Missouri Statute | Act | Code |Additional Executive Departments| US Code - US Statute | Chapter 660 Department Of Social Services

1. There is hereby created a "Department of Social Services" in
charge of a director appointed by the governor, by and with the advice
and consent of the senate. All the powers, duties and functions of the
director of the department of public health and welfare, chapters 191 and
192, RSMo and others, not previously reassigned by executive
reorganization plan number 2 of 1973 as submitted by the governor under
chapter 26, RSMo, except those assigned to the department of mental
health, are transferred by type I transfer to the director of the
department of social services and the office of the director, department
of public health and welfare is abolished. The department of public
health and welfare is abolished. All employees of the department of
social services shall be covered by the provisions of chapter 36, RSMo,
except the director of the department and his secretary, all division
directors and their secretaries, and no more than three additional
positions in each division which may be designated by the division
director.

2. It is the intent of the general assembly in establishing the
department of social services, as provided herein, to authorize the
director of the department to coordinate the state's programs devoted to
those unable to provide for themselves and for the rehabilitation of
victims of social disadvantage. The director shall use the resources
provided to the department to provide comprehensive programs and
leadership striking at the roots of dependency, disability and abuse of
society's rules with the purpose of improving service and economical
operations. The department is directed to take all steps possible to
consolidate and coordinate the field operations of the department to
maximize service to the citizens of the state.

3. All the powers, duties and functions of the division of welfare,
chapters 205, 207, 208, 209, and 210, RSMo, and others, are transferred
by type I transfer to the "Division of Family Services" which is hereby
created in the department of social services. The director of the
division shall be appointed by the director of the department. All
references to the division of welfare shall hereafter be construed to
mean the division of family services of the department of social services.

4. All the powers, duties and functions of the board of nursing home
administrators, chapter 344, RSMo, are transferred by type I transfer to
the department of social services. The public members of the board shall
be appointed by the director of the department.

5. The state's responsibility under public law 452 of the eighty-eighth
Congress and others, pertaining to the Office of Economic Opportunity, is
transferred by type I transfer to the department of social services.

6. The state's responsibility under public law 73, Older Americans Act of
1965, of the eighty-ninth Congress is transferred by type I transfer to
the department of social services.

7. All the powers, duties and functions vested by law in the curators of
the University of Missouri relating to crippled children's services,
chapter 201, RSMo, are transferred by type I transfer to the department
of social services.

8. All the powers, duties and functions vested in the state board of
training schools, chapter 219, RSMo, and others, are transferred by type
I transfer to the "Division of Youth Services" hereby authorized in the
department of social services headed by a director appointed by the
director of the department. The state board of training schools shall be
reconstituted as an advisory board on youth services, appointed by the
director of the department. The advisory board shall visit each facility
of the division as often as possible, shall file a written report with
the director of the department and the governor on conditions they
observed relating to the care and rehabilitative efforts in behalf of
children assigned to the facility, the security of the facility and any
other matters pertinent in their judgment. Copies of these reports shall
be filed with the legislative library. Members of the advisory board
shall receive reimbursement for their expenses and twenty-five dollars a
day for each day they engage in official business relating to their
duties. The members of the board shall be provided with identification
means by the director of the division permitting immediate access to all
facilities enabling them to make unannounced entrance to facilities they
wish to inspect. (L. 1973 1st Ex. Sess. S.B. 1 § 13, A.L. 1982 S.B. 717,
A.L. 1986 S.B. 426)

*Originally section 13 of the Reorganization Act of 1974, Appendix B

1. The treasurer of the state shall establish in the state
treasury a "Department of Social Services Administrative Trust Fund"
which shall be funded annually by appropriations and deposits thereto.

2. This fund shall contain moneys transferred or paid to the department
for goods and services provided by the department or its divisions to any
governmental entity or to the public.

3. The commissioner of administration shall approve disbursements from
the fund at the request of the director of the department or his designee
in accordance with appropriations made therefor.

4. 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-twelfth
of the amount either appropriated or paid or transferred to the fund
during such fiscal year, whichever is greater.

5. The director of the department shall prepare an annual report of all
receipts and disbursements from the fund. (L. 1986 H.B. 1366)

The director of the department of social services shall receive
as compensation for his or her services the salary provided by statute
and additional reimbursement for necessary traveling expenses and other
necessary expenditures incurred in the performance of official duties.
Compensation for the director and employees of the department of social
services and funds for other expenses incident to the performance of
their duties prescribed by authority of this and other laws shall be
payable from appropriations made in the same manner as for other
departments. (L. 1945 p. 945 § 4, A.L. 1980 H.B. 1266)

*Transferred 1986; formerly 191.040

If the state's net federal reimbursement allowance for fiscal
year 1994 and subsequent fiscal years exceeds one hundred thirty million
dollars, the department of social services shall include in its 1995
fiscal year budget recommendation that any revenues in excess of one
hundred thirty million dollars subject to appropriation be designated for
the following purposes:

(1) Loans for physicians and nurses who will serve in medically
underserved areas of Missouri as designated by the director of health;

(2) Primary and preventive care initiatives, including parenting classes,
as determined by the directors of health and social services; and

(3) Transitional Medicaid expenses of AFDC recipients who accept
employment which does not provide a medical benefit. As used in this
section, "net federal reimbursement allowance" shall mean that amount of
the federal reimbursement allowance in excess of the amount of state
matching funds necessary for the state to make payments required by
subsection 1 of section 208.450*, RSMo, or, if the payments exceed the
amount so required, the actual payments made for the purposes specified
in subsection 1 of section 208.450*, RSMo. This section shall cease to be
in effect if the revenues generated by sections 208.450* to 208.480,
RSMo, become ineligible for federal financial participation, if payments
cease to be made pursuant to section 208.471, RSMo, or if such sections
expire in accordance with section 208.480, RSMo. (L. 1993 H.B. 564 § 29)

*Section 208.450 was repealed by L. 1994 H.B. 1362.

The department of social services may adopt, appeal and amend
rules necessary to carry out the duties assigned to it. All rules shall
be promulgated pursuant to the provisions of this section and chapter
536, RSMo. 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. (L. 1993 H.B. 564 §
30, A.L. 1995 S.B. 3)

The director of the department of social services shall apply to
the United States Secretary of Health and Human Services for all waivers
of requirements under federal law necessary to implement the provisions
of section A of this act*. (L. 1993 H.B. 564 § 32)

*"Section A of this act" (H.B. 564, 1993) provides for the repeal and
reenactment of all sections contained in H.B. 564, except sections
149.011, 149.015, 149.035, 149.061, 149.065, 149.160 149.170, 149.180,
149.190 and 149.192, RSMo, and section 208.151, RSMo. Consult Disposition
of Sections table for definitive listing.

For the purposes of sections 660.019 to 660.021, the following
terms mean:

(1) "Caseload standards", the minimum and maximum number of cases that an
employee can reasonably be expected to perform in a normal work month
based on the number of cases handled by, or the number of different job
functions performed by, the employee;

(2) "Department", the department of social services;

(3) "Director", the director of the department of social services;

(4) "Professional caseload standards", caseload standards that are
established by the director, after consideration of caseload standards
established by national setting authorities such as the Child Welfare
League, National Eligibility Workers Associations and the National
Association of Social Workers, or caseload standards used in other states
which have similar job titles. (L. 1999 S.B. 387, et al. § 1)

1. The director shall develop caseload standards based on the
actual duties of employees in each program area of the department, after
considering recommendations of the caseload standards advisory committee,
established pursuant to section 660.021, and consistent with existing
professional caseload standards.

2. In establishing standards pursuant to sections 660.019 to 660.021, the
director shall:

(1) Ensure the standards are based on the actual duties of the caseworker;

(2) Ensure the standards are consistent with existing professional
caseload standards; and

(3) Consider standards developed by other states for workers in similar
positions of employment.

3. Such standards shall be used by the director as the basis of the
department's personnel budget request to the governor.

4. If an employee has failed to satisfactorily complete assignments that
are in excess of specified caseload standards, good faith efforts to
complete such assignments shall be among the factors considered in the
employee's performance evaluation.

5. Subject to appropriations, the department shall use the standards
established pursuant to sections 660.019 to 660.021 to assign caseloads
to individual employees. (L. 1999 S.B. 387, et al. § 2)

1. The director shall convene, at least biannually, a caseload
standards committee which shall consist of seven nonsupervisory employees
of the department and three division directors of the department or their
designees. A representative of the employees' certified majority
organization shall also serve on the committee in an advisory capacity,
but may not vote on any measure before the committee. The caseload
standards advisory committee shall include as nearly as possible
employees from each program area of the department.

2. The caseload standards advisory committee shall review professional
and other caseload standards and recommendations the committee considers
appropriate and recommend to the department minimum and maximum caseloads
for each category of workers employed by the department. (L. 1999 S.B.
387, et al. § 3)

Subject to appropriation from general revenue, the director of
social services shall offer grants, on a competitive basis, to programs
which are engaged in the resettling of refugees and legal immigrants for
the purpose of arranging for day care, transportation or other services
that will facilitate a refugee's or immigrant's accessing of English
language services. The department of social services may promulgate rules
to govern the grant program, pursuant to the provisions of chapter 536,
RSMo. Any rule or portion of a rule, as that term is defined in section
536.010, RSMo, that is promulgated by the department of social services
under the authority of this section, shall become effective only if the
department has fully complied with all of the requirements of chapter
536, RSMo, including but not limited to, section 536.028, RSMo, if
applicable, after August 28, 1998. All rulemaking authority delegated
prior to August 28, 1998, is of no force and effect and repealed as of
August 28, 1998, however nothing in this act* shall be interpreted to
repeal or affect the validity of any rule adopted and promulgated prior
to August 28, 1998. If the provisions of section 536.028, RSMo, apply,
the provisions of this section are nonseverable and if any of the powers
vested with the general assembly pursuant to section 536.028, RSMo, to
review, to delay the effective date, or to disapprove and annul a rule or
portion of a rule are held unconstitutional or invalid, the purported
grant of rulemaking authority and any rule so proposed and contained in
the order of rulemaking shall be invalid and void, except that nothing in
this act* shall affect the validity of any rule adopted and promulgated
prior to August 28, 1998. (L. 1998 S.B. 583 & 645 § 4)

*"This act" (S.B. 583 § 645, 1998) contains numerous sections. Consult
Disposition of Sections table for definitive listing.

Subject to appropriation, the director of the department of
social services, or the director's designee, may contract with and
provide funding support to federally qualified health centers, as defined
in 42 U.S.C. Section 1396d(1)(2)(B), in this state. Funds appropriated
pursuant to this section shall be used to assist such centers in ensuring
that health care, including dental care, and mental health services is
available to needy persons in this state. Such funds may also be used by
centers for capital expansion, infrastructure redesign or other similar
uses if federal funding is not available for such purposes. No later than
forty-five days following the end of each federal fiscal year, the
centers shall report to the director of the department of social services
the number of patients served by age, race, gender, method of payment and
insurance status. (L. 2001 S.B. 393)

1. The "Division of Aging" is hereby transferred from the
department of social services to the department of health and senior
services by a type I transfer as defined in the Omnibus State
Reorganization Act of 1974. The division shall aid and assist the elderly
and low-income handicapped adults living in the state of Missouri to
secure and maintain maximum economic and personal independence and
dignity. The division shall regulate adult long-term care facilities
pursuant to the laws of this state and rules and regulations of federal
and state agencies, to safeguard the lives and rights of residents in
these facilities.

2. In addition to its duties and responsibilities enumerated pursuant to
other provisions of law, the division shall:

(1) Serve as advocate for the elderly by promoting a comprehensive,
coordinated service program through administration of Older Americans Act
(OAA) programs (Title III) P.L. 89-73, (42 U.S.C. 3001, et seq.), as
amended;

(2) Assure that an information and referral system is developed and
operated for the elderly, including information on the Missouri care
options program;

(3) Provide technical assistance, planning and training to local area
agencies on aging;

(4) Contract with the federal government to conduct surveys of long-term
care facilities certified for participation in the Title XVIII program;

(5) Serve as liaison between the department of health and senior services
and the Federal Health Standards and Quality Bureau, as well as the
Medicare and Medicaid portions of the United States Department of Health
and Human Services;

(6) Conduct medical review (inspections of care) activities such as
utilization reviews, independent professional reviews, and periodic
medical reviews to determine medical and social needs for the purpose of
eligibility for Title XIX, and for level of care determination;

(7) Certify long-term care facilities for participation in the Title XIX
program;

(8) Conduct a survey and review of compliance with P.L. 96-566 Sec.
505(d) for Supplemental Security Income recipients in long-term care
facilities and serve as the liaison between the Social Security
Administration and the department of health and senior services
concerning Supplemental Security Income beneficiaries;

(9) Review plans of proposed long-term care facilities before they are
constructed to determine if they meet applicable state and federal
construction standards;

(10) Provide consultation to long-term care facilities in all areas
governed by state and federal regulations;

(11) Serve as the central state agency with primary responsibility for
the planning, coordination, development, and evaluation of policy,
programs, and services for elderly persons in Missouri consistent with
the provisions of subsection 1 of this section and serve as the
designated state unit on aging, as defined in the Older Americans Act of
1965;

(12) With the advice of the governor's advisory council on aging, develop
long-range state plans for programs, services, and activities for elderly
and handicapped persons. State plans should be revised annually and
should be based on area agency on aging plans, statewide priorities, and
state and federal requirements;

(13) Receive and disburse all federal and state funds allocated to the
division and solicit, accept, and administer grants, including federal
grants, or gifts made to the division or to the state for the benefit of
elderly persons in this state;

(14) Serve, within government and in the state at large, as an advocate
for elderly persons by holding hearings and conducting studies or
investigations concerning matters affecting the health, safety, and
welfare of elderly persons and by assisting elderly persons to assure
their rights to apply for and receive services and to be given fair
hearings when such services are denied;

(15) Provide information and technical assistance to the governor's
advisory council on aging and keep the council continually informed of
the activities of the division;

(16) After consultation with the governor's advisory council on aging,
make recommendations for legislative action to the governor and to the
general assembly;

(17) Conduct research and other appropriate activities to determine the
needs of elderly persons in this state, including, but not limited to,
their needs for social and health services, and to determine what
existing services and facilities, private and public, are available to
elderly persons to meet those needs;

(18) Maintain and serve as a clearinghouse for up-to-date information and
technical assistance related to the needs and interests of elderly
persons and persons with Alzheimer's disease or related dementias,
including information on the Missouri care options program, dementia-
specific training materials and dementia-specific trainers. Such
dementia- specific information and technical assistance shall be
maintained and provided in consultation with agencies, organizations
and/or institutions of higher learning with expertise in dementia care;

(19) Provide area agencies on aging with assistance in applying for
federal, state, and private grants and identifying new funding sources;

(20) Determine area agencies on aging annual allocations for Title XX and
Title III of the Older Americans Act expenditures;

(21) Provide transportation services, home-delivered and congregate
meals, in-home services, counseling and other services to the elderly and
low-income handicapped adults as designated in the Social Services Block
Grant Report, through contract with other agencies, and shall monitor
such agencies to ensure that services contracted for are delivered and
meet standards of quality set by the division;

(22) Monitor the process pursuant to the federal Patient
Self-determination Act, 42 U.S.C. 1396a (w), in long-term care facilities
by which information is provided to patients concerning durable powers of
attorney and living wills.

3. The division director, subject to the supervision of the director of
the department of health and senior services, shall be the chief
administrative officer of the division and shall exercise for the
division the powers and duties of an appointing authority pursuant to
chapter 36, RSMo, to employ such administrative, technical and other
personnel as may be necessary for the performance of the duties and
responsibilities of the division.

4. The division may withdraw designation of an area agency on aging only
when it can be shown the federal or state laws or rules have not been
complied with, state or federal funds are not being expended for the
purposes for which they were intended, or the elderly are not receiving
appropriate services within available resources, and after consultation
with the director of the area agency on aging and the area agency board.
Withdrawal of any particular program of services may be appealed to the
director of the department of health and senior services and the
governor. In the event that the division withdraws the area agency on
aging designation in accordance with the Older Americans Act, the
division shall administer the services to clients previously performed by
the area agency on aging until a new area agency on aging is designated.

5. Any person hired by the department of health and senior services after
August 13, 1988, to conduct or supervise inspections, surveys or
investigations pursuant to chapter 198, RSMo, shall complete at least one
hundred hours of basic orientation regarding the inspection process and
applicable rules and statutes during the first six months of employment.
Any such person shall annually, on the anniversary date of employment,
present to the department evidence of having completed at least twenty
hours of continuing education in at least two of the following
categories: communication techniques, skills development, resident care,
or policy update. The department of health and senior services shall by
rule describe the curriculum and structure of such continuing education.

6. The division may issue and promulgate rules to enforce, implement and
effectuate the powers and duties established in this section and sections
198.070 and 198.090, RSMo, and sections 660.250 and 660.300 to 660.320.
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,
2001, shall be invalid and void.

7. Missouri care options is a program, operated and coordinated by the
division of aging, which informs individuals of the variety of care
options available to them when they may need long-term care.

