PURPOSE: This rule sets forth the requirements for agencies providing maternity care, including health care plan, program and relinquishment of the infant.

1. (1) In addition to the rules for basic care agencies, an agency desiring to provide maternity care shall meet these additional general requirements-

   1. (A) A maternity residence upon request, shall provide a written description of its program to the residents, parent(s), guardian or legal custodian and to the division;
   2. (B) Written financial policies and expectations shall be made available upon request to the division and to the parent(s), guardian or legal custodian upon admission into the maternity residence.
   3. (C) A training plan shall be developed to ensure that staff working with pregnant and parenting adolescents develop skills and knowledge regarding infant and adolescent care;
   4. (D) Maternity residences shall be separate from other treatment programs; and
   5. (E) At least two (2) direct-care staff shall be available at all times.

2. (2) Health Care.

   1. (A) There shall be a written plan for all deliveries to take place in a licensed hospital.

   2. (B) Physician’s Services.

      1. 1. Each resident shall receive the ser-

vices of a licensed physician on a regular and continuing basis throughout pregnancy, delivery and post-delivery checkups.

1. 2. The maternity residence shall provide

for consultation from a licensed obstetrician who shall be available in an emergency.

1. (C) Ambulance Service. Ambulance service shall be available for emergencies.
2. (D) Medical Records. The resident’s medical record shall include a medical consent form, the name of the health care provider, a schedule of appointments, the expected date of delivery and any special needs or problems.
3. (E) Medication. No prescription or nonprescription medication shall be administered without the specific documented approval of the physician providing obstetric care.

1. (3) Program.

   1. (A) The maternity residence shall provide a program to residents addressing prenatal care, labor, delivery, nutrition, general health and hygiene, postnatal care, family planning, venereal disease and child-care techniques.
   2. (B) Upon dismissal from the maternity residence, each resident shall be given written information regarding postnatal care.
   3. (C) Professional staff shall be responsible for development of a long-term plan for the mother and infant. This plan shall be developed with the involvement of the mother and the legal guardian.

2. (4) Relinquishment of the Infant.

   1. (A) The decision to keep or relinquish the infant shall be the right of the birth parent(s). This decision shall be made without undue pressure or influence.
   2. (B) At the request of the resident, the professional staff shall arrange for referral to a licensed child-placing agency.

AUTHORITY: sections 210.481, RSMo (1986) and 210.486 and 210.506, RSMo (Cum. Supp. 1993).* This rule originally filed as 13 CSR 40-71.120. Emergency rule filed Nov. 1, 1993, effective Nov. 12, 1993, expired March 11, 1994. Emergency rule filed March 2, 1994, effective March 12, 1994, expired July 13 CSR 35-71 9, 1994. Original rule filed Nov. 1, 1993, effective June 6, 1994. Moved to 13 CSR 35- 71.120, effective Oct. 30, 2008. *Original authority: 210.481, RSMo (1982), amended 1985 and 210.486 and 210.506, RSMo (1982), amended 1993.