State of Iowa HCBS Mandated Background Checks
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1 State of Iowa HCBS Mandated Background Checks Presenters: Edie Bogaczyk Gayla Harken December 2013 This material is designed and intended for general informa1onal purposes only. The user is responsible for determining the applicability and legality of this informa1on and for determining the most recent law, statute or regula1on(s) that may be applicable to the user s par1cular situa1on. The Iowa Associa1on of Community Providers assumes no responsibility for the accuracy or legality of the informa1on contained herein.
2 Objec1ves of the Training To bener understand and fully comply with state law and Iowa Administra1ve Rules rules regarding dependent adult, child abuse, and criminal background checks. To bener understand the process in which to request state background checks. To bener understand and fully comply with federal laws on exclusion list checks.
3 Iowa Law Requires Background Checks Pursuant to Iowa Code 249A.29 and Iowa Code 135C. 33(5)(a)(1) & (5)(a)(3), all providers of Habilita1on and Home and Community Based Services (HCBS) waiver services must complete child abuse, dependent adult abuse and criminal background screenings before employment of a prospec1ve staff member who will provide care for a member or consumer.
4 Record Check Procedures for Prospec1ve Employees Applica1ons for employment must include the following statement: Do you have a record of founded child or dependent adult abuse or have you ever been convicted of a crime, in this state or any other state? Inform applicant prior to employment of the need for a records check and obtain a signed acknowledgement of the receipt of such informa1on.
5 Where Does the Process Start? Prior to employment the Provider must request that the Iowa Department of Human Services (DHS) perform a child and dependent adult abuse record check. Prior to employment the Provider must request that the Department of Public Safety perform a criminal history check.
6 The Role of DHS The DHS Record Check Evalua1on Team is responsible for the evalua1on of any hits to an applicant s record. This also includes any deferred judgments. The Records Evalua1on Team is not responsible for the records check themselves, only the evalua1on of those checks.
7 The Role of DHS DHS does not evaluate Juvenile records. DHS evaluates convic1ons. If it is an arrest only, they will not evaluate.
8 SING Computer System Providers use the State s SING system to perform background checks. The SING system gathers all of the background check informa1on needed in one point of contact: Sex Offender Registry Child Abuse Dependent Adult Abuse Criminal History
9 SING Computer System
10 SING Computer System
11 SING Computer System
12 SING Computer System
13 Record Check Procedures for Prospec1ve Employees The provider requests a background check, if it is clear, the provider may move ahead with employment of the applicant. Keep the findings as evidence and file in a confiden1al loca1on. Employees who have terminated employment for any reason or any length of 1me and wish to return to the same health care program must go through a record check again.
14 No Hit
15 Further Research is Required
16 A Hit...Now What?
17 Employer Has a Choice If there is a hit on the background check, the provider either decides not to employ the applicant or requests that DHS perform a record check evalua1on.
18 Provider Decides to Pursue Then The employer will send a completed request for a Record Check Evalua1on Form via: Fax E- mail Regular Mail
19 Form
20 Form This form is s1ll in drah version. Using the revised version instead of the form on the DHS website will reduce the evalua1on turnaround 1me. The version on the website does not have a spot for applicant posi1on, which needs to be clearly wrinen on the front page as required by Iowa Code.
21 Record Check Procedures for Prospec1ve Employees
22 Provider Checklist Employer Checklist for Comple1on of Request for Evalua1on ( ) q Page 1 Facility informa1on Prefer typed info but if wrinen it must be legible Applicant signature, posi1on, and date q Page 2 Thorough explana1on of ALL crimes/abuse Thorough descrip1on of rehab what has been done since crimes/abuse Detailed work history q Background checks (We do not evaluate maners handled in juvenile court. We do evaluate all convic1ons/deferred judgments) SING dated within 30 days Child and/or dependent adult abuse checks within 30 days Criminal check, always include rap sheet when there is criminal history q Suppor1ng documenta1on
23 What Cons1tutes a Complete Packet? ü Form is completed and signed by the applicant. ü SING is dated within 30 days of the 1me that the completed request for evalua1on is submined to DHS. ü DCI/Rap Sheet is dated within 30 days of the 1me that the completed request for evalua1on is submined to DHS. ü Any suppor1ng documents. ü Read the applicant s explana1ons. ü Use the checklist!
24 If DHS Says No Go If the DHS record check evalua1on determines the applicant should be prohibited from employment, the provider cannot hire the applicant.
25 Other Types of DHS Check Findings If the DHS record check evalua1on determines the applicant should not be prohibited from employment with no restric1ons, the provider may move ahead with employment of the applicant. Keep the findings as evidence and file in a confiden1al loca1on. If the DHS record check evalua1on includes restric1ons on employment, the provider must determine whether they can comply with the restric1ons or not, and may or may not employ the applicant.
