justicedao/ipfs_state_laws huggingface dataset:
309-013-0085 Reporting of Suspected Fraud and Embezzlement (1) Upon discovery, all cases of suspected fraud and embezzlement related to the central office shall be referred, along with all related information, to the Administrator. The Administrator shall review the case, call upon appropriate sources to investigate, and notify appropriate authorities. (2) In case of suspected fraud or embezzlement involving a state institution, the superintendent of the institution shall review the case, call upon appropriate sources to investigate, and notify appropriate authorities. All cases under review shall be reported to the Administrator. (3) Each service provider contracting with the Division shall report in writing the details of all cases of suspected fraud and embezzlement involving its employees and/or the employees of its subcontractors to the Division’s Administrator not later than one working day after the date the alleged activity comes to their attention. The report shall describe the incident and action being taken to resolve the problem. Statutory/Other Authority: ORS 179.040 & 413.042 Statutes/Other Implemented: ORS 430.021 History: MHD 18-1982, f. & ef. 8-6-82
309-013-0090 Investigation of Suspected Fraud and Embezzlement (1) In cases of suspected fraud and embezzlement involving funds and resources of the Division: (a) The Administrator shall begin the investigation immediately and may, in the course of investigation, call upon the services of appropriate law enforcement agencies, the Attorney General, the Division Audit Unit, and/or other who may be of assistance in developing the case; (b) A service provider which has contracted with the Division is responsible for developing cases of suspected fraud and embezzlement involving its employees and/or the employees of its subcontractors, and is responsible for referral to the proper authorities. However, the Division may assume control of any case not handled to the Division’s satisfaction. (2) In cases of suspected fraud and embezzlement which do not involve funds and resources of the Division: (a) The aggrieved parties shall seek their own resolution, and the Division will not become involved in development of the case or prosecution, except it may intervene in cases involving resources of clients of service providers; (b) The Division shall review the case to determine whether the lack of internal controls which allowed fraud or embezzlement to occur might also endanger Division resources. If that possibility exists, the service provider shall be required to adopt and follow procedures which the Division decides are needed to minimize chances for recurrence of the fraud or embezzlement. Failure of the service provider to adopt and follow such procedures shall constitute grounds for refusing to contract with the service provider in the future, and for terminating the existing contract. Statutory/Other Authority: ORS 179.040 & 413.042 Statutes/Other Implemented: ORS 430.021 History: MHD 18-1982, f. & ef. 8-6-82
309-013-0095 Consequences of Failure to Adopt Procedures Failure of a service provider to adopt and follow procedures which the Division decides are needed to minimize chances for fraud and embezzlement of Division resources shall constitute grounds for terminating any contract between the Division and that service provider. If the service provider is a subcontractor of a service provider contracting with the Division, then such failure on the part of the subcontractor shall constitute grounds for stipulation by the Division that no Division managed funds be used for payment to that subcontractor. Statutory/Other Authority: ORS 179.040 & 413.042 Statutes/Other Implemented: ORS 430.021 History: MHD 18-1982, f. & ef. 8-6-82
309-013-0100 Disclosure Requirement Disclosure must be made to the Division before a contract is entered into, or at the time it becomes known, of the name of any person who has ownership or control interest of five percent or more, or is an officer, director, agent, or managing employee, and has been convicted of a criminal offense related to the involvement of such person in any such program, including theft of patient funds. Failure to make this disclosure shall constitute grounds for terminating that contract. Statutory/Other Authority: ORS 179.040 & 413.042 Statutes/Other Implemented: ORS 430.021 History: MHD 18-1982, f. & ef. 8-6-82
309-013-0105 Disciplinary Action Fraud or embezzlement of Division resources and/or patient or resident funds committed by Division employees shall constitute grounds for disciplinary action. The type and extent of disciplinary action will be determined in accordance with the Division’s collective bargaining agreements and “Personnel Relations Law, Personnel Rules and Personnel Policies.” Notwithstanding any portion of these rules, existing agreements with unions representing the employee(s) involved, governing complaint investigation, shall be observed. Statutory/Other Authority: ORS 179.040 & 413.042 Statutes/Other Implemented: ORS 430.021 History: MHD 18-1982, f. & ef. 8-6-82
