The following are summaries and other information related to Proposed Rules that the Missouri Department of Health & Senior Services has submitted to the Secretary of State for Publication in the Missouri Register. These rules will not go into effect until the public has had an opportunity to submit written comments, and to attend a public hearing if one is scheduled.

Any person may offer comments on a Proposed Rule. The instructions for submitting comments, and the location and date of a hearing if one is scheduled, are located after the text of each rule. Note that the official text of a Proposed Rule is the version that appears in the Missouri Register, not the draft copy on this site. Refer to the official copy if you wish to submit comments.

We hope you find this site helpful and informative.

Section 536.175, RSMo, requires a five year rolling review by all departments of their existing rules. DHSS was required to begin their review no later than July 1, 2018, and to complete said review no later than June 30, 2019. As a result, the department reviewed 759 rules, received zero comments, and prepared the above report, which was timely filed with the Joint Committee on Administrative Rules.

 

Proposed Rule Summary Fiscal
Note(s)
Material Incorporated
by Reference
Link to
Missouri Register
Date Posted

19 CSR 30-1.064
Partial Filling of Controlled Substance Prescriptions.

In July of 2023, the DEA issued its final rule amending its regulations for partial filling of prescriptions for schedule II substances. The federal regulations were promulgated in response to the passage of the Comprehensive Addiction and Recovery Act of 2016 (“CARA”). Under CARA, physicians or patients may request pharmacists to partially fill prescriptions for schedule II substances and to allow remaining quantities to be filled up to 30 days after issuance of the prescription. This amendment simply updates Missouri’s regulation to be consistent with the federal regulation.

N/A

N/A Volume 49, Number 7 February 27, 2024

19 CSR 30-40.810
Ground Ambulance Transport of Patients to Locations That Are Not Hospitals

Emergency Rule

This proposed and emergency rule establishes training and transport requirements for ground ambulances to transport patients to Missouri Department of Mental Health designated behavioral health crisis centers and other locations for those patients who do not require transport to a hospital and whose health needs can be met by behavioral health crisis centers or other locations where patients are transported.

N/A (But see attached Small Business Regulatory Fairness Board Small Business Impact Statement)

N/A Volume 49, Number 7 February 26, 2024

19 CSR 10-3.060
Health Professional Loan Repayment Program

Emergency Rule

This proposed and emergency rule establishes guidelines for implementing the Health Professional Loan Repayment Program (HPLRP) that will reduce the burden of educational debt among selected health care, mental health and public health professionals in return for providing health care, mental health and public health services in areas of defined need.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 22 October 13, 2023

19 CSR 10-60.060
Health Professional Loan Repayment Program

Emergency Rule

This proposed and emergency rule establishes guidelines for implementing the Health Professional Loan Repayment Program (HPLRP) that will reduce the burden of educational debt among selected health care, mental health and public health professionals in return for providing health care, mental health and public health services in areas of defined need.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 21 September 28, 2023

19 CSR 30-1.002
Schedules of Controlled Substances

Emergency Rule

This proposed and emergency amendment updates the Schedules of Controlled Substances to be consistent with 21 CFR Part 1308.

N/A

N/A Volume 48, Number 21 September 25, 2023

19 CSR 10-3.050
Graduate Medical Education Grant Program

Emergency Rule

This proposed and emergency rule establishes guidelines for implementing the Graduate Medical Education Grant Program.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 19 September 1, 2023
19 CSR 15-8.400
Vendors
This proposed amendment establishes the criteria, procedures, and responsibilities for entities eligible to be vendors of consumer-directed services administered by the Department.

