justicedao/ipfs_state_laws huggingface dataset:
411-039-0240 Civil Penalties (1) An Agency with Choice that violates applicable laws, rules, or a final order as determined by the Department, may be subject to the imposition of a civil penalty not to exceed $1,000 per violation. (2) An Individual or entity who operates an AWC without a license is subject to the imposition of a civil penalty not to exceed $1,000 a day per violation. (3) Violates applicable, but is not limited to: (a) Failure to provide a written disclosure statement to the Individual or the representative prior to Agency with Choice Services being rendered; (b) Failure to provide the contracted Agency with Choice Services; (c) Failure to correct deficiencies identified during a program review or Critical Incident investigation; or (d) Refusal to allow access and program review. (4) In determining the amount of a civil penalty, the Department must consider whether: (a) The Department made repeated attempts to obtain compliance; (b) The Licensee has a history of non-compliance with licensing laws and rules; (c) The violation poses a serious risk to the public’s health; and (d) There are mitigating factors, such as a Licensee’s cooperation with an investigation or actions to come into compliance. (5) The Department must document its consideration of the factors in section (4) of this rule. (6) Each day a violation continues is an additional violation. (7) A civil penalty imposed under this rule must comply with ORS 183.746. Statutory/Other Authority: Or Laws 2024, ch. 37 Statutes/Other Implemented: ORS 124.050 & Or Laws 2024, ch. 37 History: APD 17-2025, adopt filed 12/10/2025, effective 12/15/2025
411-039-0250 Conditions (1) Conditions may be attached to a license and take effect immediately upon issuance by the Department. The type of condition attached to a license must directly relate to a risk of harm or potential risk of harm to Individuals. Conditions may be attached upon a finding that: (a) Information on the application or initial program review requires a condition to protect the health, safety, or welfare of the Individuals; (b) A threat to the health, safety, or welfare of an Individual exists; (c) There is reliable evidence of Abuse, neglect, or exploitation; and (d) The Agency with Choice is not being operated in compliance with these rules. (2) Examples of conditions that may be imposed on a Licensee include, but are not limited to: (a) Restricting the total number of Individuals served based on the Agency with Choice ability to meet the health and safety needs includes restricting new admissions when a threat to the current Individuals exists and adding new Individuals would compound that threat. (b) Requiring additional qualifications or training of Licensee and staff. (3) The Department must notify the Licensee in writing of any conditions imposed, the reason for the conditions, and be given an opportunity to request a hearing under Oregon Laws 2024, chapter 37, section 1 (13). A Licensee must request a hearing in writing within 21 calendar days after the date the notice was personally served or mailed. Conditions take effect immediately and are a final order of the Department unless later rescinded. (4) In addition to, or in-lieu of, a contested case hearing, a Licensee may request an informal conference with the Department to discuss conditions imposed. The informal conference does not diminish the Licensee's right to a hearing. (5) Conditions imposed remain in effect, until the Department has sufficient cause to believe the situation that warranted the condition has been remedied. If the Licensee believes the situation that warranted the condition has been remedied, the Licensee may request in writing to the Department that the condition be removed. (6) Conditions must be posted with the license in a prominent place in the Agency with Choice and be available for inspection at all times. Statutory/Other Authority: Or Laws 2024, ch. 37 Statutes/Other Implemented: ORS 124.050 & Or Laws 2024, ch. 37 History: APD 17-2025, adopt filed 12/10/2025, effective 12/15/2025
411-039-0260 Denial, Suspension or Revocation of License (1) The Department may deny, suspend, or revoke the license of an Agency with Choice, in accordance with Oregon Laws 2024, chapter 37, section 1 (13), for the Agency with Choice’s failure to comply with these rules or if a Licensee or Administrator of the Agency with Choice permits, aids, or abets any illegal act affecting the welfare of an Individual. (2) This section does not supersede or limit any other authority of the Department with regarding oversight of contracting entities or the imposition of civil penalties. (3) If the Department intends to suspend, revoke, or deny an Agency with Choice license, it must do so in accordance with ORS 183.411 through 183.470. (4) At any time, the Department may issue a Notice of Emergency License Suspension under ORS 183.430(2). Statutory/Other Authority: Or Laws 2024, ch. 37 Statutes/Other Implemented: ORS 124.050 & Or Laws 2024, ch. 37 History: APD 17-2025, adopt filed 12/10/2025, effective 12/15/2025
