablishesapeersupportcounseling
123programshalldevelopapolicyorrulethatimposesdisciplinarymeasuresagainstapeer
124supportadvisorwhoviolatestheconfidentialityofthepeersupportcounselingprogram
125bysharinginformationlearnedinapeersupportcounselingsessionwithpersonnelwho
HB539 4 126arenotsupervisorsorstaffofthepeersupportcounselingprogram,unlessotherwise
127exemptedundertheprovisionsofthissubsection.
128 (6)Iftheemergencyservicesproviderorlawenforcementagencyuses
129confidentialinformationobtainedduringaconfidentialpeersupportcounselingsession
130conductedbyalawenforcementagencyorbyanemergencyservicesproviderin
131violationofthissubsection,theaggrievedemployeewhoserightshavebeenviolated
132shallhaveacauseforanadverseemploymentactionagainsttheprovideroragency.
133 (7)Nothinginthissubsectionshallbeconstruedtolimitorreduceany
134confidentialityprotectionsorlegalprivilegesthatareotherwiseprovidedbylaworrule
135including,butnotlimitedto,localordinance,stateorfederallaw,orcourtrule.Any
136confidentialityprovisionenactedbylocalordinanceonorafterAugust28,2023,shall
137notdiminishtheprotectionsenumeratedinthissubsection.
138 6.Anyemergencyservicesprovider,lawenforcementagency,orstatewideor
139localcollectivebargainingorganizationthatcreatesapeersupportprogramshallbe
140subjecttotheprovisionsofthissection.Anemergencyservicesprovider,law
141enforcementagency,orcollectivebargainingorganizationshallensurethatpeersupport
142advisorsreceiveappropriatetrainingincounselingtoconductpeersupportcounseling
143sessions.Emergencyservicespersonnelandpublicsafetypersonnelmayreferany
144persontoapeersupportadvisorwithintheemergencyservicesproviderorlaw
145enforcementagencyor,ifthoseservicesarenotavailablewithintheprovideroragency,
146toanotherpeersupportcounselingprogramthatisavailableandapprovedbythe
147emergencyservicesproviderorlawenforcementagency.Notwithstandinganyother
148provisionoflawtothecontrary,publicsafetypersonnelshallnotmandatethatany
149employeeparticipateinapeersupportcounselingprogram.
150 7.Thereisherebycreatedwithinthedepartmentofmentalhealththe"First
151ResponderBehavioralHealthGrantProgram"toprovidegrantstothefollowing
152recipients:
153 (1)Unitsoflocalgovernment;
154 (2)911dispatchingagencies;
155 (3)Lawenforcementagencies;
156 (4)Fireprotectiondistricts;
157 (5)Municipalfiredepartments;
158 (6)Ambulancedistrictsthatemployfirstresponders;
159 (7)MissouriStateCouncilofFireFighterspeersupportteams;and
160 (8)MissouriFraternalOrderofPolicepeersupportteams.
161 8.(1)Thereisherebycreatedinthestatetreasurythe"FirstResponder
162BehavioralHealthGrantFund",whichshallconsistofmoneysappropriatedtoitbythe
HB539 5 163legislature.Thestatetreasurershallbecustodianofthefund.Inaccordancewith
164sections30.170and30.180,thestatetreasurermayapprovedisbursements.Thefund
165shallbeadedicatedfundandmoneysinthefundshallbeusedsolelybydepartmentof
166mentalhealthforthepurposeofmakinggrantstoeligiblerecipientsundersubsection7
167ofthissection.Notwithstandingtheprovisionsofsection33.080tothecontrary,any
168moneysremaininginthefundattheendofthebienniumshallnotreverttothecreditof
169thegeneralrevenuefund.Thestatetreasurershallinvestmoneysinthefundinthe
170samemannerasotherfundsareinvested.Anyinterestandmoneysearnedonsuch
171investmentsshallbecreditedtothefund.
172 (2)Recipientseligibleforgrantsundersubsection7ofthissectionshallusethe
173grantsforexpensesrelatedtobehavioralhealthcareservicesforfirstresponders
174including,butnotlimitedto,peersupporteducationanddevelopment,mentalhealth
175preventionandawarenesstraining,department-leveleducation,criticalincidentdata
176software,mentalhealthevaluationsoftware,telehealthservices,andreimbursementfor
177out-of-pocketcostsnotcoveredbyhealthinsurance.Anemployershallnotreduce
178behavioralhealthcareprovidedthroughafirstresponder'semployeebenefitpackageas
179aresultofthereceiptofgrantfundsunderthissubsection.Norecord,note,or
180conclusionbyatreatmentproviderprovidingbehavioralhealthcaretofirstresponders
181whoseemployersreceivegrantsunderthissubsectionshallbesharedwiththeemployer
182unlessotherwisemandatedbylaw.
