FIRSTREGULARSESSION
HOUSEBILLNO.96
103RDGENERALASSEMBLY
INTRODUCEDBYREPRESENTATIVEEALY.
0542H.01I DANARADEMANMILLER,ChiefClerk
ANACT
Toamendchapter210,RSMo,byaddingtheretoonenewsectionrelatingtolicensed
residentialcarefacilities.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Chapter210,RSMo,isamendedbyaddingtheretoonenewsection,tobe
2knownassection210.499,toreadasfollows:
210.499.1.Asusedinthissection,thefollowingtermsmean:
2 (1)"Familymember",agrandparent,parent,sibling,spouseordomestic
3partner,child,aunt,uncle,cousin,niece,nephew,grandchild,oranyotherperson
4relatedtoanindividualbyblood,adoption,marriage,orafosteringrelationship;
5 (2)"Office",theofficeofstateoversightforresidentialcarefacilities.
6 2.Thereisherebyestablishedwithinthedepartmentofsocialservicesthe
7"OfficeofStateOversightforResidentialCareFacilities"forthepurposeofassessing
8compliancewithapplicablelaws,rules,andregulationsofthefederalgovernment,the
9state,andthedivision,asthoselaws,rules,andregulationsrelatetothehealth,safety,
10welfare,andrehabilitationofachildresidinginaresidentialcarefacility.
11 3.Theofficeshallbeadministeredbyadirectorwhoshalldevotehisorher
12entiretimetothedutiesofhisorherpositionandwhoshallbeappointedbythe
13governorbyandwiththeadviceandconsentofthesenate.Thedirectorshallservea
14termofsixyearsandshallcontinuetoholdofficeuntilasuccessorhasbeenduly
15appointed.Thedirectororthedirector'sspouse,domesticpartner,parent,
16grandparent,child,orsiblingshallnotbeacurrentorformeremployeeor
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17contractorofaresidentialcarefacilityorthedivision.Thedirectorshallhavethe
18authoritytohirestaff,contractors,andunpaidvolunteers.
19 4.Theofficeshall:
20 (1)Establishandimplementproceduresforregularinspectionsofevery
21residentialcarefacilitylicensedbythedivisionorthedepartmentofhealthandsenior
22services;
23 (2)Inspecteachresidentialcarefacilityatleastonceeachyearandatleasttwo
24timeseachyearforeachfacilityinwhichtheofficehascauseformorefrequent
25inspectionsormonitoring;
26 (3)Investigatecomplaintsreceivedfromoutsidetheofficeorissuesfrom
27previousinspections;
28 (4)Publiclyissueannualinspectionreportswithrecommendationsforeach
29residentialcarefacility,includingasummaryofanydataarisingfromanycomplaint
30investigatedandresolved;
31 (5)Produceasummaryofthepoliciesandproceduresofeachresidentialcare
32facilitythatrelatetothecareofthechildrenresidinginthefacility;
33 (6)Produceacharacterizationoftheconditionsofthelivingspacewithineach
34residentialcarefacility;
35 (7)Produceacatalogregardingavailableeducationalandrehabilitative
36programsanddrugandmentalhealthtreatmentprograms.Theofficeshallalso
37provideasummaryregardingtheimplementationofandparticipationineach
38program;
39 (8)Produceasummaryofthekitchenanddiningfacilitieswithineach
40residentialcarefacility,includingtheportionsizing,edibility,andnutritionalvalueof
41foodbeingprovidedtochildren;
42 (9)Produceasummaryofvisitationpoliciesandproceduresforeachresidential
43carefacility;
44 (10)Produceasummaryofmedicalfacilitiesandmedicalproceduresand
45policiesforeachresidentialcarefacility,includingcompliancewithcontrolledsubstance
46laws;
47 (11)Produceasummaryregardinganyreviewbytheofficeregardingalock-
48downofaresidentialcarefacility;
49 (12)Produceasummaryofthestaffateachresidentialcarefacility,including
50policiesrelatingtostaff-to-childratiosandstaffrecruitment,training,supervision,and
51discipline;
52 (13)Produceasummaryofphysicalandsexualassaultsoccurringata
53residentialcarefacilitythatwerereviewedbytheoffice;
HB96 2 54 (14)Produceasummaryofanychildorstaffdeathsthatoccurredata
55residentialcarefacility;and
56 (15)Recommendchangestobemadebyeachresidentialcarefacilitytoimprove
57safetyandconditionswithinthefacility.
