Rule 23-208-2.3 - Provider QualificationsA. The Mississippi Department of Rehabilitation Services (MDRS), as the provider of Independent Living (IL) Waiver services, must satisfy all requirements set forth in Title 23 Miss. Admin. Code Part 200, Rule 4.8 in addition to the listed provider-type specific requirements and provide to the Division of Medicaid: 1. A National Provider Identifier (NPI), verification from National Plan and Provider Enumeration System (NPPES), 2. A copy of the provider's current license or permit, if applicable, 3. Verification of a social security number using a social security card, driver's license with a social security number, military ID or a notarized statement signed by the provider noting the social security number. The name noted on verification document must match the name noted on the W-9, and 4. Written confirmation from the Internal Revenue Service (IRS) confirming the provider's tax identification number and legal business name B. To participate as a Home and Community-Based Services (HCBS) IL Waiver provider, MDRS must: 1. Conduct a national criminal background check with fingerprints on all employees and volunteers prior to employment and every two (2) years thereafter, and maintain the record in the employee's personnel file. 2. Conduct registry checks, prior to employment and monthly thereafter, to ensure employees or volunteers are not listed on the Mississippi Nurse Aide Abuse Registry or listed on the Office of Inspector General's Exclusion Database and maintain the record in the employee's personnel file. 3. Not have been, or employ individuals or volunteers who have been, convicted of or pleaded guilty or nolo contendere to a felony of possession or sale of drugs, murder, manslaughter, armed robbery, rape, sexual battery, any sex offense listed in Miss. Code Ann. § 45-33-23(f), child abuse, arson, grand larceny, burglary, gratification of lust, aggravated assault, or felonious abuse and/or battery of a vulnerable adult, or that any such conviction or plea was reversed on appeal or a pardon was granted for the conviction or plea. 4. Have written criteria for service provision, including procedures for dealing with emergency service requests. 5. Have responsible personnel management including: a) An appropriate process used in the recruitment, selection, retention, and termination of employees, b) Written personnel policies and job descriptions, c) Maintenance of a current training plan as a component of the policies/procedures documenting the method for the completion of required training. The training plan must require all employees to meet training requirements as designated by the Division of Medicaid upon hire, and annually thereafter, and d) Maintenance of a personnel file on every employee and volunteer with the following required information including, but not limited to, credentialing documentation, training records, and performance reviews which must be made available to the Division of Medicaid upon request. 6. Be compliant with all federal and state regulations. C. MDRS must ensure that all employees and contracted entities meet the service specific requirements below prior to the provision of services: 1. Case Management must be provided by Registered Nurses (RN) and Case Managers who must meet the following qualifications: a) The Registered Nurse must: 1) Have a current and active unencumbered Registered Nurse license to practice in the state of Mississippi or be working in Mississippi on a privilege with a valid compact RN license, and 2) Have at least one (1) year of experience with the aged and/or individuals with disabilities. b) The Case Manager must: 1) Possess at a minimum a Bachelor's degree in Rehabilitation Counseling or other related field, and 2) Have one (1) year of experience working with individuals with disabilities. c) Mississippi Department of Rehabilitation Services (MDRS) is responsible for validating qualifications of the Registered Nurse and Rehabilitation Case Manager. d) MDRS must subscribe with the Mississippi Board of Nursing to receive immediate electronic notification of adverse or disciplinary action taken against nurse employees. e) MDRS must verify provider qualifications upon hire and at least annually. 2. Personal Care Attendant (PCA) services must be provided by a PCA who must meet the following qualifications: a) Be chosen by the person/representative as someone with whom they are comfortable providing their personal care or chosen from a list of available, eligible/qualified PCAs. b) Must meet basic competencies that include both educational and functional requirements. c) Be certified by MDRS Case Managers which includes documentation that the PCA meets the requirements. d) Must have completed training/instruction that covers the purpose, functions, and tasks associated with the PCA program. 1) The educational program must be personalized with participation of the person to ensure his/her specific needs are met. 2) The cost of training/instruction of personal care attendants cannot be provided under the waiver. 3) The individual must demonstrate competency to perform each activity of daily living task to the person/representative and Case Manager prior to rendering any IL waiver service. 