411-348-0025 Program Management, Endorsement, Certification, and Enrollment (1) CERTIFICATION, ENDORSEMENT, AND ENROLLMENT. To operate a Host Home Program, a program provider must have: (a) A Medicaid agency certificate and an endorsement for a Host Home Program as set forth in OAR chapter 411, division 323; and (b) A Medicaid Provider Identification Number assigned by the Department as described in OAR chapter 411, division 370. (2) INSPECTIONS AND INVESTIGATIONS. A program provider and in-residence caregiver must allow for inspections and investigations as described in OAR 411-323-0040. (3) MANAGEMENT AND PERSONNEL PRACTICES. A program provider must comply with the management and personnel practices described in OAR 411-323-0050. (4) IN-RESIDENCE CAREGIVER APPLICANT STUDY. A program provider must complete and submit an In-Residence Caregiver Applicant Study in accordance with OAR 411-348-0045 for each Host Home. The In-Residence Caregiver Applicant Study must be submitted to the Department as part of the application process for each host home license. (5) STAFFING SURVEY. (a) A program provider must submit annual staffing data to the nationally standardized reporting survey organization specified by the Department. (b) A program provider must ensure completion of the direct support worker staffing survey by the program provider’s staff, including the in-residence caregiver, when required by the Department. (6) COMPETENCY BASED TRAINING PLAN. (a) A program provider must have and implement a Competency Based Training Plan that meets, at a minimum, the competencies and timelines set forth in the Department’s Core Competencies. At a minimum, the Competency Based Training Plan must: (A) Address health, safety, rights, values, personal regard, and the mission of the program provider. (B) Describe competencies, training methods, timelines, how competencies of staff and in-residence caregivers are determined and documented, including steps for remediation, and when a competency may be waived by the program provider to accommodate the specific circumstances of an in-residence caregiver or staff member. (b) When a program provider opts to implement a Competency Based Training Plan other than the Department’s Core Competencies for an in-residence caregiver or other staff, the Competency Based Training Plan must include the following curriculum in accordance with the timelines stated below: (A) Prior to the admission of a child into a Host Home, the in-residence caregiver must have all of the following: (i) Received sufficient training in all of the following areas to perform the basic duties of a primary caregiver providing support to a child with intellectual or developmental disabilities: (I) Host Home Program policies and procedures, including complaint processes, safe body mechanics, missions and values, and financial management. (II) Mandatory abuse reporting. (III) Basic rights, including home and community-based services protections. (IV) Confidentiality standards. (V) Person-centered planning and person-centered practices. (VI) Individual Support Plans, including roles, how to locate information in an ISP document, and supporting documents such as nursing plans, behavior support documents, mental health plans, education plans, etc. (VII) Medical services and supports, including basic health indicators, when to report change in health, risks, protocols, and medication management. (VIII) Infection control and disease outbreak prevention and reporting. (ii) First Aid and CPR. (iii) Positive behavior supports. (iv) Emergency preparedness and emergency Response. (v) Documentation standards. (vi) Incident reporting and serious incidents. (vii) Oregon Administrative Rules, including how to find rule information. (viii) Trauma-informed care. (B) Within six months following the licensure of a Host Home, the in-residence caregiver must have received sufficient training in all of the following areas: (i) Mitigating risk and the dignity of risk. (ii) Transition to adulthood. (iii) Employment. (C) Other training topics that are recommended for initial training or ongoing training credit hours as required per OAR 411-323-0050 for in-residence caregivers or staff include, but are not limited to, the following: (i) Guardianship and educational surrogates. (ii) Sexual development and sexual health. (iii) Diversity and cultural awareness. (iv) Suicide prevention. (v) Department-approved behavior intervention curriculum (required for any in-residence caregiver or staff supporting a child with a Positive Behavior Support Plan that includes a safeguarding intervention or safeguarding equipment to address challenging behavior). (7) GENERAL STAFF AND IN-RESIDENCE CAREGIVER QUALIFICATIONS. (a) Each staff member or in-residence caregiver providing direct assistance to a child must: (A) Have knowledge of the child’s ISP and support needs, including medical, behavioral, and safety supports required by the child. (B) Have met the basic qualifications in the Competency Based Training Plan. A program provider must maintain current written documentation that staff and in-residence caregivers have demonstrated competency in areas identified by the program provider’s Competency Based Training Plan as required by section (6) of this rule, and that is appropriate to their job description. (b) An in-residence caregiver must be at least 21 years of age and unrelated to a child receiving services in their Host Home. (8) CONFIDENTIALITY OF RECORDS. (a) A program provider must ensure all children's records are kept confidential as described in OAR 411-323-0060. (b) A program provider, the in-residence caregiver, the in-residence caregiver's family, and staff must treat personal information about a child or a child's family in a confidential manner. Confidential information is to be disclosed on a need-to-know basis to law enforcement, Department staff, Oregon Health Authority staff, CDDP staff, DHS-CW staff, the Residential Facilities Ombudsman, school personnel, and licensed health care providers who are treating or providing services to a child. The information shared must be limited to the child’s health, safety, and service needs. (c) In addition to the requirements in subsections (a) and (b) of this section, a program provider, the in-residence caregiver, the in-residence caregiver’s family, and staff must comply with the provisions of ORS 192.553 through 192.568 and therefore may use or disclose a child’s protected health information only: (A) To law enforcement, Department staff, Oregon Health Authority staff, CDDP staff, DHS-CW staff, and the child’s parent or guardian, except when prohibited by a court order; (B) As authorized by the child’s parent or guardian appointed under ORS 125.305, 419B.372, 419C.481, or 419C.555; (C) For purposes of obtaining health care treatment for the child; (D) For purposes of obtaining payment for health care treatment; or (E) As permitted or required by state or federal law or by order of a court. (9) DOCUMENTATION REQUIREMENTS. Unless stated otherwise, all documentation required by these rules must comply with the agency documentation requirements described in OAR 411-323-0060. (10) ABUSE AND INCIDENT HANDLING AND REPORTING. (a) Complaints of abuse and the occurrence of serious incidents must be treated as described in OAR 411-323-0063. (b) NOTIFICATION OF SUBSTANTIATED ABUSE. (A) When a program provider receives notification of a substantiated allegation of abuse, the program provider must immediately give written notification to the following: (i) The person found to have committed abuse. (ii) The parent or guardian of the children receiving services in the Host Home. (B) A program provider's written notification of a substantiated allegation of abuse must include the following: (i) The type of abuse. (ii) When the allegation was substantiated. (iii) How to request a public record copy of the Abuse Investigation and Protective Services Report. (C) A program provider must have policies and procedures to describe how the program provider implements notification of substantiated abuse as described in this section. (11) NEED FOR SERVICES. A program provider must develop and implement written policies and procedures to review and document that each child receiving services in a Host Home continues to require the structure of services specifically available in a Host Home . The policies and procedures must include a frequency of review and address all of the following: (a) The child’s need for a formal Positive Behavior Support Plan based on the child’s Functional Needs Assessment, ISP, and Functional Behavior Assessment. (b) The child’s risk to self and others, including frequency of significant threats to safety as a result of the child’s actions or non-actions or serious behavioral incidents for the past 12 months. (c) The frequency of psychiatric hospitalization for the last 12 months, excluding initial assessment and evaluation. (d) The frequency and nature of community service response required as a result of the child’s behavior, including law enforcement and other emergency personnel, juvenile justice, and providers related to juvenile dependency for the past 12 months. (e) The child’s behavioral challenges, including if the behavior challenges continue to be a barrier to the child’s return to their family home. Statutory/Other Authority: ORS 409.050, 427.104, 441.715, 443.450 & 443.455 Statutes/Other Implemented: ORS 427.104, 441.705-441.720, 441.740, 441.745, 443.384, 443.392, 443.400-443.445, 443.450, 443.455, 443.880, 443.881 & 443.991 History: APD 36-2019, adopt filed 10/29/2019, effective 11/01/2019