58 5.Aresidentialcarefacilityshallsubmitareporttotheofficewithinthirtydays
59ofaninspectionreportmadebytheoffice.Suchreportshallincludeacorrectiveaction
60planforeachrecommendationdeterminedbytheoffice.
61 6.Theofficeshallhaveaccess,upondemandandwithoutpriornotice,tothe
62followinginallresidentialcarefacilities:
63 (1)Areasthatareusedbychildrenresidinginaresidentialcarefacility;
64 (2)Areasthatareaccessibletochildrenresidinginaresidentialcarefacility;
65and
66 (3)Allprogramsforchildrenresidinginaresidentialcarefacility.
67 7.Theofficeshallhaveaccess,upondemandandwithoutpriornotice,toareas
68withinaresidentialcarefacilitytoverifythatthestaff-to-childratiosarebeing
69maintained.Thisauthorityincludestheopportunitytoconductaninterviewwithany
70childresidinginoremployeeorcontractorofaresidentialcarefacility,orotherpersons
71involvedwiththefacility.
72 8.Theofficeshallhavetheauthoritytoregularlymeetandcommunicatewith
73childrenresidinginoremployeesorcontractorsworkinginaresidentialcarefacility.
74Suchmeetingsandcommunicationsmaybeprivateandconfidential,formalor
75informal,andbytelephone,mail,electronicmail,orinperson.
76 9.Theofficeshallhavetheauthoritytoaccess,inspect,andcopyallrelevant
77information,records,ordocumentsinthepossessionorcontrolofaresidentialcare
78facilitythattheofficeconsidersnecessaryinaninvestigationtodeterminewhetherthe
79facilityisincompliancewithrulesandregulations.Iftheinformation,records,or
80documentsarerestrictedorprivilegedandtheofficehassubmittedawrittenrequestto
81thefacilityforsuchinformation,records,ordocuments,thefacilityshallassisttheoffice
82inobtaininganynecessaryreleasesforsuchinformation,records,ordocumentswithin
83thirtydaysfromtheoffice'srequest.
84 10.Iftherecordsrequestedbytheofficepertaintoachilddeath,athreatof
85deathorbodilyharm,asexualassault,orthedenialofnecessarymedicaltreatment,the
86recordsshallbeprovidedbyaresidentialcarefacilitywithinfivedaysunlesstheoffice
87consentstoanextensionoftimenolongerthanthirtydays.
88 11.Theofficeshallestablishconfidentialityrulesandproceduresforall
89informationmaintainedbytheofficetoensurethattheprivacyofachildisprotected.
HB96 3 90Theofficemaydiscloseidentifyinginformationforthesolepurposeofcarryingoutan
91investigation.
92 12.Inspectionreportsofallresidentialcarefacilitiesshallincludethefollowing
93information:
94 (1)Sanitationofthe:
95 (a)Sleepingrooms;
96 (b)Commondormareas;
97 (c)Restrooms;
98 (d)Diningarea;
99 (e)Gymnasium,weightroom,orotherphysicalfitnessarea;
100 (f)Therapyrooms;
101 (g)Safespaces,quietrooms,ordetentionspaces;and
102 (h)Hallways;
103 (2)Accesstopropernutrition;
104 (3)Kitchencleanliness,includingpreparationareas,adequatekitchensupplies,
105andadequaterefrigerationandproceduresforreceivingdeliveriesofitemsthatrequire
106refrigeration;
107 (4)Cleanandadequatewatersupplyinthelivingareasanddiningfacility;
108 (5)Comfortabletemperaturesinthefollowingareasthatareutilizedbychildren
109residinginaresidentialcarefacility:
110 (a)Sleepingrooms;
111 (b)Commondormareas;
112 (c)Restrooms;
113 (d)Diningarea;
114 (e)Gymnasium,weightroom,orotherphysicalfitnessarea;
115 (f)Therapyrooms;and
116 (g)Safespaces,quietrooms,anddetentionspaces;and
117 (6)Anassessmentof:
118 (a)Allpoliciesandproceduresinplacebyaresidentialcarefacilityrelatingto
119thecareofachildresidinginthefacility;
120 (b)Conditionsoflivingspaces;
121 (c)Cleanliness,includingtheavailabilityofcleaningsupplies;
122 (d)Workingwaterfountains,toilets,sinks,andshowers;
123 (e)Availabilityoftoiletpaper,disposablecupsfordrinkingwater,andpaper
124towels;
125 (f)Kitchenanddiningfacilities,whenopen,foodavailability,andfoodedibility;
