Frequently Asked Questions

What is a Good Cause Waiver (GCW)?
What background screening findings disqualify an individual from employment in section 660.317, RSMo?
What background screening findings are not eligible to be waived?
As an employer, can I hire an individual who has a disqualifying finding (identified in section 660.317, RSMo.) reported in his or her background screening while awaiting the results of the GCW application?
Who do I contact to determine whether an employee may work conditionally? 
What information is required to apply for a GCW?
What information is taken into consideration during the review of the GCW application?
How will I be notified regarding the outcome of a GCW?
If a GCW application is denied, can I reapply?
As an employer, how do I verify that a GCW has been granted or is still valid?

What is a Good Cause Waiver (GCW)?
Section 660.317, RSMo, requires regulated health care employers, such as long-term care facilities, hospitals, home health agencies, in-home services providers and consumer directed services programs under contract with the Department of Health and Senior Services, hospices, and adult day care providers to obtain a background screening prior to hiring an employee. For in-home services providers, consumer directed services providers and home health agencies, this includes checking the Family Care Safety Registry (FCSR) (Sections 210.900 - 210.936, RSMo.) This statute states that an individual with a certain type of finding identified in his or her background screening cannot be hired by these employers. However, in certain circumstances, the individual has the right to apply for a GCW that, if granted, would waive the legal hiring restriction and allow him or her to be employed..

What background screening findings disqualify an individual from employment in section 660.317, RSMo?
The answer to this question depends upon the type of employer and the type of background screening finding identified:

• An individual who has committed a specific type of felony conviction (crimes against persons) is disqualified from employment in a regulated nursing home, hospital or hospice.
• An individual who is identified on the Employee Disqualification List maintained by the Department of Health and Senior Services is disqualified from employment in a regulated nursing home, hospital, home health agency, hospice, adult day care or by an in-home services provider under contract with the Department of Health and Senior Services or as an attendant through the consumer directed services program.
• An individual who has a finding reported by the FCSR cannot be employed by a regulated home health agency or in-home service provider under contract with the Department of Health and Senior Services or as a consumer directed services program attendant. Findings reported by the FCSR include substantiated child abuse or neglect, open criminal record, sex offender registry, placement on the Department of Health and Senior Services Employee Disqualification List, placement on the Department of Mental Health’s Employee Disqualification Registry, or denial/revocation/suspension of a foster parent license or child care provider license.

What background screening findings are not eligible to be waived?
Individuals who are currently on the Employee Disqualification List (EDL) maintained by the Department of Health and Senior Services are not eligible for a GCW.

As an employer, can I hire an individual who has a disqualifying finding (identified in section 660.317, RSMo.) reported in his or her background screening while awaiting the results of the GCW application?
Employers are responsible for ultimately making their own hiring/firing decisions. Licensed home health agencies and in-home service contractors may choose to retain an employee hired prior to August 28, 2003 (the effective date of SB 556) who has a disqualifying finding as long as the individual has made an application for a GCW. Any individual newly hired on or after August 28, 2003 may be employed on a conditional basis, following submission of a completed waiver application, to provide in-home services or home health services to clients or patients while they await the results of the waiver process if:

• The applicant has never been convicted of, pled guilty to or nolo contendere in this state or any other state and has never been found guilty of a crime which if committed in Missouri would be a class A or B felony violation of chapter 565, RSMo (Offenses Against the Person); chapter 566, RSMo (Sexual Offenses), or chapter 569, RSMo (Robbery, Arson, Burglary and Related Offenses), or any violation of subsection 3 of section 198.070, RSMo (required reporter that knowingly fails to report abuse or neglect of a resident of a residential care, intermediate care or skilled nursing facility) or section 568.020, RSMo (Incest); and
• The applicant is not listed on the Department of Health and Senior Services Employee Disqualification List established pursuant to section 660.315, RSMo.

If a GCW is denied to an applicant employed on or after August 28, 2003, on a conditional basis, the conditional employment shall immediately terminate.
NOTE: Conditional employment is not an option for disqualified individuals who want to work for a hospital, long-term care facility, adult day care or hospice, or who provide consumer directed services.

Who do I contact to determine whether an employee may work conditionally?
Employers must follow the rules and regulations issued to them by the agency that licenses or regulates them. Questions about conditional employment can be directed to the Department of Health and Senior Services licensing or quality assurance program staff assigned to work with the provider:

• Long Term Care and Adult Day Care: Please contact your regional staff or 573-526-8532 or 573-526-8524.
  Click here to proceed to the Long Term Care / Adult Day Care website.
• Hospitals: Please call 573-751-6303.
  Click here to proceed to the Health Services Regulation website.
• Home Health & Hospice: Please call 573-751-6336.
  Click here to proceed to the Home Health and Hospice website.
• In-Home Services: Please refer to Provider Memo (PM) 09-07, 10-06, and 10-15 or contact the Bureau of Program Integrity at 573-526-8557.
  Click here to proceed to the In-Home Services website.
• Consumer Directed Services: Please refer to Vendor Memo (VM) 09-08, 10-04, and 10-12 or contact the Bureau of Program Integrity at 573-526-8557. Click here to proceed to the Consumer Directed Services website.

