Editorial Note on Part 460
Editorial Note: Nomenclature changes to part 460 appear at 67 FR 61504, Oct. 1, 2002.

§ 460.64 Personnel qualifications for staff with direct participant contact. ( a ) *General qualification requirements.* Each member of the PACE organization's staff (employee or contractor) that has direct contact with participants must meet the following conditions: ( 1 ) Be legally authorized (for example, currently licensed, registered or certified if applicable) to practice in the State in which he or she performs the function or action;
( 2 ) Only act within the scope of his or her authority to practice;
( 3 ) Have 1 year of experience working with a frail or elderly population or, if the individual has less than 1 year of experience but meets all other requirements under paragraph (a) of this section, must receive appropriate training from the PACE organization on working with a frail or elderly population upon hiring.
( 4 ) Meet a standardized set of competencies for the specific position description established by the PACE organization before working independently.
( 5 ) Be medically cleared for communicable diseases before engaging in direct participant contact. ( i ) Staff must be cleared for communicable diseases based on a physical examination performed by a licensed physician, nurse practitioner, or physician assistant acting within the scope of their authority to practice, unless— ( A ) The PACE organization conducts an individual risk assessment that meets the conditions specified in paragraph (a)(5)(iii) of this section; and
( B ) The results of the risk assessment indicate the individual does not require a physical examination for medical clearance.
( ii ) As part of the initial physical examination, staff must be determined to be free of active Tuberculosis disease.
( iii ) If the PACE organization conducts a risk assessment on an individual under paragraphs (a)(5)(i)(A) and (B) of this section— ( A ) Policies and procedures for conducting a risk assessment on each individual with direct participant contact must be based on accepted professional standards of care;
( B ) The PACE organization's risk assessment must identify when a physical examination is required based on the results of the assessment; and
( C ) The results of the risk assessment must be reviewed by a registered nurse, physician, nurse practitioner, or physician assistant.
( D ) At a minimum, the risk assessment must do both of the following: ( 1 ) Assess whether staff have been exposed to or have any symptoms of the following diseases: ( i ) COVID-19.
( ii ) Diphtheria.
( iii ) Influenza.
( iv ) Measles.
( v ) Meningitis.
( vi ) Meningococcal Disease.
( vii ) Mumps.
( viii ) Pertussis.
( ix ) Pneumococcal Disease.
( x ) Rubella.
( xi ) Streptococcal Infection.
( xii ) Varicella Zoster Virus.
( xiii ) Any other infectious diseases noted as a potential threat to public health by the CDC.
( 2 ) Determine if staff are free of active Tuberculosis during the initial risk assessment.
( 6 ) Have all immunizations up to date before engaging in direct participant contact.
( b ) *Federally-defined qualifications for physician.* In addition to the qualification specified in paragraph (a) of this section, a physician must meet the qualifications and conditions in § 410.20 of this chapter.
[71 FR 71334, Dec. 8, 2006, as amended at 84 FR 25673, June 3, 2019; 89 FR 30844, Apr. 23, 2024]