How does a state comply with the qualified provider assurance?
A state establishes processes to monitor and verify that providers meet required licensure, certification or other standards. The state will monitor whether:
Providers meet the applicable licensure or certification standards (if any) for the type of service provided.
Providers meet any other required standards (e.g. staffing ratios, training, administrative structure etc).
Background checks were conducted, if required.
Other training requirements for non-licensed/non-certified personnel were met.
A state will typically use data from a number of different sources to provide evidence for this assurance.
- Data from a state’s Licensure and Certification Agency.
- Review of case management agency records.
- Review of provider agency records.
- Review of a sample of participant records.
Some states also use consumer surveys to determine if consumers are satisfied with how well workers are performing their jobs.
For providers where licensure is required: Percent of providers who meet state licensure standards (Data Source: state licensure data)
For professionals: Percent of social workers with a current social worker license (Data source: sample of case management agency records)
For non-professionals: Percent of personal care assistants who had required training (Data source: sample of staff records at personal care agency)