Missouri Revised Statutes
Chapter 192
Department of Health and Senior Services
←192.968
Section 192.2000.1
192.2005→
August 28, 2015
Division of aging created--duties--inspectors of nursing homes, training and continuing education requirements--promulgation of rules, procedure--dementia-specific training requirements established.
192.2000. 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 department shall aid and assist the
elderly and low-income disabled adults living in the state of Missouri to
secure and maintain maximum economic and personal independence and dignity.
The department 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 department 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. Section 3001, et seq.),
as amended;
(2) Assure that an information and referral system is developed and
operated for the elderly, including information on home and community based
services;
(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) 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;
(6) Certify long-term care facilities for participation in the Title
XIX program;
(7) 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;
(8) Review plans of proposed long-term care facilities before they
are constructed to determine if they meet applicable state and federal
construction standards;
(9) Provide consultation to long-term care facilities in all areas
governed by state and federal regulations;
(10) 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;
(11) 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;
(12) 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;
(13) 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;
(14) 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;
(15) 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 home and community based services 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;
(16) Provide area agencies on aging with assistance in applying for
federal, state, and private grants and identifying new funding sources;
(17) Determine area agencies on aging annual allocations for Title XX
and Title III of the Older Americans Act expenditures;
(18) 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;
(19) Monitor the process pursuant to the federal Patient
Self-determination Act, 42 U.S.C. Section 1396a (w), in long-term care
facilities by which information is provided to patients concerning durable
powers of attorney and living wills.
3. The department 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 department
shall administer the services to clients previously performed by the area
agency on aging until a new area agency on aging is designated.
4. 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 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.
5. The department 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 and sections 192.2400 and 192.2475 to
192.2500. Any rule or portion of a rule, as that term is defined in
section 536.010, 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 and, if applicable, section 536.028.
This section and chapter 536 are nonseverable and if any of the powers
vested with the general assembly pursuant to chapter 536 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.
6. Home and community based services is a program, operated and
coordinated by the department of health and senior services, which informs
individuals of the variety of care options available to them when they may
need long-term care.
7. The division shall maintain 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 maintain 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. 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, A.L.
2014 H.B. 1299 Revision § 192.1000)
*Transferred 2014; formerly 660.050
*Revisor's note: The term "residential care facilities" may include
"assisted living facilities", see section 198.005 regarding
changes to name reference.
2001
Prior To: 2001-HB 603
2001 (Transferred now: 192.000.2000)
660.50. 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 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 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 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, 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 and, if applicable, section 536.028. This section and chapter 536 are
nonseverable and if any of the powers vested with the general assembly
pursuant to chapter 536 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.
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.
Prior To: 2001
660.050. 1. The "Division of Aging" is hereby created and
established as a division of the department of social services. 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 under 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 under
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 social 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 social 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 a clearinghouse for information related to the needs
and interests of elderly persons, including information on the Missouri
care options program;
(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 social services, shall be the chief administrative
officer of the division and shall exercise for the division the powers and
duties of an appointing authority under 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 social 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 social 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
social 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 sections 198.070 and
198.090, RSMo, and sections 660.050, 660.250 and 660.300 to 660.320. No
rule or portion of a rule promulgated under the authority of this chapter
and sections 198.070 and 198.090, RSMo, shall become effective unless it
has been promulgated pursuant to the provisions of section 536.024, RSMo.
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.
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