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HB 2516

Establishes the "Family Mental Health Advocacy and Patient Rights Act"

2026 Regular Session Introduced by Tricia Byrnes

Establishes patient rights and a qualified family advocate to participate in treatment decisions for those detained or evaluated for mental health treatment.

Placed Back on Formal Perfection Calendar (H)
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Bill Summary · HB 2516

HB 2516 (2026) — Family Mental Health Advocacy and Patient Rights Act (Missouri)

A concise, nonpartisan overview of the bill’s purpose, provisions, affected parties, and timeline considerations.

Purpose and intent

  • Establishes the “Family Mental Health Advocacy and Patient Rights Act.”
  • Aims to protect and promote the rights of individuals admitted, detained, or evaluated for mental health treatment.
  • Introduces a framework for family involvement through a designated “qualified family advocate” who would have access to information and participation in treatment decisions during detention for evaluation and treatment.

Key provisions

New rights and roles

  • Section 632.180 establishes a set of explicit rights for individuals admitted, detained, or evaluated under Chapter 632, including:
    • Dignity and humane treatment.
    • A responsible advocate when the patient cannot self-advocate.
    • Clear explanation of diagnosis, treatment, and medication.
    • Participation in care decisions to the fullest extent possible.
    • Safe and coordinated discharge planning with outpatient providers and family when applicable.
    • A rapid appeals process for involuntary detention, denial of family access, and premature discharge.
  • Facilities must post these rights conspicuously and provide them in writing at admission/evaluation.
  • The Department of Mental Health (DMH) would investigate complaints and impose administrative sanctions as needed.

Qualified family advocate (QFA)

  • A new designation: a qualified family advocate who may access treatment information and participate in treatment team meetings.
  • Eligibility criteria (defined in Section 632.322):
    • 18 years or older.
    • Related within the first degree of consanguinity or affinity.
    • Has resided in the same household as the respondent for at least 30 consecutive days before detention.
    • Not subject to an active order of protection or substantiated finding of abuse.
  • Automatic entitlement to QFA access upon detention for evaluation and treatment (under Section 632.322) without requiring separate capacity findings, until the respondent’s capacity is restored.
  • Only one family member may be designated as QFA; if multiple qualify, family members select one.

Access, participation, and limitations

  • Upon detention, the QFA is granted:
    • Access to treatment information necessary for safety, medication decisions, discharge planning, and continuity of care.
    • Participation in treatment team meetings (care plans, medication changes, risk assessments, discharge/transfer decisions).
  • After capacity is restored, the QFA’s access/participation ends, with notification required before release.
  • Facilities may not implement blanket policies prohibiting family participation or rely solely on confidentiality laws to deny access when the statute’s conditions are met.

Compliance and rulemaking

  • Compliance with these provisions falls under mental health facility licensing regulations.
  • Violations may trigger administrative actions.
  • DMH authorized to promulgate implementing rules (with standard rulemaking protections and nonseverability tied to Chapter 536 provisions).

Who is affected

  • Mental health facilities and programs regulated under Missouri law (public and private) that evaluate, detain, or treat individuals under Chapter 632.
  • Individuals admitted, detained, or evaluated for mental health treatment and their families.
  • Potentially affected state agencies:
    • Department of Mental Health (DMH) – enforcement, investigations, rulemaking.
    • Departments sharing licensing responsibilities (e.g., Department of Health and Senior Services) due to overlapping regulation.
    • The courts and related offices may see procedural impacts through rights and potential rapid appeal processes.

Procedural and timeline notes

  • Effective date: The bill text indicates rules from DMH would be promulgated under the standard rulemaking process. As with many administrative rules, implementation would follow after final passage and rule adoption, subject to Chapter 536 (Administrative Procedures).
  • The fiscal note anticipates notable general revenue costs and 35 FTEs for DMH to implement and administer the program:
    • Estimated net general revenue impact: roughly $4.65 million in FY 2027, increasing to about $4.84 million in FY 2029 (cumulative could exceed these figures in practice).
    • Additional IT and administrative costs, including a new complaint-management IT system (contracted) estimated initially around $188k in FY27 plus ongoing support.
  • The act is not federally mandated and does not duplicate existing programs, but it creates a new framework that may interact with federal confidentiality laws (HIPAA) and existing guardianship statutes.

Fiscal and administrative considerations

  • DMH would bear the primary cost burden; estimates include personnel, benefits, equipment, and IT infrastructure.
  • Potential impacts on local jurisdictions and OSCA (courts) due to new rights, patient access, and any rapid appeal mechanisms; however, some costs are not fully quantified by the fiscal notes.
  • Some commenters express constitutional and privacy concerns (e.g., automatic capacity presumptions and guaranteed family access) that could prompt revisions if the bill advances.

This summary presents the bill’s core aims and provisions, highlighting the new rights framework, the role and criteria for a qualified family advocate, and the anticipated fiscal and regulatory implications. If you’d like, I can provide a side-by-side comparison with current Missouri law or draft a one-page briefing for policymakers.

Compiled from official sources — confirm details with the bill’s official record.

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