Idaho Admin. Code r. 16.03.10.705

Current through August 31, 2023

Section 16.03.10.705 - ADULT DD WAIVER SERVICES: PROVIDER QUALIFICATIONS AND DUTIES

All providers of waiver services must have a valid provider agreement with the Department. Performance under this agreement will be monitored by the Department. (3-17-22)

01.Residential Habilitation -- Supported Living. When residential habilitation services are provided by an agency, the agency must be certified by the Department as a Residential Habilitation Agency under IDAPA 16.04.17, "Residential Habilitation Agencies," and must supervise the direct services provided. Individuals who provide residential habilitation services in the home of the participant (supported living) must be employed by a Residential Habilitation Agency. Providers of residential habilitation services must meet the following requirements: (3-17-22)

a. Direct service staff must meet the following minimum qualifications: (3-17-22)

i. Be at least eighteen (18) years of age; (3-17-22)

ii. Be a high school graduate, or have a GED, or demonstrate the ability to provide services according to a plan of service; (3-17-22)

iii. Have current CPR and First Aid certifications; (3-17-22)

iv. Be free from communicable disease; (3-17-22)

v. Each staff person assisting with participant medications has successfully completed the "Assistance with Medications" course available through the Idaho Professional Technical Education Program approved by the Idaho State Board of Nursing or other Department-approved training. (3-17-22)

vi. Residential habilitation service providers who provide direct care or services satisfactorily completed a criminal background check in accordance with Section 009 of these rules and IDAPA 16.05.06, "Criminal History and Background Checks." (3-17-22)

vii. Have appropriate certification or licensure if required to perform tasks that require certification or licensure. (3-17-22)

b. All skill training for agency direct service staff must be provided by a Qualified Intellectual Disabilities Professional (QIDP) who has demonstrated experience in writing skill training programs. (3-17-22)

c. Prior to delivering services to a participant, agency direct service staff must complete an orientation program. The orientation program must include the following subjects: (3-17-22)

i. Purpose and philosophy of services; (3-17-22)

ii. Service rules; (3-17-22)

iii. Policies and procedures; (3-17-22)

iv. Proper conduct in relating to waiver participants; (3-17-22)

v. Handling of confidential and emergency situations that involve the waiver participant; (3-17-22)

vi. Participant rights; (3-17-22)

vii. Methods of supervising participants; (3-17-22)

viii. Working with individuals with developmental disabilities; and (3-17-22)

ix. Training specific to the needs of the participant. (3-17-22)

d. Additional training requirements must be completed within six (6) months of employment with the residential habilitation agency and include at a minimum: (3-17-22)

i. Instructional techniques: Methodologies for training in a systematic and effective manner; (3-17-22)

ii. Managing behaviors: Techniques and strategies for teaching adaptive behaviors; (3-17-22)

iii. Feeding; (3-17-22)

iv. Communication; (3-17-22)

v. Mobility; (3-17-22)

vi. Activities of daily living; (3-17-22)

vii. Body mechanics and lifting techniques; (3-17-22)

viii. Housekeeping techniques; and (3-17-22)

ix. Maintenance of a clean, safe, and healthy environment. (3-17-22)

e. The provider agency will be responsible for providing on-going training specific to the needs of the participant as needed. (3-17-22)

f. Through the duration of the COVID-19 public health emergency, agency direct service staff may begin rendering services prior to completing the training requirements, provided that they complete the training requirements within thirty (30) days of first rendering services, advise the participant or legal guardian that the individual has not yet completed the applicable trainings, and comply with any other requirements specified by the Department in a COVID-19 information release posted on the Department's website at https://healthandwelfare.idaho.gov/Providers/Providers-Medicaid/InformationReleases/tabid/264/Default.aspx. (3-17-22)