309-013-0120 Purpose and Statutory Authority (1) Purpose. These rules establish a Division procedure for audits of community mental health programs, mental health organizations and their subcontractors and vendors and any service provider agreeing to offer services through direct contract with the Division. These rules also establish basic record keeping standards for programs subject to audit under these rules, establish procedures for appealing audit findings, and set out a process to implement the findings of the final audit report. (2) Statutory Authority. These rules are authorized by ORS 179.040, 413.042 & 430.640 and are promulgated to enable the Division to carry out its responsibilities under ORS 414.018 to 414.024 and 430.610 through 430.695. Statutory/Other Authority: ORS 179.040, 413.042 & 430.640 Statutes/Other Implemented: ORS 414.018 & 430.610–430.695 History: MHD 15-1998, f. 8-12-98, cert. ef. 9-1-98, Renumbered from 309-013-0020 MHD 9-1978, f. & ef. 12-11-78
309-013-0140 Scope and Application of the Rule Under these rules, the Division may audit any service provider that provides any part of the community mental health program including the community mental health program itself, Mental Health Organizations providing services under the Oregon Health Plan including subcontractors and vendors providing mental health services, or any direct contractor. The scope of the audit shall include only Division funds or related matching funds. However, Division may include other funds in its tests to the extent necessary to audit Division funds or matching funds. These rules shall be read and applied consistently with OAR 309-014-0000 (Community Mental Health Contractors) or the Division of Medical Assistance Programs general rules (OAR 410-120-0000 through 410-120-1980) when these are applicable. Statutory/Other Authority: ORS 413.042 & 430.640 Statutes/Other Implemented: ORS 430.610–430.695 History: MHD 15-1998, f. 8-12-98, cert. ef. 9-1-98, Renumbered from 309-013-0020 MHD 9-1978, f. & ef. 12-11-78
309-013-0150 Revenue (1) A service provider shall maintain a revenue account for each income source which results from the operation of the service or is used to support the service. For example, separate revenue accounts shall be established for each service element for which the provider receives payment from Division or the Division of Medical Assistance Programs, direct federal payments, donations, fees, interest earned, rentals collected from subleases and parking lots, sales of capital equipment, training grants or any other source of income. (2) Only cash revenue may be used to match state funds unless the Division gives prior authorization in writing to use contributed services or property to match state funds. Statutory/Other Authority: ORS 179.040, 413.042 & 430.640 Statutes/Other Implemented: ORS 414.018 & 430.610–430.695 History: MHD 15-1998, f. 8-12-98, cert. ef. 9-1-98, Renumbered from 309-013-0020 MHD 9-1978, f. & ef. 12-11-78
309-013-0170 Audit Process and Reports (1) Any person, organization, or agency, including the Division, may request an audit of a community mental health program or any service provider offering a service thereunder or any direct contractor by submitting an audit request in writing to the Division Internal Audit Unit Coordinator. The request shall clearly identify the service provider to be audited, setting forth its name, location, program director, the period for which the audit is requested and the reason for the request. (2) The Internal Audit Unit Coordinator shall review the request and arrange for scheduling if an audit is considered appropriate. The Internal Audit Unit Coordinator shall notify appropriate Assistant Administrators of the audit schedule. (3) The Assistant Administrator of the Division for the Office of Finance has the discretion to notify the appropriate community mental health program director of the scheduled audit in advance. The Division retains the right to perform an audit without prior notice to the subject service provider. (4) Upon completion of the audit, the Internal Audit Unit Coordinator shall prepare a report setting forth the findings, recommendations, and auditee responses where applicable. Audit work papers shall be available showing the details of the audit findings. Statutory/Other Authority: ORS 179.040, 413.042 & 430.640 Statutes/Other Implemented: ORS 414.018 & 430.610–430.695 History: MHD 15-1998, f. 8-12-98, cert. ef. 9-1-98, Renumbered from 309-013-0020 MHD 9-1978, f. & ef. 12-11-78
309-013-0180 Disposition of Audit Findings (1) To the extent an audit documents non-allowable expenditures in non-capitated programs, the Division shall recover such funds. (2) To the extent an audit report evidences non-compliance with applicable program and/or licensing rules, the audit findings may be referred to the Administrator of the Division to assess civil penalties, where applicable, or for other corrective action deemed necessary by the program office. (3) Notwithstanding any other provisions of these rules, to the extent an audit report reveals non-compliance with Generally Accepted Accounting Principles or these rules, the Division may require corrective action to bring the deficiencies into compliance with state and federal rules and regulations. Non-compliance which results in substantial misrepresentation of financial activities may result in termination of the license and/or contract upon consultation with Division program offices and/or the local mental health authority. Statutory/Other Authority: ORS 179.040, 413.042 & 430.640 Statutes/Other Implemented: ORS 414.018 & 430.610–430.695 History: MHD 15-1998, f. 8-12-98, cert. ef. 9-1-98, Renumbered from 309-013-0020 MHD 9-1978, f. & ef. 12-11-78
