PURPOSE: This rule prescribes requirements for policies and procedures governing the operation of all community residential facilities and day programs as required by section 630.710, RSMo.

1. (1) Each facility or program shall have a written description of its goals, programs, philosophy, purpose, services and cost. The number, characteristics and special needs of the residents or clients to be served must be clearly described.

2. (2) Each facility or program shall have written policies and procedures approved by the department regarding the following:

   1. (A) Admissions, discharges and transfers which assure the following:

      1. 1. Residents or clients are not excluded

on the basis of disability, religion or ethnic origin;

1. 2. Only residents or clients are admitted

whose needs can be met directly by the facility or program or indirectly in cooperation with community resources and supports;

1. 3. At the time of admission, each resi-

dent or client is provided with written information setting forth the following in lay language:

1. A. A description of the facility or pro-

gram, its services and costs;

1. B. Information as to how to seek

release or discharge;

1. C. A statement of rights assured by

law;

1. D. Grievance procedures; and
2. E. Control and discipline; and
3. 4. Unless a resident or client can read

and understand the information presented to him/her, it shall be explained to him/her or to his/her parent or guardian. This information shall be reviewed at least annually with the resident or client, parent or guardian or other responsible party;

1. (B) Emergency policies and procedures (including instruction for staff, residents and clients) for the following situations:

   1. 1. Medical emergencies (for example,

food poisoning, epidemic);

1. 2. Natural disasters such as fire, severe

storm, tornado or flood;

1. 3. Missing or runaway residents or

clients;

1. 4. Behavioral crises;
2. 5. Death of a resident or client;
3. 6. Abuse and neglect of a resident or

client;

1. 7. Layoff from job or day program;
2. 8. Arrest or detention of a resident or

client; and

1. 9. Infectious or contagious disease;
2. (C) Personnel policies and procedures;
3. (D) The use of tabacco; and
4. (E) Confidentiality of clients’ records and information.

1. (3) Each facility or program shall have written policies and procedures governing the use of restraints and time-out. These policies and procedures shall be at least as stringent as the licensing rules regulating restraint and timeout under 9 CSR 40-3, 9 CSR 40-4, 9 CSR 40-9 or 9 CSR 40-10. Issues addressed in the policies and procedures shall include, but not be limited to:

   1. (A) Conditions under which each type of restraint and time-out will be used;
   2. (B) Who is authorized to order, apply and monitor the use of restraints and time-out;
   3. (C) Time limits of a restraint order;
   4. (D) The duration of restraint and timeouts;
   5. (E) Incorporation of restraint orders and time-out in the individualized habilitation plan (IHP) and individualized treatment plan (ITP);
   6. (F) Charting and recordkeeping; and
   7. (G) Review of use of restraints by the multidisciplinary team.
2. (4) The head of the facility or program shall review policies, procedures and resident or client rights with the resident’s and client’s parent or guardian at the time of admission and at least annually after that.
3. (5) The head of the facility or program shall permit no business activities on the premises other than those which are authorized by the department as consistent with the health, welfare and safety of the residents or clients and compatible with the integrity of the facility or program as a home or day program.
4. (6) No facility or day program administrator shall be guardian of the clients in the facility or day program as stipulated in section 475.055, RSMo.
5. (7) Each facility or day program shall have written policies and procedures relating to departures and absences. The policies shall establish a mechanism to alert staff when a client or resident is not present and is accounted for.
6. (8) In addition to the requirement of paragraph (2)(B)9. relating to emergency policies for infectious and contagious disease, each facility or day program shall have routine policies and procedures for the prevention and containment of infectious or contagious disease.

AUTHORITY: sections 630.050 and 630.705, RSMo 1994. Original rule filed Oct. 13, 1983, effective Jan. 15, 1984. Amended: Filed Aug. 4, 1987, effective Jan. 15, 1988. Amended: Filed Jan. 2, 1990, effective June 11, 1990. Amended: Filed April 1, 1993, 1983, effective July 11, 1983. Rescinded: effective Dec. 9, 1993. Amended: Filed July Filed Oct. 13, 1983, effective Jan. 15, 1984. 17, 1995, effective March 30, 1996. *Original authority: 630.050, RSMo 1980 and 630.705, RSMo 1980, amended 1982, 1984, 1985, 1990.