Bill
HB 3379
Implements stricter protections for vulnerable adults by expanding mandatory reporting, background checks, and disqualification lists across in-home and facility care settings.
HB 3379 (Missouri, 2026) — Summary of Abuse or Neglect of Vulnerable Persons Provisions
Purpose and scope
- Repeals 13 current statutes and replaces them with 16 new sections addressing abuse or neglect of vulnerable adults across various care settings.
- Focuses on adult day care programs, in-home services, home health, and licensed facilities (residential care, assisted living, intermediate care, skilled nursing).
- Establishes definitions, reporting duties, investigative processes, penalties, and background-check requirements to strengthen protection for adults who are functionally impaired or otherwise vulnerable.
Key definitions (selected)
- Abuse: physical, sexual, emotional injury or harm, including financial exploitation.
- Neglect: failure to provide reasonable and necessary services, creating imminent danger or a substantial risk of death/serious harm.
- Financial exploitation: unlawful or improper taking or misuse of a participant’s or resident’s property or funds.
- Undue influence: using authority to unduly advantage a vulnerable adult, including fiduciary abuse.
- Eligible adult / resident / participant: adults 60+, or younger adults with disabilities who need care or services.
- Protective services: state or private services needed for essential human needs.
Main provisions by setting
1) Adult Day Care Programs (192.2200, 192.2256, 192.2257)
- Mandatory reporting: professionals with reasonable cause (e.g., doctors, nurses, social workers, law enforcement, etc.) must report suspected abuse or neglect of a participant to the department.
- Reporting content: program name, participant name, nature of abuse/neglect, complainant, and additional relevant information.
- Penalties: failure to report within a reasonable time is a Class A misdemeanor; concealing abuse or neglect resulting in death or serious injury can be a Class E felony.
- Investigations: the department must begin an investigation within 24 hours; notify next of kin unless the alleged perpetrator is the subject.
- Confidentiality: reports and investigation records are confidential.
- Immunity: reporters and witnesses have civil/criminal immunity absent negligence, bad faith, or malicious intent; false elder abuse reports are a crime.
- Notifications: recipients of reports are informed of receipt and progression; elder abuse substantiated reports are forwarded to law enforcement and prosecutors.
- Employee disqualification: a list of disqualified employees is maintained; state can share this list with certain entities (licensees, funders, licensing bodies, background check providers, etc.).
2) Misappropriation of Participant Property (192.2257)
- Reporting required for misappropriation of a participant’s property or funds.
- Investigations are conducted; if probable misappropriation is found, referral to department director for action.
- Confidentiality and immunity apply as above.
3) In-Home Services and Home Health (192.2400, 192.2475)
- Expanded abuse/neglect definitions include in-home services contexts.
- Mandatory reporting by in-home services providers and personnel; also allows any person with reasonable cause to report.
- Temporary care and protection: courts may grant ex parte orders for temporary protection up to 30 days if immediate action is needed.
- Quality assurance: providers must implement a supervision/quality assurance process including random visits to verify compliance and record-keeping accuracy.
- Financial penalties: supervisory providers may face penalties if a guilty supervisor fails to report abuse.
- Employee disqualification: a detailed list of disqualified employees; sharing of the list with licensed entities and background-check providers.
- Safe-at-home evaluation (to guide care levels): nursing involvement to determine appropriate services; flexible use of other departments’ expertise for plans of service; potential mental health referrals.
- Nurse visits: at least two annual nurse visits to assess conditions; reimbursement rules specified.
- Client rights: clients must be informed of rights at initial evaluation; complaints process established for non-abuse concerns as well.
4) Background Checks and Hiring (192.2490, 192.2495)
- Hiring/criminal background checks: providers must screen applicants for state and national criminal history for roles with patient/resident contact.
- Disqualification list checks: cross-check against the department’s disqualification list.
- Penalties: individuals who knowingly fail to disclose criminal history or who knowingly hire a disqualified person face Class A misdemeanors.
- Private background checks: providers may use private investigators; costs limited (up to $5 per nationwide check) subject to appropriations.
- Good cause waivers: the department can waive certain hiring restrictions for good cause.
5) Employee Disqualification List (192.2490)
- Due process: employees notified in writing if placed on the list; timeframes for challenges and hearings; hearings may be by telephone or in person.
- Record-keeping: records of final determinations preserved; access restrictions apply; certain entities may request the list for licensure and safety purposes.
- Removal: a one-time-per-12-months request to remove a name with criteria showing no future risk; director’s decision is not subject to appeal.
6) Public Records and Confidentiality (192.2500)
- Investigation records and disciplinary notes are not public records; disclosure is limited to protect privacy, with exceptions for prevention, subpoenas, licensing reviews, and background-check dissemination.
Procedural and timeline aspects
- Investigations: must begin within 24 hours of report; notification timelines include five working days to acknowledge receipt.
- Temporary protection: courts may grant ex parte orders up to 30 days for immediate protection in in-home and facility settings.
- Reporting hierarchy: department of Health and Senior Services (DHSS) leads investigations; law enforcement involvement for substantiated elder abuse.
- Confidentiality: strong protections for complainants, patients, and records, with stated exemptions for specific regulatory or licensure actions.
- Penalties: broad coding of misdemeanor and felony penalties for noncompliance, including reporting failures and misappropriation/fraud.
Impact and who is affected
- Affects adults receiving care in adult day programs, in-home services, home health, and licensed Missouri facilities (residential care, assisted living, intermediate care, skilled nursing).
- Expands mandatory reporting duties for a wide range of professionals and the general public.
- Introduces stricter background-check and employee-disqualification processes to reduce risk of abuse or misappropriation.
- Creates or enhances mechanisms for temporary protective care orders and quality assurance measures.
- Enhances information sharing about disqualified individuals among licensed providers and regulatory bodies, while preserving confidentiality where appropriate.
Notes
- The bill reorganizes and modernizes regulatory language across elder/dependent-care sectors, aligning definitions (abuse, neglect, financial exploitation, undue influence) and creating integrated reporting, investigation, and enforcement structures.
- Specific fee structures: license fees up to $600 (graduated by capacity/duration); Medicaid/Medicare certification up to $1,000 annually; nurse visit reimbursements tied to statewide care costs; penalties described for noncompliance.
Compiled from official sources — confirm details with the bill’s official record.
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