20 CAR § 535-404 – Refusal to serve

(a)
1. (1) A selected provider may refuse to serve any beneficiary:
  1. (A) When the provider is unable to ensure the beneficiary’s or their employees’ health, safety, or welfare; or
  2. (B) Upon the occurrence of one (1) of the situations described in 20 CAR § 535-405(1) – (4).
2. (2) A provider must immediately notify the Division of Developmental Disabilities Services and the beneficiary’s assigned PASSE care coordinator when refusing to serve a beneficiary.
(b) If a provider is unable to ensure a beneficiary’s health, safety, or welfare because qualified personnel are unavailable to deliver a CES Waiver service included on the beneficiary’s PCSP, the provider must be able to demonstrate reasonable efforts to recruit and retain qualified personnel and the results of those efforts.
(c) Whether a provider is refusing to serve based on legitimate beneficiary or employee health, safety, or welfare concerns is determined in the sole discretion of the division.
(d)
1. (1) If a provider is currently serving a beneficiary when declaring a refusal to serve, the provider shall remain responsible for the delivery of CES Waiver services until the beneficiary transitions to their new provider or other placement unless there is an immediate health or safety risk to provider employees.
2. (2) A detailed description of any health and safety risk justifying the ceasing of service delivery prior to a completed transition of beneficiary to a new provider must be documented.