The following are summaries and other information related to Proposed Rules that the Missouri Department of Health & Senior Services has submitted to the Secretary of State for Publication in the Missouri Register. These rules will not go into effect until the public has had an opportunity to submit written comments, and to attend a public hearing if one is scheduled.

Any person may offer comments on a Proposed Rule. The instructions for submitting comments, and the location and date of a hearing if one is scheduled, are located after the text of each rule. Note that the official text of a Proposed Rule is the version that appears in the Missouri Register, not the draft copy on this site. Refer to the official copy if you wish to submit comments.

We hope you find this site helpful and informative.

Section 536.175, RSMo, requires a five year rolling review by all departments of their existing rules. DHSS was required to begin their review no later than July 1, 2018, and to complete said review no later than June 30, 2019. As a result, the department reviewed 759 rules, received zero comments, and prepared the above report, which was timely filed with the Joint Committee on Administrative Rules.

 

Proposed Rule Summary Fiscal
Note(s)
Material Incorporated
by Reference
Link to
Missouri Register
Date Posted
19 CSR 30-1.015
Registration and Fees
This proposed amendment provides that registrants applying for a controlled substance registration must pay for their registration fees via a credit card. The proposed amendment eliminates paying for such registration fees by checks and money orders.

Private Fiscal Note - Registration and Fees

Public Fiscal Note - Registration and Fees

N/A Volume 47, Number 18 August 11, 2022
19 CSR 30-1.017
Registration Process
This proposed amendment eliminates the alternative application process that currently allows controlled substance registrants to apply for their registration by paper (filling out a paper application and mailing it). Registrants will be required to apply for their controlled substance registration through the online process.

