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 20-70.010
Community-Based Faculty Preceptor Tax Credit
This proposed rule provides an income tax credit for qualified community-based faculty preceptors for physicians and physician assistants. This rule explains how community-based faculty preceptors may qualify for the Department of Health and Senior Services’ Preceptor Tax Credit and how qualifying individuals may claim the credit. Public Fiscal Note N/A Volume 48, Number 14 June 8, 2023
19 CSR 30-20.125
Unlicensed Assistive Personnel Training Program
This proposed and emergency amendment reclassifies a component of unlicensed assistive personnel (UAP ) Program curriculum content, amends an obsolete rule reference, exempts hospitals from complying with certain UAP training requirements if its employees can prove completion of patient care technician training programs or can submit proof of certification as a patient care technician, extends certain UAP training completion deadline from ninety (90) days to one hundred-eighty (180) days, and requires quality and safety curriculum to be covered within ninety (90) days of employment. N/A N/A Volume 48, Number 13 May 22, 2023
19 CSR 73-2.025
Licensure by Reciprocity
Current regulations allow nursing home administrators licensed in other states to seek licensure within Missouri by reciprocity by submitting an application. This proposed rule amendment requires applicants to be 18 years of age or older (reduced from 21 years of age), be Health Services Executive (HSE) qualified by the National Association of Long Term Care Administrator Boards (NAB) (or obtained a passing score on the national examination) and be in good standing for at least one year under a current administrator license issued by another jurisdiction. The amendment makes other technical changes. N/A N/A Volume 48, Number 11 April 25, 2023
19 CSR 73-2.080
Temporary Emergency Licenses
This proposed rule amendment modifies the current rule regarding temporary emergency licensesfor nursing home administrators to comply with section 344.030.4, RSMo. The proposed ruleamendment removes the temporary emergency license (TEL) extension, modifies the number ofdays to grant a TEL, lowers the minimal age that a TEL may be granted to an individual, andimplements various clean-up language. N/A Temporary Emergency License Application Volume 48, Number 11 April 25, 2023
19 CSR 10-10.110
Amending or Correcting Vital Records
This proposed rule amendment changes and/or updates procedural requirements for documenting amendments made to vital records and clarifies supporting document requirements for correcting and/or amending vital records. N/A N/A Volume 48, Number 8 March 15, 2023

19 CSR 30-105.010
Definitions

This proposed rule sets forth definitions to be used in the regulations governing the regulations of  supplemental health care services agencies.

N/A

N/A Volume 48, Number 6 February 8, 2023

19 CSR 30-105.020
Registration Fees

This proposed rule establishes the registration fees supplemental health care services agencies will have to pay in order to be registered by the Department.

Private Fiscal Note

N/A Volume 48, Number 6 February 8, 2023

19 CSR 30-105.030
Procedures and Requirements for Registration of a Supplemental Health Care Services Agency

This proposed rule requires entities operating as supplemental health care services agencies in Missouri to be registered with the department. The proposed rule sets forth the procedure in which such agencies must register (submission of application, payment of fees, etc.).

Public Fiscal Note

Private Fiscal Note

Application Form Volume 48, Number 6 February 8, 2023

19 CSR 30-105.040
Requirements for Changes to a Registered Agency

This proposed rule outlines requirements for changes (change of address, name, ownership, etc.) to an issued registration of a Supplemental Health Care Services Agency in Missouri. Public Fiscal Note Change Form Volume 48, Number 6 February 8, 2023

19 CSR 30-105.050
Inspections

This proposed rule outlines inspections, complaints, and requirements of a Supplemental Health Care Services Agency. Public Fiscal Note N/A Volume 48, Number 6 February 8, 2023

19 CSR 30-105.060
Denial, Suspension, or Revocation of Registration

This proposed rule specifies the process of denial or revocation of a registration of a Supplemental Health Care Services Agency in Missouri. N/A N/A Volume 48, Number 6 February 8, 2023

19 CSR 30-105.070
Quarterly Rate and Charge Reporting Requirements

This proposed rule specifies the quarterly rate and charge reporting requirements of a Supplemental Health Care Services Agency in Missouri. Public Fiscal Note N/A Volume 48, Number 6 February 8, 2023

19 CSR 15-7.021
In-Home Service Standards

This proposed amendment sets forth standards to be met by any agency which contracts with the Missouri Department of Social Services, Missouri Medicaid Audit and Compliance Unit for the provision of in-home services authorized by the Missouri Department of Health and Senior Services, Division of Senior and Disability Services. N/A N/A Volume 48, Number 6 February 7, 2023

