PURPOSE: This rule specifies civil rights compliance requirements for all health service providers and contractors who provide services for the Department

-,_, of Health and for all hospitals andpublic health clinics that receive federal financial assistance or reimbursements for seruicesprouided.

Editor’s Note: The secretary of rtate has determined that the publication of this rule in its entirety would be unduly cumbersome or expensiue. The entire text of the material referenced has been filed with the secretary of state. This material may be found at the Office of the Secretary of State 01 at the headquarters oftheagency andis auailable to any interested person at a cost established by state law.

1. (1) The following defmitions shall be used in theinterpretation and enforcement ofthisrule:

   1. (A) Applicant is any individual who applies for services from a covered recipient agency;
   2. (B) Assurance is a contractual agreement in which a covered recipient agency legally agrees to administer programs and services in accordance with this rule;
   3. (C) Civilrightsrequirements aretherequirements ofTitleV1 ofthe Civil Bights Act of 1964 (42 USC ZOOOd-ZOOOd.6), Section 504 of the Rehabilitation Act of 1973 (P.L. 93.516), the Age Discrimination Act of 1975, Title III of the American Disabilities Act of 1990 and this rule;
   4. (D) Complainant is any person or group of persons who allege discrimination on the basis of race, color, national origin, age, sex or disabilityinthedeliveryofhealthcaresetices by a covered recipient agency;
   5. (E) Complaint is a verbal or written allegation of discrimination which indicates that a health care service is provided in a manner that results in disparity of services to persons or groups of persons because of race, color, national origin, age, sex or disability;
   6. (F) Compliance review is a reww of a covered recipient agency conducted by the Department of Health (DOH) to determine compliance with the requirements of this rule;

   7. (G) Covered recipient agency is any facility operated primarily to provide health care services as a nonprofit or for-profit institution which receives federal reimbursements for the services provided; and

      Judith K. Moriarty (Z/16/93) secretan, Of state

   8. (H) Federal assistance is any United States government funding, reimbursement, property or aid which is given to a covered recipient agency to provide health care services or program benefits to clients or patients.
2. (2) The DOH shall strive to assure that all public health care services and benefits are made available and provided to all eligible individuals without regard to race, color, national origin, age, sex or disability status.
3. (3) To eliminate duplication of civil rights compliance efforts, the DOH and the Department of Social Services (DSS) shall follow a cooperative agreement negotiated by the two
4. (2) departments designating the responsibilities and relationships of each agency in carrying out Title XIX (Medicaid) programs.
5. (4) Contractors who provide goods to DOH are not subject to this rule.

6. (5) In all contracts for services, the DOH shall include clauses regarding civil rights.

   1. (A) A covered recipient agency shall comply with the civil rights requirements defined in subsection (l)(C) of this rule.
   2. (B) A covered recipient agency which is a government entity and is receiving federal funds through DOH shall have and maintain a personnel merit system.
   3. (C) A covered recipient agency which employs Bteen (15) or more persons shall designate an employee to coordinate civil rights efforts.
   4. (D) A covered recipient agency which receives or contract(s) with DOH and employs fifty (50) 07 more persons shall implement an affirmative action program that complies with the civil rights requirements.
   5. (E) Each covered recipient agency shall implement a public notification system which encourages participation and informs all potentialparticipants,particularlyminorities, of the availability of its programs.
   6. (F) Each covered recipient agency shall print in easily read type on all public program communications this statement: Eligibility criteria for acceptance and participation in this program are administered on a nondiscriminatory basis regardless of race, color, age, sex or disability.
   7. (G) Each covered recipient agency shall maintain a system for collecting racial/ethnic participation data. This data shall include the number of recipients of services and shall be acceptable to DOH.

