Chapter 633 Intellectual Disabilities and Developmental Disabilities

633.027 - Developmentally disabled persons to be served.

Steven Groce, Attorney Advertisement

Persons diagnosed as developmentally disabled as defined in 42 U.S.C. 6001, as amended, solely on the basis of a diagnosis of mental disorder or mental illness as defined in section 630.005 shall be served by appropriate agencies.

(L. 1990 H.B. 1383)

Effective 1-01-91

633.033 - Departments of mental health and social services to prepare plan for mental health services and support needs for children and persons seventeen years — report required when.

1.The department of mental health and the department of social services shall jointly prepare a plan to address the need for mental health services and supports for:

(1)All of the cases in the custody of the department of social services that involve children in the system due exclusively to a need for mental health services, and where there is no instance of abuse, neglect, or abandonment; and

(2)Children or persons seventeen years of age who are determined by the court to require mental health services under subdivision (5) of subsection 1 of section 211.181.

2.Such plan shall include:

(1)An analysis of federal funding, including waivers, that may be used to support the needed mental health services and supports;

(2)An analysis of the budgetary and programmatic impact of meeting the needs of the children and persons seventeen years of age for mental health services and supports; and

(3)An analysis of the feasibility, including time frames, of securing federal funds for the support of the needed mental health services and supports.

3.The plan required in this section shall be completed on or before January 1, 2004.The directors of the department of social services and the department of mental health shall submit a copy of the plan to the governor, the president pro tem of the senate, and the speaker of the house of representatives.

(L. 2003 S.B. 266 §1)

633.303 - Termination of workers on disqualification registry.

Any employee, including supervisory personnel, of a group home or developmental disability facility who has been placed on the disqualification registry pursuant to section 630.170 shall be terminated.Such requirements shall be specified in contracts between the department and providers pursuant to this section.

(L. 2008 S.B. 1081, A.L. 2011 H.B. 555 merged with H.B. 648)

633.306 - Comprehensive report required, contents — annual report to general assembly, contents.

1.Beginning January 1, 2009, all mental health facilities shall, on an annual basis, submit a comprehensive report to the department on any staff and personnel turnover at the facility.Such report shall include the number, job description, salary, and duration of employment regarding such staff and personnel turnover.Such reports shall be submitted no later than thirty days after the end of each calendar year.

2.Beginning January 1, 2009, the department shall collect the information submitted under subsection 1 of this section and submit an annual report to the general assembly on or before March fifteenth of each year regarding the staff and personnel turnover at mental health facilities.Such report shall include information that is specific to each facility, as well as information inclusive of all such facilities.

(L. 2008 S.B. 1081)

633.032 - Mental health department to develop a plan for the needs of persons on waitlist for services — report required, made to whom, when.

1.The department of mental health shall develop a plan to address the needs of persons who are on a waitlist for services, including persons in habilitation centers waiting for community placement.Such plan shall reflect the partnership between persons with developmental disabilities and their families, community providers, and state officials, and shall support the choice and control of consumers and their families in the delivery of services and supports.Such plan shall include the following:

(1)A method to reduce the waitlist for services over a period of five years and to reduce the waiting period to ninety days;

(2)A description of minimum supports and services available to all eligible individuals and their families;

(3)An evaluation of the capacity of current providers to serve more individuals;

(4)A method of adjusting support and service levels based on the needs of the eligible individual combined with family or other relevant circumstances affecting the support of such individual;

(5)A method for determining the circumstances when out-of-home twenty-four-hour care may be necessary;

(6)A description of how the plan will be implemented on a statewide basis;

(7)Any changes in state law that will be required to implement the plan; and

(8)An analysis of the budgetary and programmatic effects of providing supports and services for all eligible individuals and their families.

2.The plan required pursuant to this section shall be completed on or before November first each year beginning November 1, 2007.The director of the department of mental health shall annually submit a copy of the plan to the speaker of the house of representatives, the president pro tem of the senate, and the governor.

(L. 2003 H.B. 59 & 269 merged with S.B. 266, A.L. 2006 S.B. 974)

633.190 - Promulgation of rules.

1.The division of developmental disabilities, in cooperation with the Missouri planning council for developmental disabilities, shall adopt policies and procedures and, when necessary, shall promulgate rules and regulations regarding:

(1)Program guidelines and specifications;

(2)Additional duties of the regional advisory councils;

(3)Annual evaluation of services provided by each regional center, including an assessment of consumer satisfaction;

(4)Coordination of the family support program and the use of its funds throughout the state and within each region, with other publicly funded programs, including Medicaid;

(5)Methodology for allocating resources to families with the funds available;

(6)Resolution of grievances filed by families pertaining to actions of the family support program;

(7)Methodology for outreach and education.

2.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.

(L. 1993 H.B. 330 § 5, A.L. 1995 S.B. 3, A.L. 2011 H.B. 555 merged with H.B. 648)

633.030 - Department to develop state plan, contents.

1.The department shall prepare a state plan to secure coordinated intellectual disabilities and developmental disabilities habilitation services accessible to persons in need of them in defined geographic areas, which plan shall be reviewed and revised annually.

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

(1)A needs-assessment of the state to determine underserved, unserved and inappropriately served populations and areas;

(2)Statements of short-term and long-term goals for meeting the needs of currently served, underserved, unserved or inappropriately served populations and areas of the state;

(3)An inventory of existing private and public residential facilities, day programs and other service providers offering intellectual disability or developmental disability evaluation and habilitation services;

(4)Evaluations of the effects of habilitation programs;

(5)Descriptions of the following:

(a)Methods for assuring active consumer-oriented citizen participation throughout the system;

(b)Strategies and procedures for encouraging, coordinating and integrating community-based services, wherever practicable, to avoid duplication by private, not-for-profit and public state and community-based providers of services;

(c)Methods for monitoring the quality of evaluation and habilitation services funded by the state;

(d)Rules which set standards for construction, staffing, operations and programs, as appropriate, for any public or private entity to meet for receiving state licensing, certification or funding; and

(e)Plans for addressing the particular intellectual disability or developmental disability service needs of each region, including special strategies for rural and urban unserved, underserved or inappropriately served populations in areas of the state.

3.In preparing the state plan, the department shall take into consideration its regional plans.

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

633.130 - Evaluation of residents required — discharge thereafter.

1.At least once every one hundred eighty days, the head of each developmental disability facility shall cause the condition and status of each resident to be reviewed and evaluated for the purpose of determining whether the resident needs further residential habilitation, placement in the least restrictive environment or discharge.

2.The head of the facility shall initiate proceedings to discharge any resident whose continued residential habilitation is no longer appropriate; except, that the head of the facility may refer the resident to the appropriate regional center for placement pursuant to section 630.610.

3.A copy of the evaluation and individualized habilitation plan shall be sent to any court having jurisdiction over the resident.

