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SECOND REGULAR SESSION
HOUSE COMMITTEE SUBSTITUTE FOR
HOUSE BILL NOS. 3434, 3460 & 2628
103RD GENERAL ASSEMBL Y
7325H.03C JOSEPH ENGLER, Chief Clerk
AN ACT
T o repeal section 197.135, RSMo, and to enact in lieu thereof three new sections relating to
statewide sexual assault response.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Section 197.135, RSMo, is repealed and three new sections enacted in lieu
2 thereof, to be known as sections 191.713, 197.135, and 595.410, to read as follows:
191.713 . 1. This section shall be known and may be cited as the "Compassionate
2 Assistance for Rape Emergencies (CARE) Act".
3 2. As used in this section, unless the context clearly indicates otherwise, the
4 following terms mean:
5 (1) "Emergency care to sexual assault victims", medical examinations,
6 pr ocedur es, or services provi ded at a hospital or health car e facility to a sexual
7 assault victim following an alleged sexual assault;
8 (2) "Emergency contraception", any drug or device appr oved by the U.S. Food
9 and Drug Administration that preven ts pr egnancy after sexual inter course. The term
10 "emergency contraception" shall not include any medication appr oved by the U.S. Food
11 and Drug Administration to terminate a pr egnancy;
12 (3) "Health care facility", any urgent care center or facility that offers tr eatment
13 for patients during normal business, after business, or weekend hours and that is
14 affiliated with a licensed hospital;
15 (4) "Sexual assault", includes rape in the first degr ee, as described in section
16 566.030; rape in the second degr ee, as described in section 566.031; statutory rape in the
17 first degr ee and attempt to commit statutory rape in the first degr ee, as described in
18 section 566.032; statutory rape in the second degr ee, as described in section 566.034;
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.
19 sodomy in the first degre e, as described in section 566.060; sodomy in the second degr ee,
20 as described in section 566.061; statutory sodomy in the first degr ee and attempt to
21 commit statutory sodomy in the first degr ee, as described in section 566.062; and
22 statutory sodomy in the second degree , as described in section 566.064;
23 (5) "Sexual assault victim", a person who is alleged to have been sexually
24 assaulted and is pr esented as a patient.
25 3. It shall be the standard of car e for any hospital or any health care facility that
26 pr ovides emergency care to sexual assault victims to:
27 (1) Orally inform each sexual assault victim of the option to be pr ovided
28 emergency contraception at the hospital or health care facility;
29 (2) Pr ovide the complete r egimen of emergency contraception immediately at the
30 hospital or health care facility to each sexual assault victim who requ ests it; and
31 (3) Pr ovide sexually transmitted infection scr eening and trea tment to the sexual
32 assault victim.
33 4. The department of health and senior services shall promulg ate all rules and
34 r egulations to implement the pr ovisions of this section. Any rule or portion of a rule, as
35 that term is defined in section 536.010, that is creat ed under the authority delegated in
36 this section shall become effective only if it complies with and is subject to all of the
37 pr ovisions of chapter 536 and, if applicable, section 536.028. This section and chapter
38 536 are nonseverable and if any of the powers vested with the general assembly
39 pursuant to chapter 536 to revi ew , to delay the effective date, or to disappr ove and annul
40 a rule are subsequently held unconstitutional, then the grant of rulemaking authority
41 and any rule prop osed or adopted after August 28, 2026, shall be invalid and void.
197.135. 1. Beginning January 1, 2023, or no later than six months after the
2 establishment of the statewide telehealth network under section 192.2520, whichever is later ,
3 any hospital licensed under this chapter shall perform a forensic examination using an
4 evidentiary collection kit upon the request and consent of the victim of a sexual of fense, or
5 the victim's guardian, when the victim is at least fourteen years of age. In the case of minor
6 consent, the provisions of subsection 2 of section 595.220 shall apply . V ictims under fourteen
7 years of age shall be referred, and victims fourteen years of age or older but less than eighteen
8 years of age may be referred, to a SAFE CARE provider , as such term is defined in section
9 334.950, for medical or forensic evaluation and case review . Nothing in this section shall be
10 interpreted to preclude a hospital from performing a forensic examination for a victim under
11 fourteen years of age upon the request and consent of the victim or victim's guardian, subject
12 to the provisions of section 595.220 and the rules promulgated by the department of public
13 safety .
