rules of department of health and senior services...matt blunt (3/31/02) code of state regulations 1...

CODE OF STATE REGULATIONS 1MATT BLUNT (3/31/02)Secretary of State

Rules of

Department of Health andSenior Services

Division 15—Division of Senior ServicesChapter 4—Older Americans Act

Title Page

19 CSR 15-4.010 Definition of Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

19 CSR 15-4.020 Administration of the Older Americans Act . . . . . . . . . . . . . . . . . . . . . . . .5

19 CSR 15-4.030 Governor’s Advisory Council on Aging . . . . . . . . . . . . . . . . . . . . . . . . . .5

19 CSR 15-4.040 State Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

19 CSR 15-4.050 Funding Formula and Fiscal Management . . . . . . . . . . . . . . . . . . . . . . . . .7

19 CSR 15-4.060 State Long-Term Care Ombudsman Program . . . . . . . . . . . . . . . . . . . . . .10

19 CSR 15-4.070 Designation of Area Agencies on Aging . . . . . . . . . . . . . . . . . . . . . . . . .10

19 CSR 15-4.080 Withdrawal of Designation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

19 CSR 15-4.090 Appeal to the Assistant Secretary . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

19 CSR 15-4.100 Area Agency Governing Body . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

19 CSR 15-4.105 Area Agency Election Procedures for Governing Body Membership . . . . . . . .12

19 CSR 15-4.110 Area Agency Advisory Council . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

19 CSR 15-4.120 Affirmative Action/Equal Employment Opportunity/Preference in Hiring . . . . .13

19 CSR 15-4.130 Area Agency Staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

19 CSR 15-4.135 Area Agency Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

19 CSR 15-4.140 Area Agency Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

19 CSR 15-4.150 Waivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

2 CODE OF STATE REGULATIONS (3/31/02) MATT BLUNTSecretary of State

19 CSR 15-4.160 Review, Submission and Approval of Area Agency Area Plans andPlan Amendments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

19 CSR 15-4.170 Area Agency Fiscal Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

19 CSR 15-4.175 Funding Acquisition or Construction of Multipurpose Senior Centers . . . . . . .16

19 CSR 15-4.180 Area Agency Advocacy Responsibility . . . . . . . . . . . . . . . . . . . . . . . . . .17

19 CSR 15-4.190 Areas Agency Development of a Comprehensive andCoordinated Service Delivery System . . . . . . . . . . . . . . . . . . . . . . . . . .18

19 CSR 15-4.200 Area Agency Subgrants or Contracts . . . . . . . . . . . . . . . . . . . . . . . . . . .19

19 CSR 15-4.210 Area Agency Grievance Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

19 CSR 15-4.220 Area Agency Technical Assistance, Monitoring andEvaluation Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

19 CSR 15-4.230 Multipurpose Senior Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

19 CSR 15-4.240 Nutrition Service Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

19 CSR 15-4.250 Area Agency USDA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22

19 CSR 15-4.260 Outreach Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

19 CSR 15-4.270 Legal Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

19 CSR 15-4.280 Ombudsman Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

19 CSR 15-4.290 Information and Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

19 CSR 15-4.300 Record Keeping and Confidentiality . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

19 CSR 15-4.310 Corporate Eldercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26

Title 19—DEPARTMENT OFHEALTH AND SENIOR SERVICESDivision 15—Division of Senior Services

Chapter 4—Older Americans Act

19 CSR 15-4.010 Definition of Terms

PURPOSE: This rule defines terms used inthis chapter.

(1) Any definitions described in 13 CSR15-7.005 are applicable to 13 CSR 15-4 aswell as the terms defined in this rule.

(2) Act—The Older Americans Act of 1965,as amended through December 31, 1992.

(3) Acquiring—Obtaining ownership of anexisting facility in fee simple or by a lease often (10) or more years for use as a multipur-pose senior center.

(4) Administration on Aging (AoA)—Thefederal agency within the Department ofHealth and Human Services which is chargedwith the responsibility of administering theprovisions of the Act, with the exception ofthe Senior Community Service EmploymentProgram (SCSEP).

(5) Administrative action—Any action ordecision made by an owner, employee oragent of a long-term care (LTC) facility, or byan area agency or the division, which affectsthe provision of services to service recipients.

(6) Adequate proportion—An amount of sup-portive services funds determined by the stateagency to be sufficient to meet the need for agiven priority service in a particular planningand service area.

(7) Adult day care—A program designed toprovide care and supervision to meet theneeds of functionally impaired adults forperiods of less than twenty-four (24) hoursbut more than two (2) hours per day in aplace other than the adult’s own home.

(8) Advisory council—A council of olderindividuals (including minority individuals),representatives of older individuals and localelected officials who advise the Area Agencyon Aging on matters pertaining to develop-ment and administration of the area plan andon operations conducted under the plan.

(9) Advocacy—The act of speaking or writingin support of older persons or programs forolder persons.

(10) Altering or renovating—Making modifi-cations to an existing facility which are nec-

essary for its effective use as a multipurposesenior center, including restoration, repair,expansion and all related physical improve-ments.

(11) Area Agency on Aging (AAA)—Theagency designated by the division in a plan-ning and service area to develop and admin-ister a plan and administer available funds fora comprehensive and coordinated system ofservices for the elderly and persons with dis-abilities who require similar services.

(12) Area Agency on Aging governingbody—The policy-making board or oversightbody which directs the actions of the AAAunder local, state and federal laws and regu-lations.

(13) Area plan—The document submitted byan area agency to the division for approval inorder to receive subgrants or contracts.

(14) Assessment—The mechanism for deter-mining need and eligibility for programs andservices.

(15) Assistant secretary—The assistant secre-tary of the Department of Health and HumanServices.

(16) Collocation of services—Coordinationand scheduling representatives of providersand other agencies and organizations toassure that, in addition to a center’s usualservices, all available services benefiting theelderly are accessible and convenient forrecipients at the community focal point.

(17) Confidentiality—Procedures whichassure the anonymity of the individual servicerecipient.

(18) Construction—The building of a newmultipurpose senior center including thecosts of land, acquisition and architecturalengineering fees.

(19) Continuum of care—A full range of eco-nomic, physical, psychological and socialsupport programs and services necessary tomaintain or restore elderly persons to optimalfunctioning.

(20) Department—Missouri Department ofSocial Services.

(21) Direct service—Any activity performedto provide services directly to an individualolder person by the staff of a service provideror an area agency.

(22) Disaster preparedness plan—A regionalor statewide plan to organize local efforts toassist the elderly in the event of a disaster sit-uation which affects large numbers of people.

(23) Division—The Division of Aging withinthe Department of Social Services, the desig-nated state unit on aging.

(24) Education and training services—Sup-portive services designed to broaden theknowledge and skills of older persons, theircaregivers, advocates, and the professionalsserving them to cope more effectively withtheir economic, health and personal needs.

(25) Focal point—A facility established toencourage the maximum collocation andcoordination of services for older individuals.

(26) Greatest economic need—The needresulting from an income level at or below thepoverty line.

(27) Greatest social need—The need causedby noneconomic factors, including physicaland mental disabilities, language barriers,and cultural, social, or geographic isolation,including isolation caused by racial or ethnicstatus, which restrict the ability of an indi-vidual to perform normal daily tasks and/orthreatens the capacity of the individual to liveindependently.

(28) Health screening services—Services inwhich the service recipient’s general health isreviewed, health education is provided, sim-ple tests are provided or referral is made, ifindicated.

(29) Indirect costs—Those costs allocated toAAA grant awards based on a rate approvedby the organization’s cognizant federal agen-cy.

(30) Information and assistance source—Alocation where any public or private agencyor organization—

(A) Maintains current information withrespect to the opportunities and servicesavailable to older individuals;

(B) Employs, where feasible, a speciallytrained staff to assess the needs and capacitiesof older individuals, to inform older individ-uals of the opportunities and services whichare available and to assist those individualswith economic or social needs; and

(C) Utilizes, where feasible, electronicand/or computer database informationsources in the provision of information andassistance services.


Chapter 4—Older Americans Act 19 CSR 15-4

(31) Legal assistance—Legal advice and rep-resentation by an attorney (including, to theextent feasible, counseling or other appropri-ate assistance by a paralegal or law studentunder the supervision of an attorney). Legalassistance includes counseling or representa-tion by a nonlawyer where permitted by lawbut does not include community education.

(32) Local government—A political subdivi-sion of the state, whose authority is generaland not limited to only one (1) function orcombination of related functions.

(33) Local match—See match.

(34) Long-term care (LTC) facility—Anyfacility as defined in section 198.006, RSMo.

(35) Match—The equivalent cash value ofthird-party in-kind contributions or cashresources representing that portion of thecosts of a grant-supported project or programnot borne by the federal or state government.

(36) Medicaid—Financial assistance for med-ical services provided under section 208.151,RSMo, in accordance with Title XIX, PublicLaw 89-97, 1965 amendments to the SocialSecurity Act (42 U.S.C. 301).

(37) Monitoring—The review and evaluationof all AAA activities by the division, or ofcontractor activities by the AAA.

(38) Net cost—The total allowable costs, lessgrant-related income, for the purpose ofmeeting match requirements.

(39) Not-for-profit—An agency, institution ororganization which is owned and operated byone (1) or more corporations or associationswith no part of the net earnings benefitingany private shareholder or individual.

(40) Ombudsman—An individual assigned bythe division or the area agency to investigateand resolve complaints made by or on behalfof older individuals who are residents of LTCfacilities relating to administrative actionwhich may adversely affect the health, safety,welfare and rights of these residents.

(41) Person(s) with disabilities—Anyone whohas a mental or physical impairment whichsubstantially limits one or more of theirmajor life activities; or has a record of suchimpairment; or is regarded as having such animpairment.

(42) Planning and service area (PSA)—Ageographic area of the state that is designatedby the division for purposes of planning,

developing, delivering, monitoring andadministering services to older persons.

(43) Policy—A principle established by a gov-ernment, organization or an individual thatguides decision-making and actions.

(44) Preprint—The division’s format fordevelopment and submission of the area agen-cy plan or plan amendment.

(45) Priority services—Those service cate-gories of access, in-home and legal assis-tance.

(46) Procedure—The established sequence ofactions to be followed to accomplish a task orimplement a policy.

(47) Program—Any service funded under theapproved area plan.

(48) Program costs—Costs incurred by thearea agency in managing and delivering a ser-vice.

(49) Program evaluation—The review anddetermination of program effectiveness inmeeting recipient needs.

(50) Program monitoring—The review anddetermination of progress in meeting pro-gram objectives.

(51) Protective services—Services providedby the division in response to the need forprotection from harm or neglect to elderlypersons and persons with disabilities undersections 660.250—660.295, RSMo.

(52) Public hearing—An open hearing whichprovides an opportunity for older persons, thegeneral public, officials of general purpose,local government and other interested partiesto comment on a proposal.

(53) Public match—See match.

(54) Regional office—Department of Healthand Human Services, Administration onAging (AoA) office located in Kansas City,Missouri.

(55) Renovating—See altering.

(56) Request for proposal (RFP)—A formalinvitation to prospective contractors to submitbids for procurement of a defined set of activ-ities, services or goods.

(57) Request for qualifications (RFQ)—Atype of RFP which is a formal invitation toprospective providers to submit information

suitable for determining eligibility as a quali-fied provider.

(58) Rural areas—Any town or city with apopulation of twenty thousand (20,000) orless.

(59) SMSA (standard metropolitan statisticalarea)—One (1) or more central counties withan urbanized area of at least fifty thousand(50,000) population.

(60) SSBG—Social Services Block Grant.

(61) Staff hour—An hour of staff time spenton any activity related to the service identi-fied.

(62) Standards—The minimum requirementsto be met for the operation of programs andthe delivery of services.

(63) State plan—The document containingthe division’s priorities, goals, policy state-ments and objectives for enabling older per-sons to fulfill their potential for independentfunctioning.

(64) Structural change—Any change to theloadbearing members of a building.

(65) Target population—Individuals agedsixty (60) or over, with the greatest social andeconomic need, especially low incomeminority.

(66) Technical assistance—Specific guidanceand expertise provided by the division staff tothe area agency or by the area agency staff tothe service provider staff.

(67) Transportation service—A vehicular ser-vice which facilitates access to other ser-vices.

(68) Third-party in-kind contributions—Property or services which benefit grant-sup-ported projects or programs and which,under the grant or subgrant, are contributedby nonfederal third parties without charge tothe grantee, the subgrantee or a cost-typecontractor.

(69) Unit of general purpose local govern-ment—See local government.

(70) Urbanized area—An incorporated placeand adjacent densely settled surrounding areathat together have a minimum population offifty thousand (50,000).

(71) USDA—United States Department ofAgriculture.


19 CSR 15-4—DEPARTMENT OF HEALTH AND SENIOR SERVICES Division 15—Division of Senior Services

(72) Waiver—The granting of a deviationfrom portions of service standards, prohibi-tion of direct service delivery or any otherstate regulation.

AUTHORITY: section 660.050, RSMo Supp.1999.* This rule was previously filed as 13CSR 15-6.005 and 13 CSR 15-4.010. Originalrule filed Jan. 6, 1986, effective April 30,1986. Amended: Filed Feb. 17, 1988, effec-tive June 15, 1988. Amended: Filed June 3,1991, effective Oct. 31, 1991. Amended: FiledNov. 14, 1991, effective March 9, 1992.Amended: Filed Aug. 28, 2000, effectiveMarch 30, 2001. Moved to 19 CSR 15-4.010,effective Aug. 28, 2001.

*Original authority: 660.050, RSMo 1984, amended1988, 1992, 1993, 1994, 1995.

19 CSR 15-4.020 Administration of theOlder Americans Act

PURPOSE: This rule describes the organiza-tional structure in the state for administrationof Title III of the Older Americans Act of1965.

Editor’s Note: The secretary of state hasdetermined that the publication of this rule inits entirety would be unduly cumbersome orexpensive. The entire text of the material ref-erenced has been filed with the secretary ofstate. This material may be found at theOffice of the Secretary of State or at the head-quarters of the agency and is available to anyinterested person at a cost established bylaw.

(1) The Division of Aging, within the Depart-ment of Social Services, is the single organi-zational unit that is delegated all authorityand responsibility to administer programs forpersons aged sixty (60) and over under TitleIII of the Older Americans Act of 1965 andin accordance with all applicable federal andstate laws and regulations.

(2) The division has designated ten (10) dis-tinct planning and service areas (PSAs) with-in the state with one (1) Area Agency onAging (AAA) in each PSA. These agenciesare: Southwest Missouri Office on Aging(SMOA) (including Dallas, Polk, Dade,Lawrence, Greene, Webster, Wright, Texas,Shannon, Oregon, Howell, Douglas, Chris-tian, Barry, Stone, Taney and Ozark coun-ties); Southeast Missouri AAA (SEMO)(including Cape Girardeau, Ste. Genevieve,Perry, St. Francois, Iron, Madison,Reynolds, Wayne, Bollinger, Scott, Mississip-pi, Stoddard, Butler, Ripley, Carter, New

Madrid, Pemiscot and Dunklin counties);District III AAA (including Chariton, Car-roll, Saline, Lafayette, Johnson, Pettis,Henry, Benton, Bates, St. Clair, Hickory,Vernon and Cedar counties); Northwest Mis-souri AAA (NWAAA) (including Atchison,Daviess, Nodaway, Worth, Harrison, Mercer,Putnam, Sullivan, Grundy, Gentry, Holt,Andrew, DeKalb, Buchanan, Clinton, Cald-well, Livingston and Linn counties); North-east Missouri AAA (NEAAA) (includingAdair, Schuyler, Scotland, Clark, Knox,Lewis, Macon, Shelby, Marion, Randolph,Monroe, Ralls, Pike, Lincoln, Montgomeryand Warren counties); Central Missouri AAA(CMAAA) (including Audrain, Boone, Call-away, Cooper, Howard, Miller, Moniteau,Cole, Osage, Morgan, Gasconade, Crawford,Washington, Dent, Phelps, Maries, Pulaski,Laclede and Camden counties); Mid-America Regional Council, Department ofAging Services (including Ray, Clay, Platte,Jackson and Cass counties); Mid-East AAA(MEAAA) (including St. Louis, St. Charles,Franklin and Jefferson counties); St. LouisAAA (SLAAA) (St. Louis City); and RegionX AAA (including Barton, Jasper, Newtonand McDonald counties).