183 (3)Applicantsseekinggrantsshallapplytothedepartmentinaformand
184mannerprescribedbythedepartment.
185 9.Thedepartmentmayadoptanyrulesnecessarytoimplementthissection.
186Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatiscreated
187undertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplies
188withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section
189536.028.Thissectionandchapter536arenonseverableandifanyofthepowersvested
190withthegeneralassemblypursuanttochapter536toreview,todelaytheeffectivedate,
191ortodisapproveandannularulearesubsequentlyheldunconstitutional,thenthegrant
192ofrulemakingauthorityandanyruleproposedoradoptedafterAugust28,2023,shall
193beinvalidandvoid.
190.1015.1.Thereshallbecreatedwithinthedepartmentofpublicsafetythe
2"MissouriFirstRespondersMentalHealthTaskForce"todeveloprecommendations
3regardinggrantsissuedundersection190.1010,aswellastodevelopamechanismto
4helpreducetheriskandratesofsuicideamongfirstresponders.Thetaskforceshallbe
5composedofthefollowingmembers:
6 (1)Thedirectorofthedepartmentofmentalhealthorhisorherdesignee;
HB539 6 7 (2)Thedirectorofthedepartmentofpublicsafetyorhisorherdesignee;
8 (3)ThepresidentoftheMissouriAssociationofFireChiefsorhisorher
9designee;
10 (4)ThepresidentoftheMissouriPoliceChiefsAssociationorhisorher
11designee;
12 (5)ThepresidentoftheMissouriFraternalOrderofPoliceorhisorher
13designee;
14 (6)ThepresidentoftheMissouriStateCouncilofFireFightersorhisorher
15designee;
16 (7)Twomemberswhorepresenttwodifferentmentalhealthorganizations,
17appointedbythedirectorofthedepartmentofmentalhealth;
18 (8)Onememberwhorepresentsanorganizationthatadvocatesonbehalfof
19police,appointedbythedirectorofthedepartmentofpublicsafety;
20 (9)Onememberwhorepresentsorganizationsthatadvocateonbehalfof
21firefighters,appointedbythestatefiremarshal;and
22 (10)Onememberwhorepresentsorganizationsthatadvocateonbehalfof
23paramedicsandemergencyfirstresponders,appointedbythedirectorofthebureauof
24emergencymedicalservices.
25 2.MembersofthetaskforceshallbeappointedwithinthirtydaysafterAugust
2628,2023,andshallservewithoutcompensation.Thetaskforceshallbeginmeetingno
27laterthansixtydaysafterallmembershavebeenappointed.Thedepartmentofpublic
28safetyshallprovideadministrativesupportforthetaskforce.Ifthesubjectmatteris
29eithersensitiveorclassified,orotherwisemeetsnecessaryexemptionsundersection
30610.021forclosedmeetings,thetaskforcemayholditshearingsinprivate.
