Iowa Administrative Code › Agency 441 - Human Services Department › Title VIII - Medical Assistance › Chapter 77 - Conditions of Participation for Providers of Medical and Remedial Care › Rule 441-77.37 - Home- and Community-based Services Intellectual Disability Waiver Service Providers

Current through Register Vol. 47, No. 3, July 24, 2024
Providers shall be eligible to participate in the Medicaid
				  HCBS intellectual disability waiver program if they meet the requirements in
				  this rule and the subrules applicable to the individual service.
The standards in subrule 77.37(1) apply only to providers of
				  supported employment, respite providers certified according to subparagraph
				  77.37(15) "a "(8), and providers of supported community living services that
				  are not residential-based. The standards and certification processes in
				  subrules 77.37(2) through 77.37(7) and 77.37(9) through 77.37(12) apply only to
				  supported employment providers and non-residential-based supported community
				  living providers.
The requirements in subrule 77.37(13) apply to all providers.
				  EXCEPTION: A person hired through the consumer choices option for independent
				  support brokerage, self-directed personal care, individual-directed goods and
				  services, or self-directed community support and employment is not required to
				  enroll as a Medicaid provider and is not subject to the review requirements in
				  subrule 77.37(13). Also, services must be rendered by a person who is at least
				  16 years old (except as otherwise provided in this rule) and is not the spouse
				  of the consumer served or the parent or stepparent of a consumer aged 17 or
				  under. People who are 16 or 17 years old must be employed and supervised by an
				  enrolled HCBS provider unless they are employed to provide self-directed
				  personal care services through the consumer choices option. A person hired for
				  self-directed personal care services need not be supervised by an enrolled HCBS
				  provider. Consumer-directed attendant care and interim medical monitoring and
				  treatment providers must be at least 18 years of age.
The integrated, community-based settings standards in subrule
				  77.25(5) apply to all HCBS intellectual disability waiver service
				  providers.
(1)
Organizational
				standards (Outcome 1).
Organizational outcome-based standards for
				home- and community-based services intellectual disability providers are as
				follows:
a. The organization demonstrates the
				provision and oversight of high-quality supports and services to
				consumers.
b. The organization
				demonstrates a defined mission commensurate with consumer's needs, desires, and
				abilities.
c. The organization
				establishes and maintains fiscal accountability.
d. The organization has qualified staff
				commensurate with the needs of the consumers they serve. These staff
				demonstrate competency in performing duties and in all interactions with
				clients.
e. The organization
				provides needed training and supports to its staff. This training includes at a
				minimum:
(1) Consumer rights.
(2) Confidentiality.
(3) Provision of consumer
				medication.
(4) Identification and
				reporting of child and dependent adult abuse.
(5) Individual consumer support needs.
f. The organization has a
				systematic, organizationwide, planned approach to designing, measuring,
				evaluating, and improving the level of its performance. The organization:
(1) Measures and assesses organizational
				activities and services annually.
(2) Gathers information from consumers,
				family members, and staff.
(3)
				Conducts an internal review of consumer service records, including all major
				and minor incident reports according to subrule 77.37(8).
(4) Tracks incident data and analyzes trends
				annually to assess the health and safety of consumers served by the
				organization.
(5) Identifies areas
				in need of improvement.
(6)
				Develops a plan to address the areas in need of improvement.
(7) Implements the plan and documents the
				results.
g. Consumers and
				their legal representatives have the right to appeal the provider's
				implementation of the 20 outcomes, or staff or contractual person's action
				which affects the consumer. The provider shall distribute the policies for
				consumer appeals and procedures to consumers.
h. The provider shall have written policies
				and procedures and a staff training program for the identification and
				reporting of child and dependent adult abuse to the department pursuant to
				441-Chapters 175 and 176.
i. The
				governing body has an active role in the administration of the
				agency.
j. The governing body
				receives and uses input from a wide range of local community interests and
				consumer representation and provides oversight that ensures the provision of
				high-quality supports and services to consumers.