PURPOSE: This rule establishes procedures for how the Division of Mental Retardation and Developmental Disabilities determines eligibility for its services. Because the recently revised definition of the term “developmental disability” in section 630.005.1(8), RSMo changes the population possibly eligible for services from the division, the division must revise its procedures for accepting applications for its services and determining eligibility for those services.

PUBLISHER’S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. Therefore, the material which is so incorporated is on file with the agency who filed this rule, and with the Office of the Secretary of State. Any interested person may view this material at either agency’s headquarters or the same will be made available at the Office of the Secretary of State at a cost not to exceed actual cost of copy reproduction. The entire text of the rule is printed here. This note refers only to the incorporated by reference material.

1. (1) Through this rule, the department intends to assist applicants for division services as they proceed through the eligibility determination process and to direct division staff so that it may assist applicants and clients in expeditiously obtaining accurate, comprehensive evaluations and needed services. Specifically, the division intends to—

   1. (A) Implement the concept of functional assessment for determining eligibility and to discontinue the practice of linking eligibility to a specific diagnosis;
   2. (B) Provide equal access to eligibility determinations and habilitation services for all persons with developmental disabilities;
   3. (C) Give specific consideration to eligibility for young children at risk of becoming developmentally delayed or developmentally disabled, so adhering to the prevention mission of the department and saving future state costs by maximizing each child’s potential through early intervention and ameliorative services;
   4. (D) Reduce administrative and bureaucratic barriers to obtaining comprehensive evaluations and services so that eligible persons expeditiously may access the array of services offered by the division;
   5. (E) Accept responsibility for offering services to eligible persons and for assisting those persons—as well as those persons found ineligible—in accessing appropriate services from other state and local agencies, including other divisions within the department;
   6. (F) Emphasize that other state, county and local agencies also have a role to play in delivering coordinated, appropriate services to persons with developmental disabilities;

   7. (G) Expedite and facilitate eligibility determination by—

      1. 1. Accepting as automatically eligible

for screening those persons referred by other agencies which have found those persons eligible for their services;

1. 2. Accepting, and not duplicating,

assessment information provided by other private and public bodies, including schools, if regional centers determine that information to be reliable and appropriate;

1. 3. Using the screening process only to

facilitate an applicant’s eligibility, not to screen the applicant out of eligibility except an applicant whose disability clearly was not manifested before age twenty-two (22);

1. 4. Combining whenever possible the

screening and assessment processes so that they are not necessarily two (2) separate steps in the comprehensive evaluation process, for example, finding applicants eligible at screening, or waiving screening in favor of determining eligibility through assessment; and

1. 5. Making the application and compre-

hensive evaluation processes easy for applicants, for example, screening or assessing applicants in their homes as feasible or aiding them with transportation to regional centers as feasible;

1. (H) Ensure that eligibility decisions are based upon the following considerations, among others:

   1. 1. The best interest of the client or

applicant; and

1. 2. The client’s or applicant’s level of

adaptive behavior and functioning, including the effect upon the individual’s ability to function at either the same or an improved level of interpersonal and functional skills if services are denied or withdrawn; and

1. (I) Develop a training curriculum on the eligibility determination process and provide comprehensive initial and ongoing training for regional center personnel. 9 CSR 45-2

1. (2) Terms defined in sections 630.005, 632.005 and 633.005, RSMo are incorporated by reference for use in this rule. As used in this rule, unless the context clearly indicates otherwise, the following terms also mean:

   1. (A) Applicant—A person who has applied for services from the division or that person’s representative;
   2. (B) Assessment—The process of identifying an individual’s health status and intellectual, emotional, physical, developmental and social functioning levels for use in determining eligibility or developing the individualized habilitation plan or individualized family service plan;
   3. (C) Client—Any person who is placed by the department in a facility or program licensed and funded by the department or who is a recipient of services from a regional center;

   4. (D) Comprehensive evaluation—A study, including a sequence of observations and examinations of an individual, leading to conclusions and recommendations jointly formulated by an interdisciplinary assessment team of persons with special training and experience in the diagnosis and habilitation of persons with mental retardation and other developmental disabilities.

      1. 1. For children from birth through age

four (0–4), a comprehensive evaluation may include, but not necessarily be limited to, an interdisciplinary assessment team’s:

1. A. Assessment of the child using First

Steps eligibility criteria, or review of evidence of one (1) of the at-risk factors set out in paragraphs (3)(A)1.–3. of this rule, coupled with a review of scores on the Vineland Adaptive Behavior Scales (Vineland);

1. B. Review of available educational

and medical information;

1. C. Review of additional individual-

ized assessment and interview results to provide evidence of mental or physical impairments likely to continue indefinitely, evidence of substantial functional limitations caused by mental or physical impairments and evidence of a need for sequential and coordinated special services which may be of lifelong or extended duration; and

1. D. Formulation of conclusions and

recommendations.

1. 2. For children ages five through seven-

teen (5–17), a comprehensive evaluation may include, but not necessarily be limited to, an interdisciplinary assessment team’s:

1. A. Review of educational records;
2. B. Review of available vocational and

medical information;

1. C. Review of Vineland scores or

results of the Missouri Critical Adaptive Behaviors Inventory (MOCABI) as set out in paragraphs (3)(B)1. and 2. of this rule;

1. D. Review of additional individual-

ized assessment and interview results to provide evidence of mental or physical impairments likely to continue indefinitely, evidence of substantial functional limitations caused by mental or physical impairments and evidence of a need for sequential and coordinated special services which may be of lifelong or extended duration; and

1. E. Formulation of conclusions and

recommendations.

1. 3. For adults ages eighteen (18) and

older, a comprehensive evaluation may include, but not necessarily be limited to, an interdisciplinary assessment team’s:

1. A. Review of the results of the

MOCABI;

1. B. Review of available vocational,

medical and educational information;

1. C. Review of additional individual-

ized assessment and interview results to provide evidence of mental or physical impairments likely to continue indefinitely, evidence of substantial functional limitations caused by mental or physical impairments and evidence of a need for sequential and coordinated special services which may be of lifelong or extended duration; and

1. D. Formulation of conclusions and

recommendations;

1. (E) Developmental delay—

   1. 1. A delay, as measured and verified by

appropriate diagnostic measures and procedures (an interdisciplinary assessment), which results in a child having obtained no more than approximately fifty percent (50%) of the developmental milestones and skills that would be expected of a child of equal age and considered to be developing within normal limits. The delay must be identified in one (1) or more of the following five (5) developmental areas: cognitive, speech or language, self-help, physical (including vision and hearing) or psychosocial; or

1. 2. Demonstrated atypical development

in any one (1) of the five (5) developmental areas, based on professional judgment of an interdisciplinary assessment team and documented by—

1. A. Systematic and documented obser-

vation of functional abilities in daily routine;

1. B. Developmental history; and
2. C. Other appropriate assessment pro-

cedures which may include, but are not necessarily limited to, parent report, criteria-referenced assessment and developmental checklist;

1. (F) Developmental disability—A disability which—

1. 1. Is attributable to—

   1. A. Mental retardation, cerebral palsy,

epilepsy, head injury, autism or a learning disability related to a brain dysfunction; or

1. B. Any other mental or physical

impairment or combination of mental or physical impairments;

1. 2. Is manifested before the person

attains age twenty-two (22);

1. 3. Is likely to continue indefinitely;
2. 4. Results in substantial functional limi-

tations in two (2) or more of the following six (6) areas of major life activities: self-care, receptive and expressive language development and use, learning, self-direction, capacity for independent living or economic selfsufficiency and mobility; and

1. 5. Reflects the person’s need for a com-

bination and sequence of special, interdisciplinary or generic care, habilitation or other services which may be of lifelong or extended duration and are individually planned and coordinated;

1. (G) Eligible—Qualified through a comprehensive evaluation to receive services from the division, but not necessarily entitled to a specific service;
2. (H) First Steps—A statewide system of coordinated, comprehensive, multidisciplinary, interagency programs providing appropriate early intervention and service coordination services through individualized family service plans to all handicapped infants and toddlers (birth through age thirtysix months (0–36 months)) and their families in compliance with P. L. 99-457, Part H;

3. (I) Individualized family service plan—A written plan for providing early intervention services to a child and its family and which must—

   1. 1. Be developed jointly by the family

and appropriate qualified personnel involved in the provision of early intervention services;

1. 2. Be based on the multidisciplinary

evaluation and assessment of both the child and the family; and

1. 3. Include services to enhance the

child’s development and the capacity of the family to meet the child’s special needs;

