Effective - 28 Aug 2019
208.896. Structured family caregiving, department to apply for federal waiver — requirements — rulemaking authority. — 1. To ensure the availability of comprehensive and cost-effective choices for MO HealthNet participants who have been diagnosed with Alzheimer's or related disorders, as defined in section 172.800, to live at home in the community of their choice and to receive support from the caregivers of their choice, the department of social services shall apply to the United States Secretary of Health and Human Services for a structured family caregiver waiver under Section 1915(c) of the federal Social Security Act. Federal approval of the waiver is necessary to implement the provisions of this section. Structured family caregiving shall be considered an agency-directed model, and no financial management services shall be required.
2. The structured family caregiver waiver shall include:
(1) A choice for participants of qualified and credentialed caregivers, including family caregivers;
(2) A choice for participants of community settings in which they receive structured family caregiving. A caregiver may provide structured family caregiving services in the caregiver's home or the participant's home, but the caregiver shall reside full time in the same home as the participant;
(3) A requirement that caregivers under this section are added to the family care safety registry and comply with the provisions of sections 210.900 to 210.936;
(4) A requirement that all caregivers shall obtain liability insurance as required;
(5) A cap of three hundred participants to receive structured family caregiving;
(6) A requirement that all organizations serving as structured family caregiving agencies are considered in-home service provider agencies and are accountable for documentation of services delivered, meeting the requirements set forth for these provider agencies, qualification and requalification of caregivers and homes, caregiver training, providing a case manager or registered nurse to create a service plan tailored to each participant's needs, professional staff support for eligible people, ongoing monitoring and support through monthly home visits, deployment of electronic daily notes, and remote consultation with families;
(7) Caregivers are accountable for providing for the participant's personal care needs. This includes, but is not limited to, laundry, housekeeping, shopping, transportation, and assistance with activities of daily living;
(8) A daily payment rate for services that is adequate to pay stipends to caregivers and pay provider agencies for the cost of providing professional staff support as required under this section and administrative functions required of in-home services provider agencies. The payment to the provider agency is not to exceed thirty-five percent of the daily reimbursement rate; and
(9) Daily payment rates for structured family caregiving services that do not exceed sixty percent of the daily nursing home cost cap established by the state each year.
3. (1) Within ninety days of August 28, 2019, the department of social services shall, if necessary to implement the provisions of this section, apply to the United States Secretary of Health and Human Services for a structured family caregiver waiver. The department of social services shall request an effective date before July 2, 2020, and shall, by such date, take all administrative actions necessary to ensure timely and equitable availability of structured family caregiving services for home- and community-based care participants.
(2) Upon receipt of an approved waiver under subdivision (1) of this subsection, the department of health and senior services shall promulgate 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, 2019, shall be invalid and void.
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(L. 2019 S.B. 514)
Structure Missouri Revised Statutes
Title XII - Public Health and Welfare
Chapter 208 - Old Age Assistance, Aid to Dependent Children and General Relief
Section 208.001 - Citation of law — MO HealthNet created — division created — rulemaking authority.
Section 208.022 - TANF electronic benefit cards to include photograph of recipient.
Section 208.044 - Child day care services to be provided certain persons — eligible providers.
Section 208.048 - Aid to families with dependent child — school attendance required — rules.
Section 208.050 - Aid to dependent children denied, when.
Section 208.060 - Applications for benefits, how and where filed.
Section 208.065 - Verification of eligibility for public assistance, contract for.
Section 208.067 - TANF set-aside minimums for certain programs.
Section 208.071 - Individualized assessment of applicant — rulemaking authority.
Section 208.080 - Appeal to director of the respective division, when — procedure.
Section 208.090 - Reinstatement and payment of benefits to applicant.
Section 208.100 - Appeal to circuit court — procedure.
Section 208.110 - Appeals from circuit court.
Section 208.120 - Records, when evidence, restrictions on disclosure — penalty.
Section 208.125 - Records may be destroyed, when.
Section 208.130 - Benefits granted may be reconsidered.
Section 208.140 - Grants subject to any change of law.
Section 208.145 - Medical assistance benefits, eligibility based on receipt of AFDC benefits, when.
Section 208.146 - Ticket-to-work health assurance program — eligibility — expiration date.
Section 208.150 - Monthly benefits, how determined.
Section 208.154 - Insufficient funds, benefits to be paid pro rata.
Section 208.155 - Records concerning applicants and recipients of medical assistance confidential.
Section 208.158 - Payments to be made only when federal grants-in-aid are provided.
Section 208.159 - Payments for nursing home services, how administered — rules.
Section 208.160 - Payment rolls, how prepared — checks and warrants, how issued.
Section 208.163 - Direct payment on request by authorized providers of services.
Section 208.170 - Duties of state treasurer — special funds created.
Section 208.171 - Effective date of certain sections.
Section 208.172 - Reduction or denial of benefits, basis for, restrictions on.
Section 208.173 - Committee established.
Section 208.175 - Drug utilization review board established, members, terms, compensation, duties.
Section 208.176 - Division to provide for prospective review of drug therapy.
Section 208.180 - Payment of benefits, to whom — disposition of benefit check of deceased person.
Section 208.181 - Expedited eligibility process, pregnant women.
Section 208.190 - Division to comply with acts of congress relating to Social Security benefits.
Section 208.198 - Same or similar services, equal reimbursement rate required.
Section 208.210 - Undeclared income or property — benefits may be recovered by division, when.
