Chapter 630 Department of Mental Health

630.006 - Intellectually disabled and intellectual disability, use of terms — revisor to change statutory references.

Steven Groce, Attorney Advertisement

The phrases "mentally retarded" and "mental retardation" shall be referred to as "intellectually disabled" and "intellectual disability", respectively.The revisor of statutes shall make the appropriate changes to all such references in the revised statutes.

(L. 2014 H.B. 1064 § 1)

630.053 - Mental health earnings fund — uses — rules and regulations, procedure.

1.There is hereby created in the state treasury a fund to be known as the "Mental Health Earnings Fund".The state treasurer shall credit to the fund any interest earned from investing the moneys in the fund.Notwithstanding the provisions of section 33.080, money in the mental health earnings fund shall not be transferred and placed to the credit of general revenue at the end of the biennium.

2.Fees received pursuant to the substance abuse traffic offenders program shall be deposited in the mental health earnings fund.Such fees shall not be used for personal services, expenses and equipment or for any demonstration or other program.No other federal or state funds shall be deposited in the fund, except for the purposes provided in subsections 3 to 5 of this section.The moneys received from such fees shall be appropriated solely for assistance in securing alcohol and drug rehabilitation services for persons who are unable to pay for the services they receive.

3.The mental health earnings fund may be used for the deposit of revenue received for the provision of services under a managed care agreement entered into by the department of mental health.Subject to the approval through the appropriation process, such revenues may be expended for the purposes of providing such services pursuant to the managed care agreement and for no other purpose and shall be accounted for separately from all other revenues deposited in the fund.

4.The mental health earnings fund may, if approved through the appropriation process, be used for the deposit of revenue received pursuant to an agreement entered into by the department of mental health and an alcohol and drug abuse counselor certification board for the purpose of providing oversight of counselor certification.Such revenue shall be accounted for separately from all other revenues deposited in the fund.

5.The mental health earnings fund may be used for the deposit of revenue received from proceeds of any sales and services from Mental Health First Aid USA.Subject to the approval through the appropriation process, such proceeds shall be used for the purpose of funding Mental Health First Aid USA activities and shall be accounted for separately from all other revenues deposited in the fund.

6.The department of mental health shall promulgate rules and regulations to implement and administer the provisions of this section.No rule or portion of a rule promulgated pursuant to the authority of this chapter shall become effective unless it has been promulgated pursuant to the provisions of section 536.024.

(L. 1993 S.B. 167, A.L. 1995 S.B. 3, A.L. 1996 H.B. 1081 merged with S.B. 884 & 841, A.L. 2011 H.B. 555 merged with H.B. 557 merged with H.B. 648)

630.1005 - Comprehensive child mental health clinical advisory council established, members, duties.

1.There is hereby established in the department of mental health a "Comprehensive Child Mental Health Clinical Advisory Council".The council, under the supervision of the director of the department of mental health, shall advise the office of comprehensive child mental health established under section 630.1000.The council shall be comprised of not more than ten members and shall include, but not be limited to, individuals representing the following disciplines:pediatric medicine, child psychiatry, child psychology, social work, clinical counseling, school psychologist, research, financing, and evaluation.The director of the department of mental health, or his or her designee, and a member of the office of comprehensive child mental health established under section 630.1000 shall serve as ex officio members of the council.

2.The members of the council, other than the ex officio members, shall be appointed by the director of the department of mental health and shall serve for three-year terms.Members shall serve on the council without compensation but may be reimbursed for the actual and necessary expenses from moneys appropriated to the department of mental health for that purpose.Members of the advisory council shall:

(1)Share with the council and department information on state and national trends, evidenced-based practices and research findings within their respective fields;

(2)Serve as a liaison with their respective discipline to obtain and disseminate information;

(3)Identify funding and research opportunities within their respective field; and

(4)Advise the department in ways that knowledge from their respective field can be merged within other fields to provide a comprehensive system.

(L. 2005 S.B. 501)

630.080 - State auditor may examine records — personally identifiable information not to be revealed.

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.

(L. 1980 H.B. 1724)

630.180 - Treatment by religious practice to be permitted.

The provisions of this chapter and chapters 631, 632 and 633 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.

(L. 1980 H.B. 1724)

630.167 - 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.

1.Upon receipt of a report the department or the department of health and senior services, if such facility or program is licensed pursuant to chapter 197, shall initiate an investigation within twenty-four hours.The department of mental health shall complete all investigations within sixty days, unless good cause for the failure to complete the investigation is documented.

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)Except as otherwise provided in this section, 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 or chapter 610.Investigative reports pertaining to abuse and neglect shall remain confidential until a final report is complete, subject to the conditions contained in this section.Final reports of substantiated abuse or neglect issued on or after August 28, 2007, are open and shall be available for release in accordance with chapter 610.The names and all other identifying information in such final substantiated reports, including diagnosis and treatment information about the patient, resident, or client who is the subject of such report, shall be confidential and may only be released to the patient, resident, or client who has not been adjudged incapacitated under chapter 475, the custodial parent or guardian parent, or other guardian of the patient, resident or client.The names and other descriptive information of the complainant, witnesses, or other persons for whom findings are not made against in the final substantiated report shall be confidential and not deemed a public record.Final reports of unsubstantiated allegations of abuse and neglect shall remain closed records and shall only be released to the parents or other guardian of the patient, resident, or client who is the subject of such report, patient, resident, or client and the department vendor, provider, agent, or facility where the patient, resident, or client was receiving department services at the time of the unsubstantiated allegations of abuse and neglect, but the names and any other descriptive information of the complainant or any other person mentioned in the reports shall not be disclosed unless such complainant or person specifically consents to such disclosure.Requests for final reports of substantiated or unsubstantiated abuse or neglect from a patient, resident or client who has not been adjudged incapacitated under chapter 475 may be denied or withheld if the director of the department or his or her designee determines that such release would jeopardize the person's therapeutic care, treatment, habilitation, or rehabilitation, or the safety of others and provided that the reasons for such denial or withholding are submitted in writing to the patient, resident or client who has not been adjudged incapacitated under chapter 475.All reports referred to in this section shall be admissible in any judicial proceedings or hearing in accordance with section 621.075 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 the department of health and senior services, and to boards appointed pursuant to sections 205.968 to 205.990 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, department of health and senior 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 or mental health professionals as defined in section 632.005 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. Sections 15042 to 15044 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. Section 10801.In addition, nothing in this section shall serve to negate assurances that have been given by the governor of Missouri to the U.S. Administration on Developmental Disabilities, Office of Human Development Services, Department of Health and Human Services concerning access to records by the agency designated as the protection and advocacy system for the state of Missouri.However, such information, once obtained by such entity or agency, shall be governed in accordance with the provisions of this subsection.

4.Any person 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.(1)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.

(2)For investigations alleging neglect of a patient, resident, or client, the guardian of such patient, resident, or client shall be notified of:

(a)The investigation and given an opportunity to provide information to the investigators;

(b)The results of the investigation within five working days of the completion of the investigation and decision of the department of mental health of the results of the investigation.

6.The department of mental health shall obtain two independent reviews of all patient, resident, or client deaths that it investigates.

7.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.

8.Any person employed in a position described under subdivision (2) of subsection 1 of section 36.030 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, 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.

(L. 1980 H.B. 1724 § 630.165 subsecs. 5 to 10, A.L. 1985 S.B. 266, A.L. 1990 H.B. 1370, et al., A.L. 1993 S.B. 388, A.L. 1996 H.B. 1081 merged with S.B. 869 merged with S.B. 884 & 841, A.L. 1998 S.B. 470, A.L. 2003 S.B. 556 & 311, A.L. 2007 S.B. 3, A.L. 2008 S.B. 1081, A.L. 2011 H.B. 555 merged with H.B. 648, A.L. 2014 S.B. 716, A.L. 2018 S.B. 1007)

630.763 - Receiver may be requested, by whom, when.

The attorney general, either on his own initiative or upon the request of the department or of any other state governmental agency having an interest in the matter, a resident or residents or the guardian of a resident of a residential facility or the head of a facility may petition for appointment of a receiver for such facility when any of the following conditions exist:

(1)The facility is being operated without a license;

(2)The department has revoked the license of the facility or refused to grant an application for a license for the facility;

(3)The department has initiated revocation procedures and has determined that the lives, health, safety, or welfare of the residents cannot be adequately assured pending a full hearing on license revocation;

(4)The facility is closing or intends to close and adequate arrangements for relocation of residents have not been made at least thirty days prior to closure;

(5)An emergency exists in the facility;

(6)The licensee is insolvent; or

(7)An owner of the land or structure is insolvent and such insolvency substantially affects the operation of the facility.

(L. 1980 H.B. 1724)

630.784 - Receiver may receive license.

Other provisions of sections 630.705 to 630.760 notwithstanding, the department may issue a license to a residential facility being operated by a receiver under sections 630.763 to 630.793.The duration of a license issued under this section is limited to the duration of the receivership.

(L. 1980 H.B. 1724)

630.580 - Education and awareness programs established — cooperation of state agencies.

1.The department of mental health, in collaboration with the departments of health and senior services, elementary and secondary education, and higher education and in consultation with the Missouri eating disorder council established in section 630.575, shall develop and implement the following education and awareness programs:

(1)Health care professional education and training programs designed to prevent and treat eating disorders.Such programs shall include:

(a)Discussion of various strategies with patients from at-risk and diverse populations to promote positive behavior change and healthy lifestyles to prevent eating disorders;

(b)Identification of individuals with eating disorders and those who are at risk for developing an eating disorder;

(c)Conducting a comprehensive assessment of individual and familial health risk factors;

(2)Education and training programs for elementary and secondary and higher education professionals.Such programs shall include:

(a)Distribution of educational materials to middle and high school students in both public and private schools, including but not limited to utilization of the National Women's Health Information Center's Body Wise materials;

(b)Development of a curriculum which focuses on a healthy body image, identifying the warning signs and behaviors associated with an eating disorder, and ways to assist the individual, friends, or family members who may have an eating disorder; and

(3)General eating disorder awareness and education programs.

2.The department of mental health may seek the cooperation and assistance of any state department or agency, as the department deems necessary, in the development and implementation of the awareness and education programs implemented under this section.

(L. 2010 S.B. 754)

630.163 - Mandatory reporting requirements.

1.Any person having reasonable cause to suspect that a vulnerable person presents a likelihood of suffering serious physical harm or is the victim of abuse or neglect shall report such information to the department.Reports of vulnerable person abuse received by the departments of health and senior services and social services shall be forwarded to the department.

2.The report shall be made orally or in writing.It shall include, if known:

(1)The name, age, and address of the vulnerable person;

(2)The name and address of any person responsible for the vulnerable person's care;

(3)The nature and extent of the vulnerable person's condition; and

(4)Other relevant information.

3.The department shall have primary responsibility for investigating reported incidents of abuse and neglect of vulnerable persons.

4.Reports regarding persons determined not to be vulnerable persons as defined in section 630.005 shall be referred to the appropriate state or local authorities.

5.The department shall collaborate with the departments of health and senior services and social services to maintain a statewide toll-free phone number for receipt of reports.

(L. 2007 S.B. 3)

630.198 - Duties of research review committee.

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.

(L. 1980 H.B. 1724)

630.090 - Department to receive federal grants and aids, when — administration — application approval — reports.

1.If so designated by the governor, the department shall receive all federal grants and aids under the terms of the grants and aids and administer or pay them out subject to the provisions attached.

2.The director shall approve such applications for federal assistance administered through the department as may be considered advisable after consultation with the appropriate division director and state advisory or planning council.

3.The department shall make reports required, provide minimum standards for the maintenance and operation of residential facilities, day programs or specialized services funded by the department as are required under the terms of the grants and aids, and require compliance with these standards.

(L. 1980 H.B. 1724)

630.790 - Accounting of receiver, when — judgment for deficiencies — priority of receiver's claim.

1.Within thirty days after termination or such other time as the court may set, the receiver shall give the court a complete accounting of all property of which the receiver has taken possession, of all funds collected under section 630.772 and of the expenses of the receivership.

2.If the operating funds collected by the receiver under section 630.775 exceed the reasonable expenses of the receivership, the court shall order the payment of the surplus to the licensee.If the operating funds are insufficient to cover reasonable expenses of the receivership, the licensee shall be liable for the deficiency.The licensee may apply to the court to determine the reasonableness of any expense of the receivership.The licensee shall not be responsible for expenses in excess of what the court finds to be reasonable.

3.If a deficiency exists under subsection 2 of this section, the receiver may apply to the court for such a determination.If after notice to all interested parties and a hearing the court finds that in fact a deficiency does exist, then the court shall enter judgment in favor of the receiver and against the appropriate party or parties as set forth in subsection 2 of this section for the amount of such deficiency.Any judgment obtained under this subsection shall be treated as any other judgment and may be enforced according to law.

4.Any judgment for a deficiency obtained in accordance with this section by the receiver or any portion thereof may be assigned wholly or in part upon approval of the court.

5.The judgment shall have priority over any other judgment or lien or other interest which originates subsequent to the filing of a petition for receivership under the provisions of sections 630.763 to 630.793 except for a construction or mechanic's lien arising out of work performed with the express consent of the receiver.

(L. 1980 H.B. 1724)

630.194 - Professional review committee to review proposals, make report and recommendations — director to approve or disapprove — to review work in progress.

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.

(L. 1980 H.B. 1724)

630.199 - Research involving persons civilly detained, sections applicable.

Sections 630.194, 630.196 and 630.198 shall apply to all proposed biomedical or pharmacological research that involves persons civilly detained.

(L. 1996 S.B. 884 & 841)

630.127 - Notification protocols — rulemaking authority.

1.The department of mental health shall develop rules, guidelines, and protocols for an initial notification to a parent or guardian of a patient, resident, or client when first entering the care and custody of the department, or when first entering a facility licensed, certified, or funded by the department.Such notification shall notify the parent or guardian, or a consumer who is his or her own guardian, of the possibility of a person being placed in the facility with the patient, resident, or client who falls in one of the following categories:

(1)Individuals who are required to register as a sexual offender, under sections 589.400 to 589.425; or

(2)Individuals who have been determined to lack capacity to understand the proceedings against him or her or to assist in his or her own defense under section 552.020 for offenses the person would have otherwise been required to register as a sexual offender under sections 589.400 to 589.425.

2.Such rules, guidelines and protocols developed under subsection 1 of this section shall include the process and mechanisms for assessing risk, for planning and providing care and safety, and for the provision of services and supports necessary to mitigate risk for persons residing in a state facility or facility licensed, certified, or funded by the department.Such protocols shall also provide a mechanism for the parent or guardian, or the consumer who is his or her own guardian, to raise any concerns and to seek consultation about the placement.

3.The department of mental health shall develop rules, guidelines, and protocols for notifying a parent or guardian of a patient, resident, or client, or a consumer who is his or her own guardian, residing in a state facility or facility licensed, certified, or funded by the department that a person required to register as a sexual offender under sections 589.400 to 589.425 is residing in or has been placed in the same state facility, or facility licensed, certified, or funded by the department as the patient, resident, or client.Such protocols shall provide a mechanism for the parent or guardian, or the consumer who is his or her own guardian, to raise any concerns and to seek consultation prior to placement of the person required to register as a sexual offender.

4.The department of mental health shall develop rules, guidelines, and protocols to obtain consent from the parent or guardian of a patient, resident, or client, or a consumer who is his or her own guardian and who falls under the category in subdivision (2) of subsection 1 of this section to disclose his or her name and criminal charges to other parents or guardians of a patient, resident, or client, or to a consumer who is his or her own guardian residing in the same facility.Such request for disclosure shall inform all parties of the steps to be taken in the event consent to disclose is given or denied.Refusal to grant consent under this subsection by a parent or guardian of a patient, resident, or client, or a consumer who is his or her own guardian, of a facility licensed, certified, or funded by the department shall not prevent placement.

5.Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.

(L. 2007 S.B. 3)

630.095 - Copyrights and trademarks by department.

The department may copyright or obtain a trademark for any instructional, training and informational audio-visual materials, manuals and documents which are prepared by department personnel or by persons who receive department funding to prepare such material.If the material is sold directly or for distribution, the department shall pay the proceeds of the sales to the director of revenue for deposit to the general revenue fund, except for proceeds received under subsection 5 of section 630.053.

(L. 1980 H.B. 1724, A.L. 2011 H.B. 555 merged with H.B. 557 merged with H.B. 648)

630.927 - Rulemaking authority.

1.The director of the department of mental health shall promulgate rules, guidelines, and protocols for the mental health fatality review panel established pursuant to section 630.925.

2.The director shall promulgate guidelines and protocols for coroner and medical examiners to use to help them to identify suspicious deaths of patients, residents, or clients in the care and custody of the department of mental health.

3.Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2007, shall be invalid and void.

4.All meetings conducted, all reports and records made and maintained pursuant to sections 630.925 and 630.927 by the department of mental health, or other appropriate persons, officials, or state mental health fatality review panel shall be confidential and shall not be open to the general public except for the annual report pursuant to section 630.925.

(L. 2007 S.B. 3)

630.772 - Emergency procedure.

If it appears from the petition filed under section 198.105, or from an affidavit or affidavits filed with the petition, or from testimony of witnesses under oath when the court determines that this is necessary, that there is probable cause to believe that an emergency exists in the residential facility, the court shall immediately issue the requested order for appointment of a receiver, ex parte and without further hearing.Notice of the petition and order shall be served on the head of the facility or, if personal service is impossible, shall be posted in a conspicuous place in the facility within twenty-four hours after issuance of the order.If the petition is not filed by the attorney general, a copy of the petition shall be served on the department and upon the attorney general.A hearing on the petition shall be held within three days after notice is served or posted unless the head of the facility consents to a later date.After the hearing, the court may terminate, continue or modify the temporary order.

(L. 1980 H.B. 1724)

630.085 - Annual report by director, to whom, when, contents.

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.

(L. 1980 H.B. 1724)

630.1000 - Office of comprehensive child mental health established, duties — staff authorized.

1.There is hereby established in the department of mental health an "Office of Comprehensive Child Mental Health".The office of comprehensive child mental health, under the supervision of the director of the department of mental health, shall provide leadership in developing and implementing the comprehensive child mental health service system plan established under section 630.097. The office shall:

(1)Assure oversight and monitoring of the implementation of the comprehensive child mental health service system plan;

(2)Provide support, technical assistance and training to all departments participating in the development and implementation of the comprehensive child mental health service system established under section 630.097;

(3)Develop and coordinate service system, financing and quality assurance policy for all children's mental health services within the department of mental health;

(4)Provide leadership in program development for children's mental health services within the department of mental health, to include developing program standards and providing technical assistance in developing program capacity;

(5)Provide clinical consultation, technical assistance and clinical leadership for all child mental health within the department and to other child-serving agencies participating in the comprehensive child mental health system;

(6)Participate in the work of the coordinating board for early childhood;

(7)Participate in interagency child mental health initiatives as directed; and

(8)Provide staff support and leadership to the state comprehensive system management team established under section 630.097.

2.The departments participating in the comprehensive child mental health service system established under section 630.097 shall designate staff to represent their respective department on the state comprehensive system management team.

(L. 2005 S.B. 501)

630.162 - Mandatory reporters — preventing or discouraging reporting, penalty.