Private Fiscal Note

Small Business Business Statement

N/A Volume 48, Number 19 September 1, 2023
19 CSR 15-8.200
Eligibility
This proposed amendment sets forth the criteria and procedures for determining eligibility of an applicant to receive consumer-directed services. The proposed rule amendment updates the criteria, procedures, and responsibilities for consumers of consumer-directed services. N/A N/A Volume 48, Number 19 September 1, 2023
19 CSR 15-1.010
Organization and Operation
This proposed rescission rescinds a rule which currently provides a description of the organization and general courses and methods of the Missouri Division of Aging’s operation. It also sets forth the methods and procedures where the public may obtain information or make submissions or requests. N/A N/A Volume 48, Number 19 September 1, 2023
19 CSR 30-20.011
Definitions Relating to Hospitals
This proposed amendment updates 19 CSR 30-20.011 to update the definition of “hospital” to include facilities designated as rural emergency hospitals by the Centers for Medicare and Medicaid Services (CMS). N/A N/A Volume 48, Number 19 August 28, 2023
19 CSR 30-20.013
Incorporation of Medicare Conditions of Participation
This proposed amendment rule updates 19 CSR 30-20.013 to incorporate the federal regulatory standards governing rural emergency hospitals in the same manner the rule incorporates other federal regulatory standards (conditions of participation) that apply to other types of hospitals. Similar to how other hospital conditions of participation are incorporated, the amendatory language provides that the rule incorporates later amendments and additions to 42 CFR Part 485 (2022) (the regulatory standards governing conditions of participation for rural emergency hospitals). N/A N/A Volume 48, Number 19 August 28, 2023
19 CSR 10-3.040
Rural Primary Care Physician Grant Program
This proposed rule establishes guidelines for implementing the Rural Primary Care Physician’s Grant Program. Section 10.765 of House Bill 10, 102nd General Assembly, appropriated funding for DHSS for a rural primary care physician grant program to provide funding to rural physicians beginning practice after July 1, 2022, in a Missouri county with a population of fewer than thirty-five thousand (35,000) inhabitants in return for providing primary care clinical services in rural Missouri. Public Fiscal Note N/A Volume 48, Number 17 August 1, 2023
19 CSR 20-70.010
Community-Based Faculty Preceptor Tax Credit
This proposed rule provides an income tax credit for qualified community-based faculty preceptors for physicians and physician assistants. This rule explains how community-based faculty preceptors may qualify for the Department of Health and Senior Services’ Preceptor Tax Credit and how qualifying individuals may claim the credit. Public Fiscal Note N/A Volume 48, Number 14 June 8, 2023
19 CSR 30-20.125
Unlicensed Assistive Personnel Training Program
This proposed and emergency amendment reclassifies a component of unlicensed assistive personnel (UAP ) Program curriculum content, amends an obsolete rule reference, exempts hospitals from complying with certain UAP training requirements if its employees can prove completion of patient care technician training programs or can submit proof of certification as a patient care technician, extends certain UAP training completion deadline from ninety (90) days to one hundred-eighty (180) days, and requires quality and safety curriculum to be covered within ninety (90) days of employment. N/A N/A Volume 48, Number 13 May 22, 2023
19 CSR 73-2.025
Licensure by Reciprocity
Current regulations allow nursing home administrators licensed in other states to seek licensure within Missouri by reciprocity by submitting an application. This proposed rule amendment requires applicants to be 18 years of age or older (reduced from 21 years of age), be Health Services Executive (HSE) qualified by the National Association of Long Term Care Administrator Boards (NAB) (or obtained a passing score on the national examination) and be in good standing for at least one year under a current administrator license issued by another jurisdiction. The amendment makes other technical changes. N/A N/A Volume 48, Number 11 April 25, 2023
19 CSR 73-2.080
Temporary Emergency Licenses
This proposed rule amendment modifies the current rule regarding temporary emergency licensesfor nursing home administrators to comply with section 344.030.4, RSMo. The proposed ruleamendment removes the temporary emergency license (TEL) extension, modifies the number ofdays to grant a TEL, lowers the minimal age that a TEL may be granted to an individual, andimplements various clean-up language. N/A Temporary Emergency License Application Volume 48, Number 11 April 25, 2023
19 CSR 10-10.110
Amending or Correcting Vital Records
This proposed rule amendment changes and/or updates procedural requirements for documenting amendments made to vital records and clarifies supporting document requirements for correcting and/or amending vital records. N/A N/A Volume 48, Number 8 March 15, 2023

19 CSR 30-105.010
Definitions

This proposed rule sets forth definitions to be used in the regulations governing the regulations of  supplemental health care services agencies.

N/A

N/A Volume 48, Number 6 February 8, 2023

19 CSR 30-105.020
Registration Fees

This proposed rule establishes the registration fees supplemental health care services agencies will have to pay in order to be registered by the Department.

Private Fiscal Note

N/A Volume 48, Number 6 February 8, 2023

19 CSR 30-105.030
Procedures and Requirements for Registration of a Supplemental Health Care Services Agency

This proposed rule requires entities operating as supplemental health care services agencies in Missouri to be registered with the department. The proposed rule sets forth the procedure in which such agencies must register (submission of application, payment of fees, etc.).