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

633.175 - Community awareness program — administration of family support program.

1.Each regional center established pursuant to the provisions of section 633.040 shall make its community aware of the family support program and determine eligibility for services.

2.Each regional advisory council established pursuant to the provisions of section 633.190 shall administer the family support program from resources provided by each regional center.

(L. 1993 H.B. 330 § 2)

633.420 - Dyslexia defined — task force created, members, duties, recommendations — expiration date.

1.For the purposes of this section, the term "dyslexia" means a disorder that is neurological in origin, characterized by difficulties with accurate and fluent word recognition, and poor spelling and decoding abilities that typically result from a deficit in the phonological component of language, often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction, and of which secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.Nothing in this section shall prohibit a district from assessing students for dyslexia and offering students specialized reading instruction if a determination is made that a student suffers from dyslexia.Unless required by federal law, nothing in this definition shall require a student with dyslexia to be automatically determined eligible as a student with a disability.Nothing in this definition shall require a student with dyslexia to obtain an individualized education program (IEP) unless the student has otherwise met the federal conditions necessary.

2.There is hereby created the "Legislative Task Force on Dyslexia".The joint committee on education shall provide technical and administrative support as required by the task force to fulfill its duties; any such support involving monetary expenses shall first be approved by the chairman of the joint committee on education.The task force shall meet at least quarterly and may hold meetings by telephone or video conference.The task force shall advise and make recommendations to the governor, joint committee on education, and relevant state agencies regarding matters concerning individuals with dyslexia, including education and other adult and adolescent services.

3.The task force shall be comprised of twenty-one* members consisting of the following:

(1)Two members of the senate appointed by the president pro tempore of the senate, with one member appointed from the minority party and one member appointed from the majority party;

(2)Two members of the house of representatives appointed by the speaker of the house of representatives, with one member appointed from the minority party and one member appointed from the majority party;

(3)The commissioner of education, or his or her designee;

(4)One representative from an institution of higher education located in this state with specialized expertise in dyslexia and reading instruction;

(5)A representative from a state teachers association or the Missouri National Education Association;

(6)A representative from the International Dyslexia Association of Missouri;

(7)A representative from Decoding Dyslexia of Missouri;

(8)A representative from the Missouri Association of Elementary School Principals;

(9)A representative from the Missouri Council of Administrators of Special Education;

(10)A professional licensed in the state of Missouri with experience diagnosing dyslexia including, but not limited to, a licensed psychologist, school psychologist, or neuropsychologist;

(11)A speech-language pathologist with training and experience in early literacy development and effective research-based intervention techniques for dyslexia, including an Orton-Gillingham remediation program recommended by the Missouri Speech-Language Hearing Association;

(12)A certified academic language therapist recommended by the Academic Language Therapy** Association who is a resident of this state;

(13)A representative from an independent private provider or nonprofit organization serving individuals with dyslexia;

(14)An assistive technology specialist with expertise in accessible print materials and assistive technology used by individuals with dyslexia recommended by the Missouri assistive technology council;

(15)One private citizen who has a child who has been diagnosed with dyslexia;

(16)One private citizen who has been diagnosed with dyslexia;

(17)A representative of the Missouri State Council of the International Reading Association;

(18)A pediatrician with knowledge of dyslexia; and

(19)A member of the Missouri School Boards'*** Association.

4.The members of the task force, other than the members from the general assembly and ex officio members, shall be appointed by the president pro tempore of the senate or the speaker of the house of representatives by September 1, 2016, by alternating appointments beginning with the president pro tempore of the senate.A chairperson shall be selected by the members of the task force.Any vacancy on the task force shall be filled in the same manner as the original appointment.Members shall serve on the task force without compensation.

5.The task force shall make recommendations for a statewide system for identification, intervention, and delivery of supports for students with dyslexia, including the development of resource materials and professional development activities.These recommendations shall be included in a report to the governor and joint committee on education and shall include findings and proposed legislation and shall be made available no longer than twelve months from the task force's first meeting.

6.The recommendations and resource materials developed by the task force shall:

(1)Identify valid and reliable screening and evaluation assessments and protocols that can be used and the appropriate personnel to administer such assessments in order to identify children with dyslexia or the characteristics of dyslexia as part of an ongoing reading progress monitoring system, multitiered system of supports, and special education eligibility determinations in schools;

(2)Recommend an evidence-based reading instruction, with consideration of the National Reading Panel Report and Orton-Gillingham methodology principles for use in all Missouri schools, and intervention system, including a list of effective dyslexia intervention programs, to address dyslexia or characteristics of dyslexia for use by schools in multitiered systems of support and for services as appropriate for special education eligible students;

(3)Develop and implement preservice and in-service professional development activities to address dyslexia identification and intervention, including utilization of accessible print materials and assistive technology, within degree programs such as education, reading, special education, speech-language pathology, and psychology;

(4)Review teacher certification and professional development requirements as they relate to the needs of students with dyslexia;

(5)Examine the barriers to accurate information on the prevalence of students with dyslexia across the state and recommend a process for accurate reporting of demographic data; and

(6)Study and evaluate current practices for diagnosing, treating, and educating children in this state and examine how current laws and regulations affect students with dyslexia in order to present recommendations to the governor and the joint committee on education.

7.The task force shall hire or contract for hire specialist services to support the work of the task force as necessary with appropriations made by the general assembly to the joint committee on education for that purpose or from other available funding.

8.The task force authorized under this section shall expire on August 31, 2018, unless reauthorized by an act of the general assembly.

(L. 2016 H.B. 2379 merged with S.B. 635 merged with S.B. 638)

Expires 8-31-18

*Word "twenty" appears in original rolls of S.B. 635 and S.B. 638.

**Word "Therapists" appears in original rolls of S.B. 635, S.B. 638 and H.B. 2379.

***Word "Board" appears in original rolls of S.B. 635, S.B. 638 and H.B. 2379.

633.120 - Referral for admission to facility, when — admission or rejection, appeal — consent.

1.A regional center may refer a client for admission to a developmental disability facility only if determined by a comprehensive evaluation that:

(1)The person has a developmental disability;

(2)Protective services are required to guarantee the health, safety or mental well-being of the person;

(3)Placement in a developmental disability facility is in the best interests of the person; and

(4)All other less restrictive services, including but not limited to family support and supported living, have been explored and found inadequate to prevent placement in a developmental disability facility.

2.The regional center shall forward its comprehensive evaluation containing the determination under subsection 1 of this section and such other records as are necessary to enable the developmental disability facility to determine whether to accept or reject the referral.

