(1) If a consumer directed employer employs individual providers, then the consumer directed employer shall:
(a) Verify that each individual provider has met any training requirements established under this chapter and rules adopted under this chapter;
(b) Conduct background checks on individual providers as required under this chapter, RCW
43.43.830 through
43.43.842,
43.20A.710, and the rules adopted by the department; or verify that a background check has been conducted for each individual provider and that the background check is still valid in accordance with department rules;
(c) Implement an electronic visit verification system that complies with federal requirements, or in the absence of an electronic visit verification system, monitor a statistically valid sample of individual provider's claims to the receipt of services by the consumer;
(d) Monitor individual provider compliance with employment requirements;
(e) As authorized and determined by the consumer, provide a copy of the consumer's plan of care to the individual provider who has been selected by the consumer;
(f) Verify the individual provider is able and willing to carry out his or her responsibilities under the plan of care;
(g) Take into account information provided by the consumer or the consumer's case manager about the consumer's specific needs;
(h) Discontinue the individual provider's assignment to a consumer when the consumer directed employer has reason to believe, or the department or area agency on aging has reported, that the health, safety, or well-being of a consumer is in imminent jeopardy due to the performance of the individual provider;
(i) Reject a request by a consumer to assign a specific person as his or her individual provider, if the consumer directed employer has reason to believe that the individual will be unable to appropriately meet the care needs of the consumer; and
(j) Establish a dispute resolution process for consumers who wish to dispute decisions made under (h) and (i) of this subsection.
(2) If any individual providers are contracted with the department to provide services under this chapter, the case management responsibilities of RCW
74.39A.090 and
74.39A.095 shall include:
(a) Verifying that each individual provider has met all training requirements under this chapter and department rules;
(b) Conducting background checks on individual providers as required under this chapter, RCW
43.43.830 through
43.43.842,
43.20A.710, and department rules; or verifying that background checks have been conducted for each individual provider and that the background check is still valid in accordance with department rules;
(c) Monitoring that the individual provider is providing services as outlined in the consumer's plan of care;
(d) Attaching the consumer's plan of care to the contract with the individual provider;
(e) Verifying with the individual provider that he or she is able and willing to carry out his or her responsibilities under the plan of care;
(f) Terminating the contract between the department and the individual provider if the department, area agency on aging, or federally recognized Indian tribe finds that an individual provider's inadequate performance or inability to deliver quality care is jeopardizing the health, safety, or well-being of a consumer receiving service under this section;
(g) Summarily suspending the contract pending a fair hearing, if there is reason to believe the health, safety, or well-being of a consumer is in imminent jeopardy; and
(h) Rejecting a request by a consumer receiving services under this section to have a family member or other person serve as his or her individual provider if the department, area agency on aging, or federally recognized Indian tribe has reason to believe that the family member or other person will be unable to appropriately meet the care needs of the consumer.
(3) The consumer may request a fair hearing under chapter
34.05 RCW to contest a planned action of the department under subsection (2)(g) and (h) of this section.
(4) The department may adopt rules to implement this section.
