Current through Supplement No. 394, October, 2024
1. An individual or agency seeking
designation as a qualified service provider shall complete and return the
applicable forms supplied by the department in the form and manner prescribed.
The qualified service provider, including any employees of an agency designated
as a qualified service provider, shall meet all licensure, certification, or
competency requirements applicable under state or federal law and departmental
standards necessary to provide care to eligible individuals whose care is paid
by public funds. An application is not complete until the individual or agency
submits all required information and required provider verifications to the
department.
2. A provider or an
individual seeking designation as a qualified service provider:
a. Must have the basic ability to read,
write, and verbally communicate;
b.
Must not be an individual who has been found guilty of, pled guilty to, or pled
no contest to:
(1) An offense described in
North Dakota Century Code chapter 12.1-16, homicide; 12.1-18, kidnapping;
12.1-27.2, sexual performances by children; or 12.1-41, Uniform Act on
Prevention of and Remedies for Human Trafficking; or North Dakota Century Code
section 12.1-17-01, simple assault, if a class C felony under subdivision a of
subsection 2 of that section; 12.1-17-01.1, assault; 12.1-17-01.2, domestic
violence; 12.1-17-02, aggravated assault; 12.1-17-03, reckless endangerment;
12.1-17-04, terrorizing; 12.1-17-06, criminal coercion; 12.1-17-07.1, stalking;
12.1-17-12, assault or homicide while fleeing peace officer; 12.1-20-03, gross
sexual imposition; 12.1-20-03.1, continuous sexual abuse of a child;
12.1-20-04, sexual imposition; 12.1-20-05, corruption or solicitation of
minors; 12.1-20-05.1, luring minors by computer or other electronic means;
12.1-20-06, sexual abuse of wards; 12.1-20-06.1, sexual exploitation by
therapist; 12.1-20-07, sexual assault; 12.1-20-12.3, sexual extortion;
12.1-21-01, arson; 12.1-22-01, robbery; or 12.1-22-02, burglary, if a class B
felony under subdivision b of subsection 2 of that section; 12.1-29-01,
promoting prostitution; 12.1-29-02, facilitating prostitution; 12.1-31-05,
child procurement; 12.1-31-07, endangering a vulnerable adult; 12.1-31-07.1,
exploitation of a vulnerable adult; 14-09-22, abuse of a child; 14-09-22.1,
neglect of a child; subsection 1 of section 26.1-02.1-02.1, fraudulent
insurance acts; or an offense under the laws of another jurisdiction which
requires proof of substantially similar elements as required for conviction
under any of the enumerated North Dakota statutes; or
(2) An offense, other than a direct-bearing
offense identified in paragraph 1 of subdivision b of subsection 2, if the
department determines that the individual has not been sufficiently
rehabilitated.
(a) The department may not
consider a claim that the individual has been sufficiently rehabilitated until
any term of probation, parole, or other form of community corrections or
imprisonment without subsequent charge or conviction has elapsed, unless
sufficient evidence is provided of rehabilitation.
(b) An individual's completion of a period of
three years after final discharge or release from any term of probation,
parole, or other form of community corrections or imprisonment, without
subsequent charge or conviction, is prima facie evidence of sufficient
rehabilitation;
c. In the case of an offense described in
North Dakota Century Code section 12.1-17-01, simple assault, if a felony;
12.1-17-01.1, assault; 12.1-17-01.2, domestic violence, if a misdemeanor;
12.1-17-03, reckless endangerment; 12.1-17-04, terrorizing; 12.1-17-06,
criminal coercion; 12.1-17-07.1, stalking; 12.1-18-03, unlawful imprisonment;
12.1-20-05, corruption or solicitation of minors, if a misdemeanor; 12.1-20-07,
sexual assault, if a misdemeanor; or equivalent conduct in another jurisdiction
which requires proof of substantially similar elements as required for
conviction, the department may determine that the individual has been
sufficiently rehabilitated if five years have elapsed after final discharge or
release from any term of probation, parole, or other form of community
corrections or imprisonment, without subsequent convictions;
d. Shall maintain confidentiality;
e. Shall, using applicable forms and
providing documentation as required by the department:
(1) Revalidate qualified service provider
enrollment except as provided in paragraph 3, within the time period as
required by the Medicaid state plan option for personal care services or
Medicaid waiver program, whichever occurs first; and
(2) Provide evidence of competency, except as
provided in paragraph 3, at least every sixty months for an agency enrolled as
a qualified service provider or at least every thirty months for an individual
enrolled as a qualified service provider, and within the time period as
required by the Medicaid state plan option for personal care services or
Medicaid waiver program, whichever occurs first; or
(3) Revalidate qualified service provider
enrollment only every sixty months for an individual enrolled as a qualified
service provider providing family home care services under the SPED program and
expanded service payments for elderly and disabled;
f. Must be physically capable of performing
the service for which they were contracted with or hired as an independent
contractor; and
g. Must be at least
eighteen years of age.
h. A
representative of an enrolled qualified service provider agency or an
individual qualified service provider must complete a department-approved
qualified service provider orientation prior to initial enrollment.
