SCREENING REQUIREMENTS Missouri Medicaid Audit and Compliance Provider Certification Review Materials.

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Presentation transcript:

SCREENING REQUIREMENTS Missouri Medicaid Audit and Compliance Provider Certification Review Materials

Employment Application The employee’s signature Documentation sufficient to verify the employee meets age, education, and work experience requirements. Document employment and termination dates; Consent to pre-employment criminal record check; Consent to closed records check; Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; 19 CSR (24)(B)(1) and the MO HealthNet Personal Care Manual.

Employment Application Disclosure of all aliases and social security numbers used; Disclosure of the applicant's criminal history. This includes any conviction or a plea of guilty to a misdemeanor or felony charge and shall include any suspended imposition of sentence, any suspended execution of sentence or any period of probation or parole; Disclosure if the applicant is listed on the employee disqualification list Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; 19 CSR and the MO HealthNet Personal Care Manual.

Employee Disqualification List (EDL) Applicants must be checked prior to hire Screen for all aliases and social security numbers used by the applicant Current employees must be screened quarterly No person on the EDL may be hired for any position If current employee is found on EDL screening, they must be terminated immediately Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; RSMo and the MO HealthNet Personal Care Manual.

Family Care Safety Registry Registered with FCSR prior to client contact Screening must be completed on all aliases and social security numbers used by the applicant When the provider requests a criminal background check pursuant to section , RSMo, the requesting entity may require that the applicant reimburse the provider for the cost of such record check. When a provider requests a nationwide criminal background check pursuant to subdivision (1) of subsection 3 of this section, the total cost to the provider of any background check required pursuant to this section shall not exceed five dollars which shall be paid to the state. Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; RSMo (3)(1); RSMo (4) and the MO HealthNet Personal Care Manual.

FCSR Outcomes If a screening results in –  No findings:  No EDL finding or disclosure of any other crimes  Applicant may be hired  A finding that is a disqualifying crime:  Applicant cannot be employed until a Good Cause Waiver has been submitted AND APPROVED.  A finding that is NOT a disqualifying crime:  No EDL finding or disclosure of any disqualifying crimes  Applicant can be hired conditionally once the Good Cause Waiver has been submitted and the agency verifies submission of the Good Cause Waiver Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; 19 CSR and the MO HealthNet Personal Care Manual.

Conditional Employment If the finding on the background screening (FCSR) is not a disqualifying crime, the provider can hire the applicant conditionally, pending the results of the Good Cause Waiver (GCW). Provider must verify with FCSR that the GCW has been received. If the GCW is approved, the applicant can be hired. If the GCW is denied, the applicant must be terminated immediately. Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; 19 CSR and the MO HealthNet Personal Care Manual.

Good Cause Waiver An individual who has been disqualified from employment with one of the above provider types has the right to apply for a Good Cause Waiver (GCW), which, if granted, would not correct or remove the finding, but would remove the hiring restriction and allow the individual to be employed. Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; 19 CSR and the MO HealthNet Personal Care Manual.

Good Cause Waiver Good cause waivers are required for any in-home services employee with a finding on their background screening. An individual who has been placed on the Department of Health and Senior Services EDL is not eligible to receive a GCW. Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; 19 CSR and the MO HealthNet Personal Care Manual.

Disqualifying Crimes Class A felony violation (of chapter 565, 566, 569) Class B felony violation (of chapter 565, 566, 569) Any violation of RSMo (subsection 3) Any violation of RSMo These crimes are known as crimes against persons. A complete list can be found at: Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; 19 CSR and the MO HealthNet Personal Care Manual.

Other Screenings OIG –LEIE:  Office of the Inspector General – List of Excluded Individuals and Entities  Guidance recommends monthly screenings of all employees.  It is not required for providers at this time.  Check the LEIE database at Licensing and Certification Documentation should be kept in the personnel file. Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; 19 CSR and the MO HealthNet Personal Care Manual.

Documentation of Screenings Documentation should include: Identity of the person who was screened Dates the screening was requested and completed Outcome of the screening Documentation must be maintained in the personnel file. Applicable to the service standards for in-home personal care program under 13 CSR ; 13 CSR ; 19 CSR and the MO HealthNet Personal Care Manual.