1.When any physician, physician assistant, dentist, chiropractor, optometrist, podiatrist, intern, resident, nurse, nurse practitioner, medical examiner, social worker, licensed professional counselor, certified substance abuse counselor, psychologist, physical therapist, pharmacist, other health practitioner, minister, Christian Science practitioner, 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 under chapter 632; or employee of the departments of social services, mental health, or health and senior services; or home health agency or home health agency employee; hospital and clinic personnel engaged in examination, care, or treatment of persons; in-home services owner, provider, operator, or employee; law enforcement officer; long-term care facility administrator or employee; mental health professional; peace officer; probation or parole officer; or other nonfamilial person with responsibility for the care of a vulnerable person, as defined by section 630.005, has reasonable cause to suspect that such a person has been subjected to abuse or neglect or observes such a person being subjected to conditions or circumstances that would reasonably result in abuse or neglect, he or she shall immediately report or cause a report to be made to the department in accordance with section 630.163.Any other person who becomes aware of circumstances which may reasonably be expected to be the result of or result in abuse or neglect may report to the department.Notwithstanding any other provision of this section, a duly ordained minister, clergy, religious worker, or Christian Science practitioner while functioning in his or her ministerial capacity shall not be required to report concerning a privileged communication made to him or her in his or her professional capacity.

2.Any residential facility, day program or specialized service operated, funded or licensed by the department that prevents or discourages a patient, resident or client, employee or other person from reporting that a patient, resident or client of a facility, program or service has been abused or neglected shall be subject to loss of their license issued under sections 630.705 to 630.760, and civil fines of up to five thousand dollars for each attempt to prevent or discourage reporting.

3. Nothing in this section shall be construed to mean that a vulnerable person is abused or neglected solely because such person chooses to rely on spiritual means through prayer, in lieu of medical care, for his or her health care, as evidenced by such person's explicit consent, advance directive for health care, or practice.

(L. 2014 S.B. 491)

Effective 1-01-17

630.766 - Monitor may be assigned by department — to advise operator as to compliance — report to department.

In any situation described in section 630.763 the department may place a person to act as a monitor in the facility.The monitor shall observe operation of the residential facility and shall advise it on how to comply with state laws and regulations, and shall submit a written report periodically to the department on the operation of the facility.

(L. 1980 H.B. 1724)

630.781 - Compensation of receiver.

1.The court shall set the compensation of the receiver, which shall be considered a necessary expense of a receivership.

2.A receiver may be required by the court to post a bond, which shall be considered a necessary expense of the receivership.

(L. 1980 H.B. 1724)

630.462 - Contractors for community psychiatric rehabilitation, reviews, how conducted.

All department reviews of contractors for community psychiatric rehabilitation services shall be the same regardless of whether or not a provider is designated as an administrative entity pursuant to section 630.407.

(L. 1995 H.B. 562 § 2)

630.133 - Psychosurgery, consent required — not to be performed by department.

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.

(L. 1980 H.B. 1724)

630.546 - Lease purchase agreement authorized for use of facilities constructed by private developer on grounds of existing St. Louis state hospital, procedure — deemed to be public works, wage rate.

1.The commissioner of administration is authorized to enter into a lease-purchase agreement for the use of facilities to be constructed by a private developer on the grounds of the existing St. Louis state hospital for the use of the department of mental health, provided any facilities to be constructed shall contain provisions for a possible adaptive re-use of the present "dome" building.

2.The attorney general shall approve the instrument of conveyance as to form.

3.Not less than the rate of wages required to be paid pursuant to sections 290.210 to 290.340 shall be paid by contractors or subcontractors to employees or other workers when such contractors or subcontractors construct facilities for private developers on the grounds of the existing St. Louis state hospital for the use of the department of mental health.Such construction projects shall be considered public works and the determination of the rate of wages for the locality shall be made in accordance with the provisions of sections 290.210 to 290.340.

(L. 1991 S.B. 347 § 2, A.L. 2018 H.B. 1729, et al.)

630.717 - Alcohol and drug abuse facilities and programs exempt — fire, safety standards compliance — report to general assembly.

1.Any residential facility or day program which provides services exclusively to those persons affected by alcohol or drug abuse shall be exempt from licensure rules promulgated by the department.

2.Any residential facility or day program which offers services, treatment or rehabilitation to persons affected by alcohol or drug abuse shall submit to the department a description of the services, treatment or rehabilitation which it offers, a statement of whether each facility or program is required to meet any fire-safety standards of a municipality, political subdivision of the state, and documentation of compliance with such standards, if they apply.

3.The department shall survey all such facilities and programs and shall prepare a report for submission to the general assembly of actions necessary to bring such facilities and programs in compliance with fire-safety standards developed by the department for certification.The report shall be filed with the speaker of the house and the president pro tem of the senate by January 1, 1983.

4.Failure of a facility or program to submit information requested by the department and required by this section shall disqualify such facility or program from receiving department certification or funding until such information is submitted.

(L. 1980 H.B. 1724)

630.003 - Department created — state mental health commission — Missouri institute of mental health — transfers of powers and agencies.

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.

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 Missouri.

(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 intellectual or 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 persons with an intellectual disability or developmental disability 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 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 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 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 Missouri institute of psychiatry, which is under the board of curators of the University of Missouri is hereafter to be known as the "Missouri Institute of Mental Health".The purpose of the institute will be that of conducting research into improving services for persons served by the department of mental health for fostering the training of psychiatric residents in public psychiatry and for fostering excellence in mental health services through employee training and the study of mental health policy and ethics.To assist in this training, hospitals operated by and providers contracting with the department of mental health may be used for the same purposes and under the same arrangements as the board of curators of the University of Missouri utilizes with other hospitals in the state in supervising residency training for medical doctors.Appropriations requests for the Missouri institute of mental health shall be jointly developed by the University of Missouri and the department of mental health.All appropriations for the Missouri institute of mental health shall be made to the curators of the University of Missouri but shall be submitted separately from the appropriations of the curators of the University of Missouri.

5.There is hereby established within the department of mental health a division of 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 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, 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 developmental disabilities.The advisory council on mental retardation and developmental disabilities shall be appointed by the director of the division of developmental disabilities.

8.The advisory council on alcoholism and drug abuse, chapter 202, 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.

(L. 1973 1st Ex. Sess. S.B. 1, A.L. 1990 H.B. 1383, A.L. 1991 H.B. 568, A.L. 2011 H.B. 555 merged with H.B. 648, A.L. 2014 H.B. 1064)

*Sections 191.120, 191.130, and 191.140 were repealed by H.B. 1554 Revision, 1986.Section 191.125 was repealed by H.B. 1724, 1980. Section 191.200 was repealed by S.B. 60, 1977.

630.407 - Administrative entities may be recognized, when — contracting with vendors — subcontracting — department to promulgate rules.

1.The department may recognize providers as administrative entities under the following circumstances:

(1)Vendors operated or funded pursuant to sections 205.975 to 205.990;

(2)Vendors operated or funded pursuant to sections 205.968 to 205.973;

(3)Providers of a consortium of treatment services to the clients of the division of comprehensive psychiatric services as an agent of the division in a service area, except that such providers may not exceed thirty-six in number; or

(4)Providers of targeted case management services to the clients of the division of developmental disabilities as an agent of the division in a defined region that has not established a board as set forth in sections 205.968 to 205.973.

2.Notwithstanding any other provision of law to the contrary, the department may contract directly with vendors recognized as administrative entities without competitive bids.

3.Notwithstanding any other provision of law to the contrary, the commissioner of administration shall delegate the authority to administrative entities which are state facilities to subcontract with other vendors in order to provide a full consortium of treatment services for the service area.

4.When state contracts allow, the department may authorize administrative entities to use state contracts for pharmaceuticals or other medical supplies for the purchase of these items.

5.A designation as an administrative entity does not entitle a provider to coverage under sections 105.711 to 105.726, the state legal expense fund, or other state statutory protections or requirements.

6.The department shall promulgate regulations within twelve months of August 28, 1990, regulating the manner in which they will contract and designate and revoke designations of providers under this section.Such regulations shall not be required when the parties to such contracts are both governmental entities.

(L. 1990 S.B. 808 & 672, A.L. 2009 H.B. 481 merged with S.B. 435)

630.656 - Waiver or exception request of administrative rule or standard, procedure.

Notwithstanding any rule to the contrary, any request for a waiver or exception of administrative rule or standard shall be approved by an exceptions committee created by the filing agency and such committee shall be considered a public governmental body operating under chapter 610.

(L. 1995 S.B. 374 § 630.655)

630.115 - Patient's entitlements — administrative review of violations.

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.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

*Word "season" appears in original rolls.

630.015 - Director, appointment — duties of commission.

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.

(L. 1980 H.B. 1724)

630.215 - Pay patient, how determined — estate of patient, court to notify director and conservator — failure to pay, may discharge — appeal.

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.

3.The decision of the director shall be final, and appeal may be made to the circuit court of Cole County or the county where the person responsible for payment resides in the manner provided by chapter 536.The director shall notify the conservator and the supervising court of such failure to pay for services rendered by a facility or program operated or funded by the department at least thirty days before the patient, resident or client is discharged under chapter 31.If the conservator appeals the decision of the director, the patient, resident or client shall remain in the facility or program pending final disposition of the appeal.

(L. 1980 H.B. 1724, A.L. 1983 S.B. 44 & 45)

630.315 - Department may become payee for patient, procedure.

A department residential facility may accept an appointment to serve as representative payee or fiduciary, or in a similar capacity for payments to a patient or resident under a public or private benefit arrangement.Funds so received shall be governed by section 630.305, except to the extent that laws or regulations governing payment of the benefits provide otherwise.

(L. 1980 H.B. 1724)

630.715 - Licensing of residential facilities and day programs — fee — affidavit.

1.The department shall establish a procedure for the licensing of residential facilities and day programs for persons described in section 630.705, which procedure shall provide for the acceptance of a license, a temporary operating permit or a probationary license issued by the department of social services under sections 198.006 to 198.096 as regards the licensing requirements in the following areas:

(1)General medical and health care;

(2)Adequate physical plant facilities including fire safety, housekeeping and maintenance standards;

(3)Food service facilities;

(4)Safety precautions;

(5)Drugs and medications;

(6)Uniform system of record keeping;

(7)Resident and client rights and grievance procedures.

However, the department shall require annually that any facilities and programs already licensed by the department of social services under chapter 198 which desire to provide services to persons diagnosed with a mental disorder, mental illness, or developmental disability in accordance with sections 630.705 to 630.760 meet the department's requirements in excess of those required for licensure or certification under chapter 198, which are appropriate to admission criteria and care, treatment, habilitation and rehabilitation needs of such persons.

2.Applications for licenses shall be made to the department upon forms provided by it and shall contain such information and documents as the department requires, including, but not limited to, affirmative evidence of ability to comply with the rules adopted by the department.Each application for a license, except applications from a governmental unit or a facility caring for less than four persons, which shall not pay any fee, shall be accompanied by a license fee of ten dollars for establishments which accept more than three but less than ten persons and fifty dollars from establishments which accept ten or more.The license fee shall be paid to the director of revenue for deposit to the general revenue fund of the state treasury.

3.An applicant for a license shall submit an affidavit under oath that all documents required by the department to be filed pursuant to this section are true and correct to the best of his knowledge and belief, that the statements contained in the application are true and correct to the best of his knowledge and belief and that all required documents are either included with the application or are currently on file with the department.

(L. 1980 H.B. 1724, A.L. 1985 S.B. 266, A.L. 2011 H.B. 555 merged with H.B. 648)

630.615 - Program standards to be considered — prior to placement.

Before placing any client in a particular residential facility or day program, the department shall consider each of the following criteria:

(1)The best interests of the patient or resident;

(2)Except as provided in subdivision (5) of this section, the least restrictive environment for providing care and treatment consistent with the needs and conditions of the patient or resident;

(3)The ability to provide to the patient or resident that individual degree of care and treatment which is required for that patient or resident and which is of comparable quality to the existing care and treatment based upon investigation of the alternative place and its program of care and treatment;

(4)The relationship of the patient or resident to his family, guardian or friends, so as to maintain relationships and encourage visits beneficial to the patient or resident;

(5)Whether the facility will provide the security necessary to protect the public safety and any crime victim or other witnesses if the client was committed to the department of mental health pursuant to chapter 552, based on an accepted plea of not guilty by reason of a mental disease or defect excluding responsibility or an acquittal on that basis as provided in section 552.030 for a dangerous felony as defined in section 556.061, or a violation of section 565.020 or 566.040, or an attempt to commit one of the preceding crimes.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

630.415 - Terms of contracts.

1.Each contract shall provide by its terms for units of a single service or several services accessible to persons needing them in defined geographic areas.

2.Through monitoring of the contracts under department rules and under the contract terms, the department shall require evidence that the services funded by the state are cost-and-benefit effective.

(L. 1980 H.B. 1724)

630.640 - Costs of benefits may be paid by department — recovery.

1.If a client receiving services under this chapter is ineligible for public assistance benefits from any source, or such benefits are inadequate to meet the costs of such services, his monthly costs may be paid or supplemented out of funds appropriated for that purpose to the department.

2.If payments for the support and maintenance of the client are made from funds appropriated to the department, the department shall charge the client or those responsible for his support under this chapter for his support and maintenance pursuant to sections 630.205 to 630.215.

(L. 1980 H.B. 1724)

630.740 - Penalty for failure to obtain license — attorney general to represent department — relief to be granted.

1.Any person establishing, conducting, managing or operating any residential facility or day program without a license as provided for in sections 630.705 to 630.760 is guilty of a class C misdemeanor.

2.The attorney general shall represent the department, which may institute an action in the name of the state for an injunction or other process against any person or governmental unit to restrain or prevent the establishment, conduct, management or operation of a residential facility or day program without a license as required under this law.

(L. 1980 H.B. 1724)

630.540 - Proposed transfers and conveyances to be reviewed.

The board of public buildings, as created under section 8.010, and the commissioner of administration shall review each proposed transfer or conveyance of any interest in real property owned by the state for the department.The board and the commissioner shall report to the general assembly any recommendations either might have regarding the consideration for such transfer or conveyance to protect the interests of the state prior to such transfer or conveyance.

(L. 1980 H.B. 1724)

630.440 - Payment to grantees, procedure.

The department shall pay the grantees in periodic interim payments rather than lump sum payments and shall require that the grantees, before receiving any subsequent payments after their initial payments, submit invoices describing their expenses, progress reports on establishing the residential facilities, day programs or specialized services and written reports of the services they have provided with the funds they have received.

(L. 1980 H.B. 1724)

630.040 - Facility administrative officers to have general charge and control.

1.The chief administrative officers of the facilities of the divisions of the department, subject to the directives of the department director and the respective division directors, shall have charge, control and management of their facilities.

2.The chief administrative officer of each facility shall keep the records and make the reports which the department and the respective division deem necessary and advisable.

3.Each chief administrative officer shall exercise the powers and duties of the appointing authority under chapter 36, subject to the supervision of the department director and the respective division directors.

(L. 1980 H.B. 1724)

630.140 - Records confidential, when — may be disclosed, to whom, how, when — release to be documented — court records confidential, exceptions.

1.Information and records compiled, obtained, prepared or maintained by the residential facility, mental health 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 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, 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, 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. Sections 15042 to 15044.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. Section 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;

(9)To individuals, designated by the department of mental health as community mental health liaisons, for the purpose of coordination of care and services.

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 as permitted by the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended;

(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, 475, 552, or 632;

(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;

(9)To the department of social services or the department of health and senior 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;

(11)To parents, legal guardians, treatment professionals, law enforcement officers, and other individuals who by having such information could mitigate the likelihood of a suicide.The facility treatment team shall have determined that the consumer's safety is at some level of risk;

(12)To individuals, designated by the department of mental health as community mental health liaisons, for the purpose of coordination of care and services.

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 shall be confidential and available only to the patient, the patient's attorney, guardian, or, in the case of a minor, to a parent or other person having legal custody of the patient, to the petitioner and the petitioner's attorney, and to the Missouri state highway patrol for reporting to the National Instant Criminal Background Check System (NICS), and to individuals designated by the department of mental health as community mental health liaisons for the purpose of coordination of care and services.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 may only be disclosed as specified in subsections 2 and 3 of this section.

(L. 1980 H.B. 1724, A.L. 1984 S.B. 575, A.L. 1986 H.B. 1414, A.L. 1988 H.B. 1493, A.L. 1996 S.B. 884 & 841, A.L. 2003 S.B. 556 & 311, A.L. 2005 H.B. 462 & 463, A.L. 2007 S.B. 3 merged with S.B. 62 & 41, A.L. 2008 S.B. 1081, A.L. 2015 S.B. 426)

630.340 - Sheltered workshops and activity centers authorized — operation.

1.With the approval of the director, the head of any mental health or intellectual disability facility or regional center operated by the department may establish a vocational activity center for its patients or residents.

2.Each facility or regional center shall keep revenues received from the activity center in a separate account.The acquisition costs to obtain materials to produce any goods sold and other expenses shall be paid from this account.A minimum amount of money necessary to meet cash flow needs and current operating expenses may be maintained in this account.The remaining funds from sales of the activity center shall be deposited monthly in the state treasury to the credit of the general revenue fund.

3.This section shall not be construed to authorize any facility or regional center to establish an activity center on the grounds for patients or residents who could participate in a sheltered workshop, as defined and authorized in sections 178.900 to 178.960, off the grounds of the facility or regional center.

(L. 1980 H.B. 1724, A.L. 2014 H.B. 1064)

630.815 - Director of department to make rules — cooperate in administration.

The director of the department of mental health shall be the compact administrator who, acting jointly with like officers of other party states, shall have power to promulgate rules and regulations to carry out more effectively the terms of the compact.The compact administrator is hereby authorized, empowered and directed to cooperate with all departments, agencies and officers of and in the government of this state and its subdivisions in facilitating the proper administration of the compact or any supplementary agreement or agreements entered into by this state thereunder.

(L. 1980 H.B. 1724)

630.750 - Procedure upon finding of noncompliance which may present health or safety dangers.

The provisions of section 630.745 notwithstanding, if a duly authorized representative of the department finds upon inspection of a licensed residential facility or day program, and the director finds upon review, that the facility or program is not in substantial compliance with a standard or standards the violations of which would present either an imminent danger to the health, safety or welfare of any resident or a substantial probability that death or serious physical harm would result and which is not immediately corrected, the department shall:

(1)Give immediate written notice of the noncompliance to the head of the facility or program;

(2)Make public the fact that a notice of noncompliance has been issued to the facility or program.Copies of the notice shall be sent to appropriate hospitals and social service agencies;

(3)Send a copy of the notice of noncompliance to any concerned federal, state or local government agencies.The facility or program shall post in a conspicuous location in the facility or program a copy of the notice of noncompliance and a copy of the most recent inspection report.

(L. 1980 H.B. 1724)

630.650 - Cooperation with department of social services.

The department of social services shall cooperate with the department of mental health and its facilities in locating licensed residential facilities, day programs and specialized services, in visiting and inspecting them, and in submitting inspection and other reports regarding them and the department clients placed therein.

(L. 1980 H.B. 1724)

630.450 - Duplication of programs to be avoided.

If a residential facility, day program or other specialized service proposes to be funded by the department to provide services which the department provides through any of its facilities, programs or specialized services, the department shall determine how such services can most economically and effectively be provided and shall provide such services either directly or through contract and affiliation agreements, and shall avoid duplication of such services unless the department finds that such duplication is necessary.The department shall report any such duplication, and why the department deems such duplication necessary, in writing to the appropriations committees of the Missouri house and senate.

(L. 1980 H.B. 1724)

630.550 - Centralized supply warehouses established, costs — mental health central supply fund, created, administered — charges, operation of fund.

1.The director of the department of mental health may for the benefit of the department or its facilities establish and operate or contract for the operation of centralized supply warehouses.Such warehouses may be department-wide or regional and may provide medical supplies, medicine and drugs, food, office, maintenance, or janitorial supplies, or other types of supplies used by the department.All costs related to the operation of such warehouses, except for the actual cost of supply commodities, shall be paid out of moneys appropriated to the department of any facility operated by the department.

