PURPOSE: This rule describes the general requirements that all service providers shall meet to receive grants or subgrants to provide services for older persons or low income handicapped adults funded by the division or area agencies.

Editor’s Note: The secretary of state has determined that the publication of this rule in its entirety would be unduly cumbersome or expensive. The entire text of the rule has been filed with the secretary of state. The entire text of the rule may be found at the headquarters of the agency and is available to any interested person at a cost established by state law.

1. (1) Service providers shall meet all applicable state and local licensure and safety requirements for the provision of those particular services.
2. (2) Service providers shall maintain any licensure, certification or registration mandated by any state or local government, body or board.
3. (3) Service providers shall allow only employees or volunteers holding a current license, certification or registration to perform those tasks, duties or functions for which licensure, certification or registration is required by any state or local agency, body or board.

4. (4) Service providers shall have an adequate number of staff (paid or volunteer) who are qualified to perform assigned functions in order to implement the activities and services.

   1. (A) Multilingual staff shall be available when there are substantial numbers of non- English speaking service recipients.
   2. (B) A written job description for each position function and responsibility and the line of supervisory authority for each position (paid and volunteer) shall be developed and maintained. Personnel qualifications shall meet job description requirements.
   3. (C) A written performance evaluation of each paid staff member shall be done at least annually and shall be maintained in the employee’s personnel file.
   4. (D) A training file shall be maintained that documents the type of training provided, names of staff and volunteers participating, number of hours of training provided and date(s) training was provided. A report of each employee’s orientation and in-service training provided by the service provider and from other sources shall be placed in that employee’s personnel file.

5. (5) Centers shall be in compliance with all applicable state and local fire and safety laws, as well as the following requirements:

   1. (A) If the division determines that the state or local fire safety laws, ordinances or codes are not adequate to assure the safety of older persons or for any locality that has no governing fire and safety laws, ordinances or codes, the provisions of the National Fire Protection Association Life Safety Code (NFPA No. 101, 1981 edition) for places of assembly shall apply;
   2. (B) Centers shall have installed and shall maintain in operable condition an adequate number of smoke detectors and fire extinguishers of the appropriate type as determined by consultation with state or local fire authorities. All smoke detectors and fire extinguishers shall be located within the premises according to the recommendations of state or local fire authorities;

   3. (C) Centers shall develop a written safety and evacuation plan for assuring the safety of service recipients, staff and volunteers in case of fire or other hazardous situations and evacuation drills shall be conducted periodically. Copies of the plan shall be on file at the center and at the area agency’s office and a charted plan shall be posted conspicuously in the center. The plan and procedures shall include, but need not necessarily be limited to:

      1. 1. A written assessment of potential fire

or safety hazards present on the premises and actions and procedures that are to be followed to minimize danger;

1. 2. A written schedule for periodic check

of smoke detectors and fire extinguishers to assure that adequate pressure or battery strength is maintained for efficient operation when needed; and

1. 3. A written training plan including fre-

quency of comprehensive and refresher training for staff and volunteers on safety responsibilities and actions to be taken if an emergency situation occurs with documentation of training sessions provided; and

1. (D) Fire inspections shall be conducted annually at all centers. At least every two (2) years the inspection shall be conducted by state or local fire authorities; on alternate years the area agency may conduct the inspection provided appropriate training has been received and the form required by the division is used. Documentation of the inspector’s report, recommendations and corrections of any deficiencies shall be maintained at the area agency and center offices.

1. (6) Service providers whose staff have direct physical contact with service recipients shall make emergency arrangements in consultation with relevant agencies, for dealing with service recipient personal emergencies, that include:

   1. (A) Specific personnel designated and trained to take charge in an emergency;

   2. (B) A person, present or immediately available during all hours that the center is open, who has successfully completed a training course in first aid or emergency care that included at least:

      1. 1. Basic first aid;
      2. 2. Cardiopulmonary resuscitation

(CPR);

1. 3. Heimlich maneuver; and
2. 4. Guidelines on when to attempt first

aid or when to take alternative action; and

1. (C) Written instructions posted conspicuously by each telephone which includes the 911 emergency telephone number, if available; or other local emergency telephone numbers, such as those of physicians, ambulances, hospital emergency rooms and local civil defense or disaster offices if the 911 number is not available in the community.

