208.853. Findings and purpose.

MISSOURI STATUTES AND CODES

208.853. Findings and purpose.

Findings and purpose.

208.853. Findings and purposes.

The people of the state of Missouri find as follows:

(1) Thousands of Missouri senior citizens and people with disabilitiescontinue to live independently in their own homes and avoid placement ininstitutions such as nursing homes only as the result of the availability ofqualified personal care attendants who assist them with the activities ofdaily living.

(2) Many Missouri senior citizens and people with disabilities who couldnot otherwise afford personal care assistance services in their own homesreceive the services with assistance provided by the state and federalgovernments under the Missouri consumer directed services program.

(3) The United States Supreme Court has mandated that states provideservices to persons with disabilities "in community settings rather than ininstitutions" when remaining in the community is appropriate, consistent withthe wishes of the disabled person, and can be reasonably accommodated.

(4) In-home care is not only the choice of most senior citizens andpeople with disabilities, it is less costly than institutional care such asthat provided in nursing homes and thus saves Missouri taxpayers significantamounts of money.

(5) The consumer directed services program permits the consumers ofthese highly intimate and personal services to hire, terminate and supervisethe individual providing the services, but it does not currently giveconsumers any role in setting wage rates for personal care attendants.

(6) Personal care attendants generally receive low wages, minimal or nobenefits, little if any training, and have no meaningful input into theirterms and conditions of employment and no meaningful means of makingsuggestions for improvements in the consumer directed services program.

(7) The continued availability of quality home care services isthreatened by a looming shortage of qualified personal care attendants due tothe aging population in the state as well as low wages, a lack of benefits,and high rates of occupational injury. These poor working conditions alsocontribute to high turnover among personal care attendants that impairs thecontinuity of care.

(8) The safety of home care services is threatened by both the failureof existing safeguards to protect consumers from potentially abusiveattendants and lengthy delays in processing background checks as recentlydocumented by the state auditor.

(9) The continued availability of quality, safe home care services canbe ensured through the creation of the "Missouri Quality Home Care Council"with authority to investigate the quality, safety and availability of homecare services, recruit eligible personal care attendants, recommendqualifications for personal care attendants, improve the training of personalcare attendants, establish a statewide list of eligible personal careattendants, refer consumers to eligible personal care attendants, engage incollective bargaining with a representative of personal care attendants, andrecommend changes in personal care attendants' wages and benefits to thegeneral assembly.