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Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 40 - Division of Maternal, Child and Family Health › Chapter 9 - Universal Newborn Hearing Screening Program › Section 19 CSR 40-9.020 - Screening Methodologies and Procedures

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the screening
				  methodologies and procedures that a facility, audiologist, and/or other person
				  that performs hearing screenings outside of a facility must use to operate a
				  newborn hearing screening program and/or perform diagnostic audiological
				  assessments.
(1) Each
				facility shall designate a person responsible for carrying out the newborn
				hearing screening program at their facility, referred to as the program
				manager.
(2) By February 1, 2002,
				each facility shall notify the department, electronically or in writing, of the
				name, business address and telephone number of the program manager. Changes to
				the facility's program manager and/or changes in the business contact
				information shall be reported to the department within thirty (30) calendar
				days.
(3) Each facility operating a
				newborn hearing screening program shall establish written policies and
				procedures. These policies and procedures shall include, but are not limited
				to:
(A) The type of newborn hearing screening
				program (one or two stage) to be operated;
(B) The type of Food and Drug Administration
				(FDA)-approved hearing screening equipment being used, and screening methods,
				including the facility location(s) where the screenings will be
				completed;
(C) Specific duties for
				all persons participating in the newborn hearing screening program, including
				minimum training/experience requirements for persons performing the
				screenings;
(D) A written plan for
				initial training for all persons participating in the newborn hearing screening
				program;
(E) A method of evaluating
				and documenting the competency of each newborn hearing screener's performance
				upon completion of the initial training and at least annually
				thereafter;
(F) A plan for ensuring
				accuracy of newborn hearing screening results. The plan shall address the
				importance of attaining and maintaining acceptable referral rates;
(G) A plan to notify the parent(s) and
				primary care provider of the hearing screening results;
(H) Designation of facility personnel
				responsible for reporting newborn hearing screening results to the
				department;
(I) Distribution of the
				prescreening pamphlet to all families of newborns;
(J) Distribution of the audiologist resource
				guide;
(K) A method of referral for
				newborns who "missed" the birth admission hearing screening, or require
				rescreening and/or diagnostic audiological assessment; and
(L) Documentation of screenings refused by
				the family.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 40 - Division of Maternal, Child and Family Health › Chapter 9 - Universal Newborn Hearing Screening Program › Section 19 CSR 40-9.040 - Information to be Reported to the Department of Health

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE
:
This rule establishes the
				  information management, reporting and tracking system used by facilities,
				  primary care providers, and audiologists to report newborn hearing screening
				  data to the department. Timely reporting is necessary to assure the provision
				  of early diagnostic and intervention services.
(1) Each facility, physician, or primary care
				provider shall report all newborn hearing screening results, including missed
				screenings, via either the department's web-based reporting system or manually
				on the department's newborn hearing reporting form. This newborn hearing
				reporting form shall be developed and made available by the department. The
				results shall be reported to the department within seven (7) calendar days of
				completion of the hearing screening.
(2) Each facility, or person designated to
				perform repeat hearing screenings, shall report information for tracking
				newborns who receive "refer" results or missed the birth admission hearing
				screening. The information shall be reported to the department via either the
				web-based reporting system or manually on the department's newborn hearing
				tracking form, within seven (7) calendar days of completion of the hearing
				screening.
(3) The facility or
				person designated to perform the missed hearing screening, the rescreening,
				and/or the diagnostic audiological assessment, shall notify the department if
				the scheduled appointment was not kept. This information shall be reported to
				the department via either the department's web-based reporting system or
				manually on the department's newborn hearing tracking form, within seven (7)
				calendar days of the date of discharge or scheduled appointment date.
(4) The audiologist shall report all
				diagnostic audiological assessment results to the department, via either the
				web-based reporting system or manually on the department's newborn hearing
				tracking form, within seven (7) calendar days of completion of the
				assessment.
(5) Each facility or
				primary care provider shall provide to the department, upon request,
				information from the newborn's medical record relevant to the newborn's hearing
				status.
(6) Each facility,
				physician, primary care provider, or audiologist shall document all parental
				refusals for newborn hearing screening, and report the refusal to the
				department via either the web-based reporting system or manually on the
				department's newborn hearing screening tracking form within seven (7) calendar
				days of refusal.
*Original authority: 191.937, RSMo
					 1999.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 40 - Division of Maternal, Child and Family Health › Chapter 10 - Forensic Examinations for Sexual Assault › Section 19 CSR 40-10.010

