Current through Register Vol. 35, No. 18, September 24, 2024
A.
Application for initial certification:
(1)
Applications for the initial certification of a new program offering case
management services, behavior management skills development services, day
treatment services, group home services, all residential treatment services, or
treatment foster care services are submitted to the LCA for review and
approval. The application for initial certification of a program includes, but
is not limited to, the following:
(a) a
letter of intent naming the service for which the agency is requesting initial
certification and describing how and where the proposed service will be
delivered.
(b) policies and
procedures showing that the agency complies with both the general provisions
and the service-specific requirements of the program for which the agency is
requesting initial certification; and an index that references each policy and
procedure by the applicable certification requirement that the policy is
designed to meet.
(c) job
descriptions, required qualifications, resumes, current licenses, proof of
credentials, and criminal records clearances for professional staff;
(d) job descriptions, required qualifications
and criminal records clearances for direct service staff; and
(e) a complete set of the forms that will be
used to document the services being provided.
(2) At the discretion of the LCA, the
application process may include interviews with staff, administrators, or
program directors.
(3) When
applicant agencies have an established in-state or out-of-state history of
providing mental health or substance abuse services for children and
adolescents, whether or not the agency is currently providing such services,
the agency's record with regulatory compliance will be considered during review
of the new application;
(4)
Applications will be reviewed by the LCA within 15 business days and a written
response will be sent to the agency. The findings of the review will determine
which of the following responses will be issued by the LCA:
(a) Complete applications that comply with
all the requirements of these certification requirements will be issued an
initial certification for a period of up to 120 days.
(b) Incomplete applications will be returned
with a letter detailing what elements of the application are missing. initial
certification will not be issued.
(c) When an application is complete, but
fails to show that the agency has fully or substantially complied with all of
these certification requirements, the LCA will issue a letter detailing the
findings of the review, with a list of the changes required to show the new
program to be in compliance with these certification requirements. An initial
certification will not be issued.
(5) If, three months subsequent to the
issuance of an LCA letter detailing missing or insufficient elements of an
application, the agency has not responded with a completed application or has
not achieved compliance with these certification requirements sufficient to
warrant initial certification, the application will be considered void. The
agency may reapply for certification of the service, but will be required to
begin a new application process.
(6) COA/CARF/JCAHO Accreditation does not
confer state certification status on a program.
B. Types of certification:
(1) FULL CERTIFICATION: Full certification is
granted to a program currently serving clients and found by the LCA to be in
substantial compliance with these certification requirements. At the discretion
of the LCA, the duration of full certification status is 12 to 24
months.
(2) EXEMPLARY STATUS is a
type of full certification that may be granted to a program that has no history
of temporary certification, sanctions or loss of certification in the previous
two years and that, based on a determination made by the LCA, adheres to these
certification requirements with only minor deficiencies, which pose no health
and safety risks to clients. Exemplary status may be granted for up to 24
months.
(3) FULL CERTIFICATION:
This certification is granted to a program currently serving clients and found
to be in substantial compliance with these certification requirements, when
only minor and few deficiencies, none of which compromise client health and
safety, are identified in the LCA certification report. The program submits an
action plan for the LCA's approval within the time frame specified by the LCA,
detailing the measures that will be used to correct the deficiencies. At the
discretion of the LCA, the program may also be required to implement a directed
action(s) within specified time frames; or may be required to comply with
monitoring as specified by the LCA during the period of certification. Based on
a determination made by the LCA, the program produces proof of correction of
deficiencies and/or compliance with directed action(s) and/or monitoring
through submission of relevant documentation and/or by subsequent on-site
review. The terms and the time frames for monitoring are established in writing
in the certification report.
(a) The LCA
provides written notification indicating whether the program's action plan is
approved. Action plans may be approved with amendments recommended and/or
required within a time frame specified by the LCA. If an action plan is not
approved, the LCA will specify items that require revision or supplementation
in order to receive LCA approval.
(b) If another survey reveals additional
deficiencies, the LCA may require amendment of the action plan, and/or issue
new written directed actions, and/or implement a revised monitoring plan,
and/or sanction the program based on new deficiencies identified.
(4) TEMPORARY CERTIFICATION:
Temporary certification is granted to a program currently serving clients that
is found by the LCA to be in partial compliance with the certification
requirements, or to a program that has been on inactive status and is returning
to active status.
(a) The LCA determines the
duration of a temporary certification. Temporary certification may be granted
for a period of up to 180 days. The LCA determines the duration of temporary
certification based on factors that may include severity of deficiencies and
the program's history of compliance with certification requirements.
(b) The program submits an action plan for
the LCA's approval within 14 days of receipt of the LCA certification report
detailing its findings of deficiencies, unless otherwise specified by the LCA.
At the discretion of the LCA, the program may also be required to implement
directed action(s) within specified time frames. The program may be required to
comply with terms of monitoring specified by the LCA during the period of
temporary certification, based on a determination made by the LCA.
