Currently five states – Illinois, New Mexico, Oklahoma, Texas and Washington have laws requiring long term facilities to allow residents to request monitoring devices in resident rooms. Utah currently has legislation under consideration to allow monitoring, but the Utah legislation restricts the use of such devices to assisted living communities. Now, Missouri is looking at implementing legislation to add Missouri to the ranks of states allowing electronic monitoring in nursing homes.
At present, three bills have been introduced in the Missouri House by Representative Andrew McDaniel. To date, none of these bills have been assigned to a committee or set for hearing.
Here’s a brief summary of some of the significant requirements contained in the proposed legislation:
House Bill No. 1652 (the “Authorized Electronic Monitoring in Long-Term Care Facilities Act”) closely resembles the Illinois Electronic Monitoring in Long Term Care Facilities Act, which took effect on 1/1/16. This proposed legislation would require consent from the resident or its surrogate as well as the resident’s roommate, if any, before an electronic monitoring device may be placed in the resident’s room. Other requirements include the resident bears the costs including the device, internet connection, installation, maintenance, and removal but the facility may not charge a fee for the cost of electricity for the device. In addition, the facility would be responsible for placing signs outside the entrance of the facility and the resident’s room where the device is located to provide notice that the electronic monitoring device is present. The device must be placed in a conspicuous spot in the resident’s room. The resident may place restrictions or conditions on the use of the device, and may withdraw consent any time. Other provisions include keeping copies of the consent in residents’ clinical record, potential violations including committing a misdemeanor offense if the use is hampered, obstructed, tampered with, without the permission of the person who consented for use of the device. Privacy is also addressed, giving the facility civil and criminal immunity for inadvertent or intentional disclosure of a recording or violation of a resident’s right to privacy arising out of the monitoring. There is a prohibition against retaliation or discrimination against any resident consenting to the use of a monitoring device as well as preventing the installation or use of such device when notice and consent is provided.
House Bill No. 1654 (the “Patient Monitoring Care Act”) and House Bill No. 1655 (the “Veterans’’ Home Resident Monitoring Care Act”) are very similar with the exception of the facilities to which they apply. The Patient Monitoring Act applies to the following types of facilities: residential care facility, assisted living facility, intermediate care facility, or skilled nursing facility; whereas, the Veterans’ Home Resident Monitoring Care Act applies to any state veterans’’ home. H.B. 1654 and H.B. 1655 provide fewer details as to implementation, with the expectation that amendments could provide further guidance if enacted. These proposed Acts also allow authorization for installation and use of a monitoring device upon the facility receiving notice and resident consent, with the resident responsible for all costs for installation. A significant difference with these Acts is the requirement that at the time of admission, the facility would be required to offer the patient the option to have a monitoring device, and the facility must keep a record of the patient’s authorization or choice not to have a monitoring device and make it accessible to the state ombudsman. As required in H.B. 1652, the consent may be withdrawn, the facility is released from liability for violation of the patient’s right to privacy, provides prohibitions against discrimination or retaliation against a patient because of the choice to authorize installation of a monitoring device. Unlike H.B. 1652, which provides interference with a device a potential misdemeanor; H.B. 1654 and 1655 make intentional hampering, obstructing, tampering with, or destroying a monitoring device or a recording from such device, is a class D or E felony.
Last year, a similar bill was proposed in the Missouri House and was sent to the Health Committee, where it stalled due to concerns related to privacy and potential for “frivolous lawsuits” related to provision of care. We will keep a watch on these newly proposed Acts and provide updates on their status.
By Denise Bloch