(3) Any public or nonprofit private agency oroffice or agency of a unit of general purposelocal government, regional planning area ormetropolitan area which is designated tofunction only for the purpose of serving as anarea agency may apply to the division to bedesignated as a PSA. The division will con-sider the following factors in making a deter-mination:

(A) A population of one hundred thousand(100,000) or more;

(B) The numbers of persons aged sixty (60)or older, including those with the greatesteconomic and social need;

(C) The views of public officials represent-ing units of general purpose local govern-ments;

(D) The incidence of need for services andthe resources available to administer servicesto meet those needs; and

(E) The boundaries of units of general pur-pose local government, regional planningareas, existing economic development dis-tricts and areas within the state establishedfor planning and administering human ser-vices, including the area-wide comprehensiveplanning and development districts or regionsestablished pursuant to the state and localreview system which replaces that of theOffice of Management and Budget CircularA-95, Part IV. The division will include allportions of an economic development districtwithin a single PSA.

(4) If the division denies an application fordesignation as a PSA, the applicant shallreceive written notification which shallinclude:

(A) Explanation of the reasons for denialof the application;

(B) Provision of the opportunity for theapplicant to review any pertinent documentsupon which the determination was based; and

(C) Notification of the right to request aformal hearing on the determination.

AUTHORITY: section 660.050, RSMo 1986.*This rule previously filed as 13 CSR 15-4.020. Original rule filed Jan. 6, 1986, effec-tive April 30, 1986. Emergency amendmentfiled Jan. 5, 1989, effective Jan. 16, 1989,expired April 24, 1989. Amended: Filed Jan.5, 1989, effective March 25, 1989. Moved to19 CSR 15-4.020, effective Aug. 28, 2001.

*Original authority: 660.050, RSMo 1984, amended 1988.

19 CSR 15-4.030 Governor’s AdvisoryCouncil on Aging

PURPOSE: This rule designates the Gover-nor’s Advisory Council on Aging as an advi-sory group to the Division of Aging andestablishes bylaws under which it will oper-ate.

Editor’s Note: The secretary of state hasdetermined that the publication of this rule inits entirety would be unduly cumbersome orexpensive. The entire text of the material ref-erenced has been filed with the secretary ofstate. This material may be found at theOffice of the Secretary of State or at theheadquarters of the agency and is available toany interested person at a cost established bylaw.

(1) The Governor’s Advisory Council onAging advises and assists the division to—

(A) Develop and implement a state plan;(B) Conduct public hearings;(C) Represent the interests of older per-

sons; and(D) Review and comment on other state

plans, budgets and policies which affect olderpersons.

(2) The Governor’s Advisory Council onAging is composed of twenty-seven (27)members with more than fifty percent (50%)of the persons appointed to the council sixty(60) years of age or older. Membershipincludes participants in aging services andlow income minority persons.

(3) The bylaws of the Governor’s Advisory



Council are as follows:

Governor’s Advisory Council on Aging ofthe State of Missouri Bylaws

(A) Name and Authorization.1. The name of this organization is the

Governor’s Advisory Council on Aging forMissouri, also referred to as the council.

2. The authority for the creation of thecouncil was derived from the rules governingthe federal Older Americans Act of 1965.The Governor’s Advisory Council on Agingwas formed in 1973;

(B) Purpose. The purpose is to—1. Advise the governor on state govern-

ment’s impact on the independence and dig-nity of Missouri’s elders;

2. Advise the directors of the Depart-ment of Social Services and the Division ofAging as to the administration of these pro-grams that impact Missourians includingOlder Americans Act programs, Social Ser-vices Block Grant (SSBG) programs andlong-term care functions;

3. Encourage the coordination of all thestate’s agencies, both public and private, asthey provide services to the elderly by—

A. Encouraging appropriate services;B. Discouraging duplication; andC. Recommending new programs;

and4. Advise the governor on the state’s

budget for aging seniors;(C) Functions. The functions which the

council performs in implementing the pur-pose are to—

1. Investigate and advise about theneeds, concerns and potential of Missouri’selderly population;

2. Review and advise about the generaldirection of the Missouri Division of Agingand other statewide aging services;

3. Convene technical groups to studytopical areas (that is transportation, health,housing, etc.);

4. Provide direct access to the system forthe elderly;

5. Perform as a state level interagencycouncil on aging;

6. Advise and impact national agingrelated organizations and agencies; and

7. Promote public awareness activities toenhance the independence and dignity ofMissouri’s elderly;

(D) Membership. The council will consistof twenty-seven (27) members appointed bythe governor;

(E) Term of Membership.1. The term of membership will be for

three (3) years beginning October 1, unlessan appointment is made to fill a vacancy on

the council. When a term is completed, theterm shall extend until a successor is appoint-ed and duly qualified.

2. No member shall serve for more thantwo (2) consecutive three (3)-year terms.

3. Members who are absent for two (2)consecutive meetings will be contacted by thechairperson of the council to review their lackof participation and inquire whether themembers wish to continue to serve on thecouncil. If the member wishes no longer toserve, the chairperson will relate this infor-mation to the governor;

(F) Officers. The officers of the councilwill be one (1) chairperson, a first vice-chair-person and a second vice-chairperson whowill be elected by the council annually andshall serve no more than two (2) consecutiveone (1)-year terms in the same office;

(G) Committees, Special Committees,Subcommittees and Ad Hoc Committees.

1. The executive committee shall becomposed of the chairperson, first vice-chair-person, second vice-chairperson and the pastchairman as an honorary member. The exec-utive committee shall have all powers of thecouncil between council meetings. The exec-utive committee must immediately inform thecouncil about any actions which officiallycommunicate to the governor’s office or thedirectors of the Department of Social Ser-vices and the Division of Aging. The execu-tive committee must inform the council at itsnext meeting about actions which create orappoint special committees, subcommittees,ad hoc committees or other special appoint-ments.

2. Standing committees will be createdby the council. These committee(s) shall havethe name(s), powers, duties and existence asmay be determined from time-to-time byaction of the council.

3. The chairperson of the council willappoint special committees, subcommitteesand ad hoc committees as deemed necessary.Duration of these committees will not exceedthe term of office of the chairperson of thecouncil.

4. The chairperson and vice-chairpersonof the committee, special committee, sub-committee or ad hoc committee will beappointed by the chairperson of the council.The committee, special committee, subcom-mittee or ad hoc committee chairperson shallappoint the membership. Council memberswill be assigned to at least one (1) committeebut assigned to no more than two (2) com-mittees. Membership will not be limited tomembers of the council. Noncouncil mem-bers may serve on no more than one (1) com-mittee, special committee, subcommittee orad hoc committee;

(H) Meetings.1. There will be a minimum of four (4)

meetings, one (1) of which will be the annu-al meeting of the council.

2. Place and time of meetings will bedetermined by the council.

3. Special meetings may be called at anytime by the chairperson upon ten (10) days’notice to the members of the council. Thepurpose of these meetings must be stated atthe time the meeting is called.

4. Special meetings will be called by thechairperson when petitioned by twelve (12)members of the council within ten (10) days’notice prior to the meeting. The purpose ofthese meetings must be stated at the time themeeting is called by the chairperson.

5. A quorum will be met when twelve(12) members of the council are present forvoting;

(I) Reports. Annual reports of each com-mittee’s activities and recommendations shallbe submitted to the council chairperson atleast thirty (30) days prior to the annual meet-ing. The annual council report to the gover-nor of the council’s activities and recommen-dations shall be presented by the councilchairperson and approved by the council atthe annual meeting. Other reports will bemade as deemed necessary by the council tothe governor, director of the Department ofSocial Services and the director of the Divi-sion of Aging;

(J) Staffing. Staff for the council and itscommittees will be provided or procured, orboth, by the Division of Aging;

(K) Parliamentary Authority. Robert’sRules of Order, revised, shall be the parlia-mentary authority governing the meetings ofthe council and all committees subject to statelaw and these bylaws; and

(L) Amendments. These bylaws may beamended at any regular meeting of the coun-cil by two-thirds (2/3) of the members presentand voting; and provided that notice of theproposed amendments has been made knownto the members, with prior notice given at theprevious meeting or by letter to the councilmembers thirty (30) days prior to the meetingat which they will be discussed. Amendmentsso approved will be submitted to the gover-nor, director of the Department of Social Ser-vices and the director of the Division ofAging for review and comments prior toimplementation.

AUTHORITY: section 660.050, RSMo 1986.*This rule was previously filed as 13 CSR15-6.030 and 13 CSR 15-4.030. Original rulefiled Jan. 6, 1986, effective April 30, 1986.Moved to 19 CSR 15-4.030, effective Aug.28, 2001.




19 CSR 15-4.040 State Plan

PURPOSE: This rule describes the processwhere the division develops the state plan.

(1) The assessment and planning processused by the division to develop a comprehen-sive and integrated plan for delivery of ser-vices statewide includes, but is not limited to,consulting with area agencies, the Governor’sAdvisory Council, division staff and otheragencies and organizations to—

(A) Assess the needs of older persons inthe state;

(B) Establish statewide priorities;(C) Review procedures with regard to the

development and implementation of the stateplan; and

(D) Ensure that the objectives establishedin the state plan and the area agencies areaplans are consistent.

(2) The state plan is developed to cover aperiod of up to four (4) years, is reviewed bythe governor and submitted to the assistantsecretary. It is reviewed annually and updatedas needed reflecting input and advice fromolder persons throughout the state and fromthe AAAs.

(3) The state plan is available for review inthe office of the director of the Division ofAging.

AUTHORITY: section 660.050, RSMo Supp.1999.* This rule was previously filed as 13CSR 15-6.035 and 13 CSR 15-4.040. Origi-nal rule filed Jan. 6, 1986, effective April 30,1986. Emergency amendment filed Oct. 16,1991, effective Oct. 26, 1991, expired Feb.13, 1992. Amended: Filed Oct. 16, 1991,effective Feb. 6, 1992. Amended: Filed Aug.28, 2000, effective March 30, 2001. Moved to19 CSR 15-4.040, effective Aug. 28, 2001.

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

19 CSR 15-4.050 Funding Formula andFiscal Management

PURPOSE: This rule describes the division’sfiscal management responsibilities underTitle III of the Older Americans Act.

(1) The division in consultation with all AreaAgencies on Aging (AAAs) shall develop anduse an intrastate funding formula for the allo-cation of funds received under Title III of the

Older Americans Act (the Act) with theexception of Title III funds allocated for Dis-ease Prevention and Health Promotion Ser-vices and Title III-B funds utilized for out-reach demonstration projects and theombudsman program.

(2) The intrastate funding formula for thestate of Missouri shall be established by theproportion of the population in each planningand service area (PSA) as calculated by usingthe following four (4) factors:

(A) All individuals in each PSA sixty (60)years of age or older;

(B) All individuals in each PSA sixty (60)years of age or older who are low income;

(C) All individuals in each PSA who aresixty (60) years of age or older who arelow-income minorities;

(D) All individuals in each PSA who aresixty (60) years of age or older who are in thegreatest social need. The basis for this factorshall be determined by the number of indi-viduals who are of the appropriate age—

1. With a physical or mental disability;2. With a language barrier; 3. Who are geographically isolated; or4. Who are culturally or socially isolat-

ed; (E) Data used to compute the area agency

on aging allotment percentages was derivedfrom the 1990 Census of Population andHousing, Summary Tape 3A for the followingcategories:

1. Population sixty (60) years of age andover for funds allocated for the period July 1,1994 through June 30, 1995;

2. Population sixty (60) years of age andover, below poverty;

3. Population sixty (60) years of age andover, minority below poverty;

4. Population sixty (60) years of age andover, rural or geographically isolated; and

5. Population sixty (60) years of age andover, minority;

(F) Data from the 1990 Census of Popula-tion and Housing, Summary Tape File 4Awas used for the following categories:

1. Population sixty (60) years of age andover with a disability;

2. Population sixty (60) years of age andover with limited English;

(G) Data used to compute the area agencyon aging allotment percentages was derivedfrom the 1993 Census Estimates prepared bythe Missouri Office of Administration for thepopulation sixty (60) years of age and overfor funds allocated for the period July 1,1994 through June 30, 1995;

(H) Data used to compute the area agencyon aging allotment percentages was derivedfrom the 1993 Census Estimates prepared by

the Missouri Office of Administration for thepopulation sixty (60) years of age and overfor funds allocated for the period July 1,1995 through June 30, 1996;

(I) Data used to compute the area agencyon aging allotment percentages was derivedfrom the 1994 Census Estimates prepared bythe Missouri Office of Administration for thepopulation sixty (60) years of age and overfor funds allocated for the period July 1,1996 through June 30, 1997;

(J) Data used to compute the area agencyon aging allotment percentages was derivedfrom the 1995 Census Estimates prepared bythe Missouri Office of Administration for thepopulation sixty (60) years of age and overfor funds allocated for the period July 1,1997 through June 30, 1998;

(K) Data used to compute the area agencyon aging allotment percentages was derivedfrom the 1996 Census Estimates prepared bythe Missouri Office of Administration for thepopulation sixty (60) years of age and overfor funds allocated for the period July 1,1998 through June 30, 1999;

(L) Data used to compute the area agencyon aging allotment percentages was derivedfrom the 1997 Census Estimates prepared bythe Missouri Office of Administration for thepopulation sixty (60) years of age and overfor funds allocated for the period July 1,1999 through June 30, 2000;

(M) Data used to compute the area agencyon aging allotment percentages was derivedfrom the 1998 Census Estimates prepared bythe Missouri Office of Administration for thepopulation sixty (60) years of age and overfor funds allocated for the period July 1,2000 through June 30, 2001;

(N) Data used to compute the area agencyon aging allotment percentages was derivedfrom the 1999 Census Estimates prepared bythe Missouri Office of Administration for thepopulation sixty (60) years of age and overfor funds allocated for the period July 1,2001 through June 30, 2002;

(O) Based on the factors stated in this rule,the percentage of funds allocated to each PSAfor the period July 1, 1994 through June 30,1995, are as follows:

1. Southwest Missouri Office onAging—12.45%;

2. Southeast Missouri Area Agency onAging—10.66%;

3. District III Area Agency on Aging—6.73%;

4. Northwest Missouri Area Agency onAging—6.62%;

5. Northeast Missouri Area Agency onAging—5.76%;

6. Central Missouri Area Agency onAging—10.79%;



7. Mid-America Regional Council AreaAgency on Aging—14.21%;

8. Mid-East Area Agency on Aging—19.34%;

9. City of St. Louis Area Agency onAging—9.80%; and

10. Area Agency on Aging Region X—3.64%;

(P) Based on the factors stated in this rule,the percentage of funds allocated to each PSAfor Fiscal Year 1996 beginning on July 1,1995 and ending June 30, 1996, are as fol-lows:










10. Agency on Aging Region X—3.64%;

(Q) Based on the factors stated in this rule,the percentage of funds allocated to each PSAfor Fiscal Year 1997 beginning on July 1,1996 and ending June 30, 1997, are as fol-lows:










10. Area Agency on Aging Region X—3.64%;

(R) Based on the factors stated in this rule,the percentages of funds allocated to eachPSA for the Fiscal Year 1998 beginning on

July 1, 1997 and ending June 30, 1998, areas follows:


2. Southeast Missouri Area Agency—10.52%;

3. District III Area Agency—6.60%;4. Northwest Missouri Area Agency—

6.40%;5. Northeast Missouri Area Agency—

5.61%;6. Central Missouri Area Agency—

10.91%;7. Mid-America Regional Council—

14.39%;8. Mid-East Area Agency—20.42%;9. St. Louis Area Agency—8.82%; and10. Region X Area Agency—3.64%;

(S) Based on the factors stated in this rule,the percentages of funds allocated to eachPSA for the Fiscal Year 1999 beginning onJuly 1, 1998 and ending June 30, 1999, areas follows:








(T) Based on the factors stated in this rule,the percentages of funds allocated to eachPSA for the Fiscal Year 2000 beginning onJuly 1, 1999 and ending June 30, 2000, areas follows:








and

(U) Based on the factors stated in this rule,the percentages of funds allocated to eachPSA for the Fiscal Year 2001 beginning onJuly 1, 2000 and ending June 30, 2001, areas follows:








and(V) Based on the factors stated in this rule,

the percentages of funds allocated to eachPSA for the Fiscal Year 2002 beginning onJuly 1, 2001 and ending June 30, 2002, areas follows:







14.53%;8. Mid-East Area Agency—20.93%;9. St. Louis Area Agency—8.21%; and10. Region X Area Agency—3.63%.