8. The division shall, by January 1, 2002, establish minimum
dementia-specific training requirements for employees involved in the
delivery of care to persons with Alzheimer's disease or related dementias
who are employed by skilled nursing facilities, intermediate care
facilities, residential care facilities, agencies providing in-home care
services authorized by the division of aging, adult day-care programs,
independent contractors providing direct care to persons with Alzheimer's
disease or related dementias and the division of aging. Such training
shall be incorporated into new employee orientation and ongoing
in-service curricula for all employees involved in the care of persons
with dementia. The department of health and senior services shall, by
January 1, 2002, establish minimum dementia-specific training
requirements for employees involved in the delivery of care to persons
with Alzheimer's disease or related dementias who are employed by home
health and hospice agencies licensed by chapter 197, RSMo. Such training
shall be incorporated into the home health and hospice agency's new
employee orientation and ongoing in-service curricula for all employees
involved in the care of persons with dementia. The dementia training need
not require additional hours of orientation or ongoing in-service.
Training shall include at a minimum, the following:

(1) For employees providing direct care to persons with Alzheimer's
disease or related dementias, the training shall include an overview of
Alzheimer's disease and related dementias, communicating with persons
with dementia, behavior management, promoting independence in activities
of daily living, and understanding and dealing with family issues;

(2) For other employees who do not provide direct care for, but may have
daily contact with, persons with Alzheimer's disease or related
dementias, the training shall include an overview of dementias and
communicating with persons with dementia.

As used in this subsection, the term "employee" includes persons hired as
independent contractors. The training requirements of this subsection
shall not be construed as superceding any other laws or rules regarding
dementia-specific training. (L. 1984 H.B. 1131 § 2, A.L. 1988 S.B. 602,
A.L. 1992 S.B. 573 & 634, A.L. 1993 S.B. 52, A.L. 1994 H.B. 1335 & 1381,
A.L. 1995 H.B. 409 merged with S.B. 445 merged with S.B. 3, A.L. 2001
H.B. 603)

(1997) Amendments to this section contained in 1995 CCS HB 409 declared
unconstitutional pursuant to sections 21 and 23 of article III of the
Missouri Constitution. Missouri Health Care Association v. Attorney
General of the State of Missouri, 953 S.W.2d 617 (Mo.banc).

As used in section 199.025, RSMo, and sections 660.050 to
660.057 and 660.400 to 660.420, the following terms mean:

(1) "Area agency on aging", the agency designated by the division in a
planning and service area to develop and administer a plan and administer
available funds for a comprehensive and coordinated system of services
for the elderly and persons with disabilities who require similar
services;

(2) "Area agency board", the local policy-making board which directs the
actions of the area agency on aging under state and federal laws and
regulations;

(3) "Director", the director of the division of aging of the Missouri
department of social services;

(4) "Division", the division of aging of the Missouri department of
social services;

(5) "Elderly" or "elderly persons", persons who are sixty years of age or
older;

(6) "Disability", a mental or physical impairment that substantially
limits one or more major life activities, whether the impairment is
congenital or acquired by accident, injury or disease, where such
impairment is verified by medical findings;

(7) "Local government", a political subdivision of the state whose
authority is general or a combination of units of general purpose local
governments;

(8) "Major life activities", functions such as caring for one's self,
performing manual tasks, walking, seeing, hearing, speaking, breathing,
learning, and working;

(9) "Medicaid", medical assistance provided under section 208.151, RSMo,
et seq., in compliance with Title XIX, Public Law 89-97, 1965 amendments
to the Social Security Act (42 U.S.C. 301 et seq.), as amended;

(10) "Protective services", a service provided by the Missouri division
of aging in response to the need for protection from harm or neglect to
eligible adults under sections 660.250 to 660.295;

(11) "Registered caregiver", a person who provides primary long-term care
for an elderly person and wishes to receive information, services or
support from the shared care program;

(12) "Shared care", a program administered by the division of aging in
which Missouri families who provide primary long-term care for an elderly
person and register as a shared care member with the division of aging
shall receive access to certain supportive services and may receive a
state tax credit;

(13) "Shared care community project", a project in a community that
offers to help support shared care participation through development of
programs;

(14) "Shared care member", a registered caregiver or shared care provider
who registers with the division of aging in order to participate in the
shared care program;

(15) "Shared care provider", any state authorized long-term care provider
in the state, including, but not limited to, in-home, home health,
hospice, adult day care, residential care facility I or II, or nursing
home, who voluntarily registers with the division of aging to be
available as a resource for the shared care program;

(16) "Shared care tax credit", a tax credit to registered caregivers who
meet the requirements of section 660.055. (L. 1984 H.B. 1131 § 1, A.L.
1987 S.B. 277, A.L. 1999 H.B. 316, et al.)

1. The division of aging of the department of social services
shall establish a program to help families who provide the primary
long-term care for an elderly person. This program shall be known as
"shared care" and has the following goals:

(1) To provide services and support for families caring for an elderly
person;

(2) To increase awareness of the variety of privately funded services
which may be available to those persons caring for an elderly person;

(3) To increase awareness of the variety of government services which may
be available to those caring for an elderly person;

(4) Recognition on an annual basis by the governor for those families
participating in the shared care program and community project groups
participating in the shared care program;

(5) To provide a tax credit to members who meet the qualifications
pursuant to section 660.055; and

(6) To promote community involvement by:

(a) Providing local communities information about the shared care program
and to encourage the establishment of support groups where none are
available and to support existing support groups, and other programs for
shared care members and providers to share ideas, information and
resources on caring for an elderly person; and

(b) Encouraging local home care, adult day care or other long-term care
providers, who have regularly scheduled training sessions for paid
caregivers, to voluntarily invite shared care members to participate in
education and training sessions at no cost to the registered caregivers.
Such providers shall not be held liable in any civil or criminal action
related to or arising out of the participation or training of shared care
members in such sessions.

2. To further the goals of the shared care program, the director shall:

(1) Promulgate specific rules and procedures for the shared care program.
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 sections
660.050 to 660.057 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. All rulemaking authority delegated
prior to August 28, 1999, is of no force and effect and repealed. Nothing
in this section shall be interpreted to repeal or affect the validity of
any rule filed or adopted prior to August 28, 1999, if it fully complied
with all applicable provisions of law. 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, 1999, shall be invalid and void;

(2) Maintain a registry of names and addresses of shared care members and
shared care providers;

(3) Compile a list, updated annually, of public and private resources,
services and programs which may be available to assist and support the
registered caregiver with caring for the elderly. Such list shall be
given to shared care members along with information on shared care
providers in their community. Private organizations and providers shall
be responsible for providing information to the division of aging for
inclusion on the list. The division of aging shall establish reporting
procedures for private organizations and publicly disseminate the
division's guidelines statewide;

(4) Compile and distribute to shared care members information about the
services and benefits of the shared care program and a bibliography of
resources and materials with information helpful to such members. The
bibliography will give members an overview of available information and
is not required to be comprehensive;

(5) Encourage shared care providers, consumer groups, churches and other
philanthropic organizations to help local communities develop local
support systems where none are available and to support existing support
groups for persons caring for elderly persons and make division staff
available, if possible;

(6) In conjunction with the director of revenue, develop a physician
certification for shared care tax credit form to be given to registered
caregivers upon request. The form shall require, but is not limited to:

(a) Identifying information about the registered caregiver for tax
purposes, and the signature of the registered caregiver certifying that
he or she qualifies for the shared care tax credit as provided in section
660.055;

(b) Identifying information about the elderly person receiving care for
verification purposes;

(c) Identifying information about and the signature of the physician
licensed pursuant to the provisions of chapter 334, RSMo, for
verification and certification purposes;

(d) A description by such physician of the physical or mental condition
of the elderly person that makes them incapable of living alone and lists
the care, assistance with daily living and oversight needed at home in
order to prevent placement in a facility licensed pursuant to chapter
198, RSMo; and

(e) A complete explanation of the shared care tax credit and its
guidelines and directions on completion of the form and how to file for
the shared care tax credit with the department of revenue; and

(7) In conjunction with the director of revenue, develop a division of
aging certification for shared care tax credit form to be given at the
request of the registered caregivers when a division of aging assessment
has been completed for other purposes. The form shall require, but is not
limited to:

(a) Identifying information about the registered caregiver for tax
purposes, and the signature of the registered caregiver certifying that
he or she qualifies for the shared care tax credit as provided in section
660.055;

(b) Identifying information about the elderly person receiving care for
verification purposes;

(c) Identifying information about and the signature of the division of
aging staff for verification and certification purposes;

(d) A description by the division of aging staff of the physical or
mental condition of the elderly person that makes them incapable of
living alone and lists the care, assistance with daily living and
oversight needed at home in order to prevent placement in a facility
licensed pursuant to chapter 198, RSMo; and

(e) A complete explanation of the shared care tax credit and its
guidelines and directions for completing the form and how to file for the
shared care tax credit with the department of revenue.

3. Funds appropriated for the shared care program shall be appropriated
to and administered by the department of social services. (L. 1999 H.B.
316, et al.)

1. Any registered caregiver who meets the requirements of this
section shall be eligible for a shared care tax credit in an amount not
to exceed five hundred dollars to defray the cost of caring for an
elderly person. In order to be eligible for a shared care tax credit, a
registered caregiver shall:

(1) Care for an elderly person, age sixty or older, who:

(a) Is physically or mentally incapable of living alone, as determined
and certified by his or her physician licensed pursuant to chapter 334,
RSMo, or by the division of aging staff when an assessment has been
completed for the purpose of qualification for other services; and

(b) Requires assistance with activities of daily living to the extent
that without care and oversight at home would require placement in a
facility licensed pursuant to chapter 198, RSMo; and

(c) Under no circumstances, is able or allowed to operate a motor
vehicle; and

(d) Does not receive funding or services through Medicaid or social
services block grant funding;

(2) Live in the same residence to give protective oversight for the
elderly person meeting the requirements described in subdivision (1) of
this subsection for an aggregate of more than six months per tax year;

(3) Not receive monetary compensation for providing care for the elderly
person meeting the requirements described in subdivision (1) of this
subsection; and

(4) File the original completed and signed physician certification for
shared care tax credit form or the original completed and signed division
of aging certification for shared care tax credit form provided for in
subsection 2 of section 660.054 along with such caregiver's Missouri
individual income tax return to the department of revenue.

2. The tax credit allowed by this section shall apply to any year
beginning after December 31, 1999.

3. 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 sections
660.050 to 660.057 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. All rulemaking authority delegated
prior to August 28, 1999, is of no force and effect and repealed. Nothing
in this section shall be interpreted to repeal or affect the validity of
any rule filed or adopted prior to August 28, 1999, if it fully complied
with all applicable provisions of law. 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, 1999, shall be invalid and void.

4. Any person who knowingly falsifies any document required for the
shared care tax credit shall be subject to the same penalties for
falsifying other tax documents as provided in chapter 143, RSMo. (L. 1999
H.B. 316, et al.)

CROSS REFERENCE: Tax Credit Accountability Act of 2004, additional
requirements, RSMo 135.800 to 135.830

1. On and after August 13, 1984, an area agency on aging shall
operate with local administrative responsibility for Title III of the
Older Americans Act, and other funds allocated to it by the division. The
area agency board shall be responsible for all actions of an area agency
on aging in its jurisdiction, including, but not limited to, the
accountability for funds and compliance with federal and state laws and
rules. Such responsibility shall include all geographic areas in which
the area agency on aging is designated to operate. The respective area
agency board shall appoint a director of the area agency on aging in its
jurisdiction. Beginning January 1, 1995, the director of the area agency
on aging shall submit an annual performance report to the division
director, the speaker of the house of representatives, the president pro
tempore of the senate and the governor. Such performance report shall
give a detailed accounting of all funds which were available to and
expended by the area agency on aging from state, federal and private
sources.

2. Each area agency on aging shall have an area agency on aging advisory
council, which shall:

(1) Recommend basic policy guidelines for the administration of the
activities of the area agencies on aging on behalf of elderly persons and
advise the area agency on aging on questions of policy;

(2) Advise the area agency on aging with respect to the development of
the area plan and budget, and review and comment on the completed area
plan and budget before its transmittal to the division;

(3) Review and evaluate the effectiveness of the area agency on aging in
meeting the needs of elderly persons in the planning and service area;

(4) Meet at least quarterly, with all meetings being subject to sections
610.010 to 610.030, RSMo.

3. Each area agency board shall:

(1) Conduct local planning functions for Title III and Title XX, and such
other funds as may be available;

(2) Develop a local plan for service delivery, subject to review and
approval by the division, that complies with federal and state
requirements and in accord with locally determined objectives consistent
with the state policy on aging;

(3) Assess the needs of elderly persons within the planning and service
delivery area for service for social and health services, and determine
what resources are currently available to meet those needs;

(4) Assume the responsibility of determining services required to meet
the needs of elderly persons, assure that such services are provided
within the resources available, and determine when such services are no
longer needed;

(5) Endeavor to coordinate and expand existing resources in order to
develop within its planning and service area a comprehensive and
coordinated system for the delivery of social and health services to
elderly persons;

(6) Serve as an advocate within government and within the community at
large for the interests of elderly persons within its planning and
service area;

(7) Make grants to or enter into contracts with any public or private
agency for the provision of social or health services not otherwise
sufficiently available to elderly persons within the planning and service
area;

(8) Monitor and evaluate the activities of its service providers to
ensure that the services being provided comply with the terms of the
grant or contract. Where a provider is found to be in breach of the terms
of its grant or contract, the area agency shall enforce the terms of the
grant or contract;

(9) Conduct research, evaluation, demonstration or training activities
appropriate to the achievement of the goal of improving the quality of
life for elderly persons within its planning and service area;

(10) Comply with division requirements that have been developed in
consultation with the area agencies for client and fiscal information,
and provide to the division information necessary for federal and state
reporting, program evaluation, program management, fiscal control and
research needs.

4. Beginning January 1, 1995, the records of each area agency on aging
shall be audited at least every other year. All audits required by the
Older Americans Act of 1965, as amended, shall satisfy this requirement.
(L. 1984 H.B. 1131 § 3, A.L. 1994 H.B. 1335 & 1381)

1. The division of aging shall provide budget allotment tables
to each area agency on aging by January first of each year. Each area
agency on aging shall submit its area plan, area budget and service
contracts to the division of aging by March first of each year. Each
April, the area agencies on aging shall present their plans to the
division of aging in a public hearing scheduled by the division and held
in the area served by the area agency on aging. Within thirty days of
such hearing, the division shall report findings and recommendations to
the board of directors for the area agency on aging, the area agency on
aging advisory council, the members of the senate budget committee and
the members of the house appropriations committee for social services and
corrections.

2. Each area agency on aging shall include in its area plan performance
measures and outcomes to be achieved for each year covered by the plan.
Such measures and outcomes shall also be presented to the division during
the public hearing.

3. The division of aging shall conduct on-site monitoring of each area
agency on aging at least once a year. The division of aging shall send
all monitoring reports to the area agency on aging advisory council and
the board of directors for the area agency which is the subject of the
reports. (L. 1999 S.B. 326 § 10)

All authority, powers, duties, functions, records, personnel,
property, contracts, budgets, matters pending and other pertinent
vestiges of the division of aging shall be transferred to the department
of health and senior services. (L. 2001 H.B. 603)

1. There is hereby created a "State Board of Senior Services"
which shall consist of seven members, who shall be appointed by the
governor, by and with the advice and consent of the senate. No member of
the state board of senior services shall hold any other office or
employment under the state of Missouri other than in a consulting status
relevant to the member's professional status, licensure or designation.
Not more than four of the members of the state board of senior services
shall be from the same political party.

2. Each member shall be appointed for a term of four years; except that
of the members first appointed, two shall be appointed for a term of one
year, two for a term of two years, two for a term of three years and one
for a term of four years. The successors of each shall be appointed for
full terms of four years. No person may serve on the state board of*
senior services for more than two terms. The terms of all members shall
continue until their successors have been duly appointed and qualified.
One of the persons appointed to the state board of* senior services shall
be a person currently working in the field of gerontology. One of the
persons appointed to the state board of* senior services shall be a
physician with expertise in geriatrics. One of the persons appointed to
the state board of* senior services shall be a person with expertise in
nutrition. One of the persons appointed to the state board of* senior
services shall be a person with expertise in rehabilitation services of
persons with disabilities. One of the persons appointed to the state
board of* senior services shall be a person with expertise in mental
health issues. In making the two remaining appointments, the governor
shall give consideration to individuals having a special interest in
gerontology or disability-related issues, including senior citizens. Four
of the seven members appointed to the state board of senior services
shall be members of the governor's advisory council on aging. If a
vacancy occurs in the appointed membership, the governor may appoint a
member for the remaining portion of the unexpired term created by the
vacancy. The members shall receive actual and necessary expenses plus
twenty-five dollars per day for each day of actual attendance.

3. The board shall elect from among its membership a chairman and a vice
chairman, who shall act as chairman in his or her absence. The board
shall meet at the call of the chairman. The chairman may call meetings at
such times as he or she deems advisable, and shall call a meeting when
requested to do so by three or more members of the board.

4. The state board of senior services shall advise the department of
health and senior services in the:

(1) Promulgation of rules and regulations by the department of health and
senior services;

(2) Formulation of the budget for the department of health and senior
services; and

(3) Planning for and operation of the department of health and senior
services. (L. 2001 H.B. 603)

*Word "for" appears in original rolls.

