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

SECOND REGULAR SESSION
HOUSE BILL NO. 2516
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE BYRNES.
5997H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o repeal section 630.140, RSMo, and to enact in lieu thereof three new sections relating to
mental health patients.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Section 630.140, RSMo, is repealed and three new sections enacted in lieu
2 thereof, to be known as sections 630.140, 632.180, and 632.322, to read as follows:
630.140. 1. Information and records compiled, obtained, prepared or maintained by
2 the residential facility , mental health program operated, funded or licensed by the department
3 or otherwise, specialized service, or by any mental health facility or mental health program in
4 which people may be civilly detained pursuant to chapter 632 in the course of providing
5 services to either voluntary or involuntary patients, residents or clients shall be confidential.
6 2. The facilities or programs shall disclose information and records including
7 medication given, dosage levels, and individual ordering such medication to the following
8 upon their request:
9 (1) The parent of a minor patient, resident or client;
10 (2) The guardian or other person having legal custody of the patient, resident or
11 client;
12 (3) The attorney of a patient, resident or client who is a ward of the juvenile court, an
13 alleged incompetent, an incompetent ward or a person detained under chapter 632, as
14 evidenced by court orders of the attorney's appointment;
15 (4) An attorney or personal physician as authorized by the patient, resident or client;
16 (5) Law enforcement of ficers and agencies, information about patients, residents or
17 clients committed pursuant to chapter 552, but only to the extent necessary to carry out the
EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.
18 responsibilities of their of fice, and all such law enforcement of ficers shall be obligated to
19 keep such information confidential;
20 (6) The entity or agency authorized to implement a system to protect and advocate the
21 rights of persons with developmental disabilities under the provisions of 42 U.S.C. Sections
22 15042 to 15044. The entity or agency shall be able to obtain access to the records of a person
23 with developmental disabilities who is a client of the entity or agency if such person has
24 authorized the entity or agency to have such access; and the records of any person with
25 developmental disabilities who, by reason of mental or physical condition is unable to
26 authorize the entity or agency to have such access, if such person does not have a legal
27 guardian, conservator or other legal representative, and a complaint has been received by the
28 entity or agency with respect to such person or there is probable cause to believe that such
29 person has been subject to abuse or neglect. The entity or agency obtaining access to a
30 person's records shall meet all requirements for confidentiality as set out in this section;
31 (7) The entity or agency authorized to implement a system to protect and advocate the
32 rights of persons with mental illness under the provisions of 42 U.S.C. Section 10801 et seq.,
33 as amended, shall be able to obtain access to the records of a patient, resident or client who by
34 reason of mental or physical condition is unable to authorize the system to have such access,
35 who does not have a legal guardian, conservator or other legal representative and with respect
36 to whom a complaint has been received by the system or there is probable cause to believe
37 that such individual has been subject to abuse or neglect. The entity or agency obtaining
38 access to a person's records shall meet all requirements for confidentiality as set out in this
39 section. The provisions of this subdivision shall apply to a person who has a significant
40 mental illness or impairment as determined by a mental health professional qualified under
41 the laws and regulations of the state; [ and ]
42 (8) T o individuals, designated by the department of mental health as community
43 mental health liaisons, for the purpose of coordination of care and services ; and
44 (9) A qualified family advocate entitled to the re cords under section 632.322 .
