Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This proposed amendment establishes the
criteria and procedures by which the Children's Division will accept proof of
accreditation as a foster home, residential care facility, or child placing
agency by certain accrediting bodies as prima facie evidence of meeting the
requirements for licensure as a foster home, residential care facility, or
child placing agency in light of the amendments to section
210.112,
RSMo in HB 1414 (2020).
(1)
Purpose and Scope. This regulation applies to Licenses issued to individuals or
organizations which are accredited by an accrediting body.
(2) Definitions. For the purpose of this
regulation, the definitions set forth in section
210.481, RSMo, and
the following definitions shall apply:
(A)
"Accrediting body" shall mean the Council on Accreditation of Services for
Children and Families, Inc., the Joint Commission on Accreditation of
Healthcare Organizations, or the Commission on Accreditation of Rehabilitation
Facilities;
(B) "Individual or
organization" shall mean any adult person, corporation, partnership, religious
denomination, religious organization, or organized group of human beings;
and
(C) "Prima facie evidence"
means evidence that will establish a fact or sustain a decision unless
contradictory evidence is produced.
(3) The Children's Division shall accept accreditation
by an accrediting body as prima facie evidence that the individual or
organization meets the requirements for a license to operate a foster home,
residential care facility, or child placing agency in accordance with the
applicable provisions of sections
210.481 to
210.511,
RSMo. The division will accept accreditation for purposes of documenting
eligibility for license or relicensure. However, any individual or organization
whose license is based upon accreditation must still fully comply with all of
the requirements of licensure (including full compliance with all federal,
state, and local health and safety codes) as if not accredited for the duration
of the license to maintain the license. The safety and welfare of children
served by the individual or organization shall be the paramount consideration
in all licensing decisions.
If a service or program, including, but not limited to,
child placing, maternity, infant/toddler, residential treatment, and intensive
residential treatment in residential child care, is not accredited by the
accrediting body, than the organization must apply for and meet all licensing
requirements as for the unaccredited program or service.
(4) Application and Reapplication for
License for Accredited Individual or Organizations.
(A) The individual or organization applying
for licensure as an accredited individual or organization shall present to the
division with its application for licensure or relicensure all of the
following:
1. A copy of the individual or
organization's official final accreditation report and accreditation
certificate from the accrediting body establishing that the individual or
organization is accredited in good standing for the period of time covered by
the license;
2. A list of operating
sites which includes the capacity served, the gender served, and the ages
served by that organization. This list shall be updated if there is a change in
operating sites by the individual or organization;
3. A copy of the accrediting body's official
standards and policies for accreditation;
4. A copy of any corrective action documents
or other notices from the accrediting body regarding areas of non-compliance or
required improvement or monitoring;
5. Any documentation required at initial
licensure or relicensure as stated in chapters 13 CSR 35-71 (for residential
treatment agencies) and 13 CSR 35-73 (for child placing agencies), including,
but not limited to, agency policies, procedures, organizational charts,
budgets, staff training records, and personnel records verifying compliance
with background check requirements; and
6. Any and all other information and
documentation that the division may determine is reasonably necessary to verify
that the individual or organization is accredited in good standing and
otherwise meets all of the requirements for licensure.
(B) The division in its discretion may
conduct on-site visits to verify compliance with licensure requirements before
a license is issued.
(C) The
division shall examine the areas that the organization is applying for a
license. The division then may issue a corresponding license for those areas in
which the organization is accredited. The license shall be valid for the period
of time up to two (2) years (or such other time as may be specifically
authorized or required by statute), or when the organization's accreditation
expires, whichever is shorter.
(D)
If the individual or organization's accreditation expires during the term of
the license, the division may issue a provisional license pursuant to section
210.486,
RSMo for a period of time not to exceed six (6) months upon the individual or
organization showing that-
1. The individual
or organization is still in good standing with the accrediting body, the
re-accreditation process is being diligently pursued, and accreditation is
expected within six (6) months of the date the accreditation expired. The
division may, at its discretion, request a letter of good standing from the
accrediting body;
2. The individual
or organization otherwise demonstrates the potential capacity to meet full
requirements for licensure; and
3.
The division director is satisfied that the operation of the foster home,
residential care facility, or child placing agency provisionally licensed is
not detrimental to the health and safety of the children being
served.
(E) The division
may deny the issuance of a license to, or may suspend or revoke the license of,
any individual or organization which fails to provide information that the
division may require to establish eligibility for licensure.
(F) The individual or organization seeking
licensure under this section shall have the responsibility to apply for
accreditation and/or re-accreditation in a timely manner to ensure compliance
with all deadlines set out in this section and other applicable laws.
(5) Information Sharing.
(A) The individual or organization shall
notify the division immediately of any sentinel event, any critical incident as
required in 13 CSR 35-71.070, any unusual
event as required in 13 CSR 3573.050, and of any suspension, limitation,
including but not limited to required corrective action or monitoring, or
revocation of accreditation. The procedures and requirements for reporting
shall be the same for non-accredited, licensed individuals, and organizations
as provided in chapters 13 CSR 35-71 and 13 CSR 35-73.
(B) Sentinel events are those events which
the accrediting body requires the individual or organization to report to the
accrediting body as a condition of accreditation, but shall at a minimum
include the following:
1. A death of a child
in one (1) of the individual's or organization's facilities;
2. A serious emotional or physical injury of
a child in one of the individual's or organization's facilities. For purposes
of this regulation, a serious emotional or physical injury occurs when it is
medically reasonable or necessary for a child to obtain professional medical
intervention as a result of something that happens to the child while placed
with the individual or organization;
3. A child elopes from the individual's or
organization's facility;
4. A fire
in a location routinely occupied by children, which requires the fire
department to be called;
5. An
allegation or report of physical abuse, sexual abuse, emotional abuse, or
neglect of a child pertaining to the individual or organization, or an
employee, contractor, subcontractor, volunteer, or officer of the individual or
organization;
6. An employee is
terminated from employment in relation to the safety and care of children;
7. There is any change in the
chief executive officer;
8. There
is a lawsuit filed against the individual or organization by or on behalf of a
person who is or was in the individual's or organization's care;
9. Any known criminal charges are filed
against the individual, facility, organization, any resident of the facility,
or any employee or volunteer of the individual or organization who has contact
with children;
10. When the
individual or organization is not in compliance with any of the criteria for
accreditation, including maintaining the required level of services and
staffing levels, for more than three (3) consecutive days; or
11. Whenever a child attempts to harm
him/herself or others, including suicide attempts.
(C) The individual or organization shall
notify the division of the entrance, exit, and any performance review meetings
of the accrediting body which are held in conjunction with the accreditation of
the organization. The division has a right to attend any or all of these
meetings between the organization and the accrediting body.
(6) The division may make such
inspections and investigations as it deems necessary to ensure that the
individual or organization continues to meet the requirements of licensure, for
investigative purposes involving reports of alleged child abuse or neglect, and
to address a complaint concerning the health and safety of children which the
individual or organization serves.
(7) Any individual or organization who is
aggrieved by a decision of the division to deny, revoke, or suspend a license
based upon an organization's accreditation standing under this section may
either-
(A) Seek administrative review
following the procedures set forth in
13 CSR
35-71.030 for residential treatment agencies or
13 CSR
35-73.017 for child placing agencies; or
(B) Apply for licensure as an unaccredited
individual or organization.
