[§346-333]  Home and community-based casemanagement agency, authority over and evaluation of.  (a)  Any person,agency, or organization engaged in providing, coordinating, or monitoringcomprehensive services to clients in community care foster family homes, ormedicaid clients in expanded adult residential care homes, and assisted livingfacilities, shall meet the standards of conditions, management, and competenceset by the department and hold a license in good standing issued for thispurpose by the department.

(b)  The department shall adopt rules pursuantto chapter 91 relating to:

(1)  Standards for the organization and administrationof home and community-based case management agencies;

(2)  Standards of conditions, management, andcompetence of home and community-based case management agencies;

(3)  Procedures for obtaining and renewing a licensefrom the department; and

(4)  Minimum grievance procedures for clients of casemanagement services.

(c)  As a condition for obtaining a license, aperson, agency, or organization shall comply with rules adopted undersubsection (b)(1), (2), and (3), and satisfy the background check requirementsunder section 346-335.  The department may deny a license if:

(1)  An operator, employee, or new employee of thehome and community-based case management agency has been convicted of a crimeother than a minor traffic violation involving a fine of $50 or less;

(2)  The department finds that the criminal historyrecord of an operator, employee, or new employee poses a risk to the health,safety, or well-being of adults receiving care in community care foster familyhomes, expanded adult residential care homes, or assisted living facilities;

(3)  An operator, employee, or new employee of thehome and community-based case management agency is a perpetrator of abuse asdefined in section 346-222; or

(4)  The holder of or an applicant for a home andcommunity-based case management agency license, or one of its employees, has acertificate of approval to operate a community care foster family home, or alicense from the department of health to operate an adult residential carehome, expanded adult residential care home, or assisted living facility.

(d)  Upon approval of any home andcommunity-based case management agency, the department or its authorized agentsshall issue a license, which shall continue in force for one year, or for twoyears if a home and community-based case management agency has been licensedfor at least one year and is in good standing pursuant to standards adopted bythe department, unless sooner revoked for cause.  The department or itsauthorized agents shall renew the license only if, after an annual or biennialevaluation, the agency continues to meet the standards established by thedepartment.

(e)  The department shall evaluate the home andcommunity-based case management agency to determine compliance with therequirements established under this section:

(1)  Annually or biennially; or

(2)  Upon receipt of a complaint that the home andcommunity-based case management agency is in violation of the requirementsestablished under this section.

(f)  The department may suspend or revoke alicense if the department deems that the agency is unwilling or unable tocomply with the rules adopted under this section; provided that:

(1)  Upon suspension or revocation of a license, thehome and community-based case management agency shall no longer be licensed andshall immediately notify the agency's clients and community care foster familyhomes, expanded adult residential care homes, and assisted living facilities inwhich the agency is providing services to clients;

(2)  A home and community-based case management agencywhose license has been suspended or revoked may appeal the suspension orrevocation to the department through its established process, but the appealshall not stay the suspension or revocation;

(3)  A suspended or revoked license may be reinstatedif the department deems that the agency is willing and able to comply with therules adopted under this section; and

(4)  A revoked license shall be restored only after anew application is made and reviewed under this part.

(g)  Any home and community-based casemanagement agency shall be subject to investigation by the department at anytime and in the manner, place, and form as provided in the department's rules.

(h)  The department shall adopt standard formsof contract that the home and community-based case management agency shall usewith each of its clients, community care foster family homes, expanded adultresidential care homes, and assisted living facilities.

(i)  The department shall establish a reviewboard consisting of three operators of community care foster family homes andthree operators of expanded adult residential care homes.  The review boardshall monitor referrals and placements of clients by each home andcommunity-based case management agency on a monthly basis.  Each home andcommunity-based case management agency shall be required to provide monthlyreports to the review board.

(j)  The home and community-based casemanagement agency shall have a fiduciary duty to each client it serves.

(k)  A home and community-based case managementagency shall not enter into an agreement that requires a community care fosterfamily home to accept that agency's clients exclusively. [L 2001, c 273, pt of§1, §6; am L 2003, c 98, §3; am L 2004, c 153, pt of §1, §§2, 5; am L 2006, c236, §1]