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 191.225, RSMo 1980, amended 1989,
					 2007.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 40 - Division of Maternal, Child and Family Health › Chapter 12 - Critical Congenital Heart Disease › Section 19 CSR 40-12.010 - Critical Congenital Heart Disease Screening for Newborns

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule defines the terms used and
				  establishes the screening guidelines and information reporting required to
				  assure the provision of critical congenital heart disease screening
				  (CCHD).
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. This material as incorporated by reference in this rule shall be
				  maintained by the agency at its headquarters and shall be made available to the
				  public for inspection and copying at no more than the actual cost of
				  reproduction. This note applies only to the reference material. The entire text
				  of the rule is printed here.
(1) Definitions for purposes of this rule-
(A) "Facility" is an ambulatory surgical
				center, birthing center, or hospital that is responsible under section
				191.334,
				RSMo, for performing a Critical Congenital Heart Disease (CCHD) screening prior
				to the discharge of a newborn; and
(B) "Individual" is the person responsible
				for performing the CCHD screening under section
				191.334,
				RSMo, when the delivery of a newborn takes place outside a facility.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 45 - Division of Nutritional Health and Services › Chapter 5 - Food and Nutrition Programs › Section 19 CSR 45-5.010 - Special Supplemental Food Program for Women, Infants and Children (WIC)

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the requirements for
				  agencies participating in the Special Supplemental Food Program for Women,
				  Infants and Children.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. Therefore, the material which is so incorporated is on file with
				  the agency who filed this rule, and with the Office of the Secretary of State.
				  Any interested person may view this material at either agency's headquarters or
				  the same will be made available at the Office of the Secretary of State at a
				  cost not to exceed actual cost of copy reproduction. The entire text of the
				  rule is printed here. This note refers only to the incorporated by reference
				  material.
(1) Each Women,
				Infants and Children (WIC) program shall provide supplemental food, nutrition
				education and health care referral to eligible pregnant, breastfeeding and
				postpartum women, eligible infants and children up to five (5) years of age.
				Eligibility shall be based on inadequacy of income using the guidelines in
				19 CSR
				40-1.040(2) and assessed nutritional
				risk.
(2) Each WIC program shall
				follow the requirements of
				7 CFR
				246.1 -
				246.28 in
				administering the program.
*Original authority: 192.005.2, RSMo
					 1985.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 45 - Division of Nutritional Health and Services › Chapter 5 - Food and Nutrition Programs › Section 19 CSR 45-5.020 - State Funding for Extended Hours of the Special Supplemental Food Program for Women, Infants and Children (WIC) Clinics

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the procedures to be
				  used by the Department of Health to award grants to local health units for
				  extending clinic hours.
(1)
				The following definitions shall be used in the interpretation and enforcement
				of this rule:
(A) County health unit means
				any entity approved by Department of Health to provide Women, Infants and
				Children (WIC) services in a given service area;
(B) County poverty level means the economic
				level of a county as determined by use of the most recent United States census
				and the poverty income guidelines of
				19 CSR
				40-1.040(2).
(C) Participation means the sum of the number
				of pregnant and postpartum women, infants and children up to five (5) years of
				age who have received WIC supplemental food vouchers and the number of
				exclusively breastfed infants in the program during the reporting
				period.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 45 - Division of Nutritional Health and Services › Chapter 5 - Food and Nutrition Programs › Section 19 CSR 45-5.050 - Child and Adult Care Food Program (CACFP)