(3) The funds allocated to each area agencyshall include an identical base amount to eachAAA in the state and an amount allottedusing the factors in section (2).

(4) The division shall use the data from themost recent decennial census in computingallotment percentages. In addition, the divi-sion shall revise allotment percentages, atleast, biennially in accordance with popula-tion estimates made available through theMissouri Office of Administration.

(5) The division in consultation with allAAAs shall develop and use an intrastatefunding formula for the allocation of Title IIIfunds for Disease Prevention and Health Pro-motion Services.



(6) The intrastate funding formula for theallocation of Title III funds for Disease Pre-vention and Health Promotion Services shallbe established by the proportion of the sum ofthe factors for each PSA to the total of thefactors for the state as calculated by using thefollowing three (3) factors:

(A) Average score of the sum of the fol-lowing four (4) social and economic needindicators per region:

1. The proportion of the individuals whoare age sixty (60) and over who arelow-income to the total population of individ-uals who are age sixty (60) and over withineach county or the city of St. Louis. A scorewas assigned to each county or the city of St.Louis based upon the following scale:

A. 0.00%—6.00% = 1B. 6.01%—12.00% = 2C. 12.01%—18.00% = 3D. 18.01%—24.00% = 4E. 24.01%—100.00% = 5

2. The proportion of the individuals whoare age sixty (60) and over who are receivingMedicaid assistance to the total population ofindividuals who are age sixty (60) and overwithin each county or the city of St. Louis. Ascore was assigned to each county or the cityof St. Louis based upon the following scale:

A. 0.00%—6.00% = 1B. 6.01%—12.00% = 2C. 12.01%—18.00% = 3D. 18.01%—24.00% = 4E. 24.01%—100.00% = 5

3. The proportion of the individuals whoare age sixty (60) and over who are minorityto the total population of individuals who areage sixty (60) and over within each county orthe city of St. Louis. A score was assigned toeach county or the city of St. Louis basedupon the following scale:

A. 0.00%—1.00% = 1B. 1.01%—5.00% = 2C. 5.01%—8.00% = 3D. 8.01%—12.00% = 4E. 12.01%—100.00% = 5

4. The population density expressed asindividuals per square mile within each coun-ty or the city of St. Louis. A score wasassigned to each county or the city of St.Louis based upon the following scale:

A. 0.00—10.00 persons per squaremile = 5

B. 10.01—15.00 persons per squaremile = 4

C. 15.01—25.00 persons per squaremile = 3

D. 25.01—40.00 persons per squaremile = 2

E. 40.01—100.00 persons per squaremile = 1

(B) The proportion of individuals who areage sixty (60) and over within each PSA tothe total population of individuals who areage sixty (60) and over within the state. Thisfactor is computed by dividing the populationsixty (60) and over per PSA by the total pop-ulation sixty (60) and over within the state;the quotient is then multiplied by one hundred(100);

(C) The proportion of individuals who areage sixty (60) and over residing in a desig-nated primary care health professional short-age area (HPSA), as designated by the Unit-ed States Public Health Service, Office ofShortage Designation, within each PSA to thetotal population of individuals who are agesixty (60) and over residing in an HPSA with-in the state. This factor is computed bydividing the population sixty (60) and overresiding in an HPSA per PSA by the totalpopulation sixty (60) and over residing in anHPSA within the state; the quotient is thenmultiplied by one hundred (100);

(D) Data used for the following categorieswas derived from the 1990 Census of Popula-tion and Housing, Summary Tape File 2A:

1. Population sixty (60) and over; 2. Population sixty (60) and over minor-

ity; (E) Data used for the population sixty (60)

and over below poverty was derived from the1990 Census of Population and Housing,Summary Tape File 4A;

(F) Data used for the population per squaremile was derived from the 1990 Census ofPopulation and Housing Unit Counts, Table4;

(G) Data from the Missouri Department ofSocial Services, Division of Medical Serviceswas used for population sixty (60) and overreceiving Medicaid assistance;

(H) Data from the Federal Register, Vol-ume 59, Number 14, was used for the popu-lation sixty (60) and over residing in HPSAs;

(I) Based upon the factors stated in thisrule, the percentage of funds allocated to eachPSA for Fiscal Year 1997 is as follows:



3. District III Area Agency onAging—7.30%;




7. Mid-America Regional Council—13.51%;

8. Mid-East Area Agency onAging—11.30%;

9. St. Louis City Area Agency onAging—13.01%; and

10. Area Agency on Aging RegionX—5.19%;

(J) Data from the October 2, 1995 FederalRegister was used for the population sixty(60) and over residing in HPSAs;

(K) Based upon the factors stated in thisrule, the percentage of funds allocated to eachPSA for Fiscal Year 1998 is as follows:








(L) Data from the Department of Healthwas used for the population sixty (60) andover residing in HPSAs;

(M) Based upon the factors stated in thisrule, the percentages of funds allocated toeach PSA for Fiscal Year 1999 are as follows:








(N) Based upon the factors stated in thisrule, the percentage of funds allocated to eachPSA for Fiscal Year 2000 are as follows:





6.64%;



6. Central Missouri Area Agency—9.21%;

7. Mid-America Regional Council—18.83%;

8. Mid-East Area Agency—12.06%;9. St. Louis Area Agency—10.19%; and10. Region X Area Agency—4.85%;

(O) Based upon the factors stated in thisrule, the percentages of funds allocated toeach PSA for Fiscal Year 2001 are as follows:








and(P) Based upon the factors stated in this

rule, the percentages of funds allocated toeach PSA for Fiscal Year 2002 are as follows:







8.45%;8. Mid-East Area Agency—19.65%;9. St. Louis Area Agency—11.02%; and10. Region X Area Agency—6.04%.

(7) Area agencies on aging shall have avail-able not more than ten percent (10%) of thetotal federal Older Americans Act Title IIIPart B, Part C-1, Part C-2, and Title III Dis-ease Prevention and Health Promotion Ser-vices funds for paying such percentage, butnot more than seventy-five percent (75%) ofthe cost of administration of the area plan.The ten percent (10%) administrationallowance shall only be taken from amountsmade available to the area agencies on agingfrom federal Older Americans Act Title IIIPart B, Part C-1, and Part C-2.

AUTHORITY section 660.050, RSMo 2000.*This rule was previously filed as 13 CSR15-6.195 and 13 CSR 15-4.050. Original rulefiled Jan. 6, 1986, effective April 30, 1986.Amended: Filed Feb. 17, 1988, effective June15, 1988. Emergency amendment filed June16, 1992, effective July 1, 1992, expired Oct.28, 1992. Amended: Filed April 1, 1992,effective Sept. 6, 1992. Emergency amend-ment filed April 14, 1994, effective April 24,1994, expired Aug. 21, 1994. Emergencyamendment filed April 27, 1994, effectiveMay 13, 1994, expired Sept. 9, 1994.Amended: Filed April 14, 1994, effectiveSept. 30, 1994. Emergency amendment filedAug. 1, 1994, effective Aug. 22, 1994,expired Dec. 19, 1994. Emergency amend-ment filed Aug. 1, 1994, effective Sept. 11,1994, expired Jan. 8, 1995. Emergencyamendment filed Dec. 19, 1994, effectiveJan. 8, 1995, expired May 7, 1995. Emer-gency amendment filed April 26, 1995, effec-tive May 9, 1995, expired Sept. 5, 1995.Amended: Filed Dec. 20, 1994, effective June30, 1995. Emergency amendment filed June22, 1995, effective July 1, 1995, expired Oct.28, 1995. Amended: Filed July 17, 1995,effective Jan. 30, 1996. Emergency amend-ment filed Oct. 19, 1995, effective Oct. 29,1995, expired April 25, 1996. Amended:Filed Dec. 28, 1995, effective June 30, 1996.Amended: Filed Feb. 20, 1997, effective Aug.30, 1997. Amended: Filed March 16, 1998,effective Sept. 30, 1998. Amended: Filed Feb.11, 1999, effective Aug. 30, 1999. Amended:Filed Feb. 2, 2000, effective Aug. 30, 2000.Amended: Filed Jan. 16, 2001, effective July30, 2001. Moved to 19 CSR 15-4.050, effec-tive Aug. 28, 2001.


19 CSR 15-4.060 State Long-Term CareOmbudsman Program

PURPOSE: This rule describes how the divi-sion operates the statewide long-term careombudsman program.

(1) The statewide long-term care (LTC)ombudsman program—

(A) Investigates and resolves complaintsmade by or for older persons in LTC facilitiesabout administrative actions that mayadversely affect their health, safety, welfareor rights;

(B) Monitors the development and imple-mentation of federal, state and local laws,regulations and policies that relate to LTCfacilities in the state;

(C) Provides information to public agen-cies about the problems of older individualsin LTC facilities;

(D) Trains staff and volunteers and pro-motes and assists in the development of citi-zen organizations to participate in theombudsman program;

(E) Implements additional activities, asappropriate, that enhance the LTC ombuds-man program and are consistent with federaland state requirements and guidelines;

(F) Develops procedures to assure that rep-resentatives of the LTC ombudsman programare given appropriate access to LTC facilities,appropriate private access to residents andappropriate access to the residents’ personaland medical records; and

(G) Establishes a statewide uniform report-ing system to collect and analyze complaintsabout conditions in LTC facilities for the pur-pose of identifying problems. Informationdeveloped is submitted to the division’s licen-sure and certification section and follow-up iscoordinated to resolve significant problems.Reports on the information gathered and ana-lyzed through the statewide uniform reportingsystem are submitted to the commissioner asrequired.

AUTHORITY: section 660.050, RSMo 1986.*This rule was previously filed as 13 CSR15-6.065 and 13 CSR 15-4.060. Originalrule filed Jan. 6, 1986, effective April 30,1986. Moved to 19 CSR 15-4.060, effectiveAug. 28, 2001.


19 CSR 15-4.070 Designation of AreaAgencies on Aging

PURPOSE: This rule describes the processused to designate an Area Agency on Aging,what types of agencies may be eligible andthe criteria used by the division for designa-tion.

(1) No more than one (1) area agency will bedesignated within a planning and service area(PSA). If the division withdraws designationof one (1) of the existing area agencies inaccordance with section 660.050.4, RSMoprior to designating a new area agency, thedivision shall—

(A) Consider the views of the unit(s) ofgeneral purpose government within the PSA;and

(B) Determine through an on-site assess-ment that the potential area agency has thecapacity to perform all of the required func-tions.



(2) Any one (1) of the following types ofagencies may be designated as an area agen-cy for a PSA:

(A) Any office or agency representing aunit of general purpose local government thatis proposed by the chief elected official of theunit;

(B) Any office or agency proposed by thechief elected officials representing acombination of units of general purpose localgovernment; or

(C) Any other public or private nonprofitagency, except any regional or local agency ofthe state.

(3) Whenever a new Area Agency on Agingis designated after the date of enactment ofthe Older Americans Act amendments of1984, the division will give the right of firstrefusal to a unit of general purpose local gov-ernment if—

(A) The unit can meet the requirements ofsubsection (4)(C); and

(B) The boundaries of that unit and theboundaries of the area are reasonably con-tiguous.

(4) The division considers applicants eligiblefor designation as an area agency that meetthe following criteria:

(A) The applicant has prepared and sub-mitted to the division a comprehensive areaplan. The area plan shall be completed inaccordance with the uniform plan formatdeveloped by the division;

(B) If the applicant has responsibilitiesbeyond programs for the elderly, it shall agreeto create a single organizational unit with del-egated authority whose principal functionshall be the effective development and imple-mentation of an area plan;

(C) The applicant has demonstrated thecapacity to assess the needs of the elderly andto plan, administer, monitor and evaluate ser-vices for the entire PSA. The applicant shallbe able to work effectively with all public andprivate social, economic, ethnic, political andgeographic elements of the PSA it seeks toserve;

(D) The applicant has documented supportof local governments and any local agingcouncils. The applicant, if a privatenot-for-profit agency, has documented that itis incorporated by the Missouri secretary ofstate and maintains a current certificate ofgood standing; and

(E) The applicant, if a private not-for-prof-it agency, has documented that it has appliedto the Internal Revenue Service and receivedthe appropriate tax status designation.

AUTHORITY: section 660.050, RSMo 1986.*This rule was previously filed as 13 CSR15-6.045 and 13 CSR 15-4.070. Original rulefiled Jan. 6, 1986, effective April 30, 1986.Moved to 19 CSR 15-4.070, effective Aug. 28,2001.

*Original authority: 660.050, RSMo 1984, RSMo amend-ed 1988.

19 CSR 15-4.080 Withdrawal of Designa-tion

PURPOSE: This rule identifies the circum-stances under which the division may with-draw designation of an area agency, notifythe assistant secretary of the action and pro-vide for continuity of services.

(1) The division may withdraw an area agen-cy’s designation if—

(A) The area agency does not comply withrequirements of the federal and state laws orrules;

(B) State or federal funds are not beingexpended for the purposes for which theywere intended; and

(C) Elderly persons are not receivingappropriate services within availableresources.

(2) Withdrawal of designation of an areaagency shall not occur without consultationwith the director of the Area Agency onAging and the area agency board and anopportunity has been granted for a formalhearing and review by the governor.

(3) Should the division withdraw designationof an area agency, the division will notify theassistant secretary in writing of its action,provide a plan for the continuity of servicesin the affected planning and service area(PSA) and designate a new area agency in thePSA in a timely manner.

(4) If necessary to ensure a continuity of ser-vices in a PSA, the division, for a period ofup to one hundred eighty (180) calendar days,may perform the responsibilities of the areaagency or assign the responsibility of the areaagency to another agency in the PSA. Thedivision may request an extension of an addi-tional one hundred eighty (180) days from theassistant secretary if the need for the exten-sion can be demonstrated.

AUTHORITY: section 660.050, RSMo Supp.1999.* This rule was previously filed as 13CSR 15-6.050 and 13 CSR 15-4.080. Origi-nal rule filed Jan. 6, 1986, effective April 30,1986. Amended: Filed Aug. 28, 2000, effec-

tive March 30, 2001. Moved to 19 CSR 15-4.080, effective Aug. 28, 2001.

