Hello Missouri Members!  Yes, the column title signals you will be offered my perspective. But sometimes your perspective is more important to our field’s progress or protection. With introduction of Senate Bill 910, proposing modifications to Missouri’s adult abuse and neglect statutes, this is one of those times.

I urge you to read SB 910.  Here’s a summary, but I encourage you to read the bill’s actual language.  And, after you do, I encourage you to share with me what you think.  Your LeadingAge Missouri Advocacy Committee shared informed, thoughtful points of view, but the members divide in some respects, so gaining more perspectives from more members is important. Please email me what you think about any provision or the overall bill – billbates@leadingagemissouri.org.

If SB 910 becomes law, all long-term care facilities will be required to maintain a minimum $1million liability insurance policy (or segregate $1 million in reserves) to covers losses from negligent or criminal acts of abuse, neglect, or wrongful death of a resident.  And, if you don’t maintain the required insurance, you risk having your license revoked by DHSS.  

Many of you carry general liability policies or umbrella policies for at least $1 million.  Do your policies insure criminal and civil elder abuse?  We need to know if this requirement is something you can live with or is a big burden.  Please let me know.  

Also let me know what you think about SB 910 making it a felony for a senior care provider to knowingly act, or knowingly fail to act, in a way that results in a substantial risk to an older adult’s life, body or health.  Currently, anyone may be criminally charged for such action or inaction, but it’s a misdemeanor for ordinary citizens.  The bill sponsor is attempting  to raise a care provider’s conscious misconduct from misdemeanor to felony, just as current law makes it a felony for a long-term care administrator to knowingly conceal serious abuse or neglect.  While thoughtful people may disagree about whether it’s reasonable, for parity or otherwise, for care providers who knowingly commit serious physical elder abuse to be charged with a felony, we wonder about the workforce impact.   Will felony exposure for knowing acts or omissions make attracting and retaining care providers harder?  What do you think?

In addition, what do you think about SB 910 requiring DHSS to display a new abuse and neglect icon – similar to CMS’ “red hand” – next to a provider’s listing on DHSS’ website for 36 months when there is a substantiated finding of abuse or neglect by the provider? Clearly, this expands to state-regulated assisted living facilities the same spotlight CMS requires for nursing homes tagged for abuse and neglect.  We are troubled by imprecise language and definitions surrounding this proposal, but if we can improve the language and tighten the requirement (making it clearer and fairer), what else bothers you about this proposal.

The sponsor of SB 910 is a reasonable legislator. The Senator understands any new provider requirements further burden an already overregulated field. Accordingly, he is soliciting ideas for how he might unburden us. We met with the Senator to discuss his bill. His perspective is shaped by personal experiences with both high quality and lower quality senior care providers.  He earnestly wants to improve senior care and protect residents. To date, we have shared perceived deficiencies in his draft legislation and offered several ideas to “unburden” senior care providers, but we remain neutral on his bill. We will continue to engage with the Senator and participate in the legislative process. Help us represent our field better by sharing your perspective.

Yours in service,