As used in sections 660.067 to 660.070, the following terms
shall mean:

(1) "Adult day care", a group program that emphasizes appropriate
services for persons eighteen years of age or older having Alzheimer's
disease and related disorders and that provides services for periods of
less than twenty-four hours but more than two hours per day in a place
other than the adult's home;

(2) "Alzheimer's disease and related disorders", diseases resulting from
significant destruction of brain tissue and characterized by a decline of
memory and other intellectual functions. These diseases include but are
not limited to progressive, degenerative and dementing illnesses such as
presenile and senile dementias, Alzheimer's disease and other related
disorders;

(3) "Appropriate services", services that emphasize surveillance, safety,
behavior management and other techniques used to assist persons having
Alzheimer's disease and related disorders;

(4) "Director", the director of the division of aging of the department
of social services;

(5) "Division", the division of aging of the department of social
services;

(6) "In-home companion", someone trained to provide appropriate services
to persons having Alzheimer's disease and related disorders and who
provides those services in the home;

(7) "Respite care", a program that provides temporary and short-term
residential care, sustenance, supervision and other appropriate services
for persons having Alzheimer's disease and related disorders who
otherwise reside in their own or in a family home. (L. 1987 S.B. 200 § 6)

1. To encourage development of appropriate services for persons
having Alzheimer's disease and related disorders, the division may make
grants to public and private entities for pilot projects from funds
specifically appropriated for this purpose. Pilot projects shall have the
following goals:

(1) To prevent or postpone institutionalization of persons having
Alzheimer's disease and related disorders who currently live in their own
home or in a family home;

(2) To offer services that emphasize safety, surveillance and behavior
management rather than, or in addition to, medical treatment, homemaker,
chore or personal care services;

(3) To temporarily relieve family members or others who have assumed
direct care responsibilities by offering services that allow care givers
to leave the home. These services shall include but not be limited to
adult day care, in-home companions and respite care;

(4) To test the practical and economic feasibility of providing services
in settings and at levels designed for varying needs; and

(5) To develop program models that can be adapted and operated by other
public and private entities.

2. The director, in accordance with chapter 536, RSMo, shall promulgate
rules that establish procedures for grant application, review, selection,
monitoring and auditing of grants made pursuant to sections 660.067 to
660.070.

3. The grants shall be limited to a duration of one year but may be
renewable for one additional year at the director's discretion and if
funds are appropriated for this purpose. (L. 1987 S.B. 200 § 7)

The commissioner of administration, in consultation with the
director of the division of aging, shall promulgate rules that establish
procedures for contracting with grantees receiving funds under sections
660.067 to 660.070. No rule or portion of a rule promulgated under the
authority of sections 660.067 to 660.070 shall become effective unless it
has been promulgated pursuant to the provisions of section 536.024, RSMo.
(L. 1987 S.B. 200 § 8, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3)

1. The division of medical services shall not issue a provider
agreement to an intermediate care facility for the mentally retarded
provider after May 29, 1991, unless and until the department of mental
health transmits a certification of authorization to provide services,
provided, however, a profit or not-for-profit provider may operate a
single home of six beds or less without issuance of a certificate to the
division of medical services. Such certification shall be provider
specific and shall contain the number of beds authorized.

2. Notwithstanding any other provision of law to the contrary, any
provider intending to operate an intermediate care facility for the
mentally retarded in excess of those beds in existence on May 29, 1991,
shall give notice to the department of mental health of any intent to do
so between July first and October first of the fiscal year preceding the
fiscal year in which they intend to operate such facility.

3. In addition to other good cause as established by administrative rules
promulgated by the director of the department of mental health, such
intermediate care facility for the mentally retarded operations as may be
accommodated within the home and community-based waiver for the
developmentally disabled shall be refused certificates of authorization
by the department of mental health. The division of medical services
shall refuse intermediate care facility for the mentally retarded
provider agreements to providers to whom the department of mental health
has refused certificates of authorization. (L. 1991 H.B. 568 § 1)

Effective 5-29-91

1. The general assembly may appropriate funds in addition to the
amount currently being provided per annum for nutrition services for the
elderly. Funds so designated to provide nutrition services for the
elderly shall be allocated to the Missouri division of aging to be placed
on the formula basis and distributed to each area agency on aging
throughout the state of Missouri.

2. The general assembly may appropriate funds in addition to the amount
currently being provided per annum through the Missouri elderly and
handicapped transportation program. Funds so designated to provide
transportation for the elderly and developmentally disabled shall be
allocated to the Missouri division of aging to be placed on the formula
basis and distributed to each area agency on aging throughout the state
of Missouri.

3. The general assembly may appropriate funds in addition to the amount
currently being provided per annum for home-delivered meals for the
elderly. Such additional funds shall be allocated to the Missouri
division of aging to be placed on the formula basis and distributed to
each area agency on aging throughout the state of Missouri. (L. 1988 S.B.
555 §§ 1, 2, 3)

1. The department of social services is directed to establish a
plan for providing financial assistance to elderly households, disabled
households and qualified individual households for the payment of charges
for the primary or secondary heating or cooling source for the household.
This plan shall be known as "Utilicare".

2. For purposes of sections 660.100 to 660.136, the term "elderly" shall
mean having reached the age of sixty-five and the term "disabled" shall
mean totally and permanently disabled or blind and receiving federal
Social Security disability benefits, federal supplemental security income
benefits, veterans administration benefits, state blind pension pursuant
to sections 209.010 to 209.160, RSMo, state aid to blind persons pursuant
to section 209.240, RSMo, or state supplemental payments pursuant to
section 208.030, RSMo. For the purposes of sections 660.100 to 660.136,
but not for the purpose of determining "eligible subscribers" pursuant to
subdivision (4) of section 660.138, the term "qualified individual
household" shall mean a household in which:

(1) One or more residents of the state of Missouri reside and whose
combined household income is less than or equal to one hundred and fifty
percent of the current federal poverty level or sixty percent of the
state median income for the relevant household; and

(2) While the Federal Low Income Home Energy Assistance Program remains
in effect, the household is also determined to be eligible for assistance
under such program and related state programs of the Missouri department
of social services. (L. 1979 H.B. 545, et al. § 1, A.L. 1980 H.B. 1177,
et al., A.L. 1997 S.B. 263, A.L. 2002 S.B. 810)

Every qualified individual household for which an application is
made, and every applicant household in which the head of the household or
spouse is elderly or disabled and the income for the prior calendar year
does not exceed one hundred and fifty percent of the current federal
poverty level or sixty percent of the state median income, shall be an
"eligible household" and shall be entitled to receive assistance under
the utilicare program if moneys have been appropriated by the general
assembly to the utilicare stabilization fund established pursuant to
section 660.136. "Income" shall be as defined in section 135.010, RSMo.
(L. 1979 H.B. 545, et al. § 2, A.L. 1980 H.B. 1177, et al., A.L. 1997
S.B. 263, A.L. 2002 S.B. 810)

The department of social services shall be responsible for
coordination of all federal heating assistance programs into the
utilicare program and shall provide plans for the implementation and
administration of these programs. The department may contract with local
not-for-profit community agencies which render energy assistance pursuant
to affiliation or contract with the United States Community Service
Administration or another federal agency to distribute the federal
moneys, to administer the federal heating and cooling assistance programs
in accordance with the plan developed by the department and to provide
certain administrative services in connection with the utilicare program
which may include the processing of utilicare applications and any other
service which the department deems practical. Insofar as possible, within
the provisions of federal law and regulations, all payments made from
funds available from the Crude Oil Windfall Profit Tax Act of 1980 and
other federal sources shall be made directly to energy suppliers in a
manner similar to payments made under the state utilicare program. (L.
1979 H.B. 545, et al. § 3, A.L. 1980 H.B. 1177, et al., A.L. 1997 S.B.
263, A.L. 2002 S.B. 810)

1. For each eligible household, an amount not exceeding six
hundred dollars for each fiscal year may be paid from the utilicare
stabilization fund to the primary or secondary heating source supplier,
or both, including suppliers of heating fuels, such as gas, electricity,
wood, coal, propane and heating oil. For each eligible household, an
amount not exceeding six hundred dollars for each fiscal year may be paid
from the utilicare stabilization fund to the primary or secondary cooling
source supplier, or both; provided that the respective shares of overall
funding previously received by primary and secondary heating and cooling
source suppliers on behalf of their customers shall be substantially
maintained.

2. For an eligible household, other than a household located in publicly
owned or subsidized housing, an adult boarding facility, an intermediate
care facility, a residential care facility or a skilled nursing facility,
whose members rent their dwelling and do not pay a supplier directly for
the household's primary or secondary heating or cooling source, utilicare
payments shall be paid directly to the head of the household, except that
total payments shall not exceed eight percent of the household's annual
rent or one hundred dollars, whichever is less. (L. 1979 H.B. 545, et al.
§ 4, A.L. 1980 H.B. 1177, et al., A.L. 1997 S.B. 263, A.L. 2002 S.B. 810)

Funds appropriated under the authority of sections 660.100 to
660.136 may be used to pay the expenses of reconnecting or maintaining
service to households that have had their primary or secondary heating or
cooling source disconnected or service discontinued because of their
failure to pay their bill. Any qualified household or other household
which has as its head a person who is elderly or disabled, as defined in
section 660.100, shall be eligible for assistance under this section if
the income for the household is no more than one hundred fifty percent of
the current federal poverty level or sixty percent of the state median
income and if moneys have been appropriated by the general assembly to
the utilicare stabilization fund established pursuant to section 660.136.
Payments under this section shall be made directly to the primary or
secondary heating or cooling source supplier. Any primary or secondary
heating or cooling source supplier subject to the supervision and
regulation of the public service commission shall, at any time during the
period of the cold weather rule specified in the cold weather rule as
established and as amended by the public service commission, reconnect
and provide services to each household eligible for assistance under this
section in compliance with the terms of such cold weather rule. All home
energy suppliers receiving funds under this section shall provide service
to eligible households consistent with their contractual agreements with
the department of social services. (L. 1984 S.B. 548, A.L. 1989 S.B. 151,
A.L. 1997 S.B. 263, A.L. 1999 S.B. 495, A.L. 2002 S.B. 810)

Any false claim knowingly made in an application for *
assistance under the utilicare program or any false claim knowingly made
by the recipient of such assistance or by a supplier of the primary or
secondary heating or cooling source or of heating fuel in a request for
payment under the utilicare program shall be deemed a false declaration
as defined in section 575.060, RSMo. (L. 1979 H.B. 545, et al. § 6, A.L.
1997 S.B. 263)

Effective 7-14-97

*Word "a" appears in original rolls.

The department of social services shall design the forms and
issue rules and regulations necessary to carry out the provisions of
sections 660.100 to 660.136. No rule or portion of a rule promulgated
under the authority of sections 660.100 to 660.136 shall become effective
unless it has been promulgated pursuant to the provisions of section
536.024, RSMo. Such rules shall provide that in order for a homeowner to
be eligible such homeowner shall have met federal energy conservation
guidelines for insulation, or have made application for insulation under
the department of natural resources program or like program offered in
the state of Missouri. Large notices of the availability of this program
shall be posted in application areas and local offices of the division of
family services. (L. 1979 H.B. 545, et al. § 7, A.L. 1980 H.B. 1177, et
al., A.L. 1995 S.B. 3, A.L. 1997 S.B. 263)

Effective 7-14-97

1. Not more than five million dollars from state general revenue
shall be appropriated by the general assembly to the utilicare
stabilization fund established pursuant to section 660.136 for the
support of the utilicare program established by sections 660.100 to
660.136 for any fiscal year, except in succeeding years the amount of
state funds may be increased by a percentage which reflects the national
cost-of-living index or seven percent, whichever is lower.

2. The department of social services may, in coordination with the
department of natural resources, apply a portion of the funds
appropriated annually by the general assembly to the utilicare
stabilization fund established pursuant to section 660.136 to the low
income weatherization assistance program of the department of natural
resources; provided that any project financed with such funds shall be
consistent with federal guidelines for the Weatherization Assistance
Program for Low-Income Persons as authorized by 42 U.S.C. 6861. (L. 1979
H.B. 545, et al. § 8, A.L. 1980 H.B. 1177, et al., A.L. 1997 S.B. 263,
A.L. 2002 S.B. 810)

1. The "Utilicare Stabilization Fund" is hereby created in the
state treasury to support the provisions of sections 660.100 to 660.136.
Funds for the utilicare program may come from state, federal or other
sources including funds received by this state from the federal
government under the provisions of the Community Opportunities
Accountability and Training and Educational Services Act of 1998 (Title
III, Section 301-309, Public Law 93.568), together with any interest or
other earnings on the principal of this fund. Except as provided in
subsection 3, moneys in the utilicare stabilization fund shall be used
for the purposes established in the Federal Low Income Home Energy
Assistance Program and sections 660.100 to 660.136.

2. The provisions of section 33.080, RSMo, to the contrary
notwithstanding, money in this fund shall not be transferred and placed
to the credit of general revenue until the amount in the fund at the end
of the biennium exceeds two times the amount of the appropriation from
the fund for the preceding fiscal year. The amount, if any, in the fund,
which shall lapse, is that amount in the fund which exceeds the
appropriate multiple of the appropriations from the fund for the
preceding fiscal year. Moneys in the utilicare fund not needed currently
for the purposes designated in sections 660.100 to 660.136 may be
invested by the state treasurer in the manner that other moneys of the
state are authorized by law to be invested. All interest, income and
returns from moneys of the utilicare stabilization fund shall be
deposited in the state treasury to the credit of the utilicare
stabilization fund.

3. When the utilicare stabilization fund receives a transfer pursuant to
section 470.270, RSMo, the moneys from that transfer shall be held in the
fund for one full year after the date of transfer and shall be used to
pay for heating or cooling assistance as provided in sections 660.100 to
660.136. Any moneys remaining at the end of that year shall be deposited
in the state treasury to the credit of the general revenue fund of the
state. (L. 1997 S.B. 263, A.L. 2002 S.B. 810)

CROSS REFERENCE:

Utilicare stabilization fund, refund of natural gas or electric rates to
be transferred to fund, RSMo 470.270

The public service commission, the department of social
services, and participating providers of local exchange
telecommunications service shall comply with all requirements expressly
provided by federal order, regulation, and statute for eligible
subscribers to qualify for, and to receive matching federal low income
telephone assistance. (L. 1988 H.B. 1290)

As used in sections 660.137 to 660.149, the following terms mean:

(1) "Basic access line", a telephone line which provides switched voice
residential communications service from the local exchange
telecommunication company central office to the customer's premises which
enables the customer to originate and terminate long distance and local
calling;

(2) "Commission", the public service commission;

(3) "Economy rate telephone service", a class of local exchange telephone
service provided to eligible subscribers which is designed to meet their
minimum residential communication needs excluding all extras and fringe
benefits including call waiting, call forwarding and other such services
but providing access to telephone service for emergency calls and for the
maintenance of necessary social contacts;

(4) "Eligible subscriber", an individual who has been certified by the
department of social services to be eligible to receive utilicare
benefits pursuant to sections 660.100 to 660.135;

(5) "Zone or mileage charges", any charges required for receipt of a
basic access line which are based upon distance, by mileage or zones, of
the customer from the company central office. (L. 1986 H.B. 1301 § 1,
A.L. 1988 H.B. 1290)

Every local exchange telecommunications company which elects to
provide economy rate telephone service shall apply to the Federal
Communications Commission for the appropriate waiver of the monthly
interstate subscriber line charge. Upon federal approval, the discount
provided by the local exchange telecommunications company to subscribers
of economy rate telephone service shall be increased to include the
extent of the monthly waiver of the interstate subscriber line charge.
(L. 1988 H.B. 1290)

1. Notwithstanding the provisions of section 392.220, RSMo, to
the contrary, the public service commission may designate one or more
classes of economy rate telephone service for eligible subscribers
pursuant to the provisions of this section.

2. The rates to be charged to eligible subscribers for economy rate
telephone service shall be:

(1) Determined by the commission separately for each local exchange
telecommunications company which elects to provide the service, however,
the commission may hear and decide issues relating to the provision of
the service common to all such companies in one proceeding;

(2) Set at levels which enhance the affordability to eligible subscribers
of such service in comparison to other comparable levels of service
offered by the local exchange telecommunications company.

Such rates shall not apply to any service or charge other than that for a
basic access line, including any mileage or zone charges, except as
provided in this section.

3. Every local exchange telecommunications company which elects to
provide economy rate telephone service shall accept applications for
economy rate telephone service according to a procedure approved by the
commission.

4. An economy rate telephone service subscriber shall not be provided
with more than one basic access line in his or her principal place of
residence. An applicant for economy rate telephone service may report
only one address in this state as the principal place of residence. (L.
1986 H.B. 1301 § 2 subsecs. 1 to 4, A.L. 1988 H.B. 1290)

1. When initial installation or connection of service for an
eligible subscriber for economy rate telephone service occurs, the
applicable and approved rate for such installation or connection shall be
a significantly reduced one which shall be determined by the commission.

2. A local exchange telecommunications company which elects to provide
economy rate telephone service may not require the payment of an order
processing charge or line change charge for an eligible subscriber's
change to economy rate telephone service from any other class of
residential service. If a subscriber to economy rate telephone service no
longer qualifies as an eligible subscriber under sections 660.137 to
660.149, that subscriber may not be charged a fee for disconnecting from
economy rate telephone service and connecting to another class of
telephone service, except that the commission may allow the local
exchange telecommunications company by commission regulations to charge a
fee for eligible subscribers who frequently change, initiate, or
terminate service. (L. 1986 H.B. 1301 § 2 subsecs. 5, 6, A.L. 1988 H.B.
1290)

1. The commission shall promulgate such rules and regulations as
are necessary to implement the provisions of sections 660.138 to 660.149.
Such rules and regulations shall take into consideration available
federal programs to reduce telephone costs to specified subscribers. No
rule or portion of a rule promulgated under the authority of sections
660.138 to 660.149 shall become effective unless it has been promulgated
pursuant to the provisions of section 536.024, RSMo.