3.The head of a private developmental disability facility may, and the head of a department developmental disability facility shall, admit the person if, as a result of reviewing the evaluation, the head of the developmental disability facility determines that the client is appropriate for admission as a resident and suitable accommodations are available.If the head of a department developmental disability facility rejects the referral, the regional center may appeal the rejection to the division director.After consulting with the head of the referring regional center and the head of the department developmental disability facility, the division director shall determine the appropriate disposition of the client.

4.The person to be admitted, if competent, his parent or legal custodian, if he is a minor, or his guardian, as authorized by a court, shall consent to the admission unless otherwise ordered by a court.

5.The head of a developmental disability facility shall have an individualized habilitation plan for each resident within thirty days of the resident's admission.Such plan shall include a statement regarding the resident's anticipated length of stay in the facility and the feasibility of least restrictive alternatives.

6.If procedures are initiated under chapter 475 for the appointment of a guardian for a resident of a department developmental disability facility, the referral procedure under this section shall not apply.

(L. 1980 H.B. 1724, A.L. 1990 H.B. 1383, A.L. 2011 H.B. 555 merged with H.B. 648)

633.020 - Advisory council on developmental disabilities — members, number, terms, qualifications, appointment — organization, meetings — duties.

1.The "Missouri Developmental Disabilities Council", consisting of up to twenty-five members, the number to be determined under the council bylaws, is hereby created to advise the division and the division director.

2.The members of the Missouri planning council for developmental disabilities, created by executive order of the governor on October 26, 1979, for the remainder of their appointed terms, and up to five persons to be appointed by the director, for staggered terms of three years each, shall act as such advisory body.At the expiration of the term of each member, the director shall appoint an individual who shall hold office for a term of three years.At least one-half of the members shall be consumers.Other members shall have professional, research or personal interest in intellectual disabilities and developmental disabilities.At least one member shall be a manager of or a member of the board of directors of a sheltered workshop as defined in section 178.900.No more than one-fourth of the members shall be vendors or members of boards of directors, employees or officers of vendors, or any of their spouses, if such vendors receive more than fifteen hundred dollars under contract with the department; except that members of boards of directors of not-for-profit corporations shall not be considered members of board of directors of vendors under this subsection.

3.Meetings shall be held at least every ninety days or at the call of the division director or the council chairman, who shall be elected by the council.

4.Each member shall be reimbursed for reasonable and necessary expenses, including travel expenses, pursuant to department travel regulations, actually incurred in the performance of his official duties.

5.The council may be divided into subcouncils in accordance with its bylaws.

6.The council shall collaborate with the department in developing and administering a state plan for intellectual disabilities and developmental disabilities services.

7.No member of a state advisory council may participate in or seek to influence a decision or vote of the council if the member would be directly involved with the matter or if he would derive income from it.A violation of the prohibition contained herein shall be grounds for a person to be removed as a member of the council by the director.

8.The council shall be advisory and shall:

(1)Promote meetings and programs for the discussion of reducing the debilitating effects of intellectual disabilities and developmental disabilities and disseminate information in cooperation with any other department, agency or entity on the prevention, evaluation, care, treatment and habilitation for persons affected by intellectual disabilities and developmental disabilities;

(2)Study and review current prevention, evaluation, care, treatment and rehabilitation technologies and recommend appropriate preparation, training, retraining and distribution of manpower and resources in the provision of services to persons with an intellectual disability or a developmental disability through private and public residential facilities, day programs and other specialized services;

(3)Recommend what specific methods, means and procedures should be adopted to improve and upgrade the department's intellectual disabilities and developmental disabilities service delivery system for citizens of this state;

(4)Participate in developing and disseminating criteria and standards to qualify intellectual disability or developmental disability residential facilities, day programs and other specialized services in this state for funding or licensing, or both, by the department.

(L. 1980 H.B. 1724, A.L. 1982 H.B. 1565, A.L. 1990 S.B. 527, A.L. 2011 H.B. 555 merged with H.B. 648, A.L. 2014 H.B. 1064)

633.220 - Definitions — programs for persons with autism to be established — state to be divided into regions, regional projects, purchase of services — regional councils — advisory committee, duties — rulemaking authority.

1.For purposes of this section, the following terms shall mean:

(1)"Autism", a lifelong developmental disability that typically appears during the first three years of life resulting from a neurological disorder that affects brain functioning which interferes with communication, learning, behavior, and social development;

(2)"Division", the division of developmental disabilities;

(3)"Family support", services and helping relationships for the purpose of maintaining and enhancing family caregiving.Family support may be any combination of services that enable individuals with autism to reside within their family homes and remain integrated within their communities.Family support services shall be:

(a)Based on individual and family needs;

(b)Identified by the family;

(c)Easily accessible to the family;

(d)Family-centered and culturally sensitive;

(e)Flexible and varied to meet the changing needs of the family members; and

(f)Provided in a timely manner contingent upon the availability of resources;

(4)"Service provider", a person or entity which provides and receives reimbursement for autism programs and services as specified in this section.

2.The division of developmental disabilities shall establish programs and services for persons with autism.These programs and services shall be established in conjunction with persons with autism and with families of persons with autism.The division shall establish such programs and services in conjunction with the regional parent advisory councils and with the Missouri parent advisory committee on autism.The programs and services shall be designed to enhance persons with autism spectrum disorders and families' abilities to meet needs they identify and shall:

(1)Develop skills for persons with autism through supports, services, and teaching;

(2)Teach families to provide behavioral supports to members with autism; and

(3)Provide needed family support.

3.The division director, with input from the Missouri parent advisory council on autism, shall divide the state into at least five regions and establish autism programs and services which are responsive to the needs of persons with autism and families consistent with contemporary and emerging best practices.The boundaries of such regions, to the extent practicable, shall be contiguous with relevant boundaries of political subdivisions and health service areas.

4.The regional projects may provide or purchase, but shall not be limited to the following services in addition to other contemporary and emerging based practices:

(1)Assessment;

(2)Advocacy training;

(3)Behavior management training and supports;

(4)Communication and language therapy;

(5)Consultation on individualized education and habilitation plans;

(6)Crisis intervention;

(7)Information and referral assistance;

(8)Life skills;

(9)Music therapy;

(10)Occupational therapy, sensory integration therapy, and consultation;

(11)Parent or caregiver training;

(12)Public education and information dissemination;

(13)Respite care; and

(14)Staff training.

5.Each regional project shall have a regional parent advisory council composed of persons with autism and persons that have family members with autism, including family members that are young children, school-age children, and adults, and who have met the division's eligibility requirements to be a client as defined under section 630.005.Members of a regional parent advisory council shall be Missouri residents.No member shall be a service provider, a member of a service provider's board of directors, or an employee of a service provider or the division.

6.The responsibilities of each regional parent advisory council shall include, but not be limited to, the following:

(1)Advocacy;

(2)Contract monitoring;

(3)Review of annual audits of projects by the department of mental health;

(4)Recommendation of services to be provided based on input from families;

(5)Recommendation of policy, budget, and service priorities;

(6)Monthly review of service delivery;

(7)Planning;

(8)Public education and awareness;

(9)Recommendation of service providers to the division for administration of the project; and

(10)Recommendation of contract cancellation.