19 CSR 15-7.010
General Requirements for All Service Providers

This proposed amendment amends the purpose statement; updates terms, statutory and regulatory references, and modifies the fire, health and safety inspection requirements for providers participating in the Home and Community Based Services program. N/A N/A Volume 48, Number 6 February 7, 2023

19 CSR 15-7.005
Definitions

This proposed amendment updates definitional terms used in the chapter governing Home and Community Based Services. The proposed amendment adds new terms, deletes others, and modifies the definitions of other terms currently used in the chapter. N/A N/A Volume 48, Number 6 February 7, 2023

19 CSR 100-1.190
Microbusinesses

Emergency Rule

This proposed and emergency rule establishes standards and regulations applicable to marijuana microbusiness facilities for purposes of licensing by the Department of Health and Senior Services. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.180
Dispensary Facilities

Emergency Rule

This proposed and emergency rule establishes standards applicable to marijuana dispensary facilities for purposes of licensing by the Department of Health and Senior Services. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.170
Manufacturing Facilities

Emergency Rule

This proposed and emergency rule establishes the manufacturing facility licensee’s authority to engage in the process of manufacturing marijuana-infused products. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.160
Cultivation Facilities

Emergency Rule

This proposed and emergency rule establishes regulations governing cultivation facilities authority to engage in the process of cultivating marijuana. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.150
Marijuana Waste Disposal

Emergency Rule

This proposed and emergency rule establishes standards in which licensed and certified facilities must follow when disposing excess or unusable marijuana waste, unwanted marijuana product, or other waste from a facility. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.140
Transportation and Storage

Emergency Rule

This proposed and emergency rule establishes standards applicable to medical and marijuana facility licensees that transport and store marijuana product. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.130
Inventory Control and Seed-to-Sale Tracking

Emergency Rule

This proposed and emergency rule requires facility licensees to implement inventory control systems and processes established by the rule. The rule also establishes procedures applicable to the certification and operation of seed-to-sale tracking systems.

Public Fiscal Note

Public Fiscal Note Emergency

Private Fiscal Note

Private Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.120
Packaging, Labeling, and Product Design

Emergency Rule

This proposed and emergency rule establishes the packaging, labeling, and product design standards applicable to medical and marijuana facility licensees.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.110
Testing

Emergency Rule

This proposed and emergency rule establishes testing standards applicable to marijuana products. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.100
Facilities Generally

Emergency Rule

This proposed and emergency rule establishes regulations regarding general operating requirements that are applicable to all licensed and certificated facilities.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.090
Facility Security

Emergency Rule

This proposed and emergency rule establishes regulations regarding the security requirements of licensed or certified medical and marijuana facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.080
Facility Employee Training

Emergency Rule

This proposed and emergency rule establishes regulations relating to the training that medical and marijuana facility licensees must provide to their employees. This rule is being promulgated due to the recent passage of Amendment 3. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.070
Facility Ownership and Employment

Emergency Rule

This proposed and emergency rule establishes regulations relating to the ownership of medical and marijuana facilities. The rule also establishes regulations pertaining to employees who work at such facilities.

Private Fiscal Note

Private Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.060
Facility Applications and Selection

Emergency Rule

This proposed and emergency rule explains how medical and marijuana facility licensing and certification applications, with the exception of seed-to-sale tracking system entity and research facility applications, are submitted and how the Department of Health of Senior Services selects licenses and certificates.

Private Fiscal Note

Private Fiscal Note Emergency

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.050
Physicians and Nurse Practitioners

Emergency Rule

This proposed and emergency rule establishes how the department will implement provisions of Article XIV, Section 1 (Amendment 3) related to physicians and nurse practitioners. The rule is patterned on the now rescinded 19 CSR 30-95.110, which pertains only to physicians. With the passage of Amendment 3, nurse practitioners are authorized to certify patients for medical use of marijuana. Additionally, the certification limits have changed, and there is no longer a need for an additional opinion in order to increase those limits. This proposed rule sets forth those additional constitutional allowances. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.040
Consumers, Qualifying Patients, and Primary Caregivers

Emergency Rule

This proposed and emergency rule establishes the process and procedures the department will use to implement provisions of Article XIV (Amendment 3) relating to consumers, qualifying patients, and primary caregivers use and dispensing of legalized marijuana.