309-013-0190 Provider Appeals (1) A provider may appeal certain decisions affecting the provider by making a written request to the Division Assistant Administrator for the Office of Finance. The request must state whether the provider wants an administrative review, and/or a contested case hearing, as outlined in the OMAP General Rules OAR 410-120-1560, Provider Appeals, through 410-120-1840, Provider Hearings-Role of Hearings Officer. If the subject service provider decides to appeal the audit, it shall set forth in writing the reasons for its appeal within 30 days of receipt of the report. (2) When the Division seeks to recover funds under these rules, the Division shall negotiate the terms and conditions of repayment with the audited service provider, after consultation with the community mental health program director or the MHO director (if applicable). Statutory/Other Authority: ORS 179.040, 413.042 & 430.640 Statutes/Other Implemented: ORS 414.018 & 430.610–430.695 History: MHD 15-1998, f. 8-12-98, cert. ef. 9-1-98, Renumbered from 309-013-0020 MHD 9-1978, f. & ef. 12-11-78
309-013-0200 Basic Accounting Records A service provider subject to audit under these rules shall maintain a chart of accounts that defines all items included in determining the cost for each service element. The chart of accounts shall list all revenues and expense accounts. The organization shall have bank deposit records and documentation to verify the source of revenue. Revenue and expense accounts, with related asset, liability, and equity accounts, shall account for all expenditures related to delivery of the service. All basic accounting records shall be retained for at least three years following the expiration of the contract or from the finalization of an audit including any appeal, whichever is later. Statutory/Other Authority: ORS 179.040, 413.042 & 430.640 Statutes/Other Implemented: ORS 414.018 & 430.610–430.695 History: MHD 15-1998, f. 8-12-98, cert. ef. 9-1-98, Renumbered from 309-013-0020 MHD 9-1978, f. & ef. 12-11-78
309-013-0210 Internal Controls Establishing and maintaining an internal control structure is the responsibility of the service provider. Effective internal controls are considered essential to achieving the proper conduct of business with full accountability for the resources made available. Internal controls shall be implemented and maintained to provide reasonable assurance that: (1) The provider identifies, assembles, classifies, records, analyzes, and reports its transactions in conformity with Generally Accepted Accounting Principles or appropriate regulatory requirements for preparing financial statements and other required financial reports; (2) Losses or misappropriations of assets due to errors or irregularities in processing transactions and handling the related assets are prevented or detected; (3) Noncompliance with applicable federal and state laws and rules and regulations and terms of the contract is prevented or detected; (4) State and federal funds are reasonably, prudently and economically spent; and (5) All costs are appropriately allocated among programs, departments, and other benefiting units. Statutory/Other Authority: ORS 179.040, 413.042 & 430.640 Statutes/Other Implemented: ORS 414.018 & 430.610–430.695 History: MHD 15-1998, f. 8-12-98, cert. ef. 9-1-98, Renumbered from 309-013-0020 MHD 9-1978, f. & ef. 12-11-78
309-013-0220 Independent Audit Reports The Division may, in its discretion, accept an independent audit, in lieu of a Division audit, if it determines the workpapers and procedures of the independent auditor meet Government Auditing Standards (where applicable), Generally Accepted Auditing Standards and other audit standards which may be adopted by the Division. Statutory/Other Authority: ORS 179.040, 413.042 & 430.640 Statutes/Other Implemented: ORS 414.018 & 430.610–430.695 History: MHD 15-1998, f. 8-12-98, cert. ef. 9-1-98, Renumbered from 309-013-0020 MHD 9-1978, f. & ef. 12-11-78
309-014-0000 Purpose and Statutory Authority (1) Purpose. These rules prescribe general administrative standards for Division community mental health programs. (2) Certificate Required: To receive a certificate for the provision of behavioral health treatment services a Community Mental Health Program must meet the criteria under OAR 309-008-0100 to 309-008-1600; in addition, the Opioid Treatment Program must: (3) Renewal: The renewal of a Certificate shall be governed by OAR 309-008-0100 to 309-008-1600. (4) Denial, Revocation, Nonrenewal, Suspension: The denial, revocation, nonrenewal, or suspension of a letter of approval or license for an opioid treatment program may be based on any of the grounds set forth in OAR 309-008-1100. Statutory/Other Authority: ORS 413.042 & 430.640 Statutes/Other Implemented: ORS 430.610 – 430.695 History: MHS 23-2016, f. & cert. ef. 12-1-16 MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00 MHD 14-1982, f. & cert. ef. 7-7-82, Sