411-348-0390 Entry, Exit, Transfer, and Closure (1) NON-DISCRIMINATION. A child may not be denied services in a Host Home or otherwise discriminated against on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin, marital status, age, disability, source of income, duration of Oregon residence, or other protected classes under federal and Oregon Civil Rights laws. (2) ELIGIBILITY. A child who enters a Host Home is subject to eligibility as described in this section. To be eligible for services in a Host Home, a child must meet the following requirements: (a) Be an Oregon resident who meets the residency requirements in OAR 461-120-0010. (b) Be receiving: (A) A Medicaid Title XIX benefit package through OSIPM or HSD medical programs; or (B) A benefit package through the Healthier Oregon medical program. (c) Be determined eligible for: (A) Developmental disabilities services by the CDDP of the county of origin as described in OAR 411-320-0080; or (B) Services for Aging and People with Disabilities as described in OAR chapter 411, division 015. (d) Meet the level of care as defined in OAR 411-317-0000. (e) Not receive other Department-funded in-home, community living support, or other services in another residential setting. (f) Be determined through the Department's approved assessment process to require the structure and service delivery specific to a Host Home. (3) ENTRY. (a) A program provider considering a child for entry into a Host Home must: (A) Provide notification and obtain approval from the Department prior to the placement of a child into a Host Home. (B) Be prior authorized to provide Medicaid-funded services to the child if the child is not private pay. (C) Receive written permission from the Department prior to: (i) A child under age 18 moving into a Host Home with individuals age 18 or older; or (ii) An individual who turns 18 and continues to reside in a Host Home with children under the age of 18. (D) Gather sufficient information to make an informed choice about the ability of the program provider and in-residence caregiver to safely and adequately support the child. (b) A program provider must participate in an entry meeting with a child's case manager prior to delivering services to the child for services to be funded in a Host Home. (c) Prior to or upon an entry, a program provider must demonstrate diligent efforts to acquire the following information about the child from the referring case management entity: (A) A copy of the eligibility determination document. (B) A statement indicating the safety skills, including the ability of the child to evacuate from a building when warned by a signal device and adjust water temperature for bathing and washing. (C) A brief written history of any behavioral challenges, including supervision and support needs. (D) Medical insurance information and the child’s medical card. (E) A medical history and information on health care supports that includes (when available): (i) The results of the most recent physical exams or well-child exams; (ii) The results of any dental evaluation; (iii) A record of immunizations; (iv) A record of known communicable diseases and allergies; (v) A record of major illnesses and hospitalizations; (vi) A record of mental health diagnosis and treatment plans, if applicable; and (vii) Any additional medical documentation relevant to the child’s current care needs. (F) A written record of any current or recommended medications, treatments, diets, and aids to physical functioning. (G) A copy of the most recent functional needs assessment and previous functional needs assessment if the needs of the child have changed over time. (H) Copies of protocols, the risk tracking record, and any support documentation (if available). (I) Copies of documents relating to the guardianship, conservatorship, health care representation, power of attorney, court orders, probation and parole information, or any other legal protections or restrictions on the rights of the child (if applicable). (J) Written documentation that the child is participating in out of residence activities, including public school enrollment. (K) Written documentation to explain why preferences of the child or the child’s parent or guardian may not be implemented. (L) A copy of the most recent Functional Behavior Assessment, Positive Behavior Support Plan, ISP or Service Agreement, Nursing Service Plan, and Individualized Education Plan (if available). (d) If a child is being admitted from the child's family home and the information required in subsection (c) of this section is not available, the program provider must assess the child upon entry for issues of immediate health or safety and document a plan to secure the remaining information no later than 30 calendar days after entry. The plan must include a written justification as to why the information is not available. (e) A program provider retains the right to deny entry of any child if the program provider determines the support needs of the child may not be adequately or appropriately met by the program provider or for any other reason not specifically prohibited by these rules. (f) A program provider may not admit a child from another funding source without first determining that the service and safety needs of all children in a Host Home shall be maintained and there is prior written approval from ODDS. (4) VOLUNTARY TRANSFERS AND EXITS. (a) A program provider must promptly notify a child's case manager if the child’s parent or guardian gives notice of the intent to exit or abruptly exits services. A child’s parent or guardian is not required to give prior notice to a program provider if the child’s parent or guardian chooses to exit the child from the Host Home. (b) A program provider must notify a child's case manager prior to the voluntary transfer or exit of a child from the Host Home or services, even when the child enters into another Host Home operated by the same program provider. (c) Notification and authorization of the voluntary transfer or exit of the child must be documented in the record for