Relating to prohibitions against a person acting as a provider or as an employee, contractor, or subcontractor of a provider of home and community-based services waiver services under the Medicaid program

In an evaluation, HHS considers a number of factors including the nature and seriousness of the crime or founded abuse in relation to the position sought or held, the time that has elapsed since the commission of the crime or founded abuse, the circumstances of the crime or founded abuse, the degree of rehabilitation, the likelihood that the person will commit the crime or founded abuse again, and the number of crimes or founded abuses committed by the person involved. The person may be employed or continue to be employed by the provider if the person complies with HHS conditions, or the person may be prohibited from being employed based upon the evaluation. Under the bill, the record checks, evaluations, and HHS determinations apply to not only employees of providers with direct responsibility for or access to consumers, but also to the providers and the employees, contractors, and subcontractors of providers in any capacity including those in management or consulting positions. Under the bill, if a person is being considered as a provider, or as an employee, contractor, or subcontractor of a provider, and if the person has been convicted of a crime or has a record of founded abuse, HHS shall perform an evaluation to determine whether the crime or founded abuse warrants prohibition of the person as a provider or as an employee, contractor, or subcontractor of the provider. As under current law, if HHS determines that a provider or an employee, contractor, or subcontractor of a provider has committed a crime or has a record of founded abuse, HHS shall perform an evaluation to determine whether prohibition of the person as a provider, employee, contractor, or subcontractor is warranted. After the evaluation, HHS may allow a provider or an employee, contractor, or subcontractor of a provider to be or to continue to be a provider or an employee, contractor, or subcontractor of the provider if the person complies with HHS’s conditions. However, if HHS determines that the person has committed a crime or has a record of founded abuse which warrants prohibition as a provider or as an employee, contractor, or subcontractor of a provider, the person shall not be a provider or an employee, contractor, or subcontractor of a provider. The bill defines “employee” and “contractor” including a subcontractor for purposes of the bill.