441—77.41 (249A) HCBS physical disability waiver service providers. Providers shall be eligible to participate in the Medicaid physical disability waiver program if they meet the requirements in this rule and the subrules applicable to the individual service. Enrolled providers shall maintain the certification listed in the applicable subrules in order to remain eligible providers.
Services shall be rendered by a person who is at least 16 years old (except as otherwise provided in this rule) and is not the spouse of the consumer served or the parent or stepparent of a consumer aged 17 or under. People who are 16 or 17 years old must be employed and supervised by an enrolled HCBS provider unless they are employed to provide self-directed personal care services through the consumer choices option. A person hired for self-directed personal care services need not be supervised by an enrolled HCBS provider. A person hired through the consumer choices option for independent support brokerage, self-directed personal care, individual-directed goods and services, or self-directed community support and employment is not required to enroll as a Medicaid provider and is not subject to the requirements of subrule 77.41(1).
	 77.41(1) Enrollment process. Reviews of compliance with standards for initial enrollment shall be conducted by the department’s quality assurance staff. Enrollment carries no assurance that the approved provider will receive funding.
Review of a provider may occur at any time.
The department may request any information from the prospective service provider that is pertinent to arriving at an enrollment decision. This may include, but is not limited to:
	  a.   	 Current accreditations, evaluations, inspection reports, and reviews by regulatory and licensing agencies and associations.
	  b.   	 Fiscal capacity of the prospective provider to initiate and operate the specified programs on an ongoing basis.
	  c.   	 The prospective provider’s written agreement to work cooperatively with the state and central point of coordination in the counties to be served by the provider.
	 77.41(2) Consumer-directed attendant care providers. The following providers may provide consumer-directed attendant care service:
	  a.   	 An individual who contracts with the consumer to provide consumer-directed attendant care and who is:
	 (1) 	 At least 18 years of age.
	 (2) 	 Qualified by training or experience to carry out the consumer’s plan of care pursuant to the department-approved case plan or individual comprehensive plan.
	 (3) 	 Not the spouse or guardian of the consumer.
	 (4) 	 Not the recipient of respite services paid through home- and community-based services on behalf of a consumer who receives home- and community-based services.
	  b.   	 Home care providers that have a contract with the department of public health or have written certification from the department of public health stating that they meet the home care standards and requirements set forth in department of public health rules 641—80.5(135), 641—80.6(135), and 641—80.7(135).
	  c.   	 Home health agencies that are certified to participate in the Medicare program.
	  d.   	 Chore providers subcontracting with area agencies on aging or with letters of approval from the area agencies on aging stating that the organization is qualified to provide chore services.
	  e.   	 Community action agencies as designated in Iowa Code section 216A.103.
	  f.   	 Providers certified under an HCBS waiver for supported community living.
	  g.   	 Assisted living programs that are voluntarily accredited or certified by the department of elder affairs.
	  h.   	 Adult day service providers which meet the conditions of participation for adult day care providers as specified at 441—subrule 77.30(3), 77.33(1), 77.34(7), or 77.39(20) and which have provided a point-in-time letter of notification from the department of elder affairs or an area agency on aging stating the adult day service provider also meets the requirements of department of elder affairs rules in 321—Chapter 25.
	 77.41(3) Home and vehicle modification providers. The following providers may provide home and vehicle modifications:
	  a.   	 Providers eligible to participate as home and vehicle modification providers under the elderly or ill and handicapped waiver or certified as home and vehicle modification providers under the mental retardation or brain injury waiver.
	  b.   	 Community businesses that have all necessary licenses and permits to operate in conformity with federal, state, and local laws and regulations and that submit verification of current liability and workers’ compensation insurance.
	 77.41(4) Personal emergency response system providers. Personal emergency response system providers shall be agencies which meet the conditions of participation set forth in subrule 77.33(2).
	 77.41(5) Specialized medical equipment providers. The following providers may provide specialized medical equipment:
	  a.   	 Medical equipment and supply dealers participating as providers in the Medicaid program.
	  b.   	 Retail and wholesale businesses participating as providers in the Medicaid program which provide specialized medical equipment as defined in 441—subrule 78.46(4).
	 77.41(6) Transportation service providers. The following providers may provide transportation:
	  a.   	 Area agencies on aging as designated in 321—4.4(231) or with letters of approval from the area agencies on aging stating the organization is qualified to provide transportation services.
	  b.   	 Community action agencies as designated in Iowa Code section 216A.93.
	  c.   	 Regional transit agencies as recognized by the Iowa department of transportation.
	  d.   	 Nursing facilities licensed pursuant to Iowa Code chapter 135C.
	 77.41(7) Financial management service. Consumers who elect the consumer choices option shall work with a financial institution that meets the qualifications in subrule 77.30(13).
	 77.41(8) Independent support brokerage. Consumers who elect the consumer choices option shall work with an independent support broker who meets the qualifications in subrule 77.30(14).
	 77.41(9) Self-directed personal care. Consumers who elect the consumer choices option may choose to purchase self-directed personal care services from an individual or business that meets the requirements in subrule 77.30(15).
	 77.41(10) Individual-directed goods and services. Consumers who elect the consumer choices option may choose to purchase individual-directed goods and services from an individual or business that meets the requirements in subrule 77.30(16).
	 77.41(11) Self-directed community supports and employment. Consumers who elect the consumer choices option may choose to purchase self-directed community supports and employment from an individual or business that meets the requirements in subrule 77.30(17).
This rule is intended to implement Iowa Code section 249A.4.