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 Title XII PUBLIC HEALTH AND WELFARE

 Chapter 191 Health and Welfare 
191.005   Information exchange between departments, rulemaking authority. (8/28/1999)
191.025   Health care compact. (8/28/2011)
191.116   Alzheimer's state plan task force established — members, appointment, duties — report — expiration date. (8/28/2022)
191.127   Land may be leased for farming or grazing — procedure. (8/28/1980)
191.150   Purchase of food limited to use of institution inmates. (8/28/1980)
191.160   Board and living quarters for employees of institutions. (8/28/1980)
191.170   Mistreatment of inmates — penalty. (8/28/1980)
191.180   Furnishing unfit food to institution — penalty. (8/28/1980)
191.190   Accessory to mistreatment of inmates or furnishing of unwholesome food — penalty. (8/28/1980)
191.210   Attendance of patient by private physician. (8/28/1980)
191.211   Funding of certain programs. (8/28/2001)
191.213   Additional funding sources for certain programs. (8/28/2001)
191.226   Costs of HIV testing for certain crime victims payable by department of health and senior services, when, conditions. (8/28/1989)
191.227   Medical records to be released to patient, when, exception — fee permitted, amount — liability of provider limited — annual handling fee adjustment — disclosure of deceased patient records, when. (8/28/2018)
191.228   Physician and pharmacist not subject to discipline for cooperation. (8/28/1992)
191.229   Accreditation of not-for-profit human services organizations deemed equivalent to licensure. (8/28/1994)
191.231   Community-based integrated delivery system, qualification, powers — organization, board of directors, powers — plans. (8/28/1993)
191.235   Mercury contained in immunizations, not to be administered to certain persons — insurance reimbursement for nonmercury immunizations — exemptions, when. (8/28/2005)
191.237   Failure to participate in health information organization, no fine or penalty may be imposed — no exchange of data, when — definitions. (8/28/2013)
191.240   Patient examinations, limitation on performance of, when — notice — violation, sanction of license. (8/28/2023)
END-OF-LIFE MEDICAL DECISIONS (SIMON'S LAW)
191.250   Citation of law — definitions — DNR orders, requirements — revocation of consent — appointment of guardian, when — continuation of treatment not required, when. (8/28/2019)
GENETICS AND METABOLIC DISEASE PROGRAMS (Cystic Fibrosis, Hemophilia, Sickle Cell Anemia)
191.300   Definitions. (8/28/2007)
191.305   Missouri genetic advisory committee created — purpose — appointment, terms — qualifications — expenses. (8/28/2023)
191.310   Duties of committee — liaison officers with mental health and education, appointment. (8/28/1985)
191.315   Genetics program to be established by department — rules authorized — procedure. (8/28/1995)
191.317   Confidentiality of all tests and personal information — exceptions — retention of specimens, procedure. (8/28/2007)
191.320   Genetic diagnostic and counseling services to be established — outreach centers, duties — referral for abortion, procedure, requirements. (8/28/1985)
191.323   Powers and duties of department of health and senior services in prevention and treatment of genetic diseases and birth defects. (8/28/1985)
191.325   Cost of services, how paid — free to persons financially unable to pay — residency requirement. (8/28/1985)
191.331   Infants to be tested for metabolic and genetic diseases — reports — exceptions — refusal to test — fee for screening test, department may impose by rule, use of fees — formula provided by department, when — assistance available, when. (8/28/2007)
191.332   Supplemental newborn screening requirements — additional screenings — rulemaking authority. (8/28/2017)
191.333   Citation of law — screening for lysosomal storage diseases — rulemaking authority — fee increase authorized. (8/28/2009)
191.334   Chloe's Law — critical congenital heart disease screening, requirements — rulemaking authority. (8/28/2013)
191.335   Hemophilia program established — state assistance, when. (8/28/1979)
191.340   Hemophilia program — care and treatment — financial assistance — education — duties of department. (8/28/1985)
191.360   Trained employee of end-stage renal disease facility may initiate dialysis — not unlawful practice of medicine. (8/28/1983)
191.362   Appropriately trained employees to have completed course in dialysis techniques. (8/28/2010)
191.365   Sickle cell anemia — purposes of program — financial assistance, when. (8/28/1985)
191.370   Sickle cell anemia, development of program for care and treatment — duties of department. (8/28/1985)
191.375   Cystic fibrosis, program for care and treatment — financial assistance, when. (8/28/1985)
191.380   Cystic fibrosis, duties of department. (8/28/1985)
STATE BOARD OF HEALTH
191.400   State board of health and senior services — appointment — terms — qualifications — limitation on other employment, exception — vacancies — compensation — meetings. (8/28/2018)
191.411   System of coordinated health care services — health access incentive fund created, purpose — enhanced Medicaid payments — rules — annual report. (8/28/2007)
WOMEN'S HEART HEALTH PROGRAM
191.425   Program established, eligibility — contracting authority — conditional on receipt of federal funding — sunset provision. (8/28/2012)
HEALTH PROFESSIONAL LOAN REPAYMENT PROGRAM
191.430   Program established, purpose — department duties. (8/28/2023)
191.435   Need for health care areas to be designated. (8/28/2023)
191.440   Contracts for forgivable loans, contents — practice sites, stipulation of. (8/28/2023)
191.445   Fund created, use of moneys. (8/28/2023)
191.450   Failure to maintain acceptable employment status, liable for loan amount — recovery amount. (8/28/2023)
INVESTIGATIONAL DRUGS, BIOLOGICAL PRODUCTS, AND DEVICES
191.480   Manufacturers may make investigational drugs and devices available to eligible patients, when — definitions — requirements. (8/28/2014)
MEDICAL RESIDENCY GRANT PROGRAM
191.592   Grant program established — definitions — purpose — fund created, use of moneys — priority of expenditures — criteria, requirements — report — rulemaking authority — expiration date. (7/6/2023)
SHOW-ME COMPASSIONATE MEDICAL EDUCATION ACT