2.There is hereby created in the state treasury for use by the department of mental health a fund to be known as "The Mental Health Central Supply Fund".Moneys deposited in the fund shall be appropriated to the director of the department of mental health to be used for purchasing supply commodities, including the purchase price and related shipping and handling charges.The fund shall consist of moneys appropriated by the general assembly for starting the fund and moneys deposited pursuant to subsection 4 of this section.The provisions of section 33.080 notwithstanding, moneys in the fund shall not lapse, unless and then only to the extent to which the unencumbered balance at the close of any fiscal year exceeds one-sixth of the total amount appropriated, paid or transferred to the fund during such fiscal year.

3.Supply commodities shall be issued from the central warehouses to the director of the department of mental health and to facilities operated by such department.The director shall establish procedures for determining the amount to be charged for supply commodities issued from such warehouses.The amount charged shall be regulated to adjust actual costs for inventory obsolescence, spoilage, loss or other damage to commodities and for any cost adjustments including refunds and reimbursements received from supply vendors.

4.Charges for supply commodities issued shall be paid out of moneys appropriated to the department of mental health or facilities operated by such department.The director shall deposit moneys derived from such charges and any receipts from supply vendors, including refunds and reimbursements, in the state treasury to the credit of the mental health central supply fund.

5.The director of the department of mental health shall administer the fund and shall determine the amount of money to be maintained in the fund necessary for cash flow requirements.Amounts charged for supply commodities may be adjusted to regulate this fund balance.

(L. 1987 H.B. 871)

630.150 - Disclosure of absence to be made, when, to whom.

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, 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, any other agencies or persons designated by the head of the facility as necessary for the protection of the patient, resident or other parties.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

630.050 - Rules, promulgation, procedure — public inspection — facility policies.

1.The department shall promulgate rules under the provisions of this section and chapter 536 as necessary to prescribe policies or standards which affect charging, funding and licensing procedures of residential facilities, day programs and specialized services available to the public and for reporting and investigating complaints of abuse and neglect.The rules applicable to each facility, program or service operated, funded or licensed by the department shall be available for public inspection and review at such facility, program or service.No rule or portion of a rule promulgated under the authority of this chapter shall become effective unless it has been promulgated pursuant to the provisions of section 536.024.

2.The department shall adopt operating regulations concerning only its internal management which need not be published in the Missouri Register or the code of state regulations under chapter 536, but these regulations shall be available at department facilities for public inspection and review.

3.Under the supervision of the department and its respective divisions, each facility shall adopt policies concerning only its internal management or its procedures for its patients, residents or clients without publishing such policies in the Missouri Register or the code of state regulations under chapter 536, but the facility policies shall be available at such facility for public inspection and review.

4.The rules, operating regulations and facility policies shall be compatible with and appropriate to the facility or program mission, population served, size, type of service and other reasonable classifications.

(L. 1980 H.B. 1724, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3, A.L. 2008 S.B. 1081)

630.805 - Nonresidents may be returned to place of residence, when — reciprocal agreements authorized — transportation costs.

1.Except for those persons committed to the department of mental health pursuant to chapter 552, a person who is not a resident of this state who is committed to the department of mental health for care, treatment, detention or training in a state hospital or institution by order of a court may be returned by the department, either before or after such person's admission to a state hospital or institution, to the state of such person's residence, except that no person shall be so returned unless proper arrangements to receive the patient have been made with the state to which the person is to be returned.

2.The director of the department of mental health may enter into reciprocal agreements with other states or political subdivisions thereof for the interstate transportation or transfer of mentally ill or mentally deficient persons, or persons who are in need of mental treatment, to the state of their residence.

3.The cost of transporting a nonresident patient to the state of the patient's residence is payable out of funds appropriated to the department of mental health.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

630.350 - Limitation on bank accounts.

The department or any of its facilities shall not maintain any funds or accounts in concentrated bank accounts or other state accounts unless the funds or accounts are authorized by law.

(L. 1980 H.B. 1724)

630.005 - Definitions.

As used in this chapter and chapters 631, 632, and 633, 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;

(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 intellectual disabilities, 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, intellectual disabilities, 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 Missouri;

(9)"Developmental disability", a disability:

(a)Which is attributable to:

a.Intellectual disability, 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 that seeks to enhance and maximize a person with an intellectual disability or a developmental disability to cope with the environment and to live as determined by the person as much as possible, as is appropriate for the person considering his or her physical and mental condition and financial means;

(14)"Habilitation center", a residential facility operated by the department and serving only persons who are 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 residents and clients with an intellectual disability or a developmental disability, 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 patients and clients with mental disorders or mental illness, and which details the treatment program as required by law, rules and funding sources;

(20)"Intellectual disability", significantly subaverage general intellectual functioning which:

(a)Originates before age eighteen; and

(b)Is associated with a significant impairment in adaptive behavior;

(21)"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;

(22)"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 or her 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 persons with mental disorders, intellectual disabilities, or developmental disabilities, 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;

(23)"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;

(24)"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)Intellectual disability, 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;

(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;

(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, intellectual disability, 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, intellectual disabilities, 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;

(34)"Vulnerable person", any person in the custody, care, or control of the department that is receiving services from an operated, funded, licensed, or certified program.

(L. 1980 H.B. 1724, A.L. 1981 H.B. 399, A.L. 1982 H.B. 1565, A.L. 1990 H.B. 1383, S.B. 808 & 672, A.L. 1993 S.B. 388, A.L. 1995 H.B. 574, A.L. 1996 S.B. 884 & 841, A.L. 2007 S.B. 3, A.L. 2011 H.B. 555 merged with H.B. 648, A.L. 2014 H.B. 1064, A.L. 2018 S.B. 806)

630.305 - Funds of patient, control, expenditure, return, safekeeping.

1.For purposes of this section, the term "money" includes any legal tender, note, draft, certificate of deposit, stock, bond, check or credit card.

2.A department residential facility may require that all money which is on the person of a patient or resident, which comes to a patient or resident, or which the facility receives in place of the patient or resident under a benefit arrangement or otherwise be turned over to the facility for safekeeping.The money shall be accounted for in the name of the patient or resident and recorded periodically in the records of the patient or resident.Upon request, money accounted for in the name of the patient or resident shall be turned over to a conservator of the patient or resident, if the conservator has such authority, or to the parent of the patient or resident if the patient or resident is a minor; except the facility shall hold money it received as representative payee under terms of public or private benefit arrangements as authorized by section 630.315.

3.A patient or resident of a department facility shall have easy access to the money in his account and may keep and be allowed to spend a reasonable sum for canteen expenses and small purchases.He may spend or otherwise use the money as he chooses, except as provided in subsection 4 of this section.With the approval of the department, the facility shall establish written policies and procedures giving patients and residents easy access to the money in their accounts and allowing the money to be spent or otherwise used as the patients or residents choose.

4.A department facility may deny a patient or resident the access to and ability to spend or otherwise use the money in his account if it determines that the denial is essential in order to prevent the patient or resident from significantly dissipating his assets or that reasonable restrictions are necessary to protect the patient, resident or others.The department shall establish policies and procedures governing such determinations, including the evidence necessary to support a denial of the patient's or resident's rights.If a denial is made, the patient or resident may continue to spend or otherwise use the money in ways which would not constitute significant dissipation of the assets and which would sufficiently protect himself or others.

5.The department facility shall deposit money accounted for in the name of a patient or resident with a financial institution.Any earnings attributable to money in the account of a patient or resident shall be credited to that account.Under sections 110.070 to 110.110, the department shall receive bids from banking corporations, associations or trust companies which desire to be selected as depositaries of the department for patients' and residents' moneys.

6.The department shall deliver to the patient or resident, his conservator, if he is legally disabled, or his parent, if he is a minor, all money, including any earnings, in the patient's or resident's account upon release from the facility; except that the department may continue to serve as a depositary for the money in the account of a patient or resident who is placed through the department's placement program.

7.The department shall establish policies and procedures designed to insure that money in the accounts of patients and residents is safeguarded against theft, loss or misappropriation.The department shall guarantee against theft, loss or misappropriation the principal amounts in any patient's or resident's account.

(L. 1980 H.B. 1724, A.L. 1982 H.B. 1565, A.L. 1983 S.B. 44 & 45)

630.950 - Immunity from liability, when.

Any department employee or employee of a residential facility, day program, or specialized service operated, funded, or licensed by the department who reports on or discusses employee job performance for the purposes of making employment decisions that affect the safety of consumers and who does so in good faith and without malice shall not be subject to an action for civil damages as a result thereof, and no cause of action shall arise against him or her as a result of his or her conduct pursuant to this section.The attorney general shall defend such persons in any such action or proceeding.

(L. 2007 S.B. 3)

630.850 - Compact enacted — form.

The "Interstate Compact on the Mentally Disordered Offender", hereinafter called "the compact", is hereby enacted into law and entered into with all other jurisdictions legally joining therein, in the form substantially as contained in section 630.855.

(L. 1980 H.B. 1724)

630.205 - 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.

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, 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 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 Missouri shall be denied services from a department facility because of an inability to pay for such services on the part of the individual, the spouse or the parents.

5.Nothing in this section shall be construed to relieve an insurer or other third party from an otherwise valid obligation.

(L. 1980 H.B. 1724, A.L. 1981 H.B. 399, A.L. 1985 S.B. 265)

630.605 - Placement programs to be maintained.

The department shall establish a placement program for persons affected by a mental disorder, mental illness, intellectual disability, developmental disability or alcohol or drug abuse.The department may utilize residential facilities, day programs and specialized services which are designed to maintain a person who is accepted in the placement program in the least restrictive environment in accordance with the person's individualized treatment, habilitation or rehabilitation plan.The department shall license, certify and fund, subject to appropriations, a continuum of facilities, programs and services short of admission to a department facility to accomplish this purpose.

(L. 1980 H.B. 1724, A.L. 2011 H.B. 555 merged with H.B. 648)

630.705 - Rules for standards for facilities and programs for persons affected by mental disorder, mental illness, or developmental disability — classification of facilities and programs — certain facilities and programs not to be licensed.

1.The department shall promulgate rules setting forth reasonable standards for residential facilities and day programs for persons who are affected by a mental disorder, mental illness, intellectual disability, or developmental disability.

2.The rules shall provide for the facilities and programs to be reasonably classified as to resident or client population, size, type of services or other reasonable classification.The department shall design the rules to promote and regulate safe, humane and adequate facilities and programs for the care, treatment, habilitation and rehabilitation of persons described in subsection 1 of this section.

3.The following residential facilities and day programs shall not be licensed by the department:

(1)Any facility or program which relies solely upon the use of prayer or spiritual healing;

(2)Any educational, special educational or vocational program operated, certified or approved by the state board of education pursuant to chapters 161, 162 and 178, and regulations promulgated by the board;

(3)Any hospital, facility, program or entity operated by this state or the United States; except that facilities operated by the department shall meet these standards;

(4)Any hospital, facility or other entity, excluding those with persons who are intellectually disabled and developmentally disabled as defined in section 630.005 otherwise licensed by the state and operating under such license and within the limits of such license, unless the majority of the persons served receive activities and services normally provided by a licensed facility pursuant to this chapter;

(5)Any hospital licensed by the department of social services as a psychiatric hospital pursuant to chapter 197;

(6)Any facility or program accredited by the Joint Commission on Accreditation of Hospitals, the American Osteopathic Association, the Council on Quality and Leadership, Council on Accreditation of Services for Children and Families, Inc., or the Commission on Accreditation of Rehabilitation Facilities;

(7)Any facility or program caring for less than four persons whose care is not funded by the department.

(L. 1980 H.B. 1724, A.L. 1982 H.B. 1565, A.L. 1984 S.B. 575, A.L. 1985 S.B. 266, A.L. 1990 S.B. 808 & 672, A.L. 2000 H.B. 1085, A.L. 2011 H.B. 555 merged with H.B. 648, A.L. 2014 H.B. 1064)

630.505 - Department to name facilities.

The department shall designate the names of each of its facilities.No official name shall contain terminology which, from a public standpoint, could be regarded as stigmatizing or denigrating.

(L. 1980 H.B. 1724)

630.405 - Purchase of services, procedure — commissioner of administration to cooperate — rules, procedure.

1.The department may purchase services for patients, residents or clients from private and public vendors in this state with funds appropriated for this purpose.

2.Services that may be purchased may include prevention, diagnosis, evaluation, treatment, habilitation, rehabilitation, transportation and other special services for persons affected by mental disorders, mental illness, intellectual disabilities, developmental disabilities or alcohol or drug abuse.

3.The commissioner of administration, in consultation with the director, shall promulgate rules establishing procedures consistent with the usual state purchasing procedures pursuant to chapter 34 for the purchase of services pursuant to this section.The commissioner may authorize the department to purchase any technical service which, in his judgment, can best be purchased direct pursuant to chapter 34.The commissioner shall cooperate with the department to purchase timely services appropriate to the needs of the patients, residents or clients of the department.

4.The commissioner of administration may promulgate rules authorizing the department to review, suspend, terminate, or otherwise take remedial measures with respect to contracts with vendors as defined in subsection 1 of this section that fail to comply with the requirements of section 210.906.

5.The commissioner of administration may promulgate rules for a waiver of chapter 34 bidding procedures for the purchase of services for patients, residents and clients with funds appropriated for that purpose if, in the commissioner's judgment, such services can best be purchased directly by the department.

6.No rule or portion of a rule promulgated pursuant to the authority of this section shall become effective unless it has been promulgated pursuant to the provisions of chapter 536.

(L. 1980 H.B. 1724, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3, A.L. 2001 S.B. 48, A.L. 2011 H.B. 555 merged with H.B. 648)

630.193 - Professional review committee to make recommendations to director — committee members, appointment, qualifications, terms, compensation — organization and meetings.

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 August 13, 1980, shall serve terms of two years each.

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.

(L. 1980 H.B. 1724 § 630.192 subsecs. 2, 3, 4)

630.825 - Expenses, how paid.

All expenditures necessitated under the provisions of sections 630.810 to 630.835 shall be paid out of appropriations made to the department of mental health.

(L. 1980 H.B. 1724)

630.925 - Mental health fatality review panel established, members, duties.

1.The director of the department shall establish a mental health fatality review panel to review deaths of all adults in the care and custody of the department.The panel shall be formed and shall operate according to the rules, guidelines, and protocols provided by the department of mental health.

2.The panel shall include, but shall not be limited to, the following:

(1)A prosecuting or circuit attorney;

(2)A coroner or medical examiner;

(3)Law enforcement personnel;

(4)A representative from the departments of mental health, social services, health and senior services, and public safety;

(5)A representative of the Missouri Protection and Advocacy.

3.The director of the department of mental health shall organize the panel and shall call the first organizational meeting of the panel.The panel shall elect a chairman who shall convene the panel to meet at least quarterly to review all suspicious deaths of patients, residents, or clients who are in the care and custody of the department of mental health, which meet guidelines for review as set forth by the department of mental health.In addition, the panel may review at its own discretion any death reported to it by the medical examiner, coroner, or a parent or legal representative of a client in the care and custody of the department, even if it does not meet criteria for review as set forth by the department.The panel shall issue a final report, which shall be a public record, of each investigation to the department of mental health.The final report shall include a completed summary report form.The form shall be developed by the director of the department of mental health.The department of mental health shall analyze the mental health fatality review panel reports and periodically prepare epidemiological reports which describe the incidence, causes, location, and other factors.The department of mental health shall make recommendations and develop programs to prevent patient, resident, or client injuries and deaths.

4.For purposes of this section, "suspicious death" shall include but not be limited to when the following occurs:

(1)A crime is involved;

(2)An accident has occurred;

(3)A medical prognosis has not been ascertained; or

(4)A person has died unexpectedly.

5.The mental health fatality review panel shall enjoy such official immunity as exists at common law.

(L. 2007 S.B. 3)

630.793 - Liabilities of receivers and licensees.

No licensee may be held liable for acts or omissions of the receiver or the receiver's employees during the term of the receivership.Nothing in sections 630.763 to 630.793 shall be deemed to relieve any licensee or affiliate of a licensee of a facility placed in receivership of any civil or criminal liability incurred, or any duty imposed by law, by reason of acts or omissions of the licensee or affiliates of the licensee prior to the appointment of a receiver under section 630.763 or 630.793, nor shall anything contained in sections 630.763 to 630.793 be construed to suspend during the receivership any obligation of the licensee or any affiliate of a licensee for payment of taxes or other operating and maintenance expenses of the facility, nor of the licensee or affiliates of the licensee for the payment of mortgages or liens.

(L. 1980 H.B. 1724)

630.170 - Disqualification for employment because of conviction — appeal process — criminal record review, procedure — registry maintained, when — appeals procedure.

1.A person who is listed on the department of mental health disqualification registry pursuant to this section, who is listed on the department of social services or the department of health and senior services employee disqualification list pursuant to section 192.2490, or who has been found guilty of or pleaded guilty or nolo contendere to any crime pursuant to section 565.210*, 565.212*, or 565.214*, or section 630.155 or 630.160 shall be disqualified from holding any position in any public or private facility, day program, residential facility, or specialized service operated, licensed, certified, accredited, in possession of deemed status, or funded 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.

2.A person who has been found guilty of or pleaded guilty or nolo contendere to any felony offense as defined in chapter 195; any felony offense against persons as defined in chapter 565; any felony offense as defined in chapter 566; any felony offense defined in section 568.020, 568.045, 568.050, 568.060, 568.175, 570.023**, 569.025, 570.025**, 569.035*, 569.040, 569.050, 574.080**, 569.160, 570.030, 570.040*, 570.090, 570.145, 570.223, 575.230, or 576.080, or of an equivalent felony offense in another state, or an equivalent federal felony offense, or an equivalent offense under the Uniform Code of Military Justice, or who has been found guilty of or pleaded guilty or nolo contendere to any violation of subsection 3 of section 198.070, or has been found guilty of or pleaded guilty or nolo contendere to any offense requiring registration under section 589.400, or any employee hired after January 1, 2014, who has been found guilty of or pleaded guilty or nolo contendere to a violation of section 577.010 or section 577.012 and who is alleged and found by the court to be an aggravated or chronic offender under section 577.023, shall be disqualified from holding any direct-care position in any public or private facility, day program, residential facility or specialized service operated, licensed, certified, accredited, in possession of deemed status, or funded 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.

3.A person who has received a suspended imposition of sentence or a suspended execution of sentence following a plea of guilty to any of the disqualifying crimes listed in subsection 1 or 2 of this section shall remain disqualified.

4.Any person disqualified pursuant to the provisions of subsection 1 or 2 of this section may seek an exception to the disqualification from the director of the department or the director's designee, especially if the person is in recovery and the disqualifying felony offense was alcohol- or drug-related.The request shall be written and may not be made more than once every six 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 an exception subject to any conditions deemed appropriate and failure to comply with such terms may result in the person again being disqualified.Any person placed on the disqualification registry prior to August 28, 2012, may be removed from the registry 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.Decisions by the director or designee pursuant to the provisions of this subsection shall not be subject to appeal.The right to request an exception pursuant to this subsection shall not apply to persons who are disqualified due to being listed on the department of social services or department of health and senior services employee disqualification list pursuant to section 192.2490, nor to persons disqualified from employment due to any crime pursuant to the provisions of chapter 566 or section 565.020, 565.021, 568.020, 568.060, 569.025, or 574.080**.

5.An applicant for a position in any public or private facility, day program, residential facility, or specialized service operated, licensed, certified, accredited, in possession of deemed status, or funded 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 shall:

(1)Sign a consent form as required by section 43.540 to provide written consent for a criminal record review;

(2)Disclose the applicant's criminal history.For the purposes of this subdivision "criminal history" includes any suspended imposition of sentence, any suspended execution of sentence, or any period of probation or parole; and

(3)Disclose if the applicant is listed on the employee disqualification list as provided in section 192.2490, or the department of mental health disqualification registry as provided for in this section.

