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| Home > Statutes > Usa Missouri |
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USA Statutes : missouri
Title : PUBLIC HEALTH AND WELFARE
Chapter : Chapter 199 Rehabilitation Center--Head Injury--Tuberculosis Testing
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As used in sections 199.001 to 199.055, the following terms mean:
(1) "Division", the division of injury prevention, head injury
rehabilitation and local health services of the department of health and
senior services;
(2) "Head injury" includes head injury, traumatic head injury, and spinal
cord injury as defined in section 192.735, RSMo;
(3) "Injury or trauma", any unintentional or intentional damage to the
body resulting from acute exposure to thermal, mechanical, electrical, or
chemical energy or from the absence of such essentials as heat or oxygen;
(4) "Rehabilitation", a comprehensive series of interventions for
physical, medical, cognitive and psychological disabilities designed to
restore a person to his maximum functional potential. (L. 1991 H.B. 218
merged with S.B. 125 & 341)
Effective 8-28-91 (H.B. 218) 7-1-92 (S.B. 125 & 341)
1. The "Division of Injury Prevention, Head Injury
Rehabilitation and Local Health Services" is hereby created and shall be
a division of the department of health and senior services. The division
shall have the responsibility of ensuring that injury prevention and head
injury rehabilitation evaluation, case management, treatment,
rehabilitation, and community support services are accessible, wherever
possible. The division shall have and exercise supervision of division
rehabilitation facilities, residential programs and specialized services
operated by the division and oversight of facilities, programs and
services funded by the division. The division may also plan for
prevention, treatment, rehabilitation and care, including hospice, for
persons with other diseases as determined by the general assembly by
appropriations. The division shall also have responsibilities for the
support, development, and coordination of local health services.
2. The powers, functions and duties of the division shall include the
following:
(1) Provision of funds for planning in cooperation with the Missouri head
injury advisory council and implementation of accessible programs to
rehabilitate and care for persons with head injuries, injury prevention
and research;
(2) Provision of technical assistance and training to community-based
programs and assistance and cooperation to programs of political
subdivisions designed to assist in planning and implementing quality
services;
(3) Assurance of program quality in compliance with such appropriate
standards for residential facilities, day programs, and specialized
programs as may be established by the division;
(4) Sponsorship and encouragement of research into the causes, effects,
prevention, treatment and rehabilitation of injuries and appropriateness
and cost and benefit effectiveness of head injury rehabilitation,
residential programs and specialized services;
(5) Provision of public information relating to injury prevention and
head injury treatment and rehabilitation;
(6) Cooperation with nonstate governmental agencies and the private
sector in establishing, conducting, integrating and coordinating programs
and projects relating to injury prevention and head injury treatment and
rehabilitation;
(7) Review and oversight of those portions of the department's annual
budget which are directed for injury prevention and head injury services;
(8) Encouragement of the utilization, support, assistance and dedication
of volunteers to assist persons affected by head injuries to be accepted
and integrated into normal community activities;
(9) Support, development, and coordination of local health services,
which shall include but shall not be limited to:
(a) Professional resources and staff development;
(b) Services assessment and coordination;
(c) Standards development, implementation and quality assurance;
(d) Provision of basic public health services in areas not served by
local public health agencies;
(e) Fiscal resources and management;
(f) Technical assistance; and
(g) Assistance with public health problems, emergencies and conditions.
(L. 1991 H.B. 218 merged with S.B. 125 & 341)
Effective 8-28-91 (H.B. 218) 7-1-92 (S.B. 125 & 341)
The Missouri head injury advisory council, created by section
192.745, RSMo, shall act as the advisory body to the division and the
division director. Any power or function of the division requiring
planning activities shall be undertaken with the direct input and
cooperation of the advisory council. The division shall not undertake or
duplicate any activity or function of the council under the provisions of
section 192.745, RSMo. (L. 1991 H.B. 218 merged with S.B. 125 & 341)
Effective 8-28-91 (H.B. 218) 7-1-92 (S.B. 125 & 341)
1. The division may provide injury prevention, and head injury
evaluation, care, treatment, rehabilitation and such related services
directly or through contracts from private and public vendors in this
state, the quality of the services being equal, appropriate and
consistent with professional advice in the least restrictive environment
and as close to an individual's home community as possible, with funds
appropriated for this purpose.