Show-Me compassionate medical education day, 9.154

191.594   Citation of law — prevalence of depression and suicide study — prohibited acts — definitions. (7/7/2017)
191.596   Research project authorized — committee established, members, duties — center study, contents — annual report. (7/7/2017)
HEALTH PROFESSIONAL STUDENT LOAN REPAYMENT PROGRAM
191.600   Loan repayment program established — health professional student loan repayment program fund established — use. (8/28/2023)
191.603   Definitions. (8/28/2019)
191.605   Department to designate as areas of need — factors to be considered. (8/28/2019)
191.607   Qualifications for eligibility established by department. (8/28/2019)
191.609   Contract for repayment of loans, contents. (8/28/2001)
191.611   Loan repayment program to cover certain loans — amount paid per year of obligated service — schedule of payments — communities sharing costs to be given first consideration. (8/28/2001)
191.614   Termination of medical studies or failure to become licensed doctor, liability — breach of contract for service obligation, penalties — recovery of amount paid by contributing community. (8/28/2001)
191.615   Application for federal funds — insufficient funds, effect. (8/28/2001)
EXPOSURE TO COMMUNICABLE DISEASE BY EMERGENCY CARE PROVIDERS
191.630   Definitions. (8/28/2018)
191.631   Testing for disease, consent deemed given, when — hospital to conduct testing, written policies and procedures required — notification for confirmed exposure, by whom — limitations on testing and duties of hospitals, coroners, and medical examiners — rules. (8/28/2014)
BLOOD-BORNE PATHOGEN STANDARD
191.640   Blood-borne pathogen standard required for occupational exposure of public employees to blood and other infectious materials — definitions — requirements of needleless system and sharps — violations, penalty. (8/28/2001)
HEPATITIS C EXPOSURE
191.645   Risk of exposure to Hepatitis C, information to be made available — website to be maintained, content. (8/28/2005)
EXPEDITED PARTNER THERAPY
191.648   Expedited partner therapy permitted, requirements for physicians utilizing — rulemaking authority. (8/28/2010)
AIDS (Acquired Immunodeficiency Syndrome)

Nursing homes treating only AIDS patients not required to have certificate of need, 197.316

Nursing homes without certificate of need authorized to treat only AIDS patients, violation, penalty, 197.316

