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Last updated November 2003
Chapter 630
Department of Mental Health
Department created--state mental health commission--
630.003.
1. There is hereby created a department of mental health to be headed by a
mental health commission who shall appoint a director, by and with the advice
and consent of the senate. The director shall be the administrative head of the
department and shall serve at the pleasure of the commission and be compensated
as provided by law for the director, division of mental health. All employees
of the department shall be selected in accordance with chapter 36, RSMo.
2.
(1) The "State Mental Health Commission", composed of seven members,
is the successor to the former state mental health commission and it has all
the powers, duties and responsibilities of the former commission. All members
of the commission shall be appointed by the governor, by and with the advice
and consent of the senate. None of the members shall otherwise be employed by
the state of
(2) Three of the commission members first appointed shall be
appointed for terms of four years, and two shall be appointed for terms of
three years, and two shall be appointed for a term of two years. The governor
shall designate, at the time the appointments are made, the length of the term
of each member so appointed. Thereafter all terms shall be for four years.
(3) At least two of the members of the commission shall be
physicians, one of whom shall be recognized as an expert in the field of the
treatment of nervous and mental diseases, and one of whom shall be recognized
as an expert in the field of mental retardation or of other developmental
disabilities. At least two of the members of the commission shall be
representative of persons or groups who are consumers having substantial
interest in the services provided by the division, one of whom shall represent
the mentally retarded or developmentally disabled and one of whom shall
represent those persons being treated for nervous and mental diseases. Of the
other three members at least one must be recognized for his expertise in general
business management procedures, and two shall be
recognized for their interest and expertise in dealing with alcohol/drug abuse
problems, or community mental health services.
3.
The provisions of sections 191.120, 191.125, 191.130, 191.140, 191.150, 191.160,
191.170, 191.180, 191.190, 191.200, 191.210, RSMo,
and others as they relate to the division of mental health not previously
reassigned by executive reorganization plan number 2 of 1973 as submitted by
the governor under chapter 26, RSMo, are transferred
by specific type transfer from the department of public health and welfare to
the department of mental health. The division of mental health, department of
health and welfare, chapter 202, RSMo, and others are
abolished and all powers, duties and functions now assigned by law to the
division, the director of the divisions of mental health or any of the
institutions or officials of the division are transferred by type I transfer to
the department of mental health.
4.
The
5.
There is hereby established within the department of mental health a division
of mental retardation and developmental disabilities. The director of the
division shall be appointed by the director of the department. The division
shall administer all state facilities under the direction and authority of the
department director. The Marshall Habilitation Center, the Higginsville
Habilitation Center, the Bellefontaine Habilitation Center, the Nevada
Habilitation Center, the St. Louis Developmental Disabilities Treatment
Centers, and the regional centers located at Albany, Columbia, Hannibal,
Joplin, Kansas City, Kirksville, Poplar Bluff, Rolla, St. Louis, Sikeston and
Springfield and other similar facilities as may be established, are transferred
by type I transfer to the division of mental retardation and developmental
disabilities.
6.
All the duties, powers and functions of the advisory council on mental
retardation and community health centers, sections 202.664 to 202.666, RSMo, are hereby transferred by type I transfer to the
division of mental retardation and developmental disabilities of the department
of mental health. The advisory council on mental retardation and community
health centers shall be appointed by the division director.
7.
The advisory council on mental retardation and developmental disabilities
heretofore established by executive order and all of the duties, powers and
functions of the advisory council including the responsibilities of the
provision of the council in regard to the Federal Development Disabilities Law
(P.L. 91-517) and all amendments thereto are transferred by type I transfer to
the division of mental retardation and developmental disabilities. The advisory
council on mental retardation and developmental disabilities shall be appointed
by the director of the division of mental retardation and developmental
disabilities.
8.
The advisory council on alcoholism and drug abuse, chapter 202, RSMo, is transferred by type II transfer to the department
of mental health and the members of the advisory council shall be appointed by
the mental health director.
Definitions.
630.005.
As used in this chapter and chapters 631, 632, and 633, RSMo,
unless the context clearly requires otherwise, the following terms shall mean:
(1)
"Administrative entity", a provider of specialized services other
than transportation to clients of the department on behalf of a division of the
department;
(2)
"Alcohol abuse", the use of any alcoholic beverage, which use results
in intoxication or in a psychological or physiological dependency from
continued use, which dependency induces a mental, emotional or physical
impairment and which causes socially dysfunctional behavior;
(3)
"Chemical restraint", medication administered with the primary intent
of restraining a patient who presents a likelihood of serious physical injury
to himself or others, and not prescribed to treat a person's medical condition;
(4)
"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, as defined in section 633.005, RSMo;
(5)
"Commission", the state mental health commission;
(6)
"Consumer", a person:
(a) Who qualifies to receive department services; or
(b) Who is a parent, child or sibling of a person who
receives department services; or
(c) Who has a personal interest in services provided by the department. A person who provides services to persons
affected by mental retardation, developmental disabilities, mental disorders,
mental illness, or alcohol or drug abuse shall not be considered a consumer;
(7)
"Day program", a place conducted or maintained by any person who
advertises or holds himself out as providing prevention, evaluation, treatment,
habilitation or rehabilitation for persons affected by mental disorders, mental
illness, mental retardation, developmental disabilities or alcohol or drug
abuse for less than the full twenty-four hours comprising each daily period;
(8)
"Department", the department of mental health of the state of
(9)
"Developmental disability", a disability:
(a) Which is attributable to:
a. Mental retardation, cerebral palsy,
epilepsy, head injury or autism, or a learning disability related to a brain
dysfunction; or
b. Any other mental or physical
impairment or combination of mental or physical impairments; and
(b) Is manifested before the person attains age twenty-two; and
(c) Is likely to continue
indefinitely; and
(d) Results in substantial functional limitations in two or
more of the following areas of major life activities:
a. Self-care;
b. Receptive and expressive language
development and use;
c. Learning;
d. Self-direction;
e. Capacity for independent living
or economic self-sufficiency;
f. Mobility; and
(e) Reflects the person's need for a combination 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;
(10)
"Director", the director of the department of mental health, or his
designee;
(11)
"Domiciled in Missouri", a permanent connection between an individual
and the state of Missouri, which is more than mere residence in the state; it
may be established by the individual being physically present in Missouri with
the intention to abandon his previous domicile and to remain in Missouri
permanently or indefinitely;
(12)
"Drug abuse", the use of any drug without compelling medical reason,
which use results in a temporary mental, emotional or physical impairment and
causes socially dysfunctional behavior, or in psychological or physiological
dependency resulting from continued use, which dependency induces a mental,
emotional or physical impairment and causes socially dysfunctional behavior;
(13)
"Habilitation", a process of treatment, training, care or specialized
attention which seeks to enhance and maximize the mentally retarded or
developmentally disabled person's abilities to cope with the environment and to
live as normally as possible;
(14)
"Habilitation center", a residential facility operated by the