* Original authority: 660.050, RSMo 1984, amended1988, 1992, 1993, 1994, 1995.

19 CSR 15-4.090 Appeal to the AssistantSecretary

PURPOSE: This rule describes the actionthat the division takes when an applicationfor designation as a planning and servicearea has been denied and the denial has beenupheld in a division hearing.

(1) Any applicant for designation as a plan-ning and service area (PSA) whose applica-tion has been denied by the division and whohas requested and received a formal hearingat the state level shall be notified in writing ofthe right to appeal to the assistant secretary,Department of Health and Human Services.Written notification shall advise the applicantthat a written appeal may be filed with theassistant secretary within thirty (30) calendardays of receipt of notification of the hearingdecision.

(2) Upon request by the assistant secretary,the division shall submit the following infor-mation regarding an applicant who has filedan appeal:

(A) A copy of the applicant’s applicationfor designation as a PSA;

(B) A copy of the written decision of thedivision; and

(C) Any other relevant information theassistant secretary may require.

(3) Upon receipt of written notice of the date,time and location, the division director, ordesignated representative, or both, shallattend the assistant secretary’s hearing on theapplicant’s appeal.

AUTHORITY: section 660.050, RSMo Supp.1999.* This rule was previously filed as 13CSR 15-6.055 and 13 CSR 15-4.090. Origi-nal rule filed Jan. 6, 1986, effective April 30,1986. Amended: Filed Aug. 28, 2000, effec-tive March 30, 2001. Moved to 19 CSR 15-4.090, effective Aug. 28, 2001.


19 CSR 15-4.100 Area Agency GoverningBody

PURPOSE: This rule requires each areaagency to have a governing body and, unless



otherwise governed by local law, ordinanceor charter, specifies its composition, respon-sibilities and requirements.

(1) Each area agency, unless otherwise struc-tured by local law, ordinance or charter shallhave a governing body of adequate size andstructure to operate efficiently and effective-ly.

(2) The area agency governing body shallmaintain the ultimate authority and responsi-bility for administration of the approved areaplan to provide services to the elderly withinthe designated planning and service area inaccordance with all applicable federal, state,and local laws and regulations and divisionpolicies and procedures.

(3) The area agency governing body shallhave written bylaws, ordinances or charterthat define its membership, authority, respon-sibilities and procedures for operation.Unless specified otherwise by local laws,ordinances or charter the governing bodyshall comply with the requirements below:

(A) Officers of the governing body shall beelected by the full membership of the board;

(B) No officer of the governing body shallserve in the same office for more than two (2)consecutive terms;

(C) The composition, selection and pur-pose of standing committees shall be speci-fied in the bylaws. Standing committees mustreport to the full governing board as directedby the agency’s bylaws, but at least annually;

(D) Membership on the area agency gov-erning body shall not be restricted to individ-uals from any specific race, creed, color, sex,religion, age, national origin, disabilities orveteran status. Elections procedures shallconform to 13 CSR 15-4.105.

(E) All members of the area agency gov-erning body shall serve three (3)-year stag-gered terms, meaning one-third (1/3) of themembership is elected in year one (1), one-third (1/3) is elected in year two (2), and one-third (1/3) is elected in year three (3), thencontinue in the same manner; and

(F) The area agency governing body shallnot select, appoint or elect as a member, orex officio member, any individual who is anowner, board member or employee of a ser-vice provider agency that has currently sub-mitted a proposal to the area agency toreceive funding to provide services or that iscurrently providing services under a grant,contract or stipend with the area agency.

(4) The area agency governing body shallmaintain full and complete written minutes ofall meetings. Upon request, these minutes

shall be available for review by the divisionand the public.

(5) Meetings of the governing body must fol-low Robert’s Rules of Order and a parliamen-tarian shall be designated by the board.

(6) All meetings of the board shall be open tothe public as required by section 610.010,RSMo, et seq. commonly referred to as theSunshine Law..

(7) The governing body annually shall reviewthe bylaws and update if necessary.

(8) The area agency governing body, withinthirty (30) days, shall notify the division ofany changes it makes in its corporate status,administrative status, staff, location or tele-phone number.

AUTHORITY: section 660.050, RSMo Supp.1999.* This rule was previously filed as 13CSR 15-6.070 and 13 CSR 15-4.100. Origi-nal rule filed Jan. 6, 1986, effective April 30,1986. Amended: Filed Feb. 17, 1988, effec-tive June 15, 1988. Amended: Filed Aug. 28,2000, effective March 30, 2001. Moved to 19CSR 15-4.100, effective Aug. 28, 2001.


19 CSR 15-4.105 Area Agency ElectionProcedures for Governing Body Member-ship

PURPOSE: This rule establishes anddescribes election procedures for membershipon the area agency governing body. This ruledoes not apply to area agency board membersappointed by the chief executive of a unit oflocal government, political subdivision orcouncil of government who are elected offi-cials with the exception of section (2).

(1) Solicitation for governing board nomineesshall be publicized locally within the areafrom which a governing body member will beelected. Nominations may be made by filinga statement of intent at a publicized locationin each area or at a publicized open meetingheld in the area.

(2) Nominees must be residents of the areathey represent and must sign a code of ethicsas approved by the governing body.

(3) All voters must register to vote at thepolling location. Any person sixty (60) yearsof age or older shall be eligible to vote.

(4) The area agency governing body will des-ignate a minimum of one (1) polling locationper county.

(5) The time and location of the election shallbe publicized in community newspapers atleast seven (7) days prior to the election andposted at a minimum in all area agency spon-sored senior centers.

(6) Polling places shall be open for voting atleast six (6) consecutive hours, with provi-sions for persons with special needs, includ-ing optional absentee voting. Polling loca-tions shall not be open earlier than 6:00 a.m.,nor stay open any later than 7:00 p.m.

(7) The area agency will be responsible forprinting the official ballots. Nominees shallbe listed alphabetically.

(8) A minimum of two (2) persons designat-ed by the area agency shall be present tocount votes unless a local county clerk agreesto count votes and certify the results.

(9) Results of the election will be submittedto the area agency central office in a standardreporting format.

(10) All ballots and affidavits shall be keptfor a minimum of twenty-two (22) months asrequired by section 1974 of Title 42 UnitedStates Code for federal elections, providedthey have received final audit approval.

(11) A maximum of thirty (30) days will beallowed to contest the results of an election.

AUTHORITY: section 660.050, RSMo Supp.1999.* This rule previously filed as 13 CSR15-4.105. Original rule filed Feb. 17, 1988,effective June 15, 1988. Amended: Filed Aug.28, 2000, effective March 30, 2001. Moved to19 CSR 15-4.105, effective Aug. 28, 2001.


19 CSR 15-4.110 Area Agency AdvisoryCouncil

PURPOSE: This rule requires each areaagency to have an advisory council and estab-lishes the requirements it shall meet.

(1) Each area agency shall have an advisorycouncil which shall develop and make publicwritten bylaws which specify the role andfunctions of the advisory council, number ofmembers, procedure for selection of mem-bers, term of membership and the frequencyof meetings.



(2) The advisory council shall meet at leastquarterly.

(3) The composition of the councils shall bemore than fifty percent (50%) older persons,including older persons with the greatest eco-nomic or social need, older minority individ-uals, service recipients and also shall includerepresentatives of older persons, local electedofficials and the general public.

(4) The advisory council shall advise the areaagency on developing and administering thearea plan, conducting public hearings, repre-senting the interests of the elderly andreviewing and commenting on communitypolicies, programs and actions affecting theelderly.

(5) The area agency shall provide staff andassistance to the advisory council.

AUTHORITY: section 660.050, RSMo 1986.*This rule was previously filed as 13 CSR15-6.085 and 13 CSR 15-4.110. Original rulefiled Jan. 6, 1986, effective April 30, 1986.Moved to 19 CSR 15-4.110, effective Aug. 28,2001.


19 CSR 15-4.120 Affirmative Action/EqualEmployment Opportunity/Preference inHiring

PURPOSE: This rule requires each areaagency receiving federal or state funds tocomply with the requirements of AffirmativeAction/Equal Employment Opportunity pro-grams and to give preference in hiring to per-sons aged sixty or over.

PUBLISHER’S NOTE: The publication of thefull text of the material that the adoptingagency has incorporated by reference in thisrule would be unduly cumbersome or expen-sive. Therefore, the full text of that materialwill be made available to any interested per-son at both the Office of the Secretary of Stateand the office of the adopting agency, pur-suant to section 536.031.4, RSMo. Suchmaterial will be provided at the cost estab-lished by state law.

(1) Each area agency shall have an Affirma-tive Action/Equal Employment Opportunityprogram as required by Title V of the Code ofFederal Regulations, Part 900, Standards fora Merit System of Personnel Administration.The written Affirmative Action/EqualEmployment Opportunity plan shall be kepton file for review and shall be updated as

required.

(2) The area agency, subject to establishedjob qualification requirements or merit sys-tem requirements, shall give preference inhiring to applicants who are sixty (60) yearsof age or over for all full- or part-time posi-tions.

AUTHORITY: section 660.050, RSMo 1986.*This rule was previously filed as 13 CSR15-6.075 and 13 CSR 15-4.120. Original rulefiled Jan. 6, 1986, effective April 30, 1986.Moved to 19 CSR 15-4.120, effective Aug.28, 2001.


19 CSR 15-4.130 Area Agency Staff

PURPOSE: This rule requires the area agen-cy to have a written staffing plan, employ afull-time director and have adequate numbersof staff.

(1) The area agency shall have on file forreview—an up-to-date staffing plan thatincludes, but is not necessarily limited to, anorganizational chart; a description of the edu-cation, experience and background qualifica-tions required for each position (paid and vol-unteer); a description of the responsibilityassigned to each position (paid and volun-teer); and a salary schedule.

(2) The area agency shall employ a full-timedirector to assure the effective and efficientadministration of the area plan. The full-timedirector shall possess the education, experi-ence and background qualifications as deter-mined necessary by the governing body tofulfill the requirements and functions of thedirector’s position.

(3) The area agency shall employ sufficientstaff to carry out the required functions of thearea agency.

AUTHORITY: section 660.050, RSMo 1986.*This rule was previously filed as 13 CSR15-6.080 and 13 CSR 15-4.130. Originalrule filed Jan. 6, 1986, effective April 30,1986. Moved to 19 CSR 15-4.130, effectiveAug. 28, 2001.


19 CSR 15-4.135 Area Agency Director

PURPOSE: This rule establishes anddescribes procedures each area agency shall

follow in hiring a director unless otherwisegoverned by merit system requirements estab-lished under local law, ordinance, or charter.

(1) The governing body will appoint a searchcommittee for purposes of filling the vacancy.An interim or acting director may be appoint-ed by the board until the time a permanentdirector is selected.

(2) The governing body shall propose a jobdescription and qualifications, and update asnecessary. This responsibility may be dele-gated to the search committee.

(3) The governing body shall establish asalary range for the director of the area agen-cy which is commensurate with the duties andresponsibilities of the position.

(4) The search committee shall advertise thevacancy in at least one (1) major newspaperwith the greatest circulation in the area.

(5) The search committee will screen allapplications and conduct initial interviews.

(6) The search committee will recommend tothe full governing body a list of at least thetop three (3) finalists based on applications,interviews and reference checks. At the gov-erning body’s discretion, re-interviews of allcandidates, including the top three (3) recom-mended by the search committee may takeplace.

(7) The governing body shall review the rec-ommendations of the search committee andmake the final decision.

(8) If the desire is to promote an in-houseperson, the open search process may be con-ducted in a shorter time frame than mightotherwise be required.



19 CSR 15-4.140 Area Agency Plan

PURPOSE: This rule establishes the require-ments that the area agency shall meet todevelop or amend and submit an area plan.



(1) The area agency shall develop the areaplan in accordance with all applicable feder-al and state regulations, the uniform plan for-mat and other guidelines issued by the divi-sion.

(2) The area plan shall encompass a planningperiod as specified by the division. However,fiscal budgets, including allotments/funds forservices and planned service delivery shall beamended at least annually or as availableallotments/funds change.

(3) The area plan shall be amended under thefollowing situations:

(A) A new amended state or federal statuteor regulation requires a new provision or con-flicts with any existing provisions;

(B) A supreme court decision changes theinterpretation of a statute or regulation;

(C) The area agency changes the designa-tion of the single organizational unit or com-ponent unit;

(D) Receipt by area agency staff or boardmembers of compensation or other items ofvalue above their salaries or the normal fringebenefits available to all staff; and

(E) The area agency takes any action forwhich prior division approval is required bystate regulation, divisional policy, or preprintinstructions.

(4) The area plan or plan amendments shallnot be implemented until approved in writingby the division.

AUTHORITY: section 660.050, RSMo Supp.1999.* This rule was previously filed as 13CSR 15-6.095 and 13 CSR 15-4.140. Origi-nal rule filed Jan. 6, 1986, effective April 30,1986. Amended: Filed Feb. 17, 1988, effec-tive June 15, 1988. Amended: Filed Aug. 28,2000, effective March 30, 2001. Moved to 19CSR 15-4.140, effective Aug. 28, 2001.


19 CSR 15-4.150 Waivers

PURPOSE: This rule allows the area agencyto request a waiver from meeting specificrequirements and sets forth procedures to befollowed.

(1) An area agency shall request a waiver ifunable to comply with a specific divisionrequirement. The request shall be in writing,shall be signed by the chairperson of the gov-erning body, shall state the requirement for

which a waiver is requested and shall includesupportive documentation that explains whythe requirement cannot be met, a descriptionof the area agency’s proposed alternative formeeting the requirement and an explanationof why the proposed alternative is most appli-cable for the area agency’s situation.

(2) Public Hearing for Waivers for PriorityServices.

(A) Prior to submitting a waiver requestfor a priority service, the area agency shallconduct, at a minimum, one (1) public hear-ing on the content of a proposed waiver. Thehearing shall be scheduled at a convenienttime and location to ensure maximum atten-dance by interested parties, representatives ofthe governing body and advisory council tothe area agency, public officials and elderlypersons.

(B) Notice of the public hearing shall bepublicized through widely circulated newspa-pers and other public media at least twenty(20) calendar days before the date of the hear-ing. The notice shall be published in Englishand other languages as appropriate to the geo-graphic area or to the target population to beserved.

(C) In addition, notice of the public hear-ing shall be provided to service providers,organizations of the elderly, public officialsand other public and private agencies in theplanning and service area.

(D) Records of the public hearings heldshall be on file at the area agency office andshall be submitted to the division with thewaiver request. The records shall include thefollowing:

1. Documentation of public notice;2. List of names of persons attending the

hearing and organizations represented; and3. Written summary of all comments

received, including if and how commentswere incorporated.

(3) A waiver may be approved for the life ofthe plan, not to exceed four (4) years.

(4) A waiver request may only be submittedwith the area plan or area plan amendments.



19 CSR 15-4.160 Review, Submission andApproval of Area Agency Area Plans andPlan Amendments

PURPOSE: This rule describes the require-ments for review, submission to the divisionand the criteria for approval of the area agen-cy’s area plan or plan amendments.

(1) Where not covered by charter or estab-lished governmental procedures the followingshall apply. The area agency shall submit thearea plan and any plan amendments forreview and approval by the area agency’s gov-erning body. The area agency shall obtainsigned documentation stating that the areaplan and annual updates have been approvedby the governing body. The area agency shallalso submit the area plan and annual updatesto its advisory council for review and com-ment prior to transmittal to the state unit onaging as required by 45 CFR 1321.57. Thearea agency shall comply with the Missouristate and local review process.

(2) Following guidelines specified by thedivision in the preprint, the area agency shallsubmit the proposed area plan or amend-ments to the division for approval.

