Current through Register Vol. 49, No. 6, March 15, 2024
PURPOSE: This rule specifies civil rights compliance
requirements for all health service providers and contractors who provide
services for the Department of Health and for all hospitals and public health
clinics that receive federal financial assistance or reimbursements for
services provided.
(1) The
following definitions shall be used in the interpretation and enforcement of
this rule:
(A) Applicant is any individual
who applies for services from a covered recipient agency;
(B) Assurance is a contractual agreement in
which a covered recipient agency legally agrees to administer programs and
services in accordance with this rule;
(C) Civil rights requirements are the
requirements of Title VI of the Civil Rights Act of 1964 ( 42 USC 2000 d -
2000d.6 ), Section 504 of the Rehabilitation Act of 1973 ( P.L. 93-516 ), the
Age Discrimination Act of 1975, Title II and Title III of the American
Disabilities Act of 1990 and this rule;
(D) Complainant is any person or group of
persons who allege discrimination on the basis of race, color, national origin,
age, sex or disability in the delivery of health care services by a covered
recipient agency;
(E) Complaint is
a verbal or written allegation of discrimination which indicates that a health
care service is provided in a manner that results in disparity of services to
persons or groups of persons because of race, color, national origin, age, sex
or disability;
(F) Compliance
review is a review of a covered recipient agency conducted by the Department of
Health and Senior Services (DHSS) to determine compliance with the requirements
of this rule;
(G) Covered recipient
agency is any facility operated primarily to provide health care services as a
nonprofit or for-profit institution which receives federal reimbursements for
the services provided; and
(H)
Federal assistance is any United States government funding, reimbursement,
property or aid which is given to a covered recipient agency to provide health
care services or program benefits to clients or patients.
(2) The DHSS shall strive to assure that all
public health care services and benefits are made available and provided to all
eligible individuals without regard to race, color, national origin, age, sex
or disability status.
(3) To
eliminate duplication of civil rights compliance efforts, the DHSS and the
Department of Social Services (DSS) shall follow a cooperative agreement
negotiated by the two (2) departments designating the responsibilities and
relationships of each agency in carrying out Title XIX (Medicaid)
programs.
(4) Contractors who
provide goods to DHSS are not subject to this rule.
(5) In all contracts for services, the DHSS
shall include clauses regarding civil rights.
(A) A covered recipient agency shall comply
with the civil rights requirements defined in subsection (1)(C) of this rule. A
covered recipient agency will affirm compliance at the time of contract
signing.
(B) A covered recipient
agency which is a government entity and is receiving federal funds through DHSS
shall have and maintain a personnel merit system.
(C) A covered recipient agency which employs
fifteen (15) or more persons shall designate an employee to coordinate civil
rights efforts.
(D) A covered
recipient agency which receives or contract(s) with DHSS and employs fifty (50)
or more persons shall implement an affirmative action program that complies
with the civil rights requirements.
(E) Each covered recipient agency shall
implement a public notification system which encourages participation and
informs all potential participants, particularly minorities, of the
availability of its programs.
(F)
Each covered recipient agency shall print in easily read type on all public
program communications this statement: Eligibility criteria for acceptance and
participation in this program are administered on a nondiscriminatory basis
regardless of race, color, national origin, age, sex or disability.
(G) Each covered recipient agency shall
maintain a system for collecting racial/ethnic participation data. This data
shall include the number of recipients of services and shall be acceptable to
DHSS.
(H) Each covered recipient
agency shall display DHSS-approved nondiscrimination posters and policy
statements in all facility areas frequented by employees, applicants and
recipients of services.
(I) Each
covered recipient agency shall display notices of the availability of complaint
procedures and have appropriate guidelines in place for referring civil rights
complaints and complainants to the DHSS for review and resolution. The DHSS
shall notify the appropriate federal agency of the receipt of a complaint if
that notification is required.
(J)
Each covered recipient agency shall make reasonable accommodations for
handicapped applicants and recipients of services including, but not limited
to, provision of appropriate auxiliary aids to persons with impaired sensory or
speaking skills, parking and access to the facility for the disabled, and
removal of barriers to accessibility if the removal is readily
achievable.
(K) If the covered
recipient agency uses any funds from DHSS and contracts in a subcontract, the
contractor shall require the subcontractor to comply with subsections
(5)(A)-(L) of this rule.
(L) The
DHSS shall have the right to enforce all applicable clauses in subsections
(5)(A)-(K) of this rule by appropriate and reasonable procedures including, but
not limited to, requests, reports, site visits and inspection of relevant
documentation of the contractor.
(6) Periodically the DHSS shall assess the
compliance level of covered recipient agencies by conducting a desk audit or
on-site review on randomly selected agencies. An on-site civil rights
compliance review shall be performed by the DHSS when there is evidence of
substantial noncompliance as shown by a desk audit or a complaint
investigation.
(7) If the
contractor fails to comply with the terms of the civil rights assurance in the
contract, DHSS shall terminate the contract. Prior to termination of a
contract, DHSS shall give fifteen (15) days' notice to the contractor
specifying the reasons why the department believes the contractor is not in
compliance and shall provide the contractor an opportunity to show compliance
with the contract. The contractor may request a conference with DHSS during
this period. The request shall be in writing to the director of the
DHSS.
*Original authority: Executive Order 87-6, RSMo 1987 and
536.023.3., RSMo 1975, amended 1976,
1997.