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14 2. (1) An appropriate medical provider , as such term is defined in section 595.220,
15 shall perform the forensic examination of a victim of a sexual of fense. The hospital shall
16 ensure that any provider performing the examination has received training conducting such
17 examinations that is, at a minimum, equivalent to the training of fered by the statewide
18 telehealth network under subsection 4 of section 192.2520. Nothing in this section shall
19 require providers to utilize the training of fered by the statewide telehealth network, as long as
20 the training utilized is, at a minimum, equivalent to the training of fered by the statewide
21 telehealth network.
22 (2) If the provider is not a sexual assault nurse examiner (SANE), or another similarly
23 trained physician or nurse, then the hospital shall utilize telehealth services during the
24 examination, such as those provided by the statewide telehealth network, to provide guidance
25 and support through a SANE, or other similarly trained physician or nurse, who may observe
26 the live forensic examination and who shall communicate with and support the onsite
27 provider with the examination, forensic evidence collection, and proper transmission and
28 storage of the examination evidence.
29 3. The department of health and senior services may issue a waiver of the telehealth
30 requirements of subsection 2 of this section if the hospital demonstrates to the department, in
31 writing, a technological hardship in accessing telehealth services or a lack of access to
32 adequate broadband services suff icient to access telehealth services. Such waivers shall be
33 granted sparingly and for no more than a year in length at a time, with the opportunity for
34 renewal at the department's discretion.
35 4. The department shall waive the requirements of this section if the statewide
36 telehealth network established under section 192.2520 ceases operation, the director of the
37 department of health and senior services has provided written notice to hospitals licensed
38 under this chapter that the network has ceased operation, and the hospital cannot, in good
39 faith, comply with the requirements of this section without assistance or resources of the
40 statewide telehealth network. Such waiver shall remain in ef fect until such time as the
41 statewide telehealth network resumes operation or until the hospital is able to demonstrate
42 compliance with the provisions of this section without the assistance or resources of the
43 statewide telehealth network.
44 5. The provisions of section 595.220 shall apply to :
45 (1) The reimbursement of the reasonable costs of the examinations and medical
46 tr eatment including, but not limited to, emergency contraception; and
47 (2) The provision of the evidentiary collection kits.
48 6. No individual hospital shall be required to comply with the provisions of this
49 section and section 192.2520 unless and until the department provides such hospital with
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50 access to the statewide telehealth network for the purposes of mentoring and training services
51 required under section 192.2520 without char ge to the hospital.
52 7. A specialty hospital shall be considered exempt from the provisions of this section
53 and section 192.2520 if such hospital has a policy for the transfer of a victim of a sexual
54 of fense to an appropriate hospital with an emer gency department. As used in this section,
55 "specialty hospital" shall mean a hospital licensed under this chapter and designated by the
56 department as something other than a general acute care hospital.
