Exceptions Committee Procedures

PURPOSE: This rule establishes procedures for requesting an exception from the administrative rules of the Department of Mental Health. (1) Definitions. The following terms are defined as follows: (A) Disqualifying incident, a crime which under 9 CSR 105.190 results in a person being disqualified from employment, or one (1) or more administrative findings of abuse, neglect, or misuse of funds/property which, under 9 CSR 10-5.200 leads to a person being listed on the Department of Mental Health disqualification registry; and (B) Exception, a decision by the department not to enforce an administrative rule under the individual circumstances described in the request for an exception and the conditions described in the approval. The following requests for exceptions will not be considered: 1. A contention that the rule is not valid; 2. A contention that the provider is in fact in compliance with the rule; and 3. A request for an interpretation of a rule. (2) Rules Subject to an Exception. Only the following rules may be the subject of an exception: (A) Licensure rules for community residential programs and day programs promulgated under 9 CSR 40; (B) Certification rules for substance use disorder prevention and treatment programs and mental health programs promulgated under 9 CSR 10-7 and 9 CSR 30; (C) Certification rules under 9 CSR 45 for programs serving persons with intellectual or developmental disabilities (IDD) under the Medicaid Home- and Community-Based Services Waiver programs; (D) Any other administrative rule promulgated by the Department of Mental Health that specifically allows for an exception; and (E) Rules related to disqualification from employment under 9 CSR 10-5.190 and 9 CSR 10-5.200. In the context of employment disqualification the following apply: 1. A person may not request an exception until twelve (12) months have passed since the sentence of the court or since the department gave official notice of the person’s name being added to the Department of Mental Health disqualification registry. A. This subsection does not apply to individuals who are currently seeking certification from or have been certified by the Missouri Credentialing Board as a peer specialist and are supported for an exception by a substance use disorder treatment program, mental health program, or recovery support program that is operated, licensed, certified, accredited, in possession of deemed status, or funded by the Division of Behavioral Health. If an exception is granted to the individual under this provision, it shall be limited to the individual’s employment at the supporting program. Should the individual end employment with the substance use disorder treatment program, mental health program, or recovery support program during the twelve (12) months since the sentence of the court, the individual must seek a new exception that is subject to the same limitations as set forth herein. Once twelve (12) months have passed since the sentence of the court, the limitations set forth herein are no longer required; and 2. The exceptions option under this administrative rule does not replace or substitute for the appeal procedures afforded under Department Operating Regulation (DOR) 2.205 and 9 CSR 10-5.200 or any other administrative process. A person is not required to exhaust the appeal procedures as a prerequisite to requesting an exception; however, an exception will not be considered while an appeal is pending. (3) Eligibility for an Exception. The following may apply for an exception: (A) A chief executive officer, or designee, on behalf of a community residential program, day program, or specialized service, or an employee thereof; (B) An individual on his or her behalf, with respect to disqualification from employment under 9 CSR 10-5.190 and 9 CSR 10-5.200; (C) A facility operated by the department on behalf of a community residential program, day program, or specialized service licensed, operated, certified, accredited, in possession of deemed status, or funded by the department; and (D) Any other person or entity affected by an administrative rule under subsection (2)(E) of this rule. (4) Exceptions Process. Requests for an exception must include the information specified in this rule in order to be considered by the exceptions committee. (A) A person may request an exception by sending to the exceptions committee a written request which— 1. Cites the rule number in question; 2. Indicates why and for how long compliance with the rule should be waived; and 3. Is accompanied by supporting documentation, if appropriate. (B) In addition, the following additional items must be part of a request under 9 CSR 10-5.190, related to disqualification from employment: 1. A letter from the disqualified person containing the following information: A. A description of the disqualifying incident; B. When the disqualifying incident occurred; C. If the disqualifying incident was a crime, the sentence of the court; D. Mitigating circumstances, if any; E. Activities and accomplishments since the disqualifying incident; F. The names and dates of any relevant training or rehabilitative services; G. The type of service and/or program the applicant wishes to provide for individuals with an IDD or a behavioral health disorder; H. Identification of the type of employment or position the applicant wishes to maintain or obtain and the name of the IDD, substance use disorder, or mental health program in which he or she wishes to work or continue working; and I. Changes in personal life since the disqualifying incident (e.g., marriage, family, and education); 2. References, i.e., written recommendations from at least three (3) persons who verify the applicant’s assertions; and 3. Work history, with particular emphasis on work in the IDD and/or behavioral health field. (C) Request for exceptions should be sent to Exceptions Committee Coordinator, Office of General Counsel, Department of Mental Health, PO Box 687, Jefferson City, MO 65102. (5) Response. Within forty-five (45) calendar days of receiving a request for an exception, the exceptions committee shall respond in writing. The committee may approve a request, approve the request with conditions, deny the request, or defer a decision pending receipt of additional information. (6) Decisions. Decisions of the exceptions committee are not subject to appeal. Persons aggrieved by a decision may modify and repeat a request after six (6) months. (7) Documentation. A recipient of an exception shall maintain documentation of all approved exceptions and make the documentation available for review upon request by authorized staff of the department. (8) Expiration Date for an Exception. (A) An exception becomes null and void without any further action by the department under any of the following circumstances: 1. An expiration date is announced in the letter of approval; 2. The subject for whom the exception was granted changes employment; or 3. There are changes in other circumstances specified in the exception approval letter that invalidates the justification for granting the exception. (B) If an exception expires under this section, it may be renewed by submission of a new request. (9) Rescinding Decisions. The exceptions committee may rescind any exception if, in its judgment, any of the following occur: (A) The provider failed to meet a condition of the exception or to maintain documentation required under section (7) of this rule; (B) It is discovered the request contained misleading, incomplete, or false information; (C) The exception results in poor quality of care, or risk/harm to an individual being served; or (D) The applicant received new criminal charges since the exception was granted. (10) Notice of Rescission. If the committee rescinds an exception, the committee shall provide all concerned parties with a notice of rescission with an effective date. There shall be no appeal of a rescission of an exception. AUTHORITY: sections 630.050, 630.170, and 630.656, RSMo 2016.* Original rule filed Feb. 23, 2001, effective Sept. 30, 2001. Amended: Filed Nov. 3, 2003, effective April 30, 2004. Amended: Filed April 13, 2004, effective Oct. 30, 2004. Amended: Filed June 30, 2021, effective Dec. 30, 2021. Amended: Filed July 14, 2022, effective Jan. 30, 2023. *Original authority: 630.050, RSMo 1980, amended 1993, 1995, 2008; 630.170, RSMo 1980, amended 1982, 1996, 1998, 2001, 2003, 2008, 2012, 2013; and 630.656, RSMo 1995.