191.650   Definitions. (8/28/1996)
191.653   HIV testing performed by whom, how — consultation with subject required, when. (8/28/1996)
191.656   Confidentiality of reports and records, exceptions — violation, civil action for injunction, damages, costs and attorney fees — health care provider participating in judicial proceeding, immune from civil liability. (8/28/2002)
191.657   Disclosure of confidential HIV information, by court order, only to certain persons, procedure, when. (8/28/1999)
191.658   HIV infection status disclosure by department of health and senior services to exposed health workers or law enforcement officers, when, violation, penalty. (8/28/1999)
191.659   Department of corrections, HIV and infectious diseases testing without right of refusal — exception — minors victim of sexual assault, testing, notice to parents or custodians required. (8/28/2003)
191.662   Department of mental health, permissive HIV testing without right of refusal, when — results of testing not to be reported to department of health and senior services, when. (6/1/1988)
191.663   HIV testing, defined — court order to test certain sexual offenders — costs — bond — disclosure of results of test — parents of unemancipated minor informed, when. (8/28/1999)
191.665   Discrimination prohibited, exceptions. (6/1/1988)
191.668   Department of health and senior services and department of elementary and secondary education to prepare education programs, contents. (6/1/1988)
191.671   Insurance companies, HMOs or health service corporations, HIV testing by, regulation by department — disclosure of test results, confidentiality. (6/1/1988)
191.674   Court-ordered HIV testing without right of refusal, department of health and senior services may seek, when — court record closed, proceeding to be in camera, when. (6/1/1988)
191.677   Serious infectious or communicable diseases, prohibited acts, criminal penalties — affirmative defense — use of pseudonym, when. (8/28/2021)
191.680   Maintaining a nuisance, abatement to be ordered, when. (8/28/2002)
191.683   Reports to general assembly by department of health and senior services. (6/1/1988)
191.686   Anonymous testing sites in central Missouri, Kansas City, Springfield and St. Louis — reports of results, use of coded system — contact notification required, when. (8/28/1999)
191.689   Schools to be given notice of identity of child with HIV infection, when, by whom — identity of infected child may be released to whom by school. (6/1/1988)
191.692   Premarital HIV testing, rulemaking authorized, when. (6/1/1988)
191.694   Infection control procedures — requirements and training for health care facilities and professionals. (8/28/1992)
191.695   Rulemaking authority, department of health and senior services — procedure. (8/28/1995)
191.699   Disciplinary action for health care professionals who discriminate or require HIV testing before treatment. (8/28/1992)
191.700   Testing of all health care professionals not justified — voluntary and confidential evaluation of infected professional, procedure — expert review panel qualifications, powers and duties, practice restrictions, when — health care facilities informed only of restrictions — violations, complaints made to appropriate boards. (8/28/1992)
191.703   Death of patient with infectious or contagious disease, notification to funeral director or coroner. (8/28/1993)
PREMATURE INFANT HEALTH CARE
191.710   MO HealthNet program and SCHIPS to focus on premature infant health care. (8/28/2009)
191.711   Education publications to be prepared, contents — distribution. (8/28/2009)
DISCRIMINATION FOR RELIGIOUS BELIEFS OR MORAL CONVICTIONS
191.724   Discrimination based on religious beliefs or moral convictions prohibited, health plan coverage of abortion — no mandatory employee coverage of certain procedures — attorney general to enforce — sterilization defined. (9/12/2012)
PREGNANCY — PRENATAL AND POSTNATAL CARE AND EDUCATION FOR WOMEN AND CHILDREN (Alcohol — Cigarettes — Drugs)
191.725   Physician to counsel pregnant patients on effects of cigarettes, alcohol and controlled substances — certifying form to be signed by patient on counseling — educational materials to be furnished to physicians. (7/1/1992)
191.729   School districts to be furnished information on prenatal and postnatal effects of substances, when. (7/1/1992)
191.731   Pregnant woman referred for substance abuse to have priority for treatment — confidentiality of records. (7/1/1992)