595.410. 1. There is hereb y established the "Missouri Statewide Sexual Assault
2 Response T ask For ce", which shall be composed of the following members:
3 (1) The following four members of the general assembly:
4 (a) T wo members of the senate, with one member to be appointed by the
5 pr esident pr o tempor e of the senate and one member to be appointed by the minority
6 floor leader of the senate; and
7 (b) T wo members of the house of r epresent atives, with one member to be
8 appointed by the speaker of the house of rep res entatives and one member to be
9 appointed by the minority floor leader of the house of repr esentatives;
10 (2) Thr ee rep res entatives of the attorney general's office, with one member
11 r epresent ing the cold case section of the litigation division, one member r epresent ing the
12 SAFE Kits Initiative, and one member r epresent ing SAFET rack, with each such
13 member appointed by the attorney general or his or her designee;
14 (3) One rep res entative of the department of public safety's crime victims'
15 compensation staff, to be appointed by the dire ctor of the department of public safety or
16 his or her designee;
17 (4) One r epresent ative of the department of health and senior services' office on
18 women's health, to be appointed by the dir ector of the department of health and senior
19 services or his or her designee;
20 (5) One rep res entative of the Missouri state highway patrol rep rese nting the
21 Missouri highway patro l crime lab;
22 (6) T wo rep res entatives of the Missouri Coalition Against Domestic and Sexual
23 V iolence;
24 (7) One repr esentative of the Missouri Hospital Association;
25 (8) One repr esentative fro m the Missouri State Medical Association;
26 (9) One repr esentative of the Missouri Nurses Association;
27 (10) One rep rese ntative of the Missouri Sheriffs' Association;
28 (1 1) One rep rese ntative of the Missouri Police Chiefs Association;
29 (12) One rep rese ntative of the Missouri office of pr osecution services;
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30 (13) One repr esentative of a Sexual Assault Nurse Examiner (SANE) Pr ogram
31 that serves a community with a population of one hundred thousand inhabitants or
32 gr eater , to be appointed by the attorney general or his or her designee;
33 (14) One repr esentative of a Sexual Assault Nurse Examiner (SANE) Pr ogram
34 that serves a community with a population fewer than one hundred thousand
35 inhabitants, to be appointed by the attorney general or his or her designee;
36 (15) One rep rese ntative of the Missouri Rural Health Association;
37 (16) T wo persons who serve as victims' advocates, to be appointed by the
38 attorney general or his or her designee; and
39 (17) One person who is a private citizen who repr esents the interes ts of sexual
40 assault victims, to be appointed by the attorney general or his or her designee.
41 2. The task forc e shall study best practices and make recomme ndations
42 r egarding the statewide res ponse to sexual assault fr om the time of the complaint
43 thr ough each phase of the investigative, medical, advocacy , and justice system res ponse.
44 3. The task for ce shall determine whether a need exists for additional employees
45 or volunteers of a rape crisis center for victims of sexual assault and, if such a need does
46 exist:
47 (1) Establish a plan for how the state can pr ovide, in conjunction with rape crisis
48 centers, victims' advocate organizations, the department of social services, and the
49 department of public safety , additional employees or volunteers of a rape crisis center to
50 meet the needs identified; and
51 (2) Determine the cost of funding such a plan.
52 4. The task forc e shall evaluate whether a need exists to prov ide for ongoing
53 evaluation of the implementation of the Sexual Assault Survivor Bill of Rights under
54 section 595.201, and if it is determined that such a need exists, the task for ce shall:
55 (1) Identify the scope and nature of the need; and
56 (2) Make re commendations on how best to fill that need, whether legislatively or
57 otherwise.
58 5. The task for ce shall:
59 (1) Collect data regard ing sexual assault r eporting, arres ts, pr osecution rates,
60 access to sexual assault victims services, and any other data important for its
61 deliberations and re commendations;
62 (2) Collect feedback fr om stakeholders, practitioners, and leadership thr oughout
63 the state and local law enforc ement, victim services, for ensic science practitioners, and
64 health care communities to inform development of futur e best practices or clinical
65 guidelines r egarding the care and tr eatment of survivors;
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66 (3) Identify gaps and barriers in re sponse to sexual assault victims and pr opose
67 corr ective measur es; and
68 (4) Identify barriers to successful pr osecution of sexual assault crimes and
69 pr opose rem edies.
70 6. The office of the attorney general shall provi de administrative support to the
71 task forc e.
72 7. On or before December 31, 2028, the task forc e shall submit a re port on its
73 findings to the governor and general assembly . The rep ort shall include any dissenting
74 opinions in addition to any majority opinions.
75 8. The task for ce shall expir e on December 31, 2028.
✔
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