2. If it is determined through a comprehensive evaluation that a person
is suffering from a head injury so as to require the coordination of
provision of services, including other state governmental agencies,
nongovernmental and the private sector, and if such person, such person's
parent, if the person is a minor, or legal guardian, so requests, the
division shall, within the limits of available resources and subject to
relevant federal and state laws, secure a comprehensive program of any
necessary services for such person. Such services may include, but need
not be limited to, the following:
(1) Assessment and evaluation;
(2) Case management;
(3) Counseling;
(4) Respite care;
(5) Recreation;
(6) Rehabilitation;
(7) Cognitive retraining;
(8) Prevocational rehabilitation;
(9) Residential care;
(10) Homemaker services;
(11) Day activity programs;
(12) Supported living;
(13) Referral to appropriate services;
(14) Transportation;
(15) Supported work.
3. In securing the comprehensive program of services, the division shall
involve the patient, his family or his legal guardian in decisions
affecting his care, rehabilitation, services or referral. The quality of
the services being equal, appropriate and consistent with professional
advice, services shall be offered in the least restrictive environment
and as close to an individual's home community as possible. (L. 1991 H.B.
218 merged with S.B. 125 & 341, A.L. 1993 H.B. 481)
The curators of the University of Missouri shall provide for the
care of persons needing head injury and other rehabilitation and further,
for the treatment and commitment of persons having tuberculosis subject
to appropriation by the general assembly. (L. 1985 S.B. 19, A.L. 1991
H.B. 218 merged with S.B. 125 & 341, A.L. 1996 S.B. 540)
Effective 4-1-96
*No continuity with § 199.010 shown repealed by L. 1985 S.B. 19.
1. The following officers and their families shall, with the
permission of the department of health and senior services, reside on the
premises or other property of the center: center director, assistant
director, physicians, and other personnel required for the center's
operation as recommended by the center's director. Personnel residing at
the center shall pay a monthly rental determined annually at the lower of
cost or fair market value; except that the center director, with the
approval of the director of the department of health and senior services,
may establish a lower rate as required to fill the center's personnel
needs.
*2. This section shall terminate thirty days following the date notice is
provided to the revisor of statutes that an agreement has been executed
which transfers the Missouri rehabilitation center from the department of
health and senior services to the board of curators of the University of
Missouri. (RSMo 1939 § 9379, A.L. 1985 S.B. 19, A.L. 1996 S.B. 540)
Prior revisions: 1929 § 8682; 1919 § 12331; 1909 § 1460
Effective 7-1-96
*Contingent expiration date thirty days after the transfer of the
Missouri rehabilitation center to the University of Missouri. Termination
on 3-27-97. The Revisor of Statutes received notice on 2-25-97.
1. Employees of the Missouri rehabilitation center may organize
and file with the secretary of state an application as a not-for-profit
corporation for the purpose of establishing a child day care center. The
corporation so formed may enter into an agreement with the commissioner
of administration for the lease of appropriate space at the
rehabilitation center for use as the child day care center. The space at
the center may be made available to the corporation at a rate to be
established by the commissioner of administration.
2. The corporation may provide child day care at the Missouri
rehabilitation center. The child day care center established by the
corporation shall be licensed under the provisions of sections 210.201 to
210.245, RSMo. The operation of the day care center shall be paid for by
fees or charges, established by the corporation, and collected from those
who use its services. The corporation may receive any private donations
or grants from agencies of the federal government intended for the
support of the child day care center.