2. The general revenues of the state shall be used to fund the discount
provided to eligible subscribers of economy rate telephone service. The
amount of the discount shall determine the amount of the waiver of the
federal interstate subscriber line charge in section 660.139.

3. There is hereby created the "Economy Rate Telephone Service Fund"
which shall be administered by the commission and which shall contain
such moneys as appropriated to it by the general assembly. Moneys in the
fund shall be kept separate from all other funds of the commission and
shall be expended for the purpose specified in subsection 4* of this
section and for no other purpose.

4. Each participating local exchange telecommunications company shall
determine and report quarterly to the commission the costs incurred for
providing economy rate telephone service. Upon appropriation by the
general assembly, the commission shall authorize reimbursement for those
costs from the economy rate telephone service fund.

5. Notwithstanding the provisions of section 33.080, RSMo, the unexpended
balance in the economy rate telephone service fund at the end of each
fiscal year shall not be transferred into general revenue. (L. 1986 H.B.
1301 § 2 subsecs. 7, 8, A.L. 1988 H.B. 1290, A.L. 1993 S.B. 52, A.L. 1995
S.B. 3)

*"Subsection 11" appears in original rolls. Due to renumbering,
subsection changed.

The department of social services shall provide to the
participating local exchange telecommunications companies information
identifying persons who the department finds are eligible to receive
economy rate telephone service. The department of social services shall
on an annual basis during the time period that applications for utilicare
assistance under sections 660.100 to 660.135 are normally accepted
validate a list of those persons receiving economy rate telephone service
as provided by the local telecommunications companies to determine
continued eligibility. (L. 1986 H.B. 1301 § 3, A.L. 1988 H.B. 1290)

1. In addition to the exemptions granted under the provisions of
section 144.030, RSMo, economy rate telephone service shall also be
specifically exempted from the provisions of sections 144.010 to 144.510
and 144.600 to 144.745, RSMo, and from the computation of the tax levied,
assessed or payable under sections 144.010 to 144.510 and 144.600 to
144.745, RSMo.

2. Notwithstanding any other provision of the law to the contrary, any
local political subdivision may choose to reduce or exempt from its gross
receipts tax on economy rate telephone service. (L. 1986 H.B. 1301 §§ 4,
5)

The department of social services is directed to devise and
formulate a program of emergency financial assistance to needy families
with children under twenty-one years of age which will qualify the state
of Missouri for federal funds pursuant to Sections 603 and 606 of Title
42, United States Code, and such portions of the code of federal
regulations as may apply to said sections. Upon receiving approval of the
state plan from the United States Department of Health, Education and
Welfare, the department shall implement the plan. (L. 1979 H.B. 545, et
al. § 9)

The plan formulated by the department of social services under
section 8* shall provide for one-time financial grants, which may be
money payments or vendor payments or payments in kind, to qualified
families during defined periods of emergency need. Such grants shall be
made pursuant to regulations specified in the plan, which shall be in
accordance with and approved by the United States Department of Health,
Education and Welfare, and shall be known as "Emergency Assistance
Grants". (L. 1979 H.B. 545, et al. § 10)

*Original rolls show figure "8", but apparently should have the figure
"9", which is now § 660.150. Section 8, now § 660.135, does not require
the formulation of a plan.

For the purposes of this plan, individual family emergencies may
be declared by the department of social services when any crisis
situation exists with respect to a family which threatens the family and
creates urgent needs with respect to food, clothing, utilities or shelter
for such family and which results from a sudden occurrence or set of
circumstances which cause an immediate or extraordinary food, clothing,
utility or shelter need for such family. No funds shall be allocated for
the payment of utility expenses unless the applicant is determined to be
ineligible for available assistance under the Federal Utility Crisis
Intervention Program. (L. 1979 H.B. 545, et al. § 11)

Subject to the sufficiency of funds appropriated for this
program, emergency assistance grants may be authorized by the director of
the department of social services, or his delegate, when a finding is
made that an individual family emergency exists. Such emergency
assistance may be authorized during only one period of thirty consecutive
days in any twelve-consecutive-month period, including payments which are
to meet needs which arose before the thirty-day period or which extend
beyond the thirty-day period. The program shall provide that a finding
that an emergency does or does not exist will be made and, if applicable,
assistance will be granted within three days after receipt by the
department of a properly completed application. (L. 1979 H.B. 545, et al.
§ 12)

Eligibility for emergency assistance to needy families with
children shall be as authorized in the state plan approved by the United
States Department of Health, Education and Welfare. (L. 1979 H.B. 545, et
al. § 13)

The availability of emergency assistance shall not relieve the
department of social services of any duty to cooperate with other
agencies to reduce dependency nor its obligation to provide assistance in
the form of general relief orders in emergency situations not covered by
this plan. Receipt of assistance under this plan shall not reduce,
offset, or eliminate entitlement to any other assistance provided to any
qualified family under any other state or federal program, except as may
be required by federal law or regulation. (L. 1979 H.B. 545, et al. § 14)

The director of the department of social services, or his
delegate, is authorized, subject to the provisions of this act*, to
promulgate regulations not inconsistent with this act* as necessary to
qualify for maximum federal funds, subject to section 660.185 and the
appropriation of state funds for this program. (L. 1979 H.B. 545, et al.
§ 15)

*Original rolls contain words "this act" but apparently refer only to
sections 660.150 to 660.200.

Not more than one-half the cost of instituting or maintaining
the services provided for in this act* shall be appropriated or paid from
the general revenue fund of this state, and this act* shall terminate
thirty days after federal financial support is ended or curtailed which
would cause more than fifty percent of the cost of providing or
maintaining the services provided for in this act* to be paid by the
state from its general revenue fund. (L. 1979 H.B. 545, et al. § 16)

*Original rolls contain words "this act" but apparently refer only to
sections 660.150 to 660.200.

Not more than three hundred thousand dollars from general
revenue shall be appropriated by the general assembly for the support of
the program established by this act* for the first fiscal year and not
more than three percent of any funds appropriated shall be used for the
administrative expenses involved in administering the program. No funds
shall be expended under the provisions of this act* until there is a
specific appropriation for that purpose. (L. 1979 H.B. 545, et al. § 17)

*Original rolls contain words "this act" but apparently refer only to
sections 660.150 to 660.200.

In the event that additional services in addition to those
required by this act* are required by federal law, rule or court
decision, the department of social services shall immediately cease to
operate the plan and shall make no further emergency assistance grants.
(L. 1979 H.B. 545, et al. § 18)

*Original rolls contain words "this act" but apparently refer only to
sections 660.150 to 660.200.

No rule or portion of a rule promulgated under the authority of
sections 660.150 to 660.200 shall become effective unless it has been
promulgated pursuant to the provisions of section 536.024, RSMo. (L. 1979
H.B. 545, et al. § 19, A.L. 1981 S.B. 200, A.L. 1995 S.B. 3)

The division of aging shall use the services of community based,
not-for-profit organizations including senior centers for the provision
of home delivered meals to qualified recipients prepared by such
organizations if such service is available at not more than seventy-five
percent of the cost currently incurred by the division for the provision
of such service. (L. 1992 S.B. 573 & 634)

As used in sections 660.250 to 660.321, the following terms mean:

(1) "Abuse", the infliction of physical, sexual, or emotional injury or
harm including financial exploitation by any person, firm or corporation;

(2) "Court", the circuit court;

(3) "Department", the department of health and senior services;

(4) "Director", director of the department of health and senior services
or his or her designees;

(5) "Eligible adult", a person sixty years of age or older who is unable
to protect his or her own interests or adequately perform or obtain
services which are necessary to meet his or her essential human needs or
an adult with a disability, as defined in section 660.053, between the
ages of eighteen and fifty-nine who is unable to protect his or her own
interests or adequately perform or obtain services which are necessary to
meet his or her essential human needs;

(6) "Home health agency", the same meaning as such term is defined in
section 197.400, RSMo;

(7) "Home health agency employee", a person employed by a home health
agency;

(8) "Home health patient", an eligible adult who is receiving services
through any home health agency;

(9) "In-home services client", an eligible adult who is receiving
services in his or her private residence through any in-home services
provider agency;

(10) "In-home services employee", a person employed by an in-home
services provider agency;

(11) "In-home services provider agency", a business entity under contract
with the department or with a Medicaid participation agreement, which
employs persons to deliver any kind of services provided for eligible
adults in their private homes;

(12) "Least restrictive environment", a physical setting where protective
services for the eligible adult and accommodation is provided in a manner
no more restrictive of an individual's personal liberty and no more
intrusive than necessary to achieve care and treatment objectives;

(13) "Likelihood of serious physical harm", one or more of the following:

(a) A substantial risk that physical harm to an eligible adult will occur
because of his or her failure or inability to provide for his or her
essential human needs as evidenced by acts or behavior which has caused
such harm or which gives another person probable cause to believe that
the eligible adult will sustain such harm;

(b) A substantial risk that physical harm will be inflicted by an
eligible adult upon himself or herself, as evidenced by recent credible
threats, acts, or behavior which has caused such harm or which places
another person in reasonable fear that the eligible adult will sustain
such harm;

(c) A substantial risk that physical harm will be inflicted by another
upon an eligible adult as evidenced by recent acts or behavior which has
caused such harm or which gives another person probable cause to believe
the eligible adult will sustain such harm;

(d) A substantial risk that further physical harm will occur to an
eligible adult who has suffered physical injury, neglect, sexual or
emotional abuse, or other maltreatment or wasting of his or her financial
resources by another person;

(14) "Neglect", the failure to provide services to an eligible adult by
any person, firm or corporation with a legal or contractual duty to do
so, when such failure presents either an imminent danger to the health,
safety, or welfare of the client or a substantial probability that death
or serious physical harm would result;

(15) "Protective services", services provided by the state or other
governmental or private organizations or individuals which are necessary
for the eligible adult to meet his or her essential human needs. (L. 1980
S.B. 576 § 1, A.L. 1987 S.B. 277, A.L. 1992 S.B. 573 & 634, A.L. 1994
H.B. 1335 & 1381, A.L. 2003 S.B. 556 & 311)

1. Any person having reasonable cause to suspect that an
eligible adult presents a likelihood of suffering serious physical harm
and is in need of protective services shall report such information to
the department.

2. The report shall be made orally or in writing. It shall include, if
known:

(1) The name, age, and address of the eligible adult;

(2) The name and address of any person responsible for the eligible
adult's care;

(3) The nature and extent of the eligible adult's condition; and

(4) Other relevant information.

3. Reports regarding persons determined not to be eligible adults as
defined in section 660.250 shall be referred to the appropriate state or
local authorities.

4. The department shall maintain a statewide toll free phone number for
receipt of reports. (L. 1980 S.B. 576 § 2, A.L. 1987 S.B. 277)

Upon receipt of a report, the department shall make a prompt and
thorough investigation to determine whether or not an eligible adult is
facing a likelihood of serious physical harm and is in need of protective
services. The department shall provide for any of the following:

(1) Identification of the eligible adult and determination that the
eligible adult is eligible for services;

(2) Evaluation and diagnosis of the needs of eligible adults;

(3) Provision of social casework, counseling or referral to the
appropriate local or state authority;

(4) Assistance in locating and receiving alternative living arrangements
as necessary;

(5) Assistance in locating and receiving necessary protective services; or

(6) The coordination and cooperation with other state agencies and public
and private agencies in exchange of information and the avoidance of
duplication of services. (L. 1980 S.B. 576 § 3, A.L. 1987 S.B. 277)

Upon receipt of a report that an eligible adult between the ages
of eighteen and fifty-nine is facing a likelihood of serious physical
harm, the department shall:

(1) Investigate or refer the report to appropriate law enforcement or
state agencies; and

(2) Provide services or refer to local community or state agencies. (L.
1987 S.B. 277, A.L. 2003 S.B. 556 & 311)

1. Reports made pursuant to sections 660.250 to 660.295 shall be
confidential and shall not be deemed a public record and shall not be
subject to the provisions of section 109.180, RSMo, or chapter 610, RSMo.

2. Such reports shall be accessible for examination and copying only to
the following persons or offices, or to their designees:

(1) The department or any person or agency designated by the department;

(2) The attorney general;

(3) The department of mental health for persons referred to that
department;

(4) Any appropriate law enforcement agency; and

(5) The eligible adult or his legal guardian.

3. The name of the reporter shall not be disclosed unless:

(1) Such reporter specifically authorizes disclosure of his name; and

(2) The department determines that disclosure of the name of the reporter
is necessary in order to prevent further harm to an eligible adult.

4. Any person who violates the provisions of this section, or who permits
or encourages the unauthorized dissemination of information contained in
the central registry and in reports and records made pursuant to sections
660.250 to 660.295, shall be guilty of a class A misdemeanor.

5. The department shall maintain a central registry capable of receiving
and maintaining reports received in a manner that facilitates rapid
access and recall of the information reported, and of subsequent
investigations and other relevant information. The department shall
electronically record any telephone report of suspected abuse and neglect
received by the department and such recorded reports shall be retained by
the department for a period of one year after recording.

6. Although reports to the central registry may be made anonymously, the
department shall in all cases, after obtaining relevant information
regarding the alleged abuse or neglect, attempt to obtain the name and
address of any person making a report. (L. 1987 S.B. 277)

When an eligible adult gives consent to receive protective
services, the department shall assist the adult in locating and arranging
for necessary services in the least restrictive environment reasonably
available. (L. 1980 S.B. 576 § 4)

When the department receives a report that there has been abuse
or neglect, or that there otherwise is a likelihood of serious physical
harm to an eligible adult and that he or she is in need of protective
services and the department is unable to conduct an investigation because
access to the eligible adult is barred by any person, the director may
petition the appropriate court for a warrant or other order to enter upon
the described premises and investigate the report or to produce the
information. The application for the warrant or order shall identify the
eligible adult and the facts and circumstances which require the issuance
of the warrant or order. The director may also seek an order to enjoin
the person from barring access to an eligible adult or from interfering
with the investigation. If the court finds that, based on the report and
relevant circumstances and facts, probable cause exists showing that the
eligible adult faces abuse or neglect, or otherwise faces a likelihood of
serious physical harm and is in need of protective services and the
director has been prevented by another person from investigating the
report, the court may issue the warrant or enjoin the interference with
the investigation or both. (L. 1980 S.B. 576 § 5, A.L. 2003 S.B. 556 &
311)

If an eligible adult gives consent to receive protective
services and any other person interferes with or prevents the delivery of
such services, the director may petition the appropriate court for an
order to enjoin the interference with the delivery of the services. The
petition shall allege the consent of the eligible adult and shall allege
specific facts sufficient to show that the eligible adult faces a
likelihood of serious physical harm and is in need of the protective
services and that delivery is barred by the person named in the petition.
If the court finds upon a preponderance of evidence that the allegations
in the petition are true, the court may issue an order enjoining the
interference with the delivery of the protective services and may
establish such conditions and restrictions on the delivery as the court
deems necessary and proper under the circumstances. (L. 1980 S.B. 576 § 6)

When an eligible adult facing the likelihood of serious physical
harm and in need of protective services is unable to give consent because
of incapacity or legal disability and the guardian of the eligible adult
refuses to provide the necessary services or allow the provision of such
services, the director shall inform the court having supervisory
jurisdiction over the guardian of the facts showing that the eligible
adult faces the likelihood of serious physical harm and is in need of
protective services and that the guardian refuses to provide the
necessary services or allow the provision of such services under the
provisions of sections 660.250 to 660.295. Upon receipt of such
information, the court may take such action as it deems necessary and
proper to insure that the eligible adult is able to meet his essential
human needs. (L. 1980 S.B. 576 § 7, A.L. 1983 S.B. 44 & 45)

1. If the director determines after an investigation that an
eligible adult is unable to give consent to receive protective services
and presents a likelihood of serious physical harm, the director may
initiate proceedings pursuant to chapter 202, RSMo, or chapter 475, RSMo,
if appropriate.

2. In order to expedite adult guardianship and conservatorship cases, the
department may retain, within existing funding sources of the department,
legal counsel on a case-by-case basis. (L. 1980 S.B. 576 § 8, A.L. 2002
S.B. 810)

1. When a peace officer has probable cause to believe that an
eligible adult will suffer an imminent likelihood of serious physical
harm if not immediately placed in a medical facility for care and
treatment, that the adult is incapable of giving consent, and that it is
not possible to follow the procedures in section 660.285, the officer may
transport, or arrange transportation for, the eligible adult to an
appropriate medical facility which may admit the eligible adult and shall
notify the next of kin, if known, and the director.

2. Where access to the eligible adult is barred and a substantial
likelihood exists of serious physical harm resulting to the eligible
adult if he is not immediately afforded protective services, the peace
officer may apply to the appropriate court for a warrant to enter upon
the described premises and remove the eligible adult. The application for
the warrant shall identify the eligible adult and the circumstances and
facts which require the issuance of the warrant.

3. If immediately upon admission to a medical facility, a person who is
legally authorized to give consent for the provision of medical treatment
for the eligible adult, has not given or refused to give such consent,
and it is the opinion of the medical staff of the facility that treatment
is necessary to prevent serious physical harm, the director or the head
of the medical facility shall file a petition in the appropriate court
for an order authorizing specific medical treatment. The court shall hold
a hearing and issue its decision forthwith. Notwithstanding the above, if
a licensed physician designated by the facility for such purpose examines
the eligible adult and determines that the treatment is immediately or
imminently necessary and any delay occasioned by the hearing provided in
this subsection would jeopardize the life of the person affected, the
medical facility may treat the eligible adult prior to such court hearing.