What information is required to apply for a GCW?
A completed Application for Good Cause Waiver AND:

• A complete Explanation of Background Screening Finding form for EACH arrest/investigation that resulted in the disqualifying offense or incident. Include what happened, how it happened, why it happened, when and where it happened, any person present at the time, and the circumstances from your point of view. Include why you feel your Good Cause Waiver should be approved.
• One sponsorship letter from a current or potential employer, training agency or school. If you are not able to obtain a sponsor, submit as a substitute, three (3) character references from persons knowledgeable of your character and employment history. The reference letters cannot be from someone related to or residing with you, and should state how long the person has known you. Sponsorship or reference letters should indicate why the writer feels you should be recommended for a GCW.
• Attach your employment history since the age of 18, including time period worked for each employer.

Include (if applicable):

• If the disqualifying finding is substantiated child abuse/neglect and/or foster parent denial/revocation/suspension, attach the investigation report from the Department of Social Services (DSS). This report is approximately 10 pages long and is available to you upon telephone or written request from your local DSS office.
• If you have ever been refused a license, certificate, or registration by any public or governmental licensing board, agency or regulatory authority, explain the incident that led to the disciplinary action.
• If you have any pending felony or misdemeanor charges, include a statement explaining the circumstances and certified copies of the charging documents for all pending criminal charges.
• Explain any pending charges or reports of child abuse, neglect or endangerment.
• Explain any pending actions that might result in the denial, revocation, or involuntary suspension of a foster parent license.
• Explain any pending actions that might lead to your inclusion on the Department of Mental Health Employee Disqualification List.
• Any documentation that, in your opinion, supports your application for a GCW by demonstrating rehabilitation, positive lifestyle change, etc.

What information is taken into consideration during the review of the GCW application?
A professional panel will review the information submitted and will base a decision on:

• The applicant’s age at the time the crime was committed or at the time the incident occurred that resulted in the applicant being listed on one or more of the background databases check by the FCSR;
• The circumstances surrounding the crime or the incident;
• The length of time since the conviction or since the occurrence of the incident;
• The length of time since the applicant completed his or her sentence for the disqualifying conviction(s), whether or not the applicant was confined, conditionally released, on parole or probation;
• The applicant’s entire criminal history and history of all incidents that resulted in the applicant being listed on one or more of the background databases checked by the FCSR, including whether that history shows a repetitive pattern of offenses or incidents;
• The applicant’s prior work history;
• Whether the applicant had been employed in good standing by a provider but subsequently became ineligible for employment due to the hiring restrictions in section 660.317, RSMo;
• Whether the applicant has been convicted or found guilty of, or pled guilty or nolo contendere to any offense displaying extreme brutality or disregard for human welfare or safety;
• Whether the applicant has omitted a material fact or misrepresented a material fact pertaining to his or her criminal or employment history or to his or her history of incidents that resulted in his or her being listed on one or more of the background databases checked by the FCSR;
• Whether the applicant has ever been listed on the Employee Disqualification List maintained by the department as provided in section 660.315, RSMo;
• Whether the applicant’s criminal offenses were committed, or other disqualifying incidents occurred, during the time he or she was acting as a provider or as an employee for a provider;
• Whether the applicant has, while disqualified from employment by a provider, obtained employment by fraud, deceit, deception or misrepresentation, including misrepresentation of his or her identity;
• Whether the applicant has ever had a professional or occupational license, certification, or registration revoked, suspended, or otherwise disciplined;
• Any other information relevant to the applicant’s employment background or past actions indicating whether he or she would pose a risk to the health, safety or welfare of residents, patients or clients; and
• Whether the applicant has supplied all information requested by the department.
• If, at the time of an application for a waiver, or during the waiver consideration process, the applicant has been charged or indicted for, but not convicted of, any of the crimes covered under the provisions of section 660.317, RSMo, the department will hold the request for waiver in abeyance while such charges are pending or until a court of competent jurisdiction enters a judgment or order disposing of the matter.

How will I be notified regarding the outcome of a GCW?
Complete applications for GCW will be reviewed by a panel of health professionals. Applicants will be notified by mail regarding the decision. To check on the status of an application, please go to: Search Registrant.

If a GCW application is denied, can I reapply?
Yes, you may reapply one year from the date of the denial.

As an employer, how do I verify that a GCW has been granted or is still valid?
If an individual being considered for employment reveals the existence of a GCW or reveals the existence of an otherwise disqualifying finding, it is the employer’s responsibility to verify whether a GCW was granted and if the waiver is still valid. An Employer may verify the status by:

• Calling the FCSR toll-free access line at 1-866-422-6872 and ask to have a GCW verified. The employer will need to provide the individuals full name and social security number in order to obtain verification of the waiver.
• Emailing the FCSR at fcsr@health.mo.gov.
• The status of an application may also be checked at: Has An Application Been Submitted?