justicedao/ipfs_state_laws huggingface dataset:
333-021-0800 Administration of Vitamin K to Newborns (1) The purpose of ORS 433.303 to 433.314 is to protect newborn infants against Vitamin K Deficiency Bleeding (VKDB). (2) Physicians licensed under ORS chapters 677, 684 and 685 (medical, osteopathic, naturopathic and chiropractic physicians) or a midwife attending the mother at the birth of a child are responsible for ensuring that Vitamin K is administered to the newborn. The Vitamin K dose is to be administered within the first 24 hours after birth. If for any reason Vitamin K is not administered within 24 hours, it should be done at the earliest opportunity. A physician or midwife ensures that Vitamin K is administered to a newborn by: (a) Administering the Vitamin K themself; (b) Directing another person who is legally authorized and who is able to administer the Vitamin K; or (c) Referring the infant's family to a practitioner legally authorized to obtain and administer Vitamin K. (3) The appropriate dose of Vitamin K (phytonadione) for a newborn is 0.5 to 1.0 mg and the most effective procedure for administering is through a single intramuscular dose. Smaller, larger or additional doses may be administered on an individual basis as judged medically necessary. This rule is not intended to prevent a physician or midwife from ensuring that Vitamin K is administered by another method after seeking informed consent from the parent. (4) A parent may, after being provided a full and clear explanation, decline to permit the administration of Vitamin K. (a) The parent shall sign a form acknowledging understanding of the reason for administration of Vitamin K and possible adverse consequences. (b) A person must witness the explanation to the parent, and must also sign the form. (c) The form shall become a part of the medical record of the newborn infant. Statutory/Other Authority: ORS 433.312 Statutes/Other Implemented: ORS 433.303–433.314 History: PH 28-2017, amend filed 12/22/2017, effective 01/01/2018 HD 20-1984, f. & ef. 10-22-84
333-022-0200 HIV Testing and Confidentiality: Definitions For purposes of OAR 333-022-0205 through 333-022-0210, unless otherwise specified the following definitions shall apply: (1) "Division" means the Public Health Division within Oregon Health Authority. (2) “Health care provider” has the meaning given that term in ORS 433.045. (3) "HIV test" has the meaning given that term in ORS 433.045. (4) "HIV-positive test" means a positive result on the most definitive HIV test procedure used to test a particular individual. In the absence of any recommended confirming tests, this means the positive result of the initial test done. (5) “Insurance producer” has the meaning given that term in ORS 746.600. (6) “Insurance-support organization” has the meaning given that term in ORS 746.600. (7) “Insurer” has the meaning given that term in ORS 731.106. (8) "Licensed health care facility" means a health care facility as defined in ORS 442.015 and a mental health facility, alcohol treatment facility or drug treatment facility licensed or operated under ORS Chapters 426 or 430. (9) "Local public health administrator" has the meaning given that term in ORS 433.060. (10) “Local public health authority” has the meaning given that term in ORS 431.260. (11) “Next of kin” means an individual within the first applicable class of the following listed classes: (a) The spouse of the decedent; (b) A son or daughter of the decedent 18 years of age or older; (c) Either parent of the decedent; (d) A brother or sister of the decedent 18 years of age or older; (e) A guardian of the decedent at the time of death; (f) A person in the next degree of kindred to the decedent; (g) The personal representative of the estate of the decedent; or (h) The person nominated as the personal representative of the decedent in the decedent’s last will. (12) "Personal representative" means a person who has authority to act on behalf of an individual in making decisions related to health care. (13) "Substantial exposure" means an exposure to blood or certain body fluids that have a potential for transmitting the human immunodeficiency virus based upon current scientific information and may include but is not limited to contact with blood or blood components, semen, or vaginal/cervical secretions through percutaneous inoculation or contact with an open wound, non-intact skin, or mucous membrane of the exposed person. Statutory/Other Authority: ORS 433.045 - 433.080 Statutes/Other Implemented: ORS 433.006 & 433.065 History: PH 6-2013, f. & cert. ef 2-4-13