7.The division shall establish the Missouri parent advisory committee on autism.The committee shall be appointed by the division director.A chair of the committee shall be selected by members of the committee.It shall be composed of:

(1)Two representatives and one alternate from each of the regional parent advisory committees established in subsection 3 of this section;

(2)One person with autism and his or her alternate.

8.The division director shall make every effort to appoint members nominated by the regional parent advisory councils.The membership should represent the cultural diversity of the state and represent persons with autism of all ages and capabilities.

9.The responsibilities of the Missouri parent advisory committee on autism shall include, but not be limited to, the following:

(1)Serve as a liaison with the regional parent advisory councils and provide current information to them and the persons and families they serve;

(2)Determine project outcomes for autism services;

(3)Plan and sponsor statewide activities;

(4)Recommend service providers to the division director in the event a regional parent advisory committee and the district administrator cannot reach consensus; and

(5)Provide an annual report to the Missouri commission on autism spectrum disorders, the governor, the director of the department of mental health, and director of the division of developmental disabilities.

10.The director of the department of mental health shall promulgate rules and regulations to implement 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, 2009, shall be invalid and void.

(L. 2009 H.B. 525 merged with S.B. 157)

633.155 - Admission for respite care for limited time only.

1.The division may provide or obtain respite care for an intellectually disabled or developmentally disabled person for respite care of up to twenty-one days which may be extended up to an additional twenty-one days for good cause shown.Any additional respite care beyond forty-two days within a one-year period shall be expressly approved by the director of the division.

2.Notwithstanding the provisions of section 633.120 and section 475.120, a regional center may admit an intellectually disabled or developmentally disabled person who has been declared legally incapacitated for respite care without a court order authorizing the guardian of such person to obtain such care of up to twenty-one days for good cause shown.

(L. 1980 H.B. 1724, A.L. 1983 S.B. 44 & 45, A.L. 1990 H.B. 1383, A.L. 2011 H.B. 555 merged with H.B. 648)

633.200 - Commission established, members, duties.

1.For purposes of this section, the term "autism spectrum disorder" shall be defined as in standard diagnostic criteria for pervasive developmental disorder, to include autistic disorder; Asperger's syndrome; pervasive developmental disorder-not otherwise specified; childhood disintegrative disorder; and Rett's syndrome.

2.There is hereby created the "Missouri Commission on Autism Spectrum Disorders" to be housed within the department of mental health.The department of mental health shall provide technical and administrative support as required by the commission.The commission shall meet on at least four occasions annually, including at least two occasions before the end of December of the first year the commission is fully established.The commission may hold meetings by telephone or video conference.The commission shall advise and make recommendations to the governor, general assembly, and relevant state agencies regarding matters concerning all state levels of autism spectrum disorder services, including health care, education, and other adult and adolescent services.

3.The commission shall be composed of twenty-four members, consisting of the following:

(1)Four members of the general assembly, with two members from the senate and two members from the house of representatives.The president pro tem of the senate shall appoint one member from the senate and the minority leader of the senate shall appoint one member from the senate.The speaker of the house shall appoint one member from the house of representatives and the minority leader of the house shall appoint one member from the house of representatives;

(2)The director of the department of mental health, or his or her designee;

(3)The commissioner of the department of elementary and secondary education, or his or her designee;

(4)The director of the department of health and senior services, or his or her designee;

(5)The director of the department of public safety, or his or her designee;

(6)The commissioner of the department of higher education, or his or her designee;

(7)The director of the department of social services, or his or her designee;

(8)The director of the department of insurance, financial institutions and professional registration, or his or her designee;

(9)Two representatives from different institutions of higher learning located in Missouri;

(10)An individual employed as a director of special education at a school district located in Missouri;

(11)A speech and language pathologist;

(12)A diagnostician;

(13)A mental health provider;

(14)A primary care physician;

(15)Two parents of individuals with autism spectrum disorder, including one parent of an individual under the age of eighteen and one parent of an individual over the age of eighteen;

(16)Two individuals with autism spectrum disorder;

(17)A representative from an independent private provider or nonprofit provider or organization;

(18)A member of a county developmental disability board.

The members of the commission, other than the members from the general assembly and ex-officio members, shall be appointed by the director of the department of mental health.A chair of the commission shall be selected by the members of the commission.Of the members first appointed to the commission by the governor, half shall serve a term of four years and half shall serve a term of two years, and thereafter, members shall serve a term of four years and may be reappointed.Members shall continue to serve until their successor is duly appointed and qualified.Any vacancy on the commission shall be filled in the same manner as the original appointment.Members shall serve on the commission without compensation but may be reimbursed for their actual and necessary expenses from moneys appropriated to the department of mental health.

4.The members of the commission shall consist of a broad representation of Missouri citizens, both urban and rural, who are concerned with the health and quality of life for individuals with autism spectrum disorder.

5.The commission shall make recommendations for developing a comprehensive statewide plan for an integrated system of training, treatment, and services for individuals of all ages with autism spectrum disorder.By July 1, 2009, the commission shall issue preliminary findings and recommendations to the general assembly.

6.In preparing the state plan, the commission shall specifically perform the following responsibilities and report on them accordingly, in conjunction with state agencies and the office of autism services:

(1)Study and report on the means for developing a comprehensive, coordinated system of care delivery across the state to address the increased and increasing presence of autism spectrum disorder and ensure that resources are created, well-utilized, and appropriately spread across the state:

(a)Determine the need for the creation of additional centers for diagnostic excellence in designated sectors of the state, which could provide clinical services, including assessment, diagnoses, and treatment of patients;

(b)Plan for effectively evaluating regional service areas throughout the state and their capacity, including outlining personnel and skills that exist within the service area, other capabilities that exist, and resource needs that may be unmet;

(c)Assess the need for additional behavioral intervention capabilities and, as necessary, the means for expanding those capabilities in a regional service area;

(d)Develop recommendations for expanding these services in conjunction with hospitals after considering the resources that exist in terms of specialty clinics and hospitals, and hospital inpatient care capabilities;

(2)Conduct an assessment of the need for coordinated, enhanced and targeted special education capabilities within each region of the state;

(3)Develop a recommendation for enlisting appropriate universities and colleges to ensure support and collaboration in developing certification or degree programs for students specializing in autism spectrum disorder intervention.This may include degree programs in education, special education, social work, and psychology; and

(4)Other responsibilities may include but not be limited to:

(a)Provide recommendations regarding training programs and the content of training programs being developed;

(b)Recommend individuals to participate in a committee of major stakeholders charged with developing screening, diagnostic, assessment, and treatment standards for Missouri;

(c)Participate in recommending a panel of qualified professionals and experts to review existing models of evidence-based educational practices for adaptation specific to Missouri;

(d)Examine the barriers to accurate information of the prevalence of individuals with autism spectrum disorder across the state and recommend a process for accurate reporting of demographic data;

(e)Explore the need for the creation of interagency councils and evaluation of current councils to ensure a comprehensive, coordinated system of care for all individuals with autism spectrum disorder;

(f)Study or explore other developmental delay disorders and genetic conditions known to be associated with autism, including fragile X syndrome; Sotos syndrome; Angelman syndrome; and tuberous sclerosis.

