Missouri Statute | Act | Code |Additional Executive Departments| US Code - US Statute

1. There is hereby created a department of mental health to be
headed by a mental health commission who shall appoint a director, by and
with the advice and consent of the senate. The director shall be the
administrative head of the department and shall serve at the pleasure of
the commission and be compensated as provided by law for the director,
division of mental health. All employees of the department shall be
selected in accordance with chapter 36, RSMo.

2. (1) The "State Mental Health Commission", composed of seven members,
is the successor to the former state mental health commission and it has
all the powers, duties and responsibilities of the former commission. All
members of the commission shall be appointed by the governor, by and with
the advice and consent of the senate. None of the members shall otherwise
be employed by the state of Missouri.

(2) Three of the commission members first appointed shall be appointed
for terms of four years, and two shall be appointed for terms of three
years, and two shall be appointed for a term of two years. The governor
shall designate, at the time the appointments are made, the length of the
term of each member so appointed. Thereafter all terms shall be for four
years.

(3) At least two of the members of the commission shall be physicians,
one of whom shall be recognized as an expert in the field of the
treatment of nervous and mental diseases, and one of whom shall be
recognized as an expert in the field of mental retardation or of other
developmental disabilities. At least two of the members of the commission
shall be representative of persons or groups who are consumers having
substantial interest in the services provided by the division, one of
whom shall represent the mentally retarded or developmentally disabled
and one of whom shall represent those persons being treated for nervous
and mental diseases. Of the other three members at least one must be
recognized for his expertise in general business management procedures,
and two shall be recognized for their interest and expertise in dealing
with alcohol/drug abuse problems, or community mental health services.

3. The provisions of sections 191.120, 191.125, 191.130, 191.140,
191.150, 191.160, 191.170, 191.180, 191.190, 191.200, 191.210, RSMo, and
others as they relate to the division of mental health not previously
reassigned by executive reorganization plan number 2 of 1973 as submitted
by the governor under chapter 26, RSMo, are transferred by specific type
transfer from the department of public health and welfare to the
department of mental health. The division of mental health, department of
health and welfare, chapter 202, RSMo, and others are abolished and all
powers, duties and functions now assigned by law to the division, the
director of the divisions of mental health or any of the institutions or
officials of the division are transferred by type I transfer to the
department of mental health.

4. The Missouri institute of psychiatry, which is under the board of
curators of the University of Missouri is hereafter to be known as the
"Missouri Institute of Mental Health". The purpose of the institute will
be that of conducting research into improving services for persons served
by the department of mental health for fostering the training of
psychiatric residents in public psychiatry and for fostering excellence
in mental health services through employee training and the study of
mental health policy and ethics. To assist in this training, hospitals
operated by and providers contracting with the department of mental
health may be used for the same purposes and under the same arrangements
as the board of curators of the University of Missouri utilizes with
other hospitals in the state in supervising residency training for
medical doctors. Appropriations requests for the Missouri institute of
mental health shall be jointly developed by the University of Missouri
and the department of mental health. All appropriations for the Missouri
institute of mental health shall be made to the curators of the
University of Missouri but shall be submitted separately from the
appropriations of the curators of the University of Missouri.

5. There is hereby established within the department of mental health a
division of mental retardation and developmental disabilities. The
director of the division shall be appointed by the director of the
department. The division shall administer all state facilities under the
direction and authority of the department director. The Marshall
Habilitation Center, the Higginsville Habilitation Center, the
Bellefontaine Habilitation Center, the Nevada Habilitation Center, the
St. Louis Developmental Disabilities Treatment Centers, and the regional
centers located at Albany, Columbia, Hannibal, Joplin, Kansas City,
Kirksville, Poplar Bluff, Rolla, St. Louis, Sikeston and Springfield and
other similar facilities as may be established, are transferred by type I
transfer to the division of mental retardation and developmental
disabilities.

6. All the duties, powers and functions of the advisory council on mental
retardation and community health centers, sections 202.664 to 202.666,
RSMo, are hereby transferred by type I transfer to the division of mental
retardation and developmental disabilities of the department of mental
health. The advisory council on mental retardation and community health
centers shall be appointed by the division director.

7. The advisory council on mental retardation and developmental
disabilities heretofore established by executive order and all of the
duties, powers and functions of the advisory council including the
responsibilities of the provision of the council in regard to the Federal
Development Disabilities Law (P.L. 91-517) and all amendments thereto are
transferred by type I transfer to the division of mental retardation and
developmental disabilities. The advisory council on mental retardation
and developmental disabilities shall be appointed by the director of the
division of mental retardation and developmental disabilities.

8. The advisory council on alcoholism and drug abuse, chapter 202, RSMo,
is transferred by type II transfer to the department of mental health and
the members of the advisory council shall be appointed by the mental
health director. (L. 1973 1st Ex. Sess. S.B. 1, A.L. 1990 H.B. 1383, A.L.
1991 H.B. 568)

Effective 5-29-91

*Transferred 1986; formerly section 9, Reorganization Act 1974, Appendix B

As used in this chapter and chapters 631, 632, and 633, RSMo,
unless the context clearly requires otherwise, the following terms shall
mean:

(1) "Administrative entity", a provider of specialized services other
than transportation to clients of the department on behalf of a division
of the department;

(2) "Alcohol abuse", the use of any alcoholic beverage, which use results
in intoxication or in a psychological or physiological dependency from
continued use, which dependency induces a mental, emotional or physical
impairment and which causes socially dysfunctional behavior;

(3) "Chemical restraint", medication administered with the primary intent
of restraining a patient who presents a likelihood of serious physical
injury to himself or others, and not prescribed to treat a person's
medical condition;

(4) "Client", any person who is placed by the department in a facility or
program licensed and funded by the department or who is a recipient of
services from a regional center, as defined in section 633.005, RSMo;

(5) "Commission", the state mental health commission;

(6) "Consumer", a person:

(a) Who qualifies to receive department services; or

(b) Who is a parent, child or sibling of a person who receives department
services; or

(c) Who has a personal interest in services provided by the department. A
person who provides services to persons affected by mental retardation,
developmental disabilities, mental disorders, mental illness, or alcohol
or drug abuse shall not be considered a consumer;

(7) "Day program", a place conducted or maintained by any person who
advertises or holds himself out as providing prevention, evaluation,
treatment, habilitation or rehabilitation for persons affected by mental
disorders, mental illness, mental retardation, developmental disabilities
or alcohol or drug abuse for less than the full twenty-four hours
comprising each daily period;

(8) "Department", the department of mental health of the state of
Missouri;

(9) "Developmental disability", a disability:

(a) Which is attributable to:

a. Mental retardation, cerebral palsy, epilepsy, head injury or autism,
or a learning disability related to a brain dysfunction; or

b. Any other mental or physical impairment or combination of mental or
physical impairments; and

(b) Is manifested before the person attains age twenty-two; and

(c) Is likely to continue indefinitely; and

(d) Results in substantial functional limitations in two or more of the
following areas of major life activities:

a. Self-care;

b. Receptive and expressive language development and use;

c. Learning;

d. Self-direction;

e. Capacity for independent living or economic self-sufficiency;

f. Mobility; and

(e) Reflects the person's need for a combination and sequence of special,
interdisciplinary, or generic care, habilitation or other services which
may be of lifelong or extended duration and are individually planned and
coordinated;

(10) "Director", the director of the department of mental health, or his
designee;

(11) "Domiciled in Missouri", a permanent connection between an
individual and the state of Missouri, which is more than mere residence
in the state; it may be established by the individual being physically
present in Missouri with the intention to abandon his previous domicile
and to remain in Missouri permanently or indefinitely;

(12) "Drug abuse", the use of any drug without compelling medical reason,
which use results in a temporary mental, emotional or physical impairment
and causes socially dysfunctional behavior, or in psychological or
physiological dependency resulting from continued use, which dependency
induces a mental, emotional or physical impairment and causes socially
dysfunctional behavior;

(13) "Habilitation", a process of treatment, training, care or
specialized attention which seeks to enhance and maximize the mentally
retarded or developmentally disabled person's abilities to cope with the
environment and to live as normally as possible;

(14) "Habilitation center", a residential facility operated by the
department and serving only persons who are mentally retarded, including
developmentally disabled;

(15) "Head of the facility", the chief administrative officer, or his
designee, of any residential facility;

(16) "Head of the program", the chief administrative officer, or his
designee, of any day program;

(17) "Individualized habilitation plan", a document which sets forth
habilitation goals and objectives for mentally retarded or
developmentally disabled residents and clients, and which details the
habilitation program as required by law, rules and funding sources;

(18) "Individualized rehabilitation plan", a document which sets forth
the care, treatment and rehabilitation goals and objectives for patients
and clients affected by alcohol or drug abuse, and which details the
rehabilitation program as required by law, rules and funding sources;

(19) "Individualized treatment plan", a document which sets forth the
care, treatment and rehabilitation goals and objectives for mentally
disordered or mentally ill patients and clients, and which details the
treatment program as required by law, rules and funding sources;

(20) "Investigator", an employee or contract agent of the department of
mental health who is performing an investigation regarding an allegation
of abuse or neglect or an investigation at the request of the director of
the department of mental health or his designee;

(21) "Least restrictive environment", a reasonably available setting or
mental health program where care, treatment, habilitation or
rehabilitation is particularly suited to the level and quality of
services necessary to implement a person's individualized treatment,
habilitation or rehabilitation plan and to enable the person to maximize
his functioning potential to participate as freely as feasible in normal
living activities, giving due consideration to potentially harmful
effects on the person and the safety of other facility or program clients
and public safety. For some mentally disordered or mentally retarded
persons, the least restrictive environment may be a facility operated by
the department, a private facility, a supported community living
situation, or an alternative community program designed for persons who
are civilly detained for outpatient treatment or who are conditionally
released pursuant to chapter 632, RSMo;

(22) "Mental disorder", any organic, mental or emotional impairment which
has substantial adverse effects on a person's cognitive, volitional or
emotional function and which constitutes a substantial impairment in a
person's ability to participate in activities of normal living;

(23) "Mental illness", a state of impaired mental processes, which
impairment results in a distortion of a person's capacity to recognize
reality due to hallucinations, delusions, faulty perceptions or
alterations of mood, and interferes with an individual's ability to
reason, understand or exercise conscious control over his actions. The
term "mental illness" does not include the following conditions unless
they are accompanied by a mental illness as otherwise defined in this
subdivision:

(a) Mental retardation, developmental disability or narcolepsy;

(b) Simple intoxication caused by substances such as alcohol or drugs;

(c) Dependence upon or addiction to any substances such as alcohol or
drugs;

(d) Any other disorders such as senility, which are not of an actively
psychotic nature;

(24) "Mental retardation", significantly subaverage general intellectual
functioning which:

(a) Originates before age eighteen; and

(b) Is associated with a significant impairment in adaptive behavior;

(25) "Minor", any person under the age of eighteen years;

(26) "Patient", an individual under observation, care, treatment or
rehabilitation by any hospital or other mental health facility or mental
health program pursuant to the provisions of chapter 632, RSMo;

(27) "Psychosurgery",

(a) Surgery on the normal brain tissue of an individual not suffering
from physical disease for the purpose of changing or controlling
behavior; or

(b) Surgery on diseased brain tissue of an individual if the sole object
of the surgery is to control, change or affect behavioral disturbances,
except seizure disorders;

(28) "Rehabilitation", a process of restoration of a person's ability to
attain or maintain normal or optimum health or constructive activity
through care, treatment, training, counseling or specialized attention;

(29) "Residence", the place where the patient has last generally lodged
prior to admission or, in case of a minor, where his family has so
lodged; except, that admission or detention in any facility of the
department shall not be deemed an absence from the place of residence and
shall not constitute a change in residence;

(30) "Resident", a person receiving residential services from a facility,
other than mental health facility, operated, funded or licensed by the
department;

(31) "Residential facility", any premises where residential prevention,
evaluation, care, treatment, habilitation or rehabilitation is provided
for persons affected by mental disorders, mental illness, mental
retardation, developmental disabilities or alcohol or drug abuse; except
the person's dwelling;

(32) "Specialized service", an entity which provides prevention,
evaluation, transportation, care, treatment, habilitation or
rehabilitation services to persons affected by mental disorders, mental
illness, mental retardation, developmental disabilities or alcohol or
drug abuse;

(33) "Vendor", a person or entity under contract with the department,
other than as a department employee, who provides services to patients,
residents or clients. (L. 1980 H.B. 1724, A.L. 1981 H.B. 399, A.L. 1982
H.B. 1565, A.L. 1990 H.B. 1383, S.B. 808 & 672, A.L. 1993 S.B. 388, A.L.
1995 H.B. 574, A.L. 1996 S.B. 884 & 841)

1. The state mental health commission, established by the
omnibus reorganization act of 1974, section 9, appendix B, RSMo, shall be
composed of seven members appointed by the governor, by and with the
advice and consent of the senate. The terms of members appointed under
the reorganization act before August 13, 1980, shall continue until the
terms under which the members were regularly appointed expire. The terms
shall be for four years. Each commissioner shall hold office until his
successor has been appointed and qualified.

2. The commission shall be comprised of members who are not prohibited
from serving by sections 105.450 to 105.482, RSMo, as amended, and who
are not otherwise employed by the state. The commission shall be composed
of the following:

(1) A physician recognized as an expert in the treatment of mental
illness;

(2) A physician recognized as an expert in the evaluation or habilitation
of the mentally retarded and developmentally disabled;

(3) A representative of groups who are consumers or families of consumers
interested in the services provided by the department in the treatment of
mental illness;

(4) A representative of groups who are consumers or families of consumers
interested in the services provided by the department in the habilitation
of the mentally retarded;

(5) A person recognized for his expertise in general business matters and
procedures;

(6) A person recognized for his interest and expertise in dealing with
alcohol or drug abuse; and

(7) A person recognized for his interest or expertise in community mental
health services.

3. Vacancies occurring on the commission shall be filled by appointment
by the governor, by and with the advice and consent of the senate, for
the unexpired terms. In case of a vacancy when the senate is not in
session, the governor shall make a temporary appointment until the next
session of the general assembly, when he shall nominate someone to fill
the office.

4. The commission shall elect from its members a chairman and a
secretary. Meetings shall be held at least once a month, and special
meetings may be held at the call of the chairman.

5. The department shall pay the commission members one hundred dollars
per day for each day, or portion thereof, they actually spend in
transacting the business of the commission and shall reimburse the
commission members for necessary expenses actually incurred in the
performance of their official duties. (L. 1980 H.B. 1724)

1. The state mental health commission shall appoint the director
of the department by and with the advice and consent of the senate, and
the director shall serve at the pleasure of the commission.

2. The commission shall advise the director of the department as to all
phases of department practices in order to make them compatible with
professional standards, including the following subjects:

(1) Care, treatment, habilitation and rehabilitation facilities and
programs;

(2) Manpower recruitment, development and training;

(3) Medical and statistical records;

(4) Operational policies;

(5) Accessibility of services.

3. The commission shall advise the director in the initiation, approval
and guidance of research projects and distribution of research funds.

4. The commission shall assist the director in establishing, maintaining
and reviewing the best possible plans, practices, rules and regulations,
facilities, programs and services which are operated, funded or licensed
by the department. (L. 1980 H.B. 1724)

1. The department shall seek to do the following for the
citizens of this state:

(1) Reduce the incidence and prevalence of mental disorders,
developmental disabilities and alcohol or drug abuse through primary,
secondary and tertiary prevention;

(2) Maintain and enhance intellectual, interpersonal and functional
skills of individuals affected by mental disorders, developmental
disabilities or alcohol or drug abuse by operating, funding and licensing
modern treatment and habilitation programs provided in the least
restrictive environment possible;

(3) Improve public understanding of and attitudes toward mental
disorders, developmental disabilities and alcohol and drug abuse.

2. The department shall make necessary orders, policies and procedures
for the government, administration, discipline and management of its
facilities, programs and operations. (L. 1980 H.B. 1724)

1. The head of the department shall be the director, whose
salary shall be set by the commission at an amount not to exceed the
appropriations made for that purpose. The director shall not provide
consulting services outside his official employment, and his salary shall
be the sole personal service income of the director; except, that the
director shall not be prevented from receiving compensation from writing
and presenting professional papers and publications.

2. Before entering upon the discharge of his duties, the director shall
take an oath to support the Constitution of the United States and the
Constitution of the State of Missouri and to faithfully demean himself in
the office to which he has been appointed.

3. The director shall be the chief executive officer of the department
and shall perform such duties and exercise such powers as may be imposed
or conferred upon him by law.

4. Except as otherwise provided by law, the director may request the
governor to reorganize the internal organization of the department as
authorized under sections 26.500 to 26.540, RSMo.

5. The director shall have power to make inquiries and investigations and
to hold such hearings as may be necessary in pursuance of his duties, and
for such purpose he may subpoena witnesses and documents, administer
oaths and provide for payment and expense of witnesses. (L. 1980 H.B.
1724)

The director shall appoint the directors of the divisions of the
department, and such division directors shall serve at the pleasure of
the director. The director shall be the appointing authority under
chapter 36, RSMo, to employ such administrative, technical and other
personnel who may be assigned to the department generally rather than to
any of the department divisions or facilities and whose employment is
necessary for the performance of the powers and duties of the department.
(L. 1980 H.B. 1724)

1. The directors of the various divisions of the department,
with the approval of the department director, shall, in accordance with
chapter 36, RSMo, appoint for each facility under the administration and
control of their respective divisions chief administrative officers of
the facilities.

2. The major facilities of the department shall have chiefs of medical
staff who shall be licensed physicians with responsibilities for the
development and monitoring of medical care and treatment. (L. 1980 H.B.
1724)

1. The chief administrative officers of the facilities of the
divisions of the department, subject to the directives of the department
director and the respective division directors, shall have charge,
control and management of their facilities.

2. The chief administrative officer of each facility shall keep the
records and make the reports which the department and the respective
division deem necessary and advisable.

3. Each chief administrative officer shall exercise the powers and duties
of the appointing authority under chapter 36, RSMo, subject to the
supervision of the department director and the respective division
directors. (L. 1980 H.B. 1724)

The director of the department may appoint such personnel,
including mental health coordinators, as are necessary to carry out the
civil involuntary detention requirements of chapter 632, RSMo. The mental
health coordinators shall be subject to the exclusive direction and
supervision of the director, or his designee, who shall not be an
employee of any mental health facility. (L. 1980 H.B. 1724)

1. The department shall promulgate rules under the provisions of
this section and chapter 536, RSMo, as necessary to prescribe policies or
standards which affect charging, funding and licensing procedures of
residential facilities, day programs and specialized services available
to the public. The rules applicable to each facility, program or service
operated, funded or licensed by the department shall be available for
public inspection and review at such facility, program or service. No
rule or portion of a rule promulgated under the authority of this chapter
shall become effective unless it has been promulgated pursuant to the
provisions of section 536.024, RSMo.

2. The department shall adopt operating regulations concerning only its
internal management which need not be published in the Missouri Register
or the code of state regulations under chapter 536, RSMo, but these
regulations shall be available at department facilities for public
inspection and review.

3. Under the supervision of the department and its respective divisions,
each facility shall adopt policies concerning only its internal
management or its procedures for its patients, residents or clients
without publishing such policies in the Missouri Register or the code of
state regulations under chapter 536, RSMo, but the facility policies
shall be available at such facility for public inspection and review.

4. The rules, operating regulations and facility policies shall be
compatible with and appropriate to the facility or program mission,
population served, size, type of service and other reasonable
classifications. (L. 1980 H.B. 1724, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3)

1. There is hereby created in the state treasury a fund to be
known as the "Mental Health Earnings Fund". The state treasurer shall
credit to the fund any interest earned from investing the moneys in the
fund. Notwithstanding the provisions of section 33.080, RSMo, money in
the mental health earnings fund shall not be transferred and placed to
the credit of general revenue at the end of the biennium.

2. Fees received pursuant to the substance abuse traffic offenders
program shall be deposited in the mental health earnings fund. Such fees
shall not be used for personal services, expenses and equipment or for
any demonstration or other program. No other federal or state funds shall
be deposited in the fund, except for the purposes provided in subsections
3 and 4 of this section. The moneys received from such fees shall be
appropriated solely for assistance in securing alcohol and drug
rehabilitation services for persons who are unable to pay for the
services they receive.

3. The mental health earnings fund may be used for the deposit of revenue
received for the provision of services under a managed care agreement
entered into by the department of mental health. Subject to the approval
through the appropriation process, such revenues may be expended for the
purposes of providing such services pursuant to the managed care
agreement and for no other purpose and shall be accounted for separately
from all other revenues deposited in the fund.

4. The mental health earnings fund may, if approved through the
appropriation process, be used for the deposit of revenue received
pursuant to an agreement entered into by the department of mental health
and an alcohol and drug abuse counselor certification board for the
purpose of providing oversight of counselor certification. Such revenue
shall be accounted for separately from all other revenues deposited in
the fund.