4. The court shall conduct a hearing pursuant to chapter 475, RSMo,
forthwith and, if the court finds the eligible adult incapacitated, it
shall appoint a guardian ad litem for the person of the eligible adult to
determine the nature and extent of the medical treatment necessary for
the benefit of the eligible adult and to supervise the rendition of such
treatment. The guardian ad litem shall promptly report the completion of
treatment to the court, who shall thereupon conduct a restoration hearing
or a hearing to appoint a permanent guardian.

5. The medical care under this section may not be rendered in a mental
health facility unless authorized pursuant to the civil commitment
procedures in chapter 632, RSMo.

6. Nothing contained in this section or in any other section of sections
660.250 to 660.295 shall be construed as requiring physician or medical
care or hospitalization of any person who, because of religious faith or
conviction, relies on spiritual means or prayer to cure or prevent
disease or suffering nor shall any provision of sections 660.250 to
660.295 be construed so as to designate any person as an eligible adult
who presents a likelihood of suffering serious physical harm and is in
need of protective services solely because such person, because of
religious faith or conviction, relies on spiritual means or prayer to
cure or prevent disease or suffering. (L. 1980 S.B. 576 § 9, A.L. 1983
S.B. 44 & 45)

If an eligible adult does not consent to the receipt of
reasonable and necessary protective services, or if an eligible adult
withdraws previously given consent, the protective services shall not be
provided or continued; except that, if the director has reasonable cause
to believe that the eligible adult lacks the capacity to consent, the
director may seek a court order pursuant to the provisions of section
660.285. (L. 1980 S.B. 576 § 10)

1. When any adult day care worker; chiropractor; Christian
Science practitioner; coroner; dentist; embalmer; employee of the
departments of social services, mental health, or health and senior
services; employee of a local area agency on aging or an organized area
agency on aging program; funeral director; home health agency or home
health agency employee; hospital and clinic personnel engaged in
examination, care, or treatment of persons; in-home services owner,
provider, operator, or employee; law enforcement officer; long-term care
facility administrator or employee; medical examiner; medical resident or
intern; mental health professional; minister; nurse; nurse practitioner;
optometrist; other health practitioner; peace officer; pharmacist;
physical therapist; physician; physician's assistant; podiatrist;
probation or parole officer; psychologist; or social worker has
reasonable cause to believe that an in-home services client has been
abused or neglected, as a result of in-home services, he or she shall
immediately report or cause a report to be made to the department. If the
report is made by a physician of the in-home services client, the
department shall maintain contact with the physician regarding the
progress of the investigation.

2. When a report of deteriorating physical condition resulting in
possible abuse or neglect of an in-home services client is received by
the department, the client's case manager and the department nurse shall
be notified. The client's case manager shall investigate and immediately
report the results of the investigation to the department nurse. The
department may authorize the in-home services provider nurse to assist
the case manager with the investigation.

3. If requested, local area agencies on aging shall provide volunteer
training to those persons listed in subsection 1 of this section
regarding the detection and report of abuse and neglect pursuant to this
section.

4. 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 a class A
misdemeanor.

5. The report shall contain the names and addresses of the in-home
services provider agency, the in-home services employee, the in-home
services client, the home health agency, the home health agency employee,
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.

6. In addition to those persons required to report under subsection 1 of
this section, any other person having reasonable cause to believe that an
in-home services client or home health patient has been abused or
neglected by an in-home services employee or home health agency employee
may report such information to the department.

7. If the investigation indicates possible abuse or neglect of an in-home
services client or home health patient, the investigator shall refer the
complaint together with his or her report to the department director or
his or her designee for appropriate action. If, during the investigation
or at its completion, the department has reasonable cause to believe that
immediate action is necessary to protect the in-home services client or
home health patient 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 in-home services client or home health patient 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 in-home
services client or home health patient, for a period not to exceed thirty
days.

8. Reports shall be confidential, as provided under section 660.320.

9. Anyone, except any person who has abused or neglected an in-home
services client or home health patient, 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 or
criminal liability for making such a report or for testifying except for
liability for perjury, unless such person acted negligently, recklessly,
in bad faith, or with malicious purpose.

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

11. No person who directs or exercises any authority in an in-home
services provider agency or home health agency shall harass, dismiss or
retaliate against an in-home services client or home health patient, or
an in-home services employee or a home health agency employee because he
or any member of his or her family has made a report of any violation or
suspected violation of laws, standards or regulations applying to the
in-home services provider agency or home health agency or any in-home
services employee or home health agency employee which he has reasonable
cause to believe has been committed or has occurred.

12. Any person who abuses or neglects an in-home services client or home
health patient is subject to criminal prosecution under section 565.180,
565.182, or 565.184, RSMo. If such person is an in-home services employee
and has been found guilty by a court, and if the supervising in- home
services provider willfully and knowingly failed to report known abuse by
such employee to the department, the supervising in-home services
provider may be subject to administrative penalties of one thousand
dollars per violation to be collected by the department and the money
received therefor shall be paid to the director of revenue and deposited
in the state treasury to the credit of the general revenue fund. Any
in-home services provider which has had administrative penalties imposed
by the department or which has had its contract terminated may seek an
administrative review of the department's action pursuant to chapter 621,
RSMo. Any decision of the administrative hearing commission may be
appealed to the circuit court in the county where the violation occurred
for a trial de novo. For purposes of this subsection, the term
"violation" means a determination of guilt by a court.

13. The department shall establish a quality assurance and supervision
process for clients that requires an in-home services provider agency to
conduct random visits to verify compliance with program standards and
verify the accuracy of records kept by an in-home services employee.

14. The department shall maintain the employee disqualification list and
place on the employee disqualification list the names of any persons who
have been finally determined by the department, pursuant to section
660.315, to have recklessly, knowingly or purposely abused or neglected
an in-home services client or home health patient while employed by an
in-home services provider agency or home health agency. For purposes of
this section only, "knowingly" and "recklessly" shall have the meanings
that are ascribed to them in this section. A person acts "knowingly" with
respect to the person's conduct when a reasonable person should be aware
of the result caused by his or her conduct. A person acts "recklessly"
when the person consciously disregards a substantial and unjustifiable
risk that the person's conduct will result in serious physical injury and
such disregard constitutes a gross deviation from the standard of care
that a reasonable person would exercise in the situation.

15. At the time a client has been assessed to determine the level of care
as required by rule and is eligible for in-home services, the department
shall conduct a "Safe at Home Evaluation" to determine the client's
physical, mental, and environmental capacity. The department shall
develop the safe at home evaluation tool by rule in accordance with
chapter 536, RSMo. The purpose of the safe at home evaluation is to
assure that each client has the appropriate level of services and
professionals involved in the client's care. The plan of service or care
for each in- home services client shall be authorized by a nurse. The
department may authorize the licensed in-home services nurse, in lieu of
the department nurse, to conduct the assessment of the client's condition
and to establish a plan of services or care. The department may use the
expertise, services, or programs of other departments and agencies on a
case-by-case basis to establish the plan of service or care. The
department may, as indicated by the safe at home evaluation, refer any
client to a mental health professional, as defined in 9 CSR 30-4.030, for
evaluation and treatment as necessary.

16. Authorized nurse visits shall occur at least twice annually to assess
the client and the client's plan of services. The provider nurse shall
report the results of his or her visits to the client's case manager. If
the provider nurse believes that the plan of service requires alteration,
the department shall be notified and the department shall make a client
evaluation. All authorized nurse visits shall be reimbursed to the
in-home services provider. All authorized nurse visits shall be
reimbursed outside of the nursing home cap for in-home services clients
whose services have reached one hundred percent of the average statewide
charge for care and treatment in an intermediate care facility, provided
that the services have been preauthorized by the department.

17. All in-home services clients shall be advised of their rights by the
department at the initial evaluation. The rights shall include, but not
be limited to, the right to call the department for any reason, including
dissatisfaction with the provider or services. The department shall
establish a process to receive such nonabuse and neglect calls other than
the elder abuse and neglect hotline.

18. Subject to appropriations, all nurse visits authorized in sections
660.250 to 660.300 shall be reimbursed to the in-home services provider
agency. (L. 1992 S.B. 573 & 634, A.L. 2003 S.B. 556 & 311, A.L. 2003 2nd
Ex. Sess. S.B. 4)

Effective 9-15-03

1. Any person having reasonable cause to believe that a
misappropriation of an in-home services client's property or funds, or
the falsification of any documents verifying service delivery to the
in-home services client has occurred, may report such information to the
department.

2. For each report the department shall attempt to obtain the names and
addresses of the in-home services provider agency, the in-home services
employee, the in-home services client, information regarding the nature
of the misappropriation or falsification, the name of the complainant,
and any other information which might be helpful in an investigation.

3. Any in-home services provider agency or in-home services employee who
puts to his or her own use or the use of the in-home services provider
agency or otherwise diverts from the in-home services client's use any
personal property or funds of the in-home services client, or falsifies
any documents for service delivery, is guilty of a class A misdemeanor.

4. Upon receipt of a report, the department shall immediately initiate an
investigation and report information gained from such investigation to
appropriate law enforcement authorities.

5. If the investigation indicates probable misappropriation of property
or funds, or falsification of any documents for service delivery of an
in-home services client, the investigator shall refer the complaint
together with the investigator's report to the department director or the
director's designee for appropriate action.

6. Reports shall be confidential, as provided under section 660.320.

7. Anyone, except any person participating in or benefiting from the
misappropriation of funds, 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 or criminal liability for
making such a report or for testifying except for liability for perjury,
unless such person acted negligently, recklessly, in bad faith, or with
malicious purpose.

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

9. No person who directs or exercises any authority in an in-home
services provider agency shall harass, dismiss or retaliate against an
in-home services 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 in-home
services provider agency or any in-home services employee which he or she
has reasonable cause to believe has been committed or has occurred.

10. The department shall maintain the employee disqualification list and
place on the employee disqualification list the names of any persons who
are or have been employed by an in-home service provider agency and who
have been finally determined by the department to, pursuant to section
660.315, have misappropriated any property or funds, or falsified any
documents for service delivery of an in-home services client and who came
to be known to the person, directly, or indirectly while employed by an
in-home services provider agency. (L. 1992 S.B. 573 & 634, A.L. 2003 S.B.
556 & 311)

1. Notwithstanding any other provision of law, if the department
of health and senior services proposes to deny, suspend, place on
probation, or terminate an in-home services provider agency contract, the
department of health and senior services shall serve upon the applicant
or contractor written notice of the proposed action to be taken. The
notice shall contain a statement of the type of action proposed, the
basis for it, the date the action will become effective, and a statement
that the applicant or contractor shall have thirty days from the date of
mailing or delivery of the notice to file a complaint requesting a
hearing before the administrative hearing commission. The administrative
hearing commission may consolidate an applicant's or contractor's
complaint with any proceeding before the administrative hearing
commission filed by such contractor or applicant pursuant to subsection 3
of section 208.156, RSMo, involving a common question of law or fact.
Upon the filing of the complaint, the provisions of sections 621.110,
621.120, 621.125, 621.135, and 621.145, RSMo, shall apply. With respect
to cases in which the department has denied a contract to an in-home
services provider agency, the administrative hearing commission shall
conduct a hearing to determine the underlying basis for such denial.
However, if the administrative hearing commission finds that the contract
denial is supported by the facts and the law, the case need not be
returned to the department. The administrative hearing commission's
decision shall constitute affirmation of the department's contract denial.

2. The department of health and senior services may issue letters of
censure or warning without formal notice or hearing.

3. The administrative hearing commission may stay the suspension or
termination of an in-home services provider agency's contract, or the
placement of the contractor on probation, pending the commission's
findings and determination in the cause, upon such conditions, with or
without the agreement of the parties, 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, unless the commission finds that the
contractor has established that servicing the department's clients
pending the commission's final determination would not present an
imminent danger to the health, safety, or welfare of any client or a
substantial probability that death or serious physical harm would result.
The commission may remove the stay at any time that it finds that the
contractor has violated any of the conditions of the stay. Such stay
shall remain in effect, unless earlier removed by the commission, pending
the decision of the commission and any subsequent departmental action at
which time the stay shall be removed. In any case in which the department
has refused to issue a contract, the commission shall have no authority
to stay or to require the issuance of a contract pending final
determination by the commission.

4. Stays granted to contractors by the administrative hearing commission
shall, as a condition of the stay, require at a minimum that the
contractor under the stay operate under the same contractual requirements
and regulations as are in effect, from time to time, as are applicable to
all other contractors in the program.

5. The administrative hearing commission shall make its final decision
based upon the circumstances and conditions as they existed at the time
of the action of the department and not based upon circumstances and
conditions at the time of the hearing or decision of the commission.

6. In any proceeding before the administrative hearing commission
pursuant to this section, the burden of proof shall be on the contractor
or applicant seeking review.

7. Any person, including the department, aggrieved by a final decision of
the administrative hearing commission may seek judicial review of such
decision as provided in section 621.145, RSMo. (L. 2003 S.B. 556 & 311)

1. After an investigation and a determination has been made to
place a person's name on the employee disqualification list, that person
shall be notified in writing mailed to his or her last known address that:

(1) An allegation has been made against the person, the substance of the
allegation and that an investigation has been conducted which tends to
substantiate the allegation;

(2) The person's name will be included in the employee disqualification
list of the department;

(3) The consequences of being so listed including the length of time to
be listed; and

(4) The person's rights and the procedure to challenge the allegation.

2. If no reply has been received within thirty days of mailing the
notice, the department may include the name of such person on its list.
The length of time the person's name shall appear on the employee
disqualification list shall be determined by the director or the
director's designee, based upon the criteria contained in subsection 9 of
this section.

3. If the person so notified wishes to challenge the allegation, such
person may file an application for a hearing with the department. The
department shall grant the application within thirty days after receipt
by the department and set the matter for hearing, or the department shall
notify the applicant that, after review, the allegation has been held to
be unfounded and the applicant's name will not be listed.

4. If a person's name is included on the employee disqualification list
without notice by the department, such person may file a request with the
department for removal of the name or for a hearing. Within thirty days
after receipt of the request, the department shall either remove the name
from the list or grant a hearing and set a date therefor.

5. Any hearing shall be conducted in the county of the person's residence
by the director of the department or the director's designee. The
provisions of chapter 536, RSMo, for a contested case except those
provisions or amendments which are in conflict with this section, shall
apply to and govern the proceedings contained in this section and the
rights and duties of the parties involved. The person appealing such an
action shall be entitled to present evidence, pursuant to the provisions
of chapter 536, RSMo, relevant to the allegations.

6. Upon the record made at the hearing, the director of the department or
the director's designee shall determine all questions presented and shall
determine whether the person shall be listed on the employee
disqualification list. The director of the department or the director's
designee shall clearly state the reasons for his or her decision and
shall include a statement of findings of fact and conclusions of law
pertinent to the questions in issue.

7. A person aggrieved by the decision following the hearing shall be
informed of his or her right to seek judicial review as provided under
chapter 536, RSMo. If the person fails to appeal the director's findings,
those findings shall constitute a final determination that the person
shall be placed on the employee disqualification list.

8. A decision by the director shall be inadmissible in any civil action
brought against a facility or the in-home services provider agency and
arising out of the facts and circumstances which brought about the
employment disqualification proceeding, unless the civil action is
brought against the facility or the in-home services provider agency by
the department of health and senior services or one of its divisions.

9. The length of time the person's name shall appear on the employee
disqualification list shall be determined by the director of the
department of health and senior services or the director's designee,
based upon the following:

(1) Whether the person acted recklessly or knowingly, as defined in
chapter 562, RSMo;

(2) The degree of the physical, sexual, or emotional injury or harm; or
the degree of the imminent danger to the health, safety or welfare of a
resident or in-home services client;

(3) The degree of misappropriation of the property or funds, or
falsification of any documents for service delivery of an in-home
services client;

(4) Whether the person has previously been listed on the employee
disqualification list;

(5) Any mitigating circumstances;

(6) Any aggravating circumstances; and

(7) Whether alternative sanctions resulting in conditions of continued
employment are appropriate in lieu of placing a person's name on the
employee disqualification list. Such conditions of employment may
include, but are not limited to, additional training and employee
counseling. Conditional employment shall terminate upon the expiration of
the designated length of time and the person's submitting documentation
which fulfills the department of health and senior services' requirements.

10. The removal of any person's name from the list under this section
shall not prevent the director from keeping records of all acts finally
determined to have occurred under this section.

11. The department shall provide the list maintained pursuant to this
section to other state departments upon request and to any person,
corporation or association who:

(1) Is licensed as an operator under chapter 198, RSMo;

(2) Provides in-home services under contract with the department;

(3) Employs nurses and nursing assistants for temporary or intermittent
placement in health care facilities;

(4) Is approved by the department to issue certificates for nursing
assistants training; or

(5) Is an entity licensed under chapter 197, RSMo.

The department shall inform any person listed above who inquires of the
department whether or not a particular name is on the list. The
department may require that the request be made in writing.

12. No person, corporation or association who received the employee
disqualification list under subsection 11 of this section shall knowingly
employ any person who is on the employee disqualification list. Any
person, corporation or association who received the employee
disqualification list under subsection 11 of this section, or any person
responsible for providing health care service, who declines to employ or
terminates a person whose name is listed in this section shall be immune
from suit by that person or anyone else acting for or in behalf of that
person for the failure to employ or for the termination of the person
whose name is listed on the employee disqualification list.

