MO Register Vol. 44 No. 22. (Page 2811-2880)

LibraryMissouri Register
Enactment Date01 January 2019

Volume 44, Number 22

Pages 2811-2880

November 15, 2019

SALUS POPULI SUPREMA LEX ESTO
"The welfare of the people shall be the supreme law."

John R. Ashcroft
Secretary of State

MISSOURI
REGISTER

The Missouri Register is an official publication of the state of Missouri, under the authority granted to the secretary of state by sections 536.015 and 536.033, RSMo. Reproduction of rules is allowed; however, no reproduction shall bear the name Missouri Register or "official" without the express permission of the secretary of state.

The Missouri Register is published semi-monthly by
Secretary of State
John R. Ashoroft
Administrative Rules Division
James C. Kirkpatrick State Information Center
600 W. Main
Jefferson City, MO 65101
(573) 751-4015
Editor-in-Chief
Curtis W. Treat

Managing Editor
John C. Stegmann

Editor
vonne kilbourn

Associate Editor
Jennifer Alex Moore

Publication Specialist
Jacqueline D. White

Administrative Aide
Tammy Winkelman

Reader
Thomas Huber

ISSN 0149-2942

The Missouri Register and Code of State Regulations (CSR) are available on the Internet. The Register address is sos.mo.gov/adrules/moreg/moreg and the CSR is sos.mo.gov/adrules/csr/csr. The Administrative Rules Division may be contacted by email at rules@sos.mo.gov.

The secretary of state's office makes every effort to provide program accessibility to all citizens without regard to disability. If you desire this publication in alternate form because of a disability, please contact the Division of Administrative Rules, PO Box 1767, Jefferson City, MO 65102, (573) 751-4015. Hearing impaired citizens should contact the director through Missouri relay, (800) 735-2966.

In This Issue:

EXECUTIVE ORDERS...................2815

PROPOSED RULES

Department of Natural Resources

Air Conservation Commission...................2817

Department of Commerce and Insurance

State Board of Podiatric Medicine ................2821

ORDERS OF RULEMAKING

Department of Conservation

Conservation Commission .....................2833

Department of Elementary and Secondary Education

Missouri Commission for the Deaf and Hard of Hearing .2838

Department of Social Services

MO HealthNet Division ......................2839

Elected Officials

Secretary of State...........................2841

Attorney General ...........................2841

Department of Commerce and Insurance

Missouri State Board of Accountancy..............2845

State Board of Nursing .......................2846

IN ADDITIONS

Office of Administration

State Officials' Salary Compensation Schedule........2847

Department of Health and Senior Services

Missouri Health Facilities Review Committee.........2850

DISSOLUTIONS.........................2851

SOURCE GUIDES

RULE CHANGES SINCE UPDATE................2857

EMERGENCY RULES IN EFFECT ...............2867

EXECUTIVE ORDERS........................2869

REGISTER INDEX...........................2871

Register Filing Deadlines

Register Publication Date

Code Publication Date

Code Effective Date

July 1, 2019 July 15, 2019

August 1, 2019 August 15, 2019

August 31, 2019 August 31, 2019

September 30, 2019 September 30, 2019

August 1, 2019 August 15, 2019

September 2, 2019 September 16, 2019

September 30, 2019 September 30, 2019

October 30, 2019 October 30, 2019

September 3, 2019 September 16, 2019

October 1, 2019 October 15, 2019

October 31, 2019 October 31, 2019

November 30, 2019 November 30, 2019

October 1, 2019 October 15, 2019

November 1, 2019 November 15, 2019

November 30, 2019 November 30, 2019

December 30, 2019 December 30, 2019

November 1, 2019 November 15, 2019

December 2, 2019 December 16, 2019

December 31, 2019 December 31, 2019

January 30, 2020 January 30, 2020

December 2, 2019 December 16, 2019

January 2, 2020

January 15, 2020

January 30, 2020 January 30, 2020

February 29, 2020 February 29, 2020

January 2, 2020 January 15, 2020

February 3, 2020 February 18, 2020

February 29, 2020 February 29, 2020

March 30, 2020 March 30, 2020

Documents will be accepted for filing on all regular workdays from 8:00 a.m. until 5:00 p.m. We encourage early filings to facilitate the timely publication of the Missouri Register. Orders of Rulemaking appearing in the Missouri Register will be published in the Code of State Regulations and become effective as listed in the chart above. Advance notice of large volume filings will facilitate their timely publication. We reserve the right to change the schedule due to special circumstances. Please check the latest publication to verify that no changes have been made in this schedule. To review the entire year's schedule, please check out the website at sos.mo.gov/adrules/pubsched.