5. The department of mental health shall promulgate rules and regulations
to implement and administer the provisions of this section. No rule or
portion of a rule promulgated pursuant to the authority of this chapter
shall become effective unless it has been promulgated pursuant to the
provisions of section 536.024, RSMo. (L. 1993 S.B. 167, A.L. 1995 S.B. 3,
A.L. 1996 H.B. 1081 merged with S.B. 884 & 841)

*Transferred 1994; formerly 630.345

From funds appropriated by the general assembly for this
purpose, the department may conduct research into the causes of mental
disorders, developmental disabilities and alcohol or drug abuse, into
improving methods of care, treatment, habilitation and rehabilitation for
persons affected by such conditions, and the stigmatizing effects on
persons presently or formerly served in the department service delivery
system. Insofar as practicable, the department shall make use of and
cooperate with the services and facilities of the various state
universities and state agencies to conduct its research. (L. 1980 H.B.
1724)

The department shall seek and encourage cooperation and active
participation of communities, counties, organizations, agencies, private
and not-for-profit corporations and individuals in the effort to
establish and maintain quality programs and services for persons affected
by mental disorders, developmental disabilities or alcohol or drug abuse.
The department shall develop programs of public information and education
for this purpose. (L. 1980 H.B. 1724)

The department shall initiate and direct the development of
long-range programs and plans with respect to residential facilities, day
programs and specialized services operated, funded or licensed by the
department for persons affected by mental disorders, developmental
disabilities and alcohol or drug abuse. The department, insofar as
practicable, shall coordinate its long-range programs and plans with the
program and plan requirements and procedures of relevant federal and
state planning and funding agencies. The department shall supervise a
comprehensive utilization quality-assurance and cost-benefit monitoring
and auditing program to deal with the facilities, programs and services
operated, funded or licensed by the department. (L. 1980 H.B. 1724)

1. The provisions of chapter 287, RSMo, governing workers'
compensation are extended to include all employees and authorized student
and volunteer workers of the department. The state of Missouri shall be a
self-insurer and assume all liability imposed by chapter 287, RSMo, in
respect to such personnel of the department, without insurance, and the
attorney general shall appear on behalf of and defend the state in all
actions brought by such personnel of the department under the provisions
of the workers' compensation law.

2. The director has authority to perform such duties as may be necessary
or incidental to carry out effectively the purposes of this section.

3. The extension of chapter 287, RSMo, to include personnel of the
department is not construed as acknowledging or creating any liability in
tort, or as incurring other obligations or duties other than the duty and
obligation of complying with the provisions of chapter 287, RSMo. (L.
1980 H.B. 1724)

The department shall establish and supervise a comprehensive
program to deal with all aspects of manpower recruitment, development,
training and retention of its employees. (L. 1980 H.B. 1724)

The state auditor shall have access to all records maintained
and established by the department. Any confidential records shall not be
divulged in such a way to reveal personally identifiable information. (L.
1980 H.B. 1724)

1. The director shall make an annual written report on behalf of
the department to the governor and the general assembly within ninety
days of the end of each fiscal year.

2. The report shall include pertinent information as to the cost and
benefit effectiveness of activities, projects, plans and accomplishments
of the department and each of its divisions, together with statistics and
summaries of financial receipts and expenditures as the director may,
with the advice of the commission, deem necessary and expedient. The
reports may be presented in sections compiled on behalf of each
respective division of the department.

3. The department shall indicate every two years in every even-numbered
year whether each department facility is in compliance with standards
applicable to the facility, the deficiencies which cause the facility not
to be in compliance if it is not and the actions necessary for the
facility to achieve compliance, unless the report states the reasons for
the facility not to attempt to achieve compliance. (L. 1980 H.B. 1724)

1. If so designated by the governor, the department shall
receive all federal grants and aids under the terms of the grants and
aids and administer or pay them out subject to the provisions attached.

2. The director shall approve such applications for federal assistance
administered through the department as may be considered advisable after
consultation with the appropriate division director and state advisory or
planning council.

3. The department shall make reports required, provide minimum standards
for the maintenance and operation of residential facilities, day programs
or specialized services funded by the department as are required under
the terms of the grants and aids, and require compliance with these
standards. (L. 1980 H.B. 1724)

The department may copyright or obtain a trademark for any
instructional, training and informational audio-visual materials, manuals
and documents which are prepared by department personnel or by persons
who receive department funding to prepare such material. If the material
is sold directly or for distribution, the department shall pay the
proceeds of the sales to the director of revenue for deposit to the
general revenue fund. (L. 1980 H.B. 1724)

1. The department of mental health shall develop, in partnership
with all departments represented on the children's services commission, a
unified accountable comprehensive children's mental health service
system. The department of mental health shall establish a state
interagency comprehensive children's mental health service system team
comprised of representation from:

(1) Family-run organizations and family members;

(2) Child advocate organizations;

(3) The department of health and senior services;

(4) The department of social services' children's division, division of
youth services, and the division of medical services;

(5) The department of elementary and secondary education;

(6) The department of mental health's division of alcohol and drug abuse,
division of mental retardation and developmental disabilities, and the
division of comprehensive psychiatric services;

(7) The department of public safety;

(8) The office of state courts administrator;

(9) The juvenile justice system; and

(10) Local representatives of the member organizations of the state team
to serve children with emotional and behavioral disturbance problems,
developmental disabilities, and substance abuse problems.

The team shall be called "The Comprehensive System Management Team".
There shall be a stakeholder advisory committee to provide input to the
comprehensive system management team to assist the departments in
developing strategies and to ensure positive outcomes for children are
being achieved. The department of mental health shall obtain input from
appropriate consumer and family advocates when selecting family members
for the comprehensive system management team, in consultation with the
departments that serve on the children's services commission. The
implementation of a comprehensive system shall include all state agencies
and system partner organizations involved in the lives of the children
served. These system partners may include private and not-for-profit
organizations and representatives from local system of care teams and
these partners may serve on the stakeholder advisory committee. The
department of mental health shall promulgate rules for the implementation
of this section in consultation with all of the departments represented
on the children's services commission.

2. The department of mental health shall, in partnership with the
departments serving on the children's services commission and the
stakeholder advisory committee, develop a state comprehensive children's
mental health service system plan. This plan shall be developed and
submitted to the governor, the general assembly, and children's services
commission by December, 2004. There shall be subsequent annual reports
that include progress toward outcomes, monitoring, changes in populations
and services, and emerging issues. The plan shall:

(1) Describe the mental health service and support needs of Missouri's
children and their families, including the specialized needs of specific
segments of the population;

(2) Define the comprehensive array of services including services such as
intensive home-based services, early intervention services, family
support services, respite services, and behavioral assistance services;

(3) Establish short- and long-term goals, objectives, and outcomes;

(4) Describe and define the parameters for local implementation of
comprehensive children's mental health system teams;

(5) Describe and emphasize the importance of family involvement in all
levels of the system;

(6) Describe the mechanisms for financing, and the cost of implementing
the comprehensive array of services;

(7) Describe the coordination of services across child-serving agencies
and at critical transition points, with emphasis on the involvement of
local schools;

(8) Describe methods for service, program, and system evaluation;

(9) Describe the need for, and approaches to, training and technical
assistance; and

(10) Describe the roles and responsibilities of the state and local
child-serving agencies in implementing the comprehensive children's
mental health care system.

3. The comprehensive system management team shall collaborate to develop
uniform language to be used in intake and throughout the* provision of
services.

4. The comprehensive children's mental health services system shall:

(1) Be child centered, family focused, strength based, and family driven,
with the needs of the child and family dictating the types and mix of
services provided, and shall include the families as full participants in
all aspects of the planning and delivery of services;

(2) Provide community-based mental health services to children and their
families in the context in which the children live and attend school;

(3) Respond in a culturally competent and responsive manner;

(4) Emphasize prevention, early identification, and intervention;

(5) Assure access to a continuum of services that:

(a) Educate the community about the mental health needs of children;

(b) Address the unique physical, behavioral, emotional, social,
developmental, and educational needs of children;

(c) Are coordinated with the range of social and human services provided
to children and their families by local school districts, social
services, health and senior services, public safety, juvenile offices,
and the juvenile and family courts;

(d) Provide a comprehensive array of services through an integrated
service plan;

(e) Provide services in the least restrictive most appropriate
environment that meets the needs of the child; and

(f) Are appropriate to the developmental needs of children;

(6) Include early screening and prompt intervention to:

(a) Identify and treat the mental health needs of children in the least
restrictive environment appropriate to their needs; and

(b) Prevent further deterioration;

(7) Address the unique problems of paying for mental health services for
children, including:

(a) Access to private insurance coverage;

(b) Public funding, including:

a. Assuring that funding follows children across departments; and

b. Maximizing federal financial participation;

(c) Private funding and services;

(8) Assure a smooth transition from child to adult mental health services
when needed;

(9) Coordinate a service delivery system inclusive of services,
providers, and schools that serve children and youth with emotional and
behavioral disturbance problems, and their families through state
agencies that serve on the state comprehensive children's management
team; and

(10) Be outcome based.

5. By August 28, 2007, and periodically thereafter, the children's
services commission shall conduct and distribute to the general assembly
an evaluation of the implementation and effectiveness of the
comprehensive children's mental health care system, including an
assessment of family satisfaction and the progress of achieving outcomes.
(L. 2004 S.B. 1003)

*Word "the" does not appear in original rolls.

1. Except as provided in subsection 5 of this section, each
person admitted to a residential facility or day program and each person
admitted on a voluntary or involuntary basis to any mental health
facility or mental health program where people are civilly detained
pursuant to chapter 632, RSMo, except to the extent that the head of the
residential facility or day program determines that it is inconsistent
with the person's therapeutic care, treatment, habilitation or
rehabilitation and the safety of other facility or program clients and
public safety, shall be entitled to the following:

(1) To wear his own clothes and to keep and use his own personal
possessions;

(2) To keep and be allowed to spend a reasonable sum of his own money for
canteen expenses and small purchases;

(3) To communicate by sealed mail or otherwise with persons including
agencies inside or outside the facility;

(4) To receive visitors of his own choosing at reasonable times;

(5) To have reasonable access to a telephone both to make and receive
confidential calls;

(6) To have access to his mental and medical records;

(7) To have opportunities for physical exercise and outdoor recreation;

(8) To have reasonable, prompt access to current newspapers, magazines
and radio and television programming.

2. Any limitations imposed by the head of the residential facility or day
program or his designee on the exercise of the rights enumerated in
subsection 1 of this section by a patient, resident or client and the
reasons for such limitations shall be documented in his clinical record.

3. Each patient, resident or client shall have an absolute right to
receive visits from his attorney, physician or clergyman, in private, at
reasonable times.

4. Notwithstanding any limitations authorized under this section on the
right of communication, every patient, resident or client shall be
entitled to communicate by sealed mail with the department, his legal
counsel and with the court, if any, which has jurisdiction over the
person.

5. Persons committed to a residential facility or day program operated,
funded or licensed by the department pursuant to section 552.040, RSMo,
shall not be entitled to the rights enumerated in subdivisions (1), (3)
and (5) of subsection 1 of this section unless the head of the
residential facility or day program determines that these rights are
necessary for the person's therapeutic care, treatment, habilitation or
rehabilitation. In exercising the discretion to grant any of the rights
enumerated in subsection 1 of this section to a patient, resident or
client, the head of the residential facility or day program shall
consider the safety of the public. (L. 1980 H.B. 1724, A.L. 1996 S.B. 884
& 841)

1. Each patient, resident or client shall be entitled to the
following without limitation:

(1) To humane care and treatment;

(2) To the extent that the facilities, equipment and personnel are
available, to medical care and treatment in accordance with the highest
standards accepted in medical practice;

(3) To safe and sanitary housing;

(4) To not participate in nontherapeutic labor;

(5) To attend or not attend religious services;

(6) To receive prompt evaluation and care, treatment, habilitation or
rehabilitation about which he is informed insofar as he is capable of
understanding;

(7) To be treated with dignity as a human being;

(8) To not be the subject of experimental research without his prior
written and informed consent or that of his parent, if a minor, or his
guardian; except that no involuntary patient shall be subject to
experimental research, except as provided within this chapter;

(9) To decide not to participate or may withdraw from any research at any
time for any reason*;

(10) To have access to consultation with a private physician at his own
expense;

(11) To be evaluated, treated or habilitated in the least restrictive
environment;

(12) To not be subjected to any hazardous treatment or surgical procedure
unless he, his parent, if he is a minor, or his guardian consents; or
unless such treatment or surgical procedure is ordered by a court of
competent jurisdiction;

(13) In the case of hazardous treatment or irreversible surgical
procedures, to have, upon request, an impartial review prior to
implementation, except in case of emergency procedures required for the
preservation of his life;

(14) To a nourishing, well-balanced and varied diet;

(15) To be free from verbal and physical abuse.

2. Notwithstanding any other sections of this chapter, each patient,
resident or client shall have the right to an impartial administrative
review of alleged violations of the rights assured under this chapter.
The impartial administration review process shall be a mechanism for:

(1) Reporting alleged violations of rights assured under this chapter;

(2) Investigating alleged violations of these rights;

(3) Presenting patient, resident or client grievances on the record to a
neutral decision maker; and

(4) Requiring that the neutral decision maker issue findings of fact,
conclusions and recommendations.

3. The impartial administrative review process shall be completed within
a timely manner after the alleged violation is reported.

4. This impartial review process shall not apply to investigations of
alleged patient, resident or client abuse or neglect conducted pursuant
to section 630.167. (L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

*Word "season" appears in original rolls.

No patient or resident, either voluntary or involuntary, shall
be presumed to be incompetent, to forfeit any legal right, responsibility
or obligation or to suffer any legal disability as a citizen, unless
otherwise prescribed by law, as a consequence of receiving evaluation,
care, treatment, habilitation or rehabilitation for a mental disorder,
mental illness, mental retardation, developmental disability, alcohol
problem or drug problem. (L. 1980 H.B. 1724)

1. At the time of admission, either on a voluntary or
involuntary basis, a mental health facility or mental health program in
which people may be civilly detained pursuant to chapter 632, RSMo, or a
residential facility or day program operated, funded or licensed by the
department shall give each patient, resident or client written
information which sets forth, in lay language, the following:

(1) A description of the facility, its services and its costs;

(2) Information as to how to seek conditional release or discharge;

(3) A statement of rights assured by this chapter or the department in
its rules and regulations;

(4) A description of a patient grievance procedure.

2. Unless the patient, resident or client can read the information with
understanding, the facility personnel shall explain it to him.

3. The facility or program shall prominently post a list of patient or
residential rights in residential and activity areas. (L. 1980 H.B. 1724,
A.L. 1982 H.B. 1565, A.L. 1996 S.B. 884 & 841)

1. Every patient, whether voluntary or involuntary, in a public
or private mental health facility shall have the right to refuse
electroconvulsive therapy.

2. Before electroconvulsive therapy may be administered voluntarily to a
patient, the patient shall be informed, both orally and in writing, of
the risks of the therapy and shall give his express written voluntary
consent to receiving the therapy.

3. Involuntary electroconvulsive therapy may be administered under a
court order after a full evidentiary hearing where the patient refusing
such treatment is represented by counsel who shall advocate his or her
position. The therapy may be administered on an involuntary basis only if
it is shown, by clear and convincing evidence, that the therapy is
necessary under the following criteria:

(1) There is a strong likelihood that the therapy will significantly
improve or cure the patient's mental disorder for a substantial period of
time without causing him any serious functional harm; and

(2) There is no less drastic alternative form of therapy which could lead
to substantial improvement in the patient's condition. At the conclusion
of such hearing, if the petitioner has sustained his burden of proof, the
court may order up to a specified number of involuntary electroconvulsive
therapy treatments to be performed over a specified period of time.

4. Parents of minor patients or legal guardians of incompetent patients
shall be required to obtain court orders authorizing electroconvulsive
therapy under the procedures specified in subsection 3 of this section.

5. Persons who are diagnosed solely as mentally retarded shall not be
subject to electroconvulsive therapy.

6. If the judge finds that the respondent is unable to pay attorney's
fees for the services rendered in the proceedings the judge shall allow a
reasonable attorney's fee for the services, which fee shall be assessed
as costs and paid together with all the costs in the proceeding by the
state, in accordance with rules and regulations promulgated by the state
court administrator, from funds appropriated to the office of
administration for such purposes provided that no attorney's fees shall
be allowed for services rendered by any attorney who is a salaried
employee of a public agency or a private agency which receives public
funds. (L. 1980 H.B. 1724, A.L. 2004 S.B. 1211)

1. Psychosurgery shall not be performed involuntarily on any
patient or resident. A competent patient or resident shall be informed,
both orally and in writing, of the risks of the therapy and shall give
his express written voluntary consent before the surgery is performed.
Parents of minor patients or residents or legal guardians of incompetent
patients or residents shall be required to obtain court orders
authorizing such surgery under the procedures and criteria specified in
subsection 3 of section 630.130.

2. Psychosurgery shall not be performed by the department in any of its
facilities. (L. 1980 H.B. 1724)

The department shall promulgate reasonable rules relative to the
implementation of patient, resident and client rights described in this
chapter. (L. 1980 H.B. 1724)

1. Information and records compiled, obtained, prepared or
maintained by the residential facility, day program operated, funded or
licensed by the department or otherwise, specialized service, or by any
mental health facility or mental health program in which people may be
civilly detained pursuant to chapter 632, RSMo, in the course of
providing services to either voluntary or involuntary patients, residents
or clients shall be confidential.

2. The facilities or programs shall disclose information and records
including medication given, dosage levels, and individual ordering such
medication to the following upon their request:

(1) The parent of a minor patient, resident or client;

(2) The guardian or other person having legal custody of the patient,
resident or client;

(3) The attorney of a patient, resident or client who is a ward of the
juvenile court, an alleged incompetent, an incompetent ward or a person
detained under chapter 632, RSMo, as evidenced by court orders of the
attorney's appointment;

(4) An attorney or personal physician as authorized by the patient,
resident or client;

(5) Law enforcement officers and agencies, information about patients,
residents or clients committed pursuant to chapter 552, RSMo, but only to
the extent necessary to carry out the responsibilities of their office,
and all such law enforcement officers shall be obligated to keep such
information confidential;

(6) The entity or agency authorized to implement a system to protect and
advocate the rights of persons with developmental disabilities under the
provisions of 42 U.S.C. Sections 15042 to 15044. The entity or agency
shall be able to obtain access to the records of a person with
developmental disabilities who is a client of the entity or agency if
such person has authorized the entity or agency to have such access; and
the records of any person with developmental disabilities who, by reason
of mental or physical condition is unable to authorize the entity or
agency to have such access, if such person does not have a legal
guardian, conservator or other legal representative, and a complaint has
been received by the entity or agency with respect to such person or
there is probable cause to believe that such person has been subject to
abuse or neglect. The entity or agency obtaining access to a person's
records shall meet all requirements for confidentiality as set out in
this section;

(7) The entity or agency authorized to implement a system to protect and
advocate the rights of persons with mental illness under the provisions
of 42 U.S.C. 10801 shall be able to obtain access to the records of a
patient, resident or client who by reason of mental or physical condition
is unable to authorize the system to have such access, who does not have
a legal guardian, conservator or other legal representative and with
respect to whom a complaint has been received by the system or there is
probable cause to believe that such individual has been subject to abuse
or neglect. The entity or agency obtaining access to a person's records
shall meet all requirements for confidentiality as set out in this
section. The provisions of this subdivision shall apply to a person who
has a significant mental illness or impairment as determined by a mental
health professional qualified under the laws and regulations of the state;

(8) To mental health coordinators, but only to the extent necessary to
carry out their duties under chapter 632, RSMo.

3. The facilities or services may disclose information and records under
any of the following:

(1) As authorized by the patient, resident or client;

(2) To persons or agencies responsible for providing health care services
to such patients, residents or clients;

(3) To the extent necessary for a recipient to make a claim or for a
claim to be made on behalf of a recipient for aid or insurance;

(4) To qualified personnel for the purpose of conducting scientific
research, management audits, financial audits, program evaluations or
similar studies; provided, that such personnel shall not identify,
directly or indirectly, any individual patient, resident or client in any
report of such research, audit or evaluation, or otherwise disclose
patient, resident or client identities in any manner;

(5) To the courts as necessary for the administration of chapter 211,
RSMo, 475, RSMo, 552, RSMo, or 632, RSMo;

(6) To law enforcement officers or public health officers, but only to
the extent necessary to carry out the responsibilities of their office,
and all such law enforcement and public health officers shall be
obligated to keep such information confidential;

(7) Pursuant to an order of a court or administrative agency of competent
jurisdiction;

(8) To the attorney representing petitioners, but only to the extent
necessary to carry out their duties under chapter 632, RSMo;

(9) To the department of social services or the department of health and
senior services as necessary to report or have investigated abuse,
neglect, or rights violations of patients, residents, or clients;

(10) To a county board established pursuant to sections 205.968 to
205.972, RSMo 1986, but only to the extent necessary to carry out their
statutory responsibilities. The county board shall not identify, directly
or indirectly, any individual patient, resident or client;

(11) To parents, legal guardians, treatment professionals, law
enforcement officers, and other individuals who by having such
information could mitigate the likelihood of a suicide. The facility
treatment team shall have determined that the consumer's safety is at
some level of risk.

4. The facility or program shall document the dates, nature, purposes and
recipients of any records disclosed under this section and sections
630.145 and 630.150.

5. The records and files maintained in any court proceeding under chapter
632, RSMo, shall be confidential and available only to the patient, the
patient's attorney, guardian, or, in the case of a minor, to a parent or
other person having legal custody of the patient, and to the petitioner
and the petitioner's attorney. In addition, the court may order the
release or use of such records or files only upon good cause shown, and
the court may impose such restrictions as the court deems appropriate.

6. Nothing contained in this chapter shall limit the rights of discovery
in judicial or administrative procedures as otherwise provided for by
statute or rule.