02. Residential Habilitation -- Certified Family Home (CFH). (3-17-22)

a. An individual who provides direct residential habilitation services in their own home must be certified by the Department to operate a certified family home under IDAPA 16.03.19, "Certified Family Homes," and must receive residential habilitation program coordination services provided through the Department, or its contractor, for the residential habilitation services they provide. (3-17-22)

b. CFH providers providing residential habilitation services as a DD Waiver provider must meet the following minimum qualifications: (3-17-22)

i. Be at least eighteen (18) years of age; (3-17-22)

ii. Be a high school graduate, have a GED, or demonstrate the ability to provide services according to a plan of service; (3-17-22)

iii. Have current CPR and First Aid certifications; (3-17-22)

iv. Be free from communicable disease; (3-17-22)

v. Each CFH provider of residential habilitation services assisting with participant medications has successfully completed the "Assistance with Medications" course available through the Idaho Professional Technical Education Program approved by the Idaho State Board of Nursing, or other Department-approved training. (3-17-22)

vi. CFH providers of residential habilitation services who provide direct care and services have satisfactorily completed a criminal history check in accordance with Section 009 of these rules and IDAPA 16.05.06, "Criminal History and Background Checks;" and (3-17-22)

vii. Have appropriate certification or licensure if required to perform tasks that require certification or licensure. (3-17-22)

c. All skill training for CFH providers who are providing residential habilitation services must be provided through the Department or its contractor by qualified intellectual disabilities professional (QIDP) who has demonstrated experience in writing skill training programs. (3-17-22)

d. Prior to delivering residential habilitation services to a participant, the CFH provider must complete an orientation training in the following areas as provided by either the Department, or its contractor or both, and include the following areas: (3-17-22)

i. Purpose and philosophy of services; (3-17-22)

ii. Service rules; (3-17-22)

iii. Policies and procedures; (3-17-22)

iv. Proper conduct in relating to waiver participants; (3-17-22)

v. Handling of confidential and emergency situation that involve the waiver participant; (3-17-22)

vi. Participant rights; (3-17-22)

vii. Methods of supervising participants; (3-17-22)

viii. Working with individuals with developmental disabilities; and (3-17-22)

ix. Training specific to the needs of the participant. (3-17-22)

e. Additional training requirements for CFH providers providing residential habilitation waiver services must be completed by the CFH provider within six (6) months of certification date and include a minimum of the following: (3-17-22)

i. Instructional Techniques: Methodologies for training in a systematic and effective manner; (3-17-22)

ii. Managing behaviors: techniques and strategies for teaching adaptive behaviors; (3-17-22)

iii. Feeding; (3-17-22)

iv. Communication; (3-17-22)

v. Mobility; (3-17-22)

vi. Activities of daily living; (3-17-22)

vii. Body mechanics and lifting techniques; (3-17-22)

viii. Housekeeping techniques; and (3-17-22)

ix. Maintenance of a clean, safe, and healthy environment. (3-17-22)

f. The Department or its contractor will be responsible for providing on-going training to the CFH provider of residential habilitation specific to the needs of the participant as needed. (3-17-22)

g. Through the duration of the COVID-19 public health emergency, CFH providers may begin rendering services prior to completing the training requirements, provided that they complete the training requirements within thirty (30) days of first rendering services, advise the participant or legal guardian that the individual has not yet completed the applicable trainings, and comply with any other requirements specified by the Department in a COVID-19 information release posted on the Department's website at https://healthandwelfare.idaho.gov/Providers/Providers-Medicaid/InformationReleases/tabid/264/Default.aspx. (3-17-22)

03. Chore Services. Providers of chore services must meet the following minimum qualifications: (3-17-22)

a. Be skilled in the type of service to be provided; and (3-17-22)

b. Demonstrate the ability to provide services according to a plan of service. (3-17-22)

c. Chore service providers who provide direct care and services have satisfactorily completed a criminal history and background check in accordance with Section 009 of these rules and IDAPA 16.05.06, "Criminal History and Background Checks." (3-17-22)

04.Respite Care. Providers of respite care services must meet the following minimum qualifications: (3-17-22)

a. Have received care giving instructions in the needs of the person who will be provided the service; (3-17-22)

b. Demonstrate the ability to provide services according to a plan of service; (3-17-22)

c. Be free of communicable disease; and (3-17-22)

d. Respite care service providers who provide direct care and services have satisfactorily completed a criminal history and background check in accordance with Section 009 of these rules and IDAPA 16.05.06, "Criminal History and Background Checks." (3-17-22)

05.Supported Employment. Supported employment services must be provided by an agency that supervises the direct service and is accredited by the Commission on Accreditation of Rehabilitation Facilities or other comparable standards, or meets State requirements to be a State-approved provider. Supported employment service providers who provide direct care or services must satisfactorily complete a criminal history and background check in accordance with Section 009 of these rules and IDAPA 16.05.06, "Criminal History and Background Checks." (3-17-22)