   8. (H) Each covered recipient agency shall display DOH-approved nondiscrimination posters and policy statements in all facility areas frequented by employees, applicants and recipients of services. 19 CSR 10-2 ,

      m

7. (I) Each covered recipient agency shall display notices of the availability of complaint procedures and have appropriate guidelines in place for referring civil rights complaints and complainants to the DOH for review and resolution. The DOH shall notify the appropriate federal agency of the receipt of a complaint if that notification is required.
8. (J) Each covered recipient agency shall make reasonable accommodations for handicapped applicants and recipients of services including, but not limited to, provision of appropriate auxiliary aids to persons with impaired sensory or speaking skills, parking and access to the facility for the disabled, and removal of baniers to accessibility if the removal is readily achievable.
9. (K) If the covered recipient agency uses any funds from DOH and contracts in a subcontract, the contractor shall require the subcontractor to comply with subsections (5)(A)-(L) of this rule.
10. (L) The DOH shall have the right to enforce all applicable clauses in subsections (5)(A)-
11. (K) of this rule by appropriate and reasonable procedures including, but not limited to, requests, reports, site visits and inspection of relevant documentation of the contractor.
12. (6) All covered recipient agencies in a contractual relationship with DOH shall prepare and submit for DOH approval documentation on their civil rights requirements compliance to include assurances and an implementation ph.
13. (7) DOH staff responsible for monitoring programs administered by DOH and contracts for delivery of services shall complete a civil rights compliance review using the Department of Health Form DH-41.
14. (8) Periodically the DOH shall assess the compliance level of covered recipient agencies by conducting a desk audit or on-site review on randomly selected agencies. An on-site civil rights compliance review shall be performed by the DOH when there is evidence of substantialnoncompliance as shown by a desk audit or a complaint investigation.
15. (9) If the contractor fails to comply with the terms of the civil rights assurance in the contract, DOH shall terminate the contract. Prior to termination of a contract, DOH shall give fifteen (15) days’ notice to the contractor specifying the reasons why the department believes the contractor is not in compliance and shall provide the contractor an opportunity to show compliance with the contract. The contractormayrequest aconferencewithDOH during this period. The request shall be in writing to the director of the DOH. 19CSRlO-2-HEALTH Division lo-office of the Director

Auth: Gouernor’s Executiue Order 87.6 and section 536.023.3., RSMo (1986).* Original r&filed Sept. 8,1992, effective April 8, 1993. *Original authority: Executiue Order 87.6. RSMo (19871 and 536.023.3., RSMo (19751, amended 1976.

(Z/16/93) Judith K. Moriarty SPcrow Of state

MISSOURI DEPARTMENT

NAME OF FACILITY: STREET: CITY: COUNTY: NAME OF ADMINISTRATOR:

IES NO

IATE

Judith K. Moriarty SaCrmy Of state OF HEALTH

1. (1) Does the facility have a written non-discriminatory location where
2. (2) Are the USDA and OCR “on-discrimination
3. (3) Are all employees in the provision of services? How are employees made aware of this policy? Explain
4. (4) Does the facility publicize to race. sex. age. handicap. color. or national origin? ments, brochures, etc.,
5. (5) Does the facility persons to whom services are being provided?
6. (6) Does the facility does not result
7. (7) Do applications. indicate that services are provided of applications.
8. (8) 1s the facility following: (e, Telephones
9. (9) Are services handicapped? [IO) Are auxiliary aids available hearing disability?

Ill) I” the event the facility location where

1. (12) Are bilingual services and/or program materials available communicating
2. (13) Does the facility display DOH poster and brochures complaint system?
3. (14) Has the facility ever bee” If yes. what was the disposition?
4. (15) Total undupficated Race: White

I

(Z/16/93) COMPLIANCE REVIEW FORM

it can be see” by the public?

of the facility made aware of the policy of non-discrimination

that

currently maintain

refer persons in discrimination? stationery. brochures

stationery, etc.) accessible to and usable by the handicapped? (a) Parking (b) Entrances

provided by

for those clients/patients

is not accessible

the same services may be obtained?

people?

the subject of a compliance

“umber of employees: Black

TITLE VI, SECTION 504

posters displayed?

it provides services

records that show

for services to other agencies

and other materials

in a non-discriminatory

(c)Waiting

the facility accessible

to the handicapped.

: Other Minority

SGNATURE & TITLE OF REVIEWER

TYPE OF FACILITY:

ZIP CODE: TELEPHONE:

policy/poster displayed

to all persons without (Obtain copy of any advertise-

the race and sex of

in a manner which

used by the

manner? (Obtain copy

Please check

Areas (d) Restrooms

to and usable

that may have a speech and/or

is there a” alternate

to limited or “on-English

explaining availability

review by a federal agency? 19 CSR 10-2

EXPLANATfON OF NO’S

in a

regard

the

facility

the

by the

of the