Mo. Code Regs. tit. 19 § 15-7.010

Current through Register Vol. 49, No. 9, May 1, 2024

Section 19 CSR 15-7.010 - General Requirements for All Service Providers

PURPOSE: This amendment amends the purpose statement, updates terms and statutory and regulatory references throughout the rule, and updates requirements of service providers.

PURPOSE: This rule describes the general requirements that all service providers shall meet to receive grants or subgrants to provide services for older adults or low income adults with disabilities funded by the division or area agencies on aging.

PUBLISHER'S NOTE: The secretary of state has determined that publication of the entire text of the material that is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here.

(1) Service providers shall meet all applicable state and local licensure and safety requirements for the provision of those particular services.

(2) Service providers shall maintain any licensure, certification or registration mandated by any state or local government, body or board.

(3) Service providers shall allow only employees or volunteers holding a current license, certification or registration to perform those tasks, duties or functions for which licensure, certification or registration is required by any state or local agency, body or board.

(4) Service providers shall have an adequate number of staff (paid or volunteer) who are qualified to perform assigned functions in order to implement the activities and services.

(A) Multilingual staff shall be available when there are substantial numbers of non-English speaking participants.

(B) A written job description for each position function and responsibility and the line of supervisory authority for each position (paid and volunteer) shall be developed and maintained. Personnel qualifications shall meet job description requirements.

(C) A written performance evaluation of each paid staff member shall be done at least annually and shall be maintained in the employee's personnel file.

(D) A training file shall be maintained that documents the type of training provided, names of staff and volunteers participating, number of hours of training provided and date(s) training was provided. A report of each employee's orientation and in-service training provided by the service provider and from other sources shall be placed in that employee's personnel file.

(5) Centers shall be in compliance with all applicable state and local fire and safety laws, as well as the following requirements:

(A) If the division determines that the state or local fire safety laws, ordinances or codes are not adequate to assure the safety of older persons or for any locality that has no governing fire and safety laws, ordinances or codes, the provisions of the National Fire Protection Association Life Safety Code (NFPA No. 101, 1981 edition) for places of assembly shall apply;

(B) Centers shall have installed and shall maintain in operable condition an adequate number of smoke detectors and fire extinguishers of the appropriate type as determined by consultation with state or local fire authorities. All smoke detectors and fire extinguishers shall be located within the premises according to the recommendations of state or local fire authorities;

(C) Centers shall develop a written safety and evacuation plan for assuring the safety of participants, staff, and volunteers in case of fire or other hazardous situations and evacuation drills shall be conducted annually. Copies of the plan shall be on file at the center and at the area agency on aging's office and a charted plan shall be posted conspicuously in the center. The plan and procedures shall include but need not necessarily be limited to-

1. A written assessment of potential fire or safety hazards present on the premises and actions and procedures that are to be followed to minimize danger;

2. A written schedule for annual check of smoke detectors and fire extinguishers to assure that adequate pressure or battery strength is maintained for efficient operation when needed; and

3. A written training plan including frequency of comprehensive and refresher training for staff and volunteers on safety responsibilities and actions to be taken if an emergency situation occurs with documentation of training sessions provided; and

(D) Fire inspections shall be conducted annually at all centers by state or local fire authorities. Documentation of the inspector's report, recommendations, and corrections of any deficiencies shall be maintained at the area agency on aging and center offices.

(6) Service providers whose staff have direct physical contact with participants shall make emergency arrangements in consultation with relevant agencies for dealing with participant personal emergencies that include-

(A) Specific personnel designated and trained to take charge in an emergency;

(B) A person, present or immediately available during all hours that the center is open, who has successfully completed a training course in first aid or emergency care that included at least:

1. Basic first aid;

2. Cardiopulmonary resuscitation (CPR);

3. Heimlich maneuver; and

4. Guidelines on when to attempt first aid or when to take alternative action; and

(C) Written instructions posted conspicuously which include the 911 emergency telephone number, if available, or other local emergency telephone numbers, such as those of physicians, ambulances, hospital emergency rooms, and local civil defense or disaster offices if the 911 number is not available in the community.