333-022-0205 HIV Testing, Notification, Right to Decline (1) Pursuant to ORS 433.045, a health care provider or the provider’s designee shall, before subjecting an individual to an HIV test: (a) Notify the individual being tested; and (b) Allow the individual being tested the opportunity to decline the test. (2) A health care provider or the provider’s designee may provide an individual notice and the opportunity to decline testing verbally or in writing, including providing the notice and the opportunity to decline in a general medical consent form. (3) Whenever an insurer, insurance producer or insurance-support organization asks an applicant for insurance to take an HIV test in connection with an application for insurance, the insurer, insurance producer or insurance-support organization must reveal the use of the test to the applicant and obtain the written consent of the applicant. The consent form must disclose the purpose of the test and to whom the results may be disclosed. (4) Anyone other than those listed in sections (1) through (3) of this rule who wishes to subject an individual to an HIV test must reveal the use of the test to the individual and obtain written consent of the individual for the HIV test. (5) If an individual is deceased, next of kin may consent to an HIV test pursuant to ORS 433.075. (6) If an individual is incapable of consenting to an HIV test, the individual’s personal representative may consent on the individual’s behalf. Statutory/Other Authority: ORS 433.045 – 433.080 Statutes/Other Implemented: ORS 433.045, 433.055(3), 433.065 & 433.075 History: PH 6-2013, f. & cert. ef 2-4-13
333-022-0210 Confidentiality (1) General. Pursuant to ORS 433.045, a person may not disclose or be compelled to disclose the identity of any individual upon whom an HIV test is performed or the results of such a test in a manner that permits identification of the subject of the test, except as required or permitted by federal law, the law of this state, or these rules, or as authorized by the individual who is tested. The prohibitions on disclosure do not apply to an individual acting in a private capacity and not in an employment, occupational or professional capacity. (2) Disclosure to or for a tested individual. The results of an HIV test may be disclosed to: (a) The tested individual; (b) The health care provider or licensed health care facility or person ordering the test; and (c) Any individual to whom the tested individual has authorized disclosure. (3) Medical records. When a health care provider or licensed health care facility obtains HIV test results of an individual, the test results may be entered into the routine medical record of that individual maintained by that health care provider or licensed health care facility. The information in the record may be disclosed in a manner consistent with ORS 192.553 to 192.581 and the Health Information Portability and Accountability Act (HIPAA) regulations, 45 CFR 160 to 164. (4) Public health purposes. (a) Anyone may report the identity and HIV-related test result of an individual to the local public health authority or Division for public health purposes. (b) The Division or local public health authority may inform an individual who has had a substantial exposure to HIV of that exposure if the Division or local public health authority determines that there is clear and convincing evidence that disclosure is necessary to avoid an immediate danger to the individual or to the public. (c) The Division or local public health authority may disclose the identity of an individual with an HIV-positive test to a health care provider for the purpose of referring or facilitating treatment for HIV infection. (d) The Division or local public health authority may only disclose the minimum amount of information necessary to carry out the purposes of the disclosure. (5) Anatomical donations. The identity of a HIV tested individual and that individual’s HIV test results may be released to a health care provider or licensed health care facility to the minimum extent necessary to make medical decisions concerning organ or tissue transplants. (6) Nothing in this rule is intended to limit the extent to which a licensed health care facility or health care provider can use or disclose HIV related health information in accordance with other state and federal laws. Statutory/Other Authority: ORS 433.008 & 433.045 Statutes/Other Implemented: ORS 433.045 – 433.080 History: PH 6-2013, f. & cert. ef 2-4-13