department and serving only persons who are mentally retarded, including developmentally
disabled;
(15)
"Head of the facility", the chief administrative officer, or his
designee, of any residential facility;
(16)
"Head of the program", the chief administrative officer, or his
designee, of any day program;
(17)
"Individualized habilitation plan", a document which sets forth
habilitation goals and objectives for mentally retarded or developmentally
disabled residents and clients, and which details the habilitation program as
required by law, rules and funding sources;
(18)
"Individualized rehabilitation plan", a document which sets forth the
care, treatment and rehabilitation goals and objectives for patients and
clients affected by alcohol or drug abuse, and which details the rehabilitation
program as required by law, rules and funding sources;
(19)
"Individualized treatment plan", a document which sets forth the
care, treatment and rehabilitation goals and objectives for mentally disordered
or mentally ill patients and clients, and which details the treatment program
as required by law, rules and funding sources;
(20)
"Investigator", an employee or contract agent of the department of
mental health who is performing an investigation regarding an allegation of abuse
or neglect or an investigation at the request of the director of the department
of mental health or his designee;
(21)
"Least restrictive environment", a reasonably available setting or
mental health program where care, treatment, habilitation or rehabilitation is
particularly suited to the level and quality of services necessary to implement
a person's individualized treatment, habilitation or rehabilitation plan and to
enable the person to maximize his functioning potential to participate as freely
as feasible in normal living activities, giving due consideration to
potentially harmful effects on the person and the safety of other facility or
program clients and public safety. For some mentally disordered or mentally
retarded persons, the least restrictive environment may be a facility operated
by the department, a private facility, a supported community living situation,
or an alternative community program designed for persons who are civilly
detained for outpatient treatment or who are conditionally released pursuant to
chapter 632, RSMo;
(22)
"Mental disorder", any organic, mental or emotional impairment which
has substantial adverse effects on a person's cognitive, volitional or
emotional function and which constitutes a substantial impairment in a person's
ability to participate in activities of normal living;
(23)
"Mental illness", a state of impaired mental processes, which
impairment results in a distortion of a person's capacity to recognize reality
due to hallucinations, delusions, faulty perceptions or alterations of mood,
and interferes with an individual's ability to reason, understand or exercise
conscious control over his actions. The term "mental illness" does
not include the following conditions unless they are accompanied by a mental
illness as otherwise defined in this subdivision:
(a) Mental retardation, developmental disability or
narcolepsy;
(b) Simple intoxication caused by substances such as alcohol
or drugs;
(c) Dependence upon or addiction to any substances such as
alcohol or drugs;
(d) Any other disorders such as senility, which are not of
an actively psychotic nature;
(24)
"Mental retardation", significantly subaverage
general intellectual functioning which:
(a) Originates before age eighteen; and
(b) Is associated with a
significant impairment in adaptive behavior;
(25)
"Minor", any person under the age of eighteen years;
(26)
"Patient", an individual under observation, care, treatment or
rehabilitation by any hospital or other mental health facility or mental health
program pursuant to the provisions of chapter 632, RSMo;
(27)
"Psychosurgery",
(a) Surgery on the normal brain tissue of an individual not
suffering from physical disease for the purpose of changing or controlling
behavior; or
(b) Surgery on diseased brain tissue of an individual if the
sole object of the surgery is to control, change or affect behavioral
disturbances, except seizure disorders;
(28)
"Rehabilitation", a process of restoration of a person's ability to
attain or maintain normal or optimum health or constructive activity through
care, treatment, training, counseling or specialized attention;
(29)
"Residence", the place where the patient has last generally lodged
prior to admission or, in case of a minor, where his family has so lodged; except,
that admission or detention in any facility of the department shall not be
deemed an absence from the place of residence and shall not constitute a change
in residence;
(30)
"Resident", a person receiving residential services from a facility,
other than mental health facility, operated, funded or licensed by the
department;
(31)
"Residential facility", any premises where residential prevention,
evaluation, care, treatment, habilitation or rehabilitation is provided for
persons affected by mental disorders, mental illness, mental retardation,
developmental disabilities or alcohol or drug abuse; except the person's
dwelling;
(32)
"Specialized service", an entity which provides prevention,
evaluation, transportation, care, treatment, habilitation or rehabilitation
services to persons affected by mental disorders, mental illness, mental
retardation, developmental disabilities or alcohol or drug abuse;
(33)
"Vendor", a person or entity under contract with the department,
other than as a department employee, who provides services to patients,
residents or clients.
Mental health commission--members,
terms, qualifications, appointment, vacancies, compensation--organization,
meetings.
630.010.
1. The state mental health commission, established by the omnibus
reorganization act of 1974, section 9, appendix B, RSMo,
shall be composed of seven members appointed by the governor, by and with the
advice and consent of the senate. The terms of members appointed under the
reorganization act before
2.
The commission shall be comprised of members who are not prohibited from
serving by sections 105.450 to 105.482, RSMo, as
amended, and who are not otherwise employed by the state. The commission shall
be composed of the following:
(1) A physician recognized as an expert in the treatment of
mental illness;
(2) A physician recognized as an expert in the evaluation or
habilitation of the mentally retarded and developmentally disabled;
(3) A representative of groups who are consumers or families
of consumers interested in the services provided by the department in the
treatment of mental illness;
(4) A representative of groups who are consumers or families
of consumers interested in the services provided by the department in the
habilitation of the mentally retarded;
(5) A person recognized for his expertise in general
business matters and procedures;
(6) A person recognized for his interest and expertise in
dealing with alcohol or drug abuse; and
(7) A person recognized for his interest or expertise in
community mental health services.
3.
Vacancies occurring on the commission shall be filled by appointment by the
governor, by and with the advice and consent of the senate, for the unexpired terms. In case of a vacancy when the senate is
not in session, the governor shall make a temporary appointment until the next
session of the general assembly, when he shall nominate someone to fill the
office.
4.
The commission shall elect from its members a chairman and a secretary.
Meetings shall be held at least once a month, and special meetings may be held
at the call of the chairman.
5.
The department shall pay the commission members one hundred dollars per day for
each day, or portion thereof, they actually spend in transacting the business
of the commission and shall reimburse the commission members for necessary
expenses actually incurred in the performance of their official duties.
Director, appointment--duties of
commission.
630.015.
1. The state mental health commission shall appoint the director of the
department by and with the advice and consent of the senate, and the director
shall serve at the pleasure of the commission.
2.
The commission shall advise the director of the department as to all phases of
department practices in order to make them compatible with professional
standards, including the following subjects:
(1) Care, treatment, habilitation and rehabilitation
facilities and programs;
(2) Manpower recruitment, development and training;
(3) Medical and statistical records;
(4) Operational policies;
(5) Accessibility of services.
3.
The commission shall advise the director in the initiation, approval and
guidance of research projects and distribution of research funds.
4.
The commission shall assist the director in establishing, maintaining and
reviewing the best possible plans, practices, rules and regulations,
facilities, programs and services which are operated, funded or licensed by the
department.
Departmental goals, duties.
630.020.
1. The department shall seek to do the following for the citizens of this
state:
(1) Reduce the incidence and prevalence of mental disorders,
developmental disabilities and alcohol or drug abuse through primary, secondary
and tertiary prevention;
(2) Maintain and enhance intellectual, interpersonal and
functional skills of individuals affected by mental disorders, developmental
disabilities or alcohol or drug abuse by operating, funding and licensing
modern treatment and habilitation programs provided in the least restrictive
environment possible;
(3) Improve public understanding of and attitudes toward
mental disorders, developmental disabilities and alcohol and drug abuse.
2.
The department shall make necessary orders, policies and procedures for the
government, administration, discipline and management of its facilities,
programs and operations.
Research activities by department.
630.055.
From funds appropriated by the general assembly for this purpose, the
department may conduct research into the causes of mental disorders,
developmental disabilities and alcohol or drug abuse, into improving methods of
care, treatment, habilitation and rehabilitation for persons affected by such
conditions, and the stigmatizing effects on persons presently or formerly
served in the department service delivery system. Insofar as practicable, the
department shall make use of and cooperate with the services and facilities of
the various state universities and state agencies to conduct its research.
Cooperation with other groups.
630.060.
The department shall seek and encourage cooperation and active participation of
communities, counties, organizations, agencies, private and not-for-profit
corporations and individuals in the effort to establish and maintain quality
programs and services for persons affected by mental disorders, developmental
disabilities or alcohol or drug abuse. The department shall develop programs of
public information and education for this purpose.
State auditor may examine records--personally identifiable
information not to be revealed.
630.080.
The state auditor shall have access to all records maintained and established
by the department. Any confidential records shall not be divulged in such a way
to reveal personally identifiable information.
Annual report by director, to whom,
when, contents.
630.085.
1. The director shall make an annual written report on behalf of the department
to the governor and the general assembly within ninety days of the end of each
fiscal year.
2.
The report shall include pertinent information as to the cost and benefit
effectiveness of activities, projects, plans and accomplishments of the
department and each of its divisions, together with statistics and summaries of
financial receipts and expenditures as the director may, with the advice of the
commission, deem necessary and expedient. The reports may be presented in sections
compiled on behalf of each respective division of the department.
3.
The department shall indicate every two years in every even-numbered year
whether each department facility is in compliance with standards applicable to
the facility, the deficiencies which cause the facility not to be in compliance
if it is not and the actions necessary for the facility to achieve compliance,
unless the report states the reasons for the facility not to attempt to achieve
compliance.
Patient's rights--limitations.
630.110.
1. Except as provided in subsection 5 of this section, each person admitted to
a residential facility or day program and each person admitted on a voluntary
or involuntary basis to any mental health facility or mental health program
where people are civilly detained pursuant to chapter 632, RSMo,
except to the extent that the head of the residential facility or day program
determines that it is inconsistent with the person's therapeutic care,
treatment, habilitation or rehabilitation and the safety of other facility or
program clients and public safety, shall be entitled to the following:
(1) To wear his own clothes and to keep and use his own
personal possessions;
(2) To keep and be allowed to spend a reasonable sum of his own money for canteen expenses and small purchases;
(3) To communicate by sealed mail or otherwise with persons
including agencies inside or outside the facility;
(4) To receive visitors of his own choosing at reasonable
times;
(5) To have reasonable access to a telephone both to make
and receive confidential calls;
(6) To have access to his mental and medical records;
(7) To have opportunities for physical exercise and outdoor
recreation;
(8) To have reasonable, prompt access to current newspapers,
magazines and radio and television programming.
2.
Any limitations imposed by the head of the residential facility or day program
or his designee on the exercise of the rights enumerated in subsection 1 of
this section by a patient, resident or client and the reasons for such
limitations shall be documented in his clinical record.
3.
Each patient, resident or client shall have an absolute right to receive visits
from his attorney, physician or clergyman, in private, at reasonable times.
4.
Notwithstanding any limitations authorized under this section on the right of
communication, every patient, resident or client shall be entitled to
communicate by sealed mail with the department, his legal counsel and with the
court, if any, which has jurisdiction over the person.
5.
Persons committed to a residential facility or day program operated, funded or
licensed by the department pursuant to section 552.040, RSMo,
shall not be entitled to the rights enumerated in subdivisions (1), (3) and (5)
of subsection 1 of this section unless the head of the residential facility or
day program determines that these rights are necessary for the person's
therapeutic care, treatment, habilitation or rehabilitation. In exercising the
discretion to grant any of the rights enumerated in subsection 1 of this
section to a patient, resident or client, the head of the residential facility
or day program shall consider the safety of the public.
Patient's
entitlements--administrative review of violations.
630.115.
1. Each patient, resident or client shall be entitled to the following without
limitation:
(1) To humane care and treatment;
(2) To the extent that the facilities, equipment and
personnel are available, to medical care and treatment in accordance with the
highest standards accepted in medical practice;
(3) To safe and sanitary housing;
(4) To not participate in nontherapeutic
labor;
(5) To attend or not attend religious services;
(6) To receive prompt evaluation and care, treatment,
habilitation or rehabilitation about which he is informed insofar as he is
capable of understanding;
(7) To be treated with dignity as a human being;
(8) To not be the subject of experimental research without
his prior written and informed consent or that of his parent, if a minor, or
his guardian; except that no involuntary patient shall be subject to experimental
research, except as provided within this chapter;
(9) To decide not to participate or may withdraw from any
research at any time for any reason*;
(10) To have access to consultation with a private physician
at his own expense;
(11) To be evaluated, treated or habilitated in the least
restrictive environment;
(12) To not be subjected to any hazardous treatment or
surgical procedure unless he, his parent, if he is a minor, or his guardian
consents; or unless such treatment or surgical procedure is ordered by a court
of competent jurisdiction;
(13) In the case of hazardous treatment or irreversible
surgical procedures, to have, upon request, an impartial review prior to
implementation, except in case of emergency procedures required for the preservation
of his life;
(14) To a nourishing, well-balanced and varied diet;
(15) To be free from verbal and physical abuse.
2.
Notwithstanding any other sections of this chapter, each patient, resident or
client shall have the right to an impartial administrative review of alleged
violations of the rights assured under this chapter. The impartial
administration review process shall be a mechanism for:
(1) Reporting alleged violations of rights assured under
this chapter;
(2) Investigating alleged violations of these rights;
(3) Presenting patient, resident or client grievances on the
record to a neutral decision maker; and
(4) Requiring that the neutral decision maker issue findings
of fact, conclusions and recommendations.
3.
The impartial administrative review process shall be completed within a timely
manner after the alleged violation is reported.
4.
This impartial review process shall not apply to investigations of alleged
patient, resident or client abuse or neglect conducted pursuant to section
630.167.
*Word
"season" appears in original rolls.
No presumptions.
630.120.