Private Fiscal Note

Private Fiscal Note Emergency

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.030
Complaints, Inspections, and Investigations

Emergency Rule

This proposed and emergency rule implements the recently passed Amendment 3 and establishes the process for the Department to handle complaints, inspections, and investigations of licensed or certified facilities and identification card holders.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.010
Definitions

Emergency Rule

This proposed and emergency rule establishes definitions for the proposed rules that implement Missouri’s Amendment 3 that legalized marijuana for adult use.  The proposed rules and corresponding definitions are necessary to establish procedures for converting existing medical marijuana facility licenses to comprehensive licenses in order to serve both adult users and qualifying patients. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.020
Generally Applicable Provisions

Emergency Rule

This proposed and emergency rule applies to all individuals and entities regulated under Article XIV and explains what general provisions are necessary for the enforcement of the Article.  The proposed rules are necessary to establish procedures for converting existing medical marijuana facility licenses to comprehensive licenses in order to serve both adult users and qualifying patients.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.010
Definitions

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.010, a rule governing medical marijuana definitions. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.020
General Provisions

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.020, a rule governing medical marijuana application fees. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.025
Generally Applicable Provisions

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.025, a medical marijuana regulation, in response to the passage of Amendment 3 in November of 2022. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.028
Additional Licensing Procedures

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.028, a rule relating to medical marijuana licensing and certification procedures. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.030
Qualifying Patient/Primary Caregiver

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.030, a rule governing physician certifications to obtain medical marijuana. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.040
Medical Marijuana Facilities Generally

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.040, a rule that authorized the Department to regulate and control the operations of Cultivation, Infused Product Manufacturing, Dispensary, Testing, and Transportation facilities.  The rule also authorized the Department to grant, refuse, suspend, fine, restrict, or revoke the licenses and certifications for such facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.050
Cultivation Facility

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.050, a rule governing the regulation of medical marijuana cultivation facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.060
Infused Products Manufacturing Facility

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.060, a rule relating to the regulation of infused products manufacturing facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.070
Testing Facility

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.070, a rule governing the regulation of medical marijuana testing facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.080
Dispensary Facility

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.080, a rule governing the regulation of medical marijuana dispensary facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.090
Seed-to-Sale Tracking

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.090, a rule relating to seed-to-seed tracking. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.100
Transportation Facility

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.100, a rule relating to the regulation of medical marijuana transportation facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.110
Physicians

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.110, a rule governing the process for issuing medical marijuana physician certifications. N/A N/A Volume 48, Number 5 January 20, 2023
19 CSR 10-10.020
Vital Records Issuance
This proposed rule authorizes local registrars to issue certifications of birth and death records of events occurring in the state of Missouri.  The proposed rule changes which local registrars are authorized to issue certifications of birth and death records in Missouri and updates the requirements for issuances of certifications. N/A N/A Volume 48, Number 4 January 11, 2023
19 CSR 73-2.130
Notice of Change of Contact Information and Missouri Administrator Employment
This proposed amendment modifies the number of days (21 days to 10 calendar days) that a nursing home administrator must provide notification of personal contact information and administrator employment to the board and further clarifies the information that must be updated with the board. N/A N/A Volume 48, Number 1 November 29, 2022
19 CSR 30-40.792
Adult Trauma and Pediatric Field Triage and Transport Protocol
This proposed rule establishes protocols for transporting suspected trauma patients by severity and time of onset to the trauma centers where resources exist to provide appropriate care. Public Fiscal Note

Public Fiscal Note
N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.760
Standards for ST-Segment Elevation Myocardial Infarction (STEMI) Center Designation
This proposed and emergency rule makes several updates to this rule that were prompted by the passage of HB 2331 (2022). This rule facilitates the changes made in HB 2331 with amendatory language that prohibits DHSS from requiring providers at STEMI centers from being required to obtain continuing education for any more than what is required by national designating or verifying bodies of STEMI centers; prohibits DHSS from requiring certain physicians to obtain continuing education on STEMI for those who are emergency medicine board certified or board eligible through certain organizations; and modifies STEMI data entry requirements. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.750
ST-Segment Elevation Myocardial Infarction (STEMI) Center Designation Application and Review
This proposed and emergency amendment makes several updates to this rule that were prompted by the passage of House Bill 2331 (2022). This rule facilitates the changes made in HB 2331 with amendatory language that allows the department to conduct virtual reviews of STEMI centers; requires hospitals to provide the department with quality improvement documentation necessary for the department to conduct STEMI reviews; changes how hospitals report changes of their verification or certification status to the department and how these hospitals participate in local and regional emergency medical services systems. Private Fiscal Note Emergency Amendment