411-039-0270 Financial Transparency and Reporting Requirements (1) The rate paid to the Agency with Choice requires that: (a) The Agency with Choice will ensure that no less than 85 percent of the total payments to the Agency with Choice is spent on total compensation for Direct Support Workers who furnish those services. For the purpose of these rules, total compensation includes wages and benefits including, but not limited to, health insurance, retirement plans, life and disability insurance, paid time off, mileage, employer employment taxes, employee employment taxes, employee required training, and workers compensation; and (b) The amount for administration and overhead may not exceed 15 percent of the rate paid to the Agency with Choice by the Department. (2) Any rate increase provided by the Department requires the Agency with Choice to maintain the 85 percent direct care worker compensation and benefits threshold. (3) The Agency with Choice must ensure that any increase intended to improve Direct Support Workers’ compensation must be fully passed on to Direct Support Worker compensation and benefits. (4) The Agency with Choice must file annually with the Department detailed cost reports based on the Agency with Choice’s reporting period for the period ending each June 30th, and as requested by the Department. The Agency with Choice must submit the cost report no later than October 31st of each year. (5) The required cost report details include the following Agency with Choice expenditures: (a) Average hourly wage provided to Direct Support Workers; (b) Total costs of Direct Support Worker wages and the hours provided to Individuals; (c) Total costs of Direct Support Worker benefits including the types of benefits offered; (d) Total costs for overtime of Direct Support Workers, the percentage of Direct Support Workers receiving overtime, and the average number of overtime hours worked per week; (e) Total costs for mileage reimbursement to Direct Support Workers; (f) Supervisor and trainer wages, benefits and other expenses; (g) Administrative costs and hours including CEO compensation; and (h) Other overhead including, but not limited to, details on building, IT and corporate costs. (6) The Agency with Choice must provide early cost reports if any of the following is true: (a) The cost report is requested by the Department; (b) There is a change of ownership; or (c) The Agency with Choice’s license is terminated or expired. Statutory/Other Authority: Or Laws 2024, ch. 37 Statutes/Other Implemented: ORS 124.050 & Or Laws 2024, ch. 37 History: APD 17-2025, adopt filed 12/10/2025, effective 12/15/2025
411-040-0000 Purpose and Scope (1) Medicaid home delivered meals may be provided to eligible seniors and people with disabilities as part of a Medicaid long term care services plan to assist a participant to remain in their own home. Provision of home delivered meals reduces the reliance on paid staff during some meal times. (2) Home delivered meals are available to eligible participants who choose to receive these services in lieu of meal preparation services. Statutory/Other Authority: ORS 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 410.070 History: APD 14-2014, f. & cert. ef 6-4-14 SPD 44-2013, f. 12-13-13, cert. ef. 12-15-13 SPD 14-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13 Reverted to SPD 12-2004, f. & cert. ef. 6-1-04 SPD 26-2011(Temp), f. & cert. ef. 12-20-11 thru 6-13-12 SPD 12-2004, f. & cert. ef. 6-1-04 SSD 11-1982, f. & ef. 10-1-82
411-040-0010 Definitions Unless the context indicates otherwise, the following definitions apply to the rules in OAR chapter 411, division 040: (1) "Approved Carrier" means the United States Postal Service, or other carrier, who can ensure providers have passed criminal background checks to protect the well-being of the Medicaid eligible participant. Use of an Approved Carrier must be approved by the Department, Aging and People with Disabilities or the Area Agency on Aging (AAA). (2) “Client Liability” means the dollar amount participants with excess income must contribute to the cost of service pursuant to OAR 461-160-0610 and 461-160-0620. (3) "Department" means the Department of Human Services (DHS). (4) "Homebound" means that leaving home is a significant effort to the point that leaving home unassisted is not normally possible. (5) "Home Delivered Meals" means meals that are delivered to a Medicaid eligible participant in their own home or apartment per 411-040-0035 of this rule. (6) "Meal preparation" means safely preparing food as defined in 411-015-0007(6). (7) "Medicaid eligible individual" means a participant who meets the eligibility criteria defined in OAR 411-015-0000 through 411-015-0100. (8) "Medicaid Home Delivered Meal Provider" means an approved home delivered meal provider that meets the qualifications in these rules and has an active Medicaid provider number. (9) "Natural Supports" means resources and supports (e.g. relatives, friends, significant others, neighbors, roommates, or the community) who are willing to voluntarily provide services to an individual without the expectation of compensation. Natural supports are identified in collaboration with the individual and the potential "natural support". The natural support is required to have the skills, knowledge and ability to provide the needed services and supports. (10) "Nutrition education" means a program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to participants, caregivers, or participants and caregivers in a group or individual setting overseen by a dietitian or individual of comparable expertise. (11) “Nutrition screening survey" means the act of screening a participant’s nutrition risk. (12) "Participant" means a Medicaid eligible individual receiving Medicaid home delivered meals. (13) "Provider" means Medicaid home delivered meal provider. Statutory/Other Authority: ORS 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 410.070 History: APD 14-2014, f. & cert. ef 6-4-14
