The Missouri Medicaid Audit and Compliance Unit (MMAC) has been made aware that some HCBS providers have not been conducting FCSR checks on new employees/personal care attendants, under a mistaken assumption it was not required during the declared COVID health emergency. The Missouri Department of Health and Senior Services (DHSS), Division of Senior and Disability Services (DSDS) did grant limited flexibility on their COVID-19 Flexibility Authority Chart to “Suspend requirements for background and Good Cause Waiver to be returned prior to aides providing care”. That flexibility did not mean that FCSR checks didn’t have to be initiated before the individuals had their first contact with Medicaid participants.
On the DSDS webpage for COVID-19 HCBS Provider Information, DSDS guidance that has been in place since March 2020 states:
Family Care Safety Registry (FCSR)
The state will waive the requirement for the FCSR background check to be returned prior to the start of the individual providing care as it is anticipated there may be a delay in background check processing. The provider shall file the FCSR request prior to the aide providing care, and the aide/attendant may begin providing care immediately. If a potential aide/attendant requires a Good Cause Waiver, the state will waive the requirement for the waiver to be returned prior to the individual providing care. Providers shall only make this exception for crimes that are typically waived with the Good Cause Waiver.
HCBS providers that have not conducted FCSR checks on employees/personal care attendants that were hired since the beginning of the COVID-19 health emergency should do so immediately. Providers with questions may contact LTSS@health.mo.gov or MMACProviderReview@dss.mo.gov