No patient or resident, either voluntary or involuntary, shall be presumed to
be incompetent, to forfeit any legal right, responsibility or obligation or to
suffer any legal disability as a citizen, unless otherwise prescribed by law,
as a consequence of receiving evaluation, care, treatment, habilitation or
rehabilitation for a mental disorder, mental illness, mental retardation,
developmental disability, alcohol problem or drug problem.
Explanation of rights and
entitlements.
630.125.
1. At the time of admission, either on a voluntary or involuntary basis, a
mental health facility or mental health program in which people may be civilly
detained pursuant to chapter 632, RSMo, or a
residential facility or day program operated, funded or licensed by the
department shall give each patient, resident or client written information
which sets forth, in lay language, the following:
(1) A description of the facility, its services and its
costs;
(2) Information as to how to seek conditional release or
discharge;
(3) A statement of rights assured by this chapter or the
department in its rules and regulations;
(4) A description of a patient grievance procedure.
2.
Unless the patient, resident or client can read the information with
understanding, the facility personnel shall explain it to him.
3.
The facility or program shall prominently post a list of patient or residential
rights in residential and activity areas.
Electroconvulsive therapy,
procedure--prohibitions.
630.130.
1. Every patient, whether voluntary or involuntary, in a public or private
mental health facility shall have the right to refuse electroconvulsive
therapy.
2.
Before electroconvulsive therapy may be administered
voluntarily to a patient, the patient shall be informed, both orally and in
writing, of the risks of the therapy and shall give his express written
voluntary consent to receiving the therapy.
3.
Involuntary electroconvulsive therapy may be
administered under a court order after a full evidentiary hearing where the
patient refusing such treatment is represented by counsel who shall advocate
his position. The therapy may be administered on an involuntary basis only if
it is shown, by clear and convincing evidence, that the therapy is necessary
under the following criteria:
(1) There is a strong likelihood that the therapy will
significantly improve or cure the patient's mental disorder for a substantial
period of time without causing him any serious functional harm; and
(2) There is no less drastic alternative form of therapy
which could lead to substantial improvement in the patient's condition. At the
conclusion of such hearing, if the petitioner has sustained his burden of*
proof, the court may order up to a specified number of involuntary electroconvulsive therapy treatments to be performed over a
specified period of time.
4.
Parents of minor patients or legal guardians of incompetent patients shall be
required to obtain court orders authorizing electroconvulsive
therapy under the procedures specified in subsection 3 of this section.
5.
Persons who are diagnosed solely as mentally retarded shall not be subject to electroconvulsive therapy.
*Word
"or" appears in original rolls.
Psychosurgery, consent required--not to be performed by
department.
630.133.
1. Psychosurgery shall not be performed involuntarily on any patient or
resident. A competent patient or resident shall be informed, both orally and in
writing, of the risks of the therapy and shall give his express written
voluntary consent before the surgery is performed. Parents of minor patients or
residents or legal guardians of incompetent patients or residents shall be
required to obtain court orders authorizing such surgery under the procedures
and criteria specified in subsection 3 of section 630.130.
2.
Psychosurgery shall not be performed by the department in any of its
facilities.
Rules regarding patient's rights.
630.135.
The department shall promulgate reasonable rules relative to the implementation
of patient, resident and client rights described in this chapter.
Records confidential, when--may be disclosed, to whom, how,
when --release to be documented--court records confidential, exceptions.
630.140.
1. Information and records compiled, obtained, prepared or maintained by the residential
facility, day program operated, funded or licensed by the department or
otherwise, specialized service, or by any mental health facility or mental
health program in which people may be civilly detained pursuant to chapter 632,
RSMo, in the course of providing services to either
voluntary or involuntary patients, residents or clients shall be confidential.
2.
The facilities or programs shall disclose information and records including
medication given, dosage levels, and individual ordering such medication to the
following upon their request:
(1) The parent of a minor patient, resident or client;
(2) The guardian or other person having legal custody of the
patient, resident or client;
(3) The attorney of a patient, resident or client who is a ward
of the juvenile court, an alleged incompetent, an incompetent ward or a person
detained under chapter 632, RSMo, as evidenced by
court orders of the attorney's appointment;
(4) An attorney or personal physician as authorized by the
patient, resident or client;
(5) Law enforcement officers and agencies, information about
patients, residents or clients committed pursuant to chapter 552, RSMo, but only to the extent necessary to carry out the
responsibilities of their office, and all such law enforcement officers shall
be obligated to keep such information confidential;
(6) The entity or agency authorized to implement a system to
protect and advocate the rights of persons with developmental disabilities
under the provisions of 42 U.S.C. 6042. The entity or agency shall be able to
obtain access to the records of a person with developmental disabilities who is
a client of the entity or agency if such person has authorized the entity or
agency to have such access; and the records of any person with developmental
disabilities who, by reason of mental or physical condition is unable to
authorize the entity or agency to have such access, if such person does not
have a legal guardian, conservator or other legal representative, and a
complaint has been received by the entity or agency with respect to such person
or there is probable cause to believe that such person has been subject to
abuse or neglect. The entity or agency obtaining access to a person's records
shall meet all requirements for confidentiality as set out in this section;
(7) The entity or agency authorized to implement a system to
protect and advocate the rights of persons with mental illness under the
provisions of 42 U.S.C 10801 shall be able to obtain access to the records of a
patient, resident or client who by reason of mental or physical condition is
unable to authorize the system to have such access, who does not have a legal
guardian, conservator or other legal representative and with respect to whom a
complaint has been received by the system or there is probable cause to believe
that such individual has been subject to abuse or neglect. The entity or agency
obtaining access to a person's records shall meet all requirements for
confidentiality as set out in this section. The provisions of this subdivision
shall apply to a person who has a significant mental illness or impairment as
determined by a mental health professional qualified under the laws and
regulations of the state;
(8) To mental health coordinators, but only to the extent
necessary to carry out their duties under chapter 632, RSMo.
3.
The facilities or services may disclose information and records under any of
the following:
(1) As authorized by the patient, resident or client;
(2) To persons or agencies responsible for providing health
care services to such patients, residents or clients;
(3) To the extent necessary for a recipient to make a claim
or for a claim to be made on behalf of a recipient for aid or insurance;
(4) To qualified personnel for the purpose of conducting scientific
research, management audits, financial audits, program evaluations or similar
studies; provided, that such personnel shall not identify, directly or
indirectly, any individual patient, resident or client in any report of such
research, audit or evaluation, or otherwise disclose patient, resident or
client identities in any manner;
(5) To the courts as necessary for the administration of
chapter 211, RSMo, 475, RSMo,
552, RSMo, or 632, RSMo;
(6) To law enforcement officers or public health officers,
but only to the extent necessary to carry out the responsibilities of their
office, and all such law enforcement and public health officers shall be
obligated to keep such information confidential;
(7) Pursuant to an order of a court or administrative agency
of competent jurisdiction;
(8) To the attorney representing petitioners, but only to
the extent necessary to carry out their duties under chapter 632, RSMo;
(9) To the department of social services as necessary to
report or have investigated abuse, neglect, or rights violations of patients,
residents, or clients;
(10) To a county board established pursuant to sections
205.968 to 205.972, RSMo 1986, but only to the extent
necessary to carry out their statutory responsibilities. The county board shall
not identify, directly or indirectly, any individual patient, resident or
client.