(L. 2008 S.B. 768, A.L. 2018 S.B. 843)

633.300 - Group homes and facilities subject to federal and state law — workers subject to training requirements — rulemaking authority.

1.All group homes and developmental disability facilities as defined in section 633.005 shall be subject to all applicable federal and state laws, regulations, and monitoring, including but not limited to sections 630.705 to 630.805.

2.All mental health workers, as defined in subdivision (8) of section 210.900, shall be subject to the same training requirements established for state mental health workers with comparable positions in public group homes and mental health facilities.Such required training shall be paid for by the employer.

3.Group homes and developmental disability facilities shall be subject to the same medical errors reporting requirements of other mental health facilities and group homes.

4.The department shall promulgate rules or amend existing rules to implement the provisions of 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, 2008, shall be invalid and void.

(L. 2008 S.B. 1081, A.L. 2011 H.B. 555 merged with H.B. 648)

633.100 - Department to establish regional centers.

The department shall establish regional centers in regions located throughout the state.

(L. 1980 H.B. 1724)

633.210 - Office of autism services established, duties — autism spectrum disorder defined.

1.There is hereby established in the department of mental health within the division of developmental disabilities, an "Office of Autism Services".The office of autism services, under the supervision of the director of the division of developmental disabilities, shall provide leadership in program development for children and adults with autism spectrum disorders, to include establishment of program standards and coordination of program capacity.

2.For purposes of this section, the term "autism spectrum disorder" shall be defined as in standard diagnostic criteria for pervasive developmental disorder, to include:autistic disorder; Asperger's syndrome; pervasive developmental disorder-not otherwise specified; childhood disintegrative disorder; and Rett's syndrome.

(L. 2008 S.B. 768 § 633.225, A.L. 2011 H.B. 555 merged with H.B. 648)

633.010 - Responsibilities, powers, functions and duties of division.

1.The division of developmental disabilities, created by the omnibus reorganization act of 1974, section 9, appendix B, RSMo, shall be a division of the department.The division shall have the responsibility of insuring that intellectual disabilities and developmental disabilities prevention, evaluation, care, habilitation and rehabilitation services are accessible, wherever possible.The division shall have and exercise supervision of division residential facilities, day programs and other specialized services operated by the department, and oversight over facilities, programs and services funded or licensed by the department.

2.The powers, functions and duties of the division shall include the following:

(1)Provision of funds for the planning and implementation of accessible programs to serve persons affected by intellectual disabilities and developmental disabilities;

(2)Review of developmental disabilities plans submitted to receive state and federal funds allocated by the department;

(3)Provision of technical assistance and training to community-based programs to assist in the planning and implementation of quality services;

(4)Assurance of program quality in compliance with such appropriate standards as may be established by the department;

(5)Sponsorship and encouragement of research into the causes, effects, prevention, habilitation and rehabilitation of intellectual disabilities and developmental disabilities;

(6)Provision of public information relating to developmental disabilities and their habilitation;

(7)Cooperation with nonstate governmental agencies and the private sector in establishing, conducting, integrating and coordinating developmental disabilities programs and projects;

(8)Cooperation with other state agencies to encourage appropriate health facilities to serve, without discrimination, persons with an intellectual disability or a developmental disability who require medical care and to provide them with adequate and appropriate services;

(9)Participation in developing and implementing a statewide plan to alleviate problems relating to developmental disabilities and to overcome the barriers to their solutions;

(10)Encouragement of coordination of division services with other divisions of the department and other state agencies;

(11)Encouragement of the utilization, support, assistance and dedication of volunteers to assist persons affected by intellectual disabilities or developmental disabilities to be accepted and integrated into normal community activities;

(12)Evaluation, or the requirement of the evaluation, including the collection of appropriate necessary information, of developmental disabilities programs to determine their cost-and-benefit effectiveness;

(13)Participation in developing standards for residential facilities, day programs and specialized services operated, funded or licensed by the department for persons affected by developmental disabilities.

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

633.110 - What services may be provided — consent required, when.

1.Any person suspected to have an intellectual disability or developmental disability shall be eligible for initial diagnostic and counseling services through the regional centers.

2.If it is determined by a regional center through a comprehensive evaluation that a person has an intellectual disability or a developmental disability so as to require the provision of services, and if such person, such person's parent, if the person is a minor, or legal guardian, requests that he be registered as a client of a regional center, the regional center shall, within the limits of available resources, secure a comprehensive program of any necessary services for such person.Such services may include, but need not be limited to, the following:

(1)Diagnosis and evaluation;

(2)Counseling;

(3)Respite care;

(4)Recreation;

(5)Habilitation;

(6)Training;

(7)Vocational habilitation;

(8)Residential care;

(9)Homemaker services;

(10)Developmental day care;

(11)Sheltered workshops;

(12)Referral to appropriate services;

(13)Placement;

(14)Transportation.

3.In securing the comprehensive program of services, the regional centers shall involve the client, his family or his legal guardian in decisions affecting his care, habilitation, placement or referral.Nothing in this chapter shall be construed as authorizing the care, treatment, habilitation, referral or placement of any person with an intellectual disability or developmental disability to any residential facility, day program or other specialized service without the written consent of the client, his parent, if he is a minor, or his legal guardian, unless such care, treatment, habilitation, referral, or placement is authorized pursuant to an order of the court under the provisions of chapter 475.

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

633.145 - Transfer of patient between facilities by department — notice, consent.

1.The department may transfer a resident from one department developmental disability facility to another if the division director determines that such transfer is desirable to provide the resident improved habilitation or other services, to better insure his safety and welfare, or to locate him in closer proximity to his family and friends.

2.Transfers may only be made to a private developmental disability facility pursuant to section 630.610.

3.Determinations by the division director pursuant to this section shall be written and noted in the resident's records.The division director shall notify the resident, his guardian or next of kin of such determination.The department shall not transfer any resident unless it receives the consent of the resident, his guardian or his parent, if the resident is a minor.

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

633.045 - Duties of regional advisory councils — plans.