6.Any person who has received a good cause waiver issued by the department of health and senior services or its predecessor under subsection 10 of section 192.2495 shall not require an additional exception under this section in order to be employed in a long-term care facility licensed under chapter 198.

7.Any public or private residential facility, day program, or specialized service operated, licensed, certified, accredited, in possession of deemed status, or funded 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 shall, not later than two working days after hiring any person for a full-time, part-time, or temporary position that will have contact with clients, residents, or patients:

(1)Request a criminal background check as provided in section 43.540;

(2)Make an inquiry to the department of social services and department of health and senior services to determine whether the person is listed on the employee disqualification list as provided in section 192.2490; and

(3)Make an inquiry to the department of mental health to determine whether the person is listed on the disqualification registry as provided in this section.

8.An applicant who knowingly fails to disclose his or her criminal history as required in subsection 5 of this section is guilty of a class A misdemeanor.A provider is guilty of a class A misdemeanor if the provider hires a person to hold a direct-care position knowing that such person has been disqualified pursuant to the provisions of subsection 2 of this section.A provider is guilty of a class A misdemeanor if the provider hires a person to hold any position knowing that such person has been disqualified pursuant to the provisions of subsection 1 of this section.

9.Any public or private residential facility, day program, or specialized service operated, licensed, certified, accredited, in possession of deemed status or funded 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 that declines to employ or discharges a person who is disqualified pursuant to the provisions of subsection 1 or 2 of this section shall be immune from suit by that person or anyone else acting for or in behalf of that person for the failure to employ or for the discharge of the person due to disqualification.

10.Any employer who is required to discharge an employee because the employee was placed on a disqualification registry maintained by the department of mental health after the date of hire shall not be charged for unemployment insurance benefits based on wages paid to the employee for work prior to the date of discharge pursuant to section 288.100.

11.The department shall 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 based upon administrative substantiations made against them for abuse or neglect pursuant to department rule or regulation.Such list shall reflect that the person is barred from holding any position in any public or private facility, day program, residential facility, or specialized service operated, licensed, certified, accredited, in possession of deemed status, or funded 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.The length of time the person's name shall appear on the disqualification registry shall be determined by the director or the director's designee, based upon the criteria contained in subsection 13 of this section.

12.Persons notified that their name will be placed on the disqualification registry may appeal such determination pursuant to department rule or regulation.If the person appeals, the hearing tribunal shall not modify the length of time the person's name shall appear on the disqualification registry if the hearing tribunal upholds all of the administrative substantiations made by the director or the director's designee.If the hearing tribunal overturns part of the administrative substantiations made by the director or the director's designee, the hearing tribunal may consider modifying the length of time the person's name shall appear on the disqualification registry based upon testimony and evidence received during the hearing.

13.The length of time the person's name shall appear on the disqualification registry shall be determined by the director or the director's designee based upon the following:

(1)Whether the person acted recklessly or knowingly, as defined in chapter 562;

(2)The degree of actual or potential injury or harm to the patient, resident, or client;

(3)The degree of actual or potential danger to the health, safety, or welfare of the patient, resident, or client;

(4)The degree of misappropriation or conversion of patient, resident, or client funds or property;

(5)Whether the person has previously been listed on the department's disqualification registry;

(6)Any mitigating circumstances; and

(7)Any aggravating circumstances.

14.The department shall provide the disqualification registry maintained pursuant to this section to other state and federal agencies upon request.The department may provide the disqualification registry maintained pursuant to this section to any public or private facility, day program, residential facility, or specialized service operated, licensed, certified, accredited, in possession of deemed status, or funded by the department or to 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.The department may also provide the disqualification registry to a recognized school of nursing, medicine, or other health profession for the purpose of determining whether students scheduled to participate in clinical rotations are included in the employee disqualification registry.

(L. 1980 H.B. 1724, A.L. 1982 H.B. 1565, A.L. 1996 S.B. 884 & 841, A.L. 1998 S.B. 870, A.L. 2001 S.B. 48, A.L. 2003 S.B. 184, A.L. 2008 S.B. 1081, A.L. 2012 H.B. 1318, A.L. 2013 S.B. 229)

*Sections 565.210, 565.212, 565.214, 569.035, and 570.040 were repealed by S.B. 491, 2014, effective 1-01-17.

**The following sections were transferred by S.B. 491, 2014, effective 1-01-17: 569.020 to 570.023 569.030 to 570.025 569.070 to 574.080

630.070 - Workers' compensation law extended to employees of department.

1.The provisions of chapter 287 governing workers' compensation are extended to include all employees and authorized student and volunteer workers of the department.The state of Missouri shall be a self-insurer and assume all liability imposed by chapter 287, in respect to such personnel of the department, without insurance, and the attorney general shall appear on behalf of and defend the state in all actions brought by such personnel of the department under the provisions of the workers' compensation law.

2.The director has authority to perform such duties as may be necessary or incidental to carry out effectively the purposes of this section.

3.The extension of chapter 287 to include personnel of the department is not construed as acknowledging or creating any liability in tort, or as incurring other obligations or duties other than the duty and obligation of complying with the provisions of chapter 287.

(L. 1980 H.B. 1724)

630.097 - Comprehensive children's mental health service system to be developed — team established, members, duties — plan to be developed, content — evaluations to be conducted, when.

1.The department of mental health shall develop, in partnership with all departments represented on the children's services commission, a unified accountable comprehensive children's mental health service system.The department of mental health shall establish a state interagency comprehensive children's mental health service system team comprised of representation from:

(1)Family-run organizations and family members;

(2)Child advocate organizations;

(3)The department of health and senior services;

(4)The department of social services' children's division, division of youth services, and the MO HealthNet division;

(5)The department of elementary and secondary education;

(6)The department of mental health's division of alcohol and drug abuse, division of developmental disabilities, and the division of comprehensive psychiatric services;

(7)The department of public safety;

(8)The office of state courts administrator;

(9)The juvenile justice system; and

(10)Local representatives of the member organizations of the state team to serve children with emotional and behavioral disturbance problems, developmental disabilities, and substance abuse problems.

The team shall be called "The Comprehensive System Management Team".There shall be a stakeholder advisory committee to provide input to the comprehensive system management team to assist the departments in developing strategies and to ensure positive outcomes for children are being achieved.The department of mental health shall obtain input from appropriate consumer and family advocates when selecting family members for the comprehensive system management team, in consultation with the departments that serve on the children's services commission.The implementation of a comprehensive system shall include all state agencies and system partner organizations involved in the lives of the children served.These system partners may include private and not-for-profit organizations and representatives from local system of care teams and these partners may serve on the stakeholder advisory committee.The department of mental health shall promulgate rules for the implementation of this section in consultation with all of the departments represented on the children's services commission.

2.The department of mental health shall, in partnership with the departments serving on the children's services commission and the stakeholder advisory committee, develop a state comprehensive children's mental health service system plan.This plan shall be developed and submitted to the governor, the general assembly, and children's services commission by December, 2004.There shall be subsequent annual reports that include progress toward outcomes, monitoring, changes in populations and services, and emerging issues.The plan shall:

(1)Describe the mental health service and support needs of Missouri's children and their families, including the specialized needs of specific segments of the population;

(2)Define the comprehensive array of services including services such as intensive home-based services, early intervention services, family support services, respite services, and behavioral assistance services;

(3)Establish short- and long-term goals, objectives, and outcomes;

(4)Describe and define the parameters for local implementation of comprehensive children's mental health system teams;

(5)Describe and emphasize the importance of family involvement in all levels of the system;

(6)Describe the mechanisms for financing, and the cost of implementing the comprehensive array of services;

(7)Describe the coordination of services across child-serving agencies and at critical transition points, with emphasis on the involvement of local schools;

(8)Describe methods for service, program, and system evaluation;

(9)Describe the need for, and approaches to, training and technical assistance; and

(10)Describe the roles and responsibilities of the state and local child-serving agencies in implementing the comprehensive children's mental health care system.

3.The comprehensive system management team shall collaborate to develop uniform language to be used in intake and throughout the provision of services.

4.The comprehensive children's mental health services system shall:

(1)Be child centered, family focused, strength based, and family driven, with the needs of the child and family dictating the types and mix of services provided, and shall include the families as full participants in all aspects of the planning and delivery of services;

(2)Provide community-based mental health services to children and their families in the context in which the children live and attend school;

(3)Respond in a culturally competent and responsive manner;

(4)Emphasize prevention, early identification, and intervention;

(5)Assure access to a continuum of services that:

(a)Educate the community about the mental health needs of children;

(b)Address the unique physical, behavioral, emotional, social, developmental, and educational needs of children;

(c)Are coordinated with the range of social and human services provided to children and their families by local school districts, the departments of social services, health and senior services, and public safety, juvenile offices, and the juvenile and family courts;

(d)Provide a comprehensive array of services through an integrated service plan;

(e)Provide services in the least restrictive most appropriate environment that meets the needs of the child; and

(f)Are appropriate to the developmental needs of children;

(6)Include early screening and prompt intervention to:

(a)Identify and treat the mental health needs of children in the least restrictive environment appropriate to their needs; and

(b)Prevent further deterioration;

(7)Address the unique problems of paying for mental health services for children, including:

(a)Access to private insurance coverage;

(b)Public funding, including:

a.Assuring that funding follows children across departments; and

b.Maximizing federal financial participation;

(c)Private funding and services;

(8)Assure a smooth transition from child to adult mental health services when needed;

(9)Coordinate a service delivery system inclusive of services, providers, and schools that serve children and youth with emotional and behavioral disturbance problems, and their families through state agencies that serve on the state comprehensive children's management team; and

(10)Be outcome based.

5.By August 28, 2007, and periodically thereafter, the children's services commission shall conduct and distribute to the general assembly an evaluation of the implementation and effectiveness of the comprehensive children's mental health care system, including an assessment of family satisfaction and the progress of achieving outcomes.

(L. 2004 S.B. 1003, A.L. 2011 H.B. 555 merged with H.B. 648, A.L. 2014 H.B. 1299 Revision)

630.325 - Disposition of unclaimed personal property of patient.

If any patient or resident dies, is released, escapes, or otherwise leaves the care of the department, and leaves any article or articles of tangible personal property in the custody of a department facility, the head of the facility may, in his discretion, after the lapse of one year from the date of such death, release, escape, or other departure, if no claim therefor has been made, transfer the personal property to the state agency for surplus property for public or private sale.If such sale or sales are made, the commissioner of administration shall transmit the net proceeds thereof to the director of revenue for deposit in the general revenue fund.

(L. 1980 H.B. 1724, A.L. 1995 S.B. 454)

630.225 - Pay patient to be provided suitable clothing before admission — may receive gifts of clothing.

Before any patient who can support himself is admitted into any facility operated by the department, he shall be furnished, by those responsible for his support, with suitable changes of clothing.If patients who are able to support themselves as determined under section 630.210 are in need of clothing, the business manager, under the direction of the head of the facility, shall furnish the same.The department shall calculate expenditures for such clothing as part of the per diem expense.Nothing in this section shall be construed as prohibiting the purchase of clothing by, or gifts of clothing to, a patient or resident by his family or friends.

(L. 1980 H.B. 1724)

630.025 - Director to head department — compensation — not to have private practice — director may conduct inquiries, issue subpoenas.

1.The head of the department shall be the director, whose salary shall be set by the commission at an amount not to exceed the appropriations made for that purpose.The director shall not provide consulting services outside his official employment, and his salary shall be the sole personal service income of the director; except, that the director shall not be prevented from receiving compensation from writing and presenting professional papers and publications.

2.Before entering upon the discharge of his duties, the director shall take an oath to support the Constitution of the United States and the Constitution of the State of Missouri and to faithfully demean himself in the office to which he has been appointed.

3.The director shall be the chief executive officer of the department and shall perform such duties and exercise such powers as may be imposed or conferred upon him by law.

4.Except as otherwise provided by law, the director may request the governor to reorganize the internal organization of the department as authorized under sections 26.500 to 26.540.

5.The director shall have power to make inquiries and investigations and to hold such hearings as may be necessary in pursuance of his duties, and for such purpose he may subpoena witnesses and documents, administer oaths and provide for payment and expense of witnesses.

(L. 1980 H.B. 1724)

630.125 - Explanation of rights and entitlements.

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, 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.

(L. 1980 H.B. 1724, A.L. 1982 H.B. 1565, A.L. 1996 S.B. 884 & 841)

630.525 - Destruction of obsolete structures — procedure.

If any major building standing on property under the supervision and control of the department is in such a state of dilapidation or disrepair as to be, in the opinion of the director, dangerous to patients or residents, employees of the department or other persons frequenting such property, the department may, with the approval of the division of design and construction and, if necessary, with appropriations for this purpose from the general assembly, cause such building to be torn down or razed.For such purpose, the department may contract with any person under the rules and regulations of the division of purchasing, and may sell or otherwise dispose of the materials composing such building.

(L. 1980 H.B. 1724)

630.778 - Receiver may disregard certain contracts — factors to be considered — court may order temporary noncompliance.

1.A receiver may not be required to honor any lease, mortgage, secured transaction or other wholly or partially executory contract entered into on behalf of the facility if the agreement is unconscionable.Factors which shall be considered in determining the unconscionability include, but are not limited to, the following:

(1)The person seeking payment under the agreement was an affiliate of the individual contracting on behalf of the facility at the time the agreement was made;

(2)The rental, price, or rate of interest required to be paid under the agreement was substantially in excess of a reasonable rental, price or rate of interest at the time the agreement was entered into.

2.If the receiver is in possession of real estate or goods subject to a lease, mortgage or security interest which the receiver is permitted to avoid under subsection 1 of this section, and if the real estate or goods are necessary for the continued operation of the facility, the receiver may apply to the court to set a reasonable rental, price or rate of interest to be paid by the receiver during the duration of the receivership.The court shall hold a hearing on the application within fifteen days.The receiver shall send notice of the application to any known owners of the property involved at least ten working days prior to the hearing.Payment by the receiver of the amount determined by the court to be reasonable is a defense to any action against the receiver for payment or for possession of person who received such notice, but the payment does not relieve the licensee or head of the facility of any liability for the difference between the amount paid by the receiver and the amount due under the original lease or mortgage involved.

(L. 1980 H.B. 1724)

630.425 - Incentive grants authorized — rules and regulations — duration of grants.

1.The department may make incentive grants from funds specifically appropriated for this purpose to private and public entities seeking to establish a residential facility, day program or specialized service for persons affected by mental disorders, mental illness, intellectual disabilities, developmental disabilities or alcohol or drug abuse in unserved, underserved or inappropriately served areas of the state.

2.The department shall promulgate rules establishing procedures for monitoring and auditing such grants.

3.The grants shall be of limited duration of one year and renewable for only one additional year if the funds are appropriated for this purpose.

(L. 1980 H.B. 1724, A.L. 2011 H.B. 555 merged with H.B. 648)

630.625 - Consent required for placement.

If the client is competent to give informed consent, the department shall allow ten days to obtain his consent before making a placement.If the client is a minor or has a legal guardian, the department shall obtain the consent of the parent or guardian before placement.If the client is an involuntary patient or resident under chapter 211, 552 or 632, the department shall notify the court of competent jurisdiction of the proposed placement and allow ten days for the court to object.

(L. 1980 H.B. 1724)

630.725 - Denial or revocation — appeal — determination by administrative hearing commission — notice of revocation, when.

1.The department shall revoke a license or deny an application for a license in any case in which it finds a substantial failure to comply with the standards established under its rules or the requirements established under sections 630.705 to 630.760.

2.Any person aggrieved by the action of the department to deny or revoke a license under the provisions of sections 630.705 to 630.760 may seek a determination of the department director's decision by the administrative hearing commission pursuant to the provisions of section 621.045.It shall not be a condition to such determination that the person aggrieved seek a reconsideration, a rehearing or exhaust any other procedure within the department.

3.The administrative hearing commission may stay the revocation of such license, pending the commission's finding and determination in the cause, upon such conditions as the commission deems necessary and appropriate including the posting of bond or other security except that the commission shall not grant a stay or if a stay has already been entered shall set aside its stay, if upon application of the department the commission finds reason to believe that continued operation of a residential facility or day program pending the commission's final determination would present an imminent danger to the health, safety or welfare of any resident or a substantial probability that death or serious physical harm would result.In any case in which the department has refused to issue a license, the commission shall have no authority to stay or to require the issuance of a license pending final determination by the commission.

4.The administrative hearing commission shall make the final decision as to the issuance or revocation of a license.Any person aggrieved by a final decision of the administrative hearing commission, including the department, may seek judicial review of such decision by filing a petition for review in the court of appeals for the district in which the facility or program is located.Review shall be had, except as modified herein, in accordance with the provisions of sections 621.189 and 621.193.

5.The department of mental health shall notify the department of health and senior services within ten days of revoking a license under this section.If the department of health and senior services has not already done so, the department of health and senior services shall within thirty days of notification from the department of mental health, initiate an investigation of the facility to determine whether licensure action under sections 198.022 or 198.036 is appropriate.

(L. 1980 H.B. 1724, A.L. 2007 S.B. 3)

630.335 - Canteens and commissaries authorized — operation.

1.With the approval of the director, the head of any of the department's mental health or developmental disability facilities or regional centers may establish and operate a canteen or commissary for the use and benefit of patients, residents and employees.

2.Each facility or center shall keep revenues received from the canteen or commissary established and operated by the head of the facility in a separate account.The acquisition cost of goods sold and other expenses shall be paid from this account.A minimum amount of money necessary to meet cash flow needs and current operating expenses may be kept in this account.The remaining funds from sales of each commissary or canteen shall be deposited monthly in the state treasury to the credit of the mental health trust fund.The money in the fund shall be expended, upon appropriation, for the benefit of the patients in the improvement of the recreation, habilitation or treatment services or equipment of the facility or center from which derived.The provisions of section 33.080 to the contrary notwithstanding, the money in the mental health trust fund shall be retained for the purposes specified in this section and shall not revert or be transferred to general revenue.The department of mental health shall keep accurate records of the source of money deposited in the mental health trust fund and shall allocate appropriations from the fund to the appropriate institution, facility or center.

(L. 1980 H.B. 1724, A.L. 2011 H.B. 555 merged with H.B. 648)

630.168 - Suspected abuse to be reported.

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, 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.

(L. 1980 H.B. 1724 § 630.189, A.L. 1987 S.B. 277, A.L. 1996 S.B. 884 & 841)

630.135 - Rules regarding patient's rights.

The department shall promulgate reasonable rules relative to the implementation of patient, resident and client rights described in this chapter.

(L. 1980 H.B. 1724)

630.035 - Appointment of facility heads, medical staffs.

1.The directors of the various divisions of the department, with the approval of the department director, shall, in accordance with chapter 36, appoint for each facility under the administration and control of their respective divisions chief administrative officers of the facilities.

2.The major facilities of the department shall have chiefs of medical staff who shall be licensed physicians with responsibilities for the development and monitoring of medical care and treatment.

(L. 1980 H.B. 1724)

630.435 - Affiliation agreements from grantees required.

To coordinate the delivery system of accessible department services, to integrate the community-based program into the department system and to avoid duplication of state-provided or -supported services, the department shall require affiliation agreements with the grantees as a condition for receiving the grants.In the agreements, the department shall assign responsibility to the grantee for providing certain services for meeting the needs of unserved, underserved or inappropriately served persons for whom the state has the responsibility to serve.

(L. 1980 H.B. 1724)

630.535 - Unneeded property may be transferred to another state agency — procedure.