(3) The division will approve, in writing, anarea agency’s plan or plan amendment indi-cating that it meets federal and state regula-tions and division policies and guidelines.

(4) The division will notify the area agency,in writing, within fifteen (15) business daysof receipt at division offices of making adetermination that it finds that any provisionof the area plan or any plan amendment is notapprovable and that the division proposes todisapprove the area plan or amendment. Writ-ten notification shall include the following:

(A) Explanation of the reasons for the dis-approval;

(B) Provision for the opportunity for thearea agency to review any pertinent docu-ments upon which the determination wasbased; and

(C) Notification of the right to request aformal hearing on the determination.

AUTHORITY: section 660.050, RSMo Supp.1999.* This rule was previously filed as 13CSR 15-6.110 and 13 CSR 15-4.160. Originalrule filed Jan. 6, 1986, effective April 30,1986. Amended: Filed Aug. 28, 2000, effec-tive March 30, 2001. Moved to 19 CSR 15-4.160, effective Aug. 28, 2001.




19 CSR 15-4.170 Area Agency Fiscal Man-agement

PURPOSE: This rule describes the require-ments that the area agency shall meet in man-aging all funds related to programs funded inwhole or in part with state or federal fundsassociated by the Division of Aging.

(1) The area agency shall establish a systemto monitor financial expenditures of grantsand contracts. In order to ensure adequatemonitoring, at a minimum, the area agencyshall—

(A) Establish written policies and proce-dures governing the expenditures of funds byservice providers. These procedures shallprovide for record maintenance by each ser-vice provider;

(B) Document, through assessment re-ports, that expenditures are made in accor-dance with the provisions of part 74 of Title45 CFR;

(C) Monitor quarterly the financial trans-actions of grants and contracts;

(D) Assure that service providers haverecorded documentation of the amount ofcash and in-kind resources provided as amatch; and

(E) Require adequate bonding of personshandling fiscal responsibilities.

(2) The area agency shall submit writtenrequests for transfers according to the proce-dures established by the division.

(3) The area agency, upon request, shall pro-vide fiscal information to the division, fromarea agency documentation.

(4) The area agency shall provide assurancesthat an adequate proportion of the amountallotted for supportive services (Part B) to theplanning and service area will be expendedfor the delivery of each of the priority ser-vices. Adequate proportion shall be deter-mined by considering the area agency budgetand history for each service and currentneeds assessment data related to each service.

(5) The area agency annually shall specify inthe area plan, as submitted or as amended, indetail, the amount of funds expended for eachcategory of services during the fiscal yearmost recently concluded.

(6) Nonfederal matching requirements shallbe met by the area agency on the aggregatenet cost of social and nutrition services andadministration under Title III. Furtherrequirements are as follows:

(A) The nonfederal match shall be in theform of allowable costs of third-party in-kind

contributions or funds which are from a non-federal source and which are not used asmatch for any other federal program;

(B) The nonfederal match for administra-tive costs shall be no less than twenty-fivepercent (25%) of the net administrative cost;

(C) The nonfederal match for social andnutrition services’ net costs shall be no lessthan fifteen percent (15%) of the net cost;

(D) No less than twenty-five percent(25%) of the nonfederal match shall be in theform of allowable costs of state or local pub-lic agencies; and

(E) Five percent (5%) of the net cost shallbe met by allowable costs of the state andshall be included toward meeting the nonfed-eral matching requirements.

(7) The area agency shall have an organiza-tion-wide audit completed by an independentcertified public accountant at least every two(2) years (covering the previous two (2)-yearperiod); however, yearly audits are recom-mended. Further requirements are as follows:

(A) Audits shall be completed and submit-ted to the division no later than one hundredtwenty (120) calendar days after the close ofthe agency’s fiscal year;

(B) The area agency may request, in writ-ing, a one (1)-month extension from the divi-sion. The request shall include the reason(s)for the extension and shall be received by thedivision’s auditor no later than ten (10) work-ing days before the audit due date. The divi-sion shall approve or reject a request forextension no more than five (5) working daysafter receipt of the written request;

(C) The criteria to be followed in auditingan area agency shall be for—

1. Governmental agencies, Office ofManagement and Budget (OMB) CircularA-133 shall apply for fiscal years beginningafter December 31, 1984; and

2. All other agencies, the audit provi-sions in OMB Circular A-110, Attachment Fshall apply; and

(D) The audit shall be received by the divi-sion by the due date or the approved extend-ed due date. Audits not in compliance withfederal regulations will not be accepted.

(8) The area agency shall not delegate author-ity to award or administer funds under TitleIII to other agencies. The exception may befor transportation agreements with agencieswhich administer programs under the Reha-bilitation Act of 1973 and Titles XIX and XXof the Social Security Act to meet the com-mon need for transportation of service recip-ients under the separate programs.

(9) Unexpended Title III B, III C-1, III C-2funds and administrative allotments for whichthere are no legal obligations shall not exceedfifteen percent (15%) of each subpart’s totalallotment at the end of each fiscal year.

(10) Program income shall be—(A) Earned gross income by an area agen-

cy from activities, part or all of the cost ofwhich is either borne as a direct cost by agrant or counted as a direct cost toward meet-ing a cost-sharing or matching requirement ofa grant. It includes, but is not limited to,income in the form of fees for services per-formed during the grant or subgrant period,proceeds from sale of tangible personal orreal property, usage or rental fees and patentor copyright royalties. If income meets thisdefinition, it shall be considered programincome regardless of the method used to cal-culate the amount paid to the area agency;

(B) Used to expand services for the elder-ly in the program from which it was earned;

(C) Expended in the current fiscal year orfollowing fiscal year; and

(D) Documented as to the program underwhich income was earned and expended.

(11) The area agency shall submit fiscalreports to the division on an accrual account-ing basis. If the area agency’s fiscal recordsshow effective control and accountability, theagency may develop the reports through avail-able documentation. The area agency mayestimate outlays in instances where—

(A) There is adequate documentation onwhich to develop a sound and reasonable esti-mate of outlays; and

(B) The area agency is unable to obtainactual data in time to meet reporting dead-lines.

(12) The area agency shall follow Title 45CFR part 74 Administration of Grants exceptwhere inconsistent with federal statutes, reg-ulations or other terms of a grant or wheneither the language of the provision itself orother text in the same subpart indicates theprovision affects service provider agencies(subgrantees) and use of the term—

(A) Recipient shall be taken as referring toarea agencies (subgrantees); and

(B) Awarding party shall be taken as refer-ring to the division (granting agency).

(13) The area agency shall meet requirementsconcerning advancements, reimbursements orinterest earned on federal funds as follows:

(A) Use methods and procedures to mini-mize the time lapse between the transfer offunds and disbursement;



(B) Not request reimbursement for the fed-eral share of amounts withheld from contrac-tors to ensure satisfactory completion of workuntil it makes those payments;

(C) Expend interest earned on federalfunds for allowable costs in the fiscal year inwhich it was earned;

(D) Expend interest earned on federalfunds for allowable costs of the funds whichearned the interest;

(E) Budget and report interest earned offederal funds, distinguishing the interest fromthe fund which earned the interest; and

(F) Maintain documentation of compli-ance.

(14) The area agency shall submit monthlyinvoices for reimbursement of expenditures tothe division within fifteen (15) days after theclose of each fiscal month on forms pre-scribed by the division.

(15) The area agency shall meet the division’sreporting requirements for quarterly and finalfinancial reports as follows:

(A) Submit quarterly financial and pro-gram reports with the appropriate invoice;

(B) Submit a final financial report to thedivision within ninety (90) days after the fis-cal year of the grant ending;

(C) Submit financial reports on the formsprescribed by the division; and

(D) Be subject to the withholding of pay-ments for failure to comply with reportingrequirements, until such time as reports arereceived.

(16) Any cost allocation plans and indirectcosts rates shall be determined in accordancewith the following guidelines:

(A) For governments, OMB Circular A-87,including any amendments to the circularpublished by the United States OMB;

(B) For institutions of higher education,OMB Circular A-21 and as published in theFederal Register by OMB; and

(C) For other nonprofit organizations,OMB Circular A-122.

(17) In order to minimize a loss of funds inthe event of bank insolvency, the area agencyshall not deposit contributions and federalgrant funds in any one (1) bank in an amountthat exceeds that bank’s maximum insuredamount by the Federal Deposit InsuranceCorporation (FDIC). The total deposits inone (1) bank, regardless of the number ofseparate accounts, shall not exceed the maxi-mum amount insured by the FDIC. Anacceptable alternative is to request the bankto pledge securities to the area agency. Thesesecurities shall act as insurance for excessivecash balances. Documentation of compliance

shall be maintained by the area agency.

(18) Contributions shall be handled accordingto procedures as required for serviceproviders in 13 CSR 15-7.010(13).

AUTHORITY: section 660.050, RSMo Supp.Supp. 1999.* This rule was previously filedas 13 CSR 15-6.200 and 13 CSR 15-4.170.Original rule filed Jan. 6, 1986, effectiveApril 30, 1986. Amended: Filed Feb. 17,1988, effective June 15, 1988. Amended:Filed Aug. 28, 2000, effective March 30,2001. Moved to 19 CSR 15-4.170, effectiveAug. 28, 2001.


19 CSR 15-4.175 Funding Acquisition orConstruction of Multipurpose SeniorCenters

PURPOSE: This rule sets forth the proce-dures and guidance mandated in 42 U.S.C.3030b and Administration on Aging PI-91-04for financing multipurpose senior centersbuilding acquisitions or improvements withfunding received from the division.

(1) The requirements of this rule apply to theuse of division funding to acquire, construct,alter or renovate multipurpose senior centers.The requirements apply whether divisionfunding is used to finance the cost in wholeor in part.

(2) Area agencies may utilize supportive ser-vices funding received from the division tofinance the acquisition, construction, alter-ation or renovation of multipurpose seniorcenters only where an area plan or area planupdate has been approved by the division,where funding has been explicitly identifiedand designated in the plan or plan update forthe named center and where—

(A) The center is operated under anapproved direct service waiver where title tothe structure is held by the area agency; or

(B) A grant is made to a public or non-profit private organization where title to thestructure is held by the public or nonprofitorganization.

(3) Area agencies must notify the division inwriting within thirty (30) days of any decisionto acquire, construct, alter or renovate a cen-ter. The notification must include:

(A) Date the decision was approved by theagency’s board of directors;

(B) Amount approved by the board for theproject;

(C) Percentage of total cost which will bepaid from funding under the agency’sgrant/contract with the division;

(D) Nature of the project funded (acquisi-tion, construction, alteration or renovation);

(E) Name and address of grantee, whereapplicable; and

(F) Name and address of the center.

(4) Total cost, for the purposes of this rule,includes all costs incurred by the title holderwhether financed with division funding,other area agency funding or funding fromthird parties. Total cost does not include thevalue of any third-party in-kind contributions.

(5) Funding under the agency’s grant/contractwith the division, for the purposes of thisrule, includes funding received from the divi-sion and funding counted toward satisfyingany matching requirement for receipt of divi-sion funding.

(6) Area agencies must file the followingnotice of record with the appropriate unit oflocal government when acquiring or con-structing an agency-owned center:

“This is to serve as notice to all potential sell-ers, purchasers, transferors and recipients ofa transfer of the real property describedbelow as to the federal government’s rever-sionary interests as set forth in section 312 ofthe Older Americans Act of 1965, as amend-ed in 1987, 42 U.S.C. 3030b, which havearisen as a result of (grantee’s name) receiptand use of Department of Health and HumanServices’ grant funds in connection with thepurchase or construction of said property.The property to which this notice is applica-ble is (address) and identified as parcel(insert appropriate number(s)) in the booksand records of (insert appropriate name oflocal unit of government’s recording agency).Said real property is also described as: (insertdescription provided in survey). Furtherinformation as to the federal government’sinterest referred to above can be obtainedfrom: (name and address of area agency onaging).”

(7) Area agencies must include a requirementin all grant awards for acquisition or con-struction of a center that the grantee file thenotice of record detailed in section (6) anddeliver a copy of the filed notice to the agen-cy.

(8) Within thirty (30) days of the filing date,area agencies must deliver a copy of all filednotice of records to the division.



(9) Area agencies must notify the division inwriting within thirty (30) days when—

(A) The agency’s board of directorsapproves additional funding for a centeracquisition, construction, alteration or reno-vation project;

(B) The board approves funding to alter orrenovate a center acquired or constructedwith division funding;

(C) The title holder, original grantee orcenter has a change of name or address;

(D) The site ceases to be used as a multi-purpose senior center; or

(E) The title holder ceases to be a public ornonprofit private organization.

(10) Area agencies must maintain a perpetualinventory listing of all multipurpose seniorcenter acquisitions, constructions, alterationsor renovations financed with division fund-ing.

(11) The inventory listing must include allcenters whether owned by the area agency orby a public or nonprofit private organization.

(12) The inventory listing must include thefollowing information:

(A) Date the project was approved by theagency’s board of directors;

(B) Amount approved by the board for theproject;

(C) Percentage of total cost which will bepaid from funding under the agency’sgrant/contract with the division;

(D) Nature of the project funded (acquisi-tion, construction, alteration or renovation);

(E) Name and address of current title hold-er;

(F) Name and address of original grantee,where applicable;

(G) Name and address of the center; (H) Date the site ceased operation as a

senior center, when applicable; and (I) Date the title holder ceased to be a pub-

lic or nonprofit private organization, whenapplicable.

(13) Area agencies must update the inventorywhen any of the following occur:

(A) The board approves new or additionalfunding for a public or nonprofit private orga-nization to acquire, construct, alter or reno-vate a center;

(B) The board approves new or additionalfunding to acquire, construct, alter or reno-vate an agency-owned center;

(C) The title holder, original grantee orcenter has a change of name or address;

(D) The site ceases to be used as a multi-purpose senior center; or

(E) The title holder ceases to be a public ornonprofit private organization.

(14) The area agency must maintain an annu-al inventory listing and provide a copy to thedivision upon request.

(15) The division shall be entitled to recoverfunds from an area agency when a multipur-pose senior center within ten (10) years afteracquisition or within twenty (20) years aftercompletion of construction ceases to be—

(A) Owned by a public or nonprofit privateorganization; or

(B) Used for the purpose for which it wasacquired, constructed, altered or renovated.

(16) The amount recoverable by the divisionshall be a percentage of current market value.The percentage shall be equivalent to the per-centage of funds contributed under the agen-cy’s grant/contract with the division to thetotal original cost of the acquisition or con-struction.

(17) Area agencies are encouraged to enterinto legally binding agreements with thegrantees permitting the area agency to recov-er an equivalent amount of funding. The divi-sion shall be entitled to recover the fullamount from the area agency regardless ofthe area agency’s ability to recover fundingfrom a grantee.

(18) An area agency may petition for waiverof recovery by submitting a written requestwithin thirty (30) days of any event outlinedin section (15). The request must detail thereason(s) the area agency believes good causeexists for releasing the agency from the obli-gation.

(19) The division may approve or disapproveany waiver requested.

(20) Area agencies must maintain the follow-ing on file:

(A) Records documenting total costsincurred by the title holder;

(B) Records documenting the amount oftotal costs paid with funding under the agen-cy’s grant/contract with the division;

(C) A copy of the filed notice of record; (D) Documents supporting market value

determination at the time of any event listedin section (15); and

(E) Records documenting the receipt ofamounts recovered from public or nonprofitprivate organizations pursuant to any eventlisted in section (15).