1.Any regional advisory councils established under section 633.040 shall participate in the preparation of regional plans and annually review, advise on and recommend them before they are transmitted to the state advisory council and the division director.The plans shall include at least the following:

(1)An inventory of existing residential facilities, day programs and specialized services for persons with an intellectual disability or a developmental disability;

(2)An assessment of needs, including any special target populations, of unserved, underserved or inappropriately served persons;

(3)A statement of specific goals for the region.

2.Any staff of such regional advisory councils shall be provided only from funds appropriated specifically for that purpose.This subsection shall become effective July 1, 1981.

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

633.015 - Division director to be chief administrative officer.

The division director, subject to the supervision of the director, shall be the chief administrative officer of his division and shall exercise for the division the powers and duties of an appointing authority under chapter 36 to employ such administrative, technical and other personnel, except employees of department facilities, as may be necessary for the performance of the powers and duties of the division.

(L. 1980 H.B. 1724)

633.115 - Entities to be used by regional centers.

The regional center shall secure services for its clients in the least restrictive environment consistent with individualized habilitation plans.As a result of its comprehensive evaluation, the regional center shall utilize the following entities to secure services:

(1)Agencies serving persons not diagnosed with an intellectual disability or developmental disability in which the client would be eligible to receive available services or in which the services could be made available to the client through the purchase of assistive or supportive services;

(2)Agencies serving persons with an intellectual disability or developmental disability in which the client would be eligible to receive available services or in which services could be made available to the client through the purchase of assistive or supportive services;

(3)The regional center on a day-program basis;

(4)The regional center for short-term residential services, not to exceed six months, unless expressly authorized for a longer period by the division director;

(5)A residential facility licensed through the department placement program, but not operated by the department;

(6)A developmental disability facility operated by the department for clients who are persons with an intellectual disability or developmental disability.

(L. 1980 H.B. 1724, A.L. 1990 H.B. 1383, A.L. 2011 H.B. 555 merged with H.B. 648)

633.140 - Return of absentee, procedure.

1.If any resident leaves a developmental disability facility without authorization, the sheriff of the county where the resident is found shall apprehend and return him to the center if requested to do so by the head of the facility.

2.The head of the facility may request the return of an absent resident pursuant to subsection 1 of this section only when one of the following circumstances exists:

(1)The resident is a minor whose admission was applied for by his parent or legal custodian, and such parent or guardian has not requested the resident's release;

(2)The resident is a minor under the jurisdiction of the juvenile court;

(3)The resident has been declared legally incapacitated and his guardian has not requested his release; or

(4)The resident's condition is of such a nature that, for the protection of the resident or others, the head of the facility determines that the resident's return to the facility is necessary.Such determination shall be noted in the resident's records.

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

633.040 - Department director may establish regional councils — division director to appoint members — terms and qualifications of members.

1.The director may establish regional councils in any of the regions.If a regional council is established in a region, the division director shall appoint up to twenty members who reside in the region to serve staggered three-year terms on the councils.

2.At least one-half of the members shall be consumers and no more than one-fourth of the members shall be vendors, or employees, members of boards of directors or officers of vendors, or their spouses, if such vendors receive more than fifteen hundred dollars under contract with the department; except that members of boards of directors of not-for-profit corporations shall not be subject to the one-fourth limitation on the membership under this subsection.Any council which had duties to advise any regional center under statutes in effect before August 13, 1980, shall not be subject to the one-fourth membership restriction for vendors under this subsection until September 28, 1985.

3.No member of a regional advisory council may participate in or seek to influence a decision or vote of the council if the member would be directly involved with the matter or if he would derive income from it.A violation of the prohibition contained herein shall be grounds for a person to be removed as a member of the council by the director.

(L. 1980 H.B. 1724)

633.050 - Regional councils to review, advise and recommend — duties.

1.In addition to such other advisory functions as may be agreed upon with the division, the regional advisory councils shall review and advise on programs and policies of the regional centers.The councils shall review, advise on, and recommend regional program budgets and shall report to the division director their findings as to their conformity with the regional plans before they are transmitted to the department to be considered for inclusion in the department budget request.

2.The regional councils may advise the department, the division and the regional centers on methods of operation and service delivery which will assure comprehensive services with the minimum amount of duplication, fragmentation and unnecessary expenditures.In making such proposals, the councils shall consider the most appropriate use of existing agencies and professional personnel providing residential facilities, day programs and other specialized services for persons with an intellectual disability or developmental disability in their regions.

3.The duties of the regional advisory councils shall include:

(1)Determining the disbursement of the cash stipend as established in section 633.180 and the family support loan as established in section 633.185;

(2)Providing direction and assistance to the regional center in the development of a family support plan based upon the needs in the region;

(3)Approval of the regional family support plan;

(4)Monitoring the implementation of the family support plan;

(5)Providing an annual written report to the department of mental health regarding the activities of the family support council.

(L. 1980 H.B. 1724, A.L. 1993 H.B. 330, A.L. 2011 H.B. 555 merged with H.B. 648)

633.150 - Transfer of patient to mental health facility by head of developmental disability facility, how.

The head of a developmental disability facility may transfer a resident to a mental health facility only under the provisions of chapter 632.The director shall order that such resident be returned to the developmental disability facility when the resident is no longer in need of psychiatric care and treatment.

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

633.309 - No transfer to homes or facilities with noncompliance notices.

The department of mental health shall not transfer any person to any group home or developmental disability facility that has received a notice of noncompliance, until there is an approved plan of correction pursuant to sections 630.745 and 630.750.

(L. 2008 S.B. 1081, A.L. 2011 H.B. 555 merged with H.B. 648)

633.105 - Regional centers to secure services.

The regional centers shall be the entry and exit points in each region responsible for securing comprehensive intellectual disability and developmental disability services for clients of the department.The center shall carry out this responsibility either through contracts purchasing the required services or through the direct provision of the services if community-based services are not available, economical or as effective for the provision of the services.

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

633.401 - Definitions — assessment imposed, formula — rates of payment — fund created, use of moneys — record-keeping requirements — report — appeal process — rulemaking authority — expiration date.

1.For purposes of this section, the following terms mean:

(1)"Engaging in the business of providing health benefit services", accepting payment for health benefit services;

(2)"Intermediate care facility for the intellectually disabled", a private or department of mental health facility which admits persons who are intellectually disabled or developmentally disabled for residential habilitation and other services pursuant to chapter 630.Such term shall include habilitation centers and private or public intermediate care facilities for the intellectually disabled that have been certified to meet the conditions of participation under 42 CFR, Section 483, Subpart I;

(3)"Net operating revenues from providing services of intermediate care facilities for the intellectually disabled" shall include, without limitation, all moneys received on account of such services pursuant to rates of reimbursement established and paid by the department of social services, but shall not include charitable contributions, grants, donations, bequests and income from nonservice related fund-raising activities and government deficit financing, contractual allowance, discounts or bad debt;

(4)"Services of intermediate care facilities for the intellectually disabled" has the same meaning as the term services of intermediate care facilities for the mentally retarded, as used in Title 42 United States Code, Section 1396b(w)(7)(A)(iv), as amended, and as such qualifies as a class of health care services recognized in federal Public Law 102-234, the Medicaid Voluntary Contribution and Provider Specific Tax Amendments of 1991.

