PURPOSE: This rule describes procedures to obtain certification from the department as a provider of individualized supported living services reimbursed under the Missouri Medicaid Home and Community-Based Waiver for persons with mental retardation or other developmental disabilities. 9 CSR 45-5

1. (1) To be enrolled as a provider of individualized supported living services, an applicant shall possess a master agreement and a purchase of service contract with the department and one (1) of the following:

   1. (A) Accreditation by Accreditation Council on Services for People With Disabilities

2. (ACD) or Commission on Accreditation of Rehabilitation Facilities (CARF);

   1. (B) Residential licensure as a family living arrangement; or
   2. (C) Certification by the department that the applicant will meet the standards in 9 CSR 45-5.020.
3. (2) Applicants for certification shall apply in accordance with this rule.

4. (3) The certification unit may grant a limited certificate to a single person who will provide services to no more than three (3) individuals with mental retardation or other developmental disabilities, subject only to the provisions of sections (3)–(5) and (9) of this rule after the following conditions have been met:

   1. (A) The applicant shall be a qualified mental retardation professional (QMRP);
   2. (B) The regional center shall have completed a criminal background check of the individual and verified that s/he has not been convicted of, nor has charges pending for, any disqualifying felony offense; and
   3. (C) The regional center shall provide assurance to the certification unit that the individual provider is capable of carrying out the provisions of 9 CSR 45-5.020.
5. (4) The applicant shall submit an application to the certification unit on forms provided by the department. The stamped date of receipt shall be the date of application. The certification unit shall provide a copy to the regional center director within five (5) days after the date of application, and the regional center director or his/her designee shall review the application and provide comment and recommendation back to the certification unit within thirty (30) days after the date of application.
6. (5) A provider that meets requirements of this rule shall initially receive a probationary certificate from the department. This includes a provider that is granted a limited certificate under section (3) of this rule. The probationary certificate or the probationary limited certificate shall be in effect until a provider has one (1) year of established performance in providing supported living services. After one (1) year and each two (2) years after that, the department shall conduct an on-site review of the provider to ensure that the provider is carrying out the provisions of 9 CSR 45-5.020.
7. (6) Certification applications must be signed by the designated governing body authority.

8. (7) Qualifications for Certification.

   1. (A) The provider shall have an administrator with a bachelor’s degree from an accredited institution and at least one (1) year of full-time paid working experience in the provision of services to individuals with mental retardation and other developmental disabilities in a supervisory or administrative capacity.
   2. (B) If the administrator is not a QMRP, the provider shall employ a QMRP, either fullor part-time, to consult with staff about strategies for each recipient to achieve the outcomes specified in the seven (7) areas identified under 9 CSR 45- 5.020(2).

   3. (C) The provider shall provide a functional table of organization, a job description for each position in the organization, and policies and procedures that address the provider’s management practices in the following areas:

      1. 1. Services and supports.

         1. A. Mission statement.
         2. B. Procedure for notifying individuals

of their rights.

1. C. Grievance procedure for individu-

als served.

1. D. Unusual incident reporting and

follow-up.

1. E. Procedures for helping individuals

secure safe and appropriate housing.

1. F. Procedures for finding and devel-

oping supports.

1. G. Crisis intervention and emergency

response procedures.

1. H. Procedures for protecting confi-

dentiality;

1. 2. Administration.

   1. A. Record keeping procedures to doc-

ument the delivery of services and the quality of services delivered.

1. B. Supervision of staff.
2. C. Screening and background checks

on applicants for employment in positions involving direct service delivery.

1. D. Liability insurance for staff deliv-

ering direct services.

1. E. Staff training; and
2. 3. Board functions, if applicable, includ-

ing bylaws, a list of the board members’ names and addresses, and a statement of each member’s financial interest in the provider.

1. (8) Within thirty (30) days after receiving a properly completed application for provider certification or if the department chooses to revoke a provider’s certificate, the departand Developmental Disabilities

ment may conduct an interview with the applicant provider to review any cited deficiencies in the material submitted for certification. Within thirty (30) days after the review, the department shall notify the provider of its decision. The provider may appeal the department’s decision to the director. The director shall review the appeal within thirty (30) days.

1. (9) If the department finds the certified provider out of compliance with the standards in 9 CSR 45-5.020 to an extent that would result in substantial probability of or actual jeopardy to client safety or welfare, the department shall revoke the certificate by taking the following actions:

   1. (A) The department shall notify the certified provider in writing of the evidence and of the right to appeal the decision to the director of the department within thirty (30) days of receiving the notice; and
   2. (B) The department may suspend a certificate pending final action to revoke the certificate if, in the judgment of the director, the character of the charges warrants action.

AUTHORITY: section 630.050, RSMo 1994.* This rule was originally filed as 9 CSR 30- 5.030. Emergency rule filed Aug. 4, 1992, effective Sept. 1, 1992, expired Dec. 29, 1992. Original rule filed Aug. 4, 1992, effective Feb. 26, 1993. Amended: Filed May 25, 1995, effective Dec. 30, 1995. *Original authority: 630.050, RSMo 1980, amended 1993.