# 432.31 Training and use of subprofessional staff.
(a) *State plan requirement.* A State plan must provide for the training and effective use of subprofessional staff as community service aides, in accordance with the requirements of this section.
(b) *Recruitment and selection.* The Medicaid agency must have methods of recruitment and selection that afford opportunity for full-time or part-time employment of persons of low income, including:
(1) Young, middle-aged, and older persons;
(2) Physically and mentally disabled; and
(3) Beneficiaries.
(c) *Merit system.* Subprofessional positions must be subject to merit system requirements except where special exemption is approved on the basis of a State alternative plan for employment of disadvantaged persons.
(d) *Staffing plan.* The agency staffing plan must include the kinds of jobs that subprofessional staff can perform.
(e) *Career service.* The agency must have a career service program that allows persons:
(1) To enter employment at the subprofessional level; and
(2) To progress to positions of increasing responsibility and reward:
(i) In accordance with their abilities; and
(ii) Through work experience and pre-service and in-service training.
(f) *Training, supervision and supportive services.* The agency must have an organized training program, supervision, and supportive services for subprofessional staff.
(g) *Progressive expansion.* The agency must provide for annual increase in the number of subprofessional staff until:
(1) An appropriate ratio of subprofessional and professional staff has been achieved; and
(2) There is maximum use of subprofessional staff as community aides in the operation of the program.