4.
The facility or program shall document the dates, nature, purposes and
recipients of any records disclosed under this section and sections 630.145 and
630.150.
5.
The records and files maintained in any court proceeding under chapter 632, RSMo, shall be confidential and available only to the
patient, his attorney, guardian, or, in the case of a minor, to a parent or
other person having legal custody of the patient, and to the petitioner and his
attorney. In addition, the court may order the release or use of such records
or files only upon good cause shown, and the court may impose such restrictions
as the court deems appropriate.
6.
Nothing contained in this chapter shall limit the rights of discovery in
judicial or administrative procedures as otherwise provided for by statute or
rule.
7.
The fact of admission of a voluntary or involuntary patient to a mental health
facility under chapter 632, RSMo, may only be disclosed
as specified in subsections 2 and 3 of this section.
Department to release information to next of kin and persons
responsible for costs, when.
630.145.
1. Notwithstanding the provisions of section 630.140, a residential facility or
day program operated, funded or licensed by the department may release to a
patient's or resident's next of kin, attorney, guardian or conservator, if any,
the information that the person is presently a patient, resident or client in
the facility or program, or that the person is seriously physically ill, and
shall notify a voluntary patient's or resident's next of kin, attorney,
guardian, or conservator or any other person who may be responsible for the
costs incurred by such patient or resident, of the admittance of such patient
or resident.
2.
Upon the death of a patient or resident, the facility shall notify his next of
kin, guardian or conservator, if any, about the death and its cause.
3.
Next of kin shall be notified under this section in the following order unless
otherwise indicated by the patient or resident:
(1) Spouse;
(2) Parents;
(3) Children;
(4) Brothers and sisters;
(5) Other relatives according to the degree of relation.
4.
The patient or resident may indicate additional persons whom he wants notified
in the event of his death or serious injury or incapacity.
Disclosure of absence to be made, when,
to whom.
630.150.
1. Except as provided in subsection 2 of this section, when a patient, resident
or client is absent due to his unauthorized disappearance from a residential
facility or day program, or his whereabouts are unknown and disclosure is necessary
for the protection of the patient, resident or others, and the provisions of
section 630.140 would otherwise be applicable, notice of the disappearance,
along with relevant information, may be made to relatives, governmental law
enforcement agencies and other persons if necessary for the protection of the
patient, resident or other parties, as designated by the head of the facility
or program or physician in charge of the patient, resident or client.
2.
If the patient, resident or client was committed to the custody of the
department of mental health pursuant to chapter 552, RSMo,
and that patient, resident or client is absent due to an unauthorized
disappearance from a residential facility or day program, or such person's
whereabouts are unknown, the head of the mental health facility or a designee
shall immediately give notice of the disappearance, along with relevant
information, to the prosecutor and sheriff of the county wherein the committed
person is detained, the prosecutor and sheriff of the county wherein the
committed person was tried and acquitted, all known surviving victims as
defined in chapter 595, RSMo, any other agencies or
persons designated by the head of the facility as necessary for the protection
of the patient, resident or other parties.
Mistreatment of patient--defined--penalty.
630.155.
1. A person commits the crime of "patient, resident or client abuse or
neglect" against any person admitted on a voluntary or involuntary basis
to any mental health facility or mental health program in which people may be
civilly detained pursuant to chapter 632, RSMo, or
any patient, resident or client of any residential facility, day program or
specialized service operated, funded or licensed by the department if he
knowingly does any of the following:
(1) Beats, strikes or injures any person, patient,
resident or client;
(2) Mistreats or maltreats, handles
or treats any such person, patient, resident or client in a brutal or inhuman
manner;
(3) Uses any more force than is reasonably necessary for the
proper control, treatment or management of such person, patient, resident or
client;
(4) Fails to provide services which are reasonable and
necessary to maintain the physical and mental health of any person, patient,
resident or client when such failure presents either an imminent danger to the
health, safety or welfare of the person, patient, resident or client, or a substantial
probability that death or serious physical harm will result.
2.
Patient, resident or client abuse or neglect is a class A misdemeanor unless
committed under subdivision (2) or (4) of subsection 1 of this section in which
case such abuse or neglect shall be a class D felony.
Furnishing unfit food--defined--penalty.
630.160.
1. A person commits the crime of "furnishing unfit food to patients,
residents or clients" if he does any of the following:
(1) Knowingly furnishes or delivers any diseased, putrid or
otherwise unwholesome meat from any animal or fowl that was diseased or
otherwise unfit for food to any person admitted on a voluntary or involuntary
basis to any mental health facility or mental health program in which people
may be civilly detained pursuant to chapter 632, RSMo,
or to any residential facility or day program operated, funded or licensed by
the department;
(2) Knowingly furnishes or delivers any other unwholesome
food, vegetables or provisions whatsoever to such facilities or programs to be
used as food by the patients, residents, clients or employees thereof;
(3) Knowingly receives or consents to receive as an employee
of such facility or program any diseased or unwholesome meat, food or
provisions.
2.
Furnishing unfit food to patients, residents or clients is a class A misdemeanor.
Suspected abuse of patient, report, by whom
made, contents--effect of failure to report.
630.165.
1. When any physician, dentist, chiropractor, optometrist, podiatrist, intern,
nurse, medical examiner, social worker, psychologist, minister, Christian
Science practitioner, peace officer, pharmacist, physical therapist, facility
administrator, nurse's aide or orderly in a residential facility, day program
or specialized service operated, funded or licensed by the department or in a
mental health facility or mental health program in which people may be admitted
on a voluntary basis or are civilly detained pursuant to chapter 632, RSMo, or employee of the department has reasonable cause to
believe that a patient, resident or client of a facility, program or service
has been abused or neglected, he shall immediately report or cause a report to
be made to the department or the department of health and senior services, if
such facility or program is licensed pursuant to chapter 197, RSMo.
2.
The report shall contain the name and address of the residential facility, day
program or specialized service; the name of the patient, resident or client;
information regarding the nature of the abuse or neglect; the name of the
complainant, and any other information which might be helpful in an
investigation.
3.
Any person required in subsection 1 of this section to report or cause a report to be made to the department who fails to do
so within a reasonable time after the act of abuse or neglect is guilty of an
infraction.
4.
In addition to those persons required to report under subsection 1 of this
section, any other person having reasonable cause to believe that a resident
has been abused or neglected may report such information to the department.
Investigation of report, when made, by whom--abuse prevention
by removal, procedure--reports confidential, privileged, exceptions --immunity
of reporter, notification--retaliation prohibited --administrative discharge of
employee, appeal procedure.
630.167.
1. Upon receipt of a report, the department or its agents, contractors or
vendors or the department of health and senior services, if such facility or
program is licensed pursuant to chapter 197, RSMo,
shall initiate an investigation within twenty-four hours.