411-040-0020 Client Eligibility and Responsibilities (1) To be eligible for Medicaid home delivered meals a participant must: (a) Be Medicaid eligible per 411-015-0100, and be receiving Medicaid long term services and supports in their own home; (b) Be home-bound; (c) Be unable to do meal preparation on a regular basis without assistance; and (d) Not have natural supports available that are willing and able to provide meal preparation services. (2) To remain eligible for home delivered meals, participants are responsible for payment of their specified monthly client liability amount so home-delivered meals can be authorized. (3) If the participant is determined ineligible for Medicaid home delivered meals, but needs food assistance, the case manager shall refer the participant to the nearest Aging and Disability Resource Connection for assistance. Statutory/Other Authority: ORS 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 410.070 History: APD 14-2014, f. & cert. ef 6-4-14
411-040-0030 Medicaid Home Delivered Meal Provider Qualifications and Responsibilities (1) To be in alignment with the provision of services, home delivered meal providers must have contracts with, or be, an AAA as defined in 411-002-0100(1). (2) The provider must be in compliance, during all stages of food service operation, with applicable federal, state and local regulations, codes, and licensor requirements relating to fire; health; sanitation; safety; building and other provisions relating to the public health, safety, and welfare of meal patrons. (3) The provider must demonstrate that menu standards are developed to sustain and improve a participant’s health through the provision of safe and nutritious meals that are approved by a dietician. (4) Each provider must be an enrolled Medicaid provider approved to provide Medicaid home delivered meals. (5) The provider must ensure that all requirements in OAR 411-040-0035 through 411-040-0037 are met. (6) Providers must ensure that anyone who delivers meals: (a) Have passed a background check as defined in OAR 407-007-0275; or (b) Uses an approved carrier. (7) All requests for Medicaid home delivered meals received by the provider must be referred to the Department or the Medicaid AAA office for prior authorization. (8) Meal providers must not solicit program income or voluntary donations from Medicaid eligible participants. Statutory/Other Authority: ORS 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 410.070 History: APD 14-2014, f. & cert. ef 6-4-14
411-040-0035 Meal Requirements (1) Each meal served must meet the current United States Department of Agriculture and Health and Human Services Dietary Guidelines and contain at least 33-1/3 percent of the current Dietary Reference Intakes as established by the Food and Nutrition Board of the National Academy of Science-National Research Council. (2) Foods must be prepared, served, and transported: (a) With the least possible manual contact; (b) With suitable utensils; and (c) On surfaces that have been cleaned, rinsed, and sanitized to prevent cross contamination prior to use. (3) Meals may be hot, cold, frozen, dried, or canned with a satisfactory storage life. (4) Meal frequency. (a) In areas where the frequency of serving meals five or more days per week is not feasible, per the area plan, nutrition providers have the ability to provide meals at less frequent intervals. (b) For participants whose case managers have assessed the participant as having low risks, during the Medicaid Risk Assessment process and as part of the individualized service plan, the provider may be authorized to provide frozen meals not to exceed 31 days’ worth of meals. (5) All providers will have a safety plan to ensure participants will receive meals during emergencies, weather-related conditions, and natural disasters. Plans could include, but are not limited to, shelf-stable emergency meal packages, four-wheel drive vehicles, and volunteer arrangements with other community resources. Statutory/Other Authority: ORS 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 410.070 History: APD 14-2014, f. & cert. ef 6-4-14
411-040-0036 Service Requirements (1) Except as provided in subsection (2), providers must provide: (a) In-person delivery whereby a paid staff or volunteer delivers the meal to the participant’s home. To the extent possible, the staff or volunteers must report any changes in participant’s condition or concerns to the participant’s case manager. (b) Nutrition screening survey. (A)The nutrition screening survey must be designed to indicate signs of poor nutritional health. In situations in which the screening shows that the individual has poor nutritional health, the provider will contact the participant’s Medicaid case manager. (B) Nutrition screening surveys will be completed at intake and at annual updates. (c) Nutrition education. (A) Nutrition education will be provided a minimum of one time per year. (B) Nutrition education is required to be offered at the first nutrition risk assessment. (2) In situations where the AAA has approved alternative delivery carriers, the home delivered meal provider must have weekly contact with the participant to determine if there are any changes in condition or concerns. Statutory/Other Authority: ORS 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 410.070 History: APD 14-2014, f. & cert. ef 6-4-14