7. The fact of admission of a voluntary or involuntary patient to a
mental health facility under chapter 632, RSMo, may only be disclosed as
specified in subsections 2 and 3 of this section. (L. 1980 H.B. 1724,
A.L. 1984 S.B. 575, A.L. 1986 H.B. 1414, A.L. 1988 H.B. 1493, A.L. 1996
S.B. 884 & 841, A.L. 2003 S.B. 556 & 311, A.L. 2005 H.B. 462 & 463)

1. Notwithstanding the provisions of section 630.140, a
residential facility or day program operated, funded or licensed by the
department may release to a patient's or resident's next of kin,
attorney, guardian or conservator, if any, the information that the
person is presently a patient, resident or client in the facility or
program, or that the person is seriously physically ill, and shall notify
a voluntary patient's or resident's next of kin, attorney, guardian, or
conservator or any other person who may be responsible for the costs
incurred by such patient or resident, of the admittance of such patient
or resident.

2. Upon the death of a patient or resident, the facility shall notify his
next of kin, guardian or conservator, if any, about the death and its
cause.

3. Next of kin shall be notified under this section in the following
order unless otherwise indicated by the patient or resident:

(1) Spouse;

(2) Parents;

(3) Children;

(4) Brothers and sisters;

(5) Other relatives according to the degree of relation.

4. The patient or resident may indicate additional persons whom he wants
notified in the event of his death or serious injury or incapacity. (L.
1980 H.B. 1724, A.L. 1981 H.B. 336)

1. Except as provided in subsection 2 of this section, when a
patient, resident or client is absent due to his unauthorized
disappearance from a residential facility or day program, or his
whereabouts are unknown and disclosure is necessary for the protection of
the patient, resident or others, and the provisions of section 630.140
would otherwise be applicable, notice of the disappearance, along with
relevant information, may be made to relatives, governmental law
enforcement agencies and other persons if necessary for the protection of
the patient, resident or other parties, as designated by the head of the
facility or program or physician in charge of the patient, resident or
client.

2. If the patient, resident or client was committed to the custody of the
department of mental health pursuant to chapter 552, RSMo, and that
patient, resident or client is absent due to an unauthorized
disappearance from a residential facility or day program, or such
person's whereabouts are unknown, the head of the mental health facility
or a designee shall immediately give notice of the disappearance, along
with relevant information, to the prosecutor and sheriff of the county
wherein the committed person is detained, the prosecutor and sheriff of
the county wherein the committed person was tried and acquitted, all
known surviving victims as defined in chapter 595, RSMo, any other
agencies or persons designated by the head of the facility as necessary
for the protection of the patient, resident or other parties. (L. 1980
H.B. 1724, A.L. 1996 S.B. 884 & 841)

1. A person commits the crime of "patient, resident or client
abuse or neglect" against any person admitted on a voluntary or
involuntary basis to any mental health facility or mental health program
in which people may be civilly detained pursuant to chapter 632, RSMo, or
any patient, resident or client of any residential facility, day program
or specialized service operated, funded or licensed by the department if
he knowingly does any of the following:

(1) Beats, strikes or injures any person, patient, resident or client;

(2) Mistreats or maltreats, handles or treats any such person, patient,
resident or client in a brutal or inhuman manner;

(3) Uses any more force than is reasonably necessary for the proper
control, treatment or management of such person, patient, resident or
client;

(4) Fails to provide services which are reasonable and necessary to
maintain the physical and mental health of any person, patient, resident
or client when such failure presents either an imminent danger to the
health, safety or welfare of the person, patient, resident or client, or
a substantial probability that death or serious physical harm will result.

2. Patient, resident or client abuse or neglect is a class A misdemeanor
unless committed under subdivision (2) or (4) of subsection 1 of this
section in which case such abuse or neglect shall be a class D felony.
(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

1. A person commits the crime of "furnishing unfit food to
patients, residents or clients" if he does any of the following:

(1) Knowingly furnishes or delivers any diseased, putrid or otherwise
unwholesome meat from any animal or fowl that was diseased or otherwise
unfit for food to any person admitted on a voluntary or involuntary basis
to any mental health facility or mental health program in which people
may be civilly detained pursuant to chapter 632, RSMo, or to any
residential facility or day program operated, funded or licensed by the
department;

(2) Knowingly furnishes or delivers any other unwholesome food,
vegetables or provisions whatsoever to such facilities or programs to be
used as food by the patients, residents, clients or employees thereof;

(3) Knowingly receives or consents to receive as an employee of such
facility or program any diseased or unwholesome meat, food or provisions.

2. Furnishing unfit food to patients, residents or clients is a class A
misdemeanor. (L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

1. When any physician, dentist, chiropractor, optometrist,
podiatrist, intern, nurse, medical examiner, social worker, psychologist,
minister, Christian Science practitioner, peace officer, pharmacist,
physical therapist, facility administrator, nurse's aide or orderly in a
residential facility, day program or specialized service operated, funded
or licensed by the department or in a mental health facility or mental
health program in which people may be admitted on a voluntary basis or
are civilly detained pursuant to chapter 632, RSMo, or employee of the
department has reasonable cause to believe that a patient, resident or
client of a facility, program or service has been abused or neglected, he
or she shall immediately report or cause a report to be made to the
department or the department of health and senior services, if such
facility or program is licensed pursuant to chapter 197, RSMo.

2. The report shall contain the name and address of the residential
facility, day program or specialized service; the name of the patient,
resident or client; information regarding the nature of the abuse or
neglect; the name of the complainant, and any other information which
might be helpful in an investigation.

3. Any person required in subsection 1 of this section to report or cause
a report to be made to the department who fails to do so within a
reasonable time after the act of abuse or neglect is guilty of an
infraction.

4. In addition to those persons required to report under subsection 1 of
this section, any other person having reasonable cause to believe that a
resident has been abused or neglected may report such information to the
department.

5. Any person who knowingly files a false report of abuse or neglect is
guilty of a class A misdemeanor.

6. Any person having a prior conviction of filing false reports and who
subsequently files a false report of abuse or neglect pursuant to this
section or section 565.188, RSMo, is guilty of a class D felony. (L. 1980
H.B. 1724 § 630.165 subsecs. 1 to 4, A.L. 1996 S.B. 884 & 841, A.L. 2003
S.B. 556 & 311)

1. Upon receipt of a report, the department or its agents,
contractors or vendors or the department of health and senior services,
if such facility or program is licensed pursuant to chapter 197, RSMo,
shall initiate an investigation within twenty-four hours.

2. If the investigation indicates possible abuse or neglect of a patient,
resident or client, the investigator shall refer the complaint together
with the investigator's report to the department director for appropriate
action. If, during the investigation or at its completion, the department
has reasonable cause to believe that immediate removal from a facility
not operated or funded by the department is necessary to protect the
residents from abuse or neglect, the department or the local prosecuting
attorney may, or the attorney general upon request of the department
shall, file a petition for temporary care and protection of the residents
in a circuit court of competent jurisdiction. The circuit court in which
the petition is filed shall have equitable jurisdiction to issue an ex
parte order granting the department authority for the temporary care and
protection of the resident for a period not to exceed thirty days.

3. (1) Reports referred to in section 630.165 and the investigative
reports referred to in this section shall be confidential, shall not be
deemed a public record, and shall not be subject to the provisions of
section 109.180, RSMo, or chapter 610, RSMo; except that complete copies
of all such reports shall be open and available to the parents or other
guardian of the patient, resident, or client who is the subject of such
report, but the names and any other descriptive information of the
complainant or other person mentioned in the reports shall not be
disclosed unless such complainant or person specifically consents to such
disclosure. All reports referred to in this section shall be admissible
in any judicial proceedings or hearing in accordance with section 36.390,
RSMo, or any administrative hearing before the director of the department
of mental health, or the director's designee. All such reports may be
disclosed by the department of mental health to law enforcement officers
and public health officers, but only to the extent necessary to carry out
the responsibilities of their offices, and to the department of social
services, and the department of health and senior services, and to boards
appointed pursuant to sections 205.968 to 205.990, RSMo, that are
providing services to the patient, resident or client as necessary to
report or have investigated abuse, neglect, or rights violations of
patients, residents or clients provided that all such law enforcement
officers, public health officers, department of social services'
officers, department of health and senior services' officers, and boards
shall be obligated to keep such information confidential;

(2) Except as otherwise provided in this section, the proceedings,
findings, deliberations, reports and minutes of committees of health care
professionals as defined in section 537.035, RSMo, or mental health
professionals as defined in section 632.005, RSMo, who have the
responsibility to evaluate, maintain, or monitor the quality and
utilization of mental health services are privileged and shall not be
subject to the discovery, subpoena or other means of legal compulsion for
their release to any person or entity or be admissible into evidence into
any judicial or administrative action for failure to provide adequate or
appropriate care. Such committees may exist, either within department
facilities or its agents, contractors, or vendors, as applicable. Except
as otherwise provided in this section, no person who was in attendance at
any investigation or committee proceeding shall be permitted or required
to disclose any information acquired in connection with or in the course
of such proceeding or to disclose any opinion, recommendation or
evaluation of the committee or board or any member thereof; provided,
however, that information otherwise discoverable or admissible from
original sources is not to be construed as immune from discovery or use
in any proceeding merely because it was presented during proceedings
before any committee or in the course of any investigation, nor is any
member, employee or agent of such committee or other person appearing
before it to be prevented from testifying as to matters within their
personal knowledge and in accordance with the other provisions of this
section, but such witness cannot be questioned about the testimony or
other proceedings before any investigation or before any committee;

(3) Nothing in this section shall limit authority otherwise provided by
law of a health care licensing board of the state of Missouri to obtain
information by subpoena or other authorized process from investigation
committees or to require disclosure of otherwise confidential information
relating to matters and investigations within the jurisdiction of such
health care licensing boards; provided, however, that such information,
once obtained by such board and associated persons, shall be governed in
accordance with the provisions of this subsection;

(4) Nothing in this section shall limit authority otherwise provided by
law in subdivisions (5) and (6) of subsection 2 of section 630.140
concerning access to records by the entity or agency authorized to
implement a system to protect and advocate the rights of persons with
developmental disabilities under the provisions of 42 U.S.C. Sections
15042 to 15044 and the entity or agency authorized to implement a system
to protect and advocate the rights of persons with mental illness under
the provisions of 42 U.S.C. 10801. In addition, nothing in this section
shall serve to negate assurances that have been given by the governor of
Missouri to the U.S. Administration on Developmental Disabilities, Office
of Human Development Services, Department of Health and Human Services
concerning access to records by the agency designated as the protection
and advocacy system for the state of Missouri. However, such information,
once obtained by such entity or agency, shall be governed in accordance
with the provisions of this subsection.

4. Anyone who makes a report pursuant to this section or who testifies in
any administrative or judicial proceeding arising from the report shall
be immune from any civil liability for making such a report or for
testifying unless such person acted in bad faith or with malicious
purpose.

5. Within five working days after a report required to be made pursuant
to this section is received, the person making the report shall be
notified in writing of its receipt and of the initiation of the
investigation.

6. No person who directs or exercises any authority in a residential
facility, day program or specialized service shall evict, harass, dismiss
or retaliate against a patient, resident or client or employee because he
or she or any member of his or her family has made a report of any
violation or suspected violation of laws, ordinances or regulations
applying to the facility which he or she has reasonable cause to believe
has been committed or has occurred.

7. Any person who is discharged as a result of an administrative
substantiation of allegations contained in a report of abuse or neglect
may, after exhausting administrative remedies as provided in chapter 36,
RSMo, appeal such decision to the circuit court of the county in which
such person resides within ninety days of such final administrative
decision. The court may accept an appeal up to twenty-four months after
the party filing the appeal received notice of the department's
determination, upon a showing that:

(1) Good cause exists for the untimely commencement of the request for
the review;

(2) If the opportunity to appeal is not granted it will adversely affect
the party's opportunity for employment; and

(3) There is no other adequate remedy at law. (L. 1980 H.B. 1724 §
630.165 subsecs. 5 to 10, A.L. 1985 S.B. 266, A.L. 1990 H.B. 1370, et
al., A.L. 1993 S.B. 388, A.L. 1996 H.B. 1081 merged with S.B. 869 merged
with S.B. 884 & 841, A.L. 1998 S.B. 470, A.L. 2003 S.B. 556 & 311)

If it is alleged or suspected that any patient, resident or
client who has been admitted on a voluntary or involuntary basis to a
mental health facility or mental health program in which people are
detained pursuant to chapter 632, RSMo, or any patient, resident or
client in a residential facility, day program or specialized service
operated, funded or licensed by the department is being or has been
subjected to patient or resident abuse which results in physical injury,
and in cases of sexual abuse, the head of the facility, program or
service shall promptly notify local law enforcement authorities and
cooperate fully with any investigation by them. (L. 1980 H.B. 1724 §
630.189, A.L. 1987 S.B. 277, A.L. 1996 S.B. 884 & 841)

1. A person who is listed on the department of mental health
disqualification registry pursuant to this section, who is listed on the
department of social services or the department of health and senior
services employee disqualification list pursuant to section 660.315,
RSMo, or who has been convicted of or pled guilty or nolo contendere to
any crime pursuant to section 630.155 or 630.160 shall be disqualified
from holding any position in any public or private facility or day
program operated, funded or licensed by the department or in any mental
health facility or mental health program in which people are admitted on
a voluntary or involuntary basis or are civilly detained pursuant to
chapter 632, RSMo.

2. A person who has been convicted of or pled guilty or nolo contendere
to any felony offense against persons as defined in chapter 565, RSMo;
any felony sexual offense as defined in chapter 566, RSMo; any felony
offense defined in section 568.020, 568.045, 568.050, 568.060, 569.020,
569.025, 569.030, 569.035, 569.040, 569.050, 569.070, or 569.160, RSMo,
or of an equivalent felony offense, or who has been convicted of or pled
guilty or nolo contendere to any violation of subsection 3 of section
198.070, RSMo, shall be disqualified from holding any direct-care
position in any public or private facility, day program, residential
facility or specialized service operated, funded or licensed by the
department or any mental health facility or mental health program in
which people are admitted on a voluntary basis or are civilly detained
pursuant to chapter 632, RSMo.

3. A person who has received a suspended imposition of sentence or a
suspended execution of sentence following a plea of guilty to any of the
disqualifying crimes listed in subsection 1 or 2 of this section shall
remain disqualified.

4. Any person disqualified pursuant to the provisions of subsection 1 or
2 of this section may seek an exception to the disqualification from the
director of the department or the director's designee. The request shall
be written and may not be made more than once every twelve months. The
request may be granted by the director or designee if in the judgment of
the director or designee a clear showing has been made by written
submission only, that the person will not commit any additional acts for
which the person had originally been disqualified for or any other acts
that would be harmful to a patient, resident or client of a facility,
program or service. The director or designee may grant an exception
subject to any conditions deemed appropriate and failure to comply with
such terms may result in the person again being disqualified. Decisions
by the director or designee pursuant to the provisions of this subsection
shall not be subject to appeal. The right to request an exception
pursuant to this subsection shall not apply to persons who are
disqualified due to being listed on the department of social services or
department of health and senior services employee disqualification list
pursuant to section 660.315, RSMo, nor to persons disqualified from
employment due to any crime pursuant to the provisions of chapter 566,
RSMo, or section 565.020, 565.021, 568.020, 568.060, 569.025, or 569.070,
RSMo.

5. An applicant for a direct care position in any public or private
facility, day program, residential facility, or specialized service
operated, funded, or licensed by the department or any mental health
facility or mental health program in which people are admitted on a
voluntary basis or are civilly detained pursuant to chapter 632, RSMo,
shall:

(1) Sign a consent form as required by section 43.540, RSMo, to provide
written consent for a criminal record review;

(2) Disclose the applicant's criminal history. For the purposes of this
subdivision "criminal history" includes any suspended imposition of
sentence, any suspended execution of sentence, or any period of probation
or parole; and

(3) Disclose if the applicant is listed on the employee disqualification
list as provided in section 660.315, RSMo, or the department of mental
health disqualification registry as provided for in this section.

6. Any person who has received a good cause waiver issued by the division
of senior services or its predecessor under subsection 9 of section
660.317, RSMo, shall not require an additional exception under this
section in order to be employed in a long-term care facility licensed
under chapter 198, RSMo.

7. Any public or private residential facility, day program, or
specialized service licensed, certified, or funded by the department
shall, not later than two working days after hiring any person for a
full-time, part-time, or temporary position that will have contact with
clients, residents, or patients:

(1) Request a criminal background check as provided in section 43.540,
RSMo;

(2) Make an inquiry to the department of social services and department
of health and senior services to determine whether the person is listed
on the employee disqualification list as provided in section 660.315,
RSMo; and

(3) Make an inquiry to the department of mental health to determine
whether the person is listed on the disqualification registry as provided
in this section.

8. An applicant who knowingly fails to disclose his or her criminal
history as required in subsection 5 of this section is guilty of a class
A misdemeanor. A provider is guilty of a class A misdemeanor if the
provider hires a person to hold a direct care position knowing that such
person has been disqualified pursuant to the provisions of subsection 1
or 2 of this section.

9. The department may maintain a disqualification registry and place on
the registry the names of any persons who have been finally determined by
the department to be disqualified pursuant to this section, or who have
had administrative substantiations made against them for abuse or neglect
pursuant to department rule. Such list shall reflect that the person is
barred from holding any position in any public or private facility or day
program operated, funded or licensed by the department, or any mental
health facility or mental health program in which persons are admitted on
a voluntary basis or are civilly detained pursuant to chapter 632, RSMo.
(L. 1980 H.B. 1724, A.L. 1982 H.B. 1565, A.L. 1996 S.B. 884 & 841, A.L.
1998 S.B. 870, A.L. 2001 S.B. 48, A.L. 2003 S.B. 184)

1. No person admitted on a voluntary or involuntary basis to any
mental health facility or mental health program in which people are
civilly detained pursuant to chapter 632, RSMo, and no patient, resident
or client of a residential facility or day program operated, funded or
licensed by the department shall be subject to physical or chemical
restraint, isolation or seclusion unless it is determined by the head of
the facility or the attending licensed physician that the chosen
intervention is imminently necessary to protect the health and safety of
the patient, resident, client or others and that it provides the least
restrictive environment.

2. Every use of physical or chemical restraint, isolation or seclusion
and the reasons therefor shall be made a part of the clinical record of
the patient, resident or client under the signature of the head of the
facility or the attending licensed physician.

3. Physical or chemical restraint, isolation or seclusion shall not be
considered standard treatment or habilitation and shall cease as soon as
the circumstances causing the need for such action have ended. (L. 1980
H.B. 1724, A.L. 1996 S.B. 884 & 841)

The provisions of this chapter and chapters 631, 632 and 633,
RSMo, shall not be construed as authorizing any form of compulsory
medical treatment of any person who is being treated by prayer in the
practice of the religion of any church which teaches reliance on
spiritual means for healing unless the person or his legal guardian, if
any, consents to such treatment. (L. 1980 H.B. 1724)

Subject to other provisions of this chapter, the head of a
mental health or mental retardation facility may authorize the medical
and surgical treatment of a patient or resident under the following
circumstances:

(1) Upon consent of a patient or resident who is competent;

(2) Upon consent of a parent or legal guardian of a patient or resident
who is a minor or legally incapacitated;

(3) Pursuant to the provisions of chapter 431, RSMo;

(4) Pursuant to an order of a court of competent jurisdiction. (L. 1980
H.B. 1724, A.L. 1983 S.B. 44 & 45)

Any purchase of food in any institution under the control of the
department, other than the usual quantity purchased for the patients or
residents thereof, to be used by or for anyone other than the patients or
residents of such institution shall be charged directly to the individual
responsible for such purchase. (L. 1980 H.B. 1724)

No biomedical or pharmacological research shall be conducted in
any mental health facility or mental health program in which people may
be civilly detained pursuant to chapter 632, RSMo, or in any public or
private residential facilities or day programs operated, funded or
licensed by the department for persons affected by mental retardation,
developmental disabilities, mental illness, mental disorders or alcohol
or drug abuse unless such research is intended to alleviate or prevent
the disabling conditions or is reasonably expected to be of direct
therapeutic benefit to the participants. Without a specific court order,
no involuntary patient shall consent to participate in any biomedical or
pharmacological research. The application for the order shall be filed in
the court having probate jurisdiction in the county in which the mental
health facility is located, provided, however, that if the patient
requests that the hearing be held by the court which has committed the
patient, or if the court having probate jurisdiction deems it
appropriate, the hearing on the application shall be transferred to the
committing court. (L. 1980 H.B. 1724 § 630.192 subsec. 1, A.L. 1996 S.B.
884 & 841)

1. A "Professional Review Committee", consisting of ten members
appointed by the director is hereby created to review, report, and
recommend approval or disapproval to the director of any research
conducted by the department. The committee shall consist of persons who
reside in the state and are not employed by the department and who have
demonstrated recognized competence in medicine, pharmacology, behavioral
sciences, biomedical science, philosophy of science, or bioethics. Each
member of the committee shall serve for a term of four years following
his appointment, except one-half of the members initially appointed after
August 13, 1980, shall serve terms of two years each.

2. The department shall pay the members of the committee one hundred
dollars per day for each day, or portion thereof, they actually spend in
the performance of their official duties and shall reimburse the members
for actual necessary expenses incurred in the performance of their
official duties.

3. The committee shall elect a chairman annually. The committee shall
meet at the call of the director or the chairman and shall have a quorum
when at least five members are present. (L. 1980 H.B. 1724 § 630.192
subsecs. 2, 3, 4)

1. Persons seeking to initiate any research in residential
facilities or day programs funded, operated or licensed by the department
shall submit their research proposals to the professional review
committee for review. The committee shall prepare a report, which shall
be available to the general public, of each research proposal it reviews,
stating its finding and conclusions, and recommending either approval or
disapproval of the project to the director. The director shall state his
decision in writing and the decision shall be final.

2. The committee shall review the conduct of the research during the
progress of the project. If during the research, harm or increased risk
of harm to participants occurs, or if deviations in research protocol
occur without approval of the committee, the committee shall investigate
the project. The committee shall suspend or halt the project if deemed
appropriate to prevent harm or the increased risk of harm.