Private Fiscal Note - Registration Process

Public Fiscal Note - Registration Process

N/A Volume 47, Number 18 August 11, 2022
19 CSR 30-100.010
Newborn Safety Incubators
This proposed amendment establishes standards and specifications regarding the installation, maintenance, and oversight of newborn safety incubators. The rule sets forth how newborn safety incubators must be installed, what safety features the devices must possess (e.g. alarm system, backup electrical supply, etc.), how the devices must be inspected, and requires facilities desiring to install such devices to be registered with the Department. Public Fiscal Note N/A Volume 47, Number 17 July 29, 2022
Emergency Rule
19 CSR 30-100.010
Newborn Safety Incubators
This emergency amendment establishes standards and specifications regarding the installation, maintenance, and oversight of newborn safety incubators. The rule sets forth how newborn safety incubators must be installed, what safety features the devices must possess (e.g. alarm system, backup electrical supply, etc.), how the devices must be inspected, and requires facilities desiring to install such devices to be registered with the Department. Public Fiscal Note N/A Volume 47, Number 17 July 29, 2022
19 CSR 60-50.800
Meeting Procedures
This proposed amendment is amending the current rule to include a form used in the CON process within the rule rather than incorporating it by reference – the Representative Registration (Form MO 580-1869). N/A N/A Volume 47, Number 15 June 30, 2022
19 CSR 60-50.700
Post-Decision Activity
This proposed amendment amends the procedure for filing Periodic Progress Reports after approval of Certificate of Need (CON) applications, CONs subject to forfeiture, and the procedure for requesting a cost overrun. The proposed amendment defines what is acceptable for aboveground construction, adds budget requirements for cost overrun requests, sets forth procedures to apply for project ownership changes, project operator changes, and project site changes. The proposed amendment also adds several forms used in the CON process rather than incorporating the forms by reference. N/A N/A Volume 47, Number 15 June 30, 2022
19 CSR 60-50.500
Additional Information
This proposed amendment amends the process for submitting additional information and for requesting a public hearing on Certificate of Need (CON) applications in the CON review process. Currently, the rule provides that information submitted by affected persons must be received by the committee’s principal office at least 5 calendar days before a scheduled meeting. The proposed amendment provides that supporting, neutral, and opposing information must be received within 3 business days before a scheduled committee meeting. N/A N/A Volume 47, Number 15 June 30, 2022
19 CSR 60-50.470
Criteria and Standards for Financial Feasibility
This proposed amendment is amending the current rule to include two forms used in the CON process within the rule rather than incorporating them by reference – the Service-Specific Revenues and Expenses form (Form MO 580-1865) and the RS Means Cost Data form (Form MO 580-1866). N/A N/A Volume 47, Number 15 June 30, 2022
19 CSR 60-50.450
Criteria and Standards for Long-Term Care
This proposed amendment modifies criteria and standards against which a project involving a long-term care facility would be evaluated in a Certificate of Need (CON) review. The proposed amendment removes language related to certain demonstration and pilot projects and changes the term “patient” to “resident”. The proposed amendment also sets forth a form used in the CON process – Form MO 580-2352 (Purchase Agreement). N/A N/A Volume 47, Number 15 June 30, 2022
19 CSR 60-50.440
Criteria and Standards for Equipment and New Hospitals
This proposed amendment modifies the criteria and standards against which a project involving a long-term care facility would be evaluated in a Certificate of Need (CON) review. The proposed amendment removes certain need methodologies for new major medical units, adds three full years of utilization data for new/additional units, adds robotic surgery utilization requirements, and adds three full years of occupancy data for the construction of new hospital projects. N/A N/A Volume 47, Number 15 June 30, 2022
19 CSR 60-50.430
Application Package
This proposed amendment modifies the requirements for Certificate of Need applications. The proposed amendment adds expedited equipment application requirements, requires Missouri Secretary of State business registration documentation, requires long-term care project affiliate and Medicare and/or Medicaid certification information, updates DHSS bureau name information, decreases population estimate percentages, and adds public notice requirements for affected facilities. The amendment also sets forth within the rule certain forms used in the CON process. N/A N/A Volume 47, Number 15 June 29, 2022
19 CSR 60-50.420
Review Process
This proposed amendment modifies the filing deadlines used in the certificate of need process. The proposed amendment provides that full applications must be filed at least 71 days but not more than 100 days prior to a Missouri Health Facilities Review Committee meeting. The proposed amendment also removes the term “location” from consideration whether a CON application substantially conforms with the letter of intent (LOI). N/A N/A Volume 47, Number 15 June 29, 2022
19 CSR 60-50.410
Letter of Intent Package
This proposed amendment deletes language contained in the current section 4 as it describes the process for seeking an exemption pursuant to a statute (§197.314) that was repealed by the legislature in 2010. The amendment also sets forth forms used in the CON process – specifically Form MO 580-1860 (Letter of Intent (LOI)) and Form MO 580-2375 (Proposed Expenditures). The remainder of the proposed amendment renumbers the sections contained in the proposed rule accordingly. N/A N/A Volume 47, Number 15 June 29, 2022
19 CSR 60-50.400
Letter of Intent Process
This amendment amends the rule to restructure the wording used for the LTC bed expansion and replacement application process. The proposed rule es an expedited CON application regardless of the amount of capital expenditure in certain LTC bed expansions and requires an expedited CON application for other bed expansions if the capital expenditure for the bed replacement exceeds $600,000. The proposed rule also replaces the term “patient” with “resident”. The amendment also sets forth forms used in the CON process - specifically Form MO 580-2351(LTC Facility Expansion Certification), Form MO 580-2352 (Purchase Agreement) and Form MO 580-1871 (Periodic Progress Report). N/A N/A Volume 47, Number 15 June 29, 2022
19 CSR 60-50.300
Definitions for the Certificate of Need Process
This proposed amendment defines the terms “Affiliate” and “Request to relicense” as used in the certificate of need process. The amendment also removes verbiage that requires applicants seeking the replacement of major medical equipment not previously approved by the committee to apply for a full review and removes the definition for the term “related organization”. The proposed amendment also clarifies the non-applicability 10/10% rule and service area requirements. The proposed amendment also sets forth Form MO 580-1863 (Proposed Project Budget). N/A N/A Volume 47, Number 15 June 29, 2022
19 CSR 15-4.010
Definition of Terms
This proposed amendment updates terms defined in 19 CSR 15-4. The proposed rule amendment defines the terms used by the Department and area agencies on aging in providing services to Missouri residents age sixty (60) or over and persons age eighteen (18) to fifty-nine (59) with disabilities. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.020
Administration of the Older Americans Act
This proposed amendment updates the name of the Department and Division and updates references to the area agencies on aging. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.040
State Plan
This proposed amendment updates the Division name and adds availability to review the state plan on aging online. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.050