13. Any employer who is required to discharge an employee because the
employee was placed on a disqualification list maintained by the
department of health and senior services after the date of hire shall not
be charged for unemployment insurance benefits based on wages paid to the
employee for work prior to the date of discharge, pursuant to section
288.100, RSMo.

14. Any person who has been listed on the employee disqualification list
may request that the director remove his or her name from the employee
disqualification list. The request shall be written and may not be made
more than once every twelve months. The request will be granted by the
director upon a clear showing, by written submission only, that the
person will not commit additional acts of abuse, neglect,
misappropriation of the property or funds, or the falsification of any
documents of service delivery to an in-home services client. The director
may make conditional the removal of a person's name from the list on any
terms that the director deems appropriate, and failure to comply with
such terms may result in the person's name being relisted. The director's
determination of whether to remove the person's name from the list is not
subject to appeal. (L. 1992 S.B. 573 & 634, A.L. 2003 S.B. 556 & 311)

1. For the purposes of this section, the term "provider" means
any person, corporation or association who:

(1) Is licensed as an operator pursuant to chapter 198, RSMo;

(2) Provides in-home services under contract with the department;

(3) Employs nurses or nursing assistants for temporary or intermittent
placement in health care facilities;

(4) Is an entity licensed pursuant to chapter 197, RSMo;

(5) Is a public or private facility, day program, residential facility or
specialized service operated, funded or licensed by the department of
mental health; or

(6) Is a licensed adult day care provider.

2. For the purpose of this section "patient or resident" has the same
meaning as such term is defined in section 43.540, RSMo.

3. Prior to allowing any person who has been hired as a full-time,
part-time or temporary position to have contact with any patient or
resident the provider shall, or in the case of temporary employees hired
through or contracted for an employment agency, the employment agency
shall prior to sending a temporary employee to a provider:

(1) Request a criminal background check as provided in section 43.540,
RSMo. Completion of an inquiry to the highway patrol for criminal records
that are available for disclosure to a provider for the purpose of
conducting an employee criminal records background check shall be deemed
to fulfill the provider's duty to conduct employee criminal background
checks pursuant to this section; except that, completing the inquiries
pursuant to this subsection shall not be construed to exempt a provider
from further inquiry pursuant to common law requirements governing due
diligence. If an applicant has not resided in this state for five
consecutive years prior to the date of his or her application for
employment, the provider shall request a nationwide check for the purpose
of determining if the applicant has a prior criminal history in other
states. The fingerprint cards and any required fees shall be sent to the
highway patrol's criminal records division. The first set of fingerprints
shall be used for searching the state repository of criminal history
information. If no identification is made, the second set of fingerprints
shall be forwarded to the Federal Bureau of Investigation, Identification
Division, for the searching of the federal criminal history files. The
patrol shall notify the submitting state agency of any criminal history
information or lack of criminal history information discovered on the
individual. The provisions relating to applicants for employment who have
not resided in this state for five consecutive years shall apply only to
persons who have no employment history with a licensed Missouri facility
during that five-year period. Notwithstanding the provisions of section
610.120, RSMo, all records related to any criminal history information
discovered shall be accessible and available to the provider making the
record request; and

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

4. When the provider requests a criminal background check pursuant to
section 43.540, RSMo, the requesting entity may require that the
applicant reimburse the provider for the cost of such record check. When
a provider requests a nationwide criminal background check pursuant to
subdivision (1) of subsection 3 of this section, the total cost to the
provider of any background check required pursuant to this section shall
not exceed five dollars which shall be paid to the state. State funding
and the obligation of a provider to obtain a nationwide criminal
background check shall be subject to the availability of appropriations.

5. An applicant for a position to have contact with patients or residents
of a provider shall:

(1) Sign a consent form as required by section 43.540, RSMo, so the
provider may request a criminal records review;

(2) Disclose the applicant's criminal history. For the purposes of this
subdivision "criminal history" includes any conviction or a plea of
guilty to a misdemeanor or felony charge and shall include 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.

6. 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 knowingly hires or retains a person to have contact with
patients or residents and the person has been convicted of, pled guilty
to or nolo contendere in this state or any other state or has been found
guilty of a crime, which if committed in Missouri would be a class A or B
felony violation of chapter 565, 566 or 569, RSMo, or any violation of
subsection 3 of section 198.070, RSMo, or section 568.020, RSMo.

7. Any in-home services provider agency or home health agency shall be
guilty of a class A misdemeanor if such agency knowingly employs a person
to provide in-home services or home health services to any in-home
services client or home health patient and such person either refuses to
register with the family care safety registry or is listed on any of the
background check lists in the family care safety registry pursuant to
sections 210.900 to 210.937, RSMo.

8. The highway patrol shall examine whether protocols can be developed to
allow a provider to request a statewide fingerprint criminal records
review check through local law enforcement agencies.

9. A provider may use a private investigatory agency rather than the
highway patrol to do a criminal history records review check, and
alternatively, the applicant pays the private investigatory agency such
fees as the provider and such agency shall agree.

10. Except for the hiring restriction based on the department of health
and senior services employee disqualification list established pursuant
to section 660.315, the department of health and senior services shall
promulgate rules and regulations to waive the hiring restrictions
pursuant to this section for good cause. For purposes of this section,
"good cause" means the department has made a determination by examining
the employee's prior work history and other relevant factors that such
employee does not present a risk to the health or safety of residents.
(L. 1996 H.B. 1362, A.L. 1997 S.B. 358, A.L. 1998 H.B. 1046 merged with
H.B. 1907, A.L. 2003 S.B. 556 & 311, A.L. 2003 2nd Ex. Sess. S.B. 4)

Effective 9-15-03

1. Reports confidential under section 198.070, RSMo, and
sections 660.300 to 660.315 shall not be deemed a public record and shall
not be subject to the provisions of section 109.180, RSMo, or chapter
610, RSMo. The name of the complainant or any person mentioned in the
reports shall not be disclosed unless:

(1) The complainant, resident or the in-home services client mentioned
agrees to disclosure of his or her name;

(2) The department determines that disclosure is necessary in order to
prevent further abuse, neglect, misappropriation of property or funds, or
falsification of any documents verifying service delivery to an in-home
services client;

(3) Release of a name is required for conformance with a lawful subpoena;

(4) Release of a name is required in connection with a review by the
administrative hearing commission in accordance with section 198.039,
RSMo;

(5) The department determines that release of a name is appropriate when
forwarding a report of findings of an investigation to a licensing
authority; or

(6) Release of a name is requested by the division of family services for
the purpose of licensure under chapter 210, RSMo.

2. The department shall, upon request, provide to the division of
employment security within the department of labor and industrial
relations copies of the investigative reports that led to an employee
being placed on the disqualification list. (L. 1992 S.B. 573 & 634, A.L.
2003 S.B. 556 & 311)

Notwithstanding any other provision of law, the department shall
not disclose personally identifiable medical, social, personal, or
financial records of any eligible adult being served by the division of
senior services except when disclosed in a manner that does not identify
the eligible adult, or when ordered to do so by a court of competent
jurisdiction. Such records shall be accessible without court order for
examination and copying only to the following persons or offices, or to
their designees:

(1) The department or any person or agency designated by the department
for such purposes as the department may determine;

(2) The attorney general, to perform his or her constitutional or
statutory duties;

(3) The department of mental health for residents placed through that
department, to perform its constitutional or statutory duties;

(4) Any appropriate law enforcement agency, to perform its constitutional
or statutory duties;

(5) The eligible adult, his or her legal guardian or any other person
designated by the eligible adult; and

(6) The department of social services for individuals who receive
Medicaid benefits, to perform its constitutional or statutory duties. (L.
2003 S.B. 556 & 311)

As used in sections 660.327 to 660.355, unless the context
clearly indicates otherwise, the following terms mean:

(1) "Department", the Missouri department of social services or any
division thereof;

(2) "Entity" includes any bank, trust company, savings and loan
association, credit union, insurance company, or any corporation,
association, partnership, or individual receiving or accepting money or
its equivalent on deposit as a business in the state of Missouri;

(3) "Public assistance", assistance received by or paid on behalf of any
person under chapter 205, 207, 208, or 209, RSMo. (L. 1983 S.B. 285 § 1)

Any entity shall, upon request by the department, inform the
department of the amount deposited in the entity to the credit of any
person named in such request who is the applicant for or recipient of
public assistance. The entity shall, after ten days' written notice to
such person by the department also upon request of the department,
furnish records of any deposits and withdrawals during the past five
years concerning any applicant for or recipient of public assistance. (L.
1983 S.B. 285 § 2)

Any entity shall, upon request by the department, inform the
department of the last known address of any person or of any moneys
deposited on behalf of any person named in the request who owes a duty of
support to or for any applicant for or recipient of public assistance
wherein such support obligation has been assigned to the department or
any of its divisions either by written assignment or operation of law and
the department or division has obtained an unsatisfied judgment for such
child support and after ten days' written notice has been provided to
such person. Before any such information is provided, the department
shall provide to the entity an affidavit with specificity that all of the
requirements of this section have been met. (L. 1983 S.B. 285 § 3)

Requests made by the department pursuant to sections 660.327 and
660.330 shall be in writing and shall include sufficient information to
identify each person named in the request in a form that is compatible
with the record-keeping methods of the entity. Requests may be made in
the form of magnetic computer tape. (L. 1983 S.B. 285 § 4)

The department shall reimburse any entity for the cost of
computer time expended by the entity in making a search of its records as
a result of a request made pursuant to sections 660.325 to 660.355, at a
reasonable rate. If the request asks for records of any deposits and
withdrawals during the past five years, and the entity cannot obtain such
information by automated search of its records, the department shall
reimburse the entity at the rate of six dollars per man hour expended.
(L. 1983 S.B. 285 § 5)

Any entity which has received a request from the department as
provided by sections 660.327 and 660.330 shall provide the requested
information within sixty days of receipt of the request. Willful failure
of an entity to provide the requested information within such period
shall result in liability to the state for civil penalties of up to ten
dollars for each day thereafter. The attorney general shall, upon 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 the civil penalty to be assessed.
(L. 1983 S.B. 285 § 6)

Any entity, officer, agent, or employee of such entities
participating in good faith in providing the requested information under
sections 660.327, 660.330 and this section shall be immune from civil
liability that might otherwise result from the release of such
information to the department. (L. 1983 S.B. 285 § 7)

The disclosure of any information provided to the entity by the
department or the disclosure of any information regarding the identity of
any applicant for or recipient of public assistance, by an officer or
employee of any entity, or by any person receiving such information from
such employee or officer is prohibited. Any person violating this section
shall be guilty of a class A misdemeanor. (L. 1983 S.B. 285 § 8)

The application for or the receipt of public assistance shall be
deemed consent by any such applicant or recipient for the department to
request any information regarding such applicant or recipient from any
entity. (L. 1983 S.B. 285 § 9)

As used in sections 660.370 to 660.374, unless the context
requires otherwise, the following words and terms shall mean:

(1) "Community action agency", a not-for-profit corporation which has
authority under its charter and bylaws to receive funds to administer
community action programs and which was officially designated as a
community action agency or a community action program under the
provisions of federal law Section 210 of the Economic Opportunity Act of
1964 for fiscal year 1981, unless such community action agency or a
community action program lost its designation pursuant to the
aforementioned act as a result of failure to comply with the provisions
of such act;

(2) "Community action program", a community based and operated program
which includes an intake assessment and referral capability in each of
its counties and is designed to include a number of projects or
components to provide a range of services and activities having* a
measurable and potentially major impact on causes and conditions of
poverty in the community or those areas of the community where poverty is
a particularly acute problem. These services and activities may include,
but are not limited to, activities designed to provide opportunities for
eligible persons to:

(a) Secure and retain meaningful employment;

(b) Attain an adequate education;

(c) Make better use of available income;

(d) Obtain and maintain adequate housing and suitable living environment;

(e) Obtain emergency assistance through grants to meet immediate and
urgent individual and family needs, including the need for health
services, nutritious food, housing and employment related assistance;

(f) Maximize the role community action agencies play in supportive
mechanisms available to Missouri families;

(g) Remove obstacles and solve problems which block the achievement of
self-sufficiency;

(h) Achieve greater participation in the affairs of the community; and

(i) Make more effective use of other programs. (L. 1984 S.B. 564 § 1)

*Word "have" appears in original rolls.

1. Each community action agency shall have a board of directors,
as provided by the bylaws of the corporations, of not less than twelve
nor more than thirty-six members. One-third of the members of the board
shall be elected public officials, currently holding office, or their
representatives, except that if the number of elected officials
reasonably available and willing to serve is less than one-third of the
membership of the board, membership on the board by appointive public
officials may be counted in meeting such one-third requirement. At least
one-third of the members shall be persons chosen in accordance with
democratic selection procedures adequate to assure that they are
representative of the poor in the area served, and the remainder of the
members shall be officials or members of business, industry, labor,
religious, welfare, education, or other major groups and interests in the
community.

2. The governing board shall determine personnel, fiscal and program
policies and approve proposals for financial assistance and the
disbursement of funds. (L. 1984 S.B. 564 §§ 2, 3)

1. In the event that the Congress of the United States approves
a block grant system to fund social programs, the state may, subject to
appropriation, use such block grant funds or in-kind services to provide
a level of financial assistance for community action agencies to carry
out community action programs through the community services block grants
pursuant to the federal Community Services Block Grant Act and other such
federal funding sources which may be appropriate. Each agency shall in
accordance with section 660.376 receive a portion of available Community
Services Block Grant Act funds based on that agency's poverty population
relative to the state's total poverty population. Poverty levels shall be
determined by the department of social services using criteria
established by the United States Office of Management and Budget.

2. In the event that federal funds are not available for the support of
community action agencies, state funds may be appropriated or expended
therefor, however only in an amount as defined in subsection 1 of this
section. (L. 1984 S.B. 564 § 4, A.L. 1995 S.B. 445)

Each community action agency shall be governed by rules and
regulations promulgated by the department of social services as it
relates to the community services block grant program. (L. 1984 S.B. 564
§ 5)

As used in sections 199.025, RSMo, and 660.403 to 660.420,
unless the context clearly indicates otherwise, the following terms mean:

(1) "Adult", an individual over the age of eighteen;

(2) "Adult day care program", a group program designed to provide care
and supervision to meet the needs of functionally impaired adults for
periods of less than twenty-four hours but more than two hours per day in
a place other than the adult's own home;

(3) "Adult day care provider", the person, corporation, partnership,
association or organization legally responsible for the overall operation
of the adult day care program;

(4) "Department", the department of social services;

(5) "Director", the director of the division of aging;

(6) "Division", the division of aging;

(7) "Functionally impaired adult", an adult who by reason of age or
infirmity requires care and supervision;

(8) "License", the document issued by the division in accordance with the
provisions of sections 199.025, RSMo, and 660.403 to 660.420 to an adult
day care program which authorizes the adult day care provider to operate
the program in accordance with the provisions of sections 199.025, RSMo,
and 660.403 to 660.420 and the applicable rules promulgated pursuant
thereto;

(9) "Participant", a functionally impaired adult who is enrolled in an
adult day care program;

(10) "Person", any individual, firm, corporation, partnership,
association, agency, or an incorporated or unincorporated organization
regardless of the name used;

(11) "Provisional license", the document issued by the division in
accordance with the provisions of sections 199.025, RSMo, and 660.403 to
660.420 to an adult day care provider which is not currently meeting the
requirements necessary to obtain a license;

(12) "Related", any of the following by blood, marriage or adoption:
parent, child, grandchild, brother, sister, half-brother, half-sister,
stepparent, uncle, aunt, niece, nephew, or first cousin;

(13) "Staff participant ratio", the number of adult care staff required
by the division in relation to the number of adults being cared for by
such staff. (L. 1984 H.B. 1131 § 4)

Revisor's note: Definitions contained in section 660.053 are also
applicable to sections 660.400 to 660.420.

1. It shall be unlawful for any person to establish, maintain,
or operate an adult day care program, or to advertise or hold himself out
as being able to perform any adult day care service, unless he has
obtained the proper license.

2. All applications for licenses shall be made on forms provided by the
division and in the manner prescribed by the division. All forms provided
shall include a fee schedule.

3. The division shall conduct an investigation of the adult day care
program, and the applicant, for which a license is sought in order to
determine if such program is complying with the following:

(1) Local fire safety requirements or fire safety requirements of the
division if there are no local codes;

(2) Local or state sanitation requirements;

(3) Local building and zoning requirements, where applicable;

(4) Staff/adult ratios required by the division; and

(5) Other applicable provisions of sections 199.025, RSMo, and 660.403 to
660.420 and all applicable rules promulgated pursuant thereto, including
but not limited to:

(a) The applicant's ability to render adult day care;

(b) The proposed plan for providing adult day care;

(c) The proposed plan of operation of the adult day care program, so
that, in the judgment of the division, minimum standards are being met to
insure the health and safety of the participants.

4. Following completion of its investigation made pursuant to subsection
3 of this section and a finding that the applicant for a license has
complied with all applicable rules promulgated pursuant to sections
199.025, RSMo, and 660.403 to 660.420 the division shall issue a license
to such applicant. Such license shall be valid for the period designated
by the division, which period shall not exceed two years from the date of
issuance, for the premises and persons named in the application.

5. Each license issued under sections 199.025, RSMo, and 660.403 to
660.420 shall include the name of the provider, owner and operator; the
name of the adult day care program; the location of the adult day care
program; the hours of operations; the number and any limitations or the
type of participants who may be served; and the period for which such
license is valid.