3. The professional review committee shall review each biomedical or
pharmacological research proposal according to, but not restricted to,
the following criteria:

(1) Need for the research;

(2) Methodological adequacy;

(3) Duplication with other projects;

(4) Sufficiency of scientific and theoretical justification;

(5) Competence of the researcher;

(6) Funding sufficiency;

(7) Weighing risks against potential benefits;

(8) Appropriateness of subject population;

(9) Adequacy of consent information.

4. If the committee believes it lacks sufficient expertise in the subject
area of the proposed research, it may obtain outside experts to review
the project and recommend disposition. (L. 1980 H.B. 1724)

1. A "Research Review Committee", consisting of five members,
shall be established at each department facility where research is
proposed to be conducted. The members of the committees shall be
appointed by the head of the facilities with the approval of the division
director. The committee shall be composed of persons who reside in the
state and are not employed by the department and shall be composed of the
following:

(1) Three members shall be consumers, family members of consumers, or
representatives of consumer groups;

(2) One member shall be a licensed physician;

(3) One member shall be an attorney.

2. The members of the committees shall serve for terms of four years
each, except that two of the members initially appointed shall serve a
term of two years each.

3. The committee members shall not receive any compensation for their
services but they shall be reimbursed for the actual and necessary
expenses they incur while performing committee work.

4. Each committee shall annually elect a chairman. Each committee shall
meet at the call of the head of the facility or the committee chairman
and shall have a quorum when at least three members are* present. (L.
1980 H.B. 1724)

*Word "are" does not appear in original rolls.

1. After a project has been approved by the professional review
committee, the research review committees shall determine that the
persons selected to participate in biomedical or pharmacological research
or their parents or guardians have given informed consent as to whether
or not they wish to participate. Before any person participates in such
research, the committees shall screen the research and recommend approval
or disapproval to the director. The decision of the director shall be
final.

2. The committees shall assure that the following criteria are met in
giving informed consent:

(1) The person has the capacity to understand the risks, benefits and
procedures with respect to the project he or she is asked to engage in;

(2) The person has been given sufficient information to understand the
risks, benefits and procedures; and

(3) The person is acting of his own free volition without coercive
influence.

3. Persons may decide not to participate or may withdraw from the
research at any time for any reasons.

4. Persons who are subjects of the research shall be compensated for
their time spent in the research projects to the same extent that persons
who are not department patients, residents or clients are typically
compensated. (L. 1980 H.B. 1724)

Sections 630.194, 630.196 and 630.198 shall apply to all
proposed biomedical or pharmacological research that involves persons
civilly detained. (L. 1996 S.B. 884 & 841)

In accordance with state and federal law, no mental health
facility or mental health program in which people may be civilly detained
pursuant to chapter 632, RSMo, and no residential facility, day program
or specialized service operated, funded or licensed by the department
shall deny admission or other services to any person because of his race,
sex, creed, marital status, national origin, disability or age. (L. 1980
H.B. 1724, A.L. 1996 S.B. 884 & 841)

1. The person receiving services and the person's estate,
spouse, parents, if the person is a minor, and any fiduciary or
representative payee holding assets for the person or on the person's
behalf are jointly and severally liable for the fees for services
rendered to the person by a residential facility, day program or
specialized service operated or funded by the department. The department
shall not charge parents for services it renders to persons who are
eighteen years of age or older and who are residents of this state. If
any person, firm, corporation, or public or private agency is liable,
either pursuant to contract or otherwise, to the parents or a recipient
of services on account of personal injury to or disability or disease of
the recipient of services, the department is subrogated to the right of
the parent or recipient to recover from that part of the award or
settlement an amount equal to the amount expended by the service for
services which are not otherwise recoverable from the parent or
recipient. The acceptance of services from the department constitutes
acknowledgment of subrogation rights by the department, and the
department may take any and all action necessary to enforce the
subrogation rights.

2. Parents of minors who are domiciled in this state, as defined in
section 162.970, RSMo, shall not be liable for the cost of education or
special education and related services. If, as a result of a
comprehensive evaluation and such conclusion in the minor's
individualized education program, admission to a department facility or
placement program is necessary for such minor to receive an appropriate
education, the parents of minors who are domiciled in this state under
section 162.970, RSMo, shall not be liable for the cost of nonmedical
care and room and board.

3. For purposes of subsection 2 of this section, "special education" and
"related services" are defined pursuant to the Federal Education of the
Handicapped Act (20 U.S.C. {1401, et seq.), as amended, and the rules and
regulations promulgated in furtherance thereof.

4. No person who is domiciled in Missouri shall be denied services from a
department facility because of an inability to pay for such services on
the part of the individual, the spouse or the parents.

5. Nothing in this section shall be construed to relieve an insurer or
other third party from an otherwise valid obligation. (L. 1980 H.B. 1724,
A.L. 1981 H.B. 399, A.L. 1985 S.B. 265)

1. The director shall determine the maximum amount for services
which shall be charged in each of the residential facilities, day
programs or specialized services operated or funded by the department for
full-time or part-time inpatient, resident or outpatient evaluation,
care, treatment, habilitation, rehabilitation or other service rendered
to persons affected by mental disorder, mental illness, mental
retardation, developmental disability or drug or alcohol abuse. The
maximum charge shall be related to the per capita inpatient cost or
actual outpatient evaluation or other service costs of each facility,
program or service, which may vary from one locality to another. The
director shall promulgate rules setting forth a reasonable standard means
test which shall be applied by all facilities, programs and services
operated or funded by the department in determining the amount to be
charged to persons receiving services. The department shall pay, out of
funds appropriated to it for such purpose, all or part of the costs for
the evaluation, care, treatment, habilitation, rehabilitation or room and
board provided or arranged by the department for any patient, resident or
client who is domiciled in Missouri and who is unable to pay fully for
services.

2. The director shall apply the standard means test annually and may make
application of the test upon his own initiative or upon request of an
interested party whenever evidence is offered tending to show that the
current support status of any patient, resident or client is no longer
proper. Any change of support status shall be retroactive to the date of
application or request for review. If the persons responsible to pay
under section 630.205 or 552.080, RSMo, refuse to cooperate in providing
information necessary to properly apply the test or if retroactive
benefits are paid on behalf of the patient, resident or client, the
charges may be retroactive to a date prior to the date of application or
request for review. The decision of the director in determining the
amount to be charged for services to a patient, resident or client shall
be final. Appeals from the determination may be taken to the circuit
court of Cole County or the county where the person responsible for
payment resides in the manner provided by chapter 536, RSMo.

3. The department shall not pay for services provided to a patient,
resident or client who is not domiciled in Missouri unless the state is
fully reimbursed for the services; except that the department may pay for
services provided to a transient person for up to thirty days pending
verification of his domiciliary state, and for services provided for up
to thirty days in an emergency situation. The director shall promulgate
rules for determination of the domiciliary state of any patient, resident
or client receiving services from a facility, program or service operated
or funded by the department.

4. Whenever a patient, resident or client is receiving services from a
residential facility, day program or specialized service operated or
funded by the department, and the state, county, municipality, parent,
guardian or other person responsible for support of the patient, resident
or client fails to pay any installment required to be paid for support,
the department or the residential facility, day program or specialized
service may discharge the patient, resident or client as provided by
chapter 31, RSMo. The patient, resident or client shall not be discharged
under this subsection until the final disposition of any appeal filed
under subsection 2 of this section.

5. The standard means test may be waived for a child in need of mental
health services to avoid inappropriate custody transfers to the
children's division. The department of mental health shall notify the
child's parent or custodian that the standard means test may be waived.
The department of mental health shall promulgate rules for waiving the
standard means test. Any rule or portion of a rule, as that term is
defined in section 536.010, RSMo, that is created under the authority
delegated in this section shall become effective only if it complies with
and is subject to all of the provisions of chapter 536, RSMo, and, if
applicable, section 536.028, RSMo. This section and chapter 536, RSMo,
are nonseverable and if any of the powers vested with the general
assembly pursuant to chapter 536, RSMo, to review, to delay the effective
date, or to disapprove and annul a rule are subsequently held
unconstitutional, then the grant of rulemaking authority and any rule
proposed or adopted after August 28, 2004, shall be invalid and void. (L.
1980 H.B. 1724, A.L. 1981 H.B. 399, A.L. 1982 H.B. 1565, A.L. 1993 S.B.
52, A.L. 2004 S.B. 1003)

1. Any probate division of the circuit court having knowledge of
the existence of an estate of a patient, resident or client receiving
services from residential facilities or day programs operated or funded
by the department shall promptly notify the director of the nature and
extent of the estate and the identity of the attorney of record and
conservator. The director shall then apply the standard means test
contained in the rules of the department to determine if the estate shall
be charged for services rendered by the department.

2. If the director determines that the estate should be charged for the
evaluation, care, treatment, habilitation, rehabilitation or room and
board provided or funded by the department, and notifies the conservator,
the conservator shall pay the charges. If the conservator fails to pay
for the charges, after reasonable delay, the head of the department,
residential facility or day program may discharge the patient as provided
by chapter 31, RSMo.

3. The decision of the director shall be final, and appeal may be made to
the circuit court of Cole County or the county where the person
responsible for payment resides in the manner provided by chapter 536,
RSMo. The director shall notify the conservator and the supervising court
of such failure to pay for services rendered by a facility or program
operated or funded by the department at least thirty days before the
patient, resident or client is discharged under chapter 31, RSMo. If the
conservator appeals the decision of the director, the patient, resident
or client shall remain in the facility or program pending final
disposition of the appeal. (L. 1980 H.B. 1724, A.L. 1983 S.B. 44 & 45)

For all debts and demands whatsoever to any of the residential
facilities or day programs subject to the control of the department, and
for all damages for failure of contract, for trespass and other wrongs to
a facility operated by the department, or any of its property thereof,
real or personal, actions in any court of competent jurisdiction may be
maintained in the name of the director. Interest shall be recovered on
any and all sums due any facility or program operated or funded by the
department on account of any patient or resident thereof, the account
therefor, certified by the head of the facility, with the seal of the
institution attached, shall be prima facie evidence of the amount due.
(L. 1980 H.B. 1724)

Before any patient who can support himself is admitted into any
facility operated by the department, he shall be furnished, by those
responsible for his support, with suitable changes of clothing. If
patients who are able to support themselves as determined under section
630.210 are in need of clothing, the business manager, under the
direction of the head of the facility, shall furnish the same. The
department shall calculate expenditures for such clothing as part of the
per diem expense. Nothing in this section shall be construed as
prohibiting the purchase of clothing by, or gifts of clothing to, a
patient or resident by his family or friends. (L. 1980 H.B. 1724)

1. For purposes of this section, the term "money" includes any
legal tender, note, draft, certificate of deposit, stock, bond, check or
credit card.

2. A department residential facility may require that all money which is
on the person of a patient or resident, which comes to a patient or
resident, or which the facility receives in place of the patient or
resident under a benefit arrangement or otherwise be turned over to the
facility for safekeeping. The money shall be accounted for in the name of
the patient or resident and recorded periodically in the records of the
patient or resident. Upon request, money accounted for in the name of the
patient or resident shall be turned over to a conservator of the patient
or resident, if the conservator has such authority, or to the parent of
the patient or resident if the patient or resident is a minor; except the
facility shall hold money it received as representative payee under terms
of public or private benefit arrangements as authorized by section
630.315.

3. A patient or resident of a department facility shall have easy access
to the money in his account and may keep and be allowed to spend a
reasonable sum for canteen expenses and small purchases. He may spend or
otherwise use the money as he chooses, except as provided in subsection 4
of this section. With the approval of the department, the facility shall
establish written policies and procedures giving patients and residents
easy access to the money in their accounts and allowing the money to be
spent or otherwise used as the patients or residents choose.

4. A department facility may deny a patient or resident the access to and
ability to spend or otherwise use the money in his account if it
determines that the denial is essential in order to prevent the patient
or resident from significantly dissipating his assets or that reasonable
restrictions are necessary to protect the patient, resident or others.
The department shall establish policies and procedures governing such
determinations, including the evidence necessary to support a denial of
the patient's or resident's rights. If a denial is made, the patient or
resident may continue to spend or otherwise use the money in ways which
would not constitute significant dissipation of the assets and which
would sufficiently protect himself or others.

5. The department facility shall deposit money accounted for in the name
of a patient or resident with a financial institution. Any earnings
attributable to money in the account of a patient or resident shall be
credited to that account. Under sections 110.070 to 110.110, RSMo, the
department shall receive bids from banking corporations, associations or
trust companies which desire to be selected as depositaries of the
department for patients' and residents' moneys.

6. The department shall deliver to the patient or resident, his
conservator, if he is legally disabled, or his parent, if he is a minor,
all money, including any earnings, in the patient's or resident's account
upon release from the facility; except that the department may continue
to serve as a depositary for the money in the account of a patient or
resident who is placed through the department's placement program.

7. The department shall establish policies and procedures designed to
insure that money in the accounts of patients and residents is
safeguarded against theft, loss or misappropriation. The department shall
guarantee against theft, loss or misappropriation the principal amounts
in any patient's or resident's account. (L. 1980 H.B. 1724, A.L. 1982
H.B. 1565, A.L. 1983 S.B. 44 & 45)

A department residential facility may accept funds which a
parent, guardian or other person wishes to provide for the use or benefit
of a patient or resident of the facility. The possession and use of such
funds shall be governed by section 630.305 and by any additional
directions given by the provider of the funds. (L. 1980 H.B. 1724)

A department residential facility may accept an appointment to
serve as representative payee or fiduciary, or in a similar capacity for
payments to a patient or resident under a public or private benefit
arrangement. Funds so received shall be governed by section 630.305,
except to the extent that laws or regulations governing payment of the
benefits provide otherwise. (L. 1980 H.B. 1724)

1. If any patient or resident dies, is released, escapes or
otherwise leaves the care of the department, and leaves any personal
funds in the custody of a department facility, the head of the facility
shall use all proper diligence to refund such moneys. All reasonable
means shall be used to contact the patient or resident if living, or if
deceased, the patient's or resident's heirs to refund such moneys. If the
patient or resident is deceased, the facility may dispose of these moneys
through the probate court or otherwise release these moneys to the heirs,
if located. The facility may also make claim for these moneys for unmet
costs of care in accordance with procedures established by the director
of the department.

2. After one year from the date of such death, release, escape or other
departure, if there shall remain in the custody of a facility any money,
the owner of which is unknown, or if known, cannot be located, in each
and every such instance, the money shall be disposed of in the following
manner:

(1) Amounts less than one hundred dollars shall be deposited into the
state treasury to the credit of the mental health trust fund. Such money
shall escheat and vest absolutely in the state of Missouri, and all
persons shall be forever barred and precluded from setting up title or
claim to any of such moneys.

(2) Amounts of one hundred dollars or more shall be deposited into the
state treasury to the credit of the general revenue fund in a special
account designated as escheat. Claims may be made, as provided in this
section, for such moneys for a period of two years after deposit into the
escheat account. After remaining therein unclaimed for two years such
moneys shall escheat and vest absolutely in the state of Missouri and be
credited to the mental health trust fund. Thereafter, all persons shall
be forever barred and precluded from setting up title or claim to any of
such moneys.

3. Within two years after such money in amounts of one hundred dollars or
more has been transmitted into the escheats account, any person who
appears and claims the same may file his petition in the circuit court of
Cole County, Missouri, stating the nature of his claim and asking to be
paid such money. A copy of the petition shall be served upon the director
who shall file an answer to the same. If the court finds that such person
is entitled to any money so paid into the state treasury, it shall order
the commissioner of administration to issue a warrant for the amount of
such claim, but without interest or costs; provided, that either party
may appeal from the decision of the court in the same manner as provided
by law in other civil actions.

4. Nothing in this section shall be deemed to apply to funds regularly
due the state of Missouri for the support and maintenance of patients of
state facilities. (L. 1980 H.B. 1724, A.L. 1982 H.B. 1565, A.L. 1995 S.B.
454)

If any patient or resident dies, is released, escapes, or
otherwise leaves the care of the department, and leaves any article or
articles of tangible personal property in the custody of a department
facility, the head of the facility may, in his discretion, after the
lapse of one year from the date of such death, release, escape, or other
departure, if no claim therefor has been made, transfer the personal
property to the state agency for surplus property for public or private
sale. If such sale or sales are made, the commissioner of administration
shall transmit the net proceeds thereof to the director of revenue for
deposit in the general revenue fund. (L. 1980 H.B. 1724, A.L. 1995 S.B.
454)

1. The director may for the benefit of the department or any
residential facility operated by the department take, receive, administer
and hold in trust all grants, gifts, donations, moneys escheated under
section 630.320, devises or bequests of money or other personal property,
or any real property on behalf and in the name of the governor, and the
income or interest received or earned on any property or funds so
acquired from any person whether individual, body politic, corporate,
partnership, unincorporated association or from any other source. If any
grant, gift, donation, devise or bequest is made for a specified use or
purpose, it shall not be applied either wholly or in part for any other
use or purpose. The director may, if so authorized by the general
assembly, convey or lease any real property so acquired. The director or
the governor shall deposit the funds derived from such sale or conveyance
or lease and any other funds derived from grants, gifts, donations,
moneys escheated, devises or bequests of money or other property, whether
real or personal or income or interest therefrom, in the state treasury
where it shall be credited to a special fund known as the "Mental Health
Trust Fund", which is hereby created. The state treasurer shall credit to
the fund any interest earned from investing the moneys in the fund. The
mental health trust fund shall not lapse biennally and, accordingly,
shall be exempt from the provisions of section 33.080, RSMo, relating to
the transfer of funds to the general revenue fund of the state by the
state treasurer.

2. The moneys in the mental health trust fund shall not be appropriated
for the support of the facilities of the department in lieu of general
state revenues but shall be appropriated only for the purposes of
carrying out the objects for which the grants, gifts, donations, devises
or bequests were made, or for purposes of funding special projects or
purchasing special equipment from moneys escheated under section 630.320.

3. The director shall make an annual written report to the governor, the
commissioner of administration and the general assembly within ninety
days after the close of each fiscal year of the moneys in the mental
health trust fund. (L. 1980 H.B. 1724, A.L. 1982 H.B. 1565)

1. With the approval of the director, the head of any of the
department's mental health or mental retardation facilities or regional
centers may establish and operate a canteen or commissary for the use and
benefit of patients, residents and employees.

2. Each facility or center shall keep revenues received from the canteen
or commissary established and operated by the head of the facility in a
separate account. The acquisition cost of goods sold and other expenses
shall be paid from this account. A minimum amount of money necessary to
meet cash flow needs and current operating expenses may be kept in this
account. The remaining funds from sales of each commissary or canteen
shall be deposited monthly in the state treasury to the credit of the
mental health trust fund. The money in the fund shall be expended, upon
appropriation, for the benefit of the patients in the improvement of the
recreation, habilitation or treatment services or equipment of the
facility or center from which derived. The provisions of section 33.080,
RSMo, to the contrary notwithstanding, the money in the mental health
trust fund shall be retained for the purposes specified in this section
and shall not revert or be transferred to general revenue. The department
of mental health shall keep accurate records of the source of money
deposited in the mental health trust fund and shall allocate
appropriations from the fund to the appropriate institution, facility or
center. (L. 1980 H.B. 1724)

1. With the approval of the director, the head of any mental
health or retardation facility or regional center operated by the
department may establish a vocational activity center for its patients or
residents.

2. Each facility or regional center shall keep revenues received from the
activity center in a separate account. The acquisition costs to obtain
materials to produce any goods sold and other expenses shall be paid from
this account. A minimum amount of money necessary to meet cash flow needs
and current operating expenses may be maintained in this account. The
remaining funds from sales of the activity center shall be deposited
monthly in the state treasury to the credit of the general revenue fund.

3. This section shall not be construed to authorize any facility or
regional center to establish an activity center on the grounds for
patients or residents who could participate in a sheltered workshop, as
defined and authorized in sections 178.900 to 178.960, RSMo, off the
grounds of the facility or regional center. (L. 1980 H.B. 1724)

The department or any of its facilities shall not maintain any
funds or accounts in concentrated bank accounts or other state accounts
unless the funds or accounts are authorized by law. (L. 1980 H.B. 1724)

1. The department may purchase services for patients, residents
or clients from private and public vendors in this state with funds
appropriated for this purpose.

2. Services that may be purchased may include prevention, diagnosis,
evaluation, treatment, habilitation, rehabilitation, transportation and
other special services for persons affected by mental disorders, mental
illness, mental retardation, developmental disabilities or alcohol or
drug abuse.

3. The commissioner of administration, in consultation with the director,
shall promulgate rules establishing procedures consistent with the usual
state purchasing procedures pursuant to chapter 34, RSMo, for the
purchase of services pursuant to this section. The commissioner may
authorize the department to purchase any technical service which, in his
judgment, can best be purchased direct pursuant to chapter 34, RSMo. The
commissioner shall cooperate with the department to purchase timely
services appropriate to the needs of the patients, residents or clients
of the department.

4. The commissioner of administration may promulgate rules authorizing
the department to review, suspend, terminate, or otherwise take remedial
measures with respect to contracts with vendors as defined in subsection
1 of this section that fail to comply with the requirements of section
210.906, RSMo.

5. The commissioner of administration may promulgate rules for a waiver
of chapter 34, RSMo, bidding procedures for the purchase of services for
patients, residents and clients with funds appropriated for that purpose
if, in the commissioner's judgment, such services can best be purchased
directly by the department.