HOW TO CITE RULES AND RSMO

RULES

The rules are codified in the Code of State Regulations in this system-

Title

Division

Chapter

Rule

3

Department

CSR

Code of State Regulations

10-Agency Division

4

General area regulated

.115 Specific area regulated

and should be cited in this manner: 3 CSR 10-4.115.

Each department of state government is assigned a title. Each agency or division in the department is assigned a division number. The agency then groups its rules into general subject matter areas called chapters and specific areas called rules. Within a rule, the first breakdown is called a section and is designated as (1). Subsection is (A) with further breakdown into paragraphs 1., subparagraphs A., parts (I), subparts (a), items I. and subitems a.

The rule is properly cited by using the full citation, for example, 3 CSR 10-4.115 NOT Rule 10-4.115.

Citations of RSMo are to the Missouri Revised Statutes as of the date indicated.

Code and Register on the Internet

The Code of State Regulations and Missouri Register are available on the Internet.

The Code address is sos.mo.gov/adrules/csr/csr

The Register address is sos.mo.gov/adrules/moreg/moreg

These websites contain rulemakings and regulations as they appear in the Code and Registers.

Executive Orders

The Secretary of State shall publish all executive orders beginning January 1, 2003, pursuant to section 536.035.2, RSMo.

EXECUTIVE ORDER
19-18

WHEREAS, the use of vaping devices, also known as electronic cigarettes or e-cigarettes, has proliferated among the youth of the country and in Missouri in particular; and

WHEREAS, the United States Centers for Disease Control and Prevention (CDC) has reported that, as of October 1, 2019, there have been 1,080 lung injury cases and 1K deaths associated with using vaping products across the country this year; and

WHEREAS, as of October 4, 201 9, there have been 22 reports of vaping-related illnesses in Missouri, including one death, with a majority of such reports being among individuals aged 15-24; and

WHEREAS, public health professionals from the CDC and the United Slates Food and Drug Administration (FDA) are actively investigating these vaping-related illnesses but have not yet been able to determine the precise cause; and

WHEREAS, despite laws prohibiting the use of vaping devices by persons under 18 years old, the Missouri Student Survey has reported increased usage of vaping devices by Missouri middle school and high school students every survey year since 2014, rising from 19.1% who say they have used vaping devices at some point in their lives in 2014 to 26.9% in 2018; and

WHEREAS, the 2018 National Youth Tobacco Survey has shown that usage of vaping devices among high school students increased nationally by 78% from 2017 to 201K; and

WHEREAS, flavored vaping products containing nicotine and the targeted marketing of said products have contributed to an increase in the use of said products by the youth; and

WHEREAS, data released by the CDC and FDA show a rapid increase in youth vaping and have labeled such use an "epidemic"; and

WHEREAS, school districts around the country have recognized the harm that vaping devices have caused its student population by bringing suit against the vaping device manufacturer Juul and

WHEREAS, it is crucial the State lake actions necessary to protect the health and safety of Missouri's youth;

NOW, THEREFORE 1 MICHAEL PARSON, GOVERNOR OF THE STATE. OF MISSOURI, by virtue of the authority vested in me by the Constitution and laws of the state of Missouri, do hereby order the Department of Health and Senior Services, the Department of 1 Elementary and Secondary Education, and the Department of Public Safety to, within 30 days of this order, use existing resources and appropriations to collaborate in developing a statewide campaign designed to educate, warn, and deter the use of vaping devices among the youth of the State of Missouri. As part of the aforementioned collaboration, 1 further direct such agencies to review the evidence regarding the effects of vaping-related injuries specifically amongst youth, and tailor the education campaign to counter the marketing practices of the vaping industry that target youth. In developing said education campaign, the agencies shall further examine similar campaigns used by other slates and by the federal government in order to select a campaign that has proven successful in achieving the desired result of reducing use of vaping products by youth.

IN WITNESS WHEREOF, I have hereunto set my hand and caused to be affixed the Great Seal of the State of Missouri, in the City of Jefferson, on this 15th day of October, 2019.

__________________
Michael L. Parson
Governor

ATTEST:

John R. Ashcroft
Secretary of State

EXECUTIVE ORDER
19-19

TO ALL DEPARTMENTS AND AGENCIES:

This is to advise that state offices of the executive branch under the purview of the Governor will be closed on Friday. November 29, 2019.

IN WITNESS WHEREOF, I have hereunto set my hand and caused to be affixed the Great Seal of the State of Missouri, in the City of Jefferson, an this 4th day of November, 2019.

MICHAEL L. PARSON
GOVERNOR

ATTEST:

________________________
JOHN R. ASHCROFT
secretary of state

Proposed Rules

Under this heading will...

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