PURPOSE: This rule clarifies what types of facilities are subject to licensure, and the relationship of licensure with community residential facilities and day programs that are licensed or certified by state agencies.

Editor’s Note: The secretary of state has determined that the publication of this rule in its entirety would be unduly cumbersome or expensive. 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 or at the headquarters of the agency and is available to any interested person at a cost established by state law.

1. (1) The department shall provide the following types of licenses:
2. (A) A license to day programs serving the mentally ill, mentally disordered, mentally retarded or developmentally disabled as specified under 9 CSR 40-1, 9 CSR 40-2, 9 CSR 40-9 and 9 CSR 40-10. A day program license is not required for day program activities which take place in a licensed community residential facility if all of the day program clients are residents of the facility and the facility does not have a day program contract with the department;
3. (B) A license to community residential facilities and semi-independent living arrangements serving persons who are mentally ill, mentally disordered, mentally retarded or developmentally disabled as specified under 9 CSR 40-1, 9 CSR 40-2, 9 CSR 40-4, 9 CSR 40-5, 9 CSR 40-6, and 9 CSR 40-7;
4. (C) A license to any community residential facility licensed by the Department of Social Services as a Residential Care Agency for Children as specified in section (3) of this rule;
5. (D) A program license to residential facilities serving mentally ill, mentally disordered, mentally retarded or developmentally disabled as specified in 9 CSR 40-1, 9 CSR 40-2, 9 CSR 40-3 and 9 CSR 40-8; and
6. (E) Discrete day programs or residential facilities located in different buildings but on a single premises shall be individually licensed provided the residential facility or day program is autonomous in providing essential client accommodations and services as required by the rules. Provisions for these services must not be shared with or dependent upon the space or staff of another facility or day program. Support services may be shared.

1. (2) The department deems as licensed with a program license any community residential facility which meets each of the following criteria:

   1. (A) Has paid application fees and submitted applications as set out in 9 CSR 40- 1.055;
   2. (B) Is licensed by the Department of Social Services as set out in Chapter 198, RSMo and 13 CSR 15-10—13 CSR 15-16 as skilled nursing facility, intermediate care facility (ICF), residential care facility II or residential care facility I; and
   3. (C) Has not been inspected and had a license or program license denied or revoked as set out in 9 CSR 40-1.055.
2. (3) As set out in section 630.730, RSMo, the department delegates its survey authority to the Department of Social Services for compliance with licensing rules as a Residential Care Agency for Children under 13 CSR 40-

3. 71. Licensing rules for Residential Care Agencies for Children under 13 CSR 40-71 are incorporated by reference into this rule. The department shall issue a license to any Residential Care Agency for Children if the following conditions are met:

   1. (A) The facility has paid application fees and applied for licensing as set out in 9 CSR 40-1.055;
   2. (B) The department has received documentation from the Department of Social Services indicating the facility has been found in compliance with 13 CSR 40-71;
   3. (C) The facility has a current license from the Department of Social Services as a Residential Care Agency for Children; and
   4. (D) The facility makes no request to be subject to the department’s licensing rules under 9 CSR 40. If a facility does request to be subject to the department’s licensing rules, the department shall implement its survey procedures in accordance with 9 CSR 40- 1.055.
4. (4) Upon receipt of application and fee, the department deems as licensed any residential 9 CSR 40-1

facility, or part of it, qualifying as an ICF/MR (mentally retarded) and certified under Title XIX of the Social Security Act, 42 U.S.C. section 1396, and the regulations contained at 42 CFR part 442, so long as the facility or part of it remains certified. For these ICFs/MRs, certification standards in effect and contained at 42 U.S.C. section 1396, and 42 CFR part 442, incorporated by reference, shall constitute the applicable licensing standards for so long as the facility or part of the facility remains certified. As set out in section 630.730, RSMo, the department delegates its survey authority for these ICFs/MRs to the Department of Social Services and accepts the Department of Social Services’ certification as evidence of the facility’s compliance with the standards without any additional survey. At the option of the head of the facility, the head of the facility may apply to incorporate under one (1) license, individual facilities located at different sites under the administration of one (1) agency and one (1) head of facility.

1. (5) Any day program which is part of a Comprehensive Psychiatric Rehabilitation
2. (CPR) Program and is surveyed as part of the certification survey process under 9 CSR 30- 4 shall not require an additional survey to determine compliance with the licensing rules and shall be deemed licensed upon receipt of a current CPR certificate.

AUTHORITY: sections 630.050 and 630.705, RSMo (1994).* Original rule filed Oct. 13, 1983, effective Jan. 15, 1984. Emergency amendment filed June 10, 1985, effective June 24, 1985, expired Oct. 7, 1985. Amended: Filed June 10, 1985, effective Oct. 8, 1985. Amended: Filed July 15, 1985, effective Feb. 1, 1986. Amended: Filed Jan. 2, 1990, effective June 11, 1990. Emergency amendment filed Feb. 2, 1990, effective Feb. 15, 1990, expired May 1, 1990. Amended: Filed Feb. 2, 1990, effective Sept. 28, 1990. Amended: Filed April 1, 1993, effective Dec. 9, 1993. Amended: Filed July 17, 1995, effective March 30, 1996. Amended: Filed Aug. 11, 1995, effective March 30, 1996.

*Original authority: 630.050, RSMo (1980), amended 1993, 1995 and 630.705, RSMo (1980), amended 1982, 1984, 1985, 1990.