PURPOSE: The following definitions are listed to establish understanding of these terms as applied to Chapter 8.

1. (1) Adult day care program. A group program ‘., designed to provide care and supervision to meet the needs of five (5) or more functionally impaired adults for periods of less than twentyfour (24) hours but more than two (2) hours per dayinaplaceotherthan theadult’sown home.
2. (2) Adult day care provider. The person, corporation, partnership, association or organizationlegallyresponsiblefortheoverall operation of the adult day care program, who has a current license, or provisional license, to operate issued by the Division of Aging.
3. (3) Applicant. The person, corporation, part. nership, association or organization which has submitted an application to operate an adult day care program, but has not yet been approved and issued a license, or provisional license, by the Division of Aging.
4. (4) Associated adult day care program. An adult day care program which is physically attached with another organization established primarily to offer other services (such as medical care, long-term care and human services) but has designated space and staff for an adult day care program which is above the existing space and staffing requirements for the residents, patients or clients.
5. (5) Direct care staff. Those staff (paid and volunteer) assigned to take care of the direct needs of participants.
6. (6) Freestanding adult day care program. A program of adult day care services which does not share staffing or licensed space or any physical components of space, equipment, furnishings, dietary, security, maintenance or utilities utilized in the provision of service with any other organization.
7. (7) Functionally impaired adult. An individual aged eighteen (18) or older who, by reason of age or infirmity, requires care and supervision.

8. (8) Individual plan of care. The adult day care provider’s written description of the amount, duration and scope of services to be provided to each individual participant.

   Judith K. Moriarty sP.r.ta,y Of state

9. (9) Longterm care facility. Any facility holding a valid license to operate, issued by the Missouri Division of Aging, including: skilled nursing facilities, intermediate care facilities or residential care facilities I and II as defined by section 198, RSMo; or distinct part skilled care units, intermediate care units or residential care units licensed by the Missouri Department of Health as defined by 19 CSR 30. 20.010.

10. (10) Medical care facility, a hospital, rehabilitation facility or other facility holding a valid state license to operate, issued by the Missouri Division of Health, as defined by 19 CSR 30-20.010.

    Auth: sections 660.050, RSMo (Cum. Supp. 1992) and 660.418, RSMo (1986).* Original r&filed Oct. X,1984, effective Jan. 11,1985. *Ori&d authority: 660.050, RSMo (1984), amended 1988,1992 and 660.418, RSMo (1984).

13CSR15-S.OZOLicensureRequirements

PURPOSE: This rule establishes the general licensure and application procedures, fees and the rights of applicants for licensure of adult day careprograms.

1. (1) Any person who establishes, maintains or operates an adult day care program, or advertises or holds him/herself out as being able to perform any adult day care service, shall obtain the proper license from the division, except for the following:

   1. (A) Any adult day care program operated by a person in which care is offered for no more than two (2) hours per day;
   2. (B) Any adult day care program maintained or operated by the federal government except where care is provided through management contract;
   3. (C) Any person who cares solely for persons related to the provider or who has been designated as guardian of that person;
   4. (D) Any adult day care program which cares for no more than four (4) persons who are not related within the fourth degree of consanguinity or affinity to the adult day care provider;
   5. (E) Any adult day care program licensed by the Department of Mental Health under Chapter 630, RSMo, which provides care, treatment and habilitation, exclusively to adults who have a primary diagnosis of mental disorder, mental illness, mental retardation or developmental disability as defined; or

   6. (F) Any adult day care program administered or maintained by a religious not-forprofit organization serving a social or religious 13 CSR 15-8 ,

      m

function if the adult day care program does not hold itself out as providing the prescription or usage of physical or medical therapeutic activities or as providing or administering medicines or drugs.

