Services for Individuals with Autism Spectrum Disorder

PURPOSE: This rule establishes programs and services for persons with autism and their families. (1) Terms defined in sections 630.005, 633.005, and 633.220, RSMo are incorporated by reference for use in this rule. Also, the following terms mean: (A) Autism spectrum disorder (ASD)—a group of neurodevelopmental disorders characterized by persistent deficits in social communication and social interaction across multiple contexts as well as by restricted, repetitive patterns of behaviors, interests, or activities. Symptoms of ASD must be present in the early developmental period and cause significant impairment in social, occupational, or other important areas of functioning; (B) Family support—services and helping relationships for the purpose of maintaining and enhancing family caregiving. Family support may be any combination of services that enable individuals with autism to reside within their family homes and remain integrated within their communities. Family support services are— 1. Based on individual and family needs; 2. Easily accessible for the family; 3. Family-centered and culturally sensitive; 4. Flexible and varied to meet the changing needs of the family members; 5. Identified by the family; and 6. Provided in a timely manner contingent upon availability of resources; and (C) Service provider—a person or an entity which provides and receives reimbursement for autism programs and services as specified in section (3) of this rule. (2) The Division of Developmental Disabilities (Division of DD) shall establish programs and services for persons with autism. The Division of DD shall establish such programs and services in conjunction with persons with ASD and their families. The programs and services shall be designed to enhance the abilities of persons with ASD and their families’ abilities to meet needs they identify. The programs and services shall— (A) Develop skills for persons with autism through supports, services, and teaching; (B) Teach families to provide behavioral supports to members with autism; and (C) Provide needed family support. (3) The Division of DD Director, with input from the Missouri Parent Advisory Committee on Autism, shall divide the state into at least five (5) regions and establish autism programs and services which are responsive to the needs of persons with autism and families consistent with contemporary and emerging best practices. The boundaries of such regions, to the extent practicable, shall be contiguous with relevant boundaries of political subdivisions and health service areas. Such regions shall be referred to as regional autism projects in this rule. (4) Regional Autism Projects may provide or purchase, but shall not be limited to, the following services: (A) Assessment; (B) Advocacy training; (C) Behavior management training and supports; (D) Communication and language therapy; (E) Consultation on individualized education and habilitation plans; (F) Crisis intervention; (G) Information and referral assistance; (H) Life skills; (I) Music therapy; (J) Occupational therapy, sensory integration therapy, and consultation; (K) Parent or caregiver training; (L) Public education and information dissemination; (M) Respite care; (N) Staff training; (O) Social skills training; and (P) Other contemporary and emerging evidence-based practices. (5) Regional Autism Projects shall each have regional parent advisory councils composed of from seven to nine (7–9) persons that have family members with autism, including family members that are young children, school-age children, and adults. The members shall be Missouri residents and their family members with autism shall have met the Division of DD’s eligibility requirements specified under 630.005, RSMo. (A) One-third (1/3) of the members serving on July 1, 1995, shall continue to serve until July 1, 1996. One-third (1/3) shall serve until July 1, 1997, and the remaining onethird (1/3) shall serve until July 1, 1998. Length of those terms shall be determined by drawing lots. (B) Upon expiration of members’ terms, new members shall be nominated by the councils for three- (3-) year terms or until their successors have been elected. New members of each of the five (5) regional parent advisory councils shall be appointed by the Division of DD Director or designee from nominations submitted by the regional parent advisory councils. No member shall serve more than two (2) consecutive three- (3-) year terms. No council member shall be a service provider, a member of a service provider’s board of directors, or an employee of a service provider or the Division of DD. Regional parent advisory councils shall be encouraged to maintain membership from each region within their project boundaries. The councils shall make every effort to elect members to represent the cultural diversity of the project areas and to represent persons with autism of all ages and capabilities. (C) Each council shall elect a chairperson, vice-chairperson, and secretary. Annual elections shall occur in July. The councils shall meet bimonthly or more often at the call of the chairpersons. A simple majority of the membership shall constitute a quorum. (D) Each council shall establish bylaws specific to the council’s project area and consistent with parameters established by the Missouri Parent Advisory Council on Autism set out in section (6). (E) The councils’ responsibilities shall include, but not be limited to, the following: 1. Advocacy; 2. Contract monitoring; 3. Review of annual Department of Mental Health audits of projects; 4. Recommendation of services to be provided based on input from families; 5. Recommendation of policy, budget, and service priorities; 6. Monthly review of service delivery; 7. Planning; 8. Public education and awareness; 9. Recommendation of service providers to the Division of DD for administration of the projects; and 10. Recommendation of contract cancellation. (F) In the event a parent advisory council disagrees with a decision of the Division of DD Regional Director’s designee related to operation of the autism project, the issue may be referred to the Missouri Parent Advisory Committee on Autism for its recommendation to the Division of DD Director. (6) The Division of DD shall establish the Missouri Parent Advisory Committee on Autism. It shall be composed of two (2) representatives and one (1) alternate from each of the five (5) regional parent advisory councils set out in this rule. It shall also include one (1) person with autism and one (1) alternate, a person with autism, who are not members of a regional parent advisory council. The committee shall be appointed by the Division of DD Director. (A) The Division of DD Director shall make every effort to appoint members nominated by the regional parent advisory councils. The membership should represent the cultural diversity of the state and represent persons with autism of all ages and capabilities; (B) One-third (1/3) of the members serving on January 1, 1995, serve until January 1, 1996. One-third (1/3) shall serve until January 1, 1997, and the remaining one-third shall serve until January 1, 1998. Length of those terms shall be determined by drawing lots. (C) Upon expiration of the terms, members shall be appointed by the Division of DD Director for three- (3-) year terms or until their successors have been appointed. No member shall serve more than two (2) consecutive three- (3-) year terms. (D) At its annual meeting in July, the Missouri Parent Advisory Committee on Autism shall elect a chairperson, a vice-chairperson, and a secretary. The committee shall meet quarterly or more often at the call of the chairperson. A simple majority of the membership shall constitute a quorum. (E) The committee’s responsibilities shall include, but not be limited to, the following: 1. Communication with the projects set out in section (3) to provide up-to-date information to them and the families they serve; 2. Determining project outcomes for autism services; 3. Determining roles and responsibilities of the regional parent advisory councils set out in section (5); 4. Development of positive relationships with the Department of Elementary and Secondary Education and local school districts; 5. Establishing policy for the Missouri Parent Advisory Committee on Autism; 6. Fostering unity with and among the projects set out in section (3) to ensure joint support for legislative, budget, and other issues; 7. Planning and sponsorship of statewide activities; 8. Provision of program recommendations to the Division of DD; 9. Recommendation of service providers to the Division of DD Director in the event a regional parent advisory council and Division of DD Director’s designee cannot reach consensus; 10. Recommendation of issue resolutions to the Division of DD Director; and 11. Submission of an annual report to the Missouri Commission on Autism Spectrum Disorders, the governor, the director of the Department of Mental Health, and the director of the Division of DD. AUTHORITY: sections 630.050 and 633.220, RSMo 2016.* Original rule filed Feb. 6, 1995, effective Sept. 30, 1995. Amended: Filed July 31, 1998, effective Jan. 30, 1999. Amended: Filed July 25, 2016, effective Feb. 28, 2017. *Original authority: 630.050, RSMo 1980, amended 1993, 1995, 2008 and 633.220, RSMo 2009.