PURPOSE: This rule establishes guidelines for the screening and assessment of individuals receiving services from state owned or operated facilities to determine whether changes in behavior or mental status are caused by or associated with a medical condition.

1. (1) Definitions—

   1. (A) Department—Department of Mental Health (DMH);
   2. (B) Interdisciplinary team (IDT)—staff who know the individual well and possess the knowledge, skills, and expertise necessary to accurately identify a comprehensive array of the individual’s needs and design a program responsive to those needs; and
   3. (C) State owned or operated facilities—includes state Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) as defined in 42 CFR section 440.150, RSMo, psychiatric residential treatment facilities, and state operated home and community-based waiver services.
2. (2) The provisions of this rule do not apply to long-term care facilities licensed under Chapter 198, RSMo, hospitals licensed under Chapter 197, RSMo, or hospitals as defined in section 197.020, RSMo.
3. (3) Members of the IDT who are supporting individuals in state owned or operated facilities shall document and collect data.
4. (4) Based on a review of the data, the department shall first assess whether there is a relationship between a physiological event and/or illness and behavior. If a medical condition is suspected as the possible cause of the behavior change, medical assessment and treatment shall be accessed. After treating the medical condition or ruling out a medical or physiological event, the department shall then take other actions regarding psychiatric consultation and treatment.

AUTHORITY: section 630.050, RSMo Supp. 2013, and section 630.108, RSMo Supp. 2014.* Original rule filed Dec. 10, 2015, effective June 30, 2016. Amended: Filed May 13, 2016, effective Nov. 30, 2016. *Original authority: 630.050, RSMo 1980, amended 1993, 1995, 2008 and 630.108, RSMo 2014.