411-040-0037 Staff and Volunteer Requirements (1) Prior to having direct contact with participants, staff and volunteers must successfully pass a criminal background check. (2) All staff and volunteers involved in food preparation will have training in: (a) Portion control; (b) FDA Food Code practices for sanitary handling of food; (c) Oregon food safety requirements; and (d) Agency safety policies and procedures. (3) All staff and volunteers having direct contact with a participant will have training in: (a) Protecting confidentiality; (b) How to report concerns, which may include: change of condition; self-neglect, and abuse, to appropriate staff for follow-up; and (c) When to report to the case manager any participants considered high risk, as a result of the nutrition risk assessment. Statutory/Other Authority: ORS 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 410.070 History: APD 14-2014, f. & cert. ef 6-4-14
411-040-0040 Provider Payment (1) Providers will be reimbursed on a per meal basis, no more than 1 meal per day within the month. (2) Provider rates will be published on the Department’s rate table. Statutory/Other Authority: ORS 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 410.070 History: APD 14-2014, f. & cert. ef 6-4-14
411-040-0050 Local Office Responsibility and Oversight (1) The Department shall establish, authorize, purchase, and monitor the standards for Medicaid paid home delivered meals. (2) Case managers must authorize Medicaid home delivered meal services. (3) Subsequent yearly nutrition education: (a) May be determined by local Medicaid home delivered meal providers; and (b) Will be monitored by the Medicaid case manager at least annually. (4) Provision of the home delivered meals reduces the need for reliance on paid staff during some meal times, so meal preparation hours in the service plan must be reduced. (5) The Department shall make payments to Medicaid paid home delivered meal providers for all home-delivered meals provided to participants. Statutory/Other Authority: ORS 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 410.070 History: APD 14-2014, f. & cert. ef 6-4-14
411-040-0060 Impact on Client Liability (1) The cost for home delivered meals shall be calculated into the service plan, in addition to in-home services provided by a client-employed provider or a home care agency. (2) Participants required to make a client contribution, under OAR 461-185-0050, must have their home-delivered meal costs added to cost of care calculations. Statutory/Other Authority: ORS 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 410.070 History: APD 14-2014, f. & cert. ef 6-4-14
411-044-0000 Purpose and Scope Lifespan respite care is a community-based system of accessible respite care services for any individual and/or family regardless of age, income, ethnicity, race, special need or situation. Lifespan respite care services can include providing respite-related information to the community, recruitment and training of paid and volunteer respite providers, connecting individuals and/or families with respite care providers and linking individuals and/or families with respite care payment resources. Statutory/Other Authority: ORS 409.050 & 409.474 Statutes/Other Implemented: ORS 409.450 – 409.478 History: Renumbered from 410-015-0000 by SPD 25-2006, f. 7-12-06 cert. ef. 7-14-06 Suspended by OMAP 4-1999, f. & cert. ef. 2-23-99 OMAP 42-1998(Temp), f. & cert. ef. 11-9-98 thru 5-8-99 OMAP 19-1998, f. & cert. ef. 5-4-98
411-044-0010 Definitions (1) "Department" means the Department of Human Services of the State of Oregon. (2) "Special Needs" may encompass physical, emotional, and/or mental illnesses and/or conditions an individual may experience which result in the need for ongoing care and supervision, such as: (a) Developmental disabilities; (b) Physical disabilities; (c) Mental illnesses; (d) Emotional and behavioral disorders; (e) Alzheimer's disease and related disorders; (f) Chronic illness; and (g) Medical fragility. (3) "Special Situations" may include: (a) A time in which a high risk of abuse and/or neglect may exist; and/or (b) Other circumstances as defined by the governing body of the community-based lifespan program. Statutory/Other Authority: ORS 409.050 & 409.474 Statutes/Other Implemented: ORS 409.450 – 409.478 History: Renumbered from 410-015-0010 by SPD 25-2006, f. 7-12-06 cert. ef. 7-14-06 Suspended by OMAP 4-1999, f. & cert. ef. 2-23-99 OMAP 42-1998(Temp), f. & cert. ef. 11-9-98 thru 5-8-99 OMAP 19-1998, f. & cert. ef. 5-4-98
411-044-0020 Application Procedures (1) The Department may solicit applications for the development and implementation of community-based lifespan respite care services systems. (2) Applicants shall be: (a) Private non-profit; (b) For profit; (c) Public agency; or (d) A coalition that has a designated fiscal agent. (3) Applicants shall submit the application before the closing date and time specified in the application procedure. (4) Applications shall contain at a minimum the following information: (a) The name, address and telephone number of the applicant organization; (b) The name, address and telephone number of the contact person; (c) The names, addresses and telephone numbers of community partners participating in the development and implementation of the lifespan respite care program representing children, adults, seniors, and individuals with special needs; (d) A projected budget detailing the project's financial needs, expenses, and other sources of support; and (e) Any other information requested by the Department in the application packet. Statutory/Other Authority: ORS 409.050 & 409.474 Statutes/Other Implemented: ORS 409.450 – 409.478 History: Renumbered from 410-015-0020 by SPD 25-2006, f. 7-12-06 cert. ef. 7-14-06 Suspended by OMAP 4-1999, f. & cert. ef. 2-23-99 OMAP 42-1998(Temp), f. & cert. ef. 11-9-98 thru 5-8-99 OMAP 19-1998, f. & cert. ef. 5-4-98