Section 192.2495, RSMo, requires regulated health care employers, such as long term care facilities, hospitals, home health agencies, hospices, adult day care providers, and in-home services providers and consumer directed services programs under contract with the Department of Health and Senior Services, to obtain background screenings prior to hiring an employee. In-home services providers, consumer directed services providers, and home health agencies are required to conduct background screenings by checking the Family Care Safety Registry (FCSR) which checks seven Missouri database (Sections 210.900 - 210.936, RSMo). Section 192.2495 restricts these employers from hiring an individual with a certain type of finding identified in the background screening. This includes those individuals who have committed a crime listed in Section 192.2495.6 and thus have been disqualified from employment in a regulated nursing home, hospital, adult day care or hospice; and those individuals who have a FCSR finding listed in Section 192.2495.7 and thus have been disqualified from employment by a regulated home health agency or in-home services provider or consumer directed services program under contract with the Department of Health and Senior Services (see NOTE 1 below).An individual who has been disqualified from employment with one of the above provider types has the right to apply for a Good Cause Waiver (GCW), which, if granted, would not correct or remove the finding, but would lift the hiring restriction and allow the individual to be employed.

  • NOTE 1: An individual currently on the Department of Health and Senior Services EDL is not eligible for a GCW. Such individuals are automatically disqualified from working in a regulated long-term care facility, hospital, hospice, adult day care, home health agency or for an in-home services provider or consumer directed services program under contract with the Missouri Department of Health and Senior Services.
  • NOTE 2:  For In-Home and Consumer Directed Services caregivers, findings reported by the FCSR requiring a GCW have changed.  Questions regarding employment eligibility should be directed to the Missouri Medicaid Audit and Compliance (MMAC)
  • NOTE 3: The GCW process is not applicable to any other employer not included in section 192.2495 RSMo. The GCW process is not applicable to those seeking employment with a child care provider licensed by the Department of Health and Senior Services. If you are seeking employment with a licensed child care provider and have a finding reported by the FCSR, please go to: Background Screening Process.

How to Apply

IMPORTANT!  Incomplete applications will delay the application review.  Please review the application for all required attachments prior to submitting.

To apply for a Good Cause Waiver from the Department of Health and Senior Services, an individual must:

  • Complete an Application for Good Cause Waiver form, MO 580-3286 (08-2020). You may click on the link above or contact the Good Cause Waiver Program toll-free at 1-866-422-6872 to request a packet be mailed, Emailed, or faxed to you.
  • Complete an 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.
  • Attach one (1) sponsorship letter from a previous or current employer stating how long the person has known you and why they feel you should be recommended for a Good Cause Waiver. If you are unable to obtain a sponsorship letter, submit 3 character reference letters from persons who are knowledgeable of your character and employment history. The reference letters cannot be from someone related to or residing with you.
  • Attach a completed Employment History form noting previous employment since the age of 18.

Include (if applicable):

  • If the disqualifying finding is substantiated report of child abuse/neglect, 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 professional license, certificate, or registration by any public or governmental licensing board, agency or regulatory authority, please explain the incident that led to the disciplinary action.
  • If you have any pending disqualifying criminal history offenses, include a statement explaining the circumstances and certified copies of the charging documents for all pending criminal charges.
  • Explain any pending charges of child abuse, neglect or endangerment.
  • Explain any pending charges that might lead to your inclusion on the Department of Mental Health Employee Disqualification Registry.
  • Any documentation that, in your opinion, supports your application for a GCW by demonstrating rehabilitation, positive lifestyle change, etc.

How to Check on the Status of a Good Cause Waiver

If an individual being considered for employment by a regulated care provider described in 192.2495, RSMo 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 is required, granted, or still valid. The employer will contact the licensing or regulatory agency if unsure whether a GCW is required.  The employer may verify the status of a pending/approved GCW by one of the following methods:

  • Calling the FCSR toll-free access line at 1-866-422-6872 and asking to have a GCW verified. The employer will need to provide the individual’s full name and social security number in order to obtain verification of the waiver.
  • Emailing the FCSR at fcsr@health.mo.gov. The employer will need to provide the individual’s full name and social security number in order to obtain verification of the waiver.
  • Checking: Has An Application Been Submitted? The employer will need to provide the applicant’s full name and social security number in order to obtain the status of a waiver.  Click the Good Cause Waiver tab and Waiver Status from the drop-down menu and search the applicant’s social security number to identify if a GCW has been submitted.  If an application has been submitted, click the More Info button to submit the request for verification of the waiver.

Laws:

Regulations:

Applications & Forms

When all fields have been completed, please print form, sign and date before submitting to the Family Care Safety Registry.