2.Beginning July 1, 2008, each provider of services of intermediate care facilities for the intellectually disabled shall, in addition to all other fees and taxes now required or paid, pay assessments on their net operating revenues for the privilege of engaging in the business of providing services of the intermediate care facilities for the intellectually disabled or developmentally disabled in this state.

3.Each facility's assessment shall be based on a formula set forth in rules and regulations promulgated by the department of mental health.

4.For purposes of determining rates of payment under the medical assistance program for providers of services of intermediate care facilities for the intellectually disabled, the assessment imposed pursuant to this section on net operating revenues shall be a reimbursable cost to be reflected as timely as practicable in rates of payment applicable within the assessment period, contingent, for payments by governmental agencies, on all federal approvals necessary by federal law and regulation for federal financial participation in payments made for beneficiaries eligible for medical assistance under Title XIX of the federal Social Security Act.

5.Assessments shall be submitted by or on behalf of each provider of services of intermediate care facilities for the intellectually disabled on a monthly basis to the director of the department of mental health or his or her designee and shall be made payable to the director of the department of revenue.

6.In the alternative, a provider may direct that the director of the department of social services offset, from the amount of any payment to be made by the state to the provider, the amount of the assessment payment owed for any month.

7.Assessment payments shall be deposited in the state treasury to the credit of the "Intermediate Care Facility Intellectually Disabled Reimbursement Allowance Fund", which is hereby created in the state treasury.All investment earnings of this fund shall be credited to the fund.Notwithstanding the provisions of section 33.080 to the contrary, any unexpended balance in the intermediate care facility intellectually disabled reimbursement allowance fund at the end of the biennium shall not revert to the general revenue fund but shall accumulate from year to year.The state treasurer shall maintain records that show the amount of money in the fund at any time and the amount of any investment earnings on that amount.

8.Each provider of services of intermediate care facilities for the intellectually disabled shall keep such records as may be necessary to determine the amount of the assessment for which it is liable under this section.On or before the forty-fifth day after the end of each month commencing July 1, 2008, each provider of services of intermediate care facilities for the intellectually disabled shall submit to the department of social services a report on a cash basis that reflects such information as is necessary to determine the amount of the assessment payable for that month.

9.Every provider of services of intermediate care facilities for the intellectually disabled shall submit a certified annual report of net operating revenues from the furnishing of services of intermediate care facilities for the intellectually disabled.The reports shall be in such form as may be prescribed by rule by the director of the department of mental health.Final payments of the assessment for each year shall be due for all providers of services of intermediate care facilities for the intellectually disabled upon the due date for submission of the certified annual report.

10.The director of the department of mental health shall prescribe by rule the form and content of any document required to be filed pursuant to the provisions of this section.

11.Upon receipt of notification from the director of the department of mental health of a provider's delinquency in paying assessments required under this section, the director of the department of social services shall withhold, and shall remit to the director of the department of revenue, an assessment amount estimated by the director of the department of mental health from any payment to be made by the state to the provider.

12.In the event a provider objects to the estimate described in subsection 11 of this section, or any other decision of the department of mental health related to this section, the provider of services may request a hearing.If a hearing is requested, the director of the department of mental health shall provide the provider of services an opportunity to be heard and to present evidence bearing on the amount due for an assessment or other issue related to this section within thirty days after collection of an amount due or receipt of a request for a hearing, whichever is later.The director shall issue a final decision within forty-five days of the completion of the hearing.After reconsideration of the assessment determination and a final decision by the director of the department of mental health, an intermediate care facility for the intellectually disabled provider's appeal of the director's final decision shall be to the administrative hearing commission in accordance with sections 208.156 and 621.055.

13.Notwithstanding any other provision of law to the contrary, appeals regarding this assessment shall be to the circuit court of Cole County or the circuit court in the county in which the facility is located.The circuit court shall hear the matter as the court of original jurisdiction.

14.Nothing in this section shall be deemed to affect or in any way limit the tax-exempt or nonprofit status of any intermediate care facility for the intellectually disabled granted by state law.

15.The director of the department of mental health shall promulgate rules and regulations to implement 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, 2008, shall be invalid and void.

16.The provisions of this section shall expire on September 30, 2019.

(L. 2008 S.B. 1081, A.L. 2009 H.B. 395 merged with H.B. 740, A.L. 2011 S.B. 62, A.L. 2014 H.B. 1064, A.L. 2015 S.B. 210, A.L. 2016 H.B. 1534, A.L. 2018 S.B. 775)

Expires 9-30-19

CROSS REFERENCE:

Nonseverability clause, 190.840

633.005 - Definitions.

As used in this chapter, unless the context clearly requires otherwise, the following terms shall mean:

(1)"Comprehensive evaluation", a study, including a sequence of observations and examinations, of an individual leading to conclusions and recommendations formulated jointly by an interdisciplinary team of persons with special training and experience in the diagnosis and habilitation of a person with an intellectual disability or a developmental disability;

(2)"Developmental disability facility", a private or department facility, other than a regional center, which admits persons with an intellectual disability or a developmental disability for residential habilitation and other services and which is qualified or licensed as such by the department pursuant to chapter 630.Such terms shall include, but shall not be limited to, habilitation centers and private or public residential facilities for persons with an intellectual disability or a developmental disability;

(3)"Division", the division of developmental disabilities of the department of mental health;

(4)"Division director", the director of the division of developmental disabilities of the department of mental health, or his designee;

(5)"Group home", a residential facility serving nine or fewer residents, similar in appearance to a single-family dwelling and providing basic health supervision, habilitation training in skills of daily and independent living and community integration, and social support.Group homes do not include a family living arrangement or individualized supported living;

(6)"Regional center", an entity so designated by the department to provide, directly or indirectly, for comprehensive developmental disability services under this chapter in a particular region;

(7)"Respite care", temporary and short-term residential care, sustenance and supervision of a person with an intellectual disability or a developmental disability who otherwise resides in a family home;

(8)"State advisory council", the Missouri developmental disabilities council as created in section 633.020.

(L. 1980 H.B. 1724, A.L. 1990 H.B. 1383, A.L. 2008 S.B. 1081, A.L. 2011 H.B. 555 merged with H.B. 648)

633.170 - Definitions.