(21) Area agencies must maintain all materi-al listed in section (20) applicable to a centerfor three (3) years after the division obtainsan independent audit in conformance withfederal Office of Management and Budgetrequirements covering the period in which—

(A) The structure ceases to be owned by apublic or nonprofit private organization;

(B) The structure ceases to be used as amultipurpose senior center;

(C) Ten (10) years have elapsed from thetime division funding was used to acquire thefacility; or

(D) Twenty (20) years have elapsed fromthe time division funding was used to con-struct the facility.



19 CSR 15-4.180 Area Agency AdvocacyResponsibility

PURPOSE: This rule requires the area agen-cy to carry out activities to advocate in theinterest of the elderly.

(1) The area agency shall serve as the advo-cate for the elderly in the planning and ser-vice area by performing at least the followingactivities:

(A) Monitor, evaluate and comment on allpolicies, programs, hearings, levies and com-munity actions which affect older persons;

(B) Solicit comments from the public onthe needs of older persons;

(C) Represent the interests of older personsto public officials, public and private agenciesor organizations;

(D) Carry out activities in support of thedivision’s long-term care ombudsman pro-gram; and

(E) Coordinate planning with other agen-cies and organizations to promote new orexpanded benefits and opportunities for olderpersons.

(2) The area agency shall develop and imple-ment written policies and procedures thatdescribe how it carries out advocacy activi-ties.

AUTHORITY: section 660.050, RSMo 1986.*This rule was previously filed as 13 CSR 15-6.115 and 13 CSR 15-4.180. Original rule



filed Jan. 6, 1986, effective April 30, 1986.Moved to 19 CSR 15-4.180, effective Aug.28, 2001.


19 CSR 15-4.190 Area Agency Develop-ment of a Comprehensive and CoordinatedService Delivery System

PURPOSE: This rule describes the require-ments the area agency shall meet to develop acomprehensive and coordinated service deliv-ery system within the planning and servicearea.

(1) The area agency continuously shall worktoward development of a comprehensivecoordinated community-based system thatshall facilitate access to and utilization of allsupportive and nutritional services providedby any source within the planning and servicearea (PSA). Components of this system mayinclude:

(A) Services which facilitate access, suchas transportation, outreach, information andassistance, and case management;

(B) Services provided in the community,such as congregate meals, continuing educa-tion, health and nutrition education, healthscreening, legal assistance, program develop-ment and coordination activities, advocacy,information and assistance, case manage-ment, casework, counseling and assistance(concerning taxes, financial problems, publicbenefits, the use of facilities and services,preretirement or second career), adult dayhealth care, protective services, servicesdesigned for the unique needs of persons withdisabilities, emergency services, disasterrelief services, minor home repair, physicalfitness and recreation, services to help obtainadequate housing and alteration, renovation,acquisition and construction of facilities to beused as multipurpose senior centers;

(C) Services provided in the home, such ashome health services, homemaker services,personal care services, legal assistance,respite, case management, counseling, chore,visiting, shopping assistance, reading/letter-writing, telephone reassurance, home-deliv-ered meals and nutrition education; and

(D) Services provided to residents of care-providing facilities, such as case managementcounseling, placement and relocation assis-tance, group services, legal assistance, com-plaint and grievance resolution and visiting.Care-providing facilities include long-termfacilities, emergency shelters and other con-gregate living arrangements.

(2) The area agency shall assess the needs ofthe elderly in the PSA and the effectivenessof resources in meeting identified needs.

(3) The area agency shall establish effectiveand efficient procedures for coordination ofplanning and service delivery with otheragencies and organizations within the PSA,including agencies that administer the follow-ing:

(A) The Job Training Partnership Act(JTPA);

(B) Title II of the Domestic Volunteer Actof 1973;

(C) Titles VI, X, XVIII, XIX and XX ofthe Social Security Act;

(D) Sections 231 and 232 of the NationalHousing Act;

(E) The United States Housing Act of1959;

(F) Section 202 of the Housing Act of1959;

(G) Title I of the Housing and CommunityDevelopment Act of 1974;

(H) Title I of the Higher Education Act of1965 and the Adult Education Act;

(I) Sections 3, 9 and 16 of the Urban MassTransportation Act of 1964;

(J) The Public Health Service Act;(K) The Low-Income Home Energy Assis-

tance Act of 1981;(L) Part A of the Energy Conservation in

Existing Buildings Act of 1976;(M) The Community Services Block Grant

Act; and(N) Demographic statistics and analysis

programs conducted by the Bureau of Cen-sus.

(4) The area agency may make arrangementswith other local agencies and organizationsfor services and programs that benefit theelderly, such as—

(A) Children’s day care organizations sothat older persons can volunteer to help pro-vide the day care; and

(B) Local educational agencies, institutionsof higher education and not-for-profit privateorganizations.

(5) The area agency shall develop and publishthe methods that are used to establish priori-ties for services, particularly—

(A) Services associated with access toother services. These services include trans-portation, outreach, information and assis-tance, and case management;

(B) In-home services. These servicesinclude homemaker, personal care aide, visit-ing and telephone reassurance, chore, andsupportive services for families of elderlyvictims of Alzheimer’s disease and other neu-

rological and organic brain disorders of theAlzheimer’s type; and

(C) Legal assistance.

(6) The area agency shall give preference inthe delivery of services to elderly personswith the greatest economic or social need. Adescription of the methods and proceduresused to assure that services are provided tothose with the greatest economic and socialneed including low income minority shall beincluded in the area plan.

(7) The area agency shall provide adequateand effective opportunities for the elderly toexpress their views on policy developmentand program implementation.

(8) The area agency shall develop and imple-ment organized ongoing outreach activities toelderly individuals, particularly those resid-ing in rural areas and those with greatest eco-nomic or social need and inform them of ser-vices that are available. Area agency outreachactivities shall be coordinated with the out-reach activities required of each serviceprovider within the PSA.

(9) The area agency shall develop a compre-hensive, coordinated disaster preparednessplan which shall include service providers inthe PSA.

(10) The area agency shall assure that all ser-vice providers follow the applicable require-ments set forth in 13 CSR 15-7.

(11) The area agency shall assure that theelderly residing in the PSA have reasonablyconvenient access to information and assis-tance systems.

(12) The area agency shall designate a focalpoint for comprehensive service delivery ineach community giving special considerationto multipurpose senior centers and assuringthat the facility can accommodate the collo-cation of services.

(13) The area agency shall encourage maxi-mum collocation and coordination of servicesthrough the community focal point by—

(A) Establishing guidelines for operatingschedules that are convenient for servicerecipients;

(B) Assuring reasonably convenient accessto existing information and referral services;and

(C) Encouraging service providers to col-locate their services and coordinate withother services in the community.



(14) The area agency may plan, coordinateand provide services funded under other pro-grams if it continues to meet its area agencyresponsibilities.

AUTHORITY: section 660.050, RSMo 1999.*This rule was previously filed as 13 CSR 15-6.120 and 13 CSR 15-4.190. Original rulefiled Jan. 6, 1986, effective April 30, 1986.Amended: Filed Aug. 28, 2000, effectiveMarch 30, 2001. Moved to 19 CSR 15-4.190,effective Aug. 28, 2001.


19 CSR 15-4.200 Area Agency Subgrantsor Contracts

PURPOSE: This rule sets forth requirementsfor the area agency to follow in awarding sub-grants and contracts.

(1) The area agency shall follow applicableprocurement standards as specified in 45CFR Part 74. If an area agency utilizes arequest for qualifications (RFQ), this shall beconsidered a competitive negotiation procure-ment method as described in subsection 11cof Appendix G.

(2) The area agency shall publicly announceall solicitations at least thirty (30) calendardays prior to the deadline for acceptance ofresponses. Media announcements shall bemade within the appropriate planning andservice area in a manner that will enable cur-rent and potential service providers to benotified. The public notice shall—

(A) Identify each program/service to befunded;

(B) Specify the date by which responsesmust be submitted for consideration; and

(C) Advise how copies of the solicitationsmay be obtained.

(3) The area agency shall submit, for the divi-sion’s prior approval, any proposed contractswith profit-making organizations for the pro-vision of services under the area plan asrequired by section 212 of the Act. The areaagency is not required to submit to the divi-sion for prior approval any proposed sub-grants or contracts with public or privatenonprofit agencies or organizations.

(A) In addition to complying with all appli-cable federal procurement practices, all pur-chases shall be based on competitive bids,except that the area agency may make pur-chases of less than two thousand dollars($2,000) in value on the open market. Onany purchase estimated at ten thousand dol-

lars ($10,000) or more the agency shalladvertise for bids in at least two (2) newspa-pers of general circulation in such places asare most likely to reach prospective bidders atleast fourteen (14) days before bids are to beopened. The agency shall also solicit bids bymail from at least three (3) prospective sup-pliers on purchases of ten thousand dollars($10,000) or more. For purchases of morethan two thousand dollars ($2,000) but lessthan ten thousand dollars ($10,000) bids mustbe solicited and documented, but advertisingor direct mailings are not required. The con-tracts shall be let to lowest and best bidder.

(B) The agency may waive the requirementof competitive bids for the purchase of fooditems when special temporary market condi-tions exist and the food items can be pur-chased for at least ten percent (10%) less thanthe most current bid price for the same fooditems.

(4) The area agency shall use subgrants orcontracts with service providers to provide allservices under all OAA funding sources. Forwaiver of this requirement, the area agencyshall submit a written request that thorough-ly documents that direct provision of service,using its own employees, is necessary—

(A) To assure an adequate supply of theservice;

(B) Where those services are directly relat-ed to the area agency’s administrative func-tions; or

(C) Where those services of comparablequality can be provided more economicallyby the area agency.

(5) If an area agency receives a waiver to pro-vide a service directly, all applicable require-ments for that service as set forth in 13 CSR15-7 and 13 CSR 15-4 shall be met.



19 CSR 15-4.210 Area Agency GrievanceProcedures

PURPOSE: This rule requires area agenciesto establish written grievance procedures.

Editor’s Note: The secretary of state hasdetermined that the publication of this rule in

its entirety would be unduly cumbersome orexpensive. The entire text of the rule has beenfiled with the secretary of state. The entiretext of the rule may be found at the head-quarters of the agency and is available to anyinterested person at a cost established bystate law.

(1) Each area agency shall establish writtengrievance procedures that provide the oppor-tunity to appear before the governing body tothe following:

(A) Individuals who wish to resolve areasof conflict regarding delivery of services;

(B) Service provider applicants whoseapplication to provide services is denied; and

(C) Service providers whose subgrant orcontract is terminated or not renewed.

(2) The written grievance procedures shall befiled with the division as an addendum to thearea agency’s plan and shall include, at aminimum, the following:

(A) Time limitations, as applicable, andprocedures to be followed to request agrievance hearing;

(B) Procedures for conducting thegrievance hearing;

(C) Opportunity to review any pertinentinformation relating to the issues; and

(D) Criteria to be used for making a finaldetermination that include:

1. Time limitations for notification ofthe decision from the date of grievance hear-ing;

2. Reasons for the final determinationand the evidence on which it was based; and

3. Advice of the right to appeal to thedivision for mediation to service providerswho meet the following conditions:

A. Application to provide servicesunder an area plan has been denied; or

B. Subgrant or contract is terminatedor not renewed for reasons other than a deter-mination that the service provider has materi-ally failed to comply with the terms of thesubgrant or contract as provided in 45 CFRpart 74, subpart M.

AUTHORITY: section 660.050, RSMo 1986.*This rule was previously filed as 13 CSR 15-6.090 and 13 CSR 15-4.210. Original rulefiled Jan. 6, 1986, effective April 30, 1986.Moved to 19 CSR 15-4.210, effective Aug. 28,2001.




19 CSR 15-4.220 Area Agency TechnicalAssistance, Monitoring and EvaluationResponsibilities

PURPOSE: This rule requires the area agen-cy to provide technical assistance to serviceproviders and other organizations and tomonitor and assess service provider perfor-mance.

(1) The area agency shall provide technicalassistance to service providers, organizationswhere joint program agreements are in effect,and upon request, to groups and public andprivate organizations that are interested indeveloping or expanding programs for theelderly.

(2) The area agency shall develop and imple-ment an ongoing process for monitoring ser-vice providers that includes requiring period-ic written financial and program reports.

(3) At least annually, the area agency shallconduct a full on-site evaluation of each ser-vice provider to monitor compliance with fis-cal and program standards and to providetechnical assistance, if needed. The divisionshall have the right to require an area agencyto conduct more frequent on-site monitoringif there is evidence of inadequate quality orquantity of service being delivered by a ser-vice provider.

(4) The area agency shall develop and imple-ment written policies and procedures thatdescribe how it meets its technical assistance,monitoring and evaluation responsibilities.

AUTHORITY: section 660.050, RSMo 1986.*This rule was previously filed as 13 CSR 15-6.130 and 13 CSR 15-4.220. Original rulefiled Jan. 6, 1986, effective April 30, 1986.Moved to 19 CSR 15-4.220, effective Aug.28, 2001.


19 CSR 15-4.230 Multipurpose SeniorCenter

PURPOSE: This rule establishes the require-ments that shall be met by an area agency forconstructing, acquiring, altering, leasing andrenovating a multipurpose senior center.

(1) Area agencies may award Title III socialservice funds to a public or private nonprofitagency for the following purposes:

(A) Acquiring, altering, leasing or renovat-ing a facility for use as a multipurpose seniorcenter;

(B) Constructing a facility for use as a mul-tipurpose senior center; or

(C) Paying the costs of professional andtechnical personnel required to operate multi-purpose senior centers.

(2) In making multipurpose senior centerawards, the area agency shall give preferenceto facilities located in communities with thegreatest numbers of elderly including lowincome minority and those with economicneed.

(3) The area agency shall assure the followinggeneral requirements will be met prior toawarding funds for a multipurpose seniorcenter:

(A) It serves a cross section of all segmentsof the elderly population of its planning andservice area, with special emphasis on lowincome minority and those in economic andsocial need; and

(B) It operates a program of group activi-ties, individual services and community ser-vice opportunities in each of the followingcategories:

1. Access services;2. Community services, including

advocacy-related services;3. Services for frail, vulnerable, and at

risk elderly; and4. Nutrition services.

(4) The area agency shall submit to the divi-sion, for review and prior approval, a writtenplan for purchase or construction of a multi-purpose senior center with accompanyingjustification and documentation. The divisionshall approve the proposed plan based on thefollowing criteria:

(A) For proposed award for construction,there is no other suitable facility available tobe a community focal point for service deliv-ery; and

(B) For proposed award for purchasing orconstructing a facility, only if there are nosuitable facilities for leasing.

(5) The area agency shall submit to the divi-sion, for review and prior approval, the plansand specifications for any proposed acquisi-tion, alteration, renovation or construction ofa multipurpose senior center facility fundedwith federal or state funds in order to assurethat all applicable minimum constructionstandards shall be met, particularly therequirements of the Architectural BarriersAct of 1968.

(6) The area agency shall submit to the divi-sion, for review and prior approval, the plansand specifications for any proposed alteration

or renovation that affects the load-bearingstructures of a multipurpose senior centerwith federal or state funds, or both. The divi-sion shall review to assure that the plans andspecifications comply with all applicablelocal or state ordinances, laws or buildingcodes. In the absence of those codes, the divi-sion shall assure compliance with Chapter 23of the Uniform Building Code or Chapter 12of the Standard Building Code.

(7) The area agency shall require recipients ofan award for altering, renovating or con-structing a facility to be used as a multipur-pose senior center to comply with therequirements of the Davis-Bacon Act andother mandatory federal labor standards.

(8) A facility acquired or constructed to beused as a multipurpose senior center shall beused for that purpose for a minimum of ten(10) years from the date of acquisition ortwenty (20) years after the completion of con-struction.

(9) The area agency shall ensure that no fed-eral or state funds shall be used for religiousinstruction or worship.