191.737   Children exposed to substance abuse, referral by physician to children's division — physician making referral immune from civil liability — confidentiality of report. (8/28/2019)
191.739   Protective and preventive services to be provided by department of social services, duties. (8/28/2018)
191.748   Shaken baby syndrome video, required viewing, when. (8/28/2004)
UMBILICAL CORD BLOOD BANKING
191.755   Department to post resources on website, content. (8/28/2011)
191.756   Grants awarded by board of health and senior services — eligibility criteria. (8/28/2018)
191.758   Information to be made available by physician to pregnant women, when. (8/28/2011)
191.761   Umbilical cord blood samples, department to provide courier service to nonprofit umbilical cord blood bank — rulemaking authority. (8/28/2014)
INDOOR CLEAN AIR ACT (Smoking Regulations)
191.765   Definitions. (8/28/1992)
191.767   Persons not to smoke in public places or meetings, except in designated smoking areas — designation of space for smoking area, requirements. (8/28/1992)
191.769   Areas not considered public places. (8/28/1992)
191.771   Person in control of public places or public meetings, duties. (8/28/1992)
191.773   Violators, guilty of infraction. (8/28/1992)
191.775   Public schools and school buses — smoking, or tobacco or vapor product use prohibited — permissible use of tobacco, where. (8/28/2020)
191.776   Child day care facilities, smoking or tobacco use when children are present, prohibited, penalty. (8/28/1993)
191.777   More stringent ordinances or rules may be adopted by governing bodies or school boards. (8/28/1993)
HUNGER RELIEF AND OUTREACH
191.800   Definitions. (8/28/1992)
191.803   Boards of education to establish breakfast program — rules — waiver, procedure. (8/28/1992)
191.805   Hardship grant program, distribution of, rules. (8/28/1992)
191.807   Supplemental funding, women, infants and children supplemental food program — funding of certain county health offices, use, maximum amount of grants — rules and regulations. (8/28/1992)
191.810   Department of health and senior services to establish standards for summer food service program — where established — order of priority — waiver, filing required. (8/28/1992)
191.813   Agencies to coordinate outreach programs — specific programs — public service announcements to be designed. (8/28/1992)
191.815   Administrative rules, procedure. (8/28/1995)
HEALTH CARE INITIATIVES
191.828   Evaluations, effect of initiatives. (8/28/2023)
191.831   Health initiatives fund established, use — Alt-care pilot program, components — participation may be required. (8/28/2023)
191.835   Community 2000 grants program — local commissions, members — goals, objectives — evaluations, funding. (8/28/1993)
191.839   Education programs for persons with no or inadequate health insurance. (8/28/1993)
191.843   Authorizes grants for regional research consortia in a distressed community. (8/28/2000)
HEALTH CARE COST REDUCTION AND TRANSPARENCY ACT
191.875   Citation--definitions--estimate of cost provided, when--statement--disclosure of costs without discounts. (10/14/2016)
HEALTH CARE PAYMENT FRAUD AND ABUSE
191.900   Definitions. (8/28/2007)
191.905   False statement to receive health care payment prohibited — kickback, bribe, purpose, prohibited, exceptions — abuse prohibited — penalty — prosecution, procedure — Medicaid fraud reimbursement fund created — restitution — civil penalty — notification to disciplinary agencies — civil action authorized. (1/1/2017)
191.907   Original source of information to receive a portion of any recovery. (8/28/2007)
191.908   Whistleblower protections — violations, penalty. (8/28/2007)
191.910   Attorney general may investigate violations, powers — service authorized — prosecuting attorney, report, prosecution — provision of records — no limitation of other actions. (8/28/2007)
191.914   False report or claim, penalty. (1/1/2017)
BREAST-FEEDING
191.915   Breast-feeding information provided, when, by whom. (8/28/1999)
191.918   Breast-feeding in public permitted — not sexual conduct, public indecency, or obscenity — no municipal ordinances to prohibit or restrict. (8/28/2014)
PRENATAL SCREENING COUNSELING
191.923   Prenatally diagnosed conditions, patient to be provided information — definitions — clearinghouse of information to be established. (8/28/2007)
NEWBORN HEARING SCREENING

