PURPOSE: This rule establishes the components of CCS. It also delineates central office anddistrict andsubdistrict office roles in the components of the p”?grWL

1. (1) Central office Role.

   1. (A) The Department of Health shall see that Crippled Children’s Service (CCS) is administered strictly within the states fiscal guide lines.

      1. 1. The line of authority by which the

Department of Health administer8 CCS shall be thmueh the Division of Personal Health SWiC?S.

1. 2. The “mmam administrator shall be

held accouniab~ to the division director, who in turn shall be held accountable to the director of the Department of Health.

1. 3. The program administrator shall work

with the CCS advisory committee informing committee members of issues pertment to the operation of the program and giving due consideration to the committee’s collective advice.

1. (B) Central office may administratively revise limitations on CCS programs. CCS, for budgetary reasons, may suspend one (1) or more of the cateeories of car8 in 19 CSR 401.030(l)-(5) orVimpose or revise funding ceilings for services throughout the state.
2. (C) Central office may develop and imple ment demonstration or special projects to provide services to groups in special need. The development of the projects shall include development of policies, standards and criteria applicable to provision of the services and to the selection of gm”p8 in special need. Special funds may be set aside for these projeds and shall be liiited to no more than ten percent (10%) of the general service budget.
3. (D) Central office shall attempt to formulate written agreements with any other governmental agencies and their respective departmentsin orderto carry outthemandates stipulated in section 201.030, RSMo (1986).
4. (E) Central office shall consult with the district and subdistrict staff on complicated individual care plans and shall monitor the ~888 management function of the staff.
5. (F) Central office shall maintain statistics of children in Missouri who have congenital anomalies, birth defects and physically handicappmg conditions.

6. (G) Central office shall review the qualiications of CCS-approved providers. Notifica. tion of any changes of status or revisions will be sent to the district and subdistrict offices.

   CODEOFSTATE REGULATIONS

1. (2) District and Subdistrict Office Role.

   1. (A) Case finding is a primary function of the CCS staff at the district and subdistrict level. The staff. in coniunction with oroviders of care and o&r pubtic and privateagencies and concerned individuals, shall actively seek out children and families who may be eligible for ccs services.

   2. (B) Services shall be initiated at the district and subdistrict level.

      1. 1. The staff shall monitor requests for

diagnostic services from all providers of care and other public and private agencies and concerned individuals who may refer a child or family for the services.

1. 2. The staff shall rejed or bring up for

further review with the central CCS office any referrals and requests for services for children with condition8 not included in 19 CSR 40-1.030(l)-(5).

1. 3. Referral from district and subdistrict

staff to a” appmpriate provider of care and other public and private agencies and concerned individuals shall be made for all children or families refer& to CCS.

1. (C) Case management shall be a primary function at the district and subdistrict level. It includes all activities related to the monitoringoftheclient’smedicalprogress and the individual care plan (ICP) outlined for the client by the provider(s) of service, case manager, client’s parents and the client.

   1. 1. The staff shall provide feedback on the

client to service providers and shall work with providers and other community ~88ourc88 to create 8” appropriate ICP for ccs clients.

1. 2. The staff shall also work together 88

a” interdisciplinary team when necessary to review and implement complicated ICPs and, when necessary, to 888 that ICPs are periodltally being reviewed by the providers of am.

1. 3. The staff shall provide feedback on the

client’s CCS status within twenty (20) working days after the client or client’s family report.8 any major changes in income! household composition, insurance, M&ad coverage, medical condition or the client’s care plan; and work with the client and the client’s family to insure the client’s ICP is appropriate.

Auth: sections 192.005.2. and 201.060, RSMo (1986). This rule was preuiousl~ filed 13 CSR 50-160.060. Emergency rule filed Dec. 12,1984, effective Dec. 22,1964, expired April 20,198.S. Original rule filed Dec. 12, 1984, effective April 11, 1985. Amended: Filed June 2, 1987, effectiue Aug. 1.X1987.

Sdrrettlry 0, state

Chapter l-Crippled Children’s Service (CCS)