1.If the department discontinues the use of any building or real property on any of the grounds of a residential facility operated by it and determines it has no future use for the building or grounds, the department may inform the commissioner of administration that the unused building or property is vacant.The governor may, consistent with appropriations, transfer the control and management of the building or property to another state agency.

2.The governor shall obtain the approval of the director before making any such transfer.

(L. 1980 H.B. 1724)

630.735 - License required.

1.No person or governmental unit, acting separately or jointly with any other person or governmental unit, shall establish, conduct or maintain any residential facility in this state for the care, treatment, habilitation or rehabilitation of persons with an intellectual disability or a developmental disability without a valid license issued by the department.Licenses in effect on August 13, 1982, shall continue in effect until they regularly expire unless sooner revoked; except that in no case shall a license continue in effect beyond one year after August 13, 1982.

2.After October 1, 1983, no person or governmental unit, acting separately or jointly with any other person or governmental unit, shall establish, conduct or maintain any residential facility or day program in this state for care, treatment, habilitation or rehabilitation of persons diagnosed with a mental disorder or mental illness or day program for persons with an intellectual disability or a developmental disability unless the facilities or programs are licensed by the department.

(L. 1980 H.B. 1724, A.L. 1982 H.B. 1565, A.L. 2011 H.B. 555 merged with H.B. 648)

630.635 - Procedure when consent not given — review panel to be named — notice and hearing required — appeal — emergency transfers may be made.

1.If a resident in a developmental disability facility, or his parent if he is a minor, or his legal guardian refuses to consent to the proposed placement, the head of the developmental disability facility may petition, under the procedures in section 633.135, the director of the division of developmental disabilities to determine whether the proposed placement is appropriate under chapter 633.

2.If a patient in a mental health facility, or his parent if he is a minor, or his legal guardian refuses to consent to the proposed placement, the head of the mental health facility may petition the director of the division of comprehensive psychiatric services to determine whether the proposed placement is appropriate under sections 630.610, 630.615 and 630.620.

3.The director of the division of comprehensive psychiatric services shall refer the petition to the chairman of the state advisory council for his division who shall appoint and convene a review panel composed of three members.At least one member of the panel shall be a family member or guardian of a patient who resides in a mental health facility operated by the department.The remaining members of the panel shall be persons who are from nongovernmental organizations or groups concerned with the prevention of mental disorders, evaluation, care, treatment or rehabilitation of persons affected by the same conditions as the patient the department seeks to place and who are familiar with services and service needs of persons in mental health facilities operated by the department.No member of the panel shall be an officer or employee of the department.

4.After prompt notice and hearing, the panel shall determine whether the proposed placement is appropriate under sections 630.610, 630.615 and 630.620.The hearing shall be electronically recorded for purposes of obtaining a transcript.The council shall forward the tape recording, recommended findings of fact, conclusions of law, and decision to the director who shall enter findings of fact, conclusions of law, and the final decision.Notice of the director's decision shall be sent to the patient, or his parent if he is a minor, or his guardian by registered mail, return receipt requested.The director shall expedite this review in all respects.

5.If the patient, or his parent if he is a minor, or his guardian disagrees with the decision of the director, he may appeal the decision, within thirty days after notice of the decision is sent, to the circuit court of the county where the patient or resident, or his parent if he is a minor, or his guardian resides.The court shall review the record, proceedings and decision of the director not only under the provisions of chapter 536, but also as to whether or not the head of the facility or the department sustained its burden of proof that the proposed placement is appropriate under sections 630.110, 630.115 and 630.120.The court shall expedite this review in all respects.Notwithstanding the provisions of section 536.140, a court may, for good cause shown, hear and consider additional competent and material evidence.

6.The notice and procedure for the hearing by the panel shall be in accordance with chapter 536.

7.In all proceedings either before the panel or before the circuit court, the burden of proof shall be upon the head of the facility to demonstrate by a preponderance of evidence that the proposed placement is appropriate under the criteria set forth in sections 630.610, 630.615 and 630.120.

8.Pending the convening of the hearing panel and the final decision of the director or the court if the director's decision is appealed, the department shall not place or discharge the patient from a facility except that the department may temporarily transfer such patient in the case of a medical emergency.

9.There shall be no retaliation against any state employee as the result of a good faith decision to place the patient which is appealed and who testifies during a hearing or otherwise provides information or evidence in regard to a proposed placement.

(L. 1980 H.B. 1724, A.L. 2011 H.B. 555 merged with H.B. 648)

630.183 - Officers may authorize medical treatment for patient.

Subject to other provisions of this chapter, the head of a mental health or developmental disability 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;

(4)Pursuant to an order of a court of competent jurisdiction.

(L. 1980 H.B. 1724, A.L. 1983 S.B. 44 & 45, A.L. 2011 H.B. 555 merged with H.B. 648)

630.164 - Immunity from liability, when.

Any person, official or institution complying with the provisions of section 630.162, in the making of a report, or in cooperating with the department in any of its activities pursuant to sections 630.161 to 630.167, except the person, official, or institution accused of abusing or neglecting the vulnerable person shall be immune from any civil or criminal liability for making such a report, or in cooperating with the department, unless such person acted negligently, recklessly, in bad faith, or with malicious purpose.

(L. 2007 S.B. 3, A.L. 2014 S.B. 491)

Transferred 2014; formerly 565.220; Effective 1-01-17

630.460 - Overpayment, defined — overpayment reimbursement request by department, procedure, review procedure — interest, amount, when — collection of overpayment, attorney general.

1.For the purposes of this section, the term "overpayment" means any payment by the department to a vendor providing care, treatment, habilitation or rehabilitation services to clients under contract with the department, which is:

(1)In excess of the contracted rate less payments by the client or on his behalf as required to be made by the standard means test contained in department rules;

(2)In payment of services not provided;

(3)In payment for any service not authorized in the contract with the department; or

(4)In payment for services provided contrary to the provisions of the contract with the department.

2.The department shall notify the vendor in writing by certified mail, return receipt requested, of the amount of the overpayment, the basis for such overpayment and request reimbursement.Within thirty days of receipt of the notice of overpayment, a provider may request a review of the overpayment and reimbursement request by the department director or his designee.Such review shall be conducted in person if requested by the provider.The department director or his designee shall review the overpayment within fifteen days of the request for review.

3.If any overpayment is not fully repaid within forty-five days of the date of notice of overpayment, the department shall assess interest on the unpaid balance.Interest shall be charged on any unpaid balance beginning from the date of notice of overpayment and shall accrue at a rate not to exceed the annual rate established pursuant to the provisions of section 32.065, plus three percentage points.

4.The department and the vendor shall have forty-five days from receipt of the notice of the overpayment to negotiate a repayment plan to recover the amount of the overpayment as finally determined plus accrued interest at the rate established in subsection 3 of this section over a period determined by the department, but not to exceed twelve months from the date of final disposition of any overpayment review authorized by this section.The department shall determine the method of repayment which may include direct payment by the vendor, deduction from future amounts due to the vendor from the department, or both.

5.If any overpayment plus accrued interest not subject to a repayment plan pursuant to subsection 4 of this section is not fully repaid within six months of the date of notice of overpayment, the department may certify the amount due to the office of the attorney general, or take other appropriate collection actions.If any portion of an overpayment plus accrued interest which is subject to a repayment plan pursuant to subsection 4 of this section, but which is not repaid pursuant to the terms of the plan, the department may certify all or a portion of the overpayment plus accrued interest due to the office of the attorney general, or take other appropriate collection actions.

(L. 1984 S.B. 575, A.L. 1996 H.B. 1081)

630.660 - Written contracts required.

The department shall require residential facilities, day programs and specialized services to enter into written contracts to receive funding for services rendered to clients placed by the department.

(L. 1980 H.B. 1724)

630.760 - Patients to have same rights as those for residents of nursing homes.

In addition to rights provided for patients, residents or clients of residential facilities licensed by the department under this chapter, residents or clients in facilities and programs licensed by the department shall have the same rights as residents as defined in chapter 198 have under section 198.088.

(L. 1980 H.B. 1724)

630.787 - Receivership may be terminated by court, when.

The court may terminate a receivership:

(1)Upon a motion by any party to the petition, by the department, or by the receiver, and a finding by the court that the deficiencies and violations in the residential facility have been substantially eliminated or remedied; or

(2)If all residents in the facility have been provided alternative modes of health care, either in another facility or otherwise.

The court may immediately terminate the receivership, or may terminate the receivership subject to such terms as the court deems necessary or appropriate to prevent the conditions complained of from recurring.

(L. 1980 H.B. 1724)

630.835 - Copies of law furnished other states.

Duly authorized copies of sections 630.810 to 630.835 shall, upon its approval, be transmitted by the secretary of state to the governor of each state, the Attorney General and the Secretary of State of the United States, and the Council of State Governments.

(L. 1980 H.B. 1724)

630.060 - Cooperation with other groups.

1.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.

2.The department shall cooperate with and may directly contract with all state agencies, local units of government, and any of the governor's advisory councils or commissions, or their successor agencies, and with the Missouri Mental Health Foundation, or its successor entity, in delivery of programs designed to improve public understanding of attitudes toward mental disorders, developmental disabilities, and alcohol and drug abuse pursuant to subdivision (3) of subsection 1 of section 630.020.For purposes of this section, the contracting process of the department with these entities need not be governed by the provisions of chapter 34.

(L. 1980 H.B. 1724, A.L. 2010 H.B. 1868 merged with H.B. 1894)

630.160 - Furnishing unfit food — defined — penalty.

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, 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.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

630.330 - Department may receive gifts — disposal of gift property — mental health trust fund created.

1.The director may for the benefit of the department or any residential facility operated by the department take, receive, administer and hold in trust all grants, gifts, donations, moneys escheated under section 630.320, devises or bequests of money or other personal property, or any real property on behalf and in the name of the governor, and the income or interest received or earned on any property or funds so acquired from any person whether individual, body politic, corporate, partnership, unincorporated association or from any other source.If any grant, gift, donation, devise or bequest is made for a specified use or purpose, it shall not be applied either wholly or in part for any other use or purpose.The director may, if so authorized by the general assembly, convey or lease any real property so acquired.The director or the governor shall deposit the funds derived from such sale or conveyance or lease and any other funds derived from grants, gifts, donations, moneys escheated, devises or bequests of money or other property, whether real or personal or income or interest therefrom, in the state treasury where it shall be credited to a special fund known as the "Mental Health Trust Fund", which is hereby created.The state treasurer shall credit to the fund any interest earned from investing the moneys in the fund.The mental health trust fund shall not lapse biennially and, accordingly, shall be exempt from the provisions of section 33.080, relating to the transfer of funds to the general revenue fund of the state by the state treasurer.

2.The moneys in the mental health trust fund shall not be appropriated for the support of the facilities of the department in lieu of general state revenues but shall be appropriated only for the purposes of carrying out the objects for which the grants, gifts, donations, devises or bequests were made, or for purposes of funding special projects or purchasing special equipment from moneys escheated under section 630.320.

3.The director shall make an annual written report to the governor, the commissioner of administration and the general assembly within ninety days after the close of each fiscal year of the moneys in the mental health trust fund.

(L. 1980 H.B. 1724, A.L. 1982 H.B. 1565)

630.769 - Venue for appointment of receiver — copy of petition to be provided — hearing thereon within five days, determination within fifteen — court to appoint receiver if grounds exist.

Any petition for appointment of a receiver shall be verified and shall be accompanied by an affidavit or affidavits setting forth material facts showing there exists one or more of the conditions specified in section 198.099.The petition shall be filed in the circuit court of Cole County or in the county where the residential facility is located.If the petition is not filed by the attorney general, a copy of the petition shall be served upon the department and upon the attorney general.The court shall hold a hearing on the petition within five days of the filing of the petition and determine the matter within fifteen days of the initial hearing.The petition and notice of the hearing shall be served on the head of the facility or, if personal service is impossible, shall be posted in a conspicuous place in the residential facility not later than three days before the time specified for the hearing, unless a different period is fixed by order of the court.The court shall appoint the director of the department, or any person determined by the court to be qualified, to act as receiver if it finds that any ground exists which would authorize the appointment of a receiver under section 198.099, and that appointment of a receiver will contribute to the continuity of care or the orderly and safe transfer of residents in the facility.

(L. 1980 H.B. 1724)

630.130 - Electroconvulsive therapy, procedure — prohibitions — attorney's fees.

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 or her 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 intellectually disabled shall not be subject to electroconvulsive therapy.

6.If the judge finds that the respondent is unable to pay attorney's fees for the services rendered in the proceedings the judge shall allow a reasonable attorney's fee for the services, which fee shall be assessed as costs and paid together with all the costs in the proceeding by the state, in accordance with rules and regulations promulgated by the state court administrator, from funds appropriated to the office of administration for such purposes provided that no attorney's fees shall be allowed for services rendered by any attorney who is a salaried employee of a public agency or a private agency which receives public funds.

(L. 1980 H.B. 1724, A.L. 2004 S.B. 1211, A.L. 2014 H.B. 1064)

(2006) Section allows a healthcare provider who has a duty of care to act in the patient's best interest, even if the patient has refused treatment, if the patient is in need of the therapy.In re Dunn, 181 S.W.3d 601 (Mo.App.E.D.).

630.030 - Division directors, appointment, removal — appointment of other general personnel.

The director shall appoint the directors of the divisions of the department, and such division directors shall serve at the pleasure of the director.The director shall be the appointing authority under chapter 36 to employ such administrative, technical and other personnel who may be assigned to the department generally rather than to any of the department divisions or facilities and whose employment is necessary for the performance of the powers and duties of the department.

(L. 1980 H.B. 1724)

630.430 - Commissioner of administration to make rules and regulations for incentive grants.

1.The commissioner of administration, in consultation with the director, shall promulgate rules establishing the procedures to contract with grantees which receive incentive-grant funds under section 630.425.No rule or portion of a rule promulgated under the authority of this section shall become effective unless it has been promulgated pursuant to the provisions of section 536.024.

2.The department shall require evidence that the programs supported in whole or in part with the state incentive-grant funds are cost-and-benefit effective.

(L. 1980 H.B. 1724, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3)

630.730 - Inspection by department and others, when — may be ordered, when.

1.The department may inspect any residential facility or day program for persons described in section 630.705 at any time if a license has been issued to or an application for a license has been filed by the head of such facility or program.The department shall make or cause to be made at least one inspection per year.The department may make such other inspections, announced or unannounced, as it deems necessary to carry out the provisions of sections 630.705 to 630.760.The department may delegate its powers and duties to investigate and inspect residential facilities and day programs licensed by it to determine compliance with all or part of its standards, to another governmental agency, where practicable, if the department feels such other agency is qualified to inspect and license such facilities or programs.The governmental unit shall submit a written report of its findings to the department.The department may accept the recommendations of the governmental unit for issuance or revocation of a license.

2.If the department has reasonable grounds to believe that a residential facility or day program required to be licensed under sections 630.705 to 630.760 is operating without a license, and the department is not permitted access to inspect the facility or program, or when the head of such facility or program refuses to permit access to the department to inspect the facility or program, the department shall apply to the circuit court of the county in which the premises is located for an order authorizing entry for such inspection, and the court shall issue the order if it finds that the head of the facility or program has refused to permit the department access to inspect such facility or program.

(L. 1980 H.B. 1724)

630.630 - Alternative proposals to be prepared.

If a patient or resident, parent, if the patient or resident is a minor, or legal guardian does not consent to transfer of the patient or resident from a facility operated by the department, then the department shall propose other appropriate placement alternatives, if available, and seek to obtain consent under section 630.625 until the alternatives are exhausted.

(L. 1980 H.B. 1724)

630.186 - Purchase of food limited to that for use of patients.

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.

(L. 1980 H.B. 1724)

630.161 - Investigation of reports of vulnerable person abuse, when.

The department of mental health shall investigate incidents and reports of vulnerable person abuse using the procedures established in sections 630.163 to 630.167 and, upon substantiation of the report of vulnerable person abuse, shall promptly report the incident to the appropriate law enforcement agency and prosecutor.If the department is unable to substantiate whether abuse occurred due to the failure of the operator or any of the operator's agents or employees to cooperate with the investigation, the incident shall be promptly reported to appropriate law enforcement agencies.

(L. 2007 S.B. 3, A.L. 2014 S.B. 491)

Transferred 2014; formerly 565.216; Effective 1-01-17

630.830 - Transfer of patient, duty of administrator.

The compact administrator is hereby directed to consult with the immediate family of any proposed transferee and, in the case of a proposed transferee from an institution in this state to an institution in another party state, to take no final action without approval of the court which committed the proposed transferee.

(L. 1980 H.B. 1724)

630.065 - Planning activities by department.

The department shall initiate and direct the development of long-range programs and plans with respect to residential facilities, day programs and specialized services operated, funded or licensed by the department for persons affected by mental disorders, developmental disabilities and alcohol or drug abuse.The department, insofar as practicable, shall coordinate its long-range programs and plans with the program and plan requirements and procedures of relevant federal and state planning and funding agencies.The department shall supervise a comprehensive utilization quality-assurance and cost-benefit monitoring and auditing program to deal with the facilities, programs and services operated, funded or licensed by the department.

(L. 1980 H.B. 1724)

630.165 - Suspected abuse of patient, report, by whom made, contents — effect of failure to report — penalty.

1.When any physician, physician assistant, dentist, chiropractor, optometrist, podiatrist, intern, resident, nurse, nurse practitioner, medical examiner, social worker, licensed professional counselor, certified substance abuse counselor, psychologist, other health practitioner, minister, Christian Science practitioner, peace officer, pharmacist, physical therapist, facility administrator, nurse's aide, orderly or any other direct-care staff in a residential facility, day program, group home or developmental disability facility as defined in section 633.005, or specialized service operated, licensed, certified, or funded 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, or employee of the departments of social services, mental health, or health and senior services; or home health agency or home health agency employee; hospital and clinic personnel engaged in examination, care, or treatment of persons; in-home services owner, provider, operator, or employee; law enforcement officer, long-term care facility administrator or employee; mental health professional, probation or parole officer, or other nonfamilial person with responsibility for the care of a patient, resident, or client of a facility, program, or service has reasonable cause to suspect that a patient, resident or client of a facility, program or service has been subjected to abuse or neglect or observes such person being subjected to conditions or circumstances that would reasonably result in abuse or neglect, he or she shall immediately report or cause a report to be made to the department in accordance with section 630.163.

2.Any person who knowingly fails to make a report as required in subsection 1 of this section is guilty of a class A misdemeanor and shall be subject to a fine up to one thousand dollars.Penalties collected for violations of this section shall be transferred to the state school moneys fund as established in section 166.051 and distributed to the public schools of this state in the manner provided in section 163.031.Such penalties shall not considered charitable for tax purposes.

3.Every person who has been previously convicted of or pled guilty to failing to make a report as required in subsection 1 of this section and who is subsequently convicted of failing to make a report under subsection 2 of this section is guilty of a class E felony and shall be subject to a fine up to five thousand dollars.Penalties collected for violation of this subsection shall be transferred to the state school moneys fund as established in section 166.051 and distributed to the public schools of this state in the manner provided in section 163.031.Such penalties shall not considered charitable for tax purposes.

4.Any person who knowingly files a false report of vulnerable person abuse or neglect is guilty of a class A misdemeanor and shall be subject to a fine up to one thousand dollars.Penalties collected for violations of this subsection shall be transferred to the state school moneys fund as established in section 166.051 and distributed to the public schools of this state in the manner provided in section 163.031.Such penalties shall not considered charitable for tax purposes.

5.Every person who has been previously convicted of or pled guilty to making a false report to the department and who is subsequently convicted of making a false report under subsection 4 of this section is guilty of a class E felony and shall be subject to a fine up to five thousand dollars.Penalties collected for violations of this subsection shall be transferred to the state school moneys fund as established in section 166.051 and distributed to the public schools of this state in the manner provided in section 163.031.Such penalties shall not considered charitable for tax purposes.