1. (J) Initial service plan—A document developed by the client’s case manager to authorize immediate and necessary services after the client has been determined eligible but before the individualized habilitation plan or individualized family service plan is developed and implemented;
2. (K) Intake—The process conducted prior to determination of eligibility by which data is gathered from an applicant;
3. (L) Interdisciplinary assessment team— Qualified developmental disabilities professionals, persons with special training or expeand Developmental Disabilities

rience in the identification or habilitation of persons with developmental disabilities, and others approved by the division who participate in the comprehensive evaluation process for team determination of an applicant’s eligibility for services from the division;

1. (M) Interdisciplinary team—The client or applicant, case manager, interdisciplinary assessment team members, as appropriate, personnel from agencies providing services required or desired, and other persons (including family members) designated by the client or applicant;
2. (N) Logging—Recording in a uniform, consistent manner those dates and activities related to application, comprehensive evaluation and other eligibility determination procedures as well as dates and activities related to applicant and client appeals;

3. (O) Major life activities—

   1. 1. Self-care—Daily activities which en -

able a person to meet basic needs for food, hygiene and appearance; demonstrated ongoing ability to appropriately perform basic activities of daily living with little or no assistance or supervision;

1. 2. Receptive and expressive language—

Communication involving verbal and nonverbal behavior enabling a person to understand and express ideas and information to the general public with or without assistive devices; demonstrated ability to understand ordinary spoken and written communications and to speak and write well enough to communicate thoughts accurately and appropriately on an ongoing basis;

1. 3. Learning—General cognitive compe-

tence and ability to acquire new behaviors, perceptions and information and to apply experiences in new situations; demonstrated ongoing ability to acquire information, process experiences and appropriately perform ordinary, cognitive, age-appropriate tasks on an ongoing basis;

1. 4. Mobility—Motor development and

ability to use fine and gross motor skills; demonstrated ongoing ability to move about while performing purposeful activities with or without assistive devices and with little or no assistance or supervision;

1. 5. Self-direction—Management and con-

trol over one’s social and personal life; ability to make decisions and perform activities affecting and protecting personal interests; demonstrated ongoing ability to take charge of life activities as age-appropriate through an appropriate level of self-responsibility and assertiveness; and

1. 6. Capacity for independent living or

economic self-sufficiency—Age-appropriate ability to live without extraordinary assistance from other persons or devices, especially to maintain normal societal roles; ability to maintain adequate employment and financial support; ability to earn a living wage, net (determined by the interdisciplinary assessment team for each individual), after payment of extraordinary expenses caused by the disability; demonstrated ability to function on an ongoing basis as an adult independent of extraordinary emotional, physical, medical or financial support systems;

1. (P) Markedly disturbed social relatedness —A condition found in children from birth through age four (0–4) and characterized by—

   1. 1. Persistent failure to initiate or

respond in an age-appropriate manner to most social interactions, for example, absence of visual tracking and reciprocal play, lack of vocal imitation or playfulness, apathy, little or no spontaneity, or lack of or little curiosity and social interest; or

1. 2. Indiscriminate sociability, for exam-

ple, excessive familiarity with relative strangers by making requests and displaying affection;

1. (Q) Mental or physical impairment—

   1. 1. An impairment that results from

anatomical, physiological or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques; or

1. 2. An impairment, in the broadest inter-

pretation, which may include any neurological, sensory, biochemical, intellectual, cognitive or perceptual deficit (excluding social problems) or mood disorder, as determined by an interdisciplinary assessment team, which limits an individual’s ability to perform life, developmental or functional activities that would be expected of an individual of equal age and considered to be developing or to have developed within normal limits;

1. (R) Mental retardation—Significantly subaverage general intellectual functioning which originates before age eighteen (18) and is associated with significant impairment in adaptive behavior;
2. (S) Missouri Critical Adaptive Behaviors Inventory (MOCABI)—A structured interview tool used during screening to gather data to help determine if a substantial functional limitation exists (see Appendix A);
3. (T) Protector—An adult client’s parent, relative or other person, except for a legally appointed guardian, designated by the client and recognized by the department to assist the client in planning and participating in habilitation;

4. (U) Qualified developmental disabilities professional—An individual who has at least one (1) year of experience working directly with persons with developmental disabilities and is one (1) of the following:

   1. 1. A doctor of medicine or osteopathy,

which may include a doctor with a specific specialty;