Commission for the deaf and hard of hearing, 161.400 to 161.410

191.925   Screening for hearing loss, infants, when — procedures used — exemptions — information provided, by whom — no liability, when. (8/28/2002)
191.928   Surveillance and monitoring system for certain newborns — standards and follow-up procedure — confidentiality of information. (8/28/2002)
191.931   Early intervention services available — report, content. (8/28/1999)
191.937   Rulemaking authority, procedure. (8/28/1999)
POSTPARTUM DEPRESSION CARE ACT
191.940   Citation of law — definitions — hospitals and ambulatory surgical centers to provide information about postpartum depression. (8/28/2020)
PROSTATE CANCER PILOT PROGRAMS
191.950   Prostate cancer pilot programs — definitions — eligibility — services provided — grants — rulemaking authority — sunset provision. (8/28/2011)
ADOPTION AWARENESS
191.975   Adoption awareness, department duties — advertising campaign authorized — rulemaking authority. (8/28/2021)
HEALTH EDUCATION CENTERS
191.980   Missouri area health education centers program established — authority of director — duties. (8/28/2018)
DIABETES
191.990   Diabetes goals and benchmarks — report, contents. (8/28/2014)
HEALTH CARE ACCESS
191.1050   Definitions. (8/28/2007)
191.1053   Designation of areas — re-evaluation of designations, when — rulemaking authority. (8/28/2007)
191.1056   Fund created, use of moneys. (8/28/2007)
PALLIATIVE CARE
191.1075   Definitions. (8/28/2016)
191.1080   Council created, purpose, members, terms, duties — report — expiration date. (8/28/2016)
191.1085   Program established, purpose — website information — rulemaking authority. (8/28/2016)
VOLUNTEER HEALTH SERVICES ACT
191.1100   Citation of law — definitions. (10/11/2013)
191.1102   Additional licensure not required, when — inapplicability. (10/11/2013)
191.1104   Display of license or certificate, how satisfied. (10/11/2013)
191.1106   Registration with department required, fee, contents — quarterly reports — list of providers — recordkeeping requirements — rulemaking authority. (10/11/2013)
191.1110   Immunity from liability, when — no compensation to be received — certain military personnel deemed licensed. (10/11/2013)
191.1112   Volunteer crisis response teams — definitions — immunity from liability, inapplicability of. (10/11/2013)
SHOW-ME EXTENSION FOR COMMUNITY HEALTH CARE OUTCOMES (ECHO) PROGRAM
191.1140   Treatment of chronic, common, and complex diseases, program authorized, purpose. (8/28/2014)
TELEHEALTH
191.1145   Definitions — telehealth services authorized, when. (8/28/2018)
191.1146   Physician-patient relationship required, how established. (8/28/2020)
CAREGIVER, ADVISE, RECORD, AND ENABLE (CARE) ACT
191.1150   Citation of law — definitions — designation of caregiver, when — requirements. (8/28/2018)
ENSURING ACCESS TO HIGH QUALITY CARE FOR THE TREATMENT OF SUBSTANCE USE DISORDERS ACT
191.1164   Citation of law — definitions. (8/28/2019)
191.1165   Medication-assisted treatment — formulary medications and requirements — disclosure of MAT services provided — incarcerated persons and diversion program participants, assessment for substance use disorders. (8/28/2021)
191.1167   Contracts, policies, or procedures in violation of act deemed null and void. (8/28/2019)
191.1168   Severability clause. (8/28/2019)
COMPASSIONATE CARE VISITS
191.1400   Citation of law — definitions — compassionate care visits to be permitted, policy — limitations — informational materials — violations may be reported — immunity from liability, when. (8/28/2022)
LONG-TERM DIGNITY ACT
191.1601   Citation of law. (8/28/2020)
191.1603   Definitions. (8/28/2020)
191.1604   Long-term dignity savings account, use, requirements. (8/28/2020)
191.1605   Accounts, use of moneys — withdrawals, recapture — death of account holder, effect of. (8/28/2020)
191.1606   Reporting, forms — rulemaking authority. (8/28/2020)
191.1607   Financial institutions, requirements — no responsibility or liability, when. (8/28/2020)
MISSOURI SAVE ADOLESCENTS FROM EXPERIMENTATION (SAFE) ACT
191.1720   Gender transition — citation of law — definitions — under 18, no surgery or gender transition drugs — license revocation, when — civil action, when, procedure — exceptions. (8/28/2023)
MISSOURI PARKINSON'S DISEASE REGISTRY
191.1820   Citation of law — definitions. (8/28/2023)
191.1825   Registry established, purpose — start date — notification to patients. (8/28/2023)
191.1830   Registry advisory committee established — members. (8/28/2023)
191.1835   Collection and dissemination of information, system established — list of data points — reporting requirements, medical providers. (8/28/2023)
191.1840   Furnishing registry data, agreements, requirements — confidentiality. (8/28/2023)
191.1845   Confidentiality of information — coding system — recordkeeping. (8/28/2023)
191.1850   Facility-based registries not preempted. (8/28/2023)
191.1855   Report to general assembly, contents, publishing of. (8/28/2023)
ESSENTIAL CAREGIVER PROGRAM
191.2290   Citation of law — definitions — state of emergency, designated essential caregiver designation — requirements. (8/28/2022)
 - Cross References
Constitutional provisions relative to public health and welfare, Const. Art. IV § 37
Elderly health and nutrition act, 208.600 to 208.627
Health and senior services, department of, generally, Chap. 192
Identification badges, health care facilities personnel required to wear, when, 197.705
On-site sewage disposal systems regulations, duties of department of health and senior services, 701.025 to 701.039

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