333-022-0305 Occupational and Health Care Setting Exposures: Petition for Mandatory Testing of Source Persons (1) If a worker has complied with the process established in OAR 333-022-0300 and a source person has refused to consent to an HIV test or has failed to obtain a test within the time period established in that rule, the worker may petition the circuit court for the county in which the exposure occurred and seek a court order for mandatory testing in accordance with ORS 433.080. (2) The form for the petition shall be as prescribed by the Division and shall be obtained from the LPHA. (3) The petition shall name the source person as the respondent and shall include a short and plain statement of facts alleging: (a) The petitioner is a worker subjected to an occupational exposure and the respondent is the source person; (b) The petitioner meets the definition of worker in ORS 433.060; (c) All procedures for obtaining the respondent’s consent to an HIV test as described in OAR 333-022-0300 have been exhausted by the petitioner and the respondent has refused to consent to the test, or within the time period prescribed in OAR 333-022-0300 has failed to submit to the test; (d) The petitioner has no knowledge that he or she has a history of a positive HIV test and has since the occupational exposure submitted a specimen for an HIV test to a laboratory certified to perform testing on human specimens under the Clinical Laboratory Improvement Amendments of 1988 (P.L. 100-578,42 U.S.C. 201 and 263(a))(CLIA).; and (e) The injury that petitioner is suffering or will suffer if the source person is not ordered to submit to an HIV test. (4) The petition shall be accompanied by the certificate of the LPHA declaring that, based upon information in the possession of the administrator, the facts stated in the allegations under subsections (3)(a), (b) and (c) of this rule are true. (5) A LPHA must provide the petitioner a certificate as described in section (4) of this rule and must appear at any court hearing on the petition in accordance with ORS 433.080(7). (6) The court is required to hold a hearing on the petition in accordance with ORS 433.080. Statutory/Other Authority: ORS 433.080 Statutes/Other Implemented: ORS 433.080 History: PH 6-2013, f. & cert. ef 2-4-13
333-022-0315 Occupational and Health Care Setting Exposures: Employer Program for Prevention, Education and Testing (1) Pursuant to ORS 433.075(4), where an employer provides a program of prevention, education and testing for HIV exposures for its employees, the program will be considered to be approved by the Division if employees receive counseling regarding HIV infection control, uniform body fluids precautions, sexual/needle-sharing abstinence and safer sex practices including advice about precautionary measures to be taken with partners at risk of exposure to HIV while test results are pending. (2) The Division may make the educational materials needed for such a program available to an employer who requests such materials in writing. (3) An employer that provides HIV testing to employees must use a laboratory certified to perform testing on human specimens under the Clinical Laboratory Improvement Amendments of 1988 (P.L. 100-578,42 U.S.C. 201 and 263(a))(CLIA). (4) If an employer does not have a testing program in place, the employer shall notify the exposed worker of a health care provider who will perform testing, or an exposed worker may seek medical treatment from a health care provider of his or her choice. Statutory/Other Authority: ORS 433.075 Statutes/Other Implemented: ORS 433.075 History: PH 6-2013, f. & cert. ef 2-4-13
333-022-1000 CareAssist: Purpose and Description of Program (1) The CAREAssist program is Oregon’s AIDS Drug Assistance Program (ADAP). The core purpose of CAREAssist is to ensure access to HIV-related prescription drugs to underinsured and uninsured individuals living with HIV/AIDS. CAREAssist also helps people living with HIV or AIDS pay for medical care expenses, including but not limited to medication, insurance premiums and medical services. The program is funded through Part B of the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87), which provides grants to states and territories. (2) The Oregon Health Authority (Authority) shall make funds available for the CAREAssist program as long as it continues to receive grant funds from the federal government. (3) If insufficient funds are available for the CAREAssist program the Authority may: (a) Modify group benefits for approved clients; and (b) Institute a waiting list in lieu of accepting applications. (4) Ryan White funds may not be used for any item or service if payment has been made, or can reasonably be expected to be made by another payment source. ADAP is a last-resort payment source. As such, the Authority may require the applicant or client to enroll in the most cost-effective insurance