45 3. The facilities or services may disclose information and records under any of the
46 following:
47 (1) As authorized by the patient, resident or client;
48 (2) T o persons or agencies responsible for providing health care services to such
49 patients, residents or clients as permitted by the federal Health Insurance Portability and
50 Accountability Act of 1996 (HIP AA), as amended;
51 (3) T o the extent necessary for a recipient to make a claim or for a claim to be made
52 on behalf of a recipient for aid or insurance;
53 (4) T o qualified personnel for the purpose of conducting scientific research,
54 management audits, financial audits, program evaluations or similar studies; provided, that
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55 such personnel shall not identify , directly or indirectly , any individual patient, resident or
56 client in any report of such research, audit or evaluation, or otherwise disclose patient,
57 resident or client identities in any manner;
58 (5) T o the courts as necessary for the administration of chapter 21 1, 475, 552, or 632;
59 (6) T o law enforcement of ficers or public health officers, but only to the extent
60 necessary to carry out the responsibilities of their of fice, and all such law enforcement and
61 public health of ficers shall be obligated to keep such information confidential;
62 (7) Pursuant to an order of a court or administrative agency of competent jurisdiction;
63 (8) T o the attorney representing petitioners, but only to the extent necessary to carry
64 out their duties under chapter 632;
65 (9) T o the department of social services or the department of health and senior
66 services as necessary to report or have investigated abuse, neglect, or rights violations of
67 patients, residents, or clients;
68 (10) T o a county board established pursuant to sections 205.968 to 205.973, but only
69 to the extent necessary to carry out their statutory responsibilities. The county board shall not
70 identify , directly or indirectly , any individual patient, resident or client;
71 (1 1) T o parents, legal guardians, treatment professionals, law enforcement of ficers,
72 and other individuals who by having such information could mitigate the likelihood of a
73 suicide. The facility treatment team shall have determined that the consumer's safety is at
74 some level of risk;
75 (12) T o individuals, designated by the department of mental health as community
76 mental health liaisons, for the purpose of coordination of care and services.
77 4. The facility or program shall document the dates, nature, purposes and recipients of
78 any records disclosed under this section and sections 630.145 and 630.150.
79 5. The records and files maintained in any court proceeding under chapter 632 shall
80 be confidential and available only to the patient, the patient's attorney , guardian, or , in the
81 case of a minor , to a parent or other person having legal custody of the patient, to the
82 petitioner and the petitioner's attorney , and to the Missouri state highway patrol for reporting
83 to the National Instant Criminal Background Check System (NICS), and to individuals
84 designated by the department of mental health as community mental health liaisons for the
85 purpose of coordination of care and services. In addition, the court may order the release or
86 use of such records or files only upon good cause shown, and the court may impose such
87 restrictions as the court deems appropriate.
88 6. Nothing contained in this chapter shall limit the rights of discovery in judicial or
89 administrative procedures as otherwise provided for by statute or rule.
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90 7. The fact of admission of a voluntary or involuntary patient to a mental health
91 facility under chapter 632 may only be disclosed as specified in subsections 2 and 3 of this
92 section.
632.180. 1. This section and section 632.322 shall be known and may be cited as
2 the "Family Mental Health Advocacy and Patient Rights Act".
3 2. All individuals admitted, detained, or evaluated under this chapter shall have
4 the right to:
5 (1) Dignity and humane tr eatment;
6 (2) A re sponsible advocate when unable to self-advocate;
7 (3) Clear explanation of diagnosis, tr eatment, and medication;
8 (4) Participation in car e decisions to the fullest extent possible;
9 (5) Safe and coordinated discharge planning with outpatient pro viders and
10 household family members when applicable; and
11 (6) A rapid appeal proc ess for involuntary detention, denial of family access, and
12 pr ematur e discharge.
13 3. Mental health facilities shall post these rights in a conspicuous location and
14 pr ovide them in writing at the time of evaluation or admission.
15 4. (1) Compliance with this section shall be r equir ed under the licensing
16 r egulations applicable to mental health facilities, and a violation of this section shall be
17 gr ounds for any administrative action authorized for violations of such r egulations.
18 (2) The department of mental health shall investigate any complaints alleging
19 violations of the rights described in this section and issue orders for correct ive actions or
20 impose any other appr opriate administrative sanctions for such violations.
