18 Miss. Code. R. 2-3.3

Current through December 10, 2024
Rule 18-2-3.3 - ADMINISTRATIVE REQUIREMENTS
A.Qualified Operating Organizations

Qualified operating organizations must maintain the minimum administrative requirements below:

1. Must be willing to divest themselves of Medicaid Waiver services with the exception of Case Management.
2. Must be financially capable of and willing to maintaining each MAC Center location successfully, regardless of future state or federal funding.
3. Must serve all people requesting supports.
4. Must have and/or maintain meaningful experience/participation with CMS programs/initiatives (Money Follows the Person, Community-based Care Transitions, ADRC, etc.)
5. Must have and maintain successful experience with operating a network of service providers outside of established service area
6. Must provide the required scope of services throughout their entire designated service area. Must acquire MDHS approval for all work subcontracted to additional operating organizations.
7. Must be Alliance for Information and Referral System (AIRS) Certified.
B.Name and Logo

Standardization in naming of MAC Centers is intended to make it possible for people and their families to identify and readily locate these facilities in any location in the state. The MAC Center must have a name that contains the phrase MAC Center' and shall include this name in all of its advertising and materials. The full name of the MAC Center may include a subtitle to identify its location. All MAC Center sites associated with one operating organization shall have one consistent name that is used throughout the service area.

C.Location, Physical Plant, and Operating Hours

MAC Centers are identifiable, accessible, and welcoming places where all people can come for information and assistance. Each MAC Center site shall have signage clearly displayed on the inside and outside of the building. Visitor parking shall be available close to the building entrance and the site shall be easily accessible via public transportation, where available.

The MAC Center shall have a clearly defined and welcoming reception area where members of the public are greeted by staff that is ready to assist them. The reception area shall include display space for fliers, pamphlets, and other information materials so that visitors can easily browse. In addition to the public space, the MAC Center shall have private spaces where staff can meet and have confidential conversations with people, their families, and/or representatives. The layout of the MAC Center shall be arranged so that visitors are not able to overhear confidential conversations. The MAC Center shall have adequate storage space for both confidential and non-confidential files and resource materials. Storage of confidential information must be HIPAA compliant.

All MAC Centers shall establish, in collaboration with MDHS, uniform and consistent operating hours and days, and shall have the capacity to arrange occasional after-hours appointments as necessary. Adequate staff shall remain available during lunch hours, as this may be most convenient for the public.

D.Staffing

Each MAC Center operating organization shall be responsible for interviewing and hiring staff according to requirements set forth by MDHS. Each MAC Center employee shall be able to provide all required services in a competent and professional manner, and possess all of the skills and knowledge necessary to perform all of his or her required responsibilities. All MAC Center staff should have general knowledge of all target populations served and the ability to access information about aging and disability related services in the MAC service area. MAC Center Specialists shall have in-depth knowledge and experience relating to the target groups, as well as demonstrated capacity to provide each of the services the MAC Center offers. Regardless of whether employees are shifted from existing operating organizations or newly hired, the expectations of knowledge, experience, and ability will be the same. It is vital that MAC Center Specialists are seasoned, well-qualified professionals, as training and on-the-job demands will be extensive.

Specific requirements shall include at a minimum, but will not be limited to the following:

1. Undergraduate degree in human or health care services, or similar AND at least three post-degree years of experience working with at least one of the target population groups.

-OR-

2. Two year associate's degree in human or health care services, or similar AND at least six post-degree years of experience working with at least one of the target population groups.

-AND-

3. Community-based care experience
4. Valid Mississippi Driver's License and access to an insured and reliable vehicle for work related travel.

Traits or characteristics needed to be successful in this position include:

1. Professionalism
2. Passion for serving others
3. Interpersonal abilities
4. Resourcefulness
5. Self-motivation

Refer to Addendum 1 and 2 for specific MAC Center job description information.

MAC Centers shall employ an appropriate number of staff to meet all administrative and direct support needs. This shall include, at minimum, one MAC Center Manager, one administrative staff member to provide basic front desk information and scheduling support, and at minimum, two MAC Center Specialists who will each provide I&R, person-centered counseling, screening, assessment, etc. This will include both on-site and in-home visits, depending on the person's needs. The Manager shall also be capable of performing Specialist roles. Sites shall be prepared to hire or contract for additional assistance as work load demands increase as evidenced by reporting.

During Phase Two, MAC Centers must be equipped to provide assessment when deemed necessary and appropriate, in addition to their Phase One supports. MAC employees who complete assessments must meet minimum mandated requirements at that time.

