Section 16.03.10.587 - ICF/IID: PROVIDER QUALIFICATIONS AND DUTIES01.Provider Application and Certification. A facility must apply to participate as an ICF/IID facility.02.Licensure and Certification. a. Upon receipt of an application from a facility, the Licensing and Certification Agency will conduct a survey to determine the facility's compliance with certification standards for the type of care the facility proposes to provide to participants.b. If the Licensing and Certification Agency determines that a facility meets Title XIX certification standards for ICF/IID, the Department will certify to the appropriate branch of government that the facility meets the standards for ICF/IID types of care.c. Upon receipt of the certification from the Licensing and Certification Agency, the Bureau may enter into a provider agreement with the long-term care facility.d. After the provider agreement has been executed by the Facility Administrator and by the bureau chief, one (1) copy will be sent by certified mail to the facility and the original is to be retained by the Bureau.03.Direct Care Staff. Direct Care staff in an ICF/IID are defined as the present on-duty staff calculated over all shifts in a twenty-four (24) hour period for each defined residential living unit. Direct care staff in an ICF/IID include those employees whose primary duties include the provision of hands-on, face-to-face contact with the participants of the facility. This includes both regular and live-in/sleep-over staff. It excludes professionals such as psychologists, nurses, and others whose primary job duties are not the provision of direct care, as well as managers/supervisors who are responsible for the supervision of staff.04.Direct Care Staffing Levels. The reasonable level of direct care staffing provided to a participant in an ICF/IID setting will be dependent upon the level of involvement and the need for services and supports of the participant as determined by the Department. Level of involvement relates to the severity of a participant's intellectual disability. Those levels, in decreasing level of severity, are: profound, severe, moderate, and mild. Staffing levels will be subject to the following constraints:a. Direct care staffing for a severely and profoundly intellectually disabled participant residing in an ICF/IID must be a maximum of sixty-eight point twenty five (68.25) hours per week.b. Direct care staffing for a moderately intellectually disabled participant residing in an ICF/IID must be limited to a maximum of fifty-four point six (54.6) hours per week.c. Direct care staffing for a mildly intellectually disabled participant residing in an ICF/IID must be limited to a maximum of thirty four point one two five (34.125) hours per week.05.Direct Care Staff Hours. The annual sum total level of allowable direct care staff hours for each residential living unit will be determined in the aggregate as the sum total of the level of staffing allowable for each resident residing in that residential living unit as determined in Subsection 587.04 of these rules.06.Phase-In Period. If enactment of Subsection 587.04 of these rules requires a facility to reduce its level of direct care staffing, a six (6) month phase-in period will be allowed from the date of the enactment of this section, without any resulting disallowances. Should disallowances result, the hourly rate of direct care staff used in determining disallowances will be the weighted average of the hourly rates paid to a facility's direct care staff, plus the associated benefits, at the end of the phase-in period.07.Exceptions. Should a provider be able to show convincing evidence documenting that the annual aggregate direct care hours as allowed under this section will compromise their ability to supply adequate care to the participants, as required by federal regulations and state rules, within an ICF/IID residential living unit and that other less costly options would not alleviate the situation, the Department will approve an additional amount of direct care hours sufficient to meet the extraordinary needs. This adjustment will only be available up through September 30, 1996.Idaho Admin. Code r. 16.03.10.587