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the requirements for
				  agencies participating in the Child and Adult Care Food Program. Through this
				  program nutritious food service is provided to children and adult participants
				  in nonresidential institutions that provide care.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. Therefore, the material which is so incorporated is on file with
				  the agency who filed this rule, and with the Office of the Secretary of State.
				  Any interested person may view this material at either agency's headquarters or
				  the same will be made available at the Office of the Secretary of State at a
				  cost not to exceed actual cost of copy reproduction. The entire text of the
				  rule is printed here. This note refers only to the incorporated by reference
				  material.
(1) Sponsoring
				organizations of day care homes can request all, part, or no administrative
				advance payment when they submit an annual application for participation in the
				Child and Adult Care Food Program (CACFP).
(2) Section 708(f) of
				Public Law
				104-193, the Personal Responsibility and Work
				Opportunity Reconciliation Act of 1996 (PRWORA) states that it is beyond the
				authority of the United States Department of Agriculture (USDA) to require
				state agencies to continue to make advances to CACFP institutions, including
				administrative advances to sponsoring organizations of day care homes. Instead,
				state agencies are now given the option to issue advances. This rule outlines
				criteria that will be used by the Missouri Department of Health (MDOH) to issue
				administrative advances for sponsoring organizations of day care
				homes.
(3) The MDOH will review and
				approve advance payments for those sponsoring organizations that can
				demonstrate good program performance which includes, but is not limited to,
				financial accountability and meal quality with emphasis on proper fund
				management.
(A) If approved, the advance
				payment will be issued as specified in
				7 CFR
				226.6(b)(10), which is
				hereby incorporated by reference and made a part of this rule.
(B) If the request for advance payment is
				denied, the sponsoring organization will be provided with a written explanation
				and will be given an opportunity to appeal as specified in
				7 CFR
				226.6(k), which is hereby
				incorporated by reference and made a part of this rule.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 45 - Division of Nutritional Health and Services › Chapter 5 - Food and Nutrition Programs › Section 19 CSR 45-5.060 - Summer Food Service Program (SFSP) for Children

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the requirements for
				  agencies participating in the Summer Food Service Program. Through this program
				  nutritious food service is provided to children from needy areas during periods
				  when area schools are closed for the summer months and at other approved
				  times.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. Therefore, the material which is so incorporated is on file with
				  the agency who filed this rule, and with the Office of the Secretary of State.
				  Any interested person may view this material at either agency's headquarters or
				  the same will be made available at the Office of the Secretary of State at a
				  cost not to exceed actual cost of copy reproduction. The entire text of the
				  rule is printed here. This note refers only to the incorporated by reference
				  material.
(1) Each Summer
				Food Service Program (SFSP) shall follow the requirements of
				7 CFR
				225.1 -
				225.20
				for administering the program.
(2)
				Service institutions, as defined in section
				191.810,
				RSMo, that want to participate in the SFSP shall apply to the Department of
				Health. Applications received will be processed in accordance with the
				standards in
				7 CFR
				225.6.
(3) School food authorities in needy areas,
				as defined in section
				191.810,
				RSMo, who do not wish to sponsor the SFSP and are in areas where no other
				service institution is offering the SFSP, shall apply for a waiver as required
				in
				5 CSR
				30-680.070.
*Original authority: 191.810, RSMo
					 1992.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 50 - Division of Injury Prevention, Head Injury Rehabilitation and Local Health Services › Chapter 3 - Legal Expense Fund Coverage › Section 19 CSR 50-3.010

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 105.711 , RSMo 1983, amended 1987,
					 1989, 1990, 1993.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 50 - Division of Injury Prevention, Head Injury Rehabilitation and Local Health Services › Chapter 3 - Legal Expense Fund Coverage › Section 19 CSR 50-3.020

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 105.711 , RSMo 1983, amended 1987,
					 1989, 1990, 1993.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 50 - Division of Injury Prevention, Head Injury Rehabilitation and Local Health Services › Chapter 3 - Legal Expense Fund Coverage › Section 19 CSR 50-3.040 - Voluntary Health Services

