PURPOSE: This rule establishes dietary and food service requirements in Alcohol and Drug Abuse Treatment Programs, Comprehensive Substance Treatment and Rehabilitation Programs (CSTAR), Compulsive Gambling Treatment Programs, Substance Abuse Traffic Offender Programs (SATOP), Required Education Assessment and Community Treatment Programs (REACT), Community Psychiatric Rehabilitation Programs (CPRP), and Psychiatric Outpatient Programs.

1. (1) Dietary Standards for Programs with an Incidental Dietary Component.

   1. (A) Programs defined as having only an incidental dietary component shall include:

      1. 1. A permanent residence serving no

more than four (4) individuals; or

1. 2. Programs and service sites that do not

provide for the preparation, storage or provision of food including food brought by the individuals being served.

1. (B) Programs and service sites defined as having only an incidental dietary component shall address diet and food preparation on a person’s individualized treatment plan, if it is identified as an area in need of intervention based on the assessment.

2. (C) Where the program does not provide meals, but individuals are allowed to bring their own food, the following standards apply:

   1. 1. All appliances must be clean and in

safe and proper operating condition; and

1. 2. Hand washing facilities including hot

and cold water, soap and hand drying means shall be readily accessible.

1. (2) Dietary Standards for Programs and Treatment Sites with Minimal Dietary Component.

   1. (A) A program or service site shall be defined as having a minimal dietary component if one of the following criteria apply and it does not meet the definition of incidental dietary component:

      1. 1. It provides for the preparation, stor-

age or consumption of no more than one (1) meal a day; or

1. 2. The program or service site has an

average length of stay of less than five (5) days.

1. (B) The following standards apply for programs with a minimal dietary component:

   1. 1. Meals shall be nutritious, balanced

and varied based on the latest edition of the recommended dietary allowances of the Food and Nutrition Board of the National Research Council, National Academy of Sciences. The practical application of these recommendations can be met by following the Dietary Guidelines for Americans and the Food Guide Pyramid of U.S. Department of Agriculture and the U.S. Department of Health and Human Services;

1. 2. Special diets for medical reasons

must be provided;

1. 3. Menus shall be responsive to the cul-

tural and religious beliefs of individuals;

1. 4. Food will be served at realistic meal

times in a pleasant, relaxed dining area;

1. 5. Food will be stored safely, appropri-

ately and sanitarily;

1. 6. Food shall be in sound condition, free

from spoilage, filth or other contamination and safe for human consumption;

1. 7. All appliances shall be in safe and

proper operating condition;

1. 8. Food preparation areas will be

cleaned regularly and kept in good repair. Utensils shall be sanitized according to Missouri Department of Health standards;

1. 9. Hand washing facilities that include

hot and cold water, soap and a means of hand drying shall be readily available; and

1. 10. Paragraphs 5.–9. of this subsection

shall be met if the site has a current inspection in compliance with 19 CSR 20-1.010.

1. (3) Dietary Standards for Programs and Treatment Sites with a Substantial Dietary Component.

   1. (A) Programs with a substantial dietary component shall be defined as meeting one of the following criteria and are not the permanent residence of more than four (4) individuals:

      1. 1. Programs or treatment sites that serve

more than one (1) meal per day; and

1. 2. Programs or treatment sites with an

average length of stay of over five (5) days.

1. (B) Programs with a substantial dietary component shall have the following:

   1. 1. An annual inspection finding them in

compliance with the provisions of 19 CSR 20-1.010. Inspections should be conducted by the local health department or by the Department of Health;

1. 2. Those organizations arranging for

provision of food services by agreement or contract with the second party shall assure that the provider has demonstrated compliance with this rule;

1. 3. Programs providing meals shall

implement a written plan to meet the dietary needs of the individuals being served, including:

1. A. Written menus developed and

annually reviewed by a registered dietitian or qualified nutritionist who has at least a bachelor’s degree from an accredited college with emphasis on foods and nutrition. The organization must maintain a copy of the dietitian’s current registration or the qualified nutritionist’s academic record.

1. B. Any changes or substitution in

menus must be noted;

1. C. Menus for at least the past three

1. (3) months shall be maintained;

   1. D. The written dietary plan shall

insure that special diets for medical reasons are provided. Menu samples shall be maintained showing how special diets are developed or obtained;

1. E. Menus shall be responsive to cul-

tural and religious beliefs of individuals;

1. 4. Meals shall be served in a pleasant,

relaxed dining area; and

1. 5. Hand washing facilities including hot

and cold water, soap and hand drying means shall be readily accessible.

AUTHORITY: sections 630.050 and 630.055, RSMo 2000.* Original rule filed Feb. 28, 2001, effective Oct. 30, 2001. *Original authority: 630.050, RSMo 1980, amended 1993, 1995 and 630.055, RSMo 1980.