26 Restric1ons If the provider employs the applicant with restric1ons, the provider must ensure the employee and provider comply with any restric1ons. This should be documented in the employee personnel record. Restric1ons can only be removed by DHS. DHS shall issue all no1ces of decision in wri1ng to the employer and prospec1ve employee.
27 Appeal Process There are appeal rights to DHS within 30 days of the date of the no1ce of the results of the record check evalua1on in 441- Chapter 7. An employer is not an aggrieved party or aggrieved person, therefore, they cannot appeal a record check evalua1on. Only the applicant can appeal the final decision.
28 30 Day Period Providers, mark your calendar: The IAC (1) states that a SING/DCI check is only valid for 30 days.
29 Another 30 Day Period Providers, mark your calendar: The IAC (2) states that a DHS decision on ini1al employment is only valid for 30 days.
30 The Role of DCI The Division of Criminal Inves1ga1on (DCI) is a division within the Iowa Department of Public Safety. DCI completes the criminal history checks. DCI provides the reques1ng agency with a copy of the Iowa Criminal History (Rap Sheet).
31 Criminal History Record Check Request Form
32 The Role of DIA The Department of Inspec1on & Appeals is responsible for assuring agencies are in compliance with state laws and regula1ons. DIA licensed facili1es can be audited by this department to determine if the required background checks have been conducted by the provider.
33 Record Check Procedures for Current Employees An employer should request a current criminal or dependent adult or child abuse record check when the employer learns from any source that a current employee has a criminal or dependent adult or child abuse record that has not been previously evaluated at the health care program. Employers should request a record check evalua1on on current employees when a current employee s background check indicates a criminal or dependent adult or child abuse record.
34 Record Check Procedures for Current Employees If a person owns or operates more than one facility, and an employee of one of the facili1es is transferred to another facility without a lapse in employment, the facility is not required to request addi1onal criminal or abuse record checks of the employee or obtain a new record check evalua1on. If the record check for the current employee comes back clear or with a hit, follow appropriate procedures as we already covered. Keep the findings as evidence and file in a confiden1al loca1on.
35 Penal1es for Not Comple1ng Criminal, Child and Dependent Adult Abuse Record Checks Department of Inspec1ons and Appeals (DIA) Class II viola1on, $100 to $500. DIA class 1 viola1on, $2,000 to $10,000. DHS could withhold payments, audit 100% of services documenta1on, recoup service funds for services provided by the employee who did not have required background checks.
36 Group Ac1vity I You get a call from a current employee that she moved back with her husband into his home, and the next day his home was raided and she is now being charged with possession of illegal drugs and child endangerment. She says she did not know he had drugs in his home. She has always been trustworthy and is a good employee. How do you process and handle this scenario?
37 Group Ac1vity II You read in the local newspaper that a current employee has 5 th degree theh charges that are pending. He has said nothing to you. He has been a marginal employee. How do you process and handle this scenario?
38 Group Ac1vity III You have a current employee who brings in the local newspaper that another current employee was charged with drunken driving two weeks ago. That employee has used agency vehicles to provide transporta1on to persons served for medical appointments and ac1vi1es in the community. The employee has said nothing to you about this. How do you process and handle this scenario?
39 Sample Policy on Employee No1fica1on of Criminal Charges/Abuse Allega1ons, and Convic1ons Employees are required to no1fy the Human Resources Manager of any criminal charges, other than non- moving traffic viola1ons, and dependent adult abuse or child abuse allega1ons that are lodged against an employee. Based on an evalua1on of the situa1on, an independent determina1on will be made as to whether the employee s employment will be con1nued or modified in any way. Failure to do so within 48 hours may result in disciplinary ac1ons up to and including termina1on from employment.
40 Health and Human Services (HHS) Requirements on Exclusion Checks for Medicaid and Medicare Programs The Office of Inspector General (OIG) exclusion list must be checked prior to offering employment at: hnp:// Be sure to check all married names, maiden names, alias, and former names. Be sure you use the correct spelling and any hyphens in a name. If no results were found on the exclusion check, the provider may move ahead with employment of the prospec1ve applicant. Make a copy of the findings as evidence and file in a confiden1al loca1on.
41 Health and Human Services (HHS) Requirements on Exclusion Checks for Medicaid and Medicare Programs (Con%nued ) If the search results note the need to check the Social Security Number (SSN) or Employer Iden1fica1on Number (EIN), do this check before hiring. If no results were found on the exclusion check, the provider may move ahead with employment of the prospec1ve applicant. Make a copy of the findings as evidence and file in a confiden1al loca1on. Any 1me a prospec1ve employee is excluded, please do not employ them. You will regret it. This would be a viola1on of federal law and illegal. Make a copy of the findings as evidence and file in a confiden1al loca1on.
