Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 15 - Division of Senior and Disability Services › Chapter 7 - Service Standards › Section 19 CSR 15-7.021 - In-Home Service Standards

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment amends the purpose statement,
				  updates obsolete language and agency names throughout rule, and updates
				  criteria for providers of in-home services.
PURPOSE: This rule sets forth standards to be met by
				  any agency which contracts with the Missouri Department of Social Services,
				  Missouri Medicaid Audit and Compliance Unit for provision of in-home services
				  authorized by the Missouri Department of Health and Senior Services, Division
				  of Senior and Disability Services.
PUBLISHER'S NOTE: The secretary of state has
				  determined that publication of the entire text of the material that is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. This material as incorporated by reference in this rule shall be
				  maintained by the agency at its headquarters and shall be made available to the
				  public for inspection and copying at no more than the actual cost of
				  reproduction. This note applies only to the reference material. The entire text
				  of the rule is printed here.
(1) The Department of Health and Senior
				Services (also referred to as the department), Division of Senior and
				Disability Services' (also referred to as the division) payment to the provider
				is made on behalf of an eligible participant as an act of indirect or
				third-party reimbursement and is not made as a payment for the purchase of a
				service. Only those services authorized by the division shall be reimbursable
				to the provider.
(2) The in-home
				service provider shall deliver services in compliance with the standards set
				forth in this rule and
				13 CSR
				70-91.010,
				13 CSR
				65-2.020, and
				13 CSR
				70-3.030.
(3) Failure of the in-home service provider
				to comply with the terms of the contract and these standards may constitute a
				breach of contract.
(4) In
				accordance with the protective service mandate (Chapter 192, RSMo), the
				division may take immediate action to protect participants from providers who
				are found to be out of compliance with the requirements of this rule and of any
				other rule applicable to the in-home services program, when such noncompliance
				is determined by the division to create a risk of injury or harm to
				participants.
(A) Evidence of such risk may
				include:
1. Unreliable, inadequate,
				falsified, or fraudulent documentation of service delivery or
				training;
2. Failure to deliver
				services in a reliable and dependable manner;
3. Use of in-home service workers who do not
				meet the minimum employment requirements or training standards of this
				rule;
4. Failure to comply with the
				requirements for background screening of employees (sections
				192.2490 and
				192.2495, RSMo); or
5. Discontinuing services outside the
				provisions specified in section (16) of this rule without the knowledge and
				consent of the participant for a period of one (1) week or three (3)
				consecutive scheduled service delivery dates, whichever is
				shorter.