HOUSE BILL NO. 2628 103RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE ZIMMERMANN.
6311H.01I JOSEPH ENGLER, Chief Clerk
AN ACT To repeal sections 197.135 and 595.220, RSMo, and to enact in lieu thereof three new sections relating to victims of sexual assault.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Sections 197.135 and 595.220, RSMo, are repealed and three new sections 2 enacted in lieu thereof, to be known as sections 191.713, 197.135, and 595.220, to read as 3 follows: 191.713. 1.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 procedures, or services provided at a hospital or health care facility to a sexual 7 assault victim following an alleged sexual assault; 8 (2) "Emergency contraception", any drug or device approved by the U.S. Food 9 and Drug Administration that prevents pregnancy after sexual intercourse; 10 (3) "Health care facility", any urgent care center or facility that offers treatment 11 for patients during normal business, after business, or weekend hours and that is 12 affiliated with a licensed hospital; 13 (4) "Sexual assault", includes rape in the first degree, as described in section 14 566.030; rape in the second degree, as described in section 566.031; statutory rape in the 15 first degree and attempt to commit statutory rape in the first degree, as described in 16 section 566.032; statutory rape in the second degree, as described in section 566.034;
EXPLANATION — 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. HB 2628 2
17 sodomy in the first degree, as described in section 566.060; sodomy in the second degree, 18 as described in section 566.061; statutory sodomy in the first degree and attempt to 19 commit statutory sodomy in the first degree, as described in section 566.062; and 20 statutory sodomy in the second degree, as described in section 566.064; 21 (5) "Sexual assault victim", a person who is alleged to have been sexually 22 assaulted and is presented as a patient. 23 3. It shall be the standard of care for any hospital or any health care facility that 24 provides emergency care to sexual assault victims to: 25 (1) Orally inform each sexual assault victim of the option to be provided 26 emergency contraception at the hospital or health care facility; 27 (2) Provide the complete regimen of emergency contraception immediately at the 28 hospital or health care facility to each sexual assault victim who requests it; and 29 (3) Provide sexually transmitted infection screening and treatment to the sexual 30 assault victim. 31 4. The department of health and senior services shall promulgate all rules and 32 regulations to implement the provisions of this section. Any rule or portion of a rule, as 33 that term is defined in section 536.010, that is created under the authority delegated in 34 this section shall become effective only if it complies with and is subject to all of the 35 provisions of chapter 536 and, if applicable, section 536.028. This section and chapter 36 536 are nonseverable and if any of the powers vested with the general assembly 37 pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul 38 a rule are subsequently held unconstitutional, then the grant of rulemaking authority 39 and any rule proposed 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 offense, 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. Victims 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. HB 2628 3
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 offense. 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 offered 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 offered by the statewide telehealth network, as long as 20 the training utilized is, at a minimum, equivalent to the training offered 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 sufficient 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 effect 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 treatment 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 HB 2628 4
50 access to the statewide telehealth network for the purposes of mentoring and training services 51 required under section 192.2520 without charge 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 offense to an appropriate hospital with an emergency 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. 595.220. 1. The department of public safety shall make payments to appropriate 2 medical providers, out of appropriations made for that purpose, to cover the reasonable 3 charges of the forensic examination and medical treatment of persons who may be a victim 4 of a sexual offense if: 5 (1) The victim or the victim's guardian consents in writing to the examination and 6 medical treatment; and 7 (2) The report of the examination and medical treatment is made on a form 8 approved by the attorney general with the advice of the department of public safety. 9 10 The department shall establish maximum reimbursement rates for charges submitted under 11 this section, which shall reflect the reasonable cost of providing the forensic exam and 12 medical treatment. 13 2. A minor may consent to examination under this section. Such consent is not 14 subject to disaffirmance because of minority, and consent of parent or guardian of the minor is 15 not required for such examination. The appropriate medical provider making the examination 16 shall give written notice to the parent or guardian of a minor that such an examination has 17 taken place. 18 3. The department of public safety, with the advice of the attorney general, shall 19 develop the forms and procedures for gathering, transmitting, and storing evidence during and 20 after the forensic examination under the provisions of this section. The department of health 21 and senior services shall develop a checklist, protocols, and procedures for appropriate 22 medical providers to refer to while providing medical treatment to victims of a sexual offense, 23 including those specific to victims who are minors. The procedures for transmitting and 24 storing examination evidence shall include the following requirements: 25 (1) An appropriate medical provider shall provide electronic notification to the 26 appropriate law enforcement agency when the provider has a reported or anonymous 27 evidentiary collection kit; 28 (2) Within fourteen days of notification from the appropriate medical provider, the 29 law enforcement agency shall take possession of the evidentiary collection kit; HB 2628 5