3. If the physical, cognitive,
social, or emotional health capabilities of an applicant or provider appear to
be questionable, the department may require the applicant or provider to
present evidence of the applicant's or provider's ability to provide the
required care based on a formal evaluation. The department is not responsible
for costs of any required evaluation.
4. The offenses enumerated in paragraph 1 of
subdivision b of subsection 2 have a direct bearing on an individual's ability
to be enrolled as a qualified service provider.
a. An individual enrolled as a qualified
service provider prior to January 1, 2009, who has been found guilty of, pled
guilty to, or pled no contest to, an offense considered to have a direct
bearing on the individual's ability to provide care may be considered
rehabilitated and may continue to provide services if the individual has had no
other offenses and provides sufficient evidence of rehabilitation to the
department.
b. The department may
not approve, deny, or renew an application for an individual or employee of an
agency who is applying to enroll or re-enroll as a qualified service provider
and who has been charged with an offense considered to have a direct bearing on
the individual's ability to provide care or an offense in which the alleged
victim was under the applicant's care, until final disposition of the criminal
case against the individual.
5. Evidence of competency for adult foster
care providers serving eligible individuals eligible for the developmental
disability waiver must be provided in accordance with subdivision b of
subsection 2 of section
75-03-21-08.
6. A provider of services for adult day care,
adult foster care, attendant care, community support services, extended
personal care, family personal care, nurse assessment, personal care,
residential care, respite care, residential habilitation, supervision, and
transitional living care shall provide evidence of competency in generally
accepted procedures for:
a. Infection control
and proper handwashing methods;
b.
Handling and disposing of body fluids;
c. Tub, shower, and bed bathing
techniques;
d. Hair care
techniques, sink shampoo, and shaving;
e. Oral hygiene techniques of brushing teeth
and cleaning dentures;
f. Caring
for an eligible individual who is incontinent;
g. Feeding or assisting an eligible
individual with eating;
h. Basic
meal planning and preparation;
i.
Assisting an eligible individual with the self-administration of
medications;
j. Maintaining a
kitchen, bathroom, and other rooms used by an eligible individual in a clean
and safe condition, including dusting, vacuuming, floor care, garbage removal,
changing linens, and other similar tasks;
k. Laundry techniques, including mending,
washing, drying, folding, putting away, ironing, and related work;
l. Assisting an eligible individual with bill
paying and balancing a check book;
m. Dressing and undressing an eligible
individual;
n. Assisting with
toileting;
o. Routine eye
care;
p. Proper care of
fingernails;
q. Caring for
skin;
r. Turning and positioning an
eligible individual in bed;
s.
Transfer using a belt, standard sit, or bed to wheelchair;
t. Assisting an eligible individual with
ambulation; and
u. Making
wrinkle-free beds.
7. An
applicant for qualified service provider status for attendant care, adult
foster care, extended personal care, family personal care, nurse assessment,
personal care, residential care, supervision, transitional living care, respite
care, or adult day care must secure written verification that the applicant is
competent to perform procedures specified in subsection 5 from a physician,
chiropractor, registered nurse, licensed practical nurse, occupational
therapist, physical therapist, or an individual with a professional degree in
specialized areas of health care. Written verification of competency is not
required if the individual holds one of the following licenses or
certifications in good standing: physician, physician assistant, chiropractor,
registered nurse, licensed practical nurse, registered physical therapist,
registered occupational therapist, or certified nurse assistant. A certificate
or another form of acknowledgment of completion of a program with a curriculum
that includes the competencies in subsection 5 may be considered evidence of
competence.
8. The department may
approve global and eligible individual-specific endorsements to provide
particular procedures for a provider based on written verification of
competence to perform the procedure from a physician, chiropractor, registered
nurse, occupational therapist, physical therapist, or other individual with a
professional degree in a specialized area of health care or approved within the
scope of the individual's health care license or certification.
9. Competence may be demonstrated in the
following ways:
a. A demonstration of the
procedure being performed;
b. A
detailed verbal explanation of the procedure; or
c. A detailed written explanation of the
procedure.
10. The
department shall notify the individual or the agency of its decision on
designation as a qualified service provider.
11. The department shall maintain a list of
qualified service providers. Once the eligible individual's need for services
has been determined, the eligible individual selects a provider from the list
and the department's designee issues an authorization to provide services to
the selected qualified service provider.
12. A service payment may be issued only to a
qualified service provider who bills the department after the delivery of
authorized services.
13. Agency
providers who employ nonfamily members must have a department-approved quality
improvement program that includes a process to identify, address, and mitigate
harm to the eligible individuals they serve.
14. Agency providers who have accepted an
authorization to provide twenty-four-hour supports to an eligible individual
must give a thirty-day written notice before they can involuntarily discharge
the eligible individual from their care, unless otherwise approved by the
department.
General Authority: NDCC 50-06.2-03(6)
Law Implemented: NDCC
50-06.2-03(5)