(10) The area agency shall ensure that no fed-eral or state funds shall be used for the pro-motion of any political point of view.

(11) The area agency shall assure the follow-ing:

(A) Sufficient funds shall be available tomeet the nonfederal share of the award;

(B) Sufficient funds shall be available toeffectively use the facility as a multipurposesenior center;

(C) In a facility that is shared with otherage groups, federal or state funds shall sup-port only—

1. That part of the facility used by olderpersons; or

2. A proportionate share of the costsbased on the extent of use of the facility byolder persons; and

(D) A multipurpose senior center programmust be operated in that facility in accor-dance with standards set forth in 13 CSR 15-7.070.

AUTHORITY: section 660.050, RSMo Supp.1999.* This rule was previously filed as 13CSR 15-6.140 and 13 CSR 15-4.230. Origi-nal rule filed Jan. 6, 1986, effective April 30,1986. Amended: Filed June 3, 1991, effectiveOct. 31, 1991. Amended: Filed Aug. 28,2000, effective March 30, 2001. Moved to 19CSR 15-4.230, effective Aug. 28, 2001.




19 CSR 15-4.240 Nutrition Service Re-quirements

PURPOSE: This rule establishes the require-ments to be met by the area agency to fund,establish and operate nutrition services forthe elderly.

(1) The area agency may award nutrition ser-vices funds to a service provider to providemeals and other nutrition services, includingoutreach and nutrition education, to eligibleservice recipients within the planning andservice area (PSA).

(2) The area agency shall assess the level ofneed for congregate and home-deliveredmeals within the PSA and maintain docu-mentation of the method(s) used to assesslevel of need and how the results were used todetermine levels of services to meet thoseneeds.

(3) The area agency may make awards forcongregate and home-delivered nutrition ser-vices to a service provider that furnisheseither or both type(s) of service(s). The areaagency may award federal and state funds toa service provider that delivers only home-delivered nutrition services if congregatenutrition services are also provided throughthe area agency.

(4) The area agency shall assure that no con-tract shall be entered into for the provision ofnutrition services unless that contract hasbeen awarded through a competitive process.

(5) Primary consideration shall be given tothe provision of meals in a congregate setting,except that each area agency may awardhome-delivered nutrition funds to organiza-tions which have demonstrated an ability toprovide home-delivered meals efficiently andreasonably, and will furnish assurances to thearea agency that the organization will main-tain efforts to solicit voluntary support andthat federal funds made available to the orga-nization will not be used to supplant fundsfrom nonfederal sources. The area agencyneed not require that these organizations alsoprovide meals to older individuals in a con-gregate setting.

(6) Eligibility of individuals to receive nutri-tion services shall be determined as follows:

(A) Any person aged sixty (60) years orover and the spouse of that person regardlessof age shall be eligible to receive congregatenutrition services;

(B) Any person aged sixty (60) years orover who is homebound by reason of illness,incapacitating disability or is otherwise iso-lated shall be determined eligible for home-delivered nutrition services. Occasionalescorted trips from the home for medical orother necessary services will not affect theindividual’s eligibility for home-deliveredmeals. The following conditions shall be met:

1. The area agency shall require anassessment of the individual’s eligibility forhome-delivered nutrition services prior to ini-tiation of the service and assess the individu-al’s need for continued service at least annu-ally after that. In emergency situations,home-delivered meals may be delivered for amaximum of five (5) days prior to the initialassessment of eligibility; and

2. The area agency shall develop writtencriteria by which to determine if the spouseand/or primary caregiver who resides in thehome, regardless of their age or condition ofthe spouse, may receive a home-deliveredmeal. The criteria developed shall assure thatthe receipt of the meal by the spouse and/orcaregiver is in the best interest of the home-bound older person;

(C) Persons with disabilities under sixty(60) years of age who reside in housing facil-ities occupied primarily by the elderly atwhich congregate nutrition services are pro-vided may receive congregate nutrition ser-vices. Any person meeting these require-ments also may be eligible to receivehome-delivered nutrition services providedthe procedures of paragraph (6)(B)2. are fol-lowed; and

(D) Under the Social Services Block Grant(SSBG), persons with disabilities under sixty(60) years of age who do not reside in hous-ing facilities occupied primarily by the elder-ly may be eligible to receive congregate nutri-tion services. Any person meeting theserequirements also may be eligible to receivehome-delivered nutrition services underSSBG provided procedures in paragraph(6)(B)2. are followed.

(7) The area agency may allow guests undersixty (60) years of age to eat a meal at a nutri-tion center provided that—

(A) An eligible service recipient is notdeprived of a meal; and

(B) The full cost of the meal is paid.

(8) The area agency may allow nutrition cen-ter volunteers under sixty (60) years of age toeat a meal at the nutrition center. If volunteermeals are allowed, the criteria shall allowthese meals only if—

(A) An eligible service recipient is notdeprived of a meal;

(B) The volunteer has expended substantialdirect effort in the preparation, service,

delivery, cleanup of the meal, or a combina-tion of these; and

(C) The volunteer is afforded the opportu-nity to contribute to the cost of the meal.

(9) The area agency shall request priorapproval from the division for any new nutri-tion centers, construction of nutrition centers,renovation of nutrition centers or relocationof existing nutrition centers.

(10) The area agency shall request priorapproval, in writing, from the division forany proposed termination of a nutrition cen-ter and shall not terminate any nutrition cen-ter until written approval has been receivedfrom the division.

(11) The area agency shall report the occur-rence or suspicion of a food-borne illness tothe appropriate health authorities and thedivision. The area agency shall cooperatewith health authorities and keep the divisioninformed of the investigation status as well asprovide notice of resolution.

(12) The area agency shall hire or retain theservices of a qualified dietitian/nutritionistwho does monitoring and provides technicalassistance to service providers in the areas offood and nutrition. The dietitian/nutritionistshall meet one (1) of the following qualifica-tions:

(A) Dietitian—A person who holds a bach-elor of science degree from an accredited col-lege or university with a major in dietetics,food and nutrition or institutional food man-agement and is eligible to take the registrationexamination offered by the American Dietet-ic Association;

(B) Registered Dietitian (RD)—A dietitianwho has successfully completed the requiredexamination for registration with the Ameri-can Dietetic Association and maintains thestatus by meeting continuing educationrequirements;

(C) Nutritionist—A person who holds abachelor of science degree with a major inhuman nutrition or a major in dietetics froman accredited college or university;

(D) Food and Nutrition Specialist—A per-son who holds a bachelor of science degreewith a major in food and nutrition or institu-tional food management; or

(E) Public Health Nutritionist—A personwho holds a master of public health nutritionor master of science with a major in publichealth nutrition.

(13) The area agency shall provide for tech-nical assistance/training to nutrition serviceprovider’s staff and volunteers that shall



include, but not necessarily be limited to,meal cost and portion control, com-modity/cash use, nutrition education, nutri-tion policies and standards, modified diets,food buying and preparation, food inventory,menu planning, kitchen design, purchase ofequipment, fire and safety procedures, sani-tation, first-aid and emergency life-savingtechniques.

(A) Technical assistance and training fornutrition education, modified diets and menuplanning shall be provided by a dieti-tian/nutritionist.

(B) In all other areas, technical assistanceand training may be provided by other areaagency staff who have been trained in thesubject matter.

AUTHORITY: section 660.050, RSMo Supp1999.* This rule was previously filed as 13CSR 15-6.145 and 13 CSR 15-4.240. Origi-nal rule filed Jan. 6, 1986, effective April 30,1986. Amended: Filed Feb. 17, 1988, effec-tive June 15, 1988. Amended: Filed June 3,1991, effective Oct. 31, 1991. Amended: FiledMay 12, 2000, effective Nov. 30, 2000.Moved to 19 CSR 15-4.240, effective Aug.28, 2001.


19 CSR 15-4.250 Area Agency USDA

PURPOSE: This rule requires area agencyparticipation in the United States Departmentof Agriculture commodity/cash program anddescribes the requirements for participatingin the program.

(1) The area agency shall accept and dis-tribute United States Department of Agricul-ture (USDA) commodities or cash to nutri-tion service providers based on thepercentage of eligible meals served within theplanning and service area.

(2) Contracts with warehouses for the storageof USDA commodities foods shall include thefollowing:

(A) A method of receiving or rejectingcommodity deliveries from USDA;

(B) A cost per unit for receiving, ware-house storage and removal of commodities;

(C) An accountable recordkeeping system;(D) A method of handling losses and deter-

mining responsibility for losses; and(E) A cancellation clause.

(3) Contracts for transporting commoditiesshall include the following:

(A) The dates or days of week on whichdeliveries are to be made;

(B) The charges and method of payment;(C) The method of receiving commodities

from warehouse;(D) The refrigeration requirements for

frozen foods;(E) The method of reporting losses and

responsibility for reimbursing the area agen-cy for losses;

(F) The procedure for receiving commodi-ties at center or caterer;

(G) An accountable recordkeeping system;and

(H) A cancellation clause.

(4) The area agency shall develop a manage-ment system to assure that USDA commodi-ties and foods purchased with USDA cashshall be used to achieve maximum benefit.The system shall include the following:

(A) The maximum amount of commodityand USDA cash foods a nutrition center mayhave on inventory shall be established; and

(B) The right shall be retained by the areaagency to redistribute foods from one (1)nutrition center to another when necessaryfor best utilization.

(5) The area agency shall develop proceduresto assure that USDA cash is used in compli-ance with USDA requirements. These proce-dures shall include, but are not limited to, thefollowing:

(A) All cash received from USDA shall bespent to purchase United States agriculturalfood items;

(B) For area agencies electing to use com-modities, the USDA cash shall not be used topurchase food items currently available fromthe USDA commodity food program, unlessthe item is in short supply (less than three (3)months’ supply available to the area agency)and a USDA notice of shipment due withintwo (2) months has not been received by thearea agency for the food item;

(C) All purchases made with USDA cashshall be documented by one (1) of the follow-ing methods:

1. If food is purchased through bid, theinvoice shall show the number of units andunit cost, with a copy of the bid specificationattached that contains the statement. The foodis to be United States-produced;

2. If food is purchased without bid, thefollowing procedures shall apply:

A. Invoices for bread and fresh dairyproducts must show the number of units andunit cost. These products are assumed to beUnited States-produced;

B. When canned goods, meat prod-ucts and produce are purchased on a continu-

ing basis from a vendor, a letter from him/herstating that all food supplied to the nutritioncenter is United States-produced will be ade-quate documentation. The letter shall berenewed annually; and

C. Invoices for occasional purchasesshall show the number of units, unit cost anda statement assuring that the food was UnitedStates-produced; or

3. The contract for catered meals shallcontain a clause stating the USDA cash shallbe spent for United States-produced foodsonly and shall inure only to the benefit of thenutrition program; and

(D) The area agency will monitor the nutri-tion service provider to assure adequate doc-umentation is maintained for all these pur-chases.

(6) Prior approval of the USDA regionaloffice shall be obtained before the area agen-cy releases USDA commodities for use dur-ing a disaster/emergency. The area agencyshall contact the division in order to initiatethe approval process and provide the follow-ing information:

(A) The disaster agency that is financiallyresponsible;

(B) The type of disaster, that is flood, tor-nado;

(C) The specific counties involved in thedisaster;

(D) The location and name(s) of the disas-ter agency’s contact person(s);

(E) An identification of the affected popu-lation and estimate of number of persons tobe fed;

(F) The estimated number of days or weeksmeals may be needed; and

(G) The number of times per day mealswill be provided.

(7) During a disaster/emergency, the areaagency shall keep daily records on USDAcommodity use that include the following:

(A) The number of people fed;(B) The number of meals served;(C) The USDA commodity food items

used; and(D) The total value of each food item,

including storage and delivery costs.

AUTHORITY: section 660.050, RSMo Supp.1988.* This rule was previously filed as 13CSR 15-6.150 and 13 CSR 15-4.250. Origi-nal rule filed Jan. 6, 1986, effective April 30,1986. Amended: Filed Feb. 17, 1988, effec-tive June 15, 1988. Moved to 19 CSR 15-4.250, effective Aug. 28, 2001.




19 CSR 15-4.260 Outreach Services

PURPOSE: This rule sets forth the require-ments for outreach services and requires out-reach training.

(1) Area agencies shall provide outreach ser-vices to identify elderly persons and informthem of the availability of services. Outreachefforts should have special emphasis on therural elderly and on those with the greatesteconomic or social need. With respect tonutrition services, outreach efforts shouldensure that the maximum number of eligiblepersons have an opportunity to receive ser-vices.

(2) The area agency shall provide outreachtraining to outreach workers which shallinclude, but not be limited to, the following:

(A) An understanding of the limits towhich workers can serve persons contacted;

(B) Problems of the elderly;(C) Methods of working with the elderly;(D) Sensitivity to needs of the minority

elderly; and(E) Procedures for conducting outreach

services and assessing effectiveness of out-reach activities conducted.



19 CSR 15-4.270 Legal Assistance

PURPOSE: This rule sets forth the require-ments for legal assistance and establishes cri-teria that legal assistance providers shallmeet.

(1) The area agency shall award funds to thelegal assistance provider(s) that most fullymeets the following requirements. The legalassistance provider(s) shall—

(A) Have staff with expertise in specificareas of law affecting older persons with eco-nomic or social needs, for example, publicbenefits, institutionalization and alternativesto institutionalization;

(B) Demonstrate the capacity to provideeffective administrative and judicial represen-tation in the areas of law affecting older per-sons with economic or social need;

(C) Demonstrate the capacity to providesupport to other advocacy efforts, for exam-ple, the long-term care ombudsman program;

(D) Demonstrate the capacity to deliverlegal assistance to institutionalized, isolatedand homebound older individuals effectively;and

(E) Demonstrate the capacity to providelegal assistance in the principal language spo-ken by clients in areas where a significantnumber of clients do not speak English astheir principal language.

(2) A legal assistance provider may notrequire an older person to disclose informa-tion about income or resources as a conditionfor providing legal assistance under this part.A legal assistance provider may ask about theperson’s financial circumstances as a part ofthe process of providing legal advice, coun-seling and representation or for the purposeof identifying additional resources and bene-fits for which an older person may be eligi-ble.

(3) Each legal assistance provider, its attor-ney and employees shall comply with the fol-lowing regulations when engaged in the out-side practice of law:

(A) No attorney shall engage in any outsidepractice of law if the director of the providerhas determined that the practice is inconsis-tent with the attorney’s full-time responsibil-ities;

(B) If the requirement of subsection (3)(A)is met, a provider may permit an attorney toengage in compensated outside practice oflaw when the attorney is newly employed andhas a professional responsibility to closecases from a previous law practice and doesso as expeditiously as possible;

(C) If the requirement of subsection (3)(A)is met, a provider may permit an attorney toengage in compensated outside practice oflaw when the attorney is acting pursuant to anappointment made under a court rule or prac-tice of equal applicability to all attorneys inthe jurisdiction and remits to the provider allcompensation received; or

(D) If the requirement of subsection (3)(A)is met, a provider may permit an attorney toengage in uncompensated outside practice oflaw when the attorney is acting pursuant to anappointment made under a court rule or prac-tice of equal applicability to all attorneys inthe jurisdiction or on behalf of a close friend,family member, religious community or char-itable group.