*3. This section shall terminate thirty days following the date notice is
provided to the revisor of statutes that an agreement has been executed
which transfers the Missouri rehabilitation center from the department of
health and senior services to the board of curators of the University of
Missouri. (L. 1984 H.B. 1131 § 14, A.L. 1985 S.B. 19, A.L. 1996 S.B. 540)
Effective 7-1-96
*Contingent expiration date thirty days after the transfer of the
Missouri rehabilitation center to the University of Missouri. Termination
on 3-27-97. The Revisor of Statutes received notice on 2-25-97.
1. The division shall promulgate rules under the provisions of
this section and chapter 536, RSMo, as necessary to prescribe policies or
standards which affect charging and funding of residential care
rehabilitation programs and specialized services for persons with head
injuries available to the public. The rules applicable to each facility,
program or service operated or funded by the division shall be available
for public inspection and review at such facility, program or service.
These rules shall not apply to facilities, programs or services operated
or provided by curators of the University of Missouri.
2. The rules, operating regulations and facility policies shall be
compatible with and appropriate to the facility or program mission,
population served, size, type of service and other reasonable
classifications. 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. 1991
H.B. 218 merged with S.B. 125 & 341, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3,
A.L. 1996 S.B. 540)
Effective 7-1-96
1. The division may receive federal grants and aids for injury
prevention and for persons with head injuries and head injury
rehabilitation under the terms of the grants and aids and administer or
pay them out subject to the provisions attached.
2. The director shall approve such applications for federal assistance
administered through the division as may be considered advisable after
consultation with the Missouri head injury advisory council. (L. 1991
H.B. 218 merged with S.B. 125 & 341)
Effective 8-28-91 (H.B. 218) 7-1-92 (S.B. 125 & 341)
1. Information and records compiled, obtained, prepared or
maintained by the rehabilitation facilities, residential facility or
specialized program operated or funded by the department or otherwise in
the course of providing services to patients shall be confidential.
2. The facilities or programs shall disclose information and records to
the following upon their request:
(1) The parent of a minor patient;
(2) The guardian or other person having legal custody of the patient;
(3) The attorney of a patient who is a ward of the juvenile court, an
alleged incompetent, an incompetent ward or a person detained under
chapter 632, RSMo, as evidenced by court orders of the attorney's
appointment;
(4) An attorney or personal physician as authorized by the patient.
3. The facilities or services may disclose information and records under
any of the following:
(1) As authorized by the patient;
(2) To persons or agencies responsible for providing health care services
to such patients;
(3) To the extent necessary for a recipient to make a claim or for a
claim to be made on behalf of a recipient for aid or insurance;
(4) To qualified personnel for the purpose of conducting scientific
research, management audits, financial audits, program evaluations or
similar studies; provided, that such personnel shall not identify,
directly or indirectly, any individual patient in any report of such
research, audit or evaluation, or otherwise disclose patient identities
in any manner;
(5) To the courts as necessary for the administration of the provisions
of sections 199.001 to 199.055;
(6) To law enforcement officers or public health officers, but only to
the extent necessary to carry out the responsibilities of their office,
and all such law enforcement and public health officers shall be
obligated to keep such information confidential;
(7) Pursuant to an order of a court or administrative agency of competent
jurisdiction;
(8) To the department of social services as necessary to report or have
investigated abuse, neglect, or rights violations of patients.
4. The facility or program shall document the dates, nature, purposes and
recipients of any records disclosed under this section.
5. Nothing contained in this section shall limit the rights of discovery
in judicial or administrative procedures as otherwise provided for by
statute or rule. (L. 1991 H.B. 218 merged with S.B. 125 & 341)
Effective 8-28-91 (H.B. 218) 7-1-92 (S.B. 125 & 341)
The director of the division shall promulgate reasonable rules
relative to the implementation of patient rights described in sections
199.001 to 199.055. These rules shall not apply to facilities, programs
or services operated or provided by the curators of the University of
Missouri. (L. 1991 H.B. 218 merged with S.B. 125 & 341, A.L. 1996 S.B.