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule explains how health care providers
				  and sponsoring organizations may register with the department for liability
				  coverage under the Voluntary Health Services Act. This rule also explains the
				  procedure for the department to revoke a registration.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. This material as incorporated by reference in this rule shall be
				  maintained by the agency at its headquarters and shall be made available to the
				  public for inspection and copying at no more than the actual cost of
				  reproduction. This note applies only to the reference materials. The entire
				  text of the rule is printed here.
(1) Definitions. The following definitions
				shall be used in the interpretation and enforcement of this rule:
(A) Department refers to the Department of
				Health and Senior Services;
(B)
				Health care provider or provider refers to any physician, surgeon, dentist,
				nurse, optometrist, mental health professional licensed under Chapter 337,
				RSMo, veterinarian, or other practitioner of a health care discipline, the
				professional practice of which requires licensure or certification under
				Missouri law or under comparable law of another state, territory, district, or
				possession of the United States;
(C) Sponsoring organization refers to any
				organization that organizes or arranges for the voluntary provision of health
				care services and registers with the department as a sponsoring organization in
				accordance with this rule and section
				191.1106, RSMo; and
(D) Voluntary provision of health care
				services refers to the providing of professional health care services by a
				health care provider without charge to a recipient of the services or a third
				party. The provision of such health care services shall be the provider's
				professional practice area in which the provider is licensed or
				certified.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 50 - Division of Injury Prevention, Head Injury Rehabilitation and Local Health Services › Chapter 10 - Missouri Rehabilitation Center › Section 19 CSR 50-10.010

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 192.005, RSMo
					 1985.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 50 - Division of Injury Prevention, Head Injury Rehabilitation and Local Health Services › Chapter 10 - Missouri Rehabilitation Center › Section 19 CSR 50-10.020

Current through Register Vol. 49, No. 14, July 15, 2024
*Original authority: 192.005, RSMo 1985.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 50 - Division of Injury Prevention, Head Injury Rehabilitation and Local Health Services › Chapter 10 - Missouri Rehabilitation Center › Form - MISSOURI REHABILITATION CENTER ACKNOWLEDGMENT OF MRC POLICY PATIENT/CLIENT SELF-DETERMINATION

Current through Register Vol. 49, No. 14, July 15, 2024
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Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 50 - Division of Injury Prevention, Head Injury Rehabilitation and Local Health Services › Chapter 20 - Head Injury Program › Section 19 CSR 50-20.010 - Service Providers

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the eligibility
				  requirements and responsibilities of head injury service
				  providers.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. Therefore, the material which is so incorporated is on file with
				  the agency who filed this rule, and with the Office of the Secretary of State.
				  Any interested person may view this material at either agency's headquarters or
				  the same will be made available at the Office of the Secretary of State at a
				  cost not to exceed actual cost of copy reproduction. The entire text of the
				  rule is printed here. This note refers only to the incorporated by reference
				  material.
(1) Any person,
				organization or agency wishing to provide services shall apply to the Office of
				Head Injury Services (OHIS). Interested individuals or facilities shall meet
				eligibility criteria outlined in the Provider Manual published by the Missouri
				Department of Health, Head Injury Program, June 1993. OHIS shall notify
				providers of application approval or disapproval and shall make contractual
				agreements with facilities approved to provide services.
(2) Approved providers shall agree to accept
				the amounts established by OHIS as payments in full.
(A) If a provider receives payment from any
				source other than the OHIS which is equal to or exceeds the amount of the
				program fee schedule for the authorized services rendered, the provider shall
				not accept any additional amount from either the client or the program. Claims
				shall be submitted to any third-party payer (see
				19
				CSR 40-1.010(22) ) before submitting
				a claim to the OHIS.
(B) Approved
				providers shall submit bills on forms prescribed by the OHIS and within the
				billing time limits stated in the Provider Manual. Unless the provider receives
				a waiver of the time limit from the program administrator or designee, failure
				to comply with the time limits may result in denial of the claim.
(C) The OHIS shall reimburse for services
				only if a prior written authorization request has been approved. That request
				completed by the provider shall include a plan of care and assurance that the
				client/family participated in the plan and agree.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.010 - State Health Planning and Development Agency (SHPDA)

Current through Register Vol. 49, No. 14, July 15, 2024
(Rescinded January 12, 1990)
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.011 - Certificate of Need (CN) Definitions

Current through Register Vol. 49, No. 14, July 15, 2024
(Rescinded November 30, 1994)
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.030 - Review of Health Projects Under SSA-1122 Program

Current through Register Vol. 49, No. 14, July 15, 2024
(Rescinded January 12, 1990)
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.040 - Definitions Relating to Certificate of Need

Current through Register Vol. 49, No. 14, July 15, 2024
(Rescinded January 12, 1990)
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.051 - Information on MHFRC Meetings

Current through Register Vol. 49, No. 14, July 15, 2024
(Rescinded November 30, 1994)
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.100 - Public Hearings, Reconsideration Hearings

Current through Register Vol. 49, No. 14, July 15, 2024
(Rescinded January 12, 1990)
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.150 - Criteria and Written Findings for Review of Certificate of Need Applications

Current through Register Vol. 49, No. 14, July 15, 2024
(Rescinded January 12, 1990)
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.200 - Purpose and Structure

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule describes the purpose of the
				  Certificate of Need (CON) statute and the structure of the Missouri Health
				  Facilities Review Committee.
(1) The Certificate of Need (CON) statute,
				sections 197.300-197.366, RSMo, became effective September 28, 1979, except
				those sections which were not effective until October 1, 1980 or later. CON had
				its origin in the federal Public Law 93-641, 1974, and was initially intended
				to address issues of need, cost, and distribution of health services, as well
				as other factors which impact the health of the population.
(2) The purpose of the CON statute is to
				achieve the highest level of health for Missourians through cost containment,
				reasonable access, and public accountability. The goals are to-
(A) Review proposed health care
				services;
(B) Contain health
				costs;
(C) Promote economic
				value;
(D) Evaluate competing
				interests;
(E) Prevent unnecessary
				duplication; and
(F) Disseminate
				health-related information to affected parties.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.300 - Retail Licensees

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee is amending this rule to
				  define the terms "Affiliate" and "Request to relicense," remove verbiage
				  requiring replacement equipment to submit a full CON application and related
				  organizations, add clarity for non-applicability 10/10% rule and service area
				  requirements, and includes a CON form within the rule rather than incorporating
				  it by reference.
(1)
				Affiliate means an organization:
(A) That owns
				five percent (5%) or more of the ownership interests in the operator;
				or
(B) In which the operator owns
				five percent (5%) or more of the ownership interests. Affiliates include,
				without limitation, a parent organization, joint venture, partner, or general
				partner.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.400 - Letter of Intent Process

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee is amending this rule to
				  restructure wording for LTC bed expansion and replacement application
				  requirements, change the word patient to resident, and to include certain CON
				  forms within the rule rather than incorporating them by
				  reference.
(1) Applicants
				shall submit by mail, fax, or email a Letter of Intent (LOI) to begin the
				Certificate of Need (CON) review process so that it is received at the CON
				office at least thirty (30) days prior to the submission of the CON application
				and will remain valid in accordance with the following time frames:
(A) For full reviews, expedited equipment
				replacements, expedited long-term care (LTC) renovation or modernization
				reviews, and expedited LTC facility replacement reviews, an LOI is valid for
				six (6) months; and
(B) For
				expedited LTC bed expansion reviews in accordance with section 197.318.4, RSMo,
				an LOI is valid for twenty-four (24) months.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.410 - Letter of Intent Package

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee is amending this rule to
				  remove verbiage related to a statute that is no longer effective and to include
				  certain CON forms within the rule rather than incorporating them by
				  reference.
(1) The Letter of
				Intent (LOI) (Form MO 580-1860), included herein, shall be completed as
				follows:
(A) Project Information: sufficient
				information to identify the intended service, such as the name of the existing
				or proposed facility, whichever is applicable, and address or if address is
				unknown or not yet established, a specific description or the latitude and
				longitude identifying a specific site rather than a general area (county
				designation alone is not sufficient);
(B) Applicant Identification: the full legal
				name of all owner(s) and operator(s) which compose the applicant who, singly or
				jointly, propose to develop, offer, lease, or operate a new institutional
				health service within Missouri; provide the corporate entity, not individual
				names, of the corporate board of directors or the facility
				administrator;
(C) Type of Review:
				the applicant shall indicate if the review is for a full review, expedited
				review, or a non-applicability review;
(D) Project Description: information which
				provides details of the number and type of beds to be added, deleted, or
				replaced, square footage of new construction and/or renovation, services
				affected, and equipment to be acquired. If an application for new or additional
				long-term care beds, confirm that the bed need standard has been met or that
				special exceptions exist. If a replacement project, information which provides
				details of the facilities or equipment to be replaced, including name,
				location, distance from the current site, and its final disposition. If
				replacing equipment previously approved, provide the CON project number of
				existing equipment;
(E) Estimated
				Project Cost: total proposed expenditures necessary to achieve the
				application's objectives-not required for long-term care (LTC) bed expansions
				pursuant to section 197.318.4(1), RSMo;
(F) Authorized Contact Person Identification:
				the full name, title, address (including association), telephone number, email,
				fax number, signature, and date of signature;
(G) Applicability: page 2 of the LOI must be
				filled out by applicants requesting a non-applicability review to provide the
				reason and rationale for the non-applicability review request; and
(H) Special Exceptions: if the LOI indicates
				that special exceptions apply, applicant shall attach a separate sheet with a
				complete explanation of all reasons for such special
				exceptions.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.420 - Review Process

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee is amending this rule to add a
				  time frame for CON application submissions and remove verbiage regarding
				  expedited applications and location change from the LOI submission to the CON
				  application filing.
(1) The
				Certificate of Need (CON) filing deadlines are as follows:
(A) For full applications, at least
				seventy-one (71) days but not more than one hundred (100) days prior to each
				Missouri Health Facilities Review Committee (committee) meeting;
(B) For expedited applications, the tenth day
				of each month, or the next business day thereafter if that day is a holiday or
				weekend;
(C) For non-applicability
				reviews, the Letter of Intent (LOI) filing may occur at any
				time.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.430 - Application Package

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee is amending this rule to add
				  equipment application requirements, require MO SOS business registration
				  documentation, require long-term care project affiliate and Medicare and/or
				  Medicaid certification information, update DHSS bureau name information,
				  decrease population estimate percentages, update form reference and add public
				  notice requirements.
(1) A
				Certificate of Need (CON) application package shall be accompanied by an
				application fee which shall be a nonrefundable minimum amount of one thousand
				dollars ($1,000) or one-tenth of one percent (0.1%), which may be rounded up to
				the nearest dollar, of the total project cost, whichever is greater, made
				payable to the "Missouri Health Facilities Review Committee."
(2) A written application package consisting
				of an electronic file in PDF format or a paper original shall be prepared and
				organized as follows:
(A) The CON Applicant's
				Completeness Checklists and Table of Contents shall be used as follows:
1. Include at the front of the
				application;
2. Check the
				appropriate "done" boxes to assure completeness of the application;
3. Number all pages of the application
				sequentially and indicate the page numbers in the appropriate blanks;
4. Check the appropriate "N/A" box if an item
				in the Review Criteria is "not applicable" to the proposal type; and
5. Restate the Review Criteria (preferably in
				bold type) and answer all Review Criteria items.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.440 - Criteria and Standards for Equipment and New Hospitals

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee is amending this rule to
				  remove need methodologies for new major medical units, add three (3) full years
				  of utilization data for new/additional units, add robotic surgery utilization
				  requirements, and add three (3) full years of data for new hospital
				  projects.
(1) For new units
				or services in the service area, use the following:
(A) Provide the minimum annual utilization for each of
				the other providers in the service area for the most recent three (3) full
				years, if applicable. The provider(s) should achieve at least the following
				community need rates as follows by the final year:
1. Magnetic resonance imaging procedures:
				2,000
2. Positron emission
				tomography/computed tomography procedures: 1,000
3. Lithotripsy treatments: 1,000
4. Linear accelerator treatments:
				3,500
5. Cardiac catheterization
				procedures (include coronary angioplasties): 500
6. Gamma knife treatments: 200
7. Computed tomography: 3,500
8. Robotic surgery system: 240
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.450 - Criteria and Standards for Long-Term Care

