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Bill Summary · HB 2464

Purpose of the bill

HB 2464 would create the Missouri Terminally Ill Patient Dignity and Care Act. The core aim is to establish standardized care protocols for terminally ill patients in hospitals, improve pain and symptom management, ensure timely responses to patient and family needs, provide patient rights protections, and create oversight mechanisms to monitor compliance and deter neglect or retaliation.

Key provisions and changes

  • Definitions

    • Establishes terms for the act, including “hospital,” “neglect,” and “terminally ill patient” (death within six months as certified in writing by a physician).

  • Hospital care protocols (197.1066)

    • Hospitals must adopt and enforce care protocols for terminally ill patients.
    • Protocols must ensure:
    • Pain and symptom management are initiated and evaluated per best practice standards.
    • Response to requests for assistance (including via call light, nurse referral, or family advocate) within 30 minutes unless clinically justified.
    • No patient is left unattended while in pain or distress.
    • Patients or designated representatives are informed of protocols, offered the opportunity to designate a family member or advocate to monitor care, and given clear instructions on how to file neglect complaints.
    • Hospitals must document for each terminally ill patient:
    • Physician certification of terminal illness.
    • Interventions for pain/symptom relief and timing.
    • Time between requests/call activations and staff response.
    • Any neglect or delay complaints and how they were resolved.

  • Terminal care ombudsman (197.1069)

    • Each hospital must designate a terminal care ombudsman to:
    • Receive and review complaints about neglect or delays.
    • Track response times and protocol compliance.
    • Report annually to the Department of Health and Senior Services (DHSS) on compliance statistics.
    • Ombudsman can be an existing employee and must have access to care records and response-time logs; can recommend internal corrective actions.

  • Department oversight and enforcement (197.1072)

    • DHSS will promulgate implementing rules.
    • DHSS may investigate verified neglect complaints; can impose sanctions for substantial violations, including:
    • Corrective orders with defined timelines.
    • Civil penalties up to $5,000 per violation.
    • Suspension or revocation of a hospital license.
    • Public annual reports: hospitals’ compliance data and aggregate data on response times and complaints will be posted on the DHSS website, with patient confidentiality protected.

  • Employee protection against retaliation (197.1075)

    • Hospitals may not retaliate against employees who in good faith report neglect or delays.
    • Violations grant the employee reinstatement, back pay (double the amount lost), and interest on back pay (1% over the prime rate).

  • Patient/representative rights and notice (197.1078)

    • Terminally ill patients or their designated representatives have the right to:
    • Be informed of rights in a timely manner.
    • File complaints with the terminal care ombudsman and DHSS without fear of reprisal.
    • Have a designated family member or advocate present to intervene for comfort and care.
    • Hospitals must post a notice of these rights in each inpatient unit, including ombudsman contact information and DHSS complaint procedures.

  • Effective date

    • The act’s provisions take effect on January 1, 2027 (delayed effective date).

Who would be affected

  • Hospitals licensed to provide inpatient care in Missouri.
  • Terminally ill patients and their designated representatives or advocates.
  • Hospital staff and administrators, including designated terminal care ombudsmen.
  • The Missouri Department of Health and Senior Services, which would oversee rulemaking, investigations, sanctions, and public reporting.

Procedural and timeline aspects

  • Enactment subject to a delayed effective date: January 1, 2027.
  • Department of Health and Senior Services would promulgate implementing rules and may conduct investigations of alleged neglect.
  • Hospitals must maintain and report specific documentation and annual compliance data.
  • Public-facing reporting by DHSS to enhance transparency and accountability.

Summary

HB 2464 creates a comprehensive framework to codify dignity and care standards for terminally ill patients in Missouri hospitals. It mandates care protocols focused on pain relief, timely assistance, and patient engagement; introduces a hospital terminal care ombudsman and annual compliance reporting; provides enforcement tools and penalties for substantiated neglect; protects employees who report concerns; and guarantees patient rights and accessible complaint procedures, all with a January 2027 start date.

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

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