540)
Effective 7-1-96
The director of the division shall promulgate rules setting
forth a reasonable standard means test which shall be applied to all
facilities, programs and services operated or funded by the division in
determining the amount to be charged to persons receiving services.
Notwithstanding other provisions of sections 199.001 to 199.055, the
department shall accept funds from federal reimbursement, third-party
reimbursement, private pay or other funding sources. (L. 1991 H.B. 218
merged with S.B. 125 & 341)
Effective 8-28-91 (H.B. 218) 7-1-92 (S.B. 125 & 341)
1. Any probate division of the circuit court having knowledge of
the existence of an estate of a patient receiving services from
residential facilities or other programs operated or funded by the
division shall promptly notify the director of the nature and extent of
the estate and the identity of the attorney of record and conservator.
The director shall then apply the standard means test contained in the
rules of the division to determine if the estate shall be charged for
services rendered by the division.
2. If the director determines that the estate should be charged for the
evaluation, care, treatment, rehabilitation or room and board provided or
funded by the division, and notifies the conservator, the conservator
shall pay the charges. If the conservator fails to pay for the charges,
after reasonable delay, the head of the division, residential facility or
day program may discharge the patient.
3. The decision of the director shall be final, and appeal may be made to
the circuit court of Cole County or the county where the person
responsible for payment resides in the manner provided by chapter 536,
RSMo. The director shall notify the conservator and the supervising court
of such failure to pay for services rendered by a facility or program
operated or funded by the division at least thirty days before the
patient is discharged. If the conservator appeals the decision of the
director, the patient shall remain in the facility or program pending
final disposition of the appeal. (L. 1991 H.B. 218 merged with S.B. 125 &
341)
Effective 8-28-91 (H.B. 218) 7-1-92 (S.B. 125 & 341)
In accordance with state and federal law, no residential
facility, day program or specialized service operated or funded by the
division shall deny admission or other services to any person because of
his race, sex, creed, marital status, national origin, handicap or age.
(L. 1991 H.B. 218 merged with S.B. 125 & 341)
Effective 8-28-91 (H.B. 218) 7-1-92 (S.B. 125 & 341)
The division may inspect any facility or program at any time if
a contract has been issued or an application for a contract has been
filed. (L. 1991 H.B. 218 merged with S.B. 125 & 341)
Effective 8-28-91 (H.B. 218) 7-1-92 (S.B. 125 & 341)
The following terms, as used in sections 199.170 to 199.270,
mean:
(1) "Active tuberculosis", tuberculosis disease that is demonstrated to
be contagious by clinical, bacteriological, or radiological evidence.
Tuberculosis is considered active until cured;
(2) "Cure" or "treatment to cure", the completion of a recommended course
of therapy as defined in subdivision (5) of this section and as
determined by the attending physician;
(3) "Local board", any legally constituted local city or county board of
health or health center board of trustees or the director of health of
the city of Kansas City, the director of the Springfield-Greene County
health department, the director of health of St. Louis County or the
commissioner of health of the City of St. Louis, or in the absence of
such board, the county commission or the county board of tuberculosis
hospital commissioners of any county;
(4) "Potential transmitter", any person who has the diagnosis of
pulmonary tuberculosis but has not begun a recommended course of therapy,
or who has the diagnosis of pulmonary tuberculosis and has started a
recommended course of therapy but has not completed the therapy. This
status applies to any individual with tuberculosis, regardless of his or
her current bacteriologic status;
(5) "Recommended course of therapy", a regimen of antituberculosis
chemotherapy in accordance with medical standards of the American
Thoracic Society and the Centers for Disease Control and Prevention. (L.
1961 p. 518 § 1, A.L. 1986 H.B. 1554 Revision, A.L. 1990 H.B. 1739 merged
with S.B. 742, A.L. 1999 H.B. 721 merged with S.B. 261, A.L. 2001 S.B.
266)
1. A person found to have tuberculosis shall follow the
instructions of the local board, shall obtain the required treatment, and
shall minimize the risk of infecting others with tuberculosis.