6. No rule or portion of a rule promulgated pursuant to the authority of
this section shall become effective unless it has been promulgated
pursuant to the provisions of chapter 536, RSMo. (L. 1980 H.B. 1724, A.L.
1993 S.B. 52, A.L. 1995 S.B. 3, A.L. 2001 S.B. 48)

1. The department may recognize providers as administrative
entities under the following circumstances:

(1) Vendors operated or funded pursuant to sections 205.975 to 205.990,
RSMo;

(2) Vendors operated or funded pursuant to sections 205.968 to 205.973,
RSMo;

(3) Providers of a consortium of treatment services to the clients of the
division of comprehensive psychiatric services as an agent of the
division in a service area, except that such providers may not exceed
thirty-six in number.

2. Notwithstanding any other provision of law to the contrary, the
department may contract directly with vendors recognized as
administrative entities without competitive bids.

3. Notwithstanding any other provision of law to the contrary, the
commissioner of administration shall delegate the authority to
administrative entities which are state facilities to subcontract with
other vendors in order to provide a full consortium of treatment services
for the service area.

4. When state contracts allow, the department may authorize
administrative entities to use state contracts for pharmaceuticals or
other medical supplies for the purchase of these items.

5. A designation as an administrative entity does not entitle a provider
to coverage under sections 105.711 to 105.726, RSMo, the state legal
expense fund, or other state statutory protections or requirements.

6. The department shall promulgate regulations within twelve months of
August 28, 1990, regulating the manner in which they will contract and
designate and revoke designations of providers under this section. Such
regulations shall not be required when the parties to such contracts are
both governmental entities. (L. 1990 S.B. 808 & 672)

The department shall evaluate any proposed contract to determine
whether it meets the following criteria:

(1) Conformance with the conditions and priorities of the regional and
state division plans;

(2) Compliance with department rules and regulations. (L. 1980 H.B. 1724)

1. Each contract shall provide by its terms for units of a
single service or several services accessible to persons needing them in
defined geographic areas.

2. Through monitoring of the contracts under department rules and under
the contract terms, the department shall require evidence that the
services funded by the state are cost-and-benefit effective. (L. 1980
H.B. 1724)

To coordinate a delivery system of accessible department
services, to integrate vendor programs into the department system and to
avoid duplication of state-provided or -supported services, the
department shall require affiliation agreements with vendors as a
condition for receiving purchase-of-service funds. In the agreements, the
department shall assign responsibility to the vendors for providing
certain programs for meeting the needs of underserved, unserved or
inappropriately served persons for whom the state has the responsibility
to serve. (L. 1980 H.B. 1724)

1. The department may make incentive grants from funds
specifically appropriated for this purpose to private and public entities
seeking to establish a residential facility, day program or specialized
service for persons affected by mental disorders, mental illness, mental
retardation, developmental disabilities or alcohol or drug abuse in
unserved, underserved or inappropriately served areas of the state.

2. The department shall promulgate rules establishing procedures for
monitoring and auditing such grants.

3. The grants shall be of limited duration of one year and renewable for
only one additional year if the funds are appropriated for this purpose.
(L. 1980 H.B. 1724)

1. The commissioner of administration, in consultation with the
director, shall promulgate rules establishing the procedures to contract
with grantees which receive incentive-grant funds under section 630.425.
No rule or portion of a rule promulgated under the authority of this
section shall become effective unless it has been promulgated pursuant to
the provisions of section 536.024, RSMo.

2. The department shall require evidence that the programs supported in
whole or in part with the state incentive-grant funds are
cost-and-benefit effective. (L. 1980 H.B. 1724, A.L. 1993 S.B. 52, A.L.
1995 S.B. 3)

To coordinate the delivery system of accessible department
services, to integrate the community-based program into the department
system and to avoid duplication of state-provided or -supported services,
the department shall require affiliation agreements with the grantees as
a condition for receiving the grants. In the agreements, the department
shall assign responsibility to the grantee for providing certain services
for meeting the needs of unserved, underserved or inappropriately served
persons for whom the state has the responsibility to serve. (L. 1980 H.B.
1724)

The department shall pay the grantees in periodic interim
payments rather than lump sum payments and shall require that the
grantees, before receiving any subsequent payments after their initial
payments, submit invoices describing their expenses, progress reports on
establishing the residential facilities, day programs or specialized
services and written reports of the services they have provided with the
funds they have received. (L. 1980 H.B. 1724)

1. Each vendor or grantee under contract with the department
under this chapter or chapter 631, 632, or 633, RSMo, shall keep such
records as the department shall prescribe, including records which fully
disclose the amount and disposition by such recipient of the proceeds of
such funding; the total cost of the project, service or undertaking in
connection with which such funding is given or used; the amount of that
portion of the cost of the project, service or undertaking supplied by
other sources; and such other records as will facilitate an effective
audit as required in the rules and regulations of the department.

2. The department and the state auditor, or his designee, shall have
access for the purpose of audit and examination to any books, documents,
papers and records of the recipients that are pertinent to the funding
received from the department.

3. The department and the state auditor, or his designee, shall perform
their auditing functions in such a manner that the identity of any
individual who receives a service from a person receiving funds pursuant
to this chapter shall be confidential in accordance with state and
federal law. (L. 1980 H.B. 1724)

If a residential facility, day program or other specialized
service proposes to be funded by the department to provide services which
the department provides through any of its facilities, programs or
specialized services, the department shall determine how such services
can most economically and effectively be provided and shall provide such
services either directly or through contract and affiliation agreements,
and shall avoid duplication of such services unless the department finds
that such duplication is necessary. The department shall report any such
duplication, and why the department deems such duplication necessary, in
writing to the appropriations committees of the Missouri house and
senate. (L. 1980 H.B. 1724)

The attorney general shall represent the department to seek
restitution of any moneys dispensed under this chapter which have been
misappropriated, fraudulently obtained or overpaid. (L. 1980 H.B. 1724)

1. For the purposes of this section, the term "overpayment"
means any payment by the department to a vendor providing care,
treatment, habilitation or rehabilitation services to clients under
contract with the department, which is:

(1) In excess of the contracted rate less payments by the client or on
his behalf as required to be made by the standard means test contained in
department rules;

(2) In payment of services not provided;

(3) In payment for any service not authorized in the contract with the
department; or

(4) In payment for services provided contrary to the provisions of the
contract with the department.

2. The department shall notify the vendor in writing by certified mail,
return receipt requested, of the amount of the overpayment, the basis for
such overpayment and request reimbursement. Within thirty days of receipt
of the notice of overpayment, a provider may request a review of the
overpayment and reimbursement request by the department director or his
designee. Such review shall be conducted in person if requested by the
provider. The department director or his designee shall review the
overpayment within fifteen days of the request for review.

3. If any overpayment is not fully repaid within forty-five days of the
date of notice of overpayment, the department shall assess interest on
the unpaid balance. Interest shall be charged on any unpaid balance
beginning from the date of notice of overpayment and shall accrue at a
rate not to exceed the annual rate established pursuant to the provisions
of section 32.065, RSMo, plus three percentage points.

4. The department and the vendor shall have forty-five days from receipt
of the notice of the overpayment to negotiate a repayment plan to recover
the amount of the overpayment as finally determined plus accrued interest
at the rate established in subsection 3 of this section over a period
determined by the department, but not to exceed twelve months from the
date of final disposition of any overpayment review authorized by this
section. The department shall determine the method of repayment which may
include direct payment by the vendor, deduction from future amounts due
to the vendor from the department, or both.

5. If any overpayment plus accrued interest not subject to a repayment
plan pursuant to subsection 4 of this section is not fully repaid within
six months of the date of notice of overpayment, the department may
certify the amount due to the office of the attorney general, or take
other appropriate collection actions. If any portion of an overpayment
plus accrued interest which is subject to a repayment plan pursuant to
subsection 4 of this section, but which is not repaid pursuant to the
terms of the plan, the department may certify all or a portion of the
overpayment plus accrued interest due to the office of the attorney
general, or take other appropriate collection actions. (L. 1984 S.B. 575,
A.L. 1996 H.B. 1081)

1. There is hereby created in the department of mental health a
committee to be known as the "Review Committee for Purchasing" to review
the manner in which the department of mental health purchases services
for persons with mental health disorders and substance abuse problems. By
December 31, 1995, the committee shall recommend to the governor and the
general assembly any changes that should be made in the department of
mental health purchasing systems, including whether the department should
follow a competitive purchasing model and, if so, the time frame for
initiating such change. The recommendation of the committee shall be made
in the context of state and national health care reform and with the goal
of providing effective services in a coordinated and affordable manner.

2. The review committee on purchasing created in subsection 1 of this
section shall be composed of nine members as follows:

(1) One member of the mental health commission, appointed by the governor;

(2) One representative of the office of administration, appointed by the
governor;

(3) The governor or his designee;

(4) Two members appointed at large by the governor, with one member
representing the business community and one public member;

(5) Two members, appointed at large by the governor, with one member
being a private provider and one member being affiliated with a hospital;

(6) Two members, appointed at large by the governor, who are consumers of
mental health services or family members of consumers of mental health
services.

*3. The review committee established in subsection 1 of this section
shall be disbanded on January 1, 1996.

4. Notwithstanding any other provision of law to the contrary, beginning
July 1, 1997, if the review committee failed to make the recommendations
to the governor and the general assembly as required in subsection 1 of
this section, the department of mental health may contract directly with
vendors operated or funded pursuant to sections 205.975 to 205.990, RSMo,
or operated or funded pursuant to sections 205.968 to 205.973, RSMo,
without competitive bids. All contracts with vendors who are providers of
a consortium of treatment services to the clients of the division of
comprehensive psychiatric services shall be awarded in accordance with
chapter 34, RSMo. (L. 1995 H.B. 562 § 1)

*Review committee for purchasing to be disbanded on 1-1-96.

All department reviews of contractors for community psychiatric
rehabilitation services shall be the same regardless of whether or not a
provider is designated as an administrative entity pursuant to section
630.407. (L. 1995 H.B. 562 § 2)

The department shall designate the names of each of its
facilities. No official name shall contain terminology which, from a
public standpoint, could be regarded as stigmatizing or denigrating. (L.
1980 H.B. 1724)

At least once every three years, the department shall conduct a
complete statewide inventory of its existing facilities and a survey of
needs for persons affected by mental disorders, mental illness, mental
retardation, developmental disabilities and alcohol or drug abuse, and
shall make a public report of its inventory and survey and recommend a
state plan for the construction of additional facilities. (L. 1980 H.B.
1724)

If any major building standing on property under the supervision
and control of the department is in such a state of dilapidation or
disrepair as to be, in the opinion of the director, dangerous to patients
or residents, employees of the department or other persons frequenting
such property, the department may, with the approval of the division of
design and construction and, if necessary, with appropriations for this
purpose from the general assembly, cause such building to be torn down or
razed. For such purpose, the department may contract with any person
under the rules and regulations of the division of purchasing, and may
sell or otherwise dispose of the materials composing such building. (L.
1980 H.B. 1724)

1. If the department discontinues the use of any building or
real property on any of the grounds of a residential facility operated by
it and determines it has no future use for the building or grounds, the
department may inform the commissioner of administration that the unused
building or property is vacant. The governor may, consistent with
appropriations, transfer the control and management of the building or
property to another state agency.

2. The governor shall obtain the approval of the director before making
any such transfer. (L. 1980 H.B. 1724)

The board of public buildings, as created under section 8.010,
RSMo, and the commissioner of administration shall review each proposed
transfer or conveyance of any interest in real property owned by the
state for the department. The board and the commissioner shall report to
the general assembly any recommendations either might have regarding the
consideration for such transfer or conveyance to protect the interests of
the state prior to such transfer or conveyance. (L. 1980 H.B. 1724)

In addition to salary and wages, when the director shall
determine that it is in the best interest of the state to do so, the
department may provide any employee in any institution under its control
with board and living quarters on the grounds of its facilities. (L. 1980
H.B. 1724)

1. The commissioner of administration is authorized to enter
into a lease purchase agreement for the use of facilities to be
constructed by a private developer on the grounds of the existing St.
Louis state hospital for the use of the department of mental health,
provided any facilities to be constructed shall contain provisions for a
possible adaptive re-use of the present "dome" building.

2. The attorney general shall approve the instrument of conveyance as to
form.

3. Not less than the prevailing hourly rate of wages paid generally in
the locality in which the work is performed shall be paid by contractors
or subcontractors to employees or other workers when such contractors or
subcontractors construct facilities for private developers on the grounds
of the existing St. Louis state hospital for the use of the department of
mental health. Such construction projects shall be considered public
works and the determination of the prevailing hourly rate of wages for
the locality shall be made in accordance with the provisions of sections
290.210 to 290.340, RSMo. (L. 1991 S.B. 347 § 2)

1. The director of the department of mental health may for the
benefit of the department or its facilities establish and operate or
contract for the operation of centralized supply warehouses. Such
warehouses may be department-wide or regional and may provide medical
supplies, medicine and drugs, food, office, maintenance, or janitorial
supplies, or other types of supplies used by the department. All costs
related to the operation of such warehouses, except for the actual cost
of supply commodities, shall be paid out of moneys appropriated to the
department of any facility operated by the department.

2. There is hereby created in the state treasury for use by the
department of mental health a fund to be known as "The Mental Health
Central Supply Fund". Moneys deposited in the fund shall be appropriated
to the director of the department of mental health to be used for
purchasing supply commodities, including the purchase price and related
shipping and handling charges. The fund shall consist of moneys
appropriated by the general assembly for starting the fund and moneys
deposited pursuant to subsection 4 of this section. The provisions of
section 33.080, RSMo, notwithstanding, moneys in the fund shall not
lapse, unless and then only to the extent to which the unencumbered
balance at the close of any fiscal year exceeds one-sixth of the total
amount appropriated, paid or transferred to the fund during such fiscal
year.

3. Supply commodities shall be issued from the central warehouses to the
director of the department of mental health and to facilities operated by
such department. The director shall establish procedures for determining
the amount to be charged for supply commodities issued from such
warehouses. The amount charged shall be regulated to adjust actual costs
for inventory obsolescence, spoilage, loss or other damage to commodities
and for any cost adjustments including refunds and reimbursements
received from supply vendors.

4. Charges for supply commodities issued shall be paid out of moneys
appropriated to the department of mental health or facilities operated by
such department. The director shall deposit moneys derived from such
charges and any receipts from supply vendors, including refunds and
reimbursements, in the state treasury to the credit of the mental health
central supply fund.

5. The director of the department of mental health shall administer the
fund and shall determine the amount of money to be maintained in the fund
necessary for cash flow requirements. Amounts charged for supply
commodities may be adjusted to regulate this fund balance. (L. 1987 H.B.
871)

The department shall establish a placement program for persons
affected by a mental disorder, mental illness, mental retardation,
developmental disability or alcohol or drug abuse. The department may
utilize residential facilities, day programs and specialized services
which are designed to maintain a person who is accepted in the placement
program in the least restrictive environment in accordance with the
person's individualized treatment, habilitation or rehabilitation plan.
The department shall license, certify and fund, subject to
appropriations, a continuum of facilities, programs and services short of
admission to a department facility to accomplish this purpose. (L. 1980
H.B. 1724)

1. If the head of a facility operated by the department
determines that placement out of the facility would be appropriate for
any patient or resident, the head of the facility shall refer the patient
or resident for placement according to the department's rules. If a
patient or resident is accepted and placed under this chapter, then the
patient or resident shall be considered as discharged as a patient or
resident of the facility and reclassified as a client of the department.

2. Any person, his authorized representative, his parent, if the person
is a minor, his guardian, a court of competent jurisdiction or a state or
private facility or agency having custody of the person may apply for
placement of the person under this chapter.

3. If the department finds the application to be appropriate after
review, it shall provide for or arrange for a comprehensive evaluation,
and the preparation of an individualized treatment, habilitation or
rehabilitation plan of the person seeking to be placed, whether from a
department facility or directly, to determine if he meets the following
criteria:

(1) The person is affected by a mental disorder, mental illness, mental
retardation, developmental disability or alcohol or drug abuse; and

(2) The person is in need of special care, treatment, habilitation or
rehabilitation services as described in this chapter, including room or
board, or both; provided, however, that no person shall be accepted for
placement if the sole reason for the application or referral is that
residential placement is necessary for a school-aged child, as defined in
chapter 162, RSMo, to receive an appropriate special education. (L. 1980
H.B. 1724)

Before placing any client in a particular residential facility
or day program, the department shall consider each of the following
criteria:

(1) The best interests of the patient or resident;

(2) Except as provided in subdivision (5) of this section, the least
restrictive environment for providing care and treatment consistent with
the needs and conditions of the patient or resident;

(3) The ability to provide to the patient or resident that individual
degree of care and treatment which is required for that patient or
resident and which is of comparable quality to the existing care and
treatment based upon investigation of the alternative place and its
program of care and treatment;

(4) The relationship of the patient or resident to his family, guardian
or friends, so as to maintain relationships and encourage visits
beneficial to the patient or resident;

(5) Whether the facility will provide the security necessary to protect
the public safety and any crime victim or other witnesses if the client
was committed to the department of mental health pursuant to chapter 552,
RSMo, based on an accepted plea of not guilty by reason of a mental
disease or defect excluding responsibility or an acquittal on that basis
as provided in section 552.030, RSMo, for a dangerous felony as defined
in section 556.061, RSMo, or a violation of section 565.020 or 566.040,
RSMo, or an attempt to commit one of the preceding crimes. (L. 1980 H.B.
1724, A.L. 1996 S.B. 884 & 841)

1. Except as provided in subsection 2 of this section, the
department may place any patient or resident referred by a department
facility or any person applying directly or referred under section
630.610 who is accepted for placement, in one or more of the following
facilities or programs as soon as practicable after consultation with the
person, patient or resident, if competent, or his parents, if he is a
minor, or his guardian:

(1) A facility licensed by the department of social services under
chapter 198, RSMo, and licensed or certified, or both, by the department
under this chapter;

(2) A facility or program licensed or certified, or both, by the
department;

(3) The home of the client.

2. If the person was committed to the department of mental health
pursuant to chapter 552, RSMo, based on an accepted plea of not guilty by
reason of a mental disease or defect excluding responsibility or an
acquittal on that basis as provided in section 552.030, RSMo, for a
dangerous felony as defined in section 556.061, RSMo, or a violation of
section 565.020 or 566.040, RSMo, or an attempt to commit one of the
preceding crimes, the placement shall be to a secure facility as defined
in section 552.040, RSMo, unless a court order is entered allowing
placement in a nonsecure facility.

3. The department shall provide a written statement to the client, the
client's parent, if the client is a minor, the client's legal guardian,
the referring court or the referring state or private agency or facility,
and to the client's next of kin specifying reasons why a proposed
placement is appropriate pursuant to section 630.615. If the client was
originally committed pursuant to chapter 552, RSMo, the written statement
shall also be provided to the prosecuting attorney in the jurisdiction
where the person was tried and acquitted. (L. 1980 H.B. 1724, A.L. 1996
S.B. 884 & 841)

If the client is competent to give informed consent, the
department shall allow ten days to obtain his consent before making a
placement. If the client is a minor or has a legal guardian, the
department shall obtain the consent of the parent or guardian before
placement. If the client is an involuntary patient or resident under
chapter 211, 552 or 632, RSMo, the department shall notify the court of
competent jurisdiction of the proposed placement and allow ten days for
the court to object. (L. 1980 H.B. 1724)

If a patient or resident, parent, if the patient or resident is
a minor, or legal guardian does not consent to transfer of the patient or
resident from a facility operated by the department, then the department
shall propose other appropriate placement alternatives, if available, and
seek to obtain consent under section 630.625 until the alternatives are
exhausted. (L. 1980 H.B. 1724)

1. If a resident in a mental retardation facility, or his parent
if he is a minor, or his legal guardian refuses to consent to the
proposed placement, the head of the mental retardation facility may
petition, under the procedures in section 633.135, RSMo, the director of
the division of mental retardation and developmental disabilities to
determine whether the proposed placement is appropriate under chapter
633, RSMo.

2. If a patient in a mental health facility, or his parent if he is a
minor, or his legal guardian refuses to consent to the proposed
placement, the head of the mental health facility may petition the
director of the division of comprehensive psychiatric services to
determine whether the proposed placement is appropriate under sections
630.610, 630.615 and 630.620.

3. The director of the division of comprehensive psychiatric services
shall refer the petition to the chairman of the state advisory council
for his division who shall appoint and convene a review panel composed of
three members. At least one member of the panel shall be a family member
or guardian of a patient who resides in a mental health facility operated
by the department. The remaining members of the panel shall be persons
who are from nongovernmental organizations or groups concerned with the
prevention of mental disorders, evaluation, care, treatment or
rehabilitation of persons affected by the same conditions as the patient
the department seeks to place and who are familiar with services and
service needs of persons in mental health facilities operated by the
department. No member of the panel shall be an officer or employee of the
department.

4. After prompt notice and hearing, the panel shall determine whether the
proposed placement is appropriate under sections 630.610, 630.615 and
630.620. The hearing shall be electronically recorded for purposes of
obtaining a transcript. The council shall forward the tape recording,
recommended findings of fact, conclusions of law, and decision to the
director who shall enter findings of fact, conclusions of law, and the
final decision. Notice of the director's decision shall be sent to the
patient, or his parent if he is a minor, or his guardian by registered
mail, return receipt requested. The director shall expedite this review
in all respects.