21 5. The department of mental health shall pr omulgate rules to implement this
22 section. Any rule or portion of a rule, as that term is defined in section 536.010, that is
23 cr eated under the authority delegated in this section shall become effective only if it
24 complies with and is subject to all of the pr ovisions of chapter 536 and, if applicable,
25 section 536.028. This section and chapter 536 are nonseverable and if any of the powers
26 vested with the general assembly pursuant to chapter 536 to revi ew , to delay the
27 effective date, or to disappr ove and annul a rule are subsequently held unconstitutional,
28 then the grant of rulemaking authority and any rule pro posed or adopted after August
29 28, 2026, shall be invalid and void.
632.322. 1. As used in this section, the following terms mean:
2 (1) "Capacity", the ability of an individual to understand tr eatment information,
3 communicate decisions, and act in the individual's own best intere sts;
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4 (2) "Incapacitated", the temporary inability of an individual to understand
5 tr eatment information, communicate decisions, and act in the individual's own best
6 inter ests;
7 (3) "Qualified family advocate", an individual who:
8 (a) Is eighteen years of age or older;
9 (b) Is re lated to the r espondent within the first degre e of consanguinity or
10 affinity;
11 (c) Has re sided in the same household as the r espondent for a period of at least
12 thirty consecutive days before the date the res pondent was detained for evaluation and
13 tr eatment at a mental health facility; and
14 (d) Is not subject to any active order of pro tection or substantiated finding of
15 abuse.
16 2. A r ebuttable pres umption that an individual is incapacitated shall
1 7 automatically apply upon:
18 (1) Detention of the individual for evaluation and trea tment at a mental health
19 facility under section 632.305; or
20 (2) A finding that the individual meets the criteria for emergency psychiatric
21 evaluation due to risk of harm to self or others.
22 3. Notwithstanding any other pr ovision of law , any detention of a res pondent for
23 evaluation and trea tment under section 632.305 shall automatically entitle a qualified
24 family advocate to the access and participation described in subsection 4 of this section
25 without requ iring additional capacity findings until reeva luation of the res pondent.
26 Only one individual shall be designated as the qualified family advocate for the
27 r espondent. If mor e than one family member meets the definition of qualified family
28 advocate, the family members shall select one individual to serve as the qualified family
29 advocate for the res pondent.
30 4. Upon detention of the r espondent, the qualified family advocate for the
31 r espondent shall be granted:
32 (1) Access to tr eatment information necessary for safety , medication decisions,
33 discharge planning, and continuity of care; and
34 (2) Participation in tr eatment team meetings, including car e plans, medication
35 changes, risk assessments, and discharge or transfer decisions.
36 5. Upon documented res toration of capacity of the res pondent, the qualified
37 family advocate's access and participation under this section shall end, pr ovided that the
38 qualified family advocate shall r eceive notification befor e the r espondent's rel ease fr om
39 detention.
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40 6. A mental health facility shall not implement a blanket policy pr ohibiting
41 family participation or cite confidentiality laws as the basis for denying the access or
42 participation described in this section when the conditions of this section have been
43 satisfied.
44 7. (1) Compliance with this section shall be r equir ed under the licensing
45 r egulations applicable to mental health facilities, and a violation of this section shall be
46 gr ounds for any administrative action authorized for violations of such r egulations.
47 (2) The department of mental health shall investigate any complaints alleging
48 violations of this section and issue orders for corr ective actions or impose any other
49 appr opriate administrative sanctions for such violations.
50 8. The department of mental health shall pr omulgate rules to implement this
51 section. Any rule or portion of a rule, as that term is defined in section 536.010, that is
52 cr eated under the authority delegated in this section shall become effective only if it
53 complies with and is subject to all of the pr ovisions of chapter 536 and, if applicable,
54 section 536.028. This section and chapter 536 are nonseverable and if any of the powers
55 vested with the general assembly pursuant to chapter 536 to revi ew , to delay the
56 effective date, or to disappr ove and annul a rule are subsequently held unconstitutional,
57 then the grant of rulemaking authority and any rule pro posed or adopted after August
58 28, 2026, shall be invalid and void.
✔
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