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee is amending this rule to
				  remove verbiage related to a demonstration project that is no longer effective,
				  word updates, and to include a CON form within the rule rather than
				  incorporating it by reference.
(1) The following population-based long-term
				care bed need methodology for the fifteen- (15-) mile radius shall be used to
				determine the need:
(A) Approval of additional
				intermediate care facility/skilled nursing facility (ICF/SNF) beds will be
				based on:
1. A service area need determined
				to be fifty-three (53) beds per one thousand (1,000) year 2025 population age
				sixty-five (65) and older minus the current supply of ICF/SNF beds shown in the
				most recent Six-Quarter Occupancy of Hospital and Nursing Home Licensed and
				Available Beds report as provided by the Certificate of Need Program (CONP)
				which includes licensed and Certificate of Need (CON)-approved beds;
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.460 - Criteria and Standards for Evolving Technology

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule outlines the criteria and
				  standards against which a project involving new technology would be evaluated
				  in a Certificate of Need (CON) review.
(1) For evolving technology not currently
				available in the state or not in general usage in the state, the following
				shall be documented:
(A) The medical effects
				shall be described and documented in published scientific literature;
(B) The degree to which the objectives of the
				technology have been met in practice;
(C) Any side effects, contraindications or
				environmental exposures;
(D) The
				relationships, if any, to existing preventive, diagnostic, therapeutic or
				management technologies and the effects on the existing technologies;
(E) Food and Drug Administration
				approval;
(F) The need methodology
				used by this proposal in order to assess efficacy and cost impact of the
				proposal; and
(G) Explain the
				degree of partnership, if any, with other institutions for the joint use of and
				financing of the evolving technology.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.470 - Criteria and Standards for Financial Feasibility

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee is amending this rule to
				  include certain CON forms within the rule rather than incorporating them by
				  reference.
(1) Proposals for
				any new hospital, skilled nursing facility, intermediate care facility,
				residential care facility, or assisted living facility construction must
				include documentation that the proposed costs per square foot are reasonable
				when compared to the latest RS Means Cost Data Percentile Limit Total New
				Construction Project Costs (Form MO 580-1866), included herein, available from
				the Certificate of Need Program (CONP). Any proposal with costs in excess of
				the three-fourths (3/4) percentile must include justification for the higher
				costs.
(2) Document that sufficient
				financing will be available to assure completion of the project by providing a
				letter from a financial institution saying it is willing to finance the
				project, or an auditor's statement that unrestricted funds are available for
				the project.
(3) Document financial
				feasibility by including-
(A) The
				Service-Specific Revenues and Expenses (Form MO 5801865), included herein, as a
				financial pro forma for each revenue generating service affected by the project
				for the past three (3) full years projected through three (3) full years beyond
				project completion; and
(B) For
				existing services, a copy of the latest available audited financial statements
				or the most recent Internal Revenue Service (IRS) 990 Form or similar IRS
				filing for facilities not having individual audited financial
				statements.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.500 - Additional Information

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee is amending this rule to
				  provide submission deadlines of information by affected
				  parties.
(1) Additional
				information requested by the Missouri Health Facilities Review Committee
				(committee) shall be submitted within the time frame specified by the
				committee.
(2) If an application is
				determined to be incomplete, the applicant shall be notified within fifteen
				(15) calendar days after filing a full application or within five (5) working
				days after filing of an expedited application. The applicant's written response
				shall be received within ten (10) calendar days after receipt of
				notification.
(3) Support, neutral,
				and opposing information submitted by affected persons shall be received at the
				committee's principal office three (3) business days before the scheduled
				meeting of the committee.
(4) Copies
				of any additional information sent directly to the committee by applicants or
				affected persons shall also be sent to the Certificate of Need Program (CONP)
				for file copies.
(5) When a request
				in writing or email is filed by any affected person within thirty (30) calendar
				days from the date of publication of the Application Review Schedule, the
				committee or CONP staff shall hold a public hearing on any application under
				the following conditions:
(A) The hearing may
				be conducted in the city of the proposed project if monetarily
				feasible;
(B) The CONP staff will
				present the introductions and orientation for the public hearing;
(C) The applicant may have up to fifteen (15)
				minutes for a presentation at the public hearing;
(D) Any person may present written testimony
				and up to five (5) minutes of verbal testimony at the public hearing;
				and
(E) The testimony shall become
				a part of the record of the review.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.600 - Certificate of Need Decisions