6. The division may issue a provisional license to an adult day care
program that is not currently meeting requirements for a license but
which demonstrates the potential capacity to meet full requirements for
license; except that, no provisional license shall be issued unless the
director is satisfied that the operation of the adult day care program is
not detrimental to the health and safety of the participants being
served. The provisional license shall be nonrenewable and shall be valid
for the period designated by the division, which period shall not exceed
six months from the date of issuance. Upon issuance of a regular license,
a day care program's provisional license shall immediately be null and
void. (L. 1984 H.B. 1131 § 5)

1. The provisions of sections 199.025, RSMo, and 660.403 to
660.420 shall not apply to the following:

(1) Any adult day care program operated by a person in which care is
offered for no more than two hours per day;

(2) Any adult day care program maintained or operated by the federal
government except where care is provided through a management contract;

(3) Any person who cares solely for persons related to the provider or
who has been designated as guardian of that person;

(4) Any adult day care program which cares for no more than four persons
unrelated to the provider;

(5) Any adult day care program licensed by the department of mental
health under chapter 630, RSMo, which provides care, treatment and
habilitation exclusively to adults who have a primary diagnosis of mental
disorder, mental illness, mental retardation or developmental disability
as defined;

(6) Any adult day care program administered or maintained by a religious
not-for-profit organization serving a social or religious function if the
adult day care program does not hold itself out as providing the
prescription or usage of physical or medical therapeutic activities or as
providing or administering medicines or drugs.

2. Nothing in this section shall prohibit any person listed in subsection
1 of this section from applying for a license or receiving a license if
the adult day care program owned or operated by such person conforms to
the provisions of sections 199.025, RSMo, and 660.403 to 660.420 and all
applicable rules promulgated pursuant thereto. (L. 1984 H.B. 1131 § 6)

1. The director, or his authorized representative, shall have
the right to enter the premises of an applicant for or holder of a
license at any time during the hours of operation of a center to
determine compliance with provisions of sections 199.025, RSMo, and
660.403 to 660.420 and applicable rules promulgated pursuant thereto.
Entry shall also be granted for investigative purposes involving
complaints regarding the operations of an adult day care program. The
division shall make at least two inspections per year, at least one of
which shall be unannounced to the operator or provider. The division may
make such other inspections, announced or unannounced, as it deems
necessary to carry out the provisions of sections 199.025, RSMo, and
660.403 to 660.420.

2. The applicant for or holder of a license shall cooperate with the
investigation and inspection by providing access to the adult day care
program, records and staff, and by providing access to the adult day care
program to determine compliance with the rules promulgated pursuant to
sections 199.025, RSMo, and 660.403 to 660.420.

3. Failure to comply with any lawful request of the division in
connection with the investigation and inspection is a ground for refusal
to issue a license or for the suspension or revocation of a license.

4. The division may designate to act for it, with full authority of law,
any instrumentality of any political subdivision of the state of Missouri
deemed by the division to be competent to investigate and inspect
applicants for or holders of licenses. (L. 1984 H.B. 1131 § 7)

Each application for a license, or the renewal thereof, issued
pursuant to sections 199.025, RSMo, and 660.403 to 660.420 shall be
accompanied by a nonrefundable fee in the amount required by the
division. The fee, to be determined by the director of the division,
shall not exceed one hundred dollars and shall be based on the licensed
capacity of the applicant. (L. 1984 H.B. 1131 § 8)

The division shall offer technical assistance or consultation to
assist applicants for or holders of licenses or provisional licenses in
meeting the requirements of sections 199.025, RSMo, and 660.403 to
660.420, staff qualifications, and other aspects involving the operation
of an adult day care program, and to assist in the achievement of
programs of excellence related to the provision of adult day care. (L.
1984 H.B. 1131 § 9)

1. Whenever the division is advised or has reason to believe
that any person is operating an adult day care program without a license,
or provisional license, or that any holder of license, or provisional
license is not in compliance with the provisions of sections 199.025,
RSMo, and 660.403 to 660.420, the division shall make an investigation
and inspection to ascertain the facts. If the division is not permitted
access to the adult day care program in question, the division may apply
to the circuit court of the county in which the program is located for an
order authorizing entry for inspection. The court shall issue the order
if it finds reasonable grounds necessitating the inspection.

2. If the division finds that the adult day care program is being
operated in violation of sections 199.025, RSMo, and 660.403 to 660.420,
it may seek, among other remedies, injunctive relief against the adult
day care program. (L. 1984 H.B. 1131 § 10)

1. Any person aggrieved by an official action of the division
either refusing to issue a license or revoking or suspending a license
may seek a determination thereon by the administrative hearing commission
pursuant to the provisions of section 161.272, RSMo, et seq.; except
that, the petition must be filed with the administrative hearing
commission within thirty days after the mailing or delivery of notice to
the applicant for or holder of such license or certificate. When the
notification of the official action is mailed to the applicant for or
holder of such a license, there shall be included in the notice a
statement of the procedure whereby the applicant for or holder of such
license may appeal the decision of the division before the administrative
hearing commission. 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 division.

2. The administrative hearing commission may stay the revocation or
suspension of such certificate or license, pending the commission's
findings 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 division, the commission finds reason to believe that
continued operation of the facility to which the certificate or license
in question applies pending the commission's final determination would
present an imminent danger to the health, safety or welfare of any person
or a substantial probability that death or serious physical harm would
result. In any case in which the division has refused to issue a
certificate or license, the commission shall have no authority to stay or
to require the issuance of a license pending final determination by the
commission.

3. The administrative hearing commission shall make the final decision as
to the issuance, suspension, or revocation of a license. Any person
aggrieved by a final decision of the administrative hearing commission,
including the division, may seek judicial review of such decision by
filing a petition for review in the court of appeals for the district in
which the adult day care program to which the license in question applies
is located. Review shall be had in accordance with the provisions of
sections 161.337 and 161.338, RSMo. (L. 1984 H.B. 1131 § 11)

The director of the division shall have the authority to
promulgate rules pursuant to this section and chapter 536, RSMo, in order
to carry out the provisions of sections 199.025, RSMo, and 660.403 to
660.420. No rule or portion of a rule promulgated under the authority of
section 199.025, RSMo, and sections 660.403* to 660.420 shall become
effective unless it has been promulgated pursuant to the provisions of
section 536.024, RSMo. (L. 1984 H.B. 1131 § 12, A.L. 1993 S.B. 52, A.L.
1995 S.B. 3)

*Original rolls contain "660.430". This is an apparent typographical
error.

1. Any person who violates any provision of sections 199.025,
RSMo, and 660.403 to 660.420, or who, for himself or for any other
person, makes materially false statements in order to obtain a
certificate or license, or the renewal thereof, issued pursuant to
sections 199.025, RSMo, and 660.403 to 660.420, shall be guilty of a
class A misdemeanor.

2. Any person who is convicted pursuant to this section shall, in
addition to all other penalties provided by law, have any license issued
to him under sections 199.025, RSMo, and 660.403 to 660.420 revoked, and
shall not operate, nor hold any license to operate, any adult day care
program, or other entity governed by the provisions of sections 199.025,
RSMo, and 660.403 to 660.420 for a period of three years after such
conviction. (L. 1984 H.B. 1131 § 13)

No rule or portion of a rule promulgated under the authority of
chapter 210, RSMo, shall become effective unless it has been promulgated
pursuant to the provisions of section 536.024, RSMo. (L. 1989 S.B. 241 §
10, Repealed L. 1995 H.B. 574, A.L. 1995 S.B. 3)

1. There is hereby established in the department of social
services a special team, to be known as the "state technical assistance
team", to assist in cases of child abuse, child neglect, child sexual
abuse, child exploitation, child pornography, or child fatality. It shall
be the priority of the team to focus on those cases in which more than
one report has been received. The team shall:

(1) Provide assistance, expertise, and training to child protection
agencies and multidisciplinary teams for the investigation and
prosecution of child abuse, child neglect, child sexual abuse, child
exploitation, child pornography, or child fatality cases;

(2) Assist in the investigation of child abuse, child neglect, child
sexual abuse, child exploitation, child pornography, or child fatality
cases, upon the request of a local, county, state, or federal law
enforcement agency, county, state, or federal prosecutor, a
representative of the family courts, medical examiner, coroner, juvenile
officer, or department of social services staff. Upon being requested to
assist in an investigation, the state technical assistance team shall
notify appropriate parties specified in this subdivision of the team's
involvement. State technical assistance team investigators licensed as
peace officers by the director of the department of public safety
pursuant to chapter 590, RSMo, shall be deemed to be peace officers
within the state of Missouri while acting in an investigation or on
behalf of a child. The power of arrest of a state technical assistance
team investigator acting as a peace officer shall be limited to offenses
involving child abuse, child neglect, child sexual abuse, child
exploitation, child pornography, child fatality, or in situations of
imminent danger to the investigator or another person;

(3) Assist county multidisciplinary teams to develop and implement
protocols for the investigation and prosecution of child abuse, child
neglect, child sexual abuse, child exploitation, child pornography, or
child fatality cases.

2. The team may call upon the expertise of the office of the attorney
general, the Missouri office of prosecution services, the state highway
patrol, the department of health and senior services, the department of
mental health or any other agency or institution.

3. Each county may develop a multidisciplinary team for the purpose of
determining the appropriate investigative and therapeutic action to be
initiated on complaints referenced in subsection 1 of this section
reported to the children's division. The multidisciplinary team may
include, but is not limited to, a prosecutor, or his or her
representative, an investigator from the children's division, a
physician, a representative from a mental health care services agency and
a representative of the police agency of primary jurisdiction.

4. All reports and records made and maintained by the state technical
assistance team or local law enforcement relating to criminal
investigations conducted pursuant to this section, including arrests,
shall be available in the same manner as law enforcement records, as set
forth in sections 610.100 to 610.200, RSMo, and to the individuals
identified in subdivision (13) of subsection 2 of section 210.150, RSMo.
All other records shall be available in the same manner as provided for
in section 210.150, RSMo. (L. 1990 H.B. 1370, et al. § 1, A.L. 2000 S.B.
757 & 602, A.L. 2004 H.B. 1055)

1. By January 1, 1991, using approved state child abuse and
neglect federal grant funds, the department of social services shall
develop uniform protocols for investigations of child sexual abuse cases
pursuant to chapter 210, RSMo, and shall provide training to division of
family services employees who investigate reports of such cases.

2. The department of social services shall develop separate protocols for
multiple-suspect and multiple-victim cases. (L. 1990 H.B. 1370, et al. §
2)

The division of family services may provide treatment services
for child sexual abuse victims in instances where the perpetrator is not
listed in section 210.110, RSMo, as a person responsible for the care,
custody and control of the child, if treatment funds are available and
such treatment services are requested by the family of the child. (L.
1990 H.B. 1370, et al. § 4)

The division of family services shall ensure that all employees
and persons with contracts with the division and who specialize in either
the treatment, prosecution, or investigation of child sexual abuse cases
receive a minimum of fifteen hours of annual training. Such training
shall be in the investigation, prosecution, treatment, nature, extent and
causes of sexual abuse. (L. 1994 S.B. 595)

The department of social services shall engage community- based
public and private organizations in Jackson County to participate in a
pilot project for the purpose of formulating a community response to
child abuse and neglect, including hot line investigations, assessments
and their dispositions. (L. 2000 S.B. 757 & 602 § 1)

As used in sections 660.530 to 660.545, the following terms mean:

(1) "Child day care center", a community facility which provides care to
a child age six weeks to fourteen years. Such care shall be provided for
a portion of the day, and less than twenty-four hours outside the home in
a facility licensed and approved in accordance with applicable local,
state and federal standards for child day care;

(2) "Director", the director of the department of social services;

(3) "Residential health care facility", a facility licensed pursuant to
the provisions of chapter 198, RSMo;

(4) "Senior citizen services center", a community facility which provides
to older adults a combination of services, including the provision of
health, social, educational and recreational services. (L. 1990 H.B.
1370, et al. § 10)

1. Notwithstanding any other provision of law to the contrary,
with the amounts made available therefor by appropriation, a "Combined
Senior Citizen Services Center/Residential Health Care Facility/Child Day
Care Center Community Grants Program" is hereby established on a pilot
project basis. The purpose of such a program shall be to promote
innovative and cost-effective means of providing existing or proposed
senior citizen services center or residential health care facilities and
child day care centers in a combined center. Such centers shall provide
and combine, to the extent possible and financially feasible, services
that include, but are not limited to, staffing and administration,
transportation, nutrition and health, and the costs of utilities, heat,
insurance and rent or mortgages.

2. Grants may be awarded for combining separately existing programs or
for combining newly proposed programs. Such grants necessary to combine
programs shall be limited to start-up costs that may include planning and
administrative costs for the purpose of combining such programs, moving
expenses and minor capital improvements and up to the first two months'
expenses for salaries or wages, training, rent or mortgage payments,
utilities and insurance or such other start-up costs identified and
approved by the director of the department of social services. (L. 1990
H.B. 1370, et al. § 11)

The director of the department of social services shall
promulgate rules and regulations necessary to implement and administer
the combined senior citizen services center/child day care center or
residential health care facility/child day care center community grants
program as provided for in sections 660.530 to 660.545 on a pilot project
basis. 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. (L. 1990 H.B. 1370,
et al. § 12, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3)

1. Public and private not-for-profit organizations and
corporations shall be eligible for purposes of application for grants
provided for in sections 660.530 to 660.545 subject to any rules or
regulations promulgated by the director. Two or more organizations may
join together for the purposes of sections 660.530 to 660.545.

2. General business corporations, public and private, and not-for-profit
corporations, partnerships, limited partnerships, associations, and sole
proprietorships shall be eligible for purposes of application for grants
provided for in sections 660.530 to 660.545 subject to any rules or
regulations promulgated by the director. Two or more organizations may
join together for the purposes of sections 660.530 to 660.545. (L. 1990
H.B. 1370, et al. §§ 13, 19)

The director shall publicize the availability of moneys to be
used for the purposes of sections 660.530 to 660.545. The director shall
request, on forms prescribed by him, such information as he determines
relevant and necessary to the evaluation of each application. The
director shall solicit comments on the application from other concerned
agencies such as the designated area agency on aging, the local division
of family services office, the local department of health and from other
groups concerned with the needs of the elderly or children. (L. 1990 H.B.
1370, et al. § 14)

The application shall include plans for coordinating, combining
and consolidating existing or proposed senior citizen services centers,
or residential health care facilities and child day care centers. Such
applications shall include to the extent possible:

(1) The start-up costs necessary only to combine such programs. Such
costs may include planning and administrative expenses for the purpose of
combining such programs, moving expenses and minor capital improvements,
and up to the first two months' expenses for salaries or wages, training,
rent or mortgage payments, utilities and insurance and such other
start-up costs identified and approved by the director;

(2) An outline of steps to be taken to ensure the health, safety and
welfare of the program participants;

(3) Innovative utilization of operating funds, which may include, but not
be limited to, pooling of administrative and support staff, insurance
costs, maintenance costs, transportation services, nutrition services,
energy costs, building space, health services and supplies;

(4) The impact and effectiveness of the program in meeting the
community's need for such programs;

(5) The range and type of services to be offered and the number and types
of personnel to be employed;

(6) Coordination with other community services;

(7) Sources of revenue during the term of the pilot project and
anticipated revenue sources after the project terminates, and the manner
in which all available reimbursement for services will be sought;

(8) Such other information as required by the director to satisfy him
that senior citizen services center, residential health care and child
day care regulations and licensing requirements have been met;

(9) Such other information as deemed pertinent by the director. (L. 1990
H.B. 1370, et al. § 15)

1. The director shall review and, where necessary, require
modifications and, upon such modifications, approve no fewer than three
applications.

2. A grant amount available under this program shall not exceed the total
start-up costs necessary only to combine existing or newly proposed
programs, less any income from governmental, third party or any other
sources that may be available for the purpose of combining such programs.

3. Grants shall be made available for each combined program on a one-time
basis.

4. Notwithstanding any other provision of law to the contrary, costs
incurred combining such programs or attributable to the operation of the
child care center may not be transferred to a residential health care
facility for purposes of reimbursement under Title XIX of the federal
Social Security Act nor shall funding for combining such programs be
substituted for funds provided under the Federal Older Americans Act of
1965 as amended, the Social Service Block Grants under Title XX of the
Social Security Act, or any other federal, state or local funding.

5. Upon approval thereof, the director shall determine the amount of
payment and shall contract with each grantee who has an approved
application for payment of the start-up costs of the pilot project. (L.
1990 H.B. 1370, et al. § 16)

Each grantee receiving payments under the provisions of sections
660.530 to 660.545 shall submit to the director within a reasonable
period of time specified by the director, a report following guidelines
prepared by the director which shall include, but not be limited to:

(1) The manner in which payments as provided by subdivision (3) of
section 660.539 were expended;

(2) A description of the scope, status and quality of the project funded;

(3) The extent to which the program reduced expenditures or realized
savings;

(4) The impact and effectiveness of this program in meeting the
community's needs for senior citizen services, residential health care
and child day care and the social benefit the program provided to the
children and senior citizens in the program;

(5) The extent to which the program coordinated services with other
community services; and

(6) The manner in which all available reimbursement for services has been
sought, and the manner in which such reimbursement was expended. (L. 1990
H.B. 1370, et al. § 17)

The director shall prepare a summary of the reports required by
section 660.543 and incorporate them into an annual report, and submit
such report to the governor, the speaker of the house of representatives
and the president pro tem of the senate by January fifteenth of each year
beginning January 15, 1992. Such annual reports shall include any
recommendations for legislation. (L. 1990 H.B. 1370, et al. § 18)

1. The department of social services shall coordinate a program
entitled the "Missouri Partnership for Long-term Care" whereby private
insurance and Medicaid funds shall be combined to finance long-term care.
Under such program, an individual may purchase a precertified long-term
care insurance policy in an amount commensurate with his resources as
defined pursuant to the Medicaid program. Notwithstanding any provision
of law to the contrary, the resources of such an individual, to the
extent such resources are equal to the amount of long-term care insurance
benefit payments as provided in section 660.547, shall not be considered
by the department of social services in a determination of:

(1) His eligibility for Medicaid;

(2) The amount of any Medicaid payment. Any subsequent recovery of a
payment for medical services by the state shall be as provided by federal
law.

