Section 460.64 - Personnel qualifications for staff with direct participant contact(a)General qualification requirements. Each member of the PACE organization's staff (employee or contractor) that has direct contact with participants must meet the following conditions:(1) Be legally authorized (for example, currently licensed, registered or certified if applicable) to practice in the State in which he or she performs the function or action;(2) Only act within the scope of his or her authority to practice;(3) Have 1 year of experience working with a frail or elderly population or, if the individual has less than 1 year of experience but meets all other requirements under paragraph (a) of this section, must receive appropriate training from the PACE organization on working with a frail or elderly population upon hiring.(4) Meet a standardized set of competencies for the specific position description established by the PACE organization before working independently.(5) Be medically cleared for communicable diseases before engaging in direct participant contact. (i) Staff must be cleared for communicable diseases based on a physical examination performed by a licensed physician, nurse practitioner, or physician assistant acting within the scope of their authority to practice, unless- (A) The PACE organization conducts an individual risk assessment that meets the conditions specified in paragraph (a)(5)(iii) of this section; and(B) The results of the risk assessment indicate the individual does not require a physical examination for medical clearance.(ii) As part of the initial physical examination, staff must be determined to be free of active Tuberculosis disease.(iii) If the PACE organization conducts a risk assessment on an individual under paragraphs (a)(5)(i)(A) and (B) of this section- (A) Policies and procedures for conducting a risk assessment on each individual with direct participant contact must be based on accepted professional standards of care;(B) The PACE organization's risk assessment must identify when a physical examination is required based on the results of the assessment; and(C) The results of the risk assessment must be reviewed by a registered nurse, physician, nurse practitioner, or physician assistant.(D) At a minimum, the risk assessment must do both of the following:(1) Assess whether staff have been exposed to or have any symptoms of the following diseases: (vi) Meningococcal Disease.(ix) Pneumococcal Disease.(xi) Streptococcal Infection.(xii) Varicella Zoster Virus.(xiii) Any other infectious diseases noted as a potential threat to public health by the CDC.(2) Determine if staff are free of active Tuberculosis during the initial risk assessment.(6) Have all immunizations up to date before engaging in direct participant contact.(b)Federally-defined qualifications for physician. In addition to the qualification specified in paragraph (a) of this section, a physician must meet the qualifications and conditions in § 410.20 of this chapter. 71 FR 71334 , Dec. 8, 2006, as amended at 84 FR 25673 , June 3, 2019 84 FR 25673 , 8/2/2019; 89 FR 30844 , 6/3/2024