Public Fiscal Note

Private Fiscal Note

Application Form Volume 48, Number 6 February 8, 2023

19 CSR 30-105.040
Requirements for Changes to a Registered Agency

This proposed rule outlines requirements for changes (change of address, name, ownership, etc.) to an issued registration of a Supplemental Health Care Services Agency in Missouri. Public Fiscal Note Change Form Volume 48, Number 6 February 8, 2023

19 CSR 30-105.050
Inspections

This proposed rule outlines inspections, complaints, and requirements of a Supplemental Health Care Services Agency. Public Fiscal Note N/A Volume 48, Number 6 February 8, 2023

19 CSR 30-105.060
Denial, Suspension, or Revocation of Registration

This proposed rule specifies the process of denial or revocation of a registration of a Supplemental Health Care Services Agency in Missouri. N/A N/A Volume 48, Number 6 February 8, 2023

19 CSR 30-105.070
Quarterly Rate and Charge Reporting Requirements

This proposed rule specifies the quarterly rate and charge reporting requirements of a Supplemental Health Care Services Agency in Missouri. Public Fiscal Note N/A Volume 48, Number 6 February 8, 2023

19 CSR 15-7.021
In-Home Service Standards

This proposed amendment sets forth standards to be met by any agency which contracts with the Missouri Department of Social Services, Missouri Medicaid Audit and Compliance Unit for the provision of in-home services authorized by the Missouri Department of Health and Senior Services, Division of Senior and Disability Services. N/A N/A Volume 48, Number 6 February 7, 2023

19 CSR 15-7.010
General Requirements for All Service Providers

This proposed amendment amends the purpose statement; updates terms, statutory and regulatory references, and modifies the fire, health and safety inspection requirements for providers participating in the Home and Community Based Services program. N/A N/A Volume 48, Number 6 February 7, 2023

19 CSR 15-7.005
Definitions

This proposed amendment updates definitional terms used in the chapter governing Home and Community Based Services. The proposed amendment adds new terms, deletes others, and modifies the definitions of other terms currently used in the chapter. N/A N/A Volume 48, Number 6 February 7, 2023

19 CSR 100-1.190
Microbusinesses

Emergency Rule

This proposed and emergency rule establishes standards and regulations applicable to marijuana microbusiness facilities for purposes of licensing by the Department of Health and Senior Services. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.180
Dispensary Facilities

Emergency Rule

This proposed and emergency rule establishes standards applicable to marijuana dispensary facilities for purposes of licensing by the Department of Health and Senior Services. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.170
Manufacturing Facilities

Emergency Rule

This proposed and emergency rule establishes the manufacturing facility licensee’s authority to engage in the process of manufacturing marijuana-infused products. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.160
Cultivation Facilities

Emergency Rule

This proposed and emergency rule establishes regulations governing cultivation facilities authority to engage in the process of cultivating marijuana. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.150
Marijuana Waste Disposal

Emergency Rule

This proposed and emergency rule establishes standards in which licensed and certified facilities must follow when disposing excess or unusable marijuana waste, unwanted marijuana product, or other waste from a facility. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.140
Transportation and Storage

Emergency Rule

This proposed and emergency rule establishes standards applicable to medical and marijuana facility licensees that transport and store marijuana product. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.130
Inventory Control and Seed-to-Sale Tracking

Emergency Rule

This proposed and emergency rule requires facility licensees to implement inventory control systems and processes established by the rule. The rule also establishes procedures applicable to the certification and operation of seed-to-sale tracking systems.

Public Fiscal Note

Public Fiscal Note Emergency

Private Fiscal Note

Private Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.120
Packaging, Labeling, and Product Design

Emergency Rule

This proposed and emergency rule establishes the packaging, labeling, and product design standards applicable to medical and marijuana facility licensees.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.110
Testing

Emergency Rule

This proposed and emergency rule establishes testing standards applicable to marijuana products. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.100
Facilities Generally

Emergency Rule

This proposed and emergency rule establishes regulations regarding general operating requirements that are applicable to all licensed and certificated facilities.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.090
Facility Security

Emergency Rule

This proposed and emergency rule establishes regulations regarding the security requirements of licensed or certified medical and marijuana facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.080
Facility Employee Training

Emergency Rule

This proposed and emergency rule establishes regulations relating to the training that medical and marijuana facility licensees must provide to their employees. This rule is being promulgated due to the recent passage of Amendment 3. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.070
Facility Ownership and Employment

Emergency Rule

This proposed and emergency rule establishes regulations relating to the ownership of medical and marijuana facilities. The rule also establishes regulations pertaining to employees who work at such facilities.