(4) A provider, employee of the provider orstaff attorney shall not engage in the follow-ing prohibited political activities:

(A) A provider shall not contribute ormake available Older Americans Act (theAct) funds or any personnel requirement to

any political party or association to the cam-paign of any candidate for public or partyoffice or for use in advocating or opposingany ballot measure, initiative or referendum;

(B) No employee intentionally shall identi-fy the Title III program or provider with anypartisan or nonpartisan political activity orwith the campaign of any candidate for pub-lic or party office;

(C) No employee shall use any Act fundsfor activities prohibited to attorneys undersubsection (4)(A); nor shall an employeeintentionally identify or encourage others toidentify the provider with those activities;

(D) While engaged in legal assistanceactivities (any activity carried out during anemployee’s working hours which usesresources provided under the Act, and, infact, provides legal assistance to an eligibleclient), no employee and no staff attorney, atany time, shall—

1. Use official authority or influence forthe purpose of interfering with or affectingthe result of an election or nomination foroffice, whether partisan or nonpartisan;

2. Coerce, directly or indirectly, attemptto coerce, command or advise an employeeunder the Act to pay, lend or contribute any-thing of value to a political party or commit-tee, organizations, agency or person for polit-ical purposes; or

3. Be a candidate for partisan electivepublic office; and

(E) While engaged in legal assistanceactivities supported under the Act, no attor-ney shall engage in any—

1. Political activity;2. Activity to provide voters with trans-

portation to the polls or to provide similarassistance in connection with an election; or

3. Voter registration activity.

(5) No provider shall use funds receivedunder the Act to provide legal assistance in afee-generating case unless other adequaterepresentation is unavailable. All providersshall establish procedures for the referral offee-generating cases.

(A) Fee-generating case means any case ormatter which, if undertaken on behalf of aneligible client by an attorney in private prac-tice, reasonably may be expected to result ina fee for legal assistance from an award to aclient, from public funds or from the oppos-ing party.

(B) Other adequate representation isdeemed to be unavailable when the providerhad determined that fee referral is not possi-ble due to any of the following:

1. The case has been rejected by thelocal lawyer-referral service or by two (2)private attorneys;



2. Neither the referral service nor anylawyer will consider the case without pay-ment of a consultation fee; or

3. Emergency circumstances compelimmediate action before referral can bemade, but the client is advised that, if appro-priate, and consistent with professionalresponsibility, referral will be attempted at alater time.

(C) Other adequate representation isdeemed to be unavailable when—

1. Recovery of damages is not the prin-cipal object of the case and a request for dam-ages is merely ancillary to an action for equi-table or other nonpecuniary relief orinclusion of a counterclaim requesting dam-ages is necessary for effective defense orbecause of applicable rules governing joinderof counterclaims;

2. A court appoints a provider or anemployee for a provider pursuant to a statuteor a court rule or practice of equal applica-bility to all attorneys in the jurisdiction; or

3. An eligible client is seeking benefitsunder Title II of the Social Security Act, 42U.S.C. 401, Federal Old Age Act, Survivorsand Disability Insurance Benefits; or TitleXXVI of the Social Security Act, 42 U.S.C.1381, Supplemental Security Income forAged, Blind and Disabled.

(D) A provider may seek and accept a feeawarded or approved by a court or adminis-trative body or included in a settlement if—

1. The requirements of subsections(4)(B) and (C) are met; and

2. Funds received are not used for pur-poses prohibited by the Act.

(E) When a case or matter subject to thissection results in a recovery of damages,other than statutory benefits, a provider mayaccept reimbursement from the client for out-of-pocket costs and expenses incurred in con-nection with the case or matter, if the—

1. Requirements of subsections (4)(B)and (C) are met; and

2. Client has agreed in writing to reim-burse the provider for these costs and expens-es.

(6) While carrying out legal assistance activ-ities funded under the Act, no employeeshall—

(A) Knowingly participate in any publicdemonstration, picketing, boycott or strike,except as permitted by law in connection withthe employee’s own employment situation;

(B) Intentionally exhort, direct or coerceothers to engage in those activities or other-wise usurp or invade the rightful authority ofa client to determine what course of action tofollow; and

(C) Be prohibited, if an attorney, by anyprovision of this section from—

1. Informing and advising a client aboutlegal alternatives to litigation or the lawfulconduct of litigation; or

2. Fulfilling the professional responsi-bilities of an attorney to a client.

(7) No funds made available to a providerunder the Act shall be used, at any time,directly or indirectly, to support activitiesintended to influence the issuance, amend-ment or revocation of any executive or admin-istrative order or regulation of a federal, stateor local agency or to undertake to influencethe passage or defeat of any legislation by theCongress of the United States or by any stateor local legislative body or state proposals byinitiative petition, except that an employeemay—

(A) Respond to a request from a govern-mental agency or a legislative body, commit-tee or member made to the employee or to arecipient to testify, draft or review measuresor to make representation to the agency, body,committee or member on a specific matter;or

(B) Engage in the activities at the requestof an eligible client of a provider, to theextent the activities are necessary to the pro-vision of legal advice and representation to aclient who has sought this legal advice andrepresentation with respect to particular legalrights and responsibilities which would beaffected by particular legislation or adminis-trative measures, but no employee shall solic-it a client in violation of professional respon-sibilities for the purpose of making therepresentation possible.

(8) Providers shall adopt procedures andforms to document that the legislative andadministrative activities in which they engagefall within the activities permitted in 45 CFRsection 1321.71.

(A) With respect to activities permittedunder subsection (7)(A), a written requestsigned by an official of the governmentalagency or a member of the legislative body orcommittee making the request which statesthe type of representation or assistancerequired and identified the executive oradministrative order, regulation or legislationto be addressed;

(B) With respect to activities permittedunder subsection (7)(B), a retainer agreementsigned by the client(s) represented, or by anofficial of the client group in the case of agroup client, which agreement shall specifythe legislative or administrative measure onwhich representation is sought (appearance ata hearing, legislative drafting, etc.) and

which shall include a statement of the client’sdirect interest in the particular legislative oradministrative measure to be addressed; and

(C) Providers shall obtain the documenta-tion required by this section prior to under-taking any of the activities permitted by sub-section (7)(A) or (B) in the absence of awritten request provided that the fact, natureand circumstances of the request are subse-quently documented in writing and signed bythe requesting authority.

(9) No funds made available under the Actshall be used to—

(A) Maintain separate offices for the solepurpose of engaging in legislative activity;

(B) Pay dues to any organization (otherthan a bar association) a substantial purposeor function of which is to take positions onmatters pending before legislative or adminis-trative bodies;

(C) Pay for transportation to legislative oradministrative proceedings of persons otherthan employees engaged in activities permit-ted under this section or witnesses enteringappearances in the proceedings on behalf ofclients of the providers, except that thosefunds may be used to transport the clientwhere necessary and appropriate. This sub-section does not authorize payment of trans-portation expenses for employees not actuallyengaged in permitted representation activi-ties;

(D) Pay, in whole or in part for the conductof, or transportation to, an event if a primarypurpose of expenditure is to facilitate lobby-ing or any other activity which would be pro-hibited if conducted with funds made avail-able under the Act;

(E) Pay for administrative or related costsassociated with any activity prohibited by thispart; or

(F) Assist others, through legislative liai-son activities, to influence legislation in amanner that would be prohibited if undertak-en with funds made available under the Act.Legislative liaison activities include, but arenot limited to, attending legislative sessionsor committee hearings, gathering informationregarding pending legislation and analyzingthe effect of pending legislation.

(10) Notwithstanding the provisions of sub-section (7)(A), providers shall not use fundsmade available under the Act for publicity orpropaganda purposes designed to support ordefeat proposed legislation or legislationpending before Congress or any state legisla-ture. For purpose of this regulation, publicityor propaganda means any oral communica-tion or any advertisement, telegram, letter,article, newsletter or other printed or written



matter or device which contains a direct sug-gestion or, when taken as a whole, an indirectsuggestion to the public at large or to select-ed individuals to contact elected representa-tives in support of or in opposition to pend-ing or proposed legislation.

(11) No funds made available to a providerunder the Act shall be used to support thepreparation, production and dissemination ofany article, newsletter or other publication orwritten matter for general distribution whichcontains any reference to proposed or pend-ing legislation unless—

(A) The publication does not contain anypublicity or propaganda prohibited by section(10);

(B) The provider has adopted a policyrequiring the provider’s executive director, orhis/her designee, to review each applicationproduced by the provider prior to its dissem-ination for conformity to these regulations;

(C) The provider provides a copy of anysuch material produced by the provider to thearea agency within thirty (30) days after pub-lication; and

(D) These funds are used only for costsincident to the preparation, production anddissemination of publications to providers,providers’ staff and board members, privateattorneys representing eligible clients and thearea agency, as opposed to the public at large.

(12) Notwithstanding the provisions of sec-tion (7), no funds made available to aprovider under the Act shall be used, directlyor indirectly, to pay for any personal service,advertisement, telegram, telephone commu-nication, letter, printed or written matter orother device, intended or designed to influ-ence any decision by a federal, state or localagency, except where legal assistance is pro-vided by an employee of a provider to an eli-gible client on a particular application, claimor case, which directly involves the client’slegal rights and responsibilities or to influ-ence any member of Congress or any otherfederal, state or local elected officials to favoror oppose any acts, bills, resolutions or sim-ilar legislation or any referendum, initiative,constitutional amendment or any similar pro-cedure of Congress, any state legislature, anylocal council or any similar governing body,except that this subsection shall not precludefunds from being used in connection withcommunications made in response to any fed-eral, state or local official upon a specificmatter.

(A) The exception for communications toofficials does not authorize communicationwith anyone other than the requesting party.

(B) No employee of the provider, directlyor indirectly, shall solicit a request from anyofficial to testify or otherwise advocate thesupport or defeat of legislative measures.

(13) Nothing in this section is intended toprohibit an employee from—

(A) Communicating with a governmentalagency for the purpose of obtaining informa-tion, clarification or interpretation of theagency’s rules, practices or policies;

(B) Informing a client about a new or pro-posed statute, executive order or administra-tive regulation consistent with the require-ments of sections (10) and (11);

(C) Responding to an individual client’srequest for advice only with respect to theclient’s own communications to officialsunless otherwise prohibited by the OlderAmericans Act, Title III regulations or otherapplicable law. This provision does not autho-rize publication or training of a client on lob-bying techniques or the composition of acommunication for the client’s use; or

(D) Making direct contact with the areaagency for any purpose.

AUTHORITY: section 660.050, RSMo Supp1999.* This rule was previously filed as 13CSR 15-6.180 and 13 CSR 15-4.270. Origi-nal rule filed Jan. 6, 1986, effective April 30,1986. Amended: FIled Aug. 28, 2000, effec-tive March 30, 2001. Moved to 19 CSR 15-4.270, effective Aug. 28, 2001.

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

19 CSR 15-4.280 Ombudsman Services

PURPOSE: This rule requires the area agen-cy to support the statewide long-term careombudsman program and establishes criteriafor funding local programs.

(1) The area agency shall conduct ombuds-man activities that support the divisionadministered long-term care ombudsman pro-gram. The area agency may award funds forthe provision of a long-term care ombudsmanprogram and that award shall be based on aconsideration of the degree to which theombudsman service provider has—

(A) Established measurable objectives;(B) Identified facilities in the project area;(C) Developed a plan for informing and

serving the elderly residents of the identifiedfacilities; and

(D) Developed a plan for recordkeepingthat includes such data as to the nature of thecomplaints received, efforts made to resolvecomplaints and procedures to maintain the

confidentiality of service recipient recordsand files.



19 CSR 15-4.290 Information and Assist-ance

PURPOSE: This rule requires the area agen-cy to provide information and assistance ser-vices and describes the requirements foroperating the program.

(1) The area agency shall provide informationand assistance services sufficient to ensurethat all elderly persons within the planningand service area have reasonably convenientaccess to information about the services avail-able within their geographic region.

(2) The area agency shall comply with divi-sional standards for information and assis-tance services (see 13 CSR 15-7.050).



19 CSR 15-4.300 Record Keeping andConfidentiality

PURPOSE: This rule establishes the length oftime that the division, area agencies and ser-vice providers shall maintain records and thestandards by which confidentiality of recordswill be maintained.

(1) The division, area agencies and serviceproviders shall maintain all records underTitle III for a minimum of three (3) years;Social Services Block Grant records shall bemaintained for five (5) years.

(2) The division, area agencies and serviceproviders shall maintain the confidentiality ofrecords as follows:



(A) All records that identify individualrecipients of alternative services shall be con-fidential and may be released, for administra-tive and program monitoring purposes only,to the following:

1. Designated employees of the FederalAdministration on Aging Regional OfficeVII;

2. Designated employees of the MissouriDepartment of Social Services and the Divi-sion of Aging;

3. Designated employees of the areaagency or service provider; or

4. Court of competent jurisdiction,when subpoenaed;

(B) No information or records maintainedby the long-term care ombudsman programmay be disclosed unless the long-term careombudsman authorizes the disclosure;

(C) Lists of names of older persons shallbe used for the purpose of providing servicesand shall not be distributed, released or usedfor any other reason;

(D) Records that contain confidential clientinformation shall be released only for pur-poses of program monitoring by an autho-rized federal, state, or local monitoring agen-cy, unless—

1. The service recipient or their legalrepresentative has given informed consentprior to the release of that information;

2. The signed release indicates to whomthe information will be given;

3. Indicates the specific information tobe released; and

4. Specifies the inclusive dates forwhich the written consent is valid.

(F) Program, fiscal and statistical recordsthat do not identify individual service recipi-ents are not confidential and shall be madeavailable for public inspection upon writtenrequest.



19 CSR 15-4.310 Corporate Eldercare

PURPOSE: This rule establishes mandatoryguidelines for area agencies on aging withrespect to the development and implementa-tion of the corporate eldercare program.

(1) As used in this rule, the term corporateeldercare refers to those services provided,either directly or through a third party, by acorporation or other business organization onbehalf of its employees who have caregiverresponsibilities for an elderly person. Theseservices include, but are not necessarily lim-ited to, information and assistance services.Any contact between a corporation or busi-ness organization and an area agency or itssubsidiary to provide those services, is sub-ject to the provisions of this rule.

(2) An Area Agency on Aging (AAA) mayengage only in those activities which are con-sistent with the agency’s mission as definedin 45 CFR 1321.53. The division will deter-mine whether proposed activities conflict orinterfere with an agency’s statutory or regu-latory duties.

(3) Any AAA entering into an agreement toprovide corporate eldercare activities forfinancial remuneration shall do so throughthe formal execution of a contract.

(A) Corporate eldercare contracts shall notcontain any exclusivity clause limiting orrestricting the AAA’s ability to provide ser-vices to other older persons not referenced inthe contract. Contracts shall not restrict theAAA’s ability to act objectively and responsi-bly on behalf of all older persons residing intheir planning and service area (PSA).

(B) Corporate eldercare contracts shall notcreate any conflict of interest for the AAA,including, but not limited to, conflicts withrespect to population served by or prioritiesestablished by the area agency.

(4) AAAs proposing to enter into corporateeldercare contracts must obtain the division’sapproval prior to providing any eldercare ser-vices. This approval may be obtained by sub-mitting, as part of the agency’s area plan orplan amendment, a written request, whichshall include the following:

(A) A description of the service(s) to beprovided;

(B) A statement as to whether the existingstructure/system will provide the requestedservice(s) or if a new structure/system isneeded;

(C) A description of the new structure/sys-tem, if needed; and

(D) Signed assurances.

(5) The area plan need not detail how fundsderived from private sources by the agency,for the purposes of providing services to theelderly or their caregivers, are utilized. Theagency shall not solicit or receive funds orengage in activities for purposes inconsistent

with its mission as the AAA or inconsistentwith federal or state laws or regulations.

AUTHORITY: section 660.050, RSMo Supp.1999.* This rule previously filed as 13 CSR15-4.310. Original rule filed June 16, 1992,effective Jan. 15,1993. Amended: Filed Aug.28, 2000, effective March 30, 2001. Moved to19 CSR 15-4.310, effective Aug. 28, 2001.