Private Fiscal Note Proposed Amendment

Public Fiscal Note Proposed Amendment

STEMI application proposed amendment

STEMI application emergency amendment
N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.740
Definitions and Abbreviations Relating to ST-Segment Elevation Myocardial Infarction (STEMI) Centers
This proposed and emergency amendment adds virtual reviews to the definitions for STEMI centers. This amendment was prompted by the passage of House Bill 2331 that passed during the 2022 legislative session. House Bill 2331 made changes to section 190.241, RSMo and allows the department to conduct virtual reviews rather than only on-site reviews of STEMI centers. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.730
Standards for Stroke Center Designation
This proposed and emergency amendment makes several updates to this rule to align itself with HB 2331 (2022). This rule prohibits the department from requiring providers at stroke centers from being required to obtain continuing education on stroke for any more than what is required by national designating bodies of stroke centers; prohibits the department from requiring physicians to obtain continuing education on stroke for physicians who are emergency medicine board certified or board eligible through certain organizations and who are practicing in emergency departments of stroke centers; and allows stroke centers to enter stroke data into a national databank. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.720
Stroke Center Designation Application and Review
This proposed and emergency amendment makes several updates to this rule to align itself with changes made to the statutes in HB 2331 (2022). The rule requires stroke centers to be reviewed by the department every three (3) years; allows the department to conduct virtual reviews; adds a requirement for hospitals to provide the department with quality improvement documentation necessary for the department to conduct stroke reviews; modifies how hospitals report changes of their verification or certification to the department and how these hospitals participate in local and regional emergency medical services systems. Private Fiscal Note Emergency Amendment

Private Fiscal Note Proposed Amendment

Public Fiscal Note Proposed Amendment

Emergency Amendment Application for Stroke Certified Hospital Designation

Stroke Application proposed amendment
N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.710
Definitions and Abbreviations Relating to Stroke Centers
This proposed and emergency amendment adds virtual reviews to the definitions for stroke centers to align itself with the new requirements passed in HB 2331 (2022). House Bill 2331 made changes to section 190.241, RSMo and allows the department to conduct virtual reviews rather than only on-site reviews of stroke centers. This amendment is necessary in order to make this rule consistent with the changes made in House Bill 2331 that became effective on August 28, 2022. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.430
Standards for Trauma Center Designation
This proposed and emergency amendment modifies the TCD designation standards to align itself with HB 2331 (2022). This rule prohibits the department from requiring providers at trauma centers from being required to obtain continuing education on trauma for any more than what is required by the national verification body of trauma centers. It also prohibits the department from requiring physicians to obtain continuing education on trauma for physicians who are emergency medicine board certified or board eligible through ABEM or AEBEM and who are practicing in the emergency department of a trauma center. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.420
Trauma Center Designation Requirements
This proposed and emergency amendment makes several updates to the TCD designation rule requirements to align with HB 2331(2022). HB 2331 requires trauma centers to be reviewed by the department every three (3) years and allows the department to conduct virtual reviews of stroke centers. It requires hospitals to provide the department with quality improvement documentation necessary for the department to conduct trauma reviews. The rule modifies how hospitals report changes of their verification or certification to the department and how these hospitals participate in local and regional emergency medical services systems. Private Fiscal Note Emergency Amendment

Private Fiscal Note Proposed Amendment

Public Fiscal Note Proposed Amendment

Emergency Rule Application for trauma verified Hospital Designation

Trauma Application proposed amendment
N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.410
Definitions and Abbreviations Relating to Trauma Centers
This proposed (and emergency amendment) amendment adds virtual reviews to the definitions for trauma centers. This amendment was prompted by the passage of House Bill 2331 during the 2022 legislative session. House Bill 2331 made changes to section 190.241, RSMo and allows the department to conduct virtual reviews rather than only on-site reviews of trauma centers. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 25-30.021
Type I Permit
This proposed rule (and emergency rule) establishes the qualifications, duties, and responsibilities of a Type I permittee and the standards for laboratories in which Type I permittees perform testing. The proposed and emergency rule adds an accrediting body to the list of accrediting bodies that a laboratory performing analysis of blood, saliva, or urine for the presence of drugs must hold. N/A N/A Volume 47, Number 23 November 1, 2022
19 CSR 10-15.010
Report of Induced Termination of Pregnancy
This rule states the provisions and certifications within the report required when abortions are performed in the state of Missouri N/A Melinda Laughlin, RN, BSN, Deputy Director, Division of Community and Public Health, PO Box 570, Jefferson City, MO 65102. Volume 47, Number 21 September 23, 2022
19 CSR 30-20.144
Standards and Guidelines for Essential Caregiver Program
This proposed and emergency rule establishes the standards and guidelines to implement the "Essential Caregiver Program Act" under §191.2290, RSMo. Under the proposed rule, every hospital within Missouri must develop an essential caregiver program that allows patients or their legal guardians or representatives to designate essential caregivers for in-person contact with patients. The standards and guidelines governing essential caregivers are only operational during a state of emergency declared pursuant to Chapter 44, relating to infectious, contagious, communicable, or dangerous diseases.

Emergency Rule Private and Public Fiscal Note

Proposed Rule Private and Public Fiscal Note

N/A Volume 47, Number 20 September 15, 2022
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 47, Number 20 September 13, 2022
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

Resources