42 Health and Human Services (HHS) Requirements on Exclusion Checks for Medicaid and Medicare Programs (Con%nued ) Providers should search the HHS- OIG website monthly for exclusions or reinstatements that have occurred since the last search for current employees. If no results were found on the exclusion rechecks, the provider should make copies of the findings as evidence and file in a confiden1al loca1on. If the recheck search has results, note the need to check the Social Security Number (SSN) or Employer Iden1fica1on Number (EIN), do this check.
43 Health and Human Services (HHS) Requirements on Exclusion Checks for Medicaid and Medicare Programs (Con%nued ) If no results were found on the exclusion recheck of the SSN/EIN, make a copy of the findings as evidence and file in a confiden1al loca1on. Any 1me a current employee is excluded, they can no longer work. This would be a viola1on of federal law and illegal. Make a copy of the findings as evidence and file in a confiden1al loca1on.
44 Health and Human Services (HHS) Requirements on Exclusion Checks for Medicaid and Medicare Programs (Con%nued ) If you discover a current employee is excluded on the recheck, you need to either suspend this employee un1l he/ she can be reinstated by OIG or immediately terminate the employee. Make a self- report to IME within five days of knowledge of the exclusion and make a self- report on the OIG website. There are severe penal1es for employing someone who is excluded. Civil and possible criminal ac1ons may or will be taken by the federal government or state. Other sanc1ons could also be imposed.
45 OIG Exclusion List Website hnp://
46 OIG Website
47 OIG Website
48 Penal1es for Employing Excluded Individuals Aher it self- disclosed conduct to the OIG, Conestoga View Nursing, L.P. d/b/a Conestoga View, Pennsylvania, agreed to pay $264, for allegedly viola1ng the Civil Monetary Penal1es Law. The OIG alleged that Conestoga View employed an individual that it knew or should have known was excluded from par1cipa1on in Federal health care programs. Aher it self- disclosed conduct to the OIG, Calvin Community, Iowa, agreed to pay $56,663 for allegedly viola1ng the Civil Monetary Penal1es Law. The OIG alleged that Calvin Community employed an individual that it knew or should have known was excluded from par1cipa1on in Federal health care programs.
49 Group Ac1vity I An employee comes to you and shares that another employee told her she was excluded; and she is telling others she is excluded. Even though she has worked for only three months, you feel she has done a good job. How do you process and handle this scenario?
50 Group Ac1vity II An employee is suspected of chea1ng on his 1me cards. You do an inves1ga1on and discover he has cheated the agency and Medicaid to the sum of $1,500. You are so surprised that this person would do such a thing. How do you process and handle this? Do you report this to the DIA fraud unit or IME? Do you report this to the police?
51 SAM Exclusion List Search SAM maintains a list of par1es excluded from doing business with the Federal government, including healthcare programs receiving Federal funding or reimbursement. Most SAM excluded par1es are vendors or corpora1ons, but some may be individuals with their own businesses. hnps://
52 SAM IME recommends that providers check this list system prior to an offer of employment. Providers must gather and check all current and former names of their employees when searching SAM. If no results were found on the excluded par1es check, the provider may move ahead with employment of that prospec1ve applicant. Make a copy of the findings as evidence and file in a confiden1al loca1on.
53 SAM Any 1me a prospec1ve employee is excluded, please do not employ them. This would be a viola1on of federal law and illegal. Make a copy of the findings as evidence and file in a confiden1al loca1on. Providers should search the SAM website monthly for exclusions that have occurred since the last search for current employees.
54 SAM Any 1me a current employee is excluded, please do not con1nue to employ him or her. This would be a viola1on of federal law and illegal. Make a copy of the findings as evidence and file in a confiden1al loca1on. If a current employee is excluded make a self- report to IME within five days of knowledge of the SAM exclusion.
55 SAM Website
56 SAM Website
57 SAM Website
58 Know Your Policies Consistency of applica1on of internal policies is very important. Example: If your agency has a policy it never employs applicants with any type of criminal record, then it is best prac1ce to be consistent with your policy to avoid any poten1al discriminatory failure to hire allega1ons. Do you fully understand your liability and vehicle policy limits? Even though DHS approves the individual through its evalua1on check, your own insurance carriers make have stricter limits.
59 Last Random Thoughts Approximately 7,600 Record Check Evalua1ons are completed per year. The average turn around 1me is approximately 3-4 days. DHS returns approximately 35% of requests due to an incomplete packet this causes a delay in the hiring process. Review before sending it in!
60 Ques1ons? Contact the IACP Technical Assistance Team at:
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