6.Evidence of prior convictions of false reporting shall be heard by the court, out of the hearing of the jury, prior to the submission of the case to the jury, and the court shall determine the existence of the prior convictions.

7.Any residential facility, day program, or specialized service operated, funded, or licensed by the department that prevents or discourages a patient, resident, client, employee, or other person from reporting that a patient, resident, or client of a facility, program, or service has been abused or neglected shall be subject to loss of their license issued pursuant to sections 630.705 to 630.760 and civil fines of up to five thousand dollars for each attempt to prevent or discourage reporting.

(L. 1980 H.B. 1724 § 630.165 subsecs. 1 to 4, A.L. 1996 S.B. 884 & 841, A.L. 2003 S.B. 556 & 311, A.L. 2007, S.B. 3, A.L. 2008 S.B. 1081, A.L. 2011 H.B. 555 merged with H.B. 648, A.L. 2014 S.B. 491)

Effective 1-01-17

630.196 - Research review committee at department facilities — committee members, appointment, qualifications, terms, compensation — organization and meetings.

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.

(L. 1980 H.B. 1724)

*Word "are" does not appear in original rolls.

630.575 - Council created, members, duties, terms, meetings.

1.There is hereby established within the department of mental health the "Missouri Eating Disorder Council" which shall consist of the following persons to be selected by and the number of members to be determined by the director of the department of mental health:

(1)Director's designees from the department of mental health;

(2)Eating disorder researchers, clinicians, and patient advocacy groups; and

(3)The general public.

2.The council shall:

(1)Oversee the eating disorder education and awareness programs established in section 630.580;

(2)Identify whether adequate treatment and diagnostic services are available in the state; and

(3)Assist the department of mental health in identifying eating disorder research projects.

3.Members of the council shall serve four-year terms, with the initial terms of the members staggered as two-year, three-year, and four-year terms.The members of the council may be reappointed.The members of the council shall not receive compensation for their service on the council, but may, subject to appropriation, be reimbursed for their actual and necessary expenses incurred as members of the council.

4.The council shall conduct an organizational meeting at the call of the director of the department of mental health.At such meeting, the council shall select a chair and vice chair of the council.Subsequent meetings of the council shall be called as necessary by the chair of the council or the director of the department of mental health.

(L. 2010 S.B. 754)

630.775 - Powers and duties of receiver.

A receiver appointed under this section:

(1)May exercise those powers and shall perform those duties set out by the court;

(2)May, in his discretion, either:

(a)Take control of all day-to-day operations of the residential facility;

(b)Name an individual to conduct the day-to-day operations of the facility subject to the supervision and direction of the receiver;

(3)May upgrade deficient facilities by any methods, procedures or actions he deems necessary; provided, however, that expenditures in excess of three thousand dollars, or in excess of any amount set by the court, be first approved by the court;

(4)Shall have the same rights to possession of the building in which the facility is located and of all goods and fixtures in the building at the time the petition for receivership is filed as the head of the facility would have had if the receiver had not been appointed.The receiver shall take such action as is reasonably necessary to protect and conserve the assets or property of which the receiver takes possession, or the proceeds of any transfer thereof, and may use them only in the performance of the powers and duties set forth in this section and by order of the court;

(5)May use the building, fixtures, furnishings and any accompanying consumable goods in the provision of care and services to residents and to any other persons receiving services from the facility at the time the petition for receivership was filed.The receiver shall collect payments for all goods and services provided to residents or others during the period of receivership, at the same rate of payment as was charged by the head of the facility at the time the petition for receivership was filed, unless a different rate is set by the court;

(6)May let contracts and hire agents and employees, including legal counsel, to carry out the powers and duties created under this section or by the court;

(7)May hire or discharge any employees;

(8)Shall receive and expend in a reasonable manner the revenues of the facility due on the date of the order of appointment as receiver, and to become due during the receivership;

(9)Shall do all acts necessary or appropriate to conserve the property and promote the health, safety or care of the residents of the facility;

(10)Except as hereinafter specified in section 630.790, shall honor all leases, mortgages, secured transactions or other wholly or partially executory contracts entered into on behalf of the facility, but only to the extent of payments which become due or are for the use of the property during the period of the receivership;

(11)Shall be responsible, to the same extent as the licensee would have been, for taxes which accrue during the period of the receivership;

(12)Shall be entitled to and shall take possession of all property or assets of residents which are in possession of the head of the facility.The receiver shall preserve all property, assets and records of residents of which the receiver takes possession and shall provide for the prompt transfer of the property, assets and records to the alternative placement of any transferred or discharged resident;

(13)Shall provide, if upgrading of the facility or correction of the deficiencies is not possible, for the orderly transfer of all residents in the facility to other suitable facilities, or make other provisions for their continued health, safety and welfare;

(14)Shall, if any resident is transferred or discharged, provide for:

(a)Transportation of the resident and the resident's belongings and medical records to the place to which the resident is being transferred or discharged;

(b)Aid in locating an alternative placement and in discharge planning;

(c)If the resident is being transferred, preparation for transfer to mitigate transfer trauma;

(15)Shall, if any resident is to be transferred, permit participation by the resident or the resident's guardian in the selection of the resident's alternative placement;

(16)Shall, unless emergency transfer is necessary, prepare a resident under subdivisions (14)(c) and (15) by explaining alternative placements, and by providing orientation to the placement chosen by the resident or the resident's guardian.

(L. 1980 H.B. 1724)

630.820 - Supplementary agreements authorized, when effective.

The compact administrator is hereby authorized and empowered to enter into supplementary agreements with appropriate officials of other states pursuant to Articles VII and XI of the compact.In the event that such supplementary agreements shall require or contemplate the use of any institution or facility of this state or require or contemplate the provision of any service by this state, no such agreement shall have force or effect until approved by the head of the department or agency under whose jurisdiction the institution or facility is operated or whose department or agency will be charged with the rendering of the service.

(L. 1980 H.B. 1724)

630.192 - Limitations on research activities in mental health facilities and programs.

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 or in any public or private residential facilities or day programs operated, funded or licensed by the department for persons affected by intellectual disabilities, 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.

(L. 1980 H.B. 1724 § 630.192 subsec. 1, A.L. 1996 S.B. 884 & 841, A.L. 2011 H.B. 555 merged with H.B. 648)

630.175 - Physical and chemical restraints prohibited, exceptions — requirements for collaborative practice arrangements and supervision agreements — security escort devices and certain extraordinary measures not considered physical restraint.

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 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, the attending licensed physician, or in the circumstances specifically set forth in this section, by an advanced practice registered nurse in a collaborative practice arrangement, or a physician assistant or an assistant physician with a supervision agreement, with 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.An advanced practice registered nurse in a collaborative practice arrangement, or a physician assistant or an assistant physician with a supervision agreement, with the attending licensed physician may make a determination that the chosen intervention is necessary for patients, residents, or clients of facilities or programs operated by the department, in hospitals as defined in section 197.020 that only provide psychiatric care and in dedicated psychiatric units of general acute care hospitals as hospitals are defined in section 197.020.Any determination made by the advanced practice registered nurse, physician assistant, or assistant physician shall be documented as required in subsection 2 of this section and reviewed in person by the attending licensed physician if the episode of restraint is to extend beyond:

(1)Four hours duration in the case of a person under eighteen years of age;

(2)Eight hours duration in the case of a person eighteen years of age or older; or

(3)For any total length of restraint lasting more than four hours duration in a twenty-four-hour period in the case of a person under eighteen years of age or beyond eight hours duration in the case of a person eighteen years of age or older in a twenty-four-hour period.

The review shall occur prior to the time limit specified under subsection 6 of this section and shall be documented by the licensed physician under subsection 2 of this section.

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, or the advanced practice registered nurse in a collaborative practice arrangement, or a physician assistant or an assistant physician with a supervision agreement, with 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.

4.The use of security escort devices, including devices designed to restrict physical movement, which are used to maintain safety and security and to prevent escape during transport outside of a facility shall not be considered physical restraint within the meaning of this section.Individuals who have been civilly detained under sections 632.300 to 632.475 may be placed in security escort devices when transported outside of the facility if it is determined by the head of the facility, or the attending licensed physician, or the advanced practice registered nurse in a collaborative practice arrangement, or a physician assistant or an assistant physician with a supervision agreement, with the attending licensed physician that the use of security escort devices is necessary to protect the health and safety of the patient, resident, client, or other persons or is necessary to prevent escape.Individuals who have been civilly detained under sections 632.480 to 632.513 or committed under chapter 552 shall be placed in security escort devices when transported outside of the facility unless it is determined by the head of the facility, or the attending licensed physician, or the advanced practice registered nurse in a collaborative practice arrangement, or a physician assistant or an assistant physician with a supervision agreement, with the attending licensed physician that security escort devices are not necessary to protect the health and safety of the patient, resident, client, or other persons or is not necessary to prevent escape.

5.Extraordinary measures employed by the head of the facility to ensure the safety and security of patients, residents, clients, and other persons during times of natural or man-made disasters shall not be considered restraint, isolation, or seclusion within the meaning of this section.

6.Orders issued under this section by the advanced practice registered nurse in a collaborative practice arrangement, or a physician assistant or an assistant physician with a supervision agreement, with the attending licensed physician shall be reviewed in person by the attending licensed physician of the facility within twenty-four hours or the next regular working day of the order being issued, and such review shall be documented in the clinical record of the patient, resident, or client.

7.For purposes of this subsection, "division" shall mean the division of developmental disabilities.Restraint or seclusion shall not be used in habilitation centers or community programs that serve persons with developmental disabilities that are operated or funded by the division unless such procedure is part of an emergency intervention system approved by the division and is identified in such person's individual support plan.Direct-care staff that serve persons with developmental disabilities in habilitation centers or community programs operated or funded by the division shall be trained in an emergency intervention system approved by the division when such emergency intervention system is identified in a consumer's individual support plan.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841, A.L. 2008 S.B. 1081, A.L. 2014 H.B. 1779, A.L. 2016 H.B. 1682 merged with H.B. 1816)

630.075 - Personnel recruitment, development and training.

The department shall establish and supervise a comprehensive program to deal with all aspects of manpower recruitment, development, training and retention of its employees.

(L. 1980 H.B. 1724)

630.320 - Disposition of unclaimed funds of patient — escheats, procedure.

1.If any patient or resident dies, is released, escapes or otherwise leaves the care of the department, and leaves any personal funds in the custody of a department facility, the head of the facility shall use all proper diligence to refund such moneys.All reasonable means shall be used to contact the patient or resident if living, or if deceased, the patient's or resident's heirs to refund such moneys.If the patient or resident is deceased, the facility may dispose of these moneys through the probate court or otherwise release these moneys to the heirs, if located.The facility may also make claim for these moneys for unmet costs of care in accordance with procedures established by the director of the department.

2.After one year from the date of such death, release, escape or other departure, if there shall remain in the custody of a facility any money, the owner of which is unknown, or if known, cannot be located, in each and every such instance, the money shall be disposed of in the following manner:

(1)Amounts less than one hundred dollars shall be deposited into the state treasury to the credit of the mental health trust fund.Such money shall escheat and vest absolutely in the state of Missouri, and all persons shall be forever barred and precluded from setting up title or claim to any of such moneys.

(2)Amounts of one hundred dollars or more shall be deposited into the state treasury to the credit of the general revenue fund in a special account designated as escheat.Claims may be made, as provided in this section, for such moneys for a period of two years after deposit into the escheat account.After remaining therein unclaimed for two years such moneys shall escheat and vest absolutely in the state of Missouri and be credited to the mental health trust fund.Thereafter, all persons shall be forever barred and precluded from setting up title or claim to any of such moneys.

3.Within two years after such money in amounts of one hundred dollars or more has been transmitted into the escheats account, any person who appears and claims the same may file his petition in the circuit court of Cole County, Missouri, stating the nature of his claim and asking to be paid such money.A copy of the petition shall be served upon the director who shall file an answer to the same.If the court finds that such person is entitled to any money so paid into the state treasury, it shall order the commissioner of administration to issue a warrant for the amount of such claim, but without interest or costs; provided, that either party may appeal from the decision of the court in the same manner as provided by law in other civil actions.

4.Nothing in this section shall be deemed to apply to funds regularly due the state of Missouri for the support and maintenance of patients of state facilities.

(L. 1980 H.B. 1724, A.L. 1982 H.B. 1565, A.L. 1995 S.B. 454)

630.975 - Rulemaking authority — disclosure of records, when.

1.The director of the department of mental health shall promulgate rules, guidelines and protocols for hospitals and physicians to use to help them to identify suspicious deaths of patients, residents, or clients in the care and custody of the department of mental health.

2.Any hospital, physician, medical professional, mental health professional, or department of mental health facility shall disclose upon request all records, medical or social, of any client in the care and custody of the department of mental health who has died to the mental health fatality review panel established under section 630.925 to investigate the person's death.Any legally recognized privileged communication, except that between attorney and client, shall not apply to situations involving the death of a client in the care and custody of the department of mental health.

(L. 2007 S.B. 3)

630.875 - Citation of law — definitions — program created, purpose — requirements — rulemaking authority.

1.This section shall be known and may be cited as the "Improved Access to Treatment for Opioid Addictions Act" or "IATOA Act".

2.As used in this section, the following terms mean:

(1)"Department", the department of mental health;

(2)"IATOA program", the improved access to treatment for opioid addictions program created under subsection 3 of this section.

3.Subject to appropriations, the department shall create and oversee an "Improved Access to Treatment for Opioid Addictions Program", which is hereby created and whose purpose is to disseminate information and best practices regarding opioid addiction and to facilitate collaborations to better treat and prevent opioid addiction in this state.The IATOA program shall facilitate partnerships between assistant physicians, physician assistants, and advanced practice registered nurses practicing in federally qualified health centers, rural health clinics, and other health care facilities and physicians practicing at remote facilities located in this state.The IATOA program shall provide resources that grant patients and their treating assistant physicians, physician assistants, advanced practice registered nurses, or physicians access to knowledge and expertise through means such as telemedicine and Extension for Community Healthcare Outcomes (ECHO) programs established under section 191.1140.

4.Assistant physicians, physician assistants, and advanced practice registered nurses who participate in the IATOA program shall complete the necessary requirements to prescribe buprenorphine within at least thirty days of joining the IATOA program.

5.For the purposes of the IATOA program, a remote collaborating or supervising physician working with an on-site assistant physician, physician assistant, or advanced practice registered nurse shall be considered to be on-site.An assistant physician, physician assistant, or advanced practice registered nurse collaborating with a remote physician shall comply with all laws and requirements applicable to assistant physicians, physician assistants, or advanced practice registered nurses with on-site supervision before providing treatment to a patient.

6.An assistant physician, physician assistant, or advanced practice registered nurse collaborating with a physician who is waiver-certified for the use of buprenorphine may participate in the IATOA program in any area of the state and provide all services and functions of an assistant physician, physician assistant, or advanced practice registered nurse.

7.The department may develop curriculum and benchmark examinations on the subject of opioid addiction and treatment.The department may collaborate with specialists, institutions of higher education, and medical schools for such development.Completion of such a curriculum and passing of such an examination by an assistant physician, physician assistant, advanced practice registered nurse, or physician shall result in a certificate awarded by the department or sponsoring institution, if any.

8.An assistant physician, physician assistant, or advanced practice registered nurse participating in the IATOA program may also:

(1)Engage in community education;

(2)Engage in professional education outreach programs with local treatment providers;

(3)Serve as a liaison to courts;

(4)Serve as a liaison to addiction support organizations;

(5)Provide educational outreach to schools;

(6)Treat physical ailments of patients in an addiction treatment program or considering entering such a program;

(7)Refer patients to treatment centers;

(8)Assist patients with court and social service obligations;

(9)Perform other functions as authorized by the department; and

(10)Provide mental health services in collaboration with a qualified licensed physician.

The list of authorizations in this subsection is a nonexclusive list, and assistant physicians, physician assistants, or advanced practice registered nurses participating in the IATOA program may perform other actions.

9.When an overdose survivor arrives in the emergency department, the assistant physician, physician assistant, or advanced practice registered nurse serving as a recovery coach or, if the assistant physician, physician assistant, or advanced practice registered nurse is unavailable, another properly trained recovery coach shall, when reasonably practicable, meet with the overdose survivor and provide treatment options and support available to the overdose survivor.The department shall assist recovery coaches in providing treatment options and support to overdose survivors.

10.The provisions of this section shall supersede any contradictory statutes, rules, or regulations.The department shall implement the improved access to treatment for opioid addictions program as soon as reasonably possible using guidance within this section.Further refinement to the improved access to treatment for opioid addictions program may be done through the rules process.

11.The department shall promulgate rules to implement the provisions of the improved access to treatment for opioid addictions act as soon as reasonably possible.Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.This section and chapter 536 are nonseverable, and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2018, shall be invalid and void.

(L. 2018 S.B. 718 merged with S. B. 951)

Effective 7-06-18 (S.B. 718); 8-28-18 (S.B. 951)

630.220 - Court actions by department on behalf of institutions — interest on accounts of patients.

For all debts and demands whatsoever to any of the residential facilities or day programs subject to the control of the department, and for all damages for failure of contract, for trespass and other wrongs to a facility operated by the department, or any of its property thereof, real or personal, actions in any court of competent jurisdiction may be maintained in the name of the director.Interest shall be recovered on any and all sums due any facility or program operated or funded by the department on account of any patient or resident thereof, the account therefor, certified by the director or the director's* designee shall be prima facie evidence of the amount due.

(L. 1980 H.B. 1724, A.L. 2010 H.B. 1894 merged with S.B. 774)

*Words "his or her" appear in original rolls of S.B. 774.

630.020 - Departmental goals, duties.

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.

(L. 1980 H.B. 1724)

630.120 - No presumptions.

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, intellectual disability, developmental disability, alcohol problem or drug problem.

(L. 1980 H.B. 1724, A.L. 2011 H.B. 555 merged with H.B. 648)

630.420 - Affiliation agreements from vendors required.

To coordinate a delivery system of accessible department services, to integrate vendor programs into the department system and to avoid duplication of state-provided or -supported services, the department shall require affiliation agreements with vendors as a condition for receiving purchase-of-service funds.In the agreements, the department shall assign responsibility to the vendors for providing certain programs for meeting the needs of underserved, unserved or inappropriately served persons for whom the state has the responsibility to serve.

(L. 1980 H.B. 1724)

630.620 - Facilities and programs to be utilized in making placements.

1.Except as provided in subsection 2 of this section, the department may place any patient or resident referred by a department facility or any person applying directly or referred under section 630.610 who is accepted for placement, in one or more of the following facilities or programs as soon as practicable after consultation with the person, patient or resident, if competent, or his parents, if he is a minor, or his guardian:

(1)A facility licensed by the department of social services under chapter 198 and licensed or certified, or both, by the department under this chapter;

(2)A facility or program licensed or certified, or both, by the department;

(3)The home of the client.

2.If the person was committed to the department of mental health pursuant to chapter 552 based on an accepted plea of not guilty by reason of a mental disease or defect excluding responsibility or an acquittal on that basis as provided in section 552.030 for a dangerous felony as defined in section 556.061, or a violation of section 565.020 or 566.040, or an attempt to commit one of the preceding crimes, the placement shall be to a secure facility as defined in section 552.040, unless a court order is entered allowing placement in a nonsecure facility.

3.The department shall provide a written statement to the client, the client's parent, if the client is a minor, the client's legal guardian, the referring court or the referring state or private agency or facility, and to the client's next of kin specifying reasons why a proposed placement is appropriate pursuant to section 630.615.If the client was originally committed pursuant to chapter 552, the written statement shall also be provided to the prosecuting attorney in the jurisdiction where the person was tried and acquitted.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

630.720 - Issuance of license, term — temporary permits, when — may be transferable — posting.