(7) Caterers and centers in which food is prepared, served, or both, shall be maintained in a safe and sanitary manner and shall be in compliance with all applicable state, county, or city health codes. Each location at which food is prepared shall be inspected annually by state or local health authorities. Each location at which prepared food is received from another source shall be inspected annually by state or local health authorities. Documentation of the inspector's report, recommendations, and corrections of any deficiencies shall be kept at both the area agency on aging and center offices.

(8) Service provider staff and volunteers shall be familiar with and shall be able to recognize situations of possible abuse, neglect, exploitation, or likelihood of serious physical harm involving older adults. Instances of potential abuse, neglect, explotation, or likelihood of serious physical harm shall be immediately reported to the division's Adult Abuse and Neglect Hotline (1-800-392-0210) or Missouri Adult Abuse and Neglect Online Reporting System (https://health.mo.gov/safety/abuse/).

(9) Service providers shall provide the following:

(A) Public information and education activities to ensure that older adults are informed of the services available and have maximum opportunity for participation;

(B) Coordination with other service providers in the planning and service area to assure comprehensive delivery of services and reduce duplication; and

(C) A written complaint procedure through which the participant can communicate to the service provider aspects of the service which impact negatively upon them.

(10) Service providers who use volunteers shall develop a written plan for recruiting, orienting, training, supervising and terminating volunteers.

(11) Service providers shall serve older adults with the greatest economic or social need, especially low-income minority persons, older adults residing in rural areas, and frail individuals. Service providers may use methods such as location of services and specialization in the types of services most needed by these groups to meet this requirement. Service providers shall not use a means test to deny individuals services within the target population.

(12) Service providers shall obtain the views of participants about the services they receive.

(13) Service providers shall assure that federal funds shall be used as the payer of last resort.

(14) Service providers shall implement the provisions of the Americans with Disabilities Act (ADA) of 1990 (PL 101-336), which prohibits discrimination against people with disabilities, to include-

(A) Operation of programs, services, and activities in such a manner as to be readily accessible to and usable by persons with disabilities;

(B) Senior centers are considered places of public accommodation and must therefore comply with the ADA. The responsibility to remove barriers in existing buildings is an ongoing process and area agencies on aging should use the following priorities as a guide to increase accessibility:

1) access to the facility;

2) access to the area in which goods and services are available;

3) access to restroom facilities; and

4) removing any remaining barriers. Area agencies on aging offering services in buildings where barrier removal is not readily achievable must develop a written implementation plan designed to achieve compliance, as well as a written policy outlining alternative methods to provide services during the interim. All renovations, alterations, or new construction must ensure compliance with ADA requirements by using the ADA Standards for Accessible Design published in Appendix A to the Department of Justice Title III regulations, 28 CFR part 36 , which is incorporated by reference in this rule, as published on July 1, 2021, by the Office of the Federal Register, National Archives and Records Administration, Washington, DC 20408, and available at https:\\bookstore.gpo.gov. This rule does not incorporate any subsequent amendments or additions; and

(C) Reasonable accommodation shall be made in policies, practices, and procedures to allow participation of persons with disabilities. To the greatest extent possible, services should be provided in an integrated setting; however, when barriers cannot be removed, alternative methods of providing the services, programs, and activities must be offered.

(15) Procedures for handling contributions shall be developed and implemented that include the following:

(A) Each participant shall be provided with an opportunity to voluntarily contribute to the cost of the service;

(B) The privacy of each participant with respect to his/her contribution shall be protected;

(C) Establish and implement a system of internal control that ensures all contributions received are fully and accurately recorded, deposited, accounted for, and reported to the area agency on aging.

1. Collecting contributions in a locked box at senior centers.

2. Using two (2) persons when accessing contributions or to count receipts.

3. Keeping receipts in a secure area or locked box until deposited.

4. Recording all contributions on the date of receipt.

5. Taking precautions to prevent theft of cash receipts.

6. Reporting contribution receipts to the area agency on aging at least monthly.

7. Avoiding an accumulation of a large balance of income on hand;

(D) All contributions shall be used to expand the service for which the contribution was made. Nutrition services contributions shall be used to increase the number of meals served, to facilitate access to meals and to provide supportive services directly related to nutrition services;

(E) A suggested contribution schedule may be developed for each service provided. In developing a contribution schedule, the provider shall consider the income ranges of elderly persons in the community, the provider's other source of income and the actual cost of the service. The contribution schedule should be revised periodically as needed; and

(F) A provider shall not deny any elderly person a service because the elderly person will not or cannot contribute to the cost of the service. An eligible participant shall not be charged for participating in any service or activity.