06.Non-Medical Transportation. Providers of non-medical transportation services must: (3-17-22)

a. Possess a valid driver's license; and (3-17-22)

b. Possess valid vehicle insurance. (3-17-22)

07.Environmental Accessibility Adaptations. All services must be provided in accordance with applicable state or local building codes and meet state or local building, plumbing, and electrical requirements for certification. (3-17-22)

08.Specialized Medical Equipment and Supplies. Providers of specialized medical equipment and supplies must be enrolled in the Medicaid program as participating medical vendor providers. Providers must ensure all items meet applicable standards of manufacture, design, and installation. Preference will be given to equipment and supplies that are the most cost-effective option to meet the participant's needs. (3-17-22)

09.Personal Emergency Response System. Personal emergency response system providers must demonstrate that the devices installed in a waiver participant's home meet Federal Communications Standards, or Underwriter's Laboratory standards, or equivalent standards. (3-17-22)

10.Home Delivered Meals. Providers of home-delivered meals must be a public agency or private business, and must exercise supervision to ensure that: (3-17-22)

a. Each meal meets one-third (1/3) of the Recommended Daily Allowance, as defined by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences; (3-17-22)

b. Meals are delivered in accordance with the service plan, in a sanitary manner, and at the correct temperature for the specific type of food; (3-17-22)

c. A Registered Dietitian documents the review and approval of menus, menu cycles, and any changes or substitutions; and (3-17-22)

d. The agency or business is inspected and licensed as a food establishment under IDAPA 16.02.19, "Idaho Food Code." (3-17-22)

11.Skilled Nursing. Skilled nursing service providers must be licensed in Idaho as a licensed registered nurse or licensed practical nurse in good standing, or must be practicing on a federal reservation and be licensed in another state. Skilled nursing providers who provide direct care and services must satisfactorily complete a criminal history and background check in accordance with Section 009 of these rules and IDAPA 16.05.06, "Criminal History and Background Checks." (3-17-22)

12.Behavior Consultation or Crisis Management. Behavior Consultation or Crisis Management Providers must meet the following: (3-17-22)

a. Work under the direct supervision of a licensed psychologist or Ph.D. in Special Education, with training and experience in treating severe behavior problems and training and experience in applied behavior analysis; and (3-17-22)

b. Have a Master's Degree in a behavioral science such as social work, psychology, psychosocial rehabilitation counseling, psychiatric nursing, special education or a closely related course of study; or (3-17-22)

c. Be a licensed pharmacist; or (3-17-22)

d. Be a Qualified Intellectual Disabilities Professional (QIDP). (3-17-22)

e. Emergency back-up providers must meet the minimum residential habilitation provider qualifications described under IDAPA 16.04.17, "Residential Habilitation Agencies." (3-17-22)

f. Behavior consultation or crisis management providers who provide direct care or services must satisfactorily complete a criminal history and background check in accordance with Section 009 of these rules and IDAPA 16.05.06, "Criminal History and Background Checks." (3-17-22)

13. Adult Day Health. Providers of adult day health must meet the following requirements: (3-17-22)

a. Services provided in a facility must be provided in a facility that meets the building and health standards identified in IDAPA 16.03.21, "Developmental Disabilities Agencies (DDA)"; (3-17-22)

b. Services provided in a home must be provided in a home that meets the standards of home certification identified in IDAPA 16.03.19, "Certified Family Homes"; (3-17-22)

c. Adult day health providers who provide direct care or services must satisfactorily complete a criminal history check in accordance with Section 009 of these rules and IDAPA 16.05.06, "Criminal History and Background Checks"; (3-17-22)

d. Providers of adult day health must notify the Department on behalf of the participant, if the adult day health is provided in a certified family home other than the participant's primary residence. The adult day health provider must provide care and supervision appropriate to the participant's needs as identified on the plan. (3-17-22)

e. Adult day health providers who provide direct care or services must be free from communicable disease. (3-17-22)

14.Service Supervision. The plan of service that includes all waiver services is monitored by the plan monitor or targeted service coordinator. (3-17-22)

15.Transition Services. Transition managers as described in Section 350.01 of these rules are responsible for administering transition services. (3-17-22)

Idaho Admin. Code r. 16.03.10.705