1.Upon receipt of an application for a license, the department shall issue a license if the applicant demonstrates that his residential facility or day program meets the requirements established in the department rules and regulations.A license, unless sooner revoked, shall be issued for a period of one year.

2.The department shall notify the holder of a valid license at least sixty days prior to the expiration of such license of the date that the license application is due.Application for a license shall be made to the department at least thirty days prior to the expiration of an existing, valid license.

3.The department shall grant a temporary operating permit in order to allow for state inspection for the purposes of relicensure if the inspection process has not been completed prior to the expiration of a license and the applicant is not at fault for the failure to complete the inspection process.

4.Each license shall be issued only for the premises and persons or governmental units named in the application and shall not be transferable or assignable except with the written approval of the department.The department shall grant a temporary operating permit of sufficient duration to allow the department to evaluate any application for a license submitted as a result of any change of ownership.

5.Licenses shall be posted in a conspicuous place on the licensed premises.

(L. 1980 H.B. 1724)

630.755 - Injunctive relief may be requested — action to have priority — civil penalties may be assessed, procedure.

1.An action may be brought by the department, or by the attorney general on his own volition or at the request of the department or any other appropriate state agency, to temporarily or permanently enjoin or restrain any violation of sections 630.705 to 630.760, to enjoin the acceptance of new residents until substantial compliance with sections 630.705 to 630.760 is achieved, or to enjoin any specific action or practice of the residential facility or day program.Any action brought under the provisions of this section shall be placed at the head of the docket by the court and the court shall hold a hearing on any action brought under the provisions of this section no less than fifteen days after the filing of the action.

2.Any facility or program which has received a notice of noncompliance as provided by sections 630.745 to 630.750 is liable to the state for civil penalties of up to ten thousand dollars for each day that noncompliance continues after the notice of noncompliance is received.The attorney general shall, upon the request of the department, bring an action in a circuit court of competent jurisdiction to recover the civil penalty.The court shall have the authority to determine the amount of civil penalty to be assessed within the limits set out in this section.Appeals may be taken from the judgment of the circuit court as in other civil cases.

3.The imposition of any remedy provided for in sections 630.705 to 630.760 shall not bar the imposition of any other remedy.

4.Penalties collected for violations of this section shall be transferred to the state schools moneys established under section 166.051.Such penalties shall not be considered a charitable contribution for tax purposes.

5.To recover any civil penalty, the moving party shall prove by a preponderance of the evidence that the violation occurred.

(L. 1980 H.B. 1724, A.L. 2007 S.B. 3)

630.655 - Rules for standards for placement facilities and programs — required standards.

1.The department shall promulgate rules which set forth reasonable standards for residential facilities, day programs or specialized services such that each program's level of service, treatment, habilitation or rehabilitation may be certified and funded accordingly by the department for its placement program clients or as necessary for the facilities or programs, to meet conditions of third-party reimbursement.

2.The rules shall provide for the facilities, programs or services to be reasonably classified as to resident or client population, size, type of services or other classification.

3.The standards contained in the rules shall particularly provide for the following:

(1)The admission and commitment criteria, which shall be based upon diagnoses;

(2)The care, treatment, habilitation or rehabilitation;

(3)The general medical and health care;

(4)Adequate physical plant facilities, including fire safety, housekeeping and maintenance standards;

(5)Food service facilities;

(6)Safety precautions;

(7)Drugs and medications;

(8)A uniform system of record keeping;

(9)Resident or client rights and grievance procedures;

(10)Adequate staff.

4.The department shall certify the facilities, programs or services which meet the standards without the requirement of a fee.

(L. 1980 H.B. 1724)

630.455 - Attorney general to seek restitution for department.

The attorney general shall represent the department to seek restitution of any moneys dispensed under this chapter which have been misappropriated, fraudulently obtained or overpaid.

(L. 1980 H.B. 1724)

630.155 - Mistreatment of patient — defined — penalty.

1.A person commits the offense 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, 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 E felony.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841, A.L. 2014 S.B. 491)

Effective 1-01-17

630.055 - Research activities by department.

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.

(L. 1980 H.B. 1724)

630.108 - Interaction between physical and mental health, guidelines for screening and assessment of persons receiving services — rulemaking authority.

1.The department of mental health shall develop guidelines for the screening and assessment of persons receiving services from the department that address the interaction between physical and mental health to ensure that all potential causes of changes in behavior or mental status caused by or associated with a medical condition are assessed.

2.The provisions of this section shall only apply to state-owned or -operated facilities and not to long-term care facilities licensed under chapter 198, hospitals licensed under chapter 197, or hospitals as defined in section 197.020.

3.The department of mental health shall promulgate rules to administer this section.Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2014, shall be invalid and void.

(L. 2014 S.B. 716 § 2)

630.855 - Contracts authorized, limitations.

The department of mental health and the department of corrections may negotiate and enter into contracts on behalf of this state pursuant to Article III of the compact and may perform such contracts; provided, that no funds, personnel, facilities, equipment, supplies or materials shall be pledged for, committed or used on account of any such contract, unless legally available therefor.

THE INTERSTATE COMPACT ON MENTALLY DISORDERED OFFENDERS

ARTICLE I

(a)The party states, desiring by common action to improve their programs for the care and treatment of mentally disordered offenders, declare that it is the policy of each of the party states to:

1.Strengthen their own programs and laws for the care and treatment of the mentally disordered offender.

2.Encourage and provide for such care and treatment in the most appropriate locations, giving due recognition to the need to achieve adequacy of diagnosis, care, treatment, aftercare and auxiliary services and facilities and, to every extent practicable, to do so in geographic locations convenient for providing a therapeutic environment.

3.Authorize cooperation among the party states in providing services and facilities, when it is found that cooperative programs can be more effective and efficient than programs separately pursued.

4.Place each mentally disordered offender in a legal status which will facilitate his care, treatment and rehabilitation.

5.Authorize research and training of personnel on a cooperative basis, in order to improve the quality or quantity of personnel available for the proper staffing programs, services and facilities for mentally disordered offenders.

6.Care for and treat mentally disordered offenders under conditions which will improve the public safety.

(b)Within the policies set forth in this Article, it is the purpose of this compact to:

1.Authorize negotiation, entry into and operations under contractual arrangements among any two or more of the party states for the establishment and maintenance of cooperative programs in any one or more of the fields for which specific provision is made in the several articles of this compact.

2.Set the limits within which such contracts may operate, so as to assure protection of the civil rights of mentally disordered offenders and protection of the rights and obligations of the public and of the party states.

3.Facilitate the proper disposition of criminal charges pending against mentally disordered offenders, so that programs for their care, treatment and rehabilitation may be carried on efficiently.

ARTICLE II

As used in this compact:

(a)"Mentally disordered offender" means a person who has been determined, by adjudication or other method legally sufficient for the purpose in the party state where the determination is made, to be mentally ill and:

1.Is under sentence for the commission of crime; or

2.Who is confined or committed on account of the commission of an offense for which, in the absence of mental illness, said person would be subject to incarceration in a penal or correctional facility.

(b)"Patient" means a mentally disordered offender who is cared for, treated, or transferred pursuant to this compact.

(c)"Sending state" means a state party to this compact in which the mentally disordered offender was convicted; or the state in which he would be subject to trial on or conviction of an offense, except for his mental condition; or, within the meaning of Article V of this compact, the state whose authorities have filed a petition in connection with an untried indictment, information or complaint.

(d)"Receiving state" means a state party to this compact to which a mentally disordered offender is sent for care, aftercare, treatment or rehabilitation, or within the meaning of Article V of this compact, the state in which a petition in connection with an untried indictment, information or complaint has been filed.

ARTICLE III

(a)Each party state may make one or more contracts with any one or more of the other party states for the care and treatment of mentally disordered offenders on behalf of a sending state in facilities situated in receiving states, or for the participation of such mentally disordered offenders in programs of aftercare on conditional release administered by the receiving state.Any such contract shall provide for:

1.Its duration.

2.Payments to be made to the receiving state by the sending state for patient care, treatment, and extraordinary services, if any.

3.Determination of responsibility for ordering or permitting the furnishing of extraordinary services, if any.

4.Participation in compensated activities, if any, available to patients; the disposition or crediting of any payment received by patients on account thereof; and the crediting of proceeds from or disposal of any products resulting therefrom.

5.Delivery and retaking of mentally disordered offenders.

6.Such other matters as may be necessary and appropriate to fix the obligations, responsibilities and rights of the sending and receiving states.

(b)Prior to the construction or completion of construction of any facility for mentally disordered offenders or addition to such facility by a party state, any other party state or states may contract therewith for the enlargement of the planned capacity of the facility or addition thereto, or for the inclusion therein of particular equipment or structures, and for the reservation of a specific percentum of the capacity of the facility to be kept available for use by patients of the sending state or states so contracting.Any sending state so contracting may, to the extent that moneys are legally available therefor, pay to the receiving state, a reasonable sum as consideration for such enlargement of capacity, or provision of equipment or structures, and reservation of capacity.Such payment may be in a lump sum or in installments as provided in the contract.

(c)A party state may contract with any one or more other party states for the training of professional or other personnel whose services, by reason of such training, would become available for or be improved in respect of ability to participate in the care and treatment of mentally disordered offenders.Such contracts may provide for such training to take place at any facility being operated or to be operated for the care and treatment of mentally disordered offenders; at any institution or facility having resources suitable for the offering of such training; or may provide for the separate establishment of training facilities, provided that no such separate establishment shall be undertaken, unless it is determined that an appropriate existing facility or institution cannot be found at which to conduct the contemplated program.Any contract entered into pursuant to this paragraph shall provide for:

1.The administration, financing, and precise nature of the program.

2.The status and employment or other rights of the trainees.

3.All other necessary matters.

(d)No contract entered into pursuant to this compact shall be inconsistent with any provision thereof.

ARTICLE IV

(a)Whenever the duly constituted judicial or administrative authorities in a state party to this compact, and which has entered into a contract pursuant to Article III, shall decide that custody, care and treatment in, or transfer of a patient to, a facility within the territory of another party state, or conditional release for aftercare in another party state is necessary in order to provide adequate care and treatment or is desirable in order to provide an appropriate program of therapy or other treatment, or is desirable for clinical reasons, said officials may direct that the custody, care and treatment be within a facility or in a program of aftercare within the territory of said other party state, the receiving state to act in that regard solely as agent for the sending state.

(b)The appropriate officials of any state party to this compact shall have access, at all reasonable times, to any facility in which it has a contractual right to secure care or treatment of patients for the purpose of inspection and visiting such of its patients as may be in the facility or served by it.

(c)Except as otherwise provided in Article VI, patients in a facility pursuant to the terms of this compact shall at all times be subject to the jurisdiction of the sending state and may at any time be removed for transfer to a facility within the sending state, for transfer to another facility in which the sending state may have a contractual or other right to secure care and treatment of patients, for release on aftercare or other conditional status, for discharge, or for any other purpose permitted by the laws of the sending state; provided that the sending state shall continue to be obligated to such payments as may be required pursuant to the terms of any contract entered into under the terms of Article III.

(d)Each receiving state shall provide regular reports to each sending state on the patients of that sending state in facilities pursuant to this compact including a psychiatric and behavioral record of each patient and certify said record to the official designated by the sending state, in order that each patient may have the benefit of his or her record in determining and altering the disposition of said patient in accordance with the law which may obtain in the sending state and in order that the same may be a source of information for the sending state.

(e)All patients who may be in a facility or receiving aftercare from a facility pursuant to the provisions of this compact shall be treated in a reasonable and humane manner and shall be cared for, treated and supervised in accordance with the standards pertaining to the program administered at the facility.The fact of presence in a receiving state shall not deprive any patient of any legal rights which said patient would have had if in custody or receiving care, treatment or supervision as appropriate in the sending state.

(f)Any hearing or hearings to which a patient present in a receiving state pursuant to this compact may be entitled by the laws of the sending state shall be had before the appropriate authorities of the sending state, or of the receiving state if authorized by the sending state.The receiving state shall provide adequate facilities for such hearings as may be conducted by the appropriate officials of a sending state.In the event such hearing or hearings are had before officials of the receiving state, the governing law shall be that of the sending state and a record of the hearing or hearings as prescribed by the sending state shall be made.Said record together with any recommendations of the hearing officials shall be transmitted forthwith to the official or officials before whom the hearing would have been had if it had taken place in the sending state.In any and all proceedings had pursuant to the provisions of this paragraph, the officials of the receiving state shall act solely as agents of the sending state and no final determination shall be made in any matter except by the appropriate officials of the sending state.Costs of records made pursuant to this paragraph shall be borne by the sending state.

(g)Patient confined pursuant to this compact shall be released within the territory of the sending state unless the patient, and the sending and receiving states, shall agree upon release in some other place.The sending state shall bear the cost of such return to its territory.

(h)Any patient pursuant to the terms of this compact shall be subject to civil process and shall have any and all rights to sue, be sued and participate in and derive any benefits or incur or be relieved of any obligations or have such obligation modified or his status changed on account of any action or proceeding in which he could have participated if in any appropriate facility of the sending state or being supervised therefrom, as the case may be, located within such state.

(i)The parent, guardian, trustee, or other person or persons entitled under the laws of the sending state to act for, advise, or otherwise function with respect to any patient shall not be deprived of or restricted in his exercise of any power in respect of any patient pursuant to the terms of this compact.

ARTICLE V

(a)Whenever the authorities responsible for the care and treatment of a mentally disordered offender, whether convicted or adjudicated in the state or subject to care, aftercare, treatment or rehabilitation pursuant to a contract, are of the opinion that charges based on untried indictments, informations or complaints in another party state present obstacles to the proper care and treatment of a mentally disordered offender or to the planning or execution of a suitable program for him, such authorities may petition the appropriate court in the state where the untried indictment, information or complaint is pending for prompt disposition thereof.If the mentally disordered offender is a patient in a receiving state, the appropriate authorities of the sending state, upon recommendation of the appropriate authorities in the receiving state, shall, if they concur in the recommendation, file the petition contemplated by this paragraph.

(b)The court shall hold a hearing on the petition within thirty days of the filing thereof.Such hearing shall be only to determine whether the proper safeguarding and advancement of the public interest; the condition of the mentally disordered offender; and the prospects for more satisfactory care, treatment and rehabilitation of him warrant disposition of the untried indictment, information or complaint prior to termination of the defendant's status as a mentally disordered offender in the sending state.The prosecuting officer of the jurisdiction from which the untried indictment, information or complaint is pending, the petitioning authorities, and such other persons as the court may determine shall be entitled to be heard.

(c)Upon any hearing pursuant to this Article, the court may order such adjournments or continuances as may be necessary for the examination or observation of the mentally disordered offender or for the securing of necessary evidence.In granting or denying any such adjournment or continuance, the court shall give primary consideration to the purposes of this compact, and more particularly to the need for expeditious determination of the legal and mental status of a mentally disordered offender so that his care, treatment and discharge to the community only under conditions which will be consonant with the public safety may be implemented.

(d)The presence of a mentally disordered offender within a state wherein a petition is pending or being heard pursuant to this Article, or his presence within any other state through which he is being transported in connection with such petition or hearing, shall be only for the purposes of this compact, and no court, agency or person shall have or obtain jurisdiction over such mentally disordered offender for any other purpose by reason of his presence pursuant to this Article.The mentally disordered offender shall, at all times, remain in the custody of the sending state.Any acts of officers, employees, or agencies of the receiving state in providing or facilitating detention, housing or transportation for the mentally disordered offender shall be only as agents for the sending state.

(e)Promptly upon conclusion of the hearing the court shall dismiss the untried indictment, information or complaint, if it finds that the purposes enumerated in paragraph (b) of this Article would be served thereby.Otherwise, the court shall make such order with respect to the petition and the untried indictment, information or complaint as may be appropriate in the circumstances and consistent with the status of the defendant as a mentally disordered offender in the custody of and subject to the jurisdiction of the sending state.

(f)No fact or other matter established or adjudicated at any hearing pursuant to this Article, or in connection therewith, shall be deemed established or adjudicated, nor shall the same be admissible in evidence, in any subsequent prosecution of the untried indictment, information or complaint concerned in a petition filed pursuant to this Article unless:

1.The defendant or his duly empowered legal representative requested or expressly acquiesced in the making of the petition, and was afforded an opportunity to participate in person in the hearing; or

2.The defendant himself offers or consents to the introduction of the determination or adjudication at such subsequent proceedings.

ARTICLE VI

(a)Any decision of the sending state in respect of any matter over which it retains jurisdiction pursuant to this compact shall be conclusive upon and not reviewable within the receiving state, but if at the time the sending state seeks to remove a patient from the receiving state there is pending against the patient within such state any criminal charge or if the patient is suspected of having committed within such state a criminal offense, the patient shall not be returned without the consent of the receiving state until discharged from prosecution or other form of proceeding, imprisonment or detention for such offense.The duly accredited officers of the sending state shall be permitted to transport patients pursuant to this compact through any and all states party to this compact without interference.

(b)A patient who escapes while receiving care and treatment or who violates provisions of aftercare by leaving the jurisdiction, or while being detained or transported pursuant to this compact shall be deemed an escapee from the sending state and from the state in which the facility is situated or the aftercare was being provided.In the case of an escape to a jurisdiction other than the sending or receiving state, the responsibility for return shall be that of the sending state, but nothing contained herein shall be construed to prevent or affect the activities of officers and agencies of any jurisdiction directed toward the apprehension and return of an escapee.

ARTICLE VII

Any state party to this compact may accept federal aid for use in connection with any facility or program, the use of which is or may be affected by this compact or any contract pursuant thereto and any patient in a receiving state pursuant to this compact may participate in any such federally aided program or activity for which the sending and receiving states have made contractual provision; provided that if such program or activity is not part of the customary regimen of the facility or program the express consent of the appropriate official of the sending state shall be required therefor.

ARTICLE VIII

This compact shall enter into force and become effective and binding upon the states so acting when it has been enacted into law by any two states from among the states of Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota and Wisconsin.Thereafter, this compact shall enter into force and become effective and binding as to any other of said states, or any other state upon similar action by such state.

ARTICLE IX

This compact shall continue in force and remain binding upon a party state until it shall have enacted a statute repealing the same and providing for the sending of formal written notice of withdrawal from the compact to the appropriate officials of all other party states.An actual withdrawal shall not take effect until two years after the notices provided in said statute have been sent.Such withdrawal shall not relieve the withdrawing state from its obligations assumed hereunder prior to the effective date of withdrawal.Before the effective date of withdrawal, a withdrawing state shall remove to its territory, at its own expense, such patients as it may have in other party states pursuant to the provisions of this compact.

ARTICLE X

Nothing contained in this compact shall be construed to abrogate or impair any agreement or other arrangement which a party state may have with a nonparty state for the custody, care, treatment, rehabilitation or aftercare of patients nor to repeal any other laws of a party state authorizing the making of cooperative arrangements.

ARTICLE XI

The provisions of this compact shall be liberally construed and shall be severable.If any phrase, clause, sentence or provision of this compact is declared to be contrary to the constitution of any participating state or of the United States or the applicability thereof to any government, agency, person or circumstance is held invalid, the validity of the remainder of this compact and the applicability thereof to any government, agency, person or circumstance shall not be affected thereby.If this compact shall be held contrary to the constitution of any state participating therein, the compact shall remain in full force and effect as to the remaining states and in full force and effect as to the state affected as to all severable matters.

(L. 1980 H.B. 1724, A.L. 1990 H.B. 974)

630.200 - Discrimination prohibited.

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 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.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841)

630.110 - Patient's rights — limitations.