available, as determined by the Authority. If the client or applicant refuses to enroll in health insurance that the Authority has identified as the most cost-effective plan for which he or she is eligible, the Authority shall only provide assistance with the cost of HIV antiretroviral, Hepatitis antiviral and opportunistic infection-related medications as identified in the formulary. Statutory/Other Authority: ORS 413.042, 431.250 & 431.830 Statutes/Other Implemented: ORS 431.250 & 431.830 History: PH 23-2016, f. & cert. ef. 8-2-16 PH 30-2014, f. 11-10-14, cert. ef. 12-1-14, Renumbered from 410-121-3000 DMAP 5-2011, f. & cert. ef. 3-29-11, Renumbered from 333-012-0250 PH 25-2010(Temp), f. & cert. ef. 10-1-10 thru 3-29-11 PH 9-2005, f. 6-15-05, cert. ef. 6-21-05 HD 1-1990(Temp), f. & cert. ef. 1-8-90 HD 9-1988, f. 5-11-88, cert. ef. 5-12-88 HD 14-1987(Temp), f. & ef. 9-30-87
333-022-1010 CareAssist: Definitions (1) "AIDS" means acquired immunodeficiency syndrome. (2) "Authority" means the CAREAssist program, administered by the Oregon Health Authority. (3) "CAREAssist" includes benefits provided to clients under Bridge, UPP, Group 1 or Group 2 as those terms are used in OAR 333-022-1000 through 333-022-1170. (4) "CAREAssist formulary" or "formulary" means a list of medications available to enrolled clients of CAREAssist when the same drug or a therapeutically comparable medication is not available through the client’s primary health insurance. (5) "Federal Poverty Level" or "FPL" means the annual poverty income guidelines, published by the United States Department of Health and Human Services. (6) "Family" means all individuals counted by the Authority in determining the applicant’s or client’s family size. (7) "Monthly income" means the monthly average of any and all monies received on a periodic or predictable basis, which the family relies on to meet personal needs. (8) "Gross monthly income" means income before taxes or other withholdings. (9) "HIV" means the human immunodeficiency virus, the causative agent of AIDS. (10) "OHP" means the Oregon Health Plan. (11) "Oregon residency" means that an individual: (a) Has a physical location to reside in Oregon; and (b) Is in Oregon at least six months out of the year; and (c) Is not absent from Oregon more than three consecutive months; or (d) Is living out of state for more than three months due to temporary or seasonal employment outside of Oregon; or (e) Is living out of state for more than three months while attending an education institution full time. (12) "Refuses" means a client or applicant actively declines enrollment in the insurance identified by the Authority. (13) "Seasonal worker" means the applicant performs work cyclically during the year and most often the work is defined by seasons and typically defined by the calendar year. (14) "Special enrollment period" means a time period outside of open enrollment in which a client is eligible to apply for private insurance because they experienced a qualifying event as defined by the Affordable Care Act. (15) "UPP" means the CAREAssist Uninsured Persons Program. Statutory/Other Authority: ORS 413.042, 431.250 & 431.830 Statutes/Other Implemented: ORS 431.250 & 431.830 History: PH 23-2016, f. & cert. ef. 8-2-16 PH 30-2014, f. 11-10-14, cert. ef. 12-1-14
333-022-1020 CareAssist: Eligibility To qualify for the CAREAssist program an individual must: (1) Be HIV positive or have AIDS; and (2) Reside in Oregon; and (3) Have a monthly income based on family size which is at or below 550 percent of the FPL. Statutory/Other Authority: ORS 413.042, 431.250 & 431.830 Statutes/Other Implemented: ORS 431.250 & 431.830 History: PH 51-2022, amend filed 05/02/2022, effective 05/24/2022 PH 23-2016, f. & cert. ef. 8-2-16 PH 30-2014, f. 11-10-14, cert. ef. 12-1-14
333-022-1030 CareAssist: Application Process (1) An individual may apply for CAREAssist benefits by completing a form prescribed by the Authority and providing the documentation as instructed in the application so that the Authority can verify that the applicant: (a) Has tested positive for HIV or has AIDS; and (b) Has a monthly income based on family size at or below 550 percent of the FPL; and (c) Is a resident of Oregon. (2) An applicant must sign an authorization that permits the Authority to contact and exchange information with the applicant’s health care providers, insurers, and any other individual or entity necessary to determine the applicant’s eligibility for CAREAssist, process payments and facilitate care coordination for the client. Statutory/Other Authority: ORS 413.042, 431.250 & 431.830 Statutes/Other Implemented: ORS 431.250 & 431.830 History: PH 51-2022, amend filed 05/02/2022, effective 05/24/2022 PH 23-2016, f. & cert. ef. 8-2-16 PH 30-2014, f. 11-10-14, cert. ef. 12-1-14
