Iowa Administrative Code 441—78.34(249A) — HCBS Health and Disability Waiver Services

What this rule requires your agency to do

• 1Attendant care members/representatives must complete, sign, and date an HCBS Attendant Care Agreement stating the frequency, scope, and duration of each service component, also signed by the case manager/service worker and provider and made part of the service plan; any service component not listed in the agreement is not payable (subrule 78.34(7)"a"(1)).(Iowa Administrative Code 441—78.34(249A) — HCBS Health and Disability Waiver Services)
• 2The financial management service must conduct criminal background checks on potential employees pursuant to 441—Chapter 119, verify employee citizenship/alien status, handle payroll/tax withholding, keep records for five years, and provide an annual independent audit (subrule 78.34(13)"l").(Iowa Administrative Code 441—78.34(249A) — HCBS Health and Disability Waiver Services)
• 3Attendant care providers must document compliance with rule 441—79.3(249A), must use an electronic visit verification system capturing all Attendant Care Service Record documentation requirements (or a department-prescribed form), and any component not documented accordingly is not payable (subrule 78.34(7)"c").(Iowa Administrative Code 441—78.34(249A) — HCBS Health and Disability Waiver Services)
• 4Payment is only made for HCBS services provided in integrated, community-based settings supporting full community access to the same degree as individuals not receiving Medicaid HCBS (rule 441—78.34, opening paragraph).(Iowa Administrative Code 441—78.34(249A) — HCBS Health and Disability Waiver Services)
• 5To participate in the Consumer Choices Option a member must sign the HCBS Consumer Choices Informed Consent and Risk Agreement, hire an independent support broker, and work with an enrolled financial management service; before hiring the broker the member must receive the results of the background check conducted under 441—Chapter 119 (subrules 78.34(13)"a" and "c").(Iowa Administrative Code 441—78.34(249A) — HCBS Health and Disability Waiver Services)
• 6Skilled attendant care services shall be provided under the supervision of the member's physician or a licensed nurse/therapist, who shall retain accountability, ensure assessment/planning/evaluation, and make on-site supervisory visits every two weeks with the service provider present (subrule 78.34(7)"b").(Iowa Administrative Code 441—78.34(249A) — HCBS Health and Disability Waiver Services)
• 7Under the Consumer Choices Option, for personal care services employees must use an electronic visit verification system capturing all Consumer Choices Option Semi-Monthly Time Sheet documentation (or a department form), and members must sign and certify each timecard under penalty of perjury before submission and retain signed timecards for five years (subrule 78.34(13)"m"(4)-(5)).(Iowa Administrative Code 441—78.34(249A) — HCBS Health and Disability Waiver Services)
• 8When a legal representative provides attendant care, the rate may not exceed the median statewide reimbursement rate absent prior approval, the representative may not be paid for more than 40 hours per week, and a contingency plan must be in the service plan (subrule 78.34(7)"a"(2)).(Iowa Administrative Code 441—78.34(249A) — HCBS Health and Disability Waiver Services)