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, 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, persons detained at a county jail or at a secure facility under section 632.484 or 632.489, or persons committed to a secure facility under section 632.495, 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.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841, A.L. 2009 H.B. 826 merged with S.B. 435)

630.010 - Mental health commission — members, terms, qualifications, appointment, vacancies, compensation — organization, meetings.

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 August 13, 1980, shall continue until the terms under which the members were regularly appointed expire.The terms shall be for four years.Each commissioner shall hold office until his successor has been appointed and qualified.

2.The commission shall be comprised of members who are not prohibited from serving by sections 105.450 to 105.482, 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, licensed clinical psychologist, or other licensed clinician, recognized as an expert in the evaluation or treatment of persons with an intellectual disability or developmental disability;

(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 persons with an intellectual disability or developmental disability;

(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.

(L. 1980 H.B. 1724, A.L. 2011 H.B. 555 merged with H.B. 648, A.L. 2015 S.B. 58

630.210 - 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 — waiver of means test for certain children, when.

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, intellectual disability, 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 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 Cole County or the county where the person responsible for payment resides in the manner provided by chapter 536.

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.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.

5.The standard means test may be waived for a child in need of mental health services to avoid inappropriate custody transfers to the children's division.The department of mental health shall notify the child's parent or custodian that the standard means test may be waived.The department of mental health shall promulgate rules for waiving the standard means test.Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2004, shall be invalid and void.

(L. 1980 H.B. 1724, A.L. 1981 H.B. 399, A.L. 1982 H.B. 1565, A.L. 1993 S.B. 52, A.L. 2004 S.B. 1003, A.L. 2011 H.B. 555 merged with H.B. 648)

630.310 - Receipt of funds of patient, procedure.

A department residential facility may accept funds which a parent, guardian or other person wishes to provide for the use or benefit of a patient or resident of the facility.The possession and use of such funds shall be governed by section 630.305 and by any additional directions given by the provider of the funds.

(L. 1980 H.B. 1724)

630.945 - Maximum and intermediate facilities, work hours limited — exception for emergencies.

Beginning July 1, 2013, no state employee, regardless of job classification, who is working in a maximum or intermediate security mental health facility or any portion of a mental health facility which has maximum or intermediate security shall be mandated to work more than twelve hours in any twenty-four hour period unless the department of mental health declares an emergency workforce shortage.The provisions of this section shall not apply on the first Sunday of November each year when the standard time changes according to 15 U.S.C. Section 260a.

(L. 2012 H.B. 1318, A.L. 2018 S.B. 660)

630.710 - Required standards.

1.The standards contained in the rules shall particularly provide for the following:

(1)Admission and commitment criteria, which shall be based upon diagnoses;

(2)Care, treatment, habilitation or rehabilitation;

(3)General medical and health care;

(4)Adequate physical plant facilities, including fire safety, housekeeping and maintenance standards;

(5)Food service facilities;

(6)Safety precautions;

(7)Drugs and medications;

(8)Uniform system of record keeping;

(9)Resident or client rights and grievance procedures;

(10)Adequate staff.

2.The rules containing the standards for living units within facilities or homes shall provide for such classifications of the living units as are small enough to ensure programs based upon the personal needs of the resident as determined by individualized habilitation or treatment plans.The units may include distinct parts of other facilities such as wards, wings or floors.

(L. 1980 H.B. 1724, A.L. 1996 S.B. 884 & 841, A.L. 1998 S.B. 470)

630.610 - Applications for placement — criteria to be considered.

1.If the head of a facility operated by the department determines that placement out of the facility would be appropriate for any patient or resident, the head of the facility shall refer the patient or resident for placement according to the department's rules.If a patient or resident is accepted and placed under this chapter, then the patient or resident shall be considered as discharged as a patient or resident of the facility and reclassified as a client of the department.

2.Any person, his authorized representative, his parent, if the person is a minor, his guardian, a court of competent jurisdiction or a state or private facility or agency having custody of the person may apply for placement of the person under this chapter.

3.If the department finds the application to be appropriate after review, it shall provide for or arrange for a comprehensive evaluation, and the preparation of an individualized treatment, habilitation or rehabilitation plan of the person seeking to be placed, whether from a department facility or directly, to determine if he meets the following criteria:

(1)The person is affected by a mental disorder, mental illness, intellectual disability, developmental disability or alcohol or drug abuse; and

(2)The person is in need of special care, treatment, habilitation or rehabilitation services as described in this chapter, including room or board, or both; provided, however, that no person shall be accepted for placement if the sole reason for the application or referral is that residential placement is necessary for a school-aged child, as defined in chapter 162, to receive an appropriate special education.

(L. 1980 H.B. 1724, A.L. 2011 H.B. 555 merged with H.B. 648)

630.410 - Evaluation of contracts.

The department shall evaluate any proposed contract to determine whether it meets the following criteria:

(1)Conformance with the conditions and priorities of the regional and state division plans;

(2)Compliance with department rules and regulations.

(L. 1980 H.B. 1724)

630.510 - Inventory of facilities — plan for new facilities.

At least once every three years, the department shall conduct a complete statewide inventory of its existing facilities and a survey of needs for persons affected by mental disorders, mental illness, intellectual disabilities, developmental disabilities and alcohol or drug abuse, and shall make a public report of its inventory and survey and recommend a state plan for the construction of additional facilities.

(L. 1980 H.B. 1724, A.L. 2011 H.B. 555 merged with H.B. 648)

630.645 - Follow-up care.

The department shall provide or shall arrange for follow-up care and aftercare and shall make or arrange for reviews and visits with the client at least quarterly to the residential facility or day program in which the client has been placed to determine whether the client is receiving care, treatment, habilitation and rehabilitation, including medical care, consistent with his needs and condition.The department shall identify the facilities, programs or specialized services operated or funded by the department which shall provide necessary levels of follow-up care, aftercare, habilitation or medical treatment to clients in certain geographic areas where they are placed.After a client has been placed through the placement program, the department shall, for a period of four months following the initial placement, evaluate and review the progress of the client in the placement at least once a month.

(L. 1980 H.B. 1724)

630.745 - Noncompliance with law revealed by inspection — procedure — corrective measures, time limit — reinspection, when — probationary license — posting of noncompliance notices.

1.If a duly authorized representative of the department finds upon inspection of a residential facility or day program that it is not in compliance with the provisions of sections 630.705 to 630.760, and the standards established thereunder, the head of the facility or program shall be informed of the deficiencies in an exit interview conducted with him.A written report shall be prepared of any deficiency for which there has not been prompt remedial action, and a copy of such report and a written correction order shall be sent to the facility or program at the facility or program address within twenty working days after the inspection, stating separately each deficiency and the specific statute or regulation violated.

2.The head of the facility or program shall have twenty working days following receipt of the report and correction order to request any conference and to submit a plan of correction for the department's approval which contains specific dates for achieving compliance.Within ten working days after receiving a plan of correction, the department shall give its written approval or rejection of the plan.

3.A reinspection shall be conducted within sixty days after the original inspection to determine if deficiencies are being corrected as required in the approved correction plan or any subsequent authorized modification.If the facility or program is not in substantial compliance and the head of the facility or program is not correcting the noncompliance in accordance with the time schedules in his approved plan of correction, the department shall issue a notice of noncompliance, which shall be sent by certified mail, return receipt requested, to the head of the facility or program.

4.The notice of noncompliance shall inform the head of the facility or program that the department may seek the imposition of any of the sanctions and remedies provided for in section 630.755, or any other action authorized by law.

5.At any time after an inspection is conducted, the head of the facility or program may choose to enter into a consent agreement with the department to obtain a probationary license.The consent agreement shall include a provision that the head of the facility or program will voluntarily surrender the license if substantial compliance is not reached in accordance with the terms and deadlines established under the agreement.The agreement shall specify the stages, actions and time span to achieve substantial compliance.

6.If a notice of noncompliance has been issued, the head of the facility or program shall post a copy of the notice of noncompliance and a copy of the most recent inspection report in a conspicuous location in the facility or program, and the department shall send a copy of the notice of noncompliance to any concerned federal, state or local governmental agencies.

(L. 1980 H.B. 1724, A.L. 2018 S.B. 660)

630.545 - Board and living quarters for employees of facilities.

In addition to salary and wages, when the director shall determine that it is in the best interest of the state to do so, the department may provide any employee in any institution under its control with board and living quarters on the grounds of its facilities.

(L. 1980 H.B. 1724)

630.445 - Records required of vendors or grantees, contents — access for inspection.

1.Each vendor or grantee under contract with the department under this chapter or chapter 631, 632, or 633, shall keep such records as the department shall prescribe, including records which fully disclose the amount and disposition by such recipient of the proceeds of such funding; the total cost of the project, service or undertaking in connection with which such funding is given or used; the amount of that portion of the cost of the project, service or undertaking supplied by other sources; and such other records as will facilitate an effective audit as required in the rules and regulations of the department.

2.The department and the state auditor, or his designee, shall have access for the purpose of audit and examination to any books, documents, papers and records of the recipients that are pertinent to the funding received from the department.

3.The department and the state auditor, or his designee, shall perform their auditing functions in such a manner that the identity of any individual who receives a service from a person receiving funds pursuant to this chapter shall be confidential in accordance with state and federal law.

(L. 1980 H.B. 1724)

630.045 - Appointment of persons for civil involuntary detention actions.

The director of the department may authorize such persons, including mental health coordinators, as are necessary to carry out the civil involuntary detention requirements of chapter 632.

(L. 1980 H.B. 1724, A.L. 2008 S.B. 1081)

630.145 - Department to release information to next of kin and persons responsible for costs, when.

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.

(L. 1980 H.B. 1724, A.L. 1981 H.B. 336)

630.810 - Compact enacted — form.

The "Interstate Compact on Mental Health" is hereby enacted into law and entered into by this state with all other states legally joining therein in the form substantially as follows:

THE INTERSTATE COMPACT ON MENTAL HEALTH

The contracting states solemnly agree that:

ARTICLE I

The party states find that the proper and expeditious treatment of the mentally ill and mentally deficient can be facilitated by cooperative action, to the benefit of the patients, their families, and society as a whole.Further, the party states find that the necessity of and desirability for furnishing such care and treatment bears no primary relation to the residence or citizenship of the patient but that, on the contrary, the controlling factors of community safety and humanitarianism require that facilities and services be made available for all who are in need of them.Consequently, it is the purpose of this compact and of the party states to provide the necessary legal basis for the institutionalization or other appropriate care and treatment of the mentally ill and mentally deficient under a system that recognizes the paramount importance of patient welfare and to establish the responsibilities of the party states in terms of such welfare.

ARTICLE II

As used in this compact:

(a)"Sending state" shall mean a party state from which a patient is transported pursuant to the provisions of the compact or from which it is contemplated that a patient may be so sent.

(b)"Receiving state" shall mean a party state to which a patient is transported pursuant to the provisions of the compact or to which it is contemplated that a patient may be so sent.

(c)"Institution" shall mean any hospital or other facility maintained by a party state or political subdivision thereof for the care and treatment of mental illness or mental deficiency.

(d)"Patient" shall mean any person subject to or eligible as determined by the laws of the sending state, for institutionalization or other care, treatment, or supervision pursuant to the provisions of this compact.

(e)"Aftercare" shall mean care, treatment and services provided a patient, as defined herein, on convalescent status or conditional release.

(f)"Mental illness" shall mean mental disease to such extent that a person so afflicted requires care and treatment for his own welfare, or the welfare of others, or of the community.

(g)"Mental deficiency" shall mean mental deficiency as defined by appropriate clinical authorities to such extent that a person so afflicted is incapable of managing himself and his affairs, but shall not include mental illness as defined herein.

(h)"State" shall mean any state, territory or possession of the United States, the District of Columbia, and the Commonwealth of Puerto Rico.

ARTICLE III

(a)Whenever a person physically present in any party state shall be in need of institutionalization by reason of mental illness or mental deficiency, he shall be eligible for care and treatment in an institution in that state irrespective of his residence, settlement or citizenship qualifications.

(b)The provisions of paragraph (a) of this article to the contrary notwithstanding, any patient may be transferred to an institution in another state whenever there are factors based upon clinical determinations indicating that the care and treatment of said patient would be facilitated or improved thereby.Any such institutionalization may be for the entire period of care and treatment or for any portion or portions thereof.The factors referred to in this paragraph shall include the patient's full record with due regard for the location of the patient's family, character of the illness and probable duration thereof, and such other factors as shall be considered appropriate.

(c)No state shall be obliged to receive any patient pursuant to the provisions of paragraph (b) of this article unless the sending state has given advance notice of its intention to send the patient; furnished all available medical and other pertinent records concerning the patient; given the qualified medical or other appropriate clinical authorities of the receiving state an opportunity to examine the patient if said authorities so wish; and unless the receiving state shall agree to accept the patient.

(d)In the event that the laws of the receiving state establish a system of priorities for the admission of patients, an interstate patient under this compact shall receive the same priority as a local patient and shall be taken in the same order and at the same time that he would be taken if he were a local patient.

(e)Pursuant to this compact, the determination as to the suitable place of institutionalization for a patient may be reviewed at any time and such further transfer of the patient may be made as seems likely to be in the best interest of the patient.

ARTICLE IV

(a)Whenever, pursuant to the laws of the state in which a patient is physically present, it shall be determined that the patient should receive aftercare or supervision, such care or supervision may be provided in a receiving state.If the medical or other appropriate clinical authorities having responsibility for the care and treatment of the patient in the sending state shall have reason to believe that aftercare in another state would be in the best interest of the patient and would not jeopardize the public safety, they shall request the appropriate authorities in the receiving state to investigate the desirability of affording the patient such aftercare in said receiving state, and such investigation shall be made with all reasonable speed.The request for investigation shall be accompanied by complete information concerning the patient's intended place of residence and the identity of the person in whose charge it is proposed to place the patient, the complete medical history of the patient, and such other documents as may be pertinent.

(b)If the medical or other appropriate clinical authorities having responsibility for the care and treatment of the patient in the sending state and the appropriate authorities in the receiving state find that the best interest of the patient would be served thereby, and if the public safety would not be jeopardized thereby, the patient may receive aftercare or supervision in the receiving state.

(c)In supervising, treating, or caring for a patient on aftercare pursuant to the terms of this article, a receiving state shall employ the same standards of visitation, examination, care, and treatment that it employs for similar local patients.

ARTICLE V

Whenever a dangerous or potentially dangerous patient escapes from an institution in any party state, that state shall promptly notify all appropriate authorities within and out the jurisdiction of the escape in a manner reasonably calculated to facilitate the speedy apprehension of the escapee.Immediately upon the apprehension and identification of any such dangerous or potentially dangerous patient, he shall be detained in the state where found pending disposition in accordance with law.

ARTICLE VI

The duly accredited officers of any state party to this compact, upon the establishment of their authority and the identity of the patient, shall be permitted to transport any patient being moved pursuant to this compact through any and all states party to this compact, without interference.

ARTICLE VII

(a)No person shall be deemed a patient of more than one institution at any given time.Completion of transfer of any patient to an institution in a receiving state shall have the effect of making the person a patient of the institution in the receiving state.

(b)The sending state shall pay all costs of and incidental to the transportation of any patient pursuant to this compact, but any two or more party states may, by making a specific agreement for that purpose, arrange for a different allocation of costs as among themselves.

(c)No provision of this compact shall be construed to alter or affect any internal relationships among the departments, agencies and officers of and in the government of a party state, or between a party state and its subdivisions, as to the payment of costs, or responsibilities therefor.

(d)Nothing in this compact shall be construed to prevent any party state or subdivision thereof from asserting any right against any person, agency or other entity in regard to costs for which such party state or subdivision thereof may be responsible pursuant to any provision of this compact.

(e)Nothing in this compact shall be construed to invalidate any reciprocal agreement between a party state and a nonparty state relating to institutionalization, care or treatment of the mentally ill or mentally deficient, or any statutory authority pursuant to which such agreements may be made.

ARTICLE VIII

(a)Nothing in this compact shall be construed to abridge, diminish, or in any way impair the rights, duties, and responsibilities of any patient's guardian on his own behalf or in respect of any patient for whom he may serve, except that where the transfer of any patient to another jurisdiction makes advisable the appointment of a supplemental or substitute guardian, any court of competent jurisdiction in the receiving state may make such supplemental or substitute appointment and the court which appointed the previous guardian shall upon being duly advised of the new appointment, and upon the satisfactory completion of such accounting and other acts as such court may by law require, relieve the previous guardian of power and responsibility to whatever extent shall be appropriate in the circumstances; provided, however, that in the case of any patient having settlement in the sending state, the court of competent jurisdiction in the sending state shall have the sole discretion to relieve a guardian appointed by it or continue his power and responsibility, whichever it shall deem advisable.The court in the receiving state may, in its discretion, confirm or reappoint the person or persons previously serving as guardian in the sending state in lieu of making a supplemental or substitute appointment.

(b)The term "guardian" as used in paragraph (a) of this article shall include any guardian, trustee, legal committee, conservator, or other person or agency however denominated who is charged by law with power to act for or responsibility for the person or property of a patient.

ARTICLE IX

(a)No provision of this compact except Article V shall apply to any person institutionalized while under sentence in a penal or correctional institution or while subject to trial on a criminal charge, or whose institutionalization is due to the commission of an offense for which, in the absence of mental illness or mental deficiency, said person would be subject to incarceration in a penal or correctional institution.

(b)To every extent possible, it shall be the policy of states party to this compact that no patient shall be placed or detained in any prison, jail or lockup, but such patient shall, with all expedition, be taken to a suitable institutional facility for mental illness or mental deficiency.

ARTICLE X

(a)Each party state shall appoint a "compact administrator" who, on behalf of his state, shall act as general coordinator of activities under the compact in his state and who shall receive copies of all reports, correspondence, and other documents relating to any patient processed under the compact by his state either in the capacity of sending or receiving state.The compact administrator or his duly designated representative shall be the official with whom other party states shall deal in any matter relating to the compact or any patient processed thereunder.

(b)The compact administrators of the respective party states shall have power to promulgate reasonable rules and regulations to carry out more effectively the terms and provisions of this compact.

ARTICLE XI

The duly constituted administrative authorities of any two or more party states may enter into supplementary agreements for the provision of any service or facility or for the maintenance of any institution on a joint or cooperative basis whenever the states concerned shall find that such agreements will improve services, facilities, or institutional care and treatment in the fields of mental illness or mental deficiency.No such supplementary agreement shall be construed so as to relieve any party state of any obligation which it otherwise would have under other provisions of this compact.

ARTICLE XII

This compact shall enter into full force and effect as to any state when enacted by it into law and such state shall thereafter be a party thereto with any and all states legally joining therein.

ARTICLE XIII

(a)A state party to this compact may withdraw therefrom by enacting a statute repealing the same.Such withdrawal shall take effect one year after notice thereof has been communicated officially and in writing to the governors and compact administrators of all other party states.However, the withdrawal of any state shall not change the status of any patient who has been sent to said state or sent out of said state pursuant to the provisions of the compact.

(b)Withdrawal from any agreement permitted by Article VII(b) as to costs or from any supplementary agreement made pursuant to Article XI shall be in accordance with the terms of such agreement and paragraph (a) hereof.

ARTICLE XIV

This compact shall be liberally construed so as to effectuate the purposes thereof.The provisions of this compact shall be severable and if any phrase, clause, sentence or provision of this compact is declared to be contrary to the constitution of any party state or of the United States or the applicability thereof to any government, agency, person or circumstance is held invalid, the validity of the remainder of this compact and the applicability thereof to any government, agency, person or circumstance shall not be affected thereby.If this compact shall be held contrary to the constitution of any state party thereto, the compact shall remain in full force and effect as to the remaining states and in full force and effect as to the state affected as to all severable matters.