Funding Formula and Fiscal Management
This proposed amendment details the Department’s fiscal management responsibilities under Title III of the Older Americans Act. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.060
State Long-Term Care Ombudsman Program
This proposed amendment updates the language describing how the Department operates the statewide long-term care ombudsman program. The amendment updates the statutory authority and program name. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.070
Designation of Area Agencies on Aging
This proposed amendment updates the language describing the process for designation of an area agency on aging, what types of agencies may be eligible, and criteria used by the Department for designation. The amendment updates references to state and federal legal authority and references to area agencies on aging. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.080
Withdrawal of Designation
This proposed amendment updates terminology and makes grammatical changes to the rule which delineates the circumstances under which the Division may withdraw designation of an area agency on aging, notify the assistant secretary of the action and provide for continuity of services. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.090
Appeal to the Assistant Secretary
This proposed amendment updates the terminology and statutory authority to the rule outlining the process/procedure for when an application for designation as a planning and service area has been denied and the denial has been upheld in a Division hearing. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.100
Area Agency Governing Body
This proposed amendment updates the legal authority, regulation references, and terminology used in 19 CSR 15-4.100. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.105
Area Agency Election Procedures for Governing Body Membership
This proposed amendment updates the legal authority, regulation references, and terminology used in 19 CSR 15-4.105. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.110 Area Agency Advisory Council This proposed amendment updates the legal authority and terminology used in 19 CSR 15-4.110. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.120 Affirmative Action/Equal Employment Opportunity/Preference in Hiring This proposed amendment updates the legal authority and terminology used in 19 CSR 15-4.120. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.130 Area Agency Staff This proposed amendment updates the legal authority and terminology used in 19 CSR 15-4.130. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.135 Area Agency Director This proposed amendment updates the legal authority and terminology used in 19 CSR 15-4.135. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.140 Area Agency Plan This proposed amendment makes grammatical changes and updates legal authority and terminology used in 19 CSR 15-4.140. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.150 Waivers This proposed amendment updates legal authority and terminology used in 19 CSR 15-4.150. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.160 Review, Submission and Approval of Area Agency Area Plans and Plan Amendments This proposed amendment updates legal authority and terminology used in 19 CSR 15-4.160. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.170 Area Agency Fiscal Management This proposed amendment makes grammatical changes and updates the legal authority used in 19 CSR 15-4.170. N/A https://health.mo.gov/seniors/state-plan-aging.php Volume 47, Number 5 January 25, 2022
19 CSR 15-4.175 Funding Acquisition or Construction of Multipurpose Senior Centers This proposed amendment updates the purpose, legal authority, terminology, procedures, and guidance language used in 19 CSR 15-4.175. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.180 Area Agency Advocacy Responsibility This proposed amendment updates the legal authority language and other terminology used in 19 CSR 15-4.180. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.190 Areas Agency Development of a Comprehensive and Coordinated Service Delivery System This proposed amendment updates the legal authority language and other terminology used in 19 CSR 15-4.190. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.200 Area Agency Subgrants or Contracts This proposed amendment updates the legal authority language and other terminology used in 19 CSR 15-4.200. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.210 Area Agency Grievance Procedures This proposed amendment updates the legal authority language and other terminology used in 19 CSR 15-4.210. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.220 Area Agency Technical Assistance, Monitoring and Evaluation Responsibilities This proposed amendment updates the legal authority language and other terminology used in 19 CSR 15-4.220. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.230 Multipurpose Senior Center The proposed rule amendment updates terminology, regulatory references, procedural requirements, and statutory authority used in 19 CSR 15-4.230. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.240 Nutrition Service Requirements The proposed rule amendment updates terminology and statutory authority and adds dietary guidelines to 19 CSR 15-4.240. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.245 (19 CSR 15-7.060) Nutrition Service Standards The proposed rule amendment updates terminology, regulatory references, procedural requirements, and statutory authority; and the rule is being moved from Chapter 7 to Chapter 4. N/A https://www.dietaryguidelines.gov/ Volume 47, Number 5 January 25, 2022
19 CSR 15-4.250 Area Agency USDA The proposed rule amendment updates the nutrition program name, terminology, and statutory authority used in 19 CSR 15-4.250. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.260 Outreach Services The proposed rule amendment updates the terminology and statutory authority used in 19 CSR 15-4.260. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.270 Legal Assistance The proposed rule amendment updates the terminology and statutory authority used in 19 CSR 15-4.270. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.280 Ombudsman Services The proposed rule amendment updates the terminology and statutory authority used in 19 CSR 15-4.280. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.290 Information and Assistance The proposed rule amendment updates terminology, regulation references, and statutory authority used in 19 CSR 15-4.290. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.295 (19 CSR 15-7.050) Information and Assistance Service Standards The proposed rule amendment updates terminology and statutory authority; and moves the rule from Chapter 7 to Chapter 4. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.300 Record Keeping and Confidentiality The proposed rule amendment updates terminology, Department’s name, and statutory authority references used in 19 CSR 15-4.300. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.410 (19 CSR 15-7.040) Transportation Service Standards The proposed rule amendment establishes the minimum standards to be met by a transportation service provider receiving state or federal funds for the operation of transportation services for older adults aged sixty and over and adults with disabilities aged eighteen through fifty-nine and applies to all transportation service delivery systems, both direct and indirect. These standards are transferred from 19 CSR 15-7.040. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-4.440 (19 CSR 15-6.025) Division Formal Hearings The proposed rule amendment updates the hearing procedure and statutory authority; and moves the rule from Chapter 6 to Chapter 4. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 15-6.020 (Recission) Division Mediation Procedures The proposed rule rescinds the division’s mediation procedures used to resolve disagreements regarding the award of subgrants or contracts between an area agencies and service providers. N/A N/A Volume 47, Number 5 January 25, 2022
19 CSR 20-20.020
(Proposed)