2.
If the investigation indicates possible abuse or neglect of a patient, resident
or client, the investigator shall refer the complaint together with the
investigator's report to the department director for appropriate action. If,
during the investigation or at its completion, the department has reasonable
cause to believe that immediate removal from a facility not operated or funded
by the department is necessary to protect the residents from abuse or neglect,
the department or the local prosecuting attorney may, or the attorney general
upon request of the department shall, file a petition for temporary care and
protection of the residents in a circuit court of competent jurisdiction. The
circuit court in which the petition is filed shall have equitable jurisdiction
to issue an ex parte order granting the department authority for the temporary
care and protection of the resident for a period not to exceed thirty days.
3.
(1) Reports referred to in section 630.165 and the investigative reports
referred to in this section shall be confidential, shall not be deemed a public
record, and shall not be subject to the provisions of section 109.180, RSMo, or chapter 610, RSMo;
except that: complete copies all such reports shall be open and available to
the parents or other guardian of the patient, resident, or client who is the
subject of such report, except that the names and any other descriptive
information of the complainant or other person mentioned in the reports shall
not be disclosed unless such complainant or person specifically consents to
such disclosure. All reports referred to in this section shall be admissible in
any judicial proceedings or hearing in accordance with section 36.390, RSMo, or any administrative hearing before the director of
the department of mental health, or the director's designee. All such reports
may be disclosed by the department of mental health to law enforcement officers
and public health officers, but only to the extent necessary to carry out the
responsibilities of their offices, and to the department of social services,
and to boards appointed pursuant to sections 205.968 to 205.990, RSMo, that are providing services to the patient, resident
or client as necessary to report or have investigated abuse, neglect, or rights
violations of patients, residents or clients provided that all such law
enforcement officers, public health officers, department of social services'
officers and boards shall be obligated to keep such information confidential;
(2) Except as otherwise provided in this section, the
proceedings, findings, deliberations, reports and minutes of committees of
health care professionals as defined in section 537.035, RSMo,
or mental health professionals as defined in section 632.005, RSMo, who have the responsibility to evaluate, maintain, or
monitor the quality and utilization of mental health services are privileged
and shall not be subject to the discovery, subpoena or other means of legal
compulsion for their release to any person or entity or be admissible into
evidence into any judicial or administrative action for failure to provide
adequate or appropriate care. Such committees may exist, either within
department facilities or its agents, contractors, or vendors, as applicable.
Except as otherwise provided in this section, no person who was in attendance at
any investigation or committee proceeding shall be permitted or required to
disclose any information acquired in connection with or in the course of such
proceeding or to disclose any opinion, recommendation or evaluation of the
committee or board or any member thereof; provided, however, that information
otherwise discoverable or admissible from original sources is not to be
construed as immune from discovery or use in any proceeding merely because it
was presented during proceedings before any committee or in the course of any
investigation, nor is any member, employee or agent of such committee or other
person appearing before it to be prevented from testifying as to matters within
their personal knowledge and in accordance with the other provisions of this
section, but such witness cannot be questioned about the testimony or other
proceedings before any investigation or before any committee;
(3) Nothing in this section shall limit authority otherwise
provided by law of a health care licensing board of the state of Missouri to
obtain information by subpoena or other authorized process from investigation
committees or to require disclosure of otherwise confidential information
relating to matters and investigations within the jurisdiction of such health care
licensing boards; provided, however, that such information, once obtained by
such board and associated persons, shall be governed in accordance with the
provisions of this subsection;
(4) Nothing in this section shall limit authority otherwise
provided by law in subdivisions (5) and (6) of subsection 2 of section 630.140
concerning access to records by the entity or agency authorized to implement a
system to protect and advocate the rights of persons with developmental
disabilities under the provisions of 42 U.S.C. 6042 and the entity or agency
authorized to implement a system to protect and advocate the rights of persons
with mental illness under the provisions of 42 U.S.C. 10801. In addition,
nothing in this section shall serve to negate assurances that have been given
by the governor of
4.
Anyone who makes a report pursuant to this section or who testifies in any
administrative or judicial proceeding arising from the report shall be immune
from any civil liability for making such a report or for testifying unless such
person acted in bad faith or with malicious purpose.
5.
Within five working days after a report required to be made pursuant to this
section is received, the person making the report shall be notified in writing
of its receipt and of the initiation of the investigation.
6.
No person who directs or exercises any authority in a residential facility, day
program or specialized service shall evict, harass, dismiss or retaliate
against a patient, resident or client or employee because he or she or any
member of his or her family has made a report of any violation or suspected
violation of laws, ordinances or regulations applying to the facility which he
or she has reasonable cause to believe has been committed or has occurred.
7.
Any person who is discharged as a result of an administrative substantiation of
allegations contained in a report of abuse or neglect may, after exhausting
administrative remedies as provided in chapter 36, RSMo,
appeal such decision to the circuit court of the county in which such person
resides within ninety days of such final administrative decision. The court may
accept an appeal up to twenty-four months after the party filing the appeal
received notice of the department's determination, upon a showing that:
(1) Good cause exists for the untimely commencement of the
request for the review;
(2) If the opportunity to appeal is not granted it will
adversely affect the party's opportunity for employment; and
(3) There is no other adequate remedy at law.
Suspected abuse to be reported.
630.168.
If it is alleged or suspected that any patient, resident or client who has been
admitted on a voluntary or involuntary basis to a mental health facility or
mental health program in which people are detained pursuant to chapter 632, RSMo, or any patient, resident or client in a residential
facility, day program or specialized service operated, funded or licensed by
the department is being or has been subjected to patient or resident abuse
which results in physical injury, and in cases of sexual abuse, the head of the
facility, program or service shall promptly notify local law enforcement
authorities and cooperate fully with any investigation by them.
Disqualification for employment because of
conviction--appeal process --registry maintained, when.
630.170.
1. A person convicted of any crime pursuant to section 630.155 or 630.160 shall
be disqualified from holding any position in any public or private facility or
day program operated, funded or licensed by the department or in any mental
health facility or mental health program in which people are admitted on a
voluntary or involuntary basis or are civilly detained pursuant to chapter 632,
RSMo.
2.
A person convicted of any felony offense against persons as defined in chapter
565, RSMo; of any felony sexual offense as defined in
chapter 566, RSMo; of any felony offense defined in
section 568.045, 568.050, 568.060, 569.020, 569.030, 569.040 or 569.050, RSMo, or of an equivalent felony offense shall be
disqualified from holding any direct-care position in any public or private
facility, day program, residential facility or specialized service operated,
funded or licensed by the department or any mental health facility or mental
health program in which people are admitted on a voluntary basis or are civilly
detained pursuant to chapter 632, RSMo.
3.
