How does a state comply with the qualified provider assurance?
A state establishes processes to monitor and verify that providers meet required licensure, certification or other standards. The state will monitor whether:
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Providers meet the applicable licensure or certification standards (if any) for the type of service provided.
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Providers meet any other required standards (e.g. staffing ratios, training, administrative structure etc).
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Background checks were conducted, if required.
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Other training requirements for non-licensed/non-certified personnel were met.
A state will typically use data from a number of different sources to provide evidence for this assurance.
- Data from a state’s Licensure and Certification Agency.
- Review of case management agency records.
- Review of provider agency records.
- Review of a sample of participant records.
Some states also use consumer surveys to determine if consumers are satisfied with how well workers are performing their jobs.