Reporting Infectious, Contagious, Communicable, or Dangerous Diseases
This proposed amendment requires health care professionals, health facilities, schools, and other institutional settings to report testing results for COVID-19, whether negative or positive, to be reported to the Department of Health and Senior Services. Private Fiscal Note N/A Volume 47, Number 13  
19 CSR 20-20.020
(Emergency)

Reporting Infectious, Contagious, Communicable, or Dangerous Diseases
This emergency amendment requires health care professionals, health facilities, schools, and other institutional settings to report testing results for COVID-19, whether negative or positive, to be reported to the Department of Health and Senior Services Private Fiscal Note N/A Volume 47, Number 13  

19 CSR 73-2.120

Duplicate License

This amendment removes the fee and the affidavit requirement.

N/A

N/A

Volume 47, Number 1

December 1, 2021

19 CSR 73-2.110

Display of License

This amendment includes the new licensure level of the residential care and assisted living administrator, pursuant to 19 CSR 73-2.022.

N/A

N/A

Volume 47, Number 1

December 1, 2021

19 CSR 73-2.085

Public Complaints

This amendment provides clean-up language by removing State.

N/A

N/A

Volume 47, Number 1

December 1, 2021

19 CSR 73-2.055

Renewal of Expired License

This amendment provides clean-up language and adding the licensure types, 19 CSR 73-.2022, 19 CSR 73-2.023, and 19 CSR 73-2.025.

N/A

N/A

Volume 47, Number 1

December 1, 2021

19 CSR 73-2.015

Fees

This amendment removes the Duplicate license fee.

N/A

N/A

Volume 47, Number 1

December 1, 2021

19 CSR 73-1.010

General Organization

This amendment includes the two other licensure levels outlined in 19 CSR 73-2.022 and 19 CSR 73-2.023, replaces executive secretary with board office, and clean-up language.

N/A

N/A

Volume 47, Number 1

December 1, 2021

19 CSR 30-1.002

Schedules of Controlled Substances

This proposed and emergency amendment updates the Schedules of Controlled Substances to be consistent with 21 CFR Part 1308.

N/A

N/A

Volume 46, Number 21

September 28, 2021

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