1. (7) Caterers and centers in which food is prepared, served, or both, shall be maintained in a safe and sanitary manner and shall be in compliance with all applicable state, county or city health codes. Each location at which food is prepared shall be inspected annually by state or local health authorities. Each location at which prepared food is received from another source shall be inspected annually. The inspection shall be conducted by state or local health authorities at least every two (2) years; on alternate years the area agency may conduct the inspection provided appropriate training has been received and the form required by the division is used. Documentation of the inspector’s report, recommendations and corrections of any deficiencies shall be kept at both the area agency and center offices.

2. (8) Service provider staff and volunteers shall be familiar with and shall be able to recognize situations of possible abuse, neglect, exploitation or likelihood of serious physical harm involving older persons. Conditions or circumstances which place the older person or the household in likelihood of serious physical harm shall be immediately reported to the division’s elderly abuse hotline (1-800- 392-0210). Likelihood of serious physical harm means one (1) or more of the following:

   1. (A) A substantial risk that physical harm to an adult will occur because of failure or inability to provide for essential human needs as evidenced by acts or behavior which have caused harm or which give another person probable cause to believe that the adult will sustain harm;
   2. (B) A substantial risk that physical harm will be inflicted by an eligible adult upon him/herself, as evidenced by recent credible threats, acts or behavior which have caused harm or which places another person in reasonable fear that the eligible adult will sustain harm;
   3. (C) A substantial risk that physical harm will be inflicted by an eligible adult upon another as evidenced by recent acts or behavior which has caused harm or which gives another person probable cause to believe the eligible adult will sustain harm; or
   4. (D) A substantial risk that further physical harm will occur to an eligible adult who has suffered physical injury, neglect, sexual or emotional abuse or other maltreatment or wasting of his/her financial resources by another person.

3. (9) Service providers shall provide the following:

   1. (A) Public information activities to ensure that older persons are informed of the services available and have maximum opportunity for participation;
   2. (B) Coordination with other service providers in the planning and service area to assure comprehensive delivery of services and reduce duplication; and
   3. (C) A written complaint procedure through which the service recipient can communicate to the service provider aspects of the service which impact negatively upon them.
4. (10) Service providers who use volunteers shall develop a written plan for recruiting, orienting, training, supervising and terminating volunteers.
5. (11) Service providers shall serve older persons with the greatest economic or social need, especially low-income minority persons. Service providers may use methods such as location of services and specialization in the types of services most needed by these groups to meet this requirement. Service providers shall not use a means test to deny individuals services within the target population.
6. (12) Service providers shall obtain the views of service recipients about the services they receive.
7. (13) Service providers shall assure that federal funds shall not be used to replace funds from nonfederal sources and that the service provider shall continue or initiate efforts to obtain support from private sources or other public organizations.

8. (14) Service providers shall implement P.L. 93-112, Section 504, nondiscrimination on basis of handicap, as well as the following specific requirements:

   1. (A) Handicapped service recipients shall receive the same services provided to any other citizen except where their particular handicap prevents them from participating in an activity;
   2. (B) Any facility being considered for use as a center for delivery of alternative services shall be barrier-free and meet the requirements as set by the American Standards Institute;
   3. (C) If an existing service delivery facility is not barrier-free and cannot be structurally changed to meet barrier-free requirements, services provided at this location shall be provided to handicapped persons in their own home or in another accessible location; and
   4. (D) Transportation to barrier-free centers shall be provided if needed. Service recipients shall not be transported (embarking to disembarking) more than thirty (30) minutes’ travel time or twenty-five (25) miles in distance in order to reach an accessible center.

9. (15) Procedures for handling contributions shall be developed and implemented that include the following:

   1. (A) Each recipient shall be provided with an opportunity to voluntarily contribute to the cost of the service;
   2. (B) The privacy of each recipient with respect to his/her contribution shall be protected;

   3. (C) Appropriate measures to safeguard and account for contributions shall be established which include, at a minimum, the following:

      1. 1. Collecting contributions in a locked

box at senior centers;

1. 2. Using two (2) persons when accessing

contributions or to count receipts;

1. 3. Keeping receipts in a safe or locked

box until deposited;

1. 4. Recording and depositing all contri-

butions on the date of receipt;

1. 5. Taking precautions to prevent theft of

cash receipts;

1. 6. Reporting contribution receipts to the

area agency at least monthly; and

1. 7. Avoiding an accumulation of a large

balance of income on hand;