30 (3) Within fourteen days of taking possession, the law enforcement agency shall 31 provide the evidentiary collection kit to a laboratory; 32 (4) A law enforcement agency shall secure an evidentiary collection kit for a period 33 of thirty years if the offense has not been adjudicated. 34 4. Evidentiary collection kits shall be developed and made available, subject to 35 appropriation, to appropriate medical providers by the highway patrol or its designees and 36 eligible crime laboratories. Such kits shall be distributed with the forms and procedures for 37 gathering evidence during forensic examinations of victims of a sexual offense to appropriate 38 medical providers upon request of the provider, in the amount requested, and at no charge to 39 the medical provider. All appropriate medical providers shall, with the written consent of the 40 victim, perform a forensic examination using the evidentiary collection kit, or other collection 41 procedures developed for victims who are minors, and forms and procedures for gathering 42 evidence following the checklist for any person presenting as a victim of a sexual offense. 43 5. In reviewing claims submitted under this section, the department shall first 44 determine if the claim was submitted within ninety days of the examination and medical 45 treatment. [If the claim is submitted within ninety days, the department shall, at a minimum, 46 use the following criteria in reviewing the claim: examination charges submitted shall be 47 itemized and fall within the definition of forensic examination as defined in subdivision (7) of 48 subsection 8 of this section.] 49 6. All appropriate medical provider charges for eligible forensic examinations and 50 reasonable costs of medical treatment, including, but not limited to, emergency 51 contraception, shall be billed to and paid by the department of public safety. No appropriate 52 medical provider conducting forensic examinations and providing medical treatment to 53 victims of sexual offenses shall charge the victim for the forensic examination. For 54 appropriate medical provider charges related to the medical treatment of victims of sexual 55 offenses not covered in this section, if the victim is an eligible claimant under the crime 56 victims' compensation fund, the victim shall seek compensation under sections 595.010 to 57 595.075. 58 7. The department of public safety shall establish rules regarding the reimbursement 59 of the costs of forensic examinations for children under fourteen years of age, including 60 establishing conditions and definitions for emergency and nonemergency forensic 61 examinations and may by rule establish additional qualifications for appropriate medical 62 providers performing nonemergency forensic examinations for children under fourteen years 63 of age. The department shall provide reimbursement regardless of whether or not the findings 64 indicate that the child was abused. 65 8. For purposes of this section, the following terms mean: HB 2628 6
66 (1) "Anonymous evidentiary collection kit", an evidentiary collection kit collected 67 from a victim who wishes to remain anonymous, but who has consented, or his or her 68 designee has consented on his or her behalf, to the collection of the evidentiary collection kit 69 and to participate in the criminal justice process; 70 (2) "Appropriate medical provider": 71 (a) Any licensed nurse, physician, or physician assistant, and any institution 72 employing licensed nurses, physicians, or physician assistants, provided that such licensed 73 professionals are the only persons at such institution to perform tasks under the provisions of 74 this section; or 75 (b) For the purposes of any nonemergency forensic examination of a child under 76 fourteen years of age, the department of public safety may establish additional qualifications 77 for any provider listed in paragraph (a) of this subdivision under rules authorized under 78 subsection 7 of this section; 79 (3) "Component", any piece of evidence that contains, or may contain, DNA related 80 to the sexual offense for which the forensic examination was performed and that is not stored 81 or maintained within the evidentiary collection kit; 82 (4) "Consent", the electronically documented authorization by the victim, or his or 83 her designee, to allow the evidentiary collection kit to be analyzed; 84 (5) "Emergency forensic examination", an examination of a person under fourteen 85 years of age that occurs within five days of the alleged sexual offense. The department of 86 public safety may further define the term emergency forensic examination by rule; 87 (6) "Evidentiary collection kit", a kit used during a forensic examination that includes 88 materials necessary for appropriate medical providers to gather evidence in accordance with 89 the forms and procedures developed by the department of public safety for forensic 90 examinations; 91 (7) "Forensic examination", an examination performed by an appropriate medical 92 provider on a victim of an alleged sexual offense to gather evidence for the evidentiary 93 collection kit or using other collection procedures developed for victims who are minors; 94 (8) "Medical treatment", the treatment of all injuries and health concerns resulting 95 directly from a patient's sexual assault or victimization; 96 (9) "Nonemergency forensic examination", an examination of a person under fourteen 97 years of age that occurs more than five days after the alleged sexual offense. The department 98 of public safety may further define the term nonemergency forensic examination by rule; 99 (10) "Reported evidentiary collection kit", an evidentiary collection kit collected from 100 a victim, or his or her designee, who has consented to the collection of the evidentiary 101 collection kit and has consented to participate in the criminal justice process; HB 2628 7
102 (11) "Unreported evidentiary collection kit", an evidentiary collection kit collected 103 from a victim, or his or her designee, who has consented to the collection of the evidentiary 104 collection kit but has not consented to participate in the criminal justice process. 105 9. The attorney general shall establish protocols and an electronic platform to 106 implement an electronic evidence tracking system that: 107 (1) Identifies, documents, records, and tracks evidentiary collection kits and their 108 components, including individual specimen containers, through their existence from forensic 109 examination, to possession by a law enforcement agency, to testing, to use as evidence in 110 criminal proceedings, and until disposition of such proceedings; 111 (2) Assigns a unique alphanumeric identifier to each respective evidentiary collection 112 kit, and all its respective components, and to each respective person, or his or her designees, 113 who may handle an evidentiary test kit; 114 (3) Links the identifiers of an evidentiary collection kit and its components, which 115 shall be machine-readable indicia; 116 (4) Allows each person, or his or her designees, who is properly credentialed to 117 handle an evidentiary test kit to check the status of an evidentiary test kit or its components 118 and to save a portfolio of identifiers so that the person, or his or her designees, may track, 119 obtain reports, and receive updates on the status of evidentiary collection kits or their 120 components; and 121 (5) Allows sexual assault victims, or their designees, to track and obtain reports on 122 the status and location of their evidentiary collection kits. This shall be a secured web-based 123 or similar electronic-based communications system that shall require sexual assault victims, 124 or their designees, to