2. Notwithstanding any provision of law to the contrary, for purposes of
recovering any medical assistance paid on behalf of an individual who was
allowed an asset or resource disregard based on such long-term care
insurance policy, the definition of estate shall be expanded to include
any other real or personal property and other assets in which the
individual has any legal title or interest at the time of death, to the
extent of such interest, including such assets conveyed to a survivor,
heir, or assign of the deceased individual through joint tenancy, tenancy
in common, survivorship, life estate, living trust or other arrangement.
(L. 1990 H.B. 998 § 8, A.L. 1995 H.B. 409 merged with S.B. 357)

(1997) Amendments to this section contained in 1995 CCS HB 409 declared
unconstitutional pursuant to sections 21 and 23 of article III of the
Missouri Constitution. Missouri Health Care Association v. Attorney
General of the State of Missouri, 953 S.W.2d 617 (Mo.banc).

The department of social services shall request appropriate
waiver or waivers from the Secretary of the federal Department of Health
and Human Services to permit the use of long-term care insurance for the
preservation of resources pursuant to section 660.546. Such preservation
shall be provided, to the extent approved by the federal Department of
Health and Human Services, for any purchaser of a precertified long-term
care insurance policy delivered, issued for delivery or renewed within
five years after receipt of the federal approval of the waiver, and shall
continue for the life of the original purchaser of the policy, provided
that he maintains his obligations pursuant to the precertified long-term
care insurance policy. Insurance benefit payments made on behalf of a
claimant, for payment of services which would be covered under section
208.152, RSMo, shall be considered to be expenditures of resources as
required under chapter 208, RSMo, for eligibility for medical assistance
to the extent that such payments are:

(1) For services Medicaid approves or covers for its recipients;

(2) In an amount not in excess of the charges of the health services
provider;

(3) For nursing home care, or formal services delivered to insureds in
the community as part of a care plan approved by a coordination,
assessment and monitoring agency licensed pursuant to chapter 198, RSMo;
and

(4) For services provided after the individual meets the coverage
requirements for long-term care benefits established by the department of
social services for this program. The director of the department of
social services shall adopt regulations in accordance with chapter 536,
RSMo, to implement the provisions of sections 660.546 to 660.557,
relating to determining eligibility of applicants for Medicaid and the
coverage requirements for long-term care benefits. (L. 1990 H.B. 998 § 9)

The department of social services shall establish an outreach
program to educate consumers to:

(1) The mechanisms for financing long-term; and

(2) The asset protection provided under sections 660.546 to 660.557. (L.
1990 H.B. 998 § 10)

1. The department of insurance shall precertify long-term care
insurance policies which are issued by insurers who, in addition to
complying with other relevant laws and regulations:

(1) Alert the purchaser to the availability of consumer information and
public education provided by the division of aging and the department of
insurance pursuant to sections 660.546 to 660.557;

(2) Offer the option of home- and community-based services in lieu of
nursing home care;

(3) Offer automatic inflation protection or optional periodic per diem
upgrades until the insured begins to receive long-term care benefits;
provided, however, that such inflation protection or upgrades shall not
be required of life insurance policies or riders containing accelerated
long-term care benefits;

(4) Provide for the keeping of records and an explanation of benefits
reports to the insured and the department of insurance on insurance
payments which count toward Medicaid resource exclusion; and

(5) Provide the management information and reports necessary to document
the extent of Medicaid resource protection offered and to evaluate the
Missouri partnership for long-term care including, but not limited to,
the information listed in section 660.553. Included among those policies
precertified under this section shall be life insurance policies which
offer long-term care either by rider or integrated into the life
insurance policy.

2. No policy shall be precertified pursuant to sections 660.546 to
660.557, if it requires prior hospitalization or a prior stay in a
nursing home as a condition of providing benefits.

3. The department of insurance may adopt regulations to carry out the
provisions of sections 660.546 to 660.557. (L. 1990 H.B. 998 § 11)

The department of insurance shall provide public information to
assist individuals in choosing appropriate insurance coverage, and shall
establish an outreach program to educate consumers as to:

(1) The need for long-term; and

(2) The availability of long-term care insurance. (L. 1990 H.B. 998 § 12)

The director of the department of insurance each year, on
January first shall report in writing to the department of social
services the following information:

(1) The success in implementing the provisions of sections 660.546 to
660.557;

(2) The number of policies precertified pursuant to sections 660.546 to
660.557;

(3) The number of individuals filing consumer complaints with respect to
precertified policies; and

(4) The extent and type of benefits paid, in the aggregate, under such
policies that could count toward Medicaid resource protection. (L. 1990
H.B. 998 § 13)

The director of the department of social services shall request
the federal approvals necessary to carry out the purposes of sections
660.546 to 660.557. Each year on January first, the director of the
department of social services shall report in writing to the general
assembly on the progress of the program. Such report will include, but
not be limited to:

(1) The success in implementing the provisions of sections 660.546 to
660.557;

(2) The number of policies precertified pursuant to sections 660.546 to
660.557;

(3) The number of individuals filing consumer complaints with respect to
precertified policies;

(4) The extent and type of benefits paid, in the aggregate, under such
policies that could count toward Medicaid resource protection;

(5) Estimates of impact on present and future Medicaid expenditures;

(6) The cost effectiveness of the program; and

(7) A recommendation regarding the appropriateness of continuing the
program. (L. 1990 H.B. 998 § 14)

As used in sections 660.600 to 660.608, the following terms mean:

(1) "Division", the division of aging of the department of social
services;

(2) "Long-term care facility", any facility licensed pursuant to chapter
198, RSMo, and long-term care facilities connected with hospitals
licensed pursuant to chapter 197, RSMo;

(3) "Office", the office of the state ombudsman for long-term care
facility residents;

(4) "Ombudsman", the state ombudsman for long-term care facility
residents;

(5) "Regional ombudsman coordinators", designated individuals working
for, or under contract with, the area agencies on aging, and who are so
designated by the area agency on aging and certified by the ombudsman as
meeting the qualifications established by the division;

(6) "Resident", any person who is receiving care or treatment in a
long-term care facility. (L. 1991 H.B. 444 § 1)

1. There is hereby established within the department of health
and senior services the "Office of State Ombudsman for Long-Term Care
Facility Residents", for the purpose of helping to assure the adequacy of
care received by residents of long-term care facilities and to improve
the quality of life experienced by them, in accordance with the federal
Older Americans Act, 42 U.S.C. 3001, et seq.

2. The office shall be administered by the state ombudsman, who shall
devote his or her entire time to the duties of his or her position.

3. The office shall establish and implement procedures for receiving,
processing, responding to, and resolving complaints made by or on behalf
of residents of long-term care facilities relating to action, inaction,
or decisions of providers, or their representatives, of long-term care
services, of public agencies or of social service agencies, which may
adversely affect the health, safety, welfare or rights of such residents.

4. The department shall establish and implement procedures for resolution
of complaints. The ombudsman or representatives of the office shall have
the authority to:

(1) Enter any long-term care facility and have access to residents of the
facility at a reasonable time and in a reasonable manner. The ombudsman
shall have access to review resident records, if given permission by the
resident or the resident's legal guardian. Residents of the facility
shall have the right to request, deny, or terminate visits with an
ombudsman;

(2) Make the necessary inquiries and review such information and records
as the ombudsman or representative of the office deems necessary to
accomplish the objective of verifying these complaints.

5. The office shall acknowledge complaints, report its findings, make
recommendations, gather and disseminate information and other material,
and publicize its existence.

6. The ombudsman may recommend to the relevant governmental agency
changes in the rules and regulations adopted or proposed by such
governmental agency which do or may adversely affect the health, safety,
welfare, or civil or human rights of any resident in a facility. The
office shall analyze and monitor the development and implementation of
federal, state and local laws, regulations and policies with respect to
long-term care facilities and services in the state and shall recommend
to the department changes in such laws, regulations and policies deemed
by the office to be appropriate.

7. The office shall promote community contact and involvement with
residents of facilities through the use of volunteers and volunteer
programs directed by the regional ombudsman coordinators.

8. The office shall develop and establish by regulation of the department
statewide policies and standards for implementing the activities of the
ombudsman program, including the qualifications and the training of
regional ombudsman coordinators and ombudsman volunteers.

9. The office shall develop and propose programs for use, training and
coordination of volunteers in conjunction with the regional ombudsman
coordinators and may:

(1) Establish and conduct recruitment programs for volunteers;

(2) Establish and conduct training seminars, meetings and other programs
for volunteers; and

(3) Supply personnel, written materials and such other reasonable
assistance, including publicizing their activities, as may be deemed
necessary.

10. The regional ombudsman coordinators and ombudsman volunteers shall
have the authority to report instances of abuse and neglect to the
ombudsman hotline operated by the department.

11. If the regional ombudsman coordinator or volunteer finds that a
nursing home administrator is not willing to work with the ombudsman
program to resolve complaints, the state ombudsman shall be notified. The
department shall establish procedures by rule in accordance with chapter
536, RSMo, for implementation of this subsection.

12. The office shall prepare and distribute to each facility written
notices which set forth the address and telephone number of the office, a
brief explanation of the function of the office, the procedure to follow
in filing a complaint and other pertinent information.

13. The administrator of each facility shall ensure that such written
notice is given to every resident or the resident's guardian upon
admission to the facility and to every person already in residence, or to
his guardian. The administrator shall also post such written notice in a
conspicuous, public place in the facility in the number and manner set
forth in the regulations adopted by the department.

14. The office shall inform residents, their guardians or their families
of their rights and entitlements under state and federal laws and rules
and regulations by means of the distribution of educational materials and
group meetings. (L. 1991 H.B. 444 § 2, A.L. 2003 S.B. 556 & 311)

1. Any files maintained by the ombudsman program shall be
disclosed only at the discretion of the ombudsman having authority over
the disposition of such files, except that the identity of any
complainant or resident of a long-term care facility shall not be
disclosed by such ombudsman unless:

(1) Such complainant or resident, or the complainant's or resident's
legal representative, consents in writing to such disclosure; or

(2) Such disclosure is required by court order.

2. Any representative of the office conducting or participating in any
examination of a complaint who shall knowingly and willfully disclose to
any person other than the office, or those authorized by the office to
receive it, the name of any witness examined or any information obtained
or given upon such examination, shall be guilty of a class A misdemeanor.
However, the ombudsman conducting or participating in any examination of
a complaint shall disclose the final result of the examination to the
facility with the consent of the resident.

3. Any statement or communication made by the office relevant to a
complaint received by, proceedings before or activities of the office and
any complaint or information made or provided in good faith by any
person, shall be absolutely privileged and such person shall be immune
from suit.

4. The office shall not be required to testify in any court with respect
to matters held to be confidential in this section except as the court
may deem necessary to enforce the provisions of sections 660.600 to
660.608, or where otherwise required by court order. (L. 1991 H.B. 444 §
3)

1. Any regional coordinator or local program staff, whether an
employee or an unpaid volunteer, shall be treated as a representative of
the office. No representative of the office shall be held liable for good
faith performance of his official duties under the provisions of sections
660.600 to 660.608 and shall be immune from suit for the good faith
performance of such duties. Every representative of the office shall be
considered a state employee under section 105.711, RSMo.

2. No reprisal or retaliatory action shall be taken against any resident
or employee of a long-term care facility for any communication made or
information given to the office. Any person who knowingly or willfully
violates the provisions of this subsection shall be guilty of a class A
misdemeanor. Any person who serves or served on a quality assessment and
assurance committee required under 42 U.S.C. sec. 1396r(b)(1)(B) and 42
CFR sec. 483.75(r), or as amended, shall be immune from civil liability
only for acts done directly as a member of such committee so long as the
acts are performed in good faith, without malice and are required by the
activities of such committee as defined in 42 CFR sec. 483.75(r). (L.
1991 H.B. 444 § 4)

1. There is hereby established an "Office of Advocacy and
Assistance for Senior Citizens" within the office of lieutenant governor.

2. The senior citizen advocate shall coordinate activities with the
long-term care ombudsman program, as defined in section 660.600, on
complaints made by or on behalf of senior citizens residing in long-term
care facilities.

3. The senior citizen advocate shall conduct a suitable investigation
into any actions complained of unless the senior citizen advocate finds
that the complaint pertains to a matter outside the scope of the
authority of the senior citizen advocate, the complainant has no
substantive or procedural interest which is directly affected by the
matter complained about, or the complaint is trivial, frivolous,
vexatious or not made in good faith.

4. After completing his investigation of a complaint, the senior citizen
advocate shall inform the complainant, the agency, official or employee
of action recommended by the senior citizen advocate. The senior citizen
advocate shall make such reports and recommendations to the affected
agencies, the governor and the general assembly as he deems necessary to
further the purposes of sections 660.620 and 660.625.

5. The senior citizen advocate shall, in conjunction with the division of
senior services, act as a clearinghouse for information pertaining to and
of interest to senior citizens and shall disseminate such information as
is necessary to inform senior citizens of their rights and of
governmental and nongovernmental services available to them. (L. 1992
S.B. 676 § 1 Adopted by Referendum, Proposition C, November 3, 1992, A.L.
2005 H.B. 681)

The senior citizen advocate shall maintain confidentiality with
respect to all matters, including the identities of the complainants or
witnesses coming before the senior citizen advocate unless the
complainant consents to the use of his or her name in the course of the
investigation. (L. 1992 S.B. 676 § 2 Adopted by Referendum, Proposition
C, November 3, 1992, A.L. 2005 H.B. 681)

As used in sections 660.650 to 660.657, the following terms
shall mean:

(1) "Early head start program", any head start program as defined in
subdivision (4) of this subsection which provides services to children
age three and under, and their families;

(2) "Head start delegate agency", any organization that operates a head
start program pursuant to a contract with a head start grantee;

(3) "Head start grantee", any private not-for-profit or public
organization that operates a head start program pursuant to federal law
and regulations. A head start grantee shall be responsible for the
administration of a local head start program and, in partnership with the
head start policy council, provide policy direction for the program; and

(4) "Head start program", a community program that is operated in
compliance with federal performance standards pursuant to 42 U.S.C.
Section 9801, and 45 CFR Section 1301, et seq., and that provides
comprehensive services to children and their families. The program shall
focus on preschool children from low-income families who have not reached
the age of compulsory school attendance. A head start program shall
encompass early child development and health services, family and
community partnerships, and program design and management. Head start
services include, but are not limited to, health, education, parent
involvement, nutrition, social services, special services for children
with disabilities and other services to help children and their families
attain their full potential. (L. 1998 H.B. 1274 § 660.650 subsec. 1)

Each head start program shall have a head start policy council
or committee, with not less than fifty-one percent of the members of such
council or committee being parents of children enrolled in a head start
program. The remaining members of such council or committee may be
community representatives from the geographic area serviced by the
program. Pursuant to federal regulations, the head start policy council
or committee shall, in partnership with the head start grantee or
delegate agency, provide policy direction for the local head start
program. (L. 1998 H.B. 1274 § 660.650 subsec. 2)

1. Head start grantees shall take an active role in community
planning to encourage strong communication, cooperation and the sharing
of information among the agencies and their community partners, and to
improve the delivery of community services to children and families. Head
start grantees shall take affirmative steps to establish ongoing
collaborative relationships with community organizations in order to
promote access for children and their families to community services that
are responsive to their needs, and to ensure that early head start and
head start programs respond to community needs. Head start grantees shall
perform outreach to encourage volunteers from the community to
participate in early head start and head start programs. To enable the
effective participation of children with disabilities and their families,
a head start grantee shall make specific efforts to develop interagency
agreements with local education agencies and other organizations within
the grantee's service area.

2. Each head start grantee directly operating an early head start or head
start program, shall establish and maintain a health services advisory
committee which includes professionals and volunteers from the community.
Head start grantees shall also establish and maintain such other service
advisory committees as they deem appropriate to address program service
issues, such as the development of community partnerships, and to help
agencies respond to community needs.

3. A head start grantee shall establish and maintain procedures to
support successful transitions for enrolled children and families from
head start and other child care and development programs into elementary
school, preschool programs or other child care settings.

4. Each head start grantee, with the concurrence of the head start policy
council or committee, may promulgate and implement local policies and
procedures that shall be consistent with federal and state laws and
regulations. (L. 1998 H.B. 1274 § 660.650 subsecs. 3, 4, 5, 6)

In order to protect the community spouse of an individual living
in a residential care facility I or residential care facility II, as
defined in section 198.006, RSMo, from impoverishment and to prevent
premature placement in a more expensive, more restrictive environment,
the division of family services shall comply with the provisions of
subsection 6 of section 208.010, RSMo, when determining the eligibility
for benefits pursuant to section 208.030, RSMo. (L. 2002 S.B. 810)

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