Any person disqualified pursuant to the provisions of subsection 1 or 2 of this
section may appeal the disqualification to the director of the department or
the director's designee. The request shall be written and may not be made more
than once every twelve months. The request may be granted by the director or
designee if in the judgment of the director or designee a clear showing has
been made by written submission only, that the person will not commit any
additional acts for which the person had originally been disqualified for or
any other acts that would be harmful to a patient, resident or client of a
facility, program or service. The director or designee may grant the appeal
subject to any conditions deemed appropriate and failure to comply with such
terms may result in the person again being disqualified. Decisions by the
director or designee pursuant to the provisions of this subsection shall not be
subject to appeal. The right to appeal pursuant to this subsection shall not
apply to persons convicted of any crime pursuant to the provisions of chapter
566 or 568, RSMo, or section 565.020 or 565.021, RSMo.
4.
The department may maintain a disqualification registry and place on the
registry the names of any persons who have been finally determined by the
department to be disqualified pursuant to this section, or who have had
administrative substantiations made against them for abuse or neglect pursuant
to department rule. Such list shall reflect that the person is barred from
holding any position in any public or private facility or day program operated,
funded or licensed by the department, or any mental
health facility or mental health program in which persons are admitted on a
voluntary basis or are civilly detained pursuant to chapter 632, RSMo.
Physical and chemical restraints prohibited,
exceptions.
630.175.
1. No person admitted on a voluntary or involuntary basis to any mental health
facility or mental health program in which people are civilly detained pursuant
to chapter 632, RSMo, and no patient, resident or
client of a residential facility or day program operated, funded or licensed by
the department shall be subject to physical or chemical restraint, isolation or
seclusion unless it is determined by the head of the facility or the attending
licensed physician that the chosen intervention is imminently necessary to
protect the health and safety of the patient, resident, client or others and that
it provides the least restrictive environment.
2.
Every use of physical or chemical restraint, isolation or seclusion and the
reasons therefor shall be made a part of the clinical
record of the patient, resident or client under the signature of the head of
the facility or the attending licensed physician.
3.
Physical or chemical restraint, isolation or seclusion shall not be considered
standard treatment or habilitation and shall cease as soon as the circumstances
causing the need for such action have ended.
Treatment by religious practice to
be permitted.
630.180.
The provisions of this chapter and chapters 631, 632 and 633, RSMo, shall not be construed as authorizing any form of
compulsory medical treatment of any person who is being treated by prayer in
the practice of the religion of any church which teaches reliance on spiritual
means for healing unless the person or his legal guardian, if any, consents to
such treatment.
Officers may authorize medical treatment for patient.
630.183.
Subject to other provisions of this chapter, the head of a mental health or
mental retardation facility may authorize the medical and surgical treatment of
a patient or resident under the following circumstances:
(1) Upon consent of a patient or resident who is competent;
(2) Upon consent of a parent or legal guardian of a patient
or resident who is a minor or legally incapacitated;
(3) Pursuant to the provisions of chapter 431, RSMo;
(4) Pursuant to an order of a court of competent
jurisdiction.
Purchase of food limited to that for use of patients.
630.186.
Any purchase of food in any institution under the control of the department,
other than the usual quantity purchased for the patients or residents thereof,
to be used by or for anyone other than the patients or residents of such
institution shall be charged directly to the individual responsible for such
purchase.
Limitations on research activities
in mental health facilities and programs.
630.192.
No biomedical or pharmacological research shall be conducted in any mental
health facility or mental health program in which people may be civilly
detained pursuant to chapter 632, RSMo, or in any
public or private residential facilities or day programs operated, funded or
licensed by the department for persons affected by mental retardation,
developmental disabilities, mental illness, mental disorders or alcohol or drug
abuse unless such research is intended to alleviate or prevent the disabling
conditions or is reasonably expected to be of direct therapeutic benefit to the
participants. Without a specific court order, no involuntary patient shall
consent to participate in any biomedical or pharmacological research. The
application for the order shall be filed in the court having probate
jurisdiction in the county in which the mental health facility is located,
provided, however, that if the patient requests that the hearing be held by the
court which has committed the patient, or if the court having probate
jurisdiction deems it appropriate, the hearing on the application shall be
transferred to the committing court.
Professional review committee to
make recommendations to director --committee members, appointment,
qualifications, terms, compensation --organization and meetings.
630.193.
1. A "Professional Review Committee", consisting of ten members
appointed by the director is hereby created to review, report, and recommend
approval or disapproval to the director of any research conducted by the
department. The committee shall consist of persons who reside in the state and
are not employed by the department and who have demonstrated recognized
competence in medicine, pharmacology, behavioral sciences, biomedical science,
philosophy of science, or bioethics. Each member of the committee shall serve
for a term of four years following his appointment, except one-half of the
members initially appointed after
2.
The department shall pay the members of the committee one hundred dollars per
day for each day, or portion thereof, they actually spend in the performance of
their official duties and shall reimburse the members for actual necessary
expenses incurred in the performance of their official duties.
3.
The committee shall elect a chairman annually. The committee shall meet at the
call of the director or the chairman and shall have a quorum when at least five
members are present.
Professional review committee to review proposals, make
report and recommendations--director to approve or disapprove--to review work
in progress.
630.194.
1. Persons seeking to initiate any research in residential facilities or day
programs funded, operated or licensed by the department shall submit their
research proposals to the professional review committee for review. The
committee shall prepare a report, which shall be available to the general
public, of each research proposal it reviews, stating its finding and
conclusions, and recommending either approval or disapproval of the project to
the director. The director shall state his decision in writing and the decision
shall be final.
2.
The committee shall review the conduct of the research during the progress of
the project. If during the research, harm or increased risk of harm to
participants occurs, or if deviations in research protocol occur without
approval of the committee, the committee shall investigate the project. The
committee shall suspend or halt the project if deemed appropriate to prevent
harm or the increased risk of harm.
3.
The professional review committee shall review each biomedical or
pharmacological research proposal according to, but not restricted to, the
following criteria:
(1) Need for the research;
(2) Methodological adequacy;
(3) Duplication with other projects;
(4) Sufficiency of scientific and theoretical justification;
(5) Competence of the researcher;
(6) Funding sufficiency;
(7) Weighing risks against potential benefits;
(8) Appropriateness of subject population;
(9) Adequacy of consent information.
4.
If the committee believes it lacks sufficient expertise in the subject area of
the proposed research, it may obtain outside experts to review the project and
recommend disposition.
Research review committee at
department facilities--committee members, appointment, qualifications, terms,
compensation--organization and meetings.
630.196.
1. A "Research Review Committee", consisting of five members, shall
be established at each department facility where research is proposed to be
conducted. The members of the committees shall be appointed by the head of the
facilities with the approval of the division director. The committee shall be
composed of persons who reside in the state and are not employed by the
department and shall be composed of the following:
(1) Three members shall be consumers, family members of
consumers, or representatives of consumer groups;
(2) One member shall be a licensed physician;
(3) One member shall be an attorney.
2.
The members of the committees shall serve for terms of four years each, except
that two of the members initially appointed shall serve a term of two years
each.
3.