Private Fiscal Note

Private Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.060
Facility Applications and Selection

Emergency Rule

This proposed and emergency rule explains how medical and marijuana facility licensing and certification applications, with the exception of seed-to-sale tracking system entity and research facility applications, are submitted and how the Department of Health of Senior Services selects licenses and certificates.

Private Fiscal Note

Private Fiscal Note Emergency

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.050
Physicians and Nurse Practitioners

Emergency Rule

This proposed and emergency rule establishes how the department will implement provisions of Article XIV, Section 1 (Amendment 3) related to physicians and nurse practitioners. The rule is patterned on the now rescinded 19 CSR 30-95.110, which pertains only to physicians. With the passage of Amendment 3, nurse practitioners are authorized to certify patients for medical use of marijuana. Additionally, the certification limits have changed, and there is no longer a need for an additional opinion in order to increase those limits. This proposed rule sets forth those additional constitutional allowances. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.040
Consumers, Qualifying Patients, and Primary Caregivers

Emergency Rule

This proposed and emergency rule establishes the process and procedures the department will use to implement provisions of Article XIV (Amendment 3) relating to consumers, qualifying patients, and primary caregivers use and dispensing of legalized marijuana.

Private Fiscal Note

Private Fiscal Note Emergency

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.030
Complaints, Inspections, and Investigations

Emergency Rule

This proposed and emergency rule implements the recently passed Amendment 3 and establishes the process for the Department to handle complaints, inspections, and investigations of licensed or certified facilities and identification card holders.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.010
Definitions

Emergency Rule

This proposed and emergency rule establishes definitions for the proposed rules that implement Missouri’s Amendment 3 that legalized marijuana for adult use.  The proposed rules and corresponding definitions are necessary to establish procedures for converting existing medical marijuana facility licenses to comprehensive licenses in order to serve both adult users and qualifying patients. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 100-1.020
Generally Applicable Provisions

Emergency Rule

This proposed and emergency rule applies to all individuals and entities regulated under Article XIV and explains what general provisions are necessary for the enforcement of the Article.  The proposed rules are necessary to establish procedures for converting existing medical marijuana facility licenses to comprehensive licenses in order to serve both adult users and qualifying patients.

Public Fiscal Note

Public Fiscal Note Emergency

N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.010
Definitions

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.010, a rule governing medical marijuana definitions. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.020
General Provisions

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.020, a rule governing medical marijuana application fees. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.025
Generally Applicable Provisions

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.025, a medical marijuana regulation, in response to the passage of Amendment 3 in November of 2022. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.028
Additional Licensing Procedures

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.028, a rule relating to medical marijuana licensing and certification procedures. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.030
Qualifying Patient/Primary Caregiver

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.030, a rule governing physician certifications to obtain medical marijuana. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.040
Medical Marijuana Facilities Generally

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.040, a rule that authorized the Department to regulate and control the operations of Cultivation, Infused Product Manufacturing, Dispensary, Testing, and Transportation facilities.  The rule also authorized the Department to grant, refuse, suspend, fine, restrict, or revoke the licenses and certifications for such facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.050
Cultivation Facility

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.050, a rule governing the regulation of medical marijuana cultivation facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.060
Infused Products Manufacturing Facility

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.060, a rule relating to the regulation of infused products manufacturing facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.070
Testing Facility

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.070, a rule governing the regulation of medical marijuana testing facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.080
Dispensary Facility

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.080, a rule governing the regulation of medical marijuana dispensary facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.090
Seed-to-Sale Tracking

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.090, a rule relating to seed-to-seed tracking. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.100
Transportation Facility

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.100, a rule relating to the regulation of medical marijuana transportation facilities. N/A N/A Volume 48, Number 5 January 20, 2023