1. 2. A registered nurse; or
2. 3. An individual who holds at least a

bachelor’s degree in occupational therapy, physical therapy, psychology, social work, speech-language pathology, audiology, recreation, dietetics, sociology, special education, rehabilitation counseling, or a related field approved by the division director;

1. (V) Representative—Applicant’s or client’s legal guardian, parent (if applicant or client is a minor) or protector (for adult clients);
2. (W) Screening—Initial evaluation services, possibly including review by an interdisciplinary assessment team of information collected during the intake and application processes to substantiate that the applicant is developmentally disabled or is suspected to be developmentally disabled and requires further assessment for eligibility determination;
3. (X) Special education services—Programs designed to meet the needs and maximize the capabilities of children who are handicapped or severely handicapped and which include, but are not limited to, the provision of diagnostic and evaluation services; student and parent counseling; itinerant, homebound and referral assistance; organized instructional and therapeutic programs; transportation; and corrective and supporting services;
4. (Y) Substantial functional limitation—An inability, due to a mental or physical impairment, to individually and independently perform a major life activity within expectations of age and culture;
5. (Z) Temporary action plan—A written plan developed by (at least) the applicant, the applicant’s family and case manager to authorize additional assessment and counseling services only for the purpose of completing the comprehensive evaluation; and
6. (AA) Vineland Adaptive Behavior Scales (Vineland)—A screening device for evaluating an individual’s performance in daily activities by assessing the four (4) domains of communication, daily living, socialization and motor development.

1. (3) Eligibility for services from the division is predicated on the applicant’s either having mental retardation or a developmental disability or being at risk of becoming developmentally delayed or developmentally disabled. The following criteria shall be used in carrying out comprehensive evaluations for determining eligibility for services from the division: 9 CSR 45-2

   1. (A) Children From Birth Through Age Four (0–4). Children who are eligible for the First Steps program, as well as children who, except for age, would be eligible for that program, even though the children may not be eligible for public school services, automatically shall be eligible for services except for children whose sole service needs are specialized medical treatment for diagnosed health conditions or for children served by the Department of Health under an interagency agreement with the Department of Mental Health. The division shall determine eligibility for those children on an individualized basis; or any one (1) of the following at-risk circumstances, when coupled with a score of at least one and one-half (1.5) standard deviations below the norm in any one (1) of the four (4) developmental areas of the Vineland shall make a child eligible:

      1. 1. Receipt by the division of documenta-

tion, based upon an individualized assessment from a qualified developmental disabilities professional, that there is markedly disturbed social relatedness in most contexts which puts the child at risk of becoming developmentally delayed or developmentally disabled;

1. 2. Determination by a regional center

that a child’s primary care giver has a developmental disability and that the developmental disability could put the child at risk of becoming developmentally delayed or developmentally disabled; or

1. 3. A Division of Family Services refer-

ral of a child who that division has found reason to suspect is abused or neglected and who a qualified developmental disabilities professional has documented, based upon an individualized assessment, is at risk of becoming developmentally delayed or developmentally disabled;

1. (B) Children Ages Five Through Seventeen (5–17).

   1. 1. Children scoring as follows on the

Vineland shall be considered to have substantial functional limitations in two (2) or more areas of major life activity:

1. A. One and one-half (1.5) standard

deviations below the norm in at least two (2) developmental areas; or

1. B. Two (2) or more standard devia-

tions below the norm in only one (1) developmental area.

1. 2. Children of older ages in this age

range for whom the MOCABI may be a more appropriate screening instrument and whose scores on the MOCABI, or through additional individualized assessment or interview, indicate deficits in two (2) or more of the areas of major life activity shall be considered to have substantial functional limitations in those areas; and

1. (C) Adults Ages Eighteen (18) and Older. Adults whose comprehensive evaluations indicate deficits in two (2) or more of the areas of major life activity shall be considered to have substantial functional limitations in those areas.

1. (4) The procedure for determining eligibility for applicants and clients shall be a comprehensive evaluation consisting of phases rather than a series of discrete and sequential steps. That is, screening and assessment shall not necessarily be separate and required steps. Thus, a screening itself may find an applicant eligible for services, and further assessment would be completed primarily to assist in development of the individualized habilitation plan or individualized family service plan. Furthermore, only if screening does not result in a determination of eligibility shall further assessment be conducted for the purpose of determining eligibility. On the other hand, if there is convincing evidence that an applicant has a developmental disability, neither screening nor assessment shall be necessary for the purpose of determining eligibility. Rather, the regional center shall conduct an assessment for the purpose of developing the individualized habilitation plan or individualized family service plan. No applicant shall be found ineligible solely as a result of screening except an applicant whose disability clearly was not manifested before age twenty-two (22); a finding of ineligibility shall be made only after completion of the comprehensive evaluation. Each regional center director shall designate a member of the staff to help ensure that the eligibility determination process proceeds in a timely manner. The name of that individual shall be posted in the center and shall be given to all applicants. This staff member shall have access to all necessary information from the interdisciplinary assessment teams.