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee proposes to amend this rule to
				  reduce the timeframe a committee member can submit their expedited CON
				  ballot.
(1) Decisions on full
				Certificate of Need (CON) applications and contested expedited applications
				shall be subject to the following:
(A)
				Parliamentary procedures for all face-to-face, video graphic, telephonic, and
				computerized meetings shall follow
Robert's Rules of Order,
incorporated by reference, newly revised edition, 10th edition, published
				October 2000, Perseus Publishing, 11 Cambridge Center, Cambridge, MA 02142.
				This rule does not include any later amendments or additions;
(B) The CON Program's analysis becomes the
				findings of fact for the Missouri Health Facilities Review Committee
				(committee) decision except to the extent that it is expressly rejected,
				amended, or replaced by the committee in which case the minutes of the
				committee will contain the changes and become the amended findings of fact of
				the committee. The committee's final vote becomes conclusion of law;
				and
(C) A final decision is
				rendered on any application after each committee member present is given the
				opportunity to vote and the chair announces the passage or defeat of the motion
				on the floor. The chair or acting chair shall vote only in case of a
				tie.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 60 - Missouri Health Facilities Review Committee › Chapter 50 - Certificate of Need Program › Section 19 CSR 60-50.900 - Administration

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The committee proposes to amend the title of
				  the CONP director. The term "director" is assigned to the leader of a
				  division.
(1) The role of the
				Missouri Health Facilities Review Committee (committee) includes the following:
(A) Make specific decisions about
				applications, applicability and administrative matters;
(B) Make policy decisions to include the
				development of rules; and
(C)
				Oversee operations of the Certificate of Need Program (CONP) staff.
Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 70 - Division of Chronic Disease Prevention and Health Promotion › Chapter 21 - Cancer › Section 19 CSR 70-21.010 - Reporting of Cancer Cases

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes a method of mandatory
				  reporting of all cancer cases of inpatients and outpatients in order to conduct
				  cancer incidence surveillance and epidemiologic studies and to facilitate
				  development, implementation and evaluation of cancer prevention and control
				  measures in Missouri as required by sections
				  192.650,
				  196.653,
				  192.655
				  and 192.657, RSMo Supp. 1999.
PUBLISHER'S NOTE: The publication of the full text of
				  the material that the adopting agency has incorporated by reference in this
				  rule would be unduly cumbersome or expensive. Therefore, the full text of that
				  material will be made available to any interested person at both the Office of
				  the Secretary of State and the office of the adopting agency, pursuant to
				  section 536.031.4, RSMo. Such material will be provided at the cost established
				  by state law.
(1) The
				following are definitions of terminology used throughout this rule.
(A) Cancer-those malignant neoplasms included
				in the list of cancers with a fifth digit of two or three listed under the
				heading, "Morphology of Neoplasms," contained in the current editions of
				"International Classification of Diseases" (ICD) or "International
				Classification of Diseases for Oncology" (ICD-O) published by the World Health
				Organization.
(B) Department-the
				Missouri Department of Health.
(C)
				Non-melanomatous skin cancers- cutaneous, malignant basal and squamous cell
				neoplasms as defined in the current edition of the
Missouri Cancer
				Registry Abstract Code Manual
, which is incorporated by reference in
				this rule.
(D) State registry-a
				centralized cancer reporting system maintained by the Missouri Department of
				Health for the collection, storage, analysis and interpretation of data on
				cancer patients.
(E) Reporting
				entity-hospital, pathology laboratory, ambulatory surgical center, freestanding
				cancer clinic and treatment center, physician office, skilled nursing facility,
				intermediate care facility or residential care facility I or II.
(F) Case-A primary incidence of cancer. A
				patient may have more than one primary incidence of cancer.