19 CSR 30-95.110
Physicians

Emergency Rule

This proposed and emergency rule rescinds 19 CSR 30-95.110, a rule governing the process for issuing medical marijuana physician certifications. N/A N/A Volume 48, Number 5 January 20, 2023
19 CSR 10-10.020
Vital Records Issuance
This proposed rule authorizes local registrars to issue certifications of birth and death records of events occurring in the state of Missouri.  The proposed rule changes which local registrars are authorized to issue certifications of birth and death records in Missouri and updates the requirements for issuances of certifications. N/A N/A Volume 48, Number 4 January 11, 2023
19 CSR 73-2.130
Notice of Change of Contact Information and Missouri Administrator Employment
This proposed amendment modifies the number of days (21 days to 10 calendar days) that a nursing home administrator must provide notification of personal contact information and administrator employment to the board and further clarifies the information that must be updated with the board. N/A N/A Volume 48, Number 1 November 29, 2022
19 CSR 30-40.792
Adult Trauma and Pediatric Field Triage and Transport Protocol
This proposed rule establishes protocols for transporting suspected trauma patients by severity and time of onset to the trauma centers where resources exist to provide appropriate care. Public Fiscal Note

Public Fiscal Note
N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.760
Standards for ST-Segment Elevation Myocardial Infarction (STEMI) Center Designation
This proposed and emergency rule makes several updates to this rule that were prompted by the passage of HB 2331 (2022). This rule facilitates the changes made in HB 2331 with amendatory language that prohibits DHSS from requiring providers at STEMI centers from being required to obtain continuing education for any more than what is required by national designating or verifying bodies of STEMI centers; prohibits DHSS from requiring certain physicians to obtain continuing education on STEMI for those who are emergency medicine board certified or board eligible through certain organizations; and modifies STEMI data entry requirements. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.750
ST-Segment Elevation Myocardial Infarction (STEMI) Center Designation Application and Review
This proposed and emergency amendment makes several updates to this rule that were prompted by the passage of House Bill 2331 (2022). This rule facilitates the changes made in HB 2331 with amendatory language that allows the department to conduct virtual reviews of STEMI centers; requires hospitals to provide the department with quality improvement documentation necessary for the department to conduct STEMI reviews; changes how hospitals report changes of their verification or certification status to the department and how these hospitals participate in local and regional emergency medical services systems. Private Fiscal Note Emergency Amendment

Private Fiscal Note Proposed Amendment

Public Fiscal Note Proposed Amendment

STEMI application proposed amendment

STEMI application emergency amendment
N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.740
Definitions and Abbreviations Relating to ST-Segment Elevation Myocardial Infarction (STEMI) Centers
This proposed and emergency amendment adds virtual reviews to the definitions for STEMI centers. This amendment was prompted by the passage of House Bill 2331 that passed during the 2022 legislative session. House Bill 2331 made changes to section 190.241, RSMo and allows the department to conduct virtual reviews rather than only on-site reviews of STEMI centers. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.730
Standards for Stroke Center Designation
This proposed and emergency amendment makes several updates to this rule to align itself with HB 2331 (2022). This rule prohibits the department from requiring providers at stroke centers from being required to obtain continuing education on stroke for any more than what is required by national designating bodies of stroke centers; prohibits the department from requiring physicians to obtain continuing education on stroke for physicians who are emergency medicine board certified or board eligible through certain organizations and who are practicing in emergency departments of stroke centers; and allows stroke centers to enter stroke data into a national databank. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.720
Stroke Center Designation Application and Review
This proposed and emergency amendment makes several updates to this rule to align itself with changes made to the statutes in HB 2331 (2022). The rule requires stroke centers to be reviewed by the department every three (3) years; allows the department to conduct virtual reviews; adds a requirement for hospitals to provide the department with quality improvement documentation necessary for the department to conduct stroke reviews; modifies how hospitals report changes of their verification or certification to the department and how these hospitals participate in local and regional emergency medical services systems. Private Fiscal Note Emergency Amendment