   1. (A) Regional centers shall complete comprehensive evaluations within thirty (30) working days after receipt of valid applications from all applicants except applicants for services under the First Steps program. For applicants for services under the First Steps program, regional centers shall complete comprehensive evaluations and develop individualized family service plans within fortyfive (45) days after receiving referrals for services under that program.

   2. (B) Individuals may apply for services only on application forms provided by the division.

      1. 1. By the end of the next working day

after any referral, inquiry or request for services, a regional center shall provide application forms and information about services offered by the division and the regional centers unless it is clearly evident that the inquiry, request or referral has been made to the division inappropriately or is for a person who is ineligible for services. In cases of evident ineligibility or inappropriate inquiries, requests or referrals, regional centers shall refer individuals for whom services have been requested to appropriate agencies within five (5) working days after the inquiry, request or referral.

1. 2. For an individual’s request for ser-

vices to be considered, the regional center must receive a valid application for services. An application shall be valid only if signed or marked by the applicant. A mark must be witnessed.

1. 3. Regional center staff shall contact the

individual within ten (10) working days of receipt of an invalid application to obtain a valid application so that the comprehensive evaluation process can continue.

1. 4. If the regional center has not received

an application within thirty (30) days of the date it was provided to the individual, regional center staff shall contact the individual directly by telephone or mail, if possible, and in person, if necessary, to determine if the individual desires to continue the application for services and, if so, if assistance is needed in completing an application.

1. (C) Except as otherwise required in subsection (4)(A), within thirty (30) working days of receipt of a valid application, a regional center shall complete a comprehensive evaluation and determine eligibility for services. A comprehensive training program shall be developed to train staff to evaluate persons from any disability group which may be eligible for services under the definition of developmental disability.

   1. 1. If screening is required—

      1. A. The Vineland shall be used during

screening of children up to age eighteen (18) to help to determine if substantial functional limitations exist unless administration of the MOCABI is considered more appropriate for children of older ages in the age range of five through seventeen (5–17); or

1. B. The MOCABI shall be used during

screening of adults age eighteen (18) and older to help determine if substantial functional limitations exist.

1. 2. Regional centers shall conduct

screenings and assessments in applicants’ homes as feasible unless applicants request other sites. If screenings or assessments are not done in applicants’ homes, reasons shall and Developmental Disabilities

be documented in applicants’ files. If screenings or assessments are to be done at the regional centers, the regional centers shall work with applicants to secure transportation to the centers.

1. 3. If applicants are not found eligible

through screening, regional centers shall conduct further assessments to complete comprehensive evaluations. Applicants not found eligible pursuant to the definition of developmental disability but who claim eligibility due to mental retardation shall refer to subsection (4)(D) of this rule.

1. (D) If an applicant who claims eligibility due to mental retardation has not been found to have substantial functional limitations in two (2) or more areas of major life activity under this rule, the interdisciplinary assessment team shall conduct further cognitive and behavioral assessments to determine if the applicant has mental retardation. One (1) or more standardized testing tools currently defined by the American Association on Mental Retardation shall be used in conducting the cognitive and behavioral assessments.

2. (E) If within thirty (30) working days of receipt of a valid application the interdisciplinary assessment team finds the applicant ineligible for services, the regional center shall—

   1. 1. Provide, to the applicant, within

one (1) working day of the decision, written notice of right to appeal the decision, a statement of the legal and factual reasons for the denial, a notice of the appeals process contained in 9 CSR 45-2.020 and a brochure which explains the appeals process;

1. 2. Orally provide to the applicant, with-

in one (1) working day of the decision, if possible, the reasons for ineligibility and an explanation of the applicant’s right to appeal, along with the name of the applicant’s case manager and the telephone number at the regional center; and

1. 3. Make referrals within five (5) work-

ing days of the decision, to other agencies and monitor services received by the applicant for at least thirty (30) days from the date of the ineligibility determination.

