PURPOSE: This rule specifies the licensing and program requirements for family living arrangements (FLA).

1. (1) Regulations. In addition to the requirements of this rule, providers of family living arrangements (FLA) shall comply with 9 CSR 40-1 unless specified otherwise in this rule.

2. (2) Licensure Requirements. Applicants for licensure to provide services and supports in a FLA must have documentation of ownership of their home or, if renting, documentation of a current lease agreement and approval from the landlord to provide family living arrangements.

   1. (A) Each applicant must—

      1. 1. Be twenty-five (25) years of age or

older;

1. 2. Have at least a high school diploma or

equivalent certificate;

1. 3. Successfully complete all background

screenings required by the department, including out-of-state background screenings and/or reference checks, if he or she has resided in Missouri for less than five (5) years;

1. 4. Submit to a home study, an interview

and selection process, and licensure by the department; and

1. 5. Have safe, reliable transportation and

appropriate insurance as required by Missouri laws.

1. (B) Providers must complete specialized training required by the department. Training must be documented as specified in 9 CSR 40-1.060(4)(E).

1. (3) Fire Safety. FLA providers shall comply with 9 CSR 40-1.090 Fire Safety and Emergency Preparedness, with modifications as specified:

   1. (A) Subsection (1)(A), Division of Fire Safety inspection is waived;
   2. (B) Subsection (1)(D), evacuation routes do not need to be posted in the home. Documented training and education on safe exit from the home shall be provided for individuals served. Training and education must be documented, including dates and signature of provider; and
   3. (C) Subsection (1)(M), notification and documentation from the local fire authority is waived.

2. (4) Program Structure. FLA providers will be trained, supervised, and supported by staff of the referring/administering agency. FLA providers may serve one (1) to three (3) individuals in the home.

   1. (A) FLA providers have a primary role in the therapeutic interventions and supports provided to the individual(s) served and will be responsible for implementing the individual treatment plan (ITP) or individual support plan (ISP).
   2. (B) Placement, duration, and intensity of services and supports will be based on admission criteria established by the department.
   3. (C) Individuals served shall have the opportunity to participate in daily family and community life, including services and activities such as religious affiliation (if desired), physical activities, shopping, and volunteering in accordance with their ITP or ISP.
   4. (D) Supervision of individuals served shall be provided as specified in their ITP or ISP.
   5. (E) Services and supports provided must be documented as required by the department.
   6. (F) Providers shall maintain contact with staff of the administering/referring agency and the individual’s parents/guardian and other family members/natural supports as specified in the ITP or ISP and as required by the department.
   7. (G) Provider(s) shall participate in preplacement meetings and ongoing meetings with the individual’s support team or treatment team, including development of the ITP or ISP and updating the plan as required by the department and/or referring/administering agency.
   8. (H) A copy of each individual’s current ITP or ISP and crisis prevention plan or safety crisis plan, as applicable, shall be maintained in a manner so they are readily accessible.
   9. (I) Staff from the referring/administering agency will regularly monitor each individual’s progress and provide adjunctive services in accordance with his or her ITP or ISP.

AUTHORITY: sections 630.050 and 630.705, RSMo 2016.* Original rule filed May 14, 2020, effective Dec. 30, 2020.

*Original authority: 630.050, RSMo 1980, amended 1993, 1995, 2008 and 630.705, RSMo 1980, amended 1982, 1984, 1985, 1990, 2000, 2011, 2014.