4) In addition to the technical skills required, the PCA must demonstrate the ability to comprehend and comply with basic written and verbal instructions at a level determined by the person/representative and Case Manager to be adequate in fulfilling the responsibilities of personal care. (a) PCA training must be conducted by the person/representative and the Case Manager, or an agency permitted by law to train nurse aides, and must include: (i) The purpose and philosophy of self-directed services by the disabled, (ii) Disability awareness, (iii) Employee-employer relationships and the need for respect for the participant's privacy and property. (iv) Basic elements of body functions, (v) Infection control procedures, (vi) Maintaining a clean and safe environment, (vii) Appropriate and safe techniques in personal hygiene and grooming to include bed, sponge, tub, or shower bath, hair care, nail and skin care, oral hygiene, dressing, bladder and bowel routine, transfers, and equipment use and maintenance. (viii) Meal preparation and menus that provide a balanced, nutritional diet. e) A prospective PCA who has satisfactorily completed a nurse aide training program for a hospital, nursing facility, or home health agency or who was continuously employed for twelve (12) months during the last three (3) years as a nurse aide, orderly, nursing assistant or an equivalent position by one of the above medical facilities is deemed to meet the classroom training requirements. Competency certification for these personal care providers by the person/representative and Case Manager is required. A PCA that has satisfactorily provided PCA services for four (4) weeks prior to coverage under the IL waiver program, with such service certified by and verified by the person/representative and Case Manager, is deemed to meet the training requirement. f) PCA services can be furnished by family members provided they are not the spouse or the parent or step-parent of a minor child, or reside in the home with the person. Only qualified family members not legally responsible for the waiver person can be employed as the PCA. Family members must meet provider standards and be certified competent to perform the required tasks by the person and Case Manager. There must be adequate justification for the family member to function as the PCA such as lack of other qualified attendants in the remote area. g) Minimum requirements include: 1) Must be at least 18 years of age, 2) Must be a high school graduate, have a general educational development (GED) certificate or demonstrates the ability to read and write to complete required forms and reports of visits, 3) Must be able to follow verbal and written instructions, 4) Must have no physical/mental impairment to prevent lifting, transferring or providing any other assistance to person, 5) Must be certified as meeting the training and competence requirement by the person and the Case Manager, and 6) Must be able to communicate effectively and carry out directions. h) MDRS must verify the competency for all PCAs as needed. 3. Specialized Medical Equipment and Supplies must be provided by entities who meet the following qualifications: a) Have a permanent local address and phone number, b) Have a State of Mississippi sales tax number, c) Have Federal identification number or social security number, d) Have liability insurance, e) Must honor the manufacturer's guarantee or warranty as published, f) Must provide repair capability for products, and g) Meet the following additional standards if providing custom in-house seating systems, powered mobility, three wheel scooters, and high-tech systems: 1) Must provide documented proof of attendance of training with seating and positioning, 2) Maintain a current list of power chair manufacturers represented, 3) Have on staff a technician certified as being trained to repair each power chair manufacturer represented, if offered by the manufacturer, 4) Maintain basic inventory of electronic parts to repair power chairs of manufacturers represented or demonstrate the capability to repair motors, modules, joysticks, and parts to repair the above, 5) Must be able to deliver and assemble all equipment to be ready for final adjustment and fitting, 6) Must have and present at purchase all necessary manuals and written warranties, 7) Must be able to provide instruction in proper use and care of equipment, 8) Must be capable to provide training in safe and effective operation of the equipment, as well as maintenance schedule as a component part of the purchase price, and 9) Must have available a list of key contact personnel at various manufacturers for immediate technical support or special handling of specific needs including complete parts, manuals, and accessory catalogs along with updates and current technical service bulletins. 4. Transition Assistance services must be provided by a Registered Nurse and/or Case Manager. 5. Environmental Accessibility Adaptation services must be provided by entities who meet the following: a) Meet all state or local requirements for licensure/certification including, but not limited to, building contractors, plumbers, electricians or engineers. b) Provide services in accordance with applicable state housing and local building codes. c) Ensure the quality of work provided meets standards identified below: 1) All work must be done in a fashion that exhibits good craftsmanship. 2) All materials, equipment, and supplies must be installed clean, and in accordance with manufacturer's instructions. 3) The contractor must obtain all permits required by local governmental bodies. 4) All non-salvaged supplies and/or materials must be new and of best quality, without defects. 5) The contractor must remove all excess materials and trash, leaving the site clear of debris at completion of the project, 6) All work must be accomplished in compliance with applicable codes, ordinances, regulations and laws. 7) The specifications and drawings cannot be modified without a written change order from the case manager. 8) No accessibility barriers can be created by the modification and/or construction process. 23 Miss. Code. R. 208-2.3
42 C.F.R. 455, Subpart E; 42 C.F.R. §§ 440.180, 441.302; Miss. Code Ann. §§ 37-33-157, 43-13-117, 43-13-121.