048-34 Wyo. Code R. §§ 34-18 - Participant Direction of CCW Services
(a) The participant, legal guardian, or
another appropriate individual designated by the participant may serve as the
Employer of Record (EOR) and assume responsibility for managing the activities
associated with the direction of CCW services.
(b) The EOR must sign an agreement of
understanding that they are willing and able to assume the EOR responsibilities
and comply with established EOR standards.
(c) The EOR cannot delegate or assign the
responsibilities of the EOR to another person or entity and cannot be
reimbursed to provide CCW services to the participant.
(d) The EOR shall carry out the duties and
responsibilities associated with participant direction of CCW services, such
as:
(i) Recruiting employees;
(ii) Verifying that employees meet the
minimum qualifications established by the Department;
(iii) Specifying, verifying, and maintaining
documentation of any additional employee qualifications;
(iv) Hiring employees as the common law
employer;
(v) Determining employee
duties consistent with the service scope and limitations;
(vi) Determining employee wages within the
limits established by the Department;
(vii) Scheduling employees;
(viii) Orienting and instructing employees in
their duties;
(ix) Supervising
employees;
(x) Evaluating employee
performance;
(xi) Verifying the
time worked by employees and approving time sheets; and
(xii) Terminating
employees.
(e) An EOR's
failure to carry out duties and responsibilities in accordance with this
Section may result in the EOR being disqualified to act as an EOR by the
Department.
(i) The Department shall maintain
a list of disqualified EOR's and employees and prohibit their future employment
under the participant-directed service delivery option.
(ii) The Department shall establish policies
and procedures for disqualification, placement on the list, and the EOR's
opportunities to dispute disqualification and removal from such a
list.
(f) The
participant's case manager shall provide information and assistance in support
of participant direction, such as:
(i)
Assisting the EOR in obtaining and submitting employer enrollment
documentation;
(ii) Determining the
participant-directed budget based on the participant's assessed needs and the
approved methodology;
(iii)
Assisting the participant or EOR in obtaining and completing required
documents;
(iv) Coordinating with
the Fiscal Management Services agency;
(v) Monitoring participant-directed service
effectiveness, quality, and expenditures as determined by the
Department;
(vi) Reviewing and
updating the participant-directed budget as required by the Department;
and
(vii) Facilitating the
transition of a participant to a different service delivery option when the
participant voluntarily terminates, or is involuntarily terminated from,
participant direction.
(g) Participant-Directed Employees.
(i) The Department shall establish the
minimum employee qualifications for all participant-directed eligible
services.
(ii) The EOR may require
their employees to meet additional training, education, or experience
requirements in addition to the Department's minimum qualifications.
(iii) The EOR may hire a participant's
relative or spouse as an employee provided it is authorized in the CMS approved
waiver agreement and they meet the requirements and standards established by
the Department.
(h) The
participant may choose to withdraw from the participant-directed service
delivery option at any time.
(i) Participants
who elect to voluntarily withdraw from the participant-directed service
delivery must contact their case manager to facilitate the transition to an
alternative service delivery option.
(ii) Participants who voluntarily withdraw
from the participant-directed service delivery option may return to the
participant-directed service delivery option at any time.
(i) Participants shall be involuntarily
terminated from the participant-directed service option if they no longer meet
the Departments standards and requirements.
(i) Participants involuntarily terminated
from the participant-directed service option will be provided a Notice of
Adverse Action and informed of the opportunity to request a fair hearing in
accordance with Wyoming Medicaid Rules Chapter 4.
(ii) Participants who are involuntarily
terminated from participant direction may be prohibited from electing the
participant-directed service delivery option in the
future.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(a) The participant, legal guardian, or another appropriate individual designated by the participant may serve as the Employer of Record (EOR) and assume responsibility for managing the activities associated with the direction of CCW services.
(b) The EOR must sign an agreement of understanding that they are willing and able to assume the EOR responsibilities and comply with established EOR standards.
(c) The EOR cannot delegate or assign the responsibilities of the EOR to another person or entity and cannot be reimbursed to provide CCW services to the participant.
(d) The EOR shall carry out the duties and responsibilities associated with participant direction of CCW services, such as:
(i) Recruiting employees;
(ii) Verifying that employees meet the minimum qualifications established by the Department;
(iii) Specifying, verifying, and maintaining documentation of any additional employee qualifications;
(iv) Hiring employees as the common law employer;
(v) Determining employee duties consistent with the service scope and limitations;
(vi) Determining employee wages within the limits established by the Department;
(vii) Scheduling employees;
(viii) Orienting and instructing employees in their duties;
(ix) Supervising employees;
(x) Evaluating employee performance;
(xi) Verifying the time worked by employees and approving time sheets; and
(xii) Terminating employees.
(e) An EOR's failure to carry out duties and responsibilities in accordance with this Section may result in the EOR being disqualified to act as an EOR by the Department.
(i) The Department shall maintain a list of disqualified EOR's and employees and prohibit their future employment under the participant-directed service delivery option.
(ii) The Department shall establish policies and procedures for disqualification, placement on the list, and the EOR's opportunities to dispute disqualification and removal from such a list.
(f) The participant's case manager shall provide information and assistance in support of participant direction, such as:
(i) Assisting the EOR in obtaining and submitting employer enrollment documentation;
(ii) Determining the participant-directed budget based on the participant's assessed needs and the approved methodology;
(iii) Assisting the participant or EOR in obtaining and completing required documents;
(iv) Coordinating with the Fiscal Management Services agency;
(v) Monitoring participant-directed service effectiveness, quality, and expenditures as determined by the Department;
(vi) Reviewing and updating the participant-directed budget as required by the Department; and
(vii) Facilitating the transition of a participant to a different service delivery option when the participant voluntarily terminates, or is involuntarily terminated from, participant direction.
(g) Participant-Directed Employees.
(i) The Department shall establish the minimum employee qualifications for all participant-directed eligible services.
(ii) The EOR may require their employees to meet additional training, education, or experience requirements in addition to the Department's minimum qualifications.
(iii) The EOR may hire a participant's relative or spouse as an employee provided it is authorized in the CMS approved waiver agreement and they meet the requirements and standards established by the Department.
(h) The participant may choose to withdraw from the participant-directed service delivery option at any time.
(i) Participants who elect to voluntarily withdraw from the participant-directed service delivery must contact their case manager to facilitate the transition to an alternative service delivery option.
(ii) Participants who voluntarily withdraw from the participant-directed service delivery option may return to the participant-directed service delivery option at any time.
(i) Participants shall be involuntarily terminated from the participant-directed service option if they no longer meet the Departments standards and requirements.
(i) Participants involuntarily terminated from the participant-directed service option will be provided a Notice of Adverse Action and informed of the opportunity to request a fair hearing in accordance with Wyoming Medicaid Rules Chapter 4.
(ii) Participants who are involuntarily terminated from participant direction may be prohibited from electing the participant-directed service delivery option in the future.