2. When a person with active tuberculosis, or a person who is a potential
transmitter, violates the rules, regulations, instructions, or orders
promulgated by the department of health and senior services or the local
board, and is thereby conducting himself or herself so as to expose other
persons to danger of infection, after having been directed by the local
board to comply with such rules, regulations, instructions, or orders,
the local board may institute proceedings by petition for commitment,
returnable to the circuit court of the county in which such person
resides, or if the person be a nonresident or has no fixed place of
abode, then in the county in which the person is found. Strictness of
pleading shall not be required and a general allegation that the public
health requires commitment of the person named therein shall be
sufficient.
3. If the board determines that a person with active tuberculosis, or a
person who is a potential transmitter, poses an immediate threat by
conducting himself or herself so as to expose other persons to an
immediate danger of infection, the board may file an ex parte petition
for emergency temporary commitment pursuant to subsection 5 of section
199.200. (L. 1961 p. 518 § 2, A.L. 1990 H.B. 1739 merged with S.B. 742,
A.L. 1999 H.B. 721 merged with S.B. 261, A.L. 2001 S.B. 266)
No potential transmitter who in his home or other place obeys
the rules and regulations of the department of health and senior services
for the control of tuberculosis or who voluntarily accepts care in a
tuberculosis institution, sanatorium, hospital, his home, or other place
and obeys the rules and regulations of the department of health and
senior services for the control of contagious tuberculosis shall be
committed under the provisions of sections 199.170 to 199.270. (L. 1961
p. 518 § 8, A.L. 1990 H.B. 1739 merged with S.B. 742)
1. Upon filing of the petition, the court shall set the matter
down for a hearing either during term time or in vacation, which time
shall be not less than five days nor more than fifteen days subsequent to
filing. A copy of the petition together with summons stating the time and
place of hearing shall be served upon the person three days or more prior
to the time set for the hearing. Any X-ray picture and report of any
written report relating to sputum examinations certified by the
department of health and senior services or local board shall be
admissible in evidence without the necessity of the personal testimony of
the person or persons making the examination and report.
2. The prosecuting attorney or the city attorney shall act as legal
counsel for their respective local boards in this proceeding and such
authority is hereby granted. The court shall appoint legal counsel for
the individual named in the petition if requested to do so if such
individual is unable to employ counsel.
3. All court costs incurred in proceedings under sections 199.170 to
199.270, including examinations required by order of the court but
excluding examinations procured by the person named in the petition,
shall be borne by the county in which the proceedings are brought.
4. Summons shall be served by the sheriff of the county in which
proceedings under sections 199.170 to 199.270 are initiated and return
thereof shall be made as in other civil cases.
5. Upon the filing of an ex parte petition for emergency temporary
commitment pursuant to subsection 3 of section 199.180, the court shall
hear the matter within ninety-six hours of such filing. The local board
shall have the authority to detain the individual named in the petition
pending the court's ruling on the ex parte petition for emergency
temporary commitment. If the petition is granted, the individual named in
the petition shall be confined in a facility designated by the curators
of the University of Missouri in accordance with section 199.230 until a
full hearing pursuant to subsections 1 to 4 of this section is held. (L.
1961 p. 518 § 3, A.L. 2001 S.B. 266)
1. Upon the hearing set in the order, the individual named in
the order shall have a right to be represented by counsel, to confront
and cross-examine witnesses against him, and to have compulsory process
for the securing of witnesses and evidence in his own behalf. The court
may in its discretion call and examine witnesses and secure the
production of evidence in addition to that adduced by the parties; such
additional witnesses being subject to cross-examination by either or both
parties.
2. Upon a consideration of the petition and evidence, if the court finds
that the person named in the petition is a potential transmitter and
conducts himself so as to be a danger to the public health, an order
shall be issued committing the individual named in the petition to a
facility designated by the curators of the University of Missouri and
directing the sheriff to take him into custody and deliver him to the
facility. If the court does not so find, the petition shall be dismissed.