As used in sections 633.170 to 633.195* and section 208.500**, the following terms mean:

(1)"Adult", a person eighteen years of age or older;

(2)"Child", a person under the age of eighteen;

(3)"Developmental disability", a disability which:

(a)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 a combination of mental and physical impairments;

(b)Is manifested before the person attains age twenty-two;

(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; and

f.Mobility;

(e)Reflects the person's need for a combination and sequence of special, interdisciplinary or generic care, or other services;

(f)Reflects the person's need for services and supports which may be of lifelong or extended duration and are individually planned and coordinated;

(4)"Family or private caregiver", the person or persons with whom the individual who has a developmental disability resides or who is primarily responsible for the physical care, education, health, and nurturing of the person with a disability.The term does not apply to persons providing care through hospitals, habilitation centers, nursing homes, group homes, or any other such institution;

(5)"Family support", services and helping relationships whose purpose is to maintain and enhance family caregiving.Family support may be one or many services that enable individuals with disabilities to reside within the family home and remain integrated within their community and are:

(a)Based on individual and family needs;

(b)Identified by the family;

(c)Easily accessible for the family;

(d)Flexible and varied to meet the ever-changing needs of family members;

(e)Provided in a timely manner; and

(f)Family-centered and culturally sensitive;

(6)"Family support program", a coordinated system of family support services which enhance family caregiving, strengthen family functioning, reduce family stress, foster community integration, promote individual and family independence and encourage economic self-sufficiency for the purpose of helping children with developmental disabilities remain with their families.

(L. 1993 H.B. 330 § 1, A.L. 2014 H.B. 1064)

*Section 633.195 does not exist.

**Section 208.500 was repealed by H.B. 1608, 2012.

633.029 - Definition to determine status of eligibility.

All persons determined eligible for services provided by the division of developmental disabilities prior to January 1, 1991, shall be eligible for services on the basis of their earlier determination of eligibility without regard to their eligibility status under the definition of developmental disability contained in section 630.005.

(L. 1990 H.B. 1383, A.L. 2011 H.B. 555 merged with H.B. 648)

633.125 - Discharge from facility, when — may be denied, procedure thereafter — referral to regional center for placement, when.

1.A resident admitted to a developmental disability facility pursuant to section 633.120 shall be discharged immediately when the person who applied for his admission requests the release orally, in writing or otherwise from the head of the developmental disability facility; except, that if the head of the developmental disability facility regards the resident as presenting a likelihood of serious harm to himself or others, the head of the facility may initiate involuntary detention procedures pursuant to chapter 632, if appropriate, or any individual, including the head of the facility or the mental health coordinator may initiate guardianship proceedings and, if appropriate, obtain an emergency commitment order pursuant to chapter 475.

2.A resident shall be discharged from a department developmental disability facility if it is determined in a comprehensive evaluation or periodic review that the person is not intellectually disabled or developmentally disabled, and if the resident, parent, if a minor, or guardian consents to the discharge.If consent is not obtained, the head of the facility shall initiate appeal proceedings under section 633.135, before a resident can be discharged.

3.A resident shall either be discharged from a department developmental disability facility or shall be referred to a regional center for placement in a least restrictive environment pursuant to section 630.610, if it is determined in a comprehensive evaluation or periodic review that the following criteria exist:

(1)The resident's condition is not of such a nature that for the protection or adequate care of the resident or others the resident needs department residential habilitation or other services;

(2)The developmental disability facility does not offer a program which best meets the resident's needs; or

(3)The developmental disability facility does not provide the least restrictive environment feasible.A resident may not be discharged without his consent or the consent of his parent, if he is a minor, or guardian unless proceedings have been completed under section 633.135.

4.After a resident's discharge pursuant to subsection 3 of this section, the resident shall be referred to an appropriate regional center for assistance in obtaining any necessary services.

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

633.025 - Services to be provided.

The division may provide habilitation and such related services directly or through contracts with an appropriate residential facility, day program or specialized service licensed and funded by the department.

(L. 1980 H.B. 1724)

633.035 - Department director to establish regions.

The director shall divide the state into regions.The boundaries of such regions, to the extent practicable, shall be contiguous with relevant boundaries of political subdivisions and health service areas.

(L. 1980 H.B. 1724)

633.135 - Refusal of consent for placement or discharge, effect — procedure — department director to make final determination — appeal, procedure — burden of proof.

1.If a resident, or his parent if he is a minor, or his legal guardian refuses to consent to the proposed placement or to discharge from the facility, the head of the developmental disability facility may petition the director of the division to determine whether the proposed placement is appropriate under sections 630.610, 630.615 and 630.620 or whether the proposed discharge is appropriate under sections 633.120, 633.125 and 633.130.

2.The division director shall refer the petition to the chairman of the state advisory council who shall appoint and convene a review panel composed of three members.At least one member of the panel shall be a parent or guardian of a resident who resides in a department developmental disability facility.The remaining members of the panel shall be persons who are from nongovernmental organizations or groups concerned with the prevention of intellectual disability or developmental disability, evaluation, care and habilitation of intellectually disabled or developmentally disabled persons and who are familiar with services and service needs of intellectually disabled or developmentally disabled persons in facilities operated by the department.No member of the panel shall be an officer or employee of the department.

3.After prompt notice and hearing, the panel shall determine whether the proposed placement is appropriate under sections 630.610, 630.615 and 630.620 or whether the proposed discharge is appropriate under sections 633.120, 633.125 and 633.130.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 resident, 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.

4.If the resident, 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 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 sustained his burden of proof that the proposed placement is appropriate under sections 630.110, 630.115 and 630.120, or the proposed discharge is appropriate under sections 633.120, 633.125 and 633.130.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.

5.Any resident of a developmental disability facility who is age eighteen or older and who does not have a legal guardian shall not be discharged unless probate division of the circuit court approval is obtained to confirm that the resident is not in need of the care, treatment or programs now being received in the developmental disability facility.

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 preponderance of evidence that the proposed placement is appropriate under the criteria set forth in sections 630.610, 630.615, and 630.120, or that the proposed discharge is appropriate under the criteria set forth in sections 633.120, 633.125 and 633.130.

8.Pending a 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 resident from a facility except that the department may temporarily transfer such resident in the case of a medical emergency.

9.There shall be no disciplinary action against any state employee who in good faith testifies or otherwise provides information or evidence in regard to a proposed placement or discharge.

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

633.160 - Emergency admission may be made, duration, conditions.

If a person presents himself, or is presented, to a regional center or department developmental disability facility and is determined to be intellectually disabled or developmentally disabled and, as a result, presents an imminent likelihood of serious harm to himself or others as defined in chapter 632, the regional center or developmental disability facility may accept the person for detention for evaluation and treatment for a period not to exceed ninety-six hours under the same procedures contained in chapter 632.The head of the regional center or developmental disability facility may initiate guardianship proceedings to have the person detained beyond the ninety-six hours under chapter 475, or may refer the person to a mental health facility, if the person is mentally ill, for further detention under the procedures in chapter 632.