1. (2) An application shall be submitted to the division for each proposed associated or freestanding adult day care program on forms supplied by the Division of Aging.
2. (3) A nonrefundable fee shall accompany each adult day care program application for license according to the following schedule for licensed capacity which is the number of program participants who may be present at any one time:
3. (A) For eight (8) participants or fewer, the fee is twenty-five dollars ($25);
4. (B) For nine through sixteen (9-X) participants, the fee is fifty dollars ($50);
5. (C) For seventeen through twenty.four (17-24) participants, the fee is seventy-five dollars ($75); and
6. (D) For twenty-five (25) or more participants, the fee is one hundred dollars ($100).
7. (4) The division shall review each application and investigate each applicant and adult day care program to determine that they comply with the adult day care licensure law and these rules and to insure that the health and safety of the participants are protected.
8. (5) If the adult day care program and the applicant are found to be in compliance, a regular license will be issued for a period not to exceed two (2) years.
9. (6) If an adult day care program is not currently meeting all of the requirements for licensure but demonstrates the potential capacity to meet the full requirements for licensure, a provisional license may be issued if there is no threat to the health and safety of the participants in the program. The provisional license is nonrenewable and will be valid for a maximum of six (6) months. Any regular license issued subsequent to a provisional license will be valid for a period not to exceed two (2) years from the date that the provisional license was issued.
10. (7) Licensure renewal applications will be sent to adult day care providers at least sixty (60) days prior to the expiration of the current license. Renewal applications must be aceom. pa&d by a nonrefundable fee and be postmarked at least thirty (30) days prior to expiration date of the current license. The nonrefundable fee is identified in the fee schedule in section (3) of this rule. 13 CSR 15-G-SOCIAL SERVICES
11. (8) A regular or provisional license may be revoked or suspended for failure to cooperate with the division or failure to comply with statutory or regulatory requirements.
12. (9) If any person is refused a license, or a license is suspended or revoked, or other official action by the division is detrimental to the provider of an adult day care program, a determination from the administrative hearing commission may be requested pursuant to provisions of section 161.272,, RSMo. This action must be taken within thirty (30) calendar days of official notification of the adverse action taken by the division.
13. (IO) The license, or provisional license, issued to the adult day care provider, shall not be transferable when there is a change of ownership or when the program is moved to another location or facility.

14. (11) The application for an adult day care program license shall be signed by the applicant’s owner, chairman of the board or chief executive officer and shall be notarized. Auth: sections 660.050, RSMo (Cum. Supp. 1992) and 660.418, RSMo (1986J.* Original rule filed Oct. l&1984, effective Jan. 11, 1985. *Original authority: 660.050, RSMo (19841, amended1988,1992and660.418, RSMo119841.

    Judith K. Moriarty

    COOLOF STATE REGULATIONS secretary Of S,tsh

    Application

    FEE SCHEDULE

Check licensed capa$cg,gr;quested: 0 8 or fewer 0 9 through 16 $ 50.00 0 17 through 24 $ 75.00 0 25 or more $100.00

1. 1. In accordance with the requirements of sections 660.400 through 660.420, RSMo (1986) and 13 CSR 15-8.010 through 13 CSR 15-8.080 an application is hereby made for license to establish, conduct or maintain an adult day care program as: icheek one] 0 Freestanding Adult Day Care Program 0 Associated Adult Day Care Program

2. 2. Name of the adult day care program Address (Street, RFD, Box Number)

   (city)

3. 3. If a change of ownership, former name of adult day care program
4. 4. Type of provider of the adult day care program: (check onej Governmental 0 City 0 county 0 state

5. 5. Name of provider Address (Street, RFD, Box Number)

   (city)

6. 6. Name, address and percentage of ownership of any individual or entity who owns an interest of five percent (5%) or more in the land, structure(s), mortgage or other obligation, or lease on which an adult day care program is being conducted. Indicate whether this ownership involves land, structure, mortgage or lease.
7. 7. Name of the adult day care program director
8. 8. Has the program director or any corporate officers, directors or holders of five percent (5%) or more stock or ownership ever been convicted of a misdemeanor relating to the operation of an adult day care program, long-term care facility or of any felony 0 Yes 0 No If yes, list the person’s name and type of conviction

9. 9. For all initial applications, provide a diagram of the building that houses the adult day care program if it is freestanding. This diagram shall be labeled to show exits; fire extinguishers; smoke detectors and room use, such as dining, crafts, quiet room, therapy or offices. This diagram shall give exact measurements of the area to be used for the adult day care program.

   Judith K. Moriarty SPClmy 0, Slate Department of Social Services Missouri Division of Aging for License to Operate an Adult Dsy Care Program

   (Name of Associated Organization)

   (Zip Code)

   (State)

Not-for-profit 0 Religious organization 0 Corporation 0 Other

(State) (Zip Code)

COOE OF STATE REGULATIONS 13 CSR 15-8 , m

DO NOT WRITE IN THIS SPACE

Application No. Origid Relicensure License Fee Received Receipt No. Provisional License No. Issued Regular License No. Issued Effective Date Expiration Date

(Area Code/Phone No.)

(County)

Proprietary 0 Individual 0 Partnership 0 Corporation

(Area Code/Phone No.)

(County)

13 CSR 15-8-SOCIAL SERVICES

1. 10. For all initial applications, provide a diagram of the designated space for the adult day care program if it is an associated facility. This diagram shall show the portion set aside for the adult day care program including office, dining, quiet area, craft area, general adult day care meeting area or therapy. This diagram shall give exact measurement of the area used for the adult day care program and also show exits or entrances for day care, fire extinguishers and other fire safety features, such as pull stations and smoke detectors.

2. 11. The fee must be submitted with this application. Enclose a check or money order only, payable to the Director of Revenue, Missouri Department of Revenue. I hereby affirm that I as an individual, or that the operating corporation or partnership for which I sign, have adequate financial resources to properly construct, equip and operate the facility referred to in this application. I further affirm that I am familiar with the requirements of the adult day care licensure law (1986) and the regulations of the Division of Aging established thereunder. I further affirm that I understand that I am eligible for a license only if the program and the provider are in compliance with the law and the regulations thereunder, and that a license may be revoked at any time that the facility or the operator fails to comply with such law and regulations. I further affirm under the penalties ofperjury, that all documents and information required by the division to be filed pursuant to this application are true and correct to the best of my knowledge and belief, that the statements contained in this application and any attached information are true and correct to the best of my knowledge and belief and that all required documents are either included with the application or are currently on file with the division. Date: (Applicant (Owner/Chairman of Board/Chief Executive Officer) Signed and sworn to before me this day of ,19 ~.

   (Notary,;;blic or Other Officer Authorized to Administer Oaths)

My commission expires 13CSR 15-8.030Participants’Rights and Program Policies PURPOSE: This rule establishescertain rights of participants in adult day care programs and requiresprouiders to have written program policies. (1) Each participant of the adult day care program shall be assured of the following rights:

1. (A) To be treated as an adult, with respect and dignity regardless of race, color, sex or creed;
2. (B) To participate in a program of services and activities which promote positive attitudes regarding one’s usefulness and capabilities;
3. (C) To participate in a program of services designed to encourage learning, growth and awareness of constructive ways to develop one’s interests and talents;
4. (D) To maintain one’s independence to the extent that conditions and circumstances permit, and to be involved in a program of services designed topromotepersonalindepen. dew;
5. (E) To be encouraged to attain self-determi. nation within the adult day care setting, including the opportunity to participate in developing one’s plan for services; to decide whether or not to participate in any given activity and to be involved in the extent possible in program planning and operation;
6. (F) To be cared about in an atmosphere of sincere interest and concern in which needed support and services are provided;
7. (G) To have access to a telephone to make or receive calls, unless necessary restrictions are indicated in the individual care plan;

8. (H) To have privacy and confidentiality;

   1. (I) To be free of mental or physical abuse;
9. (J) To be free to choose whether or not to perform services for the facility;
10. (K) To be free of restraint, unless under physician’s order as indicated in individual care plan; and
11. (L) To be free of interference, coercion, discrimination or reprisal.

1. (2) Participants and their families shall be advised of participants’ rights and program policies upon admission to the adult day care program.
2. (3) Participants’ rights shall be posted in a conspicuous location in the adult day care program facility.

3. (4) The adult day care provider shall have a written program description, copies of which are available to the division, participants, families and other interested agencies and individuals. The document shall describe at least-administrative organization, including

   Judith K. Moriarty smet.Iy 0, state

role of the advisory committee if applicable; maximum number of participants that can be served; types of participants that shall and shall not be admitted; days of the week and hours of operation; services available to participants and families; procedures/requirements for admission; emergency arrangements for participants; criteria and procedure for discontinuing service to a participant; participant/family procedure for resolving grievances and confidentiality of participant information and records.

Auth: sections 660.050, RSMo (Cum. Supp. 1992) and 660.418, RSMo (1986).* Original rule filed Oct. I&1984, effective Jan. II,1985 *Original authority: 660.050, RSMo 11984). amended 1988,1992 and 660.418, RSMo (1984j.