HB96 4 126 (g)Doorstobedroomsopeningandclosingproperlyandadequatestorageina
127child'sroomforthechild'sclothing;
128 (h)Workinglaundryfacilitiesandavailabilityoflaundrydetergent;
129 (i)Accessibilityandavailabilityofpersonalhygieneproductsincluding,butnot
130limitedto,soaporbodywash,shampoo,conditioner,toothpaste,lotion,washcloths,and
131towels;
132 (j)Securelocationsforthechild'svaluables;
133 (k)Availabilityofeducationalandrehabilitativeprograms,includingrecordson
134howoftenitisavailable,andactiveparticipationbystaffandchildrenresidingina
135residentialcarefacility;
136 (l)Availabilityofdrugandmentalhealthtreatment,includingrecordsonhow
137oftenitisavailable,andactiveparticipationbystaffandchildrenresidingina
138residentialcarefacility;
139 (m)Allpoliciesandproceduresrelatingtovisitationbothonandoffcampus;
140 (n)Allmedicalfacilitiesandmedicalproceduresandpolicies,including
141controlledmedicationlogs;
142 (o)Thenumberoflock-downsataresidentialcarefacilitysincethelast
143inspectionbytheoffice;and
144 (p)Staffingataresidentialcarefacility,including:
145 a.Thenumberandjobassignmentsofdormstaff;
146 b.Theratioofdormstafftochildrenresidingataresidentialcarefacility;and
147 c.Thestaffpositionvacancyrateataresidentialcarefacility.
148 13.Theofficeshallreviewproceduresofthedivisiontodetermineifthe
149proceduresareadequateforreceiving,processing,respondingto,andresolving
150complaintsmadebyoronbehalfofachildinthecustodyofthedivisionrelatingto
151action,inaction,ordecisionsofaresidentialcarefacilitystafforcontractorsthatmay
152adverselyaffectthehealth,safety,welfare,orrightsofsuchchild.
153 14.Forthereviewprocessundersubsection13ofthissection,theofficeshall
154havetheauthorityto:
155 (1)Monitorlivingspaceandassesswhetherresidentialcarefacilitystaffisin
156compliancewithapplicablefederal,state,anddivisionrulesandregulationsthatrelate
157tothehealth,safety,welfare,andrehabilitationofachild;
158 (2)Reviewandanalyzedatarelatingtocomplaintsreceivedbythedivisionand
159datarelatingtothefollowing:
160 (a)Deaths,suicides,andsuicideattemptswhileinthecustodyofthedivision;
161 (b)Physicalandsexualassaultswhileinthecustodyofthedivision;
HB96 5 162 (c)Thenumberofchildrenplacedinadministrativesegregationorsolitary
163confinement,andthedurationofstayinsuchsegregationorconfinement;
164 (d)Thenumberoflock-downsataresidentialcarefacilitylastinglongerthan
165twenty-fourhours;
166 (e)Thenumberofstaffvacanciesateachresidentialcarefacility;
167 (f)Staff-to-childratiosateachresidentialcarefacility;
168 (g)Stafftenureandturnoverateachresidentialcarefacility;
169 (h)Thenumberofin-personvisitsbyafamilymember,mentor,guardianad
170litem,orcasemanagertoachildthatwereallowedordeniedbyaresidentialcare
171facility;
172 (i)Incidentreportsinvolvingphysicalorsexualassaultsordeaths,injuries,or
173physicalrestraintsataresidentialcarefacility;
174 (j)Reviewoftherecruitment,training,supervision,anddisciplineofthestaffof
175aresidentialcarefacility;and
176 (k)Anyotheraspectoftheoperationofaresidentialcarefacilitythattheoffice
177deemsnecessaryoverthecourseofaninspection.
178 15.Uponcompletionofthereview,theofficeshallproduceareporttobemade
179availabletothepublicontheoffice'swebsite.Suchreportshallbedeliveredtothe
180governor,theattorneygeneral,thepresidentprotemporeofthesenate,thespeakerof
181thehouseofrepresentatives,andthedirectorofthedivision.Thereportshallinclude:
182 (1)Asummaryofthedivision'scomplaintpoliciesandprocedures;and
183 (2)Anyrecommendationsthatwereprovidedtothedivisionaddressing
184necessaryimprovements.
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HB96 6