5. If the patient, or his parent if he is a minor, or his guardian
disagrees with the decision of the director, he may appeal the decision,
within thirty days after notice of the decision is sent, to the circuit
court of the county where the patient or resident, or his parent if he is
a minor, or his guardian resides. The court shall review the record,
proceedings and decision of the director not only under the provisions of
chapter 536, RSMo, but also as to whether or not the head of the facility
or the department sustained its burden of proof that the proposed
placement is appropriate under sections 630.110, 630.115 and 630.120. The
court shall expedite this review in all respects. Notwithstanding the
provisions of section 536.140, RSMo, a court may, for good cause shown,
hear and consider additional competent and material evidence.

6. The notice and procedure for the hearing by the panel shall be in
accordance with chapter 536, RSMo.

7. In all proceedings either before the panel or before the circuit
court, the burden of proof shall be upon the head of the facility to
demonstrate by a preponderance of evidence that the proposed placement is
appropriate under the criteria set forth in sections 630.610, 630.615 and
630.120.

8. Pending the convening of the hearing panel and the final decision of
the director or the court if the director's decision is appealed, the
department shall not place or discharge the patient from a facility
except that the department may temporarily transfer such patient in the
case of a medical emergency.

9. There shall be no retaliation against any state employee as the result
of a good faith decision to place the patient which is appealed and who
testifies during a hearing or otherwise provides information or evidence
in regard to a proposed placement. (L. 1980 H.B. 1724)

1. If a client receiving services under this chapter is
ineligible for public assistance benefits from any source, or such
benefits are inadequate to meet the costs of such services, his monthly
costs may be paid or supplemented out of funds appropriated for that
purpose to the department.

2. If payments for the support and maintenance of the client are made
from funds appropriated to the department, the department shall charge
the client or those responsible for his support under this chapter for
his support and maintenance pursuant to sections 630.205 to 630.215. (L.
1980 H.B. 1724)

The department shall provide or shall arrange for follow-up care
and aftercare and shall make or arrange for reviews and visits with the
client at least quarterly to the residential facility or day program in
which the client has been placed to determine whether the client is
receiving care, treatment, habilitation and rehabilitation, including
medical care, consistent with his needs and condition. The department
shall identify the facilities, programs or specialized services operated
or funded by the department which shall provide necessary levels of
follow-up care, aftercare, habilitation or medical treatment to clients
in certain geographic areas where they are placed. After a client has
been placed through the placement program, the department shall, for a
period of four months following the initial placement, evaluate and
review the progress of the client in the placement at least once a month.
(L. 1980 H.B. 1724)

The department of social services shall cooperate with the
department of mental health and its facilities in locating licensed
residential facilities, day programs and specialized services, in
visiting and inspecting them, and in submitting inspection and other
reports regarding them and the department clients placed therein. (L.
1980 H.B. 1724)

1. The department shall promulgate rules which set forth
reasonable standards for residential facilities, day programs or
specialized services such that each program's level of service,
treatment, habilitation or rehabilitation may be certified and funded
accordingly by the department for its placement program clients or as
necessary for the facilities or programs, to meet conditions of
third-party reimbursement.

2. The rules shall provide for the facilities, programs or services to be
reasonably classified as to resident or client population, size, type of
services or other classification.

3. The standards contained in the rules shall particularly provide for
the following:

(1) The admission and commitment criteria, which shall be based upon
diagnoses;

(2) The care, treatment, habilitation or rehabilitation;

(3) The general medical and health care;

(4) Adequate physical plant facilities, including fire safety,
housekeeping and maintenance standards;

(5) Food service facilities;

(6) Safety precautions;

(7) Drugs and medications;

(8) A uniform system of record keeping;

(9) Resident or client rights and grievance procedures;

(10) Adequate staff.

4. The department shall certify the facilities, programs or services
which meet the standards without the requirement of a fee. (L. 1980 H.B.
1724)

Notwithstanding any rule to the contrary, any request for a
waiver or exception of administrative rule or standard shall be approved
by an exceptions committee created by the filing agency and such
committee shall be considered a public governmental body operating under
chapter 610, RSMo. (L. 1995 S.B. 374 § 630.655)

The department shall require residential facilities, day
programs and specialized services to enter into written contracts to
receive funding for services rendered to clients placed by the
department. (L. 1980 H.B. 1724)

1. The department shall promulgate rules setting forth
reasonable standards for residential facilities and day programs for
persons who are affected by a mental disorder, mental illness, mental
retardation or developmental disability.

2. The rules shall provide for the facilities and programs to be
reasonably classified as to resident or client population, size, type of
services or other reasonable classification. The department shall design
the rules to promote and regulate safe, humane and adequate facilities
and programs for the care, treatment, habilitation and rehabilitation of
persons described in subsection 1 of this section.

3. The following residential facilities and day programs shall not be
licensed by the department:

(1) Any facility or program which relies solely upon the use of prayer or
spiritual healing;

(2) Any educational, special educational or vocational program operated,
certified or approved by the state board of education pursuant to
chapters 161, 162 and 178, RSMo, and regulations promulgated by the board;

(3) Any hospital, facility, program or entity operated by this state or
the United States; except that facilities operated by the department
shall meet these standards;

(4) Any hospital, facility or other entity, excluding those with persons
who are mentally retarded and developmentally disabled as defined in
section 630.005 otherwise licensed by the state and operating under such
license and within the limits of such license, unless the majority of the
persons served receive activities and services normally provided by a
licensed facility pursuant to this chapter;

(5) Any hospital licensed by the department of social services as a
psychiatric hospital pursuant to chapter 197, RSMo;

(6) Any facility or program accredited by the Joint Commission on
Accreditation of Hospitals, the American Osteopathic Association,
Accreditation Council for Services for Mentally Retarded or other
Developmentally Disabled Persons, Council on Accreditation of Services
for Children and Families, Inc., or the Commission on Accreditation of
Rehabilitation Facilities;

(7) Any facility or program caring for less than four persons whose care
is not funded by the department. (L. 1980 H.B. 1724, A.L. 1982 H.B. 1565,
A.L. 1984 S.B. 575, A.L. 1985 S.B. 266, A.L. 1990 S.B. 808 & 672, A.L.
2000 H.B. 1085)

1. The standards contained in the rules shall particularly
provide for the following:

(1) Admission and commitment criteria, which shall be based upon
diagnoses;

(2) Care, treatment, habilitation or rehabilitation;

(3) General medical and health care;

(4) Adequate physical plant facilities, including fire safety,
housekeeping and maintenance standards;

(5) Food service facilities;

(6) Safety precautions;

(7) Drugs and medications;

(8) Uniform system of record keeping;

(9) Resident or client rights and grievance procedures;

(10) Adequate staff.

2. The rules containing the standards for living units within facilities
or homes shall provide for such classifications of the living units as
are small enough to ensure programs based upon the personal needs of the
resident as determined by individualized habilitation or treatment plans.
The units may include distinct parts of other facilities such as wards,
wings or floors. (L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841, A.L. 1998
S.B. 470)

1. The department shall establish a procedure for the licensing
of residential facilities and day programs for persons described in
section 630.705, which procedure shall provide for the acceptance of a
license, a temporary operating permit or a probationary license issued by
the department of social services under sections 198.006 to 198.096,
RSMo, as regards the licensing requirements in the following areas:

(1) General medical and health care;

(2) Adequate physical plant facilities including fire safety,
housekeeping and maintenance standards;

(3) Food service facilities;

(4) Safety precautions;

(5) Drugs and medications;

(6) Uniform system of recordkeeping;

(7) Resident and client rights and grievance procedures. However, the
department shall require annually that any facilities and programs
already licensed by the department of social services under chapter 198,
RSMo, which desire to provide services to persons diagnosed as mentally
disordered, mentally ill, mentally retarded or developmentally disabled
in accordance with sections 630.705 to 630.760 meet the department's
requirements in excess of those required for licensure or certification
under chapter 198, RSMo, which are appropriate to admission criteria and
care, treatment, habilitation and rehabilitation needs of such persons.

2. Applications for licenses shall be made to the department upon forms
provided by it and shall contain such information and documents as the
department requires, including, but not limited to, affirmative evidence
of ability to comply with the rules adopted by the department. Each
application for a license, except applications from a governmental unit
or a facility caring for less than four persons, which shall not pay any
fee, shall be accompanied by a license fee of ten dollars for
establishments which accept more than three but less than ten persons and
fifty dollars from establishments which accept ten or more. The license
fee shall be paid to the director of revenue for deposit to the general
revenue fund of the state treasury.

3. An applicant for a license shall submit an affidavit under oath that
all documents required by the department to be filed pursuant to this
section are true and correct to the best of his knowledge and belief,
that the statements contained in the application are true and correct to
the best of his knowledge and belief and that all required documents are
either included with the application or are currently on file with the
department. (L. 1980 H.B. 1724, A.L. 1985 S.B. 266)

1. Any residential facility or day program which provides
services exclusively to those persons affected by alcohol or drug abuse
shall be exempt from licensure rules promulgated by the department.

2. Any residential facility or day program which offers services,
treatment or rehabilitation to persons affected by alcohol or drug abuse
shall submit to the department a description of the services, treatment
or rehabilitation which it offers, a statement of whether each facility
or program is required to meet any fire-safety standards of a
municipality, political subdivision of the state, and documentation of
compliance with such standards, if they apply.

3. The department shall survey all such facilities and programs and shall
prepare a report for submission to the general assembly of actions
necessary to bring such facilities and programs in compliance with
fire-safety standards developed by the department for certification. The
report shall be filed with the speaker of the house and the president pro
tem of the senate by January 1, 1983.

4. Failure of a facility or program to submit information requested by
the department and required by this section shall disqualify such
facility or program from receiving department certification or funding
until such information is submitted. (L. 1980 H.B. 1724)

1. Upon receipt of an application for a license, the department
shall issue a license if the applicant demonstrates that his residential
facility or day program meets the requirements established in the
department rules and regulations. A license, unless sooner revoked, shall
be issued for a period of one year.

2. The department shall notify the holder of a valid license at least
sixty days prior to the expiration of such license of the date that the
license application is due. Application for a license shall be made to
the department at least thirty days prior to the expiration of an
existing, valid license.

3. The department shall grant a temporary operating permit in order to
allow for state inspection for the purposes of relicensure if the
inspection process has not been completed prior to the expiration of a
license and the applicant is not at fault for the failure to complete the
inspection process.

4. Each license shall be issued only for the premises and persons or
governmental units named in the application and shall not be transferable
or assignable except with the written approval of the department. The
department shall grant a temporary operating permit of sufficient
duration to allow the department to evaluate any application for a
license submitted as a result of any change of ownership.

5. Licenses shall be posted in a conspicuous place on the licensed
premises. (L. 1980 H.B. 1724)

1. The department shall revoke a license or deny an application
for a license in any case in which it finds a substantial failure to
comply with the standards established under its rules or the requirements
established under sections 630.705 to 630.760.

2. Any person aggrieved by the action of the department to deny or revoke
a license under the provisions of sections 630.705 to 630.760 may seek a
determination of the department director's decision by the administrative
hearing commission pursuant to the provisions of section 621.045, RSMo.
It shall not be a condition to such determination that the person
aggrieved seek a reconsideration, a rehearing or exhaust any other
procedure within the department.

3. The administrative hearing commission may stay the revocation of such
license, pending the commission's finding and determination in the cause,
upon such conditions as the commission deems necessary and appropriate
including the posting of bond or other security except that the
commission shall not grant a stay or if a stay has already been entered
shall set aside its stay, if upon application of the department the
commission finds reason to believe that continued operation of a
residential facility or day program pending the commission's final
determination would present an imminent danger to the health, safety or
welfare of any resident or a substantial probability that death or
serious physical harm would result. In any case in which the department
has refused to issue a license, the commission shall have no authority to
stay or to require the issuance of a license pending final determination
by the commission.

4. The administrative hearing commission shall make the final decision as
to the issuance or revocation of a license. Any person aggrieved by a
final decision of the administrative hearing commission, including the
department, may seek judicial review of such decision by filing a
petition for review in the court of appeals for the district in which the
facility or program is located. Review shall be had, except as modified
herein, in accordance with the provisions of sections 621.189 and
621.193, RSMo. (L. 1980 H.B. 1724)

1. The department may inspect any residential facility or day
program for persons described in section 630.705, RSMo, at any time if a
license has been issued to or an application for a license has been filed
by the head of such facility or program. The department shall make or
cause to be made at least one inspection per year. The department may
make such other inspections, announced or unannounced, as it deems
necessary to carry out the provisions of sections 630.705 to 630.760. The
department may delegate its powers and duties to investigate and inspect
residential facilities and day programs licensed by it to determine
compliance with all or part of its standards, to another governmental
agency, where practicable, if the department feels such other agency is
qualified to inspect and license such facilities or programs. The
governmental unit shall submit a written report of its findings to the
department. The department may accept the recommendations of the
governmental unit for issuance or revocation of a license.

2. If the department has reasonable grounds to believe that a residential
facility or day program required to be licensed under sections 630.705 to
630.760 is operating without a license, and the department is not
permitted access to inspect the facility or program, or when the head of
such facility or program refuses to permit access to the department to
inspect the facility or program, the department shall apply to the
circuit court of the county in which the premises is located for an order
authorizing entry for such inspection, and the court shall issue the
order if it finds that the head of the facility or program has refused to
permit the department access to inspect such facility or program. (L.
1980 H.B. 1724)

1. No person or governmental unit, acting separately or jointly
with any other person or governmental unit, shall establish, conduct or
maintain any residential facility in this state for the care, treatment,
habilitation or rehabilitation of mentally retarded or developmentally
disabled persons without a valid license issued by the department.
Licenses in effect on August 13, 1982, shall continue in effect until
they regularly expire unless sooner revoked; except that in no case shall
a license continue in effect beyond one year after August 13, 1982.

2. After October 1, 1983, no person or governmental unit, acting
separately or jointly with any other person or governmental unit, shall
establish, conduct or maintain any residential facility or day program in
this state for care, treatment, habilitation or rehabilitation of persons
diagnosed as mentally disordered or mentally ill or day program for
mentally retarded or developmentally disabled persons unless the
facilities or programs are licensed by the department. (L. 1980 H.B.
1724, A.L. 1982 H.B. 1565)

1. Any person establishing, conducting, managing or operating
any residential facility or day program without a license as provided for
in sections 630.705 to 630.760 is guilty of a class C misdemeanor.

2. The attorney general shall represent the department, which may
institute an action in the name of the state for an injunction or other
process against any person or governmental unit to restrain or prevent
the establishment, conduct, management or operation of a residential
facility or day program without a license as required under this law. (L.
1980 H.B. 1724)

1. If a duly authorized representative of the department finds
upon inspection of a residential facility or day program that it is not
in compliance with the provisions of sections 630.705 to 630.760, and the
standards established thereunder, the head of the facility or program
shall be informed of the deficiencies in an exit interview conducted with
him. A written report shall be prepared of any deficiency for which there
has not been prompt remedial action, and a copy of such report and a
written correction order shall be sent to the head of the facility or
program by certified mail, return receipt requested, at the facility or
program address within twenty working days after the inspection, stating
separately each deficiency and the specific statute or regulation
violated.

2. The head of the facility or program shall have twenty working days
following receipt of the report and correction order to request any
conference and to submit a plan of correction for the department's
approval which contains specific dates for achieving compliance. Within
ten working days after receiving a plan of correction, the department
shall give its written approval or rejection of the plan.

3. A reinspection shall be conducted within fifty-five days after the
original inspection to determine if deficiencies are being corrected as
required in the approved correction plan or any subsequent authorized
modification. If the facility or program is not in substantial compliance
and the head of the facility or program is not correcting the
noncompliance in accordance with the time schedules in his approved plan
of correction, the department shall issue a notice of noncompliance,
which shall be sent by certified mail, return receipt requested, to the
head of the facility or program.

4. The notice of noncompliance shall inform the head of the facility or
program that the department may seek the imposition of any of the
sanctions and remedies provided for in section 630.755, or any other
action authorized by law.

5. At any time after an inspection is conducted, the head of the facility
or program may choose to enter into a consent agreement with the
department to obtain a probationary license. The consent agreement shall
include a provision that the head of the facility or program will
voluntarily surrender the license if substantial compliance is not
reached in accordance with the terms and deadlines established under the
agreement. The agreement shall specify the stages, actions and time span
to achieve substantial compliance.

6. If a notice of noncompliance has been issued, the head of the facility
or program shall post a copy of the notice of noncompliance and a copy of
the most recent inspection report in a conspicuous location in the
facility or program, and the department shall send a copy of the notice
of noncompliance to any concerned federal, state or local governmental
agencies. (L. 1980 H.B. 1724)

The provisions of section 630.745 notwithstanding, if a duly
authorized representative of the department finds upon inspection of a
licensed residential facility or day program, and the director finds upon
review, that the facility or program is not in substantial compliance
with a standard or standards the violations of which would present either
an imminent danger to the health, safety or welfare of any resident or a
substantial probability that death or serious physical harm would result
and which is not immediately corrected, the department shall:

(1) Give immediate written notice of the noncompliance to the head of the
facility or program;

(2) Make public the fact that a notice of noncompliance has been issued
to the facility or program. Copies of the notice shall be sent to
appropriate hospitals and social service agencies;

(3) Send a copy of the notice of noncompliance to any concerned federal,
state or local government agencies. The facility or program shall post in
a conspicuous location in the facility or program a copy of the notice of
noncompliance and a copy of the most recent inspection report. (L. 1980
H.B. 1724)

1. An action may be brought by the department, or by the
attorney general on his own volition or at the request of the department
or any other appropriate state agency, to temporarily or permanently
enjoin or restrain any violation of sections 630.705 to 630.760, to
enjoin the acceptance of new residents until substantial compliance with
sections 630.705 to 630.760 is achieved, or to enjoin any specific action
or practice of the residential facility or day program. Any action
brought under the provisions of this section shall be placed at the head
of the docket by the court and the court shall hold a hearing on any
action brought under the provisions of this section no less than fifteen
days after the filing of the action.

2. Any facility or program which has received a notice of noncompliance
as provided by sections 630.745 to 630.750 is liable to the state for
civil penalties of up to one hundred dollars for each day that
noncompliance continues after the notice of noncompliance is received.
The attorney general shall, upon the request of the department, bring an
action in a circuit court of competent jurisdiction to recover the civil
penalty. The court shall have the authority to determine the amount of
civil penalty to be assessed. (L. 1980 H.B. 1724)

In addition to rights provided for patients, residents or
clients of residential facilities licensed by the department under this
chapter, residents or clients in facilities and programs licensed by the
department shall have the same rights as residents as defined in chapter
198, RSMo, have under section 198.088, RSMo. (L. 1980 H.B. 1724)

The attorney general, either on his own initiative or upon the
request of the department or of any other state governmental agency
having an interest in the matter, a resident or residents or the guardian
of a resident of a residential facility or the head of a facility may
petition for appointment of a receiver for such facility when any of the
following conditions exist:

(1) The facility is being operated without a license;

(2) The department has revoked the license of the facility or refused to
grant an application for a license for the facility;

(3) The department has initiated revocation procedures and has determined
that the lives, health, safety, or welfare of the residents cannot be
adequately assured pending a full hearing on license revocation;

(4) The facility is closing or intends to close and adequate arrangements
for relocation of residents have not been made at least thirty days prior
to closure;

(5) An emergency exists in the facility;

(6) The licensee is insolvent; or

(7) An owner of the land or structure is insolvent and such insolvency
substantially affects the operation of the facility. (L. 1980 H.B. 1724)

In any situation described in section 630.763 the department may
place a person to act as a monitor in the facility. The monitor shall
observe operation of the residential facility and shall advise it on how
to comply with state laws and regulations, and shall submit a written
report periodically to the department on the operation of the facility.
(L. 1980 H.B. 1724)

Any petition for appointment of a receiver shall be verified and
shall be accompanied by an affidavit or affidavits setting forth material
facts showing there exists one or more of the conditions specified in
section 198.099, RSMo. The petition shall be filed in the circuit court
of Cole County or in the county where the residential facility is
located. If the petition is not filed by the attorney general, a copy of
the petition shall be served upon the department and upon the attorney
general. The court shall hold a hearing on the petition within five days
of the filing of the petition and determine the matter within fifteen
days of the initial hearing. The petition and notice of the hearing shall
be served on the head of the facility or, if personal service is
impossible, shall be posted in a conspicuous place in the residential
facility not later than three days before the time specified for the
hearing, unless a different period is fixed by order of the court. The
court shall appoint the director of the department, or any person
determined by the court to be qualified, to act as receiver if it finds
that any ground exists which would authorized the appointment of a
receiver under section 198.099, RSMo, and that appointment of a receiver
will contribute to the continuity of care or the orderly and safe
transfer of residents in the facility. (L. 1980 H.B. 1724)

If it appears from the petition filed under section 198.105,
RSMo, or from an affidavit or affidavits filed with the petition, or from
testimony of witnesses under oath when the court determines that this is
necessary, that there is probable cause to believe that an emergency
exists in the residential facility, the court shall immediately issue the
requested order for appointment of a receiver, ex parte and without
further hearing. Notice of the petition and order shall be served on the
head of the facility or, if personal service is impossible, shall be
posted in a conspicuous place in the facility within twenty-four hours
after issuance of the order. If the petition is not filed by the attorney
general, a copy of the petition shall be served on the department and
upon the attorney general. A hearing on the petition shall be held within
three days after notice is served or posted unless the head of the
facility consents to a later date. After the hearing, the court may
terminate, continue or modify the temporary order. (L. 1980 H.B. 1724)

A receiver appointed under this section:

(1) May exercise those powers and shall perform those duties set out by
the court;

(2) May, in his discretion, either:

(a) Take control of all day-to-day operations of the residential facility;

(b) Name an individual to conduct the day-to-day operations of the
facility subject to the supervision and direction of the receiver;