1. (F) Except as otherwise required in subsection (4)(A), if the interdisciplinary assessment team cannot make an eligibility determination within thirty (30) working days of receipt of a valid application because the regional center has not received collateral data or other information critical to the determination, an interdisciplinary team shall develop a temporary action plan within that thirty (30) working day period, and the center may take up to thirty (30) additional days to determine eligibility.

   1. 1. For an applicant then determined eli-

gible during the additional thirty (30)-day period, the interdisciplinary team also shall develop the individualized habilitation plan or individualized family service plan within the thirty (30)-day additional period.

1. 2. For an applicant determined ineligible

during the additional thirty (30)-day period, the regional center shall provide written and oral notices as set out in paragraphs (4)(E)1. and 2. of this rule and shall make referrals to other agencies and monitor services received by the applicant as set out in paragraph (4)(E)3. of this rule.

1. (G) If the interdisciplinary assessment team does not make a determination on eligibility within thirty (30) working days of receipt of a valid application, even though the regional center has received collateral data and all other information critical to the determination, the regional center staff member designated under section (4) of this rule or the applicant shall notify the center director, who shall direct the interdisciplinary assessment team to make the eligibility determination within five (5) working days of the notification from the staff member designated under section (4) of this rule, or the applicant.

   1. 1. For an applicant then determined eli-

gible, the center shall proceed as set out in paragraphs (4)(H)1.–3. of this rule.

1. 2. For an applicant then determined

ineligible, the center shall proceed as set out in paragraphs (4)(E)1.–3. of this rule.

1. (H) For an applicant determined eligible within thirty (30) working days of receipt of valid application—

   1. 1. The regional center shall provide

written notice of eligibility and client status within three (3) working days of the determination;

1. 2. The interdisciplinary team shall

develop an individualized habilitation plan or individualized family service plan within thirty (30) days after the date of the eligibility determination; and

1. 3. For clients needing immediate ser-

vices, the case manager also shall develop an initial service plan within five (5) working days after the eligibility determination unless an individualized habilitation plan or individualized family service plan already has been developed.

1. (I) Using a comprehensive evaluation, regional centers shall periodically review the eligibility status of their clients and shall discharge clients who are no longer eligible for services and clients for whom division services are no longer appropriate. At a minimum, all clients shall be reassessed through comprehensive evaluations on or immediate- 9 CSR 45-2

ly before their fifth, eighteenth and twentysecond birthdays.

1. 1. Not later than sixty (60) days before a

reassessment, the regional center shall provide to the client a written notice of the upcoming reassessment and of the possibility that division services may be discontinued.

1. 2. If, as a result of the comprehensive

evaluation, a client is found ineligible or no longer in need of services, the regional center shall provide written and oral notice as set out in paragraphs (4)(E)1. and 2. of this rule and shall prepare a discharge plan which shall provide at least sixty (60) days from the date of that plan for the client to transition from division services into services from other agencies. The center shall monitor and assist with that transition.

1. (J) For purposes of quality assurance and consistency, the regional center staff member designated under section (4) of this rule shall conduct timely reviews of all individual assessments, diagnostic impressions and findings of the interdisciplinary assessment team and report irregularities to the center director. This quality assurance procedure is not part of the eligibility determination process and shall not delay delivery of services to eligible individuals.
2. (K) Regional center staff shall log the disposition of all applications, including eligibility determinations, appeals and referrals to other agencies. Comprehensive evaluation activities noted throughout this rule shall be logged immediately or on the same working day.
3. (L) If an applicant or client disagrees with an ineligibility determination, the determination may be appealed under procedures contained in 9 CSR 45-2.020.

AUTHORITY: section 630.050, RSMo (1994).* This rule was previously filed as 9 CSR 50-1.045. Original rule filed Oct. 2, 1991, effective May 14, 1992. Amended: Filed May 25, 1995, effective Dec. 30, 1995. Amended: Filed Oct. 25, 1995, effective April 30, 1996. Amended: Filed June 25, 1996, effective Feb. 28, 1997. *Original authority: 630.050, RSMo 1980, amended 1993, 1995. and Developmental Disabilities and Developmental Disabilities and Developmental Disabilities and Developmental Disabilities and Developmental Disabilities and Developmental Disabilities and Developmental Disabilities and Developmental Disabilities and Developmental Disabilities