Private Fiscal Note Proposed Amendment

Public Fiscal Note Proposed Amendment

Emergency Amendment Application for Stroke Certified Hospital Designation

Stroke Application proposed amendment
N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.710
Definitions and Abbreviations Relating to Stroke Centers
This proposed and emergency amendment adds virtual reviews to the definitions for stroke centers to align itself with the new requirements passed in HB 2331 (2022). House Bill 2331 made changes to section 190.241, RSMo and allows the department to conduct virtual reviews rather than only on-site reviews of stroke centers. This amendment is necessary in order to make this rule consistent with the changes made in House Bill 2331 that became effective on August 28, 2022. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.430
Standards for Trauma Center Designation
This proposed and emergency amendment modifies the TCD designation standards to align itself with HB 2331 (2022). This rule prohibits the department from requiring providers at trauma centers from being required to obtain continuing education on trauma for any more than what is required by the national verification body of trauma centers. It also prohibits the department from requiring physicians to obtain continuing education on trauma for physicians who are emergency medicine board certified or board eligible through ABEM or AEBEM and who are practicing in the emergency department of a trauma center. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.420
Trauma Center Designation Requirements
This proposed and emergency amendment makes several updates to the TCD designation rule requirements to align with HB 2331(2022). HB 2331 requires trauma centers to be reviewed by the department every three (3) years and allows the department to conduct virtual reviews of stroke centers. It requires hospitals to provide the department with quality improvement documentation necessary for the department to conduct trauma reviews. The rule modifies how hospitals report changes of their verification or certification to the department and how these hospitals participate in local and regional emergency medical services systems. Private Fiscal Note Emergency Amendment

Private Fiscal Note Proposed Amendment

Public Fiscal Note Proposed Amendment

Emergency Rule Application for trauma verified Hospital Designation

Trauma Application proposed amendment
N/A Volume 48, Number 1 November 22, 2022
19 CSR 30-40.410
Definitions and Abbreviations Relating to Trauma Centers
This proposed (and emergency amendment) amendment adds virtual reviews to the definitions for trauma centers. This amendment was prompted by the passage of House Bill 2331 during the 2022 legislative session. House Bill 2331 made changes to section 190.241, RSMo and allows the department to conduct virtual reviews rather than only on-site reviews of trauma centers. N/A N/A Volume 48, Number 1 November 22, 2022
19 CSR 25-30.021
Type I Permit
This proposed rule (and emergency rule) establishes the qualifications, duties, and responsibilities of a Type I permittee and the standards for laboratories in which Type I permittees perform testing. The proposed and emergency rule adds an accrediting body to the list of accrediting bodies that a laboratory performing analysis of blood, saliva, or urine for the presence of drugs must hold. N/A N/A Volume 47, Number 23 November 1, 2022
19 CSR 10-15.010
Report of Induced Termination of Pregnancy
This rule states the provisions and certifications within the report required when abortions are performed in the state of Missouri N/A Melinda Laughlin, RN, BSN, Deputy Director, Division of Community and Public Health, PO Box 570, Jefferson City, MO 65102. Volume 47, Number 21 September 23, 2022
19 CSR 30-20.144
Standards and Guidelines for Essential Caregiver Program
This proposed and emergency rule establishes the standards and guidelines to implement the "Essential Caregiver Program Act" under §191.2290, RSMo. Under the proposed rule, every hospital within Missouri must develop an essential caregiver program that allows patients or their legal guardians or representatives to designate essential caregivers for in-person contact with patients. The standards and guidelines governing essential caregivers are only operational during a state of emergency declared pursuant to Chapter 44, relating to infectious, contagious, communicable, or dangerous diseases.

Emergency Rule Private and Public Fiscal Note

Proposed Rule Private and Public Fiscal Note

N/A Volume 47, Number 20 September 15, 2022
19 CSR 30-1.002
Schedules of Controlled Substances
This proposed and emergency amendment updates the Schedules of Controlled Substances to be consistent with 21 CFR Part 1308.

N/A

N/A Volume 47, Number 20 September 13, 2022
19 CSR 30-1.015
Registration and Fees
This proposed amendment provides that registrants applying for a controlled substance registration must pay for their registration fees via a credit card. The proposed amendment eliminates paying for such registration fees by checks and money orders.

Private Fiscal Note - Registration and Fees

Public Fiscal Note - Registration and Fees

N/A Volume 47, Number 18 August 11, 2022
19 CSR 30-1.017
Registration Process
This proposed amendment eliminates the alternative application process that currently allows controlled substance registrants to apply for their registration by paper (filling out a paper application and mailing it). Registrants will be required to apply for their controlled substance registration through the online process.

Private Fiscal Note - Registration Process

Public Fiscal Note - Registration Process

N/A Volume 47, Number 18 August 11, 2022

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