(3) May upgrade deficient facilities by any methods, procedures or
actions he deems necessary; provided, however, that expenditures in
excess of three thousand dollars, or in excess of any amount set by the
court, be first approved by the court;

(4) Shall have the same rights to possession of the building in which the
facility is located and of all goods and fixtures in the building at the
time the petition for receivership is filed as the head of the facility
would have had if the receiver had not been appointed. The receiver shall
take such action as is reasonably necessary to protect and conserve the
assets or property of which the receiver takes possession, or the
proceeds of any transfer thereof, and may use them only in the
performance of the powers and duties set forth in this section and by
order of the court;

(5) May use the building, fixtures, furnishings and any accompanying
consumable goods in the provision of care and services to residents and
to any other persons receiving services from the facility at the time the
petition for receivership was filed. The receiver shall collect payments
for all goods and services provided to residents or others during the
period of receivership, at the same rate of payment as was charged by the
head of the facility at the time the petition for receivership was filed,
unless a different rate is set by the court;

(6) May let contracts and hire agents and employees, including legal
counsel, to carry out the powers and duties created under this section or
by the court;

(7) May hire or discharge any employees;

(8) Shall receive and expend in a reasonable manner the revenues of the
facility due on the date of the order of appointment as receiver, and to
become due during the receivership;

(9) Shall do all acts necessary or appropriate to conserve the property
and promote the health, safety or care of the residents of the facility;

(10) Except as hereinafter specified in section 630.790, shall honor all
leases, mortgages, secured transactions or other wholly or partially
executory contracts entered into on behalf of the facility, but only to
the extent of payments which become due or are for the use of the
property during the period of the receivership;

(11) Shall be responsible, to the same extent as the licensee would have
been, for taxes which accrue during the period of the receivership;

(12) Shall be entitled to and shall take possession of all property or
assets of residents which are in possession of the head of the facility.
The receiver shall preserve all property, assets and records of residents
of which the receiver takes possession and shall provide for the prompt
transfer of the property, assets and records to the alternative placement
of any transferred or discharged resident;

(13) Shall provide, if upgrading of the facility or correction of the
deficiencies is not possible, for the orderly transfer of all residents
in the facility to other suitable facilities, or make other provisions
for their continued health, safety and welfare;

(14) Shall, if any resident is transferred or discharged, provide for:

(a) Transportation of the resident and the resident's belongings and
medical records to the place to which the resident is being transferred
or discharged;

(b) Aid in locating an alternative placement and in discharge planning;

(c) If the resident is being transferred, preparation for transfer to
mitigate transfer trauma;

(15) Shall, if any resident is to be transferred, permit participation by
the resident or the resident's guardian in the selection of the
resident's alternative placement;

(16) Shall, unless emergency transfer is necessary, prepare a resident
under subdivisions (14)(c) and (15) by explaining alternative placements,
and by providing orientation to the placement chosen by the resident or
the resident's guardian. (L. 1980 H.B. 1724)

1. A receiver may not be required to honor any lease, mortgage,
secured transaction or other wholly or partially executory contract
entered into on behalf of the facility if the agreement is
unconscionable. Factors which shall be considered in determining the
unconscionability include, but are not limited to, the following:

(1) The person seeking payment under the agreement was an affiliate of
the individual contracting on behalf of the facility at the time the
agreement was made;

(2) The rental, price, or rate of interest required to be paid under the
agreement was substantially in excess of a reasonable rental, price or
rate of interest at the time the agreement was entered into.

2. If the receiver is in possession of real estate or goods subject to a
lease, mortgage or security interest which the receiver is permitted to
avoid under subsection 1 of this section, and if the real estate or goods
are necessary for the continued operation of the facility, the receiver
may apply to the court to set a reasonable rental, price or rate of
interest to be paid by the receiver during the duration of the
receivership. The court shall hold a hearing on the application within
fifteen days. The receiver shall send notice of the application to any
known owners of the property involved at least ten working days prior to
the hearing. Payment by the receiver of the amount determined by the
court to be reasonable is a defense to any action against the receiver
for payment or for possession of person who received such notice, but the
payment does not relieve the licensee or head of the facility of any
liability for the difference between the amount paid by the receiver and
the amount due under the original lease or mortgage involved. (L. 1980
H.B. 1724)

1. The court shall set the compensation of the receiver, which
shall be considered a necessary expense of a receivership.

2. A receiver may be required by the court to post a bond, which shall be
considered a necessary expense of the receivership. (L. 1980 H.B. 1724)

Other provisions of section 630.705 to 630.760 notwithstanding,
the department may issue a license to a residential facility being
operated by a receiver under sections 630.763 to 630.793. The duration of
a license issued under this section is limited to the duration of the
receivership. (L. 1980 H.B. 1724)

The court may terminate a receivership:

(1) Upon a motion by any party to the petition, by the department, or by
the receiver, and a finding by the court that the deficiencies and
violations in the residential facility have been substantially eliminated
or remedied; or

(2) If all residents in the facility have been provided alternative modes
of health care, either in another facility or otherwise. The court may
immediately terminate the receivership, or may terminate the receivership
subject to such terms as the court deems necessary or appropriate to
prevent the conditions complained of from recurring. (L. 1980 H.B. 1724)

1. Within thirty days after termination or such other time as
the court may set, the receiver shall give the court a complete
accounting of all property of which the receiver has taken possession, of
all funds collected under section 630.772 and of the expenses of the
receivership.

2. If the operating funds collected by the receiver under section 630.775
exceed the reasonable expenses of the receivership, the court shall order
the payment of the surplus to the licensee. If the operating funds are
insufficient to cover reasonable expenses of the receivership, the
licensee shall be liable for the deficiency. The licensee may apply to
the court to determine the reasonableness of any expense of the
receivership. The licensee shall not be responsible for expenses in
excess of what the court finds to be reasonable.

3. If a deficiency exists under subsection 2 of this section, the
receiver may apply to the court for such a determination. If after notice
to all interested parties and a hearing the court finds that in fact a
deficiency does exist, then the court shall enter judgment in favor of
the receiver and against the appropriate party or parties as set forth in
subsection 2 of this section for the amount of such deficiency. Any
judgment obtained under this subsection shall be treated as any other
judgment and may be enforced according to law.

4. Any judgment for a deficiency obtained in accordance with this section
by the receiver or any portion thereof may be assigned wholly or in part
upon approval of the court.

5. The judgment shall have priority over any other judgment or lien or
other interest which originates subsequent to the filing of a petition
for receivership under the provisions of sections 630.763 to 630.793
except for a construction or mechanic's lien arising out of work
performed with the express consent of the receiver. (L. 1980 H.B. 1724)

No licensee may be held liable for acts or omissions of the
receiver or the receiver's employees during the term of the receivership.
Nothing in sections 630.763 to 630.793 shall be deemed to relieve any
licensee or affiliate of a licensee of a facility placed in receivership
of any civil or criminal liability incurred, or any duty imposed by law,
by reason of acts or omissions of the licensee or affiliates of the
licensee prior to the appointment of a receiver under section 630.763 or
630.793, nor shall anything contained in sections 630.763 to 630.793 be
construed to suspend during the receivership any obligation of the
licensee or any affiliate of a licensee for payment of taxes or other
operating and maintenance expenses of the facility, nor of the licensee
or affiliates of the licensee for the payment of mortgages or liens. (L.
1980 H.B. 1724)

1. Except for those persons committed to the department of
mental health pursuant to chapter 552, RSMo, a person who is not a
resident of this state who is committed to the department of mental
health for care, treatment, detention or training in a state hospital or
institution by order of a court may be returned by the department, either
before or after such person's admission to a state hospital or
institution, to the state of such person's residence, except that no
person shall be so returned unless proper arrangements to receive the
patient have been made with the state to which the person is to be
returned.

2. The director of the department of mental health may enter into
reciprocal agreements with other states or political subdivisions thereof
for the interstate transportation or transfer of mentally ill or mentally
deficient persons, or persons who are in need of mental treatment, to the
state of their residence.

3. The cost of transporting a nonresident patient to the state of the
patient's residence is payable out of funds appropriated to the
department of mental health. (L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

The "Interstate Compact on Mental Health" is hereby enacted into
law and entered into by this state with all other states legally joining
therein in the form substantially as follows:

THE INTERSTATE COMPACT ON MENTAL HEALTH

The contracting states solemnly agree that:

ARTICLE I

The party states find that the proper and expeditious treatment of the
mentally ill and mentally deficient can be facilitated by cooperative
action, to the benefit of the patients, their families, and society as a
whole. Further, the party states find that the necessity of and
desirability for furnishing such care and treatment bears no primary
relation to the residence or citizenship of the patient but that, on the
contrary, the controlling factors of community safety and humanitarianism
require that facilities and services be made available for all who are in
need of them. Consequently, it is the purpose of this compact and of the
party states to provide the necessary legal basis for the
institutionalization or other appropriate care and treatment of the
mentally ill and mentally deficient under a system that recognizes the
paramount importance of patient welfare and to establish the
responsibilities of the party states in terms of such welfare.

ARTICLE II

As used in this compact:

(a) "Sending state" shall mean a party state from which a patient is
transported pursuant to the provisions of the compact or from which it is
contemplated that a patient may be so sent.

(b) "Receiving state" shall mean a party state to which a patient is
transported pursuant to the provisions of the compact or to which it is
contemplated that a patient may be so sent.

(c) "Institution" shall mean any hospital or other facility maintained by
a party state or political subdivision thereof for the care and treatment
of mental illness or mental deficiency.

(d) "Patient" shall mean any person subject to or eligible as determined
by the laws of the sending state, for institutionalization or other care,
treatment, or supervision pursuant to the provisions of this compact.

(e) "Aftercare" shall mean care, treatment and services provided a
patient, as defined herein, on convalescent status or conditional release.

(f) "Mental illness" shall mean mental disease to such extent that a
person so afflicted requires care and treatment for his own welfare, or
the welfare of others, or of the community.

(g) "Mental deficiency" shall mean mental deficiency as defined by
appropriate clinical authorities to such extent that a person so
afflicted is incapable of managing himself and his affairs, but shall not
include mental illness as defined herein.

(h) "State" shall mean any state, territory or possession of the United
States, the District of Columbia, and the Commonwealth of Puerto Rico.

ARTICLE III

(a) Whenever a person physically present in any party state shall be in
need of institutionalization by reason of mental illness or mental
deficiency, he shall be eligible for care and treatment in an institution
in that state irrespective of his residence, settlement or citizenship
qualifications.

(b) The provisions of paragraph (a) of this article to the contrary
notwithstanding, any patient may be transferred to an institution in
another state whenever there are factors based upon clinical
determinations indicating that the care and treatment of said patient
would be facilitated or improved thereby. Any such institutionalization
may be for the entire period of care and treatment or for any portion or
portions thereof. The factors referred to in this paragraph shall include
the patient's full record with due regard for the location of the
patient's family, character of the illness and probable duration thereof,
and such other factors as shall be considered appropriate.

(c) No state shall be obliged to receive any patient pursuant to the
provisions of paragraph (b) of this article unless the sending state has
given advance notice of its intention to send the patient; furnished all
available medical and other pertinent records concerning the patient;
given the qualified medical or other appropriate clinical authorities of
the receiving state an opportunity to examine the patient if said
authorities so wish; and unless the receiving state shall agree to accept
the patient.

(d) In the event that the laws of the receiving state establish a system
of priorities for the admission of patients, an interstate patient under
this compact shall receive the same priority as a local patient and shall
be taken in the same order and at the same time that he would be taken if
he were a local patient.

(e) Pursuant to this compact, the determination as to the suitable place
of institutionalization for a patient may be reviewed at any time and
such further transfer of the patient may be made as seems likely to be in
the best interest of the patient.

ARTICLE IV

(a) Whenever, pursuant to the laws of the state in which a patient is
physically present, it shall be determined that the patient should
receive aftercare or supervision, such care or supervision may be
provided in a receiving state. If the medical or other appropriate
clinical authorities having responsibility for the care and treatment of
the patient in the sending state shall have reason to believe that
aftercare in another state would be in the best interest of the patient
and would not jeopardize the public safety, they shall request the
appropriate authorities in the receiving state to investigate the
desirability of affording the patient such aftercare in said receiving
state, and such investigation shall be made with all reasonable speed.
The request for investigation shall be accompanied by complete
information concerning the patient's intended place of residence and the
identity of the person in whose charge it is proposed to place the
patient, the complete medical history of the patient, and such other
documents as may be pertinent.

(b) If the medical or other appropriate clinical authorities having
responsibility for the care and treatment of the patient in the sending
state and the appropriate authorities in the receiving state find that
the best interest of the patient would be served thereby, and if the
public safety would not be jeopardized thereby, the patient may receive
aftercare or supervision in the receiving state.

(c) In supervising, treating, or caring for a patient on aftercare
pursuant to the terms of this article, a receiving state shall employ the
same standards of visitation, examination, care, and treatment that it
employs for similar local patients.

ARTICLE V

Whenever a dangerous or potentially dangerous patient escapes from an
institution in any party state, that state shall promptly notify all
appropriate authorities within and out the jurisdiction of the escape in
a manner reasonably calculated to facilitate the speedy apprehension of
the escapee. Immediately upon the apprehension and identification of any
such dangerous or potentially dangerous patient, he shall be detained in
the state where found pending disposition in accordance with law.

ARTICLE VI

The duly accredited officers of any state party to this compact, upon the
establishment of their authority and the identity of the patient, shall
be permitted to transport any patient being moved pursuant to this
compact through any and all states party to this compact, without
interference.

ARTICLE VII

(a) No person shall be deemed a patient of more than one institution at
any given time. Completion of transfer of any patient to an institution
in a receiving state shall have the effect of making the person a patient
of the institution in the receiving state.

(b) The sending state shall pay all costs of and incidental to the
transportation of any patient pursuant to this compact, but any two or
more party states may, by making a specific agreement for that purpose,
arrange for a different allocation of costs as among themselves.

(c) No provision of this compact shall be construed to alter or affect
any internal relationships among the departments, agencies and officers
of and in the government of a party state, or between a party state and
its subdivisions, as to the payment of costs, or responsibilities
therefor.

(d) Nothing in this compact shall be construed to prevent any party state
or subdivision thereof from asserting any right against any person,
agency or other entity in regard to costs for which such party state or
subdivision thereof may be responsible pursuant to any provision of this
compact.

(e) Nothing in this compact shall be construed to invalidate any
reciprocal agreement between a party state and a nonparty state relating
to institutionalization, care or treatment of the mentally ill or
mentally deficient, or any statutory authority pursuant to which such
agreements may be made.

ARTICLE VIII

(a) Nothing in this compact shall be construed to abridge, diminish, or
in any way impair the rights, duties, and responsibilities of any
patient's guardian on his own behalf or in respect of any patient for
whom he may serve, except that where the transfer of any patient to
another jurisdiction makes advisable the appointment of a supplemental or
substitute guardian, any court of competent jurisdiction in the receiving
state may make such supplemental or substitute appointment and the court
which appointed the previous guardian shall upon being duly advised of
the new appointment, and upon the satisfactory completion of such
accounting and other acts as such court may by law require, relieve the
previous guardian of power and responsibility to whatever extent shall be
appropriate in the circumstances; provided, however, that in the case of
any patient having settlement in the sending state, the court of
competent jurisdiction in the sending state shall have the sole
discretion to relieve a guardian appointed by it or continue his power
and responsibility, whichever it shall deem advisable. The court in the
receiving state may, in its discretion, confirm or reappoint the person
or persons previously serving as guardian in the sending state in lieu of
making a supplemental or substitute appointment.

(b) The term "guardian" as used in paragraph (a) of this article shall
include any guardian, trustee, legal committee, conservator, or other
person or agency however denominated who is charged by law with power to
act for or responsibility for the person or property of a patient.

ARTICLE IX

(a) No provision of this compact except Article V shall apply to any
person institutionalized while under sentence in a penal or correctional
institution or while subject to trial on a criminal charge, or whose
institutionalization is due to the commission of an offense for which, in
the absence of mental illness or mental deficiency, said person would be
subject to incarceration in a penal or correctional institution.

(b) To every extent possible, it shall be the policy of states party to
this compact that no patient shall be placed or detained in any prison,
jail or lockup, but such patient shall, with all expedition, be taken to
a suitable institutional facility for mental illness or mental deficiency.

ARTICLE X

(a) Each party state shall appoint a "compact administrator" who, on
behalf of his state, shall act as general coordinator of activities under
the compact in his state and who shall receive copies of all reports,
correspondence, and other documents relating to any patient processed
under the compact by his state either in the capacity of sending or
receiving state. The compact administrator or his duly designated
representative shall be the official with whom other party states shall
deal in any matter relating to the compact or any patient processed
thereunder.

(b) The compact administrators of the respective party states shall have
power to promulgate reasonable rules and regulations to carry out more
effectively the terms and provisions of this compact.

ARTICLE XI

The duly constituted administrative authorities of any two or more party
states may enter into supplementary agreements for the provision of any
service or facility or for the maintenance of any institution on a joint
or cooperative basis whenever the states concerned shall find that such
agreements will improve services, facilities, or institutional care and
treatment in the fields of mental illness or mental deficiency. No such
supplementary agreement shall be construed so as to relieve any party
state of any obligation which it otherwise would have under other
provisions of this compact.

ARTICLE XII

This compact shall enter into full force and effect as to any state when
enacted by it into law and such state shall thereafter be a party thereto
with any and all states legally joining therein.

ARTICLE XIII

(a) A state party to this compact may withdraw therefrom by enacting a
statute repealing the same. Such withdrawal shall take effect one year
after notice thereof has been communicated officially and in writing to
the governors and compact administrators of all other party states.
However, the withdrawal of any state shall not change the status of any
patient who has been sent to said state or sent out of said state
pursuant to the provisions of the compact.

(b) Withdrawal from any agreement permitted by Article VII(b) as to costs
or from any supplementary agreement made pursuant to Article XI shall be
in accordance with the terms of such agreement and paragraph (a) hereof.

ARTICLE XIV

This compact shall be liberally construed so as to effectuate the
purposes thereof. The provisions of this compact shall be severable and
if any phrase, clause, sentence or provision of this compact is declared
to be contrary to the constitution of any party state or of the United
States or the applicability thereof to any government, agency, person or
circumstance is held invalid, the validity of the remainder of this
compact and the applicability thereof to any government, agency, person
or circumstance shall not be affected thereby. If this compact shall be
held contrary to the constitution of any state party thereto, the compact
shall remain in full force and effect as to the remaining states and in
full force and effect as to the state affected as to all severable
matters. (L. 1980 H.B. 1724)

The director of the department of mental health shall be the
compact administrator who, acting jointly with like officers of other
party states, shall have power to promulgate rules and regulations to
carry out more effectively the terms of the compact. The compact
administrator is hereby authorized, empowered and directed to cooperate
with all departments, agencies and officers of and in the government of
this state and its subdivisions in facilitating the proper administration
of the compact or any supplementary agreement or agreements entered into
by this state thereunder. (L. 1980 H.B. 1724)

The compact administrator is hereby authorized and empowered to
enter into supplementary agreements with appropriate officials of other
states pursuant to Articles VII and XI of the compact. In the event that
such supplementary agreements shall require or contemplate the use of any
institution or facility of this state or require or contemplate the
provision of any service by this state, no such agreement shall have
force or effect until approved by the head of the department or agency
under whose jurisdiction the institution or facility is operated or whose
department or agency will be charged with the rendering of the service.
(L. 1980 H.B. 1724)

All expenditures necessitated under the provisions of sections
630.810 to 630.835 shall be paid out of appropriations made to the
department of mental health. (L. 1980 H.B. 1724)

The compact administrator is hereby directed to consult with the
immediate family of any proposed transferee and, in the case of a
proposed transferee from an institution in this state to an institution
in another party state, to take no final action without approval of the
court which committed the proposed transferee. (L. 1980 H.B. 1724)

Duly authorized copies of sections 630.810 to 630.835 shall,
upon its approval, be transmitted by the secretary of state to the
governor of each state, the Attorney General and the Secretary of State
of the United States, and the Council of State Governments. (L. 1980 H.B.
1724)

The "Interstate Compact on the Mentally Disordered Offender",
hereinafter called "the compact", is hereby enacted into law and entered
into with all other jurisdictions legally joining therein, in the form
substantially as contained in section 630.855. (L. 1980 H.B. 1724)

The department of mental health and the department of
corrections may negotiate and enter into contracts on behalf of this
state pursuant to Article III of the compact and may perform such
contracts; provided, that no funds, personnel, facilities, equipment,
supplies or materials shall be pledged for, committed or used on account
of any such contract, unless legally available therefor.

THE INTERSTATE COMPACT ON

MENTALLY DISORDERED OFFENDERS

ARTICLE I

(a) The party states, desiring by common action to improve their programs
for the care and treatment of mentally disordered offenders, declare that
it is the policy of each of the party states to:

1. Strengthen their own programs and laws for the care and treatment of
the mentally disordered offender.

2. Encourage and provide for such care and treatment in the most
appropriate locations, giving due recognition to the need to achieve
adequacy of diagnosis, care, treatment, aftercare and auxiliary services
and facilities and, to every extent practicable, to do so in geographic
locations convenient for providing a therapeutic environment.

3. Authorize cooperation among the party states in providing services and
facilities, when it is found that cooperative programs can be more
effective and efficient than programs separately pursued.

4. Place each mentally disordered offender in a legal status which will
facilitate his care, treatment and rehabilitation.

5. Authorize research and training of personnel on a cooperative basis,
in order to improve the quality or quantity of personnel available for
the proper staffing programs, services and facilities for mentally
disordered offenders.