(c) Items 9.B(3)(a) and (b) above are
applicable for action plans that accompany temporary certification.
(d) For programs returning to active status,
an action plan, directed action, and/or monitoring are not required unless
specified by the LCA.
(e) If the
program does not achieve substantial compliance with these certification
requirements at the end of a temporary certification period, a sanction(s) may
be imposed including non-renewal of certification.
(f) At the discretion of the LCA, a second
consecutive temporary certificate may be issued for a period of up to 180 days,
or certification may be allowed to expire without renewal.
(5) INITIAL CERTIFICATION: This certification
is granted for a period of 120 days to a program that has met the minimum
requirements to provide child and adolescent mental health or substance abuse
services as determined by the application process described in certification
requirement 9. A above. If the program has no clients at the end of 120 days, a
second 120-day initial certification may be granted. If the program remains
without clients beyond 240 days, the program's initial certificate expires and
re-application for certification is required; or, at the discretion of the LCA,
inactive status may be granted.
(6)
INACTIVE STATUS: This certification is granted to a program not presently
serving clients, but which has served clients within the current period of
certification. A certificate of inactive status covers a period of time not to
exceed 180 days from the date of issue. If the program continues without
clients beyond 180 days, a second 180-Day certificate of inactive status may be
granted upon request. If the program remains without clients beyond 365 days,
the program's inactive status expires and re-application for initial
certification is required.
(a) To return to
active status from inactive status for a certified service, the program must
notify the LCA in writing at least two weeks prior to its intended admission of
clients. In addition to the written notice, the agency must submit the
following to the LCA: information on any changes in personnel or agency
policies and procedures during inactive status; proof of criminal records
clearances, qualifications, and, as applicable, licensure for new supervisory
and direct service staff of the certified program.
(b) Upon review of the submitted information,
the LCA may grant temporary certification. The agency will not admit any
client(s) until the LCA issues and the program receives temporary
certification.
(7)
AMENDED CERTIFICATE: This certification is granted to a program currently
serving clients that has had a change of ownership or licensee, or that chooses
to change its name. The agency submits a written request for an amended
certificate to the LCA ten business days prior to the change.
(8) DEEMED CERTIFICATION: The LCA has
discretion to grant deemed certification when a program is accredited by the
council on accreditation (COA), the council on accreditation of rehabilitation
facilities (CARF), or for residential treatment services, by the joint
commission on accreditation of health care organizations (JCAHO), and the LCA
determines that the standards of the accrediting body apply substantially to
the program for which deemed certification is being considered. A certified
program that is accredited by one of these organizations and wishes to request
deemed certification must provide a copy of the accreditation report to the LCA
within 30 days of receipt of the report, and must provide any other
accreditation-related documentation to the LCA upon request. Upon receipt and
review of the COA, CARF or JCAHO survey reports, the LCA, at its discretion,
may issue deemed certification status effective for up to 24 months. For those
intervening years that the above-mentioned accrediting bodies do not conduct
on-site visits, the LCA may conduct annual or biennial certification on-site
surveys.
(a) EXCEPTION: The deemed
certification may not apply when COA, CARF or JCAHO identify any condition that
the LCA, at its sole discretion, determines to be a significant violation of
certification or accreditation standards, or that requires follow-up by the
accrediting body; or when any condition reported to the LCA appears to pose a
threat to health and/or safety; or when there is any other information
indicating the existence of such a threat.
(b) All agencies and programs that receive
deemed certification must comply with all applicable provisions of the
Children's Health Act of 2000 and these certification requirements.
C. AUTOMATIC
EXPIRATIONS OF A CERTIFICATION:
(1) A
certificate automatically expires at midnight on the day a certified program
discontinues or suspends operation or changes location.
(2) A certificate automatically expires at
midnight on the tenth day after a certified program is sold, leased, or
otherwise changes ownership and/or licensee, unless the agency has made a
timely written request for amended certification. In such a case, the automatic
expiration is stayed, and previous certification remains in effect if the
agency has until the LCA acts on the application or takes other certification
action.
D. WAIVERS
AND/OR VARIANCES: Upon written request of the agency and at the discretion of
the LCA, the LCA may issue a waiver and/or variance
E. CERTIFICATION REVIEWS: When possible, the
LCA schedules on-site program reviews prior to expiration of certification. If
the LCA does not perform a certification on-site review of a program prior to
the expiration of its certification, and the program has not received a written
report from the LCA recommending that the program's certification be allowed to
expire, the certification continues in effect until the LCA performs a
certification review.
F. The LCA,
at its sole discretion, may extend any certification for a period of up to 12
months.
G. In the event that a
program's certification is revoked, suspended, denied, or not renewed, the
medicaid provider agreement terminates on the date of the revocation,
suspension or denial.