The committee members shall not receive any compensation for their services but
they shall be reimbursed for the actual and necessary expenses they incur while
performing committee work.
4.
Each committee shall annually elect a chairman. Each committee shall meet at
the call of the head of the facility or the committee chairman and shall have a
quorum when at least three members are* present.
*Word
"are" does not appear in original rolls.
Duties of research review committee.
630.198.
1. After a project has been approved by the professional review committee, the
research review committees shall determine that the persons selected to
participate in biomedical or pharmacological research or their parents or
guardians have given informed consent as to whether or not they wish to
participate. Before any person participates in such research, the committees
shall screen the research and recommend approval or disapproval to the
director. The decision of the director shall be final.
2.
The committees shall assure that the following criteria are met in giving
informed consent:
(1) The person has the capacity to understand the risks,
benefits and procedures with respect to the project he or she is asked to
engage in;
(2) The person has been given sufficient information to
understand the risks, benefits and procedures; and
(3) The person is acting of his own free volition without
coercive influence.
3.
Persons may decide not to participate or may withdraw from the research at any
time for any reasons.
4.
Persons who are subjects of the research shall be compensated for their time
spent in the research projects to the same extent that persons who are not
department patients, residents or clients are typically compensated.
Research involving persons civilly detained,
sections applicable.
630.199.
Sections 630.194, 630.196 and 630.198 shall apply to all proposed biomedical or
pharmacological research that involves persons civilly detained.
Discrimination prohibited.
630.200.
In accordance with state and federal law, no mental health facility or mental
health program in which people may be civilly detained pursuant to chapter 632,
RSMo, and no residential facility, day program or
specialized service operated, funded or licensed by the department shall deny
admission or other services to any person because of his race, sex, creed,
marital status, national origin, disability or age.
Patient or representative liable for costs of services
rendered --parents not liable, when--denial of services for inability to pay
prohibited, when--department subrogated to rights of patient, parent, or
recipient, when.
630.205.
1. The person receiving services and the person's estate, spouse, parents, if
the person is a minor, and any fiduciary or representative payee holding assets
for the person or on the person's behalf are jointly and severally liable for
the fees for services rendered to the person by a residential facility, day
program or specialized service operated or funded by the department. The
department shall not charge parents for services it renders to persons who are
eighteen years of age or older and who are residents of this state. If any
person, firm, corporation, or public or private agency is liable, either
pursuant to contract or otherwise, to the parents or a recipient of services on
account of personal injury to or disability or disease of the recipient of
services, the department is subrogated to the right of the parent or recipient
to recover from that part of the award or settlement an amount equal to the
amount expended by the service for services which are not otherwise recoverable
from the parent or recipient. The acceptance of services from the department
constitutes acknowledgment of subrogation rights by the department, and the
department may take any and all action necessary to enforce the subrogation
rights.
2.
Parents of minors who are domiciled in this state, as defined in section
162.970, RSMo, shall not be liable for the cost of
education or special education and related services. If, as a result of a
comprehensive evaluation and such conclusion in the minor's individualized
education program, admission to a department facility or placement program is
necessary for such minor to receive an appropriate education, the parents of
minors who are domiciled in this state under section 162.970, RSMo, shall not be liable for the cost of nonmedical care and room and board.
3.
For purposes of subsection 2 of this section, "special education" and
"related services" are defined pursuant to the Federal Education of
the Handicapped Act (20 U.S.C. {1401, et seq.), as amended, and the rules and
regulations promulgated in furtherance thereof.
4.
No person who is domiciled in
5.
Nothing in this section shall be construed to relieve an insurer or other third
party from an otherwise valid obligation.
Charges for pay patients--each facility considered a
separate unit --director to determine rules for means test and domicile
verification --failure to pay, effect--exceptions, emergency treatment for
transients.
630.210.
1. The director shall determine the maximum amount for services which shall be
charged in each of the residential facilities, day programs or specialized
services operated or funded by the department for full-time or part-time
inpatient, resident or outpatient evaluation, care, treatment, habilitation,
rehabilitation or other service rendered to persons affected by mental
disorder, mental illness, mental retardation, developmental disability or drug
or alcohol abuse. The maximum charge shall be related to the per capita
inpatient cost or actual outpatient evaluation or other service costs of each
facility, program or service, which may vary from one locality to another. The
director shall promulgate rules setting forth a reasonable standard means test
which shall be applied by all facilities, programs and services operated or
funded by the department in determining the amount to be charged to persons
receiving services. The department shall pay, out of funds appropriated to it
for such purpose, all or part of the costs for the evaluation, care, treatment,
habilitation, rehabilitation or room and board provided or arranged by the
department for any patient, resident or client who is domiciled in Missouri and
who is unable to pay fully for services.
2.
The director shall apply the standard means test annually and may make
application of the test upon his own initiative or upon request of an
interested party whenever evidence is offered tending to show that the current
support status of any patient, resident or client is no longer proper. Any
change of support status shall be retroactive to the date of application or
request for review. If the persons responsible to pay under section 630.205 or
552.080, RSMo, refuse to cooperate in providing
information necessary to properly apply the test or if retroactive benefits are
paid on behalf of the patient, resident or client, the charges may be
retroactive to a date prior to the date of application or request for review.
The decision of the director in determining the amount to be charged for
services to a patient, resident or client shall be final. Appeals from the
determination may be taken to the circuit court of
3.
The department shall not pay for services provided to a patient, resident or
client who is not domiciled in Missouri unless the state is fully reimbursed
for the services; except that the department may pay for services provided to a
transient person for up to thirty days pending verification of his domiciliary
state, and for services provided for up to thirty days in an emergency
situation. The director shall promulgate rules for determination of the
domiciliary state of any patient, resident or client receiving services from a
facility, program or service operated or funded by the department.
4.
Whenever a patient, resident or client is receiving services from a residential
facility, day program or specialized service operated or funded by the
department, and the state, county, municipality, parent, guardian or other
person responsible for support of the patient, resident or client fails to pay
any installment required to be paid for support, the department or the
residential facility, day program or specialized service may discharge the
patient, resident or client as provided by chapter 31, RSMo.
The patient, resident or client shall not be discharged under this subsection until
the final disposition of any appeal filed under subsection 2 of this section.
Pay patient, how determined--estate
of patient, court to notify director and conservator--failure to pay, may
discharge--appeal.
630.215.
1. Any probate division of the circuit court having knowledge of the existence
of an estate of a patient, resident or client receiving services from
residential facilities or day programs operated or funded by the department
shall promptly notify the director of the nature and extent of the estate and
the identity of the attorney of record and conservator. The director shall then
apply the standard means test contained in the rules of the department to determine
if the estate shall be charged for services rendered by the department.
2. If the director determines that the estate should be charged for the evaluation, care, treatment, habilitation, rehabilitation or room and board provided or funded by the department, and notifies the conservator, the conservator shall pay the charges. If the conservator fails to pay for the charges, after reasonable delay, the head of the department, residential facility or day program may discharge the patient as provided by chapter 31, RSMo.