333-022-1050 CareAssist: Approval or Denial of Application (1) If the Authority determines that an applicant is eligible for CAREAssist benefits the applicant shall be notified in writing within 14 calendar days of the Authority’s determination and be assigned to a benefit group as follows: (a) Group 1: Clients who are enrolled in a private, group or individual insurance policy. (b) Group 2: Clients whose primary prescription benefits are provided by OHP or the Department of Veterans Affairs (VA). (2) A client’s notification must describe: (a) The eligibility effective date and end date; (b) Group number and benefits associated with that group; (c) A list of CAREAssist in-network pharmacies; (d) Recertification date and process; and (e) The repercussions of not recertifying. (3) CAREAssist eligibility is for six months. (4) If the Authority determines that an applicant is not eligible for CAREAssist benefits an applicant shall be notified in writing in accordance with ORS 183.415. (5) An applicant who has been denied may reapply at any time. Statutory/Other Authority: ORS 413.042, 431.250 & 431.830 Statutes/Other Implemented: ORS 431.250 & 431.830 History: PH 23-2016, f. & cert. ef. 8-2-16 PH 30-2014, f. 11-10-14, cert. ef. 12-1-14
333-022-1060 CareAssist: Group 1 and 2 Benefits (1) Group 1 and 2 clients are eligible for assistance with: (a) The cost of health insurance premiums if applicable, provided the coverage, at a minimum includes pharmaceutical benefits equivalent to the HIV antiretroviral and opportunistic infection-related medications on the CAREAssist formulary as well as coverage for other essential medical benefits as defined by the Affordable Care Act. (b) Copays, coinsurance and deductibles on prescription drugs covered by the client’s primary health insurance, with the exception of medications prescribed to treat erectile dysfunction. (c) Copays, coinsurance and deductibles on medical services covered by the client’s primary health insurance, up to a maximum amount set by the program each calendar year. Eligible medical services include but are not limited to laboratory tests, office visits, emergency room visits, X-rays, and hospital stays. (d) The full cost of CAREAssist formulary prescriptions, filled at an in-network pharmacy when: (A) The client has successfully enrolled in insurance but coverage is not yet active; or (B) The client’s insurance policy does not cover the cost of the prescription; and (C) The prescribing provider submitted a Prior Authorization Request to the client’s primary insurance, the request was denied and there is no acceptable therapeutic substitution. (e) Prescription drugs if the required copay exceeds the cost of the prescription medication and the insurance policy therefore does not pay. (f) Medication therapy management. (2) CAREAssist clients who smoke or chew tobacco may be eligible to receive additional and enhanced services from the Oregon Tobacco Quit Line (1-800-QUIT-NOW), if funding is available. (3) A client on restricted status may not be entitled to some of the benefits described in section (1) and (2) of this rule. (4) The Authority shall only make payments directly to a service provider or benefits administrator. No reimbursements or direct payments may be made to a client or an individual who pays on behalf of a client. Statutory/Other Authority: ORS 413.042, 431.250 & 431.830 Statutes/Other Implemented: ORS 431.250 & 431.830 History: PH 30-2014, f. 11-10-14, cert. ef. 12-1-14
333-022-1070 CareAssist: Prescriptions (1) Unless an exception applies under subsections (3)(a) or (b) of this rule, CAREAssist clients must use an Authority-approved CAREAssist in-network pharmacy for all: (a) Medications not designated as acute on the CAREAssist formulary; (b) Chronic care medications; and (c) Medications paid for in full by the Authority (2) The Authority must provide to each client a list of approved pharmacies and post the information on the CAREAssist website. (3) A CAREAssist client may use a non-CAREAssist in-network pharmacy if: (a) His or her insurance carrier requires use of a pharmacy that is not a CAREAssist in-network pharmacy; and (b) He or she has provided the Authority with a copy of the insurance summary of benefits for that insurance plan and the requirement to use a non-CAREAssist in-network pharmacy is explicitly stated in that insurance summary. Statutory/Other Authority: ORS 413.042, 431.250 & 431.830 Statutes/Other Implemented: ORS 431.250 & 431.830 History: PH 30-2014, f. 11-10-14, cert. ef. 12-1-14