Sbs: Provider Qualifications And Duties

Qualifications for covered services include licensure and acting within the scope of practice, where applicable. (7-1-26) 01. Behavioral Intervention. Provided by, or under the supervision of, an intervention specialist or professional. Individuals providing behavioral intervention must be one (1) of the following: (7-1-26) a. Intervention Paraprofessional. Provides direct services. The specialist or professional observes and reviews the direct services performed by the paraprofessional monthly, or more often as necessary, to ensure the paraprofessional demonstrates the necessary skills to correctly provide the direct service. An intervention paraprofessional under the direction of a qualified intervention specialist or professional must: (7-1-26) i. Be at least eighteen (18) years of age; (7-1-26) ii. Demonstrate the knowledge, have the skills needed to support the program to which they are assigned; (7-1-26) iii. Meet the paraprofessional requirements under IDAPA 08.02.02. (7-1-26) b. Intervention Technician. As defined for CHIS services but does not need to be the employee of a DDA. (7-1-26) c. Intervention Specialist. Provides direct services, completes assessments, and develops implementation plans. Intervention specialists who will complete assessments must have documented training and experience in completing assessments and designing and implementing comprehensive therapies for students with functional or behavioral needs, or both. The qualifications for this provider type can be met by one (1) of the following: (7-1-26) i. An individual who holds an Idaho Standard Instructional Certificate who meets qualifications for an endorsement specific to special education as defined in State Board of Education Policy Section IV.B; (7-1-26) ii. An individual who holds a Habilitative Intervention Certificate of Completion in Idaho with an expiration date of July 1, 2019, or later, and does not have a gap of more than three (3) years of employment as an intervention specialist; or (7-1-26) iii. An individual who holds a bachelor's degree from an accredited institution in a human services field or has a bachelor's degree and a minimum of twenty-four (24) semester credits in a human services field, can demonstrate one thousand forty (1,040) hours of supervised experience working with children who demonstrate functional or behavioral needs, and meets the competency requirements by completing one (1) of the following: (7-1-26) (1) A Department-approved competency checklist referenced in the Idaho Medicaid Provider Handbook; (7-1-26) (2) A minimum of forty (40) hours of applied behavior analysis training delivered by an individual who is certified or credentialed to provide the training; or (7-1-26) (3) Other Department-approved competencies as defined in the Idaho Medicaid Provider Handbook. (7-1-26) d. Intervention Professional. The services and qualifications for this provider type can be met by one IDAHO ADMINISTRATIVE CODE IDAPA 16.03.26 Department of Health & Welfare Medicaid Plan Benefits Section 325 Page 88 (1) of the requirements for a CHIS intervention professional. (7-1-26) e. Evidence-Based Model (EBM) Intervention Paraprofessional. As defined for CHIS services. (7-1-26) f. Evidence Based Model (EBM) Intervention Specialist. As defined for CHIS services. (7-1-26) g. Evidence-Based Model (EBM) Intervention Professional. As defined for CHIS services provides direct services, completes assessments, develops implementation plans, and may supervise EBM intervention paraprofessionals or specialists working within the same evidence-based model in which they are certified or credentialed. (7-1-26) 02. Behavioral Consultation. Must be provided by a professional who has a Doctoral or Master’s degree in psychology, education, applied behavioral analysis, or has a related discipline with one thousand five hundred (1,500) hours of relevant coursework or training, or both, in principles of child development, learning theory, positive behavior support techniques, dual diagnosis psychology, education, or behavior analysis (may be included as part of degree program), and who meets one (1) of the following: (7-1-26) a. An individual who holds an Idaho Standard Instructional Certificate who meets qualifications for an endorsement specific to special education as defined in State Board of Education Policy Section IV.B; (7-1-26) b. An individual with a Pupil Personnel Certificate who meets the qualifications defined under IDAPA 08.02.02, excluding an RN or audiologist; (7-1-26) c. An occupational therapist; (7-1-26) d. An intervention professional; or (7-1-26) e. An EBM intervention professional. (7-1-26) 03. Crisis Intervention. Must be provided by, or under the supervision of, an intervention specialist or professional. Individuals providing crisis intervention must be one (1) of the following: (7-1-26) a. An intervention paraprofessional; (7-1-26) b. An intervention technician; (7-1-26) c. An intervention specialist; (7-1-26) d. An intervention professional; (7-1-26) e. An EBM intervention paraprofessional; (7-1-26) f. An EBM intervention