(16) Administrative policies and procedures shall be followed which include-

(A) A current Affirmative Action/Equal Employment Opportunity Plan and Program as required by the Civil Rights Act of 1964 and the Equal Employment Opportunity Act of 1972;

(B) Record keeping and confidentiality as cited in 19 CSR 15-4.300;

(C) Reporting systems to document and report all required program, fiscal, and administrative information needed

1. Documentation of the total unduplicated low-income minority persons receiving services;

2. Records of paid staff time and volunteer time; and

3. Documentation of service recipient eligibility;];

(D) Bonding for all volunteers, staff or governing body members who have fiscal responsibilities, to protect against loss of federal and state funds or agency income;

(E) Insurance coverage which includes-

1. Workers' Compensation-statutory amount as prescribed by the laws of Missouri;

2. Comprehensive general liability covering employees, volunteers and participants;

3. Product liability as applicable to the service provided; and

4. Automobile liability for service provider vehicles and, for volunteers using their own vehicles, at least a procedure for verifying that the volunteer maintains adequate insurance and understands his/her liability;

(F) Written policies that specify which holidays and special event days may be observed by curtailing delivery of services and procedures for publicizing these dates and assuring that participants are informed;

(G) Written policies and procedures to be followed when service delivery must be interrupted due to emergency situations including-

1. Definition of types of emergencies (weather, natural disaster, health, pandemic, and the like);

2. Specifications of the person/position responsible for making the decision to interrupt scheduled service delivery; and

3. Identification of procedures to be followed for notifying participants; and

(H) Written policies and procedures to be followed when it is necessary to terminate or deny services to an individual participant that include-

1. Justification for termination or denial;

2. Referral to other needed services; and

3. Follow-up for return to service, when appropriate.

(17) Any facility altered, renovated, acquired by purchase or lease, or constructed using federal or state funds may not be used for religious instruction or as a place of worship, as follows:

(A) Federal and state funds shall not be used to renovate, alter or construct a building that is also intended to be used, or is used, as a place of worship even though the building may serve as a multipurpose senior center;

(B) Service providers shall have a written agreement with sectarian organizations housing alternative services programs which includes the provision that all equipment purchased with federal funds remain the property of the area agency on aging, as per 45 CFR part 75 , which is incorporated by reference in this rule, as published on October 1, 2021, by the Office of the Federal Register, National Archives and Records Administration, Washington, DC 20408, and available at https:\\bookstore.gpo.gov. This rule does not incorporate any subsequent amendments or additions;

(C) Each individual participant shall have a free choice of whether or not they wish to participate in prayer and no staff (paid or volunteer for that day) shall initiate, lead, organize or encourage a prayer or moment of silence; and

(D) Service providers shall ensure that no federal or state funds shall be used for religious instruction or worship.

(18) Any facility altered, renovated, acquired by purchase or lease, or constructed using federal or state funds may not be used for political campaigning on behalf of any candidate for local, state, or national office unless-

(A) The political discussion is a planned, scheduled activity;

(B) All candidates for a particular office are personally present or afforded the opportunity to be present; and

(C) All candidates are afforded the opportunity to present their views through a series of discussions, scheduled at intervals, but given equal time.

19 CSR 15-7.010

AUTHORITY: section 660.050, RSMo Supp 1999.* This rule was previously filed as 13 CSR 15-6.135. Original rule filed Jan. 6, 1986, effective April 30, 1986. Amended: Filed Feb. 17, 1988, effective June 15, 1988. Amended: Filed June 3, 1991, effective Oct. 31, 1991. Amended: Filed Aug. 28, 2000, effective March 30, 2001. Moved to 19 CSR 15-7.010, effective Aug. 28, 2001.

Amended by Missouri Register July 17, 2023/Volume 48, Number 14, effective 8/31/2023

*Original authority: 660.050 RSMo 1984, amended 1988, 1992, 1993, 1994, 1995.