1. (D) All contributions shall be used to expand the service for which the contribution was made. Nutrition services contributions shall be used to increase the number of meals served, to facilitate access to meals and to 13 CSR 15-7

provide supportive services directly related to nutrition services;

1. (E) A suggested contribution schedule may be developed for each service provided. In developing a contribution schedule, the provider shall consider the income ranges of elderly persons in the community, the provider’s other source of income and the actual cost of the service. The contribution schedule should be revised periodically as needed; and
2. (F) A provider shall not deny any elderly person a service because the elderly person will not or cannot contribute to the cost of the service. An eligible service recipient shall not be charged for participating in any service or activity.

1. (16) Administrative policies and procedures shall be followed which include:

   1. (A) A current Affirmative Action/Equal Employment Opportunity Plan and Program as required by the Civil Rights Act of 1964 and the Federal Equal Opportunity Act of 1972;
   2. (B) Recordkeeping and confidentiality as cited in 13 CSR 15-4.300;

   3. (C) Reporting systems to document and report all required program, fiscal and administrative information needed by the area agency. The system shall include format and timelines for submission and the following records:

      1. 1. Documentation of the total undupli-

cated low-income minority persons receiving services;

1. 2. Records of paid staff time and volun-

teer time; and

1. 3. Documentation of service recipient

eligibility;

1. (D) Bonding for all volunteers, staff or governing body members who have fiscal responsibilities, to protect against loss of federal and state funds or agency income;

2. (E) Insurance coverage which includes:

   1. 1. Workers’ Compensation—statutory

amount as prescribed by the laws of Missouri;

1. 2. Comprehensive general liability cov-

ering employees, volunteers and service recipients;

1. 3. Product liability as applicable to the

service provided; and

1. 4. Automobile liability for service

provider vehicles and, for volunteers using their own vehicles, at least a procedure for verifying that the volunteer maintains adequate insurance and understands his/her liability;

1. (F) Written policies that specify which holidays and special event days may be observed by curtailing delivery of services and procedures for publicizing these dates and assuring that service recipients are informed;

2. (G) Written policies and procedures to be followed when service delivery must be interrupted due to emergency situations including:

   1. 1. Definition of types of emergencies

(weather, natural disaster, health, and the like);

1. 2. Specifications of the person/position

responsible for making the decision to interrupt scheduled service delivery; and

1. 3. Identification of procedures to be fol-

lowed for notifying service recipients; and

1. (H) Written policies and procedures to be followed when it is necessary to terminate or deny services to an individual service recipient that include:

   1. 1. Justification for termination or

denial;

1. 2. Referral to other needed services; and
2. 3. Follow-up for return to service, when

appropriate.

1. (17) Any facility altered, renovated, acquired by purchase or lease or constructed using federal or state funds may not be used for religious instruction or as a place of worship, as follows:

   1. (A) Federal and state funds shall not be used to renovate, alter or construct a building that is also intended to be used, or is used, as a place of worship even though the building may serve as a multipurpose senior center;
   2. (B) Service providers shall have a written agreement with sectarian organizations housing alternative services programs which includes the provision that all equipment purchased with federal funds remain the property of the area agency, as per 45 CFR part 74;
   3. (C) Each individual participant shall have a free choice of whether or not they wish to participate in prayer and no staff (paid or volunteer for that day) shall initiate, lead, organize or encourage a prayer or moment of silence; and
   4. (D) Service providers shall ensure that no federal or state funds shall be used for religious instruction or worship.

2. (18) Any facility altered, renovated, acquired by purchase or lease or constructed using federal or state funds may not be used for political campaigning on behalf of any candidate for local, state or national office unless—

   1. (A) The political discussion is a planned, scheduled activity;
   2. (B) All candidates for a particular office are personally present or afforded the opportunity to be present; and
   3. (C) All candidates are afforded the opportunity to present their views through a series of discussions, scheduled at intervals, but given equal time.

AUTHORITY: section 660.050, RSMo 1994.* This rule was previously filed as 13 CSR 15- 6.135. Original rule filed Jan. 6, 1986, effective April 30, 1986. Amended: Filed Feb. 17, 1988, effective June 15, 1988. Amended: Filed June 3, 1991, effective Oct. 31, 1991. *Original authority 1984, amended 1988, 1992, 1993.