specialist; (7-1-26) g. An EBM intervention professional; (7-1-26) h. A licensed physician, licensed practitioner of the healing arts; (7-1-26) i. An advanced practice registered nurse; (7-1-26) j. A licensed psychologist; (7-1-26) k. A licensed clinical professional counselor or professional counselor; (7-1-26) l. A licensed marriage and family therapist; (7-1-26) IDAHO ADMINISTRATIVE CODE IDAPA 16.03.26 Department of Health & Welfare Medicaid Plan Benefits Section 325 Page 89 m. A licensed Masters social worker, licensed clinical social worker, or licensed social worker; (7-1-26) n. A psychologist extender; (7-1-26) o. An RN; (7-1-26) p. A licensed occupational therapist; or (7-1-26) q. An endorsed or certified school psychologist. (7-1-26) 04. Habilitative Skill Building. Must be provided by, or under the supervision of, an intervention specialist or professional. Individuals providing habilitative skill building must be one (1) of the following under behavioral intervention: (7-1-26) a. An intervention paraprofessional; (7-1-26) b. An EBM intervention paraprofessional; (7-1-26) c. An EBM intervention specialist; or (7-1-26) d. An EBM intervention professional. (7-1-26) 05. Interdisciplinary Training. Must be provided by one (1) of the following under behavioral intervention: (7-1-26) a. An intervention specialist; (7-1-26) b. An intervention professional; (7-1-26) c. An EBM intervention specialist; (7-1-26) d. An EBM intervention professional. (7-1-26) 06. Medical Equipment and Supplies. (7-1-26) 07. Nursing Services. (7-1-26) 08. Occupational Therapy and Evaluation. Therapy rules apply. (7-1-26) 09. Personal Care Services (PCS). Must be provided by or under the direction of an RN. (7-1-26) a. Providers of PCS must have at least one (1) of the following qualifications: (7-1-26) i. Licensed Registered Nurse (RN). (7-1-26) ii. Licensed Practical Nurse (LPN). (7-1-26) iii. Certified Nursing Assistant (CNA). (7-1-26) iv. Personal Assistant. A person with training to ensure the quality of services who is at least eighteen (18) years of age. (7-1-26) b. The RN must review or complete, or both, the PCS assessment and develop or review, or both, the written plan of care annually. Oversight provided by the RN must include all of the following: (7-1-26) i. Development of the written PCS plan of care; (7-1-26) IDAHO ADMINISTRATIVE CODE IDAPA 16.03.26 Department of Health & Welfare Medicaid Plan Benefits Section 325 Page 90 ii. Review of the treatment given by the personal assistant through a review of the student’s PCS service detail reports as maintained by the provider; and (7-1-26) iii. Reevaluation of the plan of care as necessary, but at least annually. (7-1-26) c. The RN must conduct supervisory visits on a quarterly basis, or more frequently as determined by the IEP team and defined as part of the PCS plan of care. (7-1-26) 10. Physical Therapy and Evaluation. Therapy rules apply. (7-1-26) 11. Psychological Evaluation. (7-1-26) 12. Psychotherapy. (7-1-26) 13. Skills Building/Community-Based Rehabilitation Services (CBRS). Skills Building/CBRS must be provided by one (1) of the following: (7-1-26) a. Licensed physician, licensed practitioner of the healing arts; (7-1-26) b. Advanced practice registered nurse; (7-1-26) c. Licensed psychologist; (7-1-26) d. Licensed clinical professional counselor or professional counselor; (7-1-26) e. Licensed marriage and family therapist; (7-1-26) f. Licensed master’s social worker, licensed clinical social worker, or licensed social worker; (7-1-26) g. Psychologist extender registered with the Division of Occupational and professional Licenses; (7-1-26) h. Licensed registered nurse (RN); (7-1-26) i. Licensed occupational therapist; (7-1-26) j. Endorsed or certified school psychologist; (7-1-26) k. Skills Building/Community Based Rehabilitation Services specialist who must: (7-1-26) i. Be an individual who has a bachelor’s degree or higher and is under the supervision of a licensed behavioral health professional, a physician, nurse, or an endorsed or certified school psychologist. The supervising practitioner is required to have regular one-to-one (1:1) supervision of the specialist monthly to review treatment provided to student participants on an ongoing basis. Supervision can be conducted using synchronous virtual care when it is equally effective as direct on-site supervision; and (7-1-26) ii. Have a credential required for CBRS specialists. (7-1-26) 14. Speech/Audiological Therapy. Therapy rules apply. (7-1-26) 15. Social History and Evaluation. (7-1-26) 16. Transportation. Must be provided by an individual who has a current Idaho driver's license and is covered under vehicle liability insurance that covers passengers for business use. (7-1-26) IDAHO ADMINISTRATIVE CODE IDAPA 16.03.26 Department of Health & Welfare Medicaid Plan Benefits Section 326 Page 91 17. Therapy Paraprofessionals. The schools may use paraprofessionals to provide occupational therapy, physical therapy, and speech therapy. The portions of the treatment plan delegated to the paraprofessional must be identified in the IEP or transitional IFSP. (7-1-26)