31 3.Thetaskforceshallproviderecommendationsforagenciesandorganizations
32toaccessmentalhealthandwellnessservices,including,butnotlimitedto,peersupport
33programs,andprovideongoingeducationrelatedtomentalhealthwellnessincluding,
34butnotlimitedto:
35 (1)Revisingagencyororganizationemployeeassistanceprograms;
36 (2)Urginghealthcareproviderstoreplaceoutdatedhealthcareplansand
37includemoreprogressiveoptionscateringtotheneedsanddisproportionaterisks
38shoulderedbyfirstresponders;
39 (3)Providingresourcesforfundingorpublicserviceannouncementsand
40messagingcampaignsaimedatraisingawarenessofavailableassistanceoptions;
41 (4)Encouragingagenciesandorganizationstoattachlistsofallavailable
42resourcestotrainingmanualsandcontinuingeducationrequirements;
HB539 7 43 (5)Identifyingandrecommendinglocalandnationwidementalhealthfacilities
44thatspecializeintreatmentoffirstresponders;
45 (6)Encouragingagenciesandorganizationstosponsororfacilitatefirst
46responderswithspecializedtrainingintheareasofpsychologicalfitness,depressive
47disorders,earlydetection,andmitigationbestpractices.Suchtrainingscouldbe
48accomplishedby:
49 (a)Assigning,appointing,ordesignatingonememberofanagencyor
50organizationtoattendspecializedtrainingssponsoredbyanaccreditedagency,
51association,ororganizationrecognizedinthemember'sfieldsofstudy;
52 (b)Seekinggrants,sponsorships,orconductingfundraiserstohostannualor
53semiannualon-sitevisitsfromqualifiedcliniciansorphysicianstoprovideearly
54detectiontechniquestrainingortoprovideregularaccesstomentalhealth
55professionals;
56 (c)Requiringthataminimumnumberofhoursoftrainingondisordersand
57wellnessbeincorporatedintoreoccurringannualorbiannualtrainingstandards,
58examinations,andcurricula,takingintocloseconsiderationrespectiveagencyor
59organizationsize,frequency,andnumberofallcurrentfederalandstatemandatory
60examinationsandtrainingsexpectedrespectively;and
61 (d)Emphasizingthecrucialimportanceofabalanceddiet,sleep,mindfulness-
62basedstressreductiontechniques,moderateandvigorousintensityactivities,and
63recreationalhobbies,whichhavebeenscientificallyproventoplayamajorroleinbrain
64healthandmentalwellness;
65 (7)Encouragingadministratorsandleadershippersonneltosolicittraining
66servicesfromevidence-based,data-drivenorganizationswithpersonneltrainedonthe
67analyticalreviewandinterpretationofspecificfieldsrelatedtothenatureoffirst
68responders'needs,suchasposttraumaticstressdisorder,substanceabuse,andachronic
69stateofduress;
70 (8)Encouragingfundingforexpansionofpreliminaryself-diagnosing
71technologiesbycontactinganaccreditedagency,association,ororganization
72recognizedinthefieldorfieldsofspecificstudy;normalizinghelp-seekingbehaviors
73forbothfirstrespondersandtheirfamiliesthroughregularmessagingandpeersupport
74outreach,beginningwithacademycurriculaandcontinuingeducationthroughout
75individuals'careers;fundingandimplementingawarenesscampaignsthatprovideclear
76andconcisecallstoactionaboutmentalhealthandwellness,resiliency,help-seeking,
77treatment,andrecovery;promotingandraisingawarenessofnonprofitorganizations
78currentlyavailabletoassistindividualsinsearchofcareandtreatment;expanding
79FamilyandMedicalLeaveActprotectionsforindividualsvoluntarilyseeking
HB539 8 80preventivetreatment;andpromotingandensuringcompletepatientconfidentiality
81protections;and
82 (9)Encouragingagenciesandorganizationstoincorporatethefollowingtraining
83componentsintoalreadyexistingmodulesandeducationalcurricula:
84 (a)Bolsteringacademyandschoolcurriculabyrequiringdepressivedisorder
85trainingcateredtoposttraumaticstressdisorder,substanceabuse,andearlydetection
86techniquestraining,takingintocloseconsiderationrespectiveagencyororganization
87sizeandthefrequencyandnumberofallcurrentfederalandstatemandatory
88examinationsandtrainingsexpectedrespectively;
89 (b)Continuingtoallocateormatchfederalandstatefundstomaintainthe
90Missouricrisisinterventionteam;
91 (c)Incorporatingastate-approvedcertificateforpeersupporttraininginto
92alreadyexistingstatewidecurriculaandmandatoryexaminations,annualstatefire
93marshalexaminations,andphysicalfitnessexaminations.Thesubjectmatterofthe
94certificateshouldhaveanemphasisonmentalhealthandwellness,aswellas
95familiarizationwithtopicsrangingfromclinicalsocialwork,clinicalpsychology,clinical
96behavioristwork,andclinicalpsychiatry;
97 (d)Incorporatingandperformingstatewidementalhealthcheck-insduringthe
98sametimesasalreadymandatedtrainings.Thesechecksshallnotbecomparedorused
99asmeasuresoffitnessfordutyevaluationsorstructuredpsychologicalexaminations;
100and
101 (e)Recommendingcomprehensiveandevidence-basedtrainingonthe
102importanceofpreventivemeasuresonthetopicsofsleep,nutrition,mindfulness,and
103physicalmovement.
âś”
HB539 9