6. Care for and treat mentally disordered offenders under conditions
which will improve the public safety.

(b) Within the policies set forth in this Article, it is the purpose of
this compact to:

1. Authorize negotiation, entry into and operations under contractual
arrangements among any two or more of the party states for the
establishment and maintenance of cooperative programs in any one or more
of the fields for which specific provision is made in the several
articles of this compact.

2. Set the limits within which such contracts may operate, so as to
assure protection of the civil rights of mentally disordered offenders
and protection of the rights and obligations of the public and of the
party states.

3. Facilitate the proper disposition of criminal charges pending against
mentally disordered offenders, so that programs for their care, treatment
and rehabilitation may be carried on efficiently.

ARTICLE II

As used in this compact:

(a) "Mentally disordered offender" means a person who has been
determined, by adjudication or other method legally sufficient for the
purpose in the party state where the determination is made, to be
mentally ill and:

1. Is under sentence for the commission of crime; or

2. Who is confined or committed on account of the commission of an
offense for which, in the absence of mental illness, said person would be
subject to incarceration in a penal or correctional facility.

(b) "Patient" means a mentally disordered offender who is cared for,
treated, or transferred pursuant to this compact.

(c) "Sending state" means a state party to this compact in which the
mentally disordered offender was convicted; or the state in which he
would be subject to trial on or conviction of an offense, except for his
mental condition; or, within the meaning of Article V of this compact,
the state whose authorities have filed a petition in connection with an
untried indictment, information or complaint.

(d) "Receiving state" means a state party to this compact to which a
mentally disordered offender is sent for care, aftercare, treatment or
rehabilitation, or within the meaning of Article V of this compact, the
state in which a petition in connection with an untried indictment,
information or complaint has been filed.

ARTICLE III

(a) Each party state may make one or more contracts with any one or more
of the other party states for the care and treatment of mentally
disordered offenders on behalf of a sending state in facilities situated
in receiving states, or for the participation of such mentally disordered
offenders in programs of aftercare on conditional release administered by
the receiving state. Any such contract shall provide for:

1. Its duration.

2. Payments to be made to the receiving state by the sending state for
patient care, treatment, and extraordinary services, if any.

3. Determination of responsibility for ordering or permitting the
furnishing of extraordinary services, if any.

4. Participation in compensated activities, if any, available to
patients; the disposition or crediting of any payment received by
patients on account thereof; and the crediting of proceeds from or
disposal of any products resulting therefrom.

5. Delivery and retaking of mentally disordered offenders.

6. Such other matters as may be necessary and appropriate to fix the
obligations, responsibilities and rights of the sending and receiving
states.

(b) Prior to the construction or completion of construction of any
facility for mentally disordered offenders or addition to such facility
by a party state, any other party state or states may contract therewith
for the enlargement of the planned capacity of the facility or addition
thereto, or for the inclusion therein of particular equipment or
structures, and for the reservation of a specific percentum of the
capacity of the facility to be kept available for use by patients of the
sending state or states so contracting. Any sending state so contracting
may, to the extent that moneys are legally available therefor, pay to the
receiving state, a reasonable sum as consideration for such enlargement
of capacity, or provision of equipment or structures, and reservation of
capacity. Such payment may be in a lump sum or in installments as
provided in the contract.

(c) A party state may contract with any one or more other party states
for the training of professional or other personnel whose services, by
reason of such training, would become available for or be improved in
respect of ability to participate in the care and treatment of mentally
disordered offenders. Such contracts may provide for such training to
take place at any facility being operated or to be operated for the care
and treatment of mentally disordered offenders; at any institution or
facility having resources suitable for the offering of such training; or
may provide for the separate establishment of training facilities,
provided that no such separate establishment shall be undertaken, unless
it is determined that an appropriate existing facility or institution
cannot be found at which to conduct the contemplated program. Any
contract entered into pursuant to this paragraph shall provide for:

1. The administration, financing, and precise nature of the program.

2. The status and employment or other rights of the trainees.

3. All other necessary matters.

(d) No contract entered into pursuant to this compact shall be
inconsistent with any provision thereof.

ARTICLE IV

(a) Whenever the duly constituted judicial or administrative authorities
in a state party to this compact, and which has entered into a contract
pursuant to Article III, shall decide that custody, care and treatment
in, or transfer of a patient to, a facility within the territory of
another party state, or conditional release for aftercare in another
party state is necessary in order to provide adequate care and treatment
or is desirable in order to provide an appropriate program of therapy or
other treatment, or is desirable for clinical reasons, said officials may
direct that the custody, care and treatment be within a facility or in a
program of aftercare within the territory of said other party state, the
receiving state to act in that regard solely as agent for the sending
state.

(b) The appropriate officials of any state party to this compact shall
have access, at all reasonable times, to any facility in which it has a
contractual right to secure care or treatment of patients for the purpose
of inspection and visiting such of its patients as may be in the facility
or served by it.

(c) Except as otherwise provided in Article VI, patients in a facility
pursuant to the terms of this compact shall at all times be subject to
the jurisdiction of the sending state and may at any time be removed for
transfer to a facility within the sending state, for transfer to another
facility in which the sending state may have a contractual or other right
to secure care and treatment of patients, for release on aftercare or
other conditional status, for discharge, or for any other purpose
permitted by the laws of the sending state; provided that the sending
state shall continue to be obligated to such payments as may be required
pursuant to the terms of any contract entered into under the terms of
Article III.

(d) Each receiving state shall provide regular reports to each sending
state on the patients of that sending state in facilities pursuant to
this compact including a psychiatric and behavioral record of each
patient and certify said record to the official designated by the sending
state, in order that each patient may have the benefit of his or her
record in determining and altering the disposition of said patient in
accordance with the law which may obtain in the sending state and in
order that the same may be a source of information for the sending state.

(e) All patients who may be in a facility or receiving aftercare from a
facility pursuant to the provisions of this compact shall be treated in a
reasonable and humane manner and shall be cared for, treated and
supervised in accordance with the standards pertaining to the program
administered at the facility. The fact of presence in a receiving state
shall not deprive any patient of any legal rights which said patient
would have had if in custody or receiving care, treatment or supervision
as appropriate in the sending state.

(f) Any hearing or hearings to which a patient present in a receiving
state pursuant to this compact may be entitled by the laws of the sending
state shall be had before the appropriate authorities of the sending
state, or of the receiving state if authorized by the sending state. The
receiving state shall provide adequate facilities for such hearings as
may be conducted by the appropriate officials of a sending state. In the
event such hearing or hearings are had before officials of the receiving
state, the governing law shall be that of the sending state and a record
of the hearing or hearings as prescribed by the sending state shall be
made. Said record together with any recommendations of the hearing
officials shall be transmitted forthwith to the official or officials
before whom the hearing would have been had if it had taken place in the
sending state. In any and all proceedings had pursuant to the provisions
of this paragraph, the officials of the receiving state shall act solely
as agents of the sending state and no final determination shall be made
in any matter except by the appropriate officials of the sending state.
Costs of records made pursuant to this paragraph shall be borne by the
sending state.

(g) Patient confined pursuant to this compact shall be released within
the territory of the sending state unless the patient, and the sending
and receiving states, shall agree upon release in some other place. The
sending state shall bear the cost of such return to its territory.

(h) Any patient pursuant to the terms of this compact shall be subject to
civil process and shall have any and all rights to sue, be sued and
participate in and derive any benefits or incur or be relieved of any
obligations or have such obligation modified or his status changed on
account of any action or proceeding in which he could have participated
if in any appropriate facility of the sending state or being supervised
therefrom, as the case may be, located within such state.

(i) The parent, guardian, trustee, or other person or persons entitled
under the laws of the sending state to act for, advise, or otherwise
function with respect to any patient shall not be deprived of or
restricted in his exercise of any power in respect of any patient
pursuant to the terms of this compact.

ARTICLE V

(a) Whenever the authorities responsible for the care and treatment of a
mentally disordered offender, whether convicted or adjudicated in the
state or subject to care, aftercare, treatment or rehabilitation pursuant
to a contract, are of the opinion that charges based on untried
indictments, informations or complaints in another party state present
obstacles to the proper care and treatment of a mentally disordered
offender or to the planning or execution of a suitable program for him,
such authorities may petition the appropriate court in the state where
the untried indictment, information or complaint is pending for prompt
disposition thereof. If the mentally disordered offender is a patient in
a receiving state, the appropriate authorities of the sending state, upon
recommendation of the appropriate authorities in the receiving state,
shall, if they concur in the recommendation, file the petition
contemplated by this paragraph.

(b) The court shall hold a hearing on the petition within thirty days of
the filing thereof. Such hearing shall be only to determine whether the
proper safeguarding and advancement of the public interest; the condition
of the mentally disordered offender; and the prospects for more
satisfactory care, treatment and rehabilitation of him warrant
disposition of the untried indictment, information or complaint prior to
termination of the defendant's status as a mentally disordered offender
in the sending state. The prosecuting officer of the jurisdiction from
which the untried indictment, information or complaint is pending, the
petitioning authorities, and such other persons as the court may
determine shall be entitled to be heard.

(c) Upon any hearing pursuant to this Article, the court may order such
adjournments or continuances as may be necessary for the examination or
observation of the mentally disordered offender or for the securing of
necessary evidence. In granting or denying any such adjournment or
continuance, the court shall give primary consideration to the purposes
of this compact, and more particularly to the need for expeditious
determination of the legal and mental status of a mentally disordered
offender so that his care, treatment and discharge to the community only
under conditions which will be consonant with the public safety may be
implemented.

(d) The presence of a mentally disordered offender within a state wherein
a petition is pending or being heard pursuant to this Article, or his
presence within any other state through which he is being transported in
connection with such petition or hearing, shall be only for the purposes
of this compact, and no court, agency or person shall have or obtain
jurisdiction over such mentally disordered offender for any other purpose
by reason of his presence pursuant to this Article. The mentally
disordered offender shall, at all times, remain in the custody of the
sending state. Any acts of officers, employees, or agencies of the
receiving state in providing or facilitating detention, housing or
transportation for the mentally disordered offender shall be only as
agents for the sending state.

(e) Promptly upon conclusion of the hearing the court shall dismiss the
untried indictment, information or complaint, if it finds that the
purposes enumerated in paragraph (b) of this Article would be served
thereby. Otherwise, the court shall make such order with respect to the
petition and the untried indictment, information or complaint as may be
appropriate in the circumstances and consistent with the status of the
defendant as a mentally disordered offender in the custody of and subject
to the jurisdiction of the sending state.

(f) No fact or other matter established or adjudicated at any hearing
pursuant to this Article, or in connection therewith, shall be deemed
established or adjudicated, nor shall the same be admissible in evidence,
in any subsequent prosecution of the untried indictment, information or
complaint concerned in a petition filed pursuant to this Article unless:

1. The defendant or his duly empowered legal representative requested or
expressly acquiesced in the making of the petition, and was afforded an
opportunity to participate in person in the hearing; or

2. The defendant himself offers or consents to the introduction of the
determination or adjudication at such subsequent proceedings.

ARTICLE VI

(a) Any decision of the sending state in respect of any matter over which
it retains jurisdiction pursuant to this compact shall be conclusive upon
and not reviewable within the receiving state, but if at the time the
sending state seeks to remove a patient from the receiving state there is
pending against the patient within such state any criminal charge or if
the patient is suspected of having committed within such state a criminal
offense, the patient shall not be returned without the consent of the
receiving state until discharged from prosecution or other form of
proceeding, imprisonment or detention for such offense. The duly
accredited officers of the sending state shall be permitted to transport
patients pursuant to this compact through any and all states party to
this compact without interference.

(b) A patient who escapes while receiving care and treatment or who
violates provisions of aftercare by leaving the jurisdiction, or while
being detained or transported pursuant to this compact shall be deemed an
escapee from the sending state and from the state in which the facility
is situated or the aftercare was being provided. In the case of an escape
to a jurisdiction other than the sending or receiving state, the
responsibility for return shall be that of the sending state, but nothing
contained herein shall be construed to prevent or affect the activities
of officers and agencies of any jurisdiction directed toward the
apprehension and return of an escapee.

ARTICLE VII

Any state party to this compact may accept federal aid for use in
connection with any facility or program, the use of which is or may be
affected by this compact or any contract pursuant thereto and any patient
in a receiving state pursuant to this compact may participate in any such
federally aided program or activity for which the sending and receiving
states have made contractual provision; provided that if such program or
activity is not part of the customary regimen of the facility or program
the express consent of the appropriate official of the sending state
shall be required therefor.

ARTICLE VIII

This compact shall enter into force and become effective and binding upon
the states so acting when it has been enacted into law by any two states
from among the states of Illinois, Indiana, Iowa, Kansas, Michigan,
Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota and
Wisconsin. Thereafter, this compact shall enter into force and become
effective and binding as to any other of said states, or any other state
upon similar action by such state.

ARTICLE IX

This compact shall continue in force and remain binding upon a party
state until it shall have enacted a statute repealing the same and
providing for the sending of formal written notice of withdrawal from the
compact to the appropriate officials of all other party states. An actual
withdrawal shall not take effect until two years after the notices
provided in said statute have been sent. Such withdrawal shall not
relieve the withdrawing state from its obligations assumed hereunder
prior to the effective date of withdrawal. Before the effective date of
withdrawal, a withdrawing state shall remove to its territory, at its own
expense, such patients as it may have in other party states pursuant to
the provisions of this compact.

ARTICLE X

Nothing contained in this compact shall be construed to abrogate or
impair any agreement or other arrangement which a party state may have
with a nonparty state for the custody, care, treatment, rehabilitation or
aftercare of patients nor to repeal any other laws of a party state
authorizing the making of cooperative arrangements.

ARTICLE XI

The provisions of this compact shall be liberally construed and shall be
severable. If any phrase, clause, sentence or provision of this compact
is declared to be contrary to the constitution of any participating state
or of the United States or the applicability thereof to any government,
agency, person or circumstance is held invalid, the validity of the
remainder of this compact and the applicability thereof to any
government, agency, person or circumstance shall not be affected thereby.
If this compact shall be held contrary to the constitution of any state
participating therein, the compact shall remain in full force and effect
as to the remaining states and in full force and effect as to the state
affected as to all severable matters. (L. 1980 H.B. 1724, A.L. 1990 H.B.
974)

1. The director of the department of mental health, in
partnership with the department of health and senior services and in
collaboration with the departments of social services, elementary and
secondary education, higher education, and corrections, and other
appropriate agencies, organizations, and institutions in the community,
shall design a proposed state suicide prevention plan using an evidence-
based public health approach focused on suicide prevention.

2. The plan shall include, but not be limited to:

(1) Promoting the use of employee assistance and workplace programs to
support employees with depression and other psychiatric illnesses and
substance abuse disorders, and refer them to services. In promoting such
programs, the director shall collaborate with employer and professional
associations, unions, and safety councils;

(2) Promoting the use of student assistance and educational programs to
support students with depression and other psychiatric illnesses and
substance abuse disorders. In promoting such programs, the director shall
collaborate with educators, administrators, students, and parents with
emphasis on identification of the risk factors associated with suicide;

(3) Providing training and technical assistance to local public health
and other community-based professionals to provide for integrated
implementation of best practices for preventing suicides;

(4) Establishing a toll-free suicide prevention hotline; and

(5) Coordinating with federal, state, and local agencies to collect,
analyze, and annually issue a public report on Missouri-specific data on
suicide and suicidal behaviors.

3. The proposed state suicide prevention plan designed and developed
pursuant to this section shall be submitted to the general assembly by
December 31, 2004, and shall include any recommendations regarding
statutory changes and implementation and funding requirements of the
plan. (L. 2003 H.B. 59 & 269 merged with S.B. 618)

1. There is hereby created within the department of mental
health the "Suicide Prevention Advisory Committee" to be comprised of the
following eighteen members:

(1) Six representatives from each of the following state departments:
mental health, health and senior services, social services, elementary
and secondary education, corrections, and higher education;

(2) Ten citizen members representing suicide survivors, the criminal
justice system, the business community, clergy, schools, youth, mental
health professionals, health care providers, nonprofit organizations, and
a researcher to be appointed by the governor;

(3) One member from the house of representatives to be appointed by the
speaker of the house of representatives; and

(4) One member of the senate to be appointed by the president pro tem of
the senate.

2. The initial appointments to the advisory committee shall be made by
October 1, 2005. The initial ten members appointed under subdivision (2)
of subsection 1 of this section shall be appointed as follows: four
members shall be appointed for a four-year term, three members shall be
appointed for a three-year term, and three members shall be appointed for
a two-year term.

3. The first meeting of the advisory committee shall be scheduled by the
director of the department of mental health and held on or before
December 1, 2005. The committee shall meet at least quarterly thereafter.
The director of the department of mental health, or the director's
designee, shall be the chair of the advisory committee. Each of the
departments listed in subdivision (1) of subsection 1 of this section
shall provide staff and technical support for the advisory committee.

4. The advisory committee shall:

(1) Provide oversight, technical support, and outcome promotion for
prevention activities;

(2) Develop annual goals and objectives for ongoing suicide prevention
efforts;

(3) Make information on prevention and mental health intervention models
available to community groups implementing suicide prevention programs;

(4) Promote the use of outcome methods that will allow comparison and
evaluation of the efficacy, effectiveness, cultural competence, and cost-
effectiveness of plan-supported interventions, including making specific
recording and monitoring instruments available for plan-supported
projects;

(5) Review and recommend changes to existing or proposed statutes, rules,
and policies to prevent suicides; and

(6) Coordinate and issue a biannual report on suicide and suicidal
behaviors in the state using information drawn from federal, state, and
local sources.

5. Members of the committee shall serve without compensation but the ten
citizen members may be reimbursed for any actual expenses incurred in the
performance of their duties as members of the advisory committee. (L.
2005 H.B. 462 & 463)

1. The department of mental health, in consultation with the
department of health and senior services, shall seek funding from the
Centers for Disease Control and Prevention to participate in the National
Violent Death Reporting System (NVDRS) to obtain better information about
violent deaths, including suicide.

2. If such funding under subsection 1 of this section is not available to
the state of Missouri, on or before July 1, 2006, the department of
mental health, in consultation with the department of health and senior
services and subject to appropriation, shall develop a state- based
reporting system based on the National Violent Death Reporting System
that will provide information needed to accurately assess the factors
causing violent deaths, including suicide.

3. Information obtained from this state's participation in the National
Violent Death Reporting System under subsection 1 of this section or the
state-based system developed under subsection 2 of this section shall be
used to help answer questions regarding the magnitude, trends, and
characteristics of violent deaths and assist in the evaluation and
improvement of violence prevention policies and programs.

4. Information obtained under this section shall be provided to the
suicide prevention advisory committee established under section 630.910.

5. Pursuant to section 23.253, RSMo, of the Missouri sunset act:

(1) The provisions of the new program authorized under this section shall
automatically sunset six years after August 28, 2005, unless reauthorized
by an act of the general assembly; and

(2) If such program is reauthorized, the program authorized under this
section shall automatically sunset twelve years after the effective date
of the reauthorization of this section; and

(3) This section shall terminate on September first of the calendar year
immediately following the calendar year in which the program authorized
under this section is sunset. (L. 2005 H.B. 462 & 463)

Sunsets 8-28-11, unless reauthorized

Terminates 9-1-12, unless reauthorized

1. There is hereby established in the department of mental
health an "Office of Comprehensive Child Mental Health". The office of
comprehensive child mental health, under the supervision of the director
of the department of mental health, shall provide leadership in
developing and implementing the comprehensive child mental health service
system plan established under section 630.097. The office shall:

(1) Assure oversight and monitoring of the implementation of the
comprehensive child mental health service system plan;

(2) Provide support, technical assistance and training to all departments
participating in the development and implementation of the comprehensive
child mental health service system established under section 630.097;

(3) Develop and coordinate service system, financing and quality
assurance policy for all children's mental health services within the
department of mental health;

(4) Provide leadership in program development for children's mental
health services within the department of mental health, to include
developing program standards and providing technical assistance in
developing program capacity;

(5) Provide clinical consultation, technical assistance and clinical
leadership for all child mental health within the department and to other
child-serving agencies participating in the comprehensive child mental
health system;

(6) Participate in the work of the coordinating board for early childhood;

(7) Participate in interagency child mental health initiatives as
directed; and

(8) Provide staff support and leadership to the state comprehensive
system management team established under section 630.097.

2. The departments participating in the comprehensive child mental health
service system established under section 630.097 shall designate staff to
represent their respective department on the state comprehensive system
management team. (L. 2005 S.B. 501)

1. There is hereby established in the department of mental
health a "Comprehensive Child Mental Health Clinical Advisory Council".
The council, under the supervision of the director of the department of
mental health, shall advise the office of comprehensive child mental
health established under section 630.1000. The council shall be comprised
of not more than ten members and shall include, but not be limited to,
individuals representing the following disciplines: pediatric medicine,
child psychiatry, child psychology, social work, clinical counseling,
school psychologist, research, financing, and evaluation. The director of
the department of mental health, or his or her designee, and a member of
the office of comprehensive child mental health established under section
630.1000 shall serve as ex officio members of the council.

2. The members of the council, other than the ex officio members, shall
be appointed by the director of the department of mental health and shall
serve for three-year terms. Members shall serve on the council without
compensation but may be reimbursed for the actual and necessary expenses
from moneys appropriated to the department of mental health for that
purpose. Members of the advisory council shall:

(1) Share with the council and department information on state and
national trends, evidenced-based practices and research findings within
their respective fields;

(2) Serve as a liaison with their respective discipline to obtain and
disseminate information;

(3) Identify funding and research opportunities within their respective
field; and

(4) Advise the department in ways that knowledge from their respective
field can be merged within other fields to provide a comprehensive
system. (L. 2005 S.B. 501)

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