Section 208.212 - Annuities, affect on Medicaid eligibility — rulemaking authority.
Section 208.213 - Personal care contracts, effect on eligibility.
Section 208.221 - Jurisdiction, administrative hearing commission, procedure.
Section 208.223 - Reimbursement for ambulance service to be based on mileage.
Section 208.225 - Medicaid per diem rate recalculation for nursing homes, amount.
Section 208.229 - Rebates on outpatient drugs — definitions.
Section 208.230 - Public assistance beneficiary employer disclosure act — report, content.
Section 208.238 - Eligibility, automated process to check applicants and recipients.
Section 208.240 - Statewide dental delivery system authorized.
Section 208.247 - Food stamp eligibility, felony conviction not to make ineligible, when.
Section 208.250 - Definitions.
Section 208.265 - Rules and procedures, developed by whom, published, where.
Section 208.341 - School programs — postponing sexual involvement — QUEST — rites of passage.
Section 208.342 - Earned income tax credit program, AFDC recipients.
Section 208.345 - Protocols for referral of public assistance recipients to federal programs.
Section 208.400 - Definitions.
Section 208.405 - JOBS program established, duties of department.
Section 208.420 - Department to apply for and accept federal funds.
Section 208.425 - Welfare reform coordinating committee established.
Section 208.431 - Medicaid managed care organization reimbursement allowance, amount.
Section 208.432 - Record keeping required, submission to department.
Section 208.434 - Amount final, when — protest, procedure.
Section 208.435 - Rulemaking authority.
Section 208.436 - Remittance to the department — deposit in dedicated fund.
Section 208.455 - Formula for federal reimbursement allowance established by rule — procedure.
Section 208.463 - Documents content and form prescribed by rule.
Section 208.469 - Tax exempt or nonprofit status granted by state not to be affected.
Section 208.471 - Medicaid reimbursement payments to hospitals, amount, how calculated.
Section 208.475 - Effective date of allowance.
Section 208.477 - Medicaid eligibility, criteria used, effect when more restrictive than FY2003.
Section 208.480 - Federal reimbursement allowance expiration date.
Section 208.530 - Definitions.
Section 208.533 - Commission established — members, qualifications — terms — expenses.
Section 208.535 - Commission, duties.
Section 208.600 - Citation of law, definitions.
Section 208.603 - Department of health and senior services to administer federal program.
Section 208.618 - Program to address mental health needs.
Section 208.621 - Program, at-risk elderly.
Section 208.624 - Invest in caring, model program — intergenerational care and training program.
Section 208.627 - Report, delivery of case management services, contents — delivery of report.
Section 208.631 - Program established, terminates, when — definitions.
Section 208.633 - Eligible children, income limits of parents or guardians.
Section 208.636 - Requirements of parents or guardians.
Section 208.640 - Co-payments required, when, amount, limitations.
Section 208.643 - Rules, compliance with federal law.
Section 208.646 - Waiting period required, when.
Section 208.647 - Special health care needs, waiver of waiting period for coverage.
Section 208.650 - Studies and reports required by department of social services.
Section 208.655 - Abortion counseling prohibited, exceptions.
Section 208.657 - Rules, effective when, invalid when.
Section 208.659 - Revision of eligibility requirements for uninsured women's health program.
Section 208.670 - Practice of telehealth, definitions — reimbursement of providers.
Section 208.677 - School children, parental authorization required for telehealth.
Section 208.690 - Citation of law — definitions.
Section 208.692 - Program established, purpose — asset disregard — departments duties — rules.
Section 208.694 - Eligibility — discontinuance of program, effect of — reciprocal agreements.
Section 208.696 - Director's duties — rules.
Section 208.698 - Reports required.
Section 208.750 - Title — definitions.
Section 208.760 - Eligibility — withdrawal of moneys, when.
Section 208.765 - Forfeiture of account moneys, when — death of account holder, effect of.
Section 208.770 - Tax exemption, credit, when.
Section 208.775 - Independent evaluation — report.
Section 208.780 - Definitions.
Section 208.782 - Missouri Rx plan established, purpose — rulemaking authority.
Section 208.786 - Authority of department in providing benefits — start of program benefits, when.
Section 208.788 - Program not an entitlement — payer of last resort requirements.
Section 208.794 - Fund created.
Section 208.798 - Termination date.
Section 208.853 - Findings and purpose.
Section 208.856 - Council created, expenses, members, terms, removal.
Section 208.859 - Powers and duties of the council.
Section 208.862 - Consumer rights and employment relations.
Section 208.865 - Definitions.
Section 208.868 - Federal approval and funding.
Section 208.871 - Severability clause.
Section 208.900 - Definitions.
Section 208.903 - Financial assistance for personal care, eligibility requirements.
Section 208.909 - Responsibilities of recipients and vendors.
Section 208.918 - Vendor requirements, philosophy and services.
Section 208.921 - Denial of eligibility, applicant entitled to hearing.
Section 208.924 - Discontinuation of services, when.
Section 208.927 - Rulemaking authority.
Section 208.935 - Assessment tool, home and community-based services.
Section 208.951 - Request for proposals.
Section 208.952 - Committee established, members, duties.
Section 208.955 - Committee established, members, duties — issuance of findings.
Section 208.990 - MO HealthNet eligibility requirements.
Section 208.991 - Definitions — persons eligible for MO HealthNet — rulemaking authority.
Section 208.1050 - Fund created, use of moneys.
Section 208.1060 - Food banks, state plan to be submitted for federal project.