E.Training

Each employee must attend and successfully complete all initial and ongoing trainings relating to his or her job specifications. These mandated trainings will be provided by MDHS. There will be at least eight (8) mandated forms of training:

1. General training on the proper and effective operation and management of a No Wrong Door (NWD) system. This may require initial out-of-state travel for some staff.
2. Specific and extensive training on each of the waivers will be provided by representatives from partnering agencies, including Departments of Rehabilitation Services, Mental Health, and Medicaid.
3. I&R training provided by local partners concerning services and support opportunities for all income and eligibility levels
4. Person Centered Thinking training.
5. Long-Term Services & Supports (LTSS) system software training.
6. Alliance for Information and Referral System (AIRS) certification.
7. Training on how to administer and score the screening tool and full assessment instrument.
8. Each MAC Center employee will be required to fulfill 40 clock hours of Continuing Education/training during his or her first year of service, and 20 Continuing Education/training hours during subsequent years.
F.Accessibility

MAC Centers are expected to be able to effectively serve people who have physical or functional limitations, language differences, or cultural differences that may make it difficult for them to access, communicate, or use the services provided. MAC Centers must be able to:

1. Be physically accessible and comply with the Americans with Disabilities Act.
2. Have the ability to meet face-to-face with people as requested.
3. For people with cognitive disabilities, provide opportunities for family members and other representatives who know the person and can convey his or her needs and preferences.
4. Provide services in a manner that is respectful of and responsive to its customers' racial, ethnic, and cultural identities.
5. All material can be made available to all people.
G.Person-centered Counseling

MAC Center staff should use the person-centered counseling process to work with people to find the best service options. Person-centered counseling is a process, directed by the person with long-term care needs, intended to identify strengths, capacities, preferences, needs and desired outcomes. The process can include participants freely chosen by the person (family member or other representative) who are able to serve as important contributors.

H.Separation of Case Management and Service Delivery

It is the intent of CMS that the Balancing Incentive Program funding and activities incorporate conflict-free case management. In order to meet this requirement, a MAC Center operating organization shall not provide any direct services unless an MDHS approved, conflict-free firewall has been put in place. A MAC Center operating organization shall not have any control of nor interest in an LLC or other entity created to provide direct services.

I.Marketing and Outreach

The MAC Center shall develop and implement an ongoing program of marketing, outreach, and public education to make its services known to members of its participant populations. This should include people who are isolated or otherwise hard to reach, and to community agencies and service providers in its service area to inform them of the availability of its services. Marketing activities may include some of the following: production and distribution of printed materials, radio or television advertisements, outreach to service providers or medical offices, local government agencies, community service organizations, consumer advocacy and self-help groups, etc.

The logo which has been designated as the official MAC Center logo shall be included in all advertising and materials. No individual MAC Center may create and/or include its own logo in said venues.

The MAC Center shall establish goals for and monitor the effectiveness of its marketing activities. As part of this effort, the MAC Center should track the number of interactions it has with people (and their family members or representatives) of its appropriate populations for the purpose of providing or obtaining information and assistance. See Reporting' section for examples.

J.Quality Assurance and Evaluation

Each MAC Center must fully cooperate with and participate in the development of quality assurance indicators and ongoing program evaluation activities performed by and on behalf of MDHS and/or Medicaid.

K.Sustainability Plan

Each operating organization shall develop, in coordination with MDHS, a sustainability plan for the immediate continuation of the MAC Center System after the Balancing Incentive Program funding has expired. It is the strong desire of MDHS and DOM for each MAC Center to not only survive, but to grow and thrive as well. Accordingly, it is the intent of both MDHS and DOM to stay involved with and support MAC Center operating organizations with any means available and appropriate at that time to promote, facilitate, and ensure the successful continuation of the MAC Center/NWD system.

L.Advisory Board Participation

At least one person from each MAC Center will be required to serve on a state-wide advisory board that will eventually oversee and guide the further implementation of the MAC Network. This board will be a part of the MAC 2.0 I&R workgroup. This group will work to share information amongst agencies concerning service and support opportunities, up-to-date reporting, unmet needs, etc.

M.Reporting

Each MAC Center shall provide all relevant reports and other documentation as may be required by MDHS and/or Medicaid in a timely manner. Examples may include:

1. Contacts per month
2. Contact type (walk-in, telephone, home visit, etc.)
3. Time lapse between request for home visit and completion of home visit
4. Number of education outreach events and community forums per month

18 Miss. Code. R. 2-3.3

Miss. Code Ann. 43-1-2, 43-9-1, 42 USCA § 1396d