the child. (d) A program provider is responsible for the provision of services until a child exits the Host Home when the exit is a voluntary exit from the Host Home. (5) INVOLUNTARY TRANSFERS AND EXITS. (a) A program provider must only transfer or exit a child involuntarily for one or more of the following reasons: (A) The behavior of the child poses an imminent risk of danger to self or others. (B) The child experiences a medical emergency that results in the child requiring substantially increased ongoing support that the program provider is unable to meet. (C) The service needs of the child exceed the ability of the program provider. (D) Payment is not available from Medicaid or other third-party reimbursement. (E) The program provider's license for the home is suspended, revoked, not renewed, or voluntarily surrendered. (F) The program provider’s Medicaid provider enrollment agreement or contract has been terminated. (G) The program provider’s certification or endorsement described in OAR chapter 411, division 323 is suspended, revoked, not renewed, or voluntarily surrendered. (b) NOTICE OF INVOLUNTARY REDUCTION, TRANSFER, OR EXIT. A program provider must not reduce services, transfer, or exit a child involuntarily without giving advance written notice 30 calendar days prior to the reduction, transfer, or exit. The notice of involuntary reduction, transfer, or exit must be provided to the child’s parent or guardian and case manager, except in the case of a medical emergency or when a child is engaging in behavior that poses an imminent danger to self or others in the Host Home as described in subsection (c) of this section. (A) The written notice must be provided on the applicable Department form and include: (i) The reason for the reduction, transfer, or exit; and (ii) The right of the child or the child’s parent or guardian on behalf of the child to a hearing as described in section (6) of this rule. (B) A notice is not required when a child’s parent or guardian requests the reduction, transfer, or exit. (c) A program provider may give advance written notice less than 30 calendar days prior to an exit or transfer only in a medical emergency or when a child is engaging in behavior that poses an imminent danger to self or others in the Host Home and undue delay in moving the child increases the risk of harm. The notice must be provided to the child’s parent or guardian and case manager immediately upon the program provider's determination of the need for a reduction, transfer, or exit. (d) A program provider must demonstrate through documentation, attempts to resolve the reason for the involuntary reduction, transfer, or exit, including consideration of alternatives to the reduction, transfer, or exit and engagement of the case manager in the process. (e) A program provider is responsible for the provision of services until the date of reduction, transfer, or exit identified in the notice, or when a child’s parent or guardian requests a hearing, until the hearing is resolved. (6) HEARING RIGHTS. (a) A child, or child’s parent or guardian on behalf of the child, must be given the opportunity for a hearing under ORS chapter 183 and OAR 411-318-0030 to dispute an involuntary reduction, transfer, or exit, except when a program provider's license is revoked, not renewed, voluntarily surrendered, or the program provider's Medicaid contract is terminated. (b) If a child’s parent or guardian requests a hearing within 15 calendar days after the date of the notice and requests continuation of services, the child must receive the same services until the hearing is resolved. (c) When a child has been given written notice less than 30 calendar days in advance of a reduction, transfer, or exit as described in section (5)(c) of this rule and the child’s parent or guardian has requested a hearing, the program provider must reserve the room of the child and deliver services according to the child’s needs until receipt of the Final Order. (d) A child’s parent or guardian may request an expedited hearing as described in OAR 411-318-0030. (7) EXIT MEETING. A program provider must participate in an exit meeting before any decision to exit a child is made, unless the exit meeting is waived in accordance with OAR 411-415-0080. (8) CLOSURE. A program provider must notify the Department and case management entity in writing prior to announcing a voluntary closure of a Host Home to a child and the child’s parent or guardian. (a) The program provider must give each child’s parent or guardian and the case management entity written notice 30 calendar days in advance of the planned closure, except in circumstances where undue delay might jeopardize the health, safety, or welfare of the children, the program provider, or in-residence caregiver. (b) If the program provider has more than one Host Home, a child may not be moved from one Host Home to another without: (A) Providing the child’s parent or guardian and the case management entity written notice 30 calendar days in advance of the planned move, unless prior approval is given and agreement obtained from the child’s parent or guardian and the case management entity, or when undue delay might jeopardize the health, safety, or welfare of the child, program provider, or in-residence caregiver; (B) Choice advising provided to the child and the child’s parent or guardian informing them of all alternative placement and service options available; and (C) All exit and entry requirements met in accordance with this rule. (c) A program provider must return the license for a Host Home to the Department if the Host Home closes prior to the expiration of the license. Statutory/Other Authority: ORS 409.050, 427.104, 441.715, 430.662, 443.450 & 443.455 Statutes/Other Implemented: ORS 409.010, 427.007, 427.104, 430.215, 430.610, 430.662, 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 53-2022, amend filed 12/14/2022, effective 12/15/2022 APD 34-2022, temporary amend filed 07/01/2022, effective 07/01/2022 through 12/27/2022 APD 36-2019, adopt filed 10/29/2019, effective 11/01/2019