The cost of transporting the person to the facility designated by the
curators of the University of Missouri shall be paid out of general
county funds. (L. 1961 p. 518 § 4, A.L. 1971 H.B. 581, A.L. 1985 S.B. 19,
A.L. 1990 H.B. 1739 merged with S.B. 742, A.L. 1996 S.B. 540)
Effective 7-1-96
The order shall be subject to review at the instance of either
party, as in other civil cases. (L. 1961 p. 518 § 5)
Upon commitment, the patient shall be confined in a facility
designated by the curators of the University of Missouri until such time
as the director of the facility determines that the patient no longer has
active tuberculosis or that the patient's discharge will not endanger
public health. (L. 1961 p. 518 § 6, A.L. 1971 H.B. 581, A.L. 1985 S.B.
19, A.L. 1996 S.B. 540, A.L. 1999 H.B. 721 merged with S.B. 261)
No person committed to a facility designated by the curators of
the University of Missouri under sections 199.170 to 199.270 shall be
required to submit to medical or surgical treatment without his consent,
or, if incapacitated, without the consent of his legal guardian, or, if a
minor, without the consent of a parent or next of kin. (L. 1961 p. 518 §
9, A.L. 1971 H.B. 581, A.L. 1983 S.B. 44 & 45, A.L. 1985 S.B. 19, A.L.
1996 S.B. 540)
Effective 7-1-96
1. The department of health and senior services may, by
agreement with the curators of the University of Missouri, contract for
such facilities at the Missouri rehabilitation center as are necessary to
carry out the functions of the tuberculosis testing laboratory and may
employ personnel as are necessary for the operation of such laboratory.
2. The expenses incurred in the operation of the tuberculosis testing
laboratory at the rehabilitation center or elsewhere shall be paid from
state or federal or other funds appropriated for the maintenance and
operation of the tuberculosis testing laboratory. (L. 1961 p. 518 §§ 10,
11, A.L. 1971 H.B. 581, A.L. 1985 S.B. 19, A.L. 1991 H.B. 218 merged with
S.B. 125 & 341, A.L. 1996 S.B. 540)
Effective 7-1-96
Any person committed under the provisions of sections 199.170 to
199.270 who leaves the facility designated by the curators of the
University of Missouri without having been discharged by the director of
the facility or other officer in charge or by order of court shall be
taken into custody and returned thereto by the sheriff of any county
where such person may be found, upon an affidavit being filed with the
sheriff by the director of the facility, or duly authorized officer in
charge thereof, to which the person had been committed. (L. 1961 p. 518 §
12, A.L. 1971 H.B. 581, A.L. 1985 S.B. 19, A.L. 1996 S.B. 540)
Effective 7-1-96
Any time after commitment, the patient or any friend or relative
having reason to believe that such patient no longer has contagious
tuberculosis or that his discharge will not endanger public health, may
institute proceedings by petition, in the circuit court of the county
wherein the confinement exists, whereupon the court shall set the matter
down for a hearing before him within fifteen days requiring the person or
persons to whose care the patient was committed to show cause on a day
certain why the patient should not be released. The court shall also
require that the patient be allowed the right to be examined prior to the
hearing by a licensed physician of his own choice, if so desired, and at
his own personal expense. Thereafter all proceedings shall be conducted
the same as on the proceedings for commitment with the right of appeal by
either party as herein provided; provided, however, such petition for
discharge shall not be brought or renewed oftener than once every six
months. (L. 1961 p. 518 § 7)
The department shall have the authority to promulgate rules and
regulations which require the preadmission testing for tuberculosis of
all residents in nursing homes in the state and the annual testing of all
health care workers and volunteers in nursing homes in the state, and
residents and staff of state correctional centers. The department shall
annually issue screening guidelines on other groups determined by the
department to be at high risk for tuberculosis. (L. 1992 S.B. 511 & 556 §
2)
*Transferred 1994; formerly 198.041
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