Assurance 3 - Qualified Providers
Agencies and workers providing HCBS services are qualified.
A state must assure that only those agencies and individuals meeting the state’s qualification requirements provide services to HCBS waiver participants.
What are the requirements of this HCBS waiver assurance?
A state must establish qualification requirements for individuals and agencies that provide each type of service offered under the HCBS waiver. Specific qualifications may differ from state to state; general requirements are described below.
A state must verify that provider agencies and the workers they employ, if applicable, meet the state’s licensure and certification standards initially and on an ongoing basis. The specific licensing or certification standards may vary from state to state. (click here for more information about licensure and certification requirements)Examples of licensure or certification requirements for agencies:
- Minimum staffing ratios
- Qualification credentials of staff
- Administrative capacity and reporting
Examples of licensure or certification standards for facilities:
- Admission policies
- Physical Environment
- Minimum staffing ratios
- Staff training and qualifications
- Staff supervision
- Resident rights
- Medication administration
- Use of Restrictive interventions
- Incident reporting
- Provision/arrangement of health services
Examples of licensure or certification requirements of individuals:
- Nurses and social workers have to meet state licensure laws; pass state exams, have required training
Examples of state requirements for non-licensed and non-certified individuals include:
- Personal care assistants have to be at least 18, pass a criminal background check and have required hours of pre-service and in-service training
A state must monitor non-licensed and non-certified providers. State licensure or certification standards may not apply to all types of provider agencies and workers. A state may have other requirements or standards for non-licensed and non-certified providers. These minimum standards may include background checks, maintenance of an abuse registry, and/or requirements related to basic competencies such as language or age. (click here for more information about monitoring non-licensed and non-certified providers)A state may elect to pay relatives or legal guardians for the provision of HCBS waiver services only in specific circumstances. Such circumstances must be specified by the state. Specific circumstances might include:
- (a) the lack of a qualified provider in remote areas of the state;
- (b) the lack of a qualified provider who can furnish services at necessary times and places;
- (c) the unique ability of a relative or legal guardian to meet the needs of a person; and/or,
- (d) other circumstances specified by the state.
A state must have policies and procedures related to provider training and must monitor that the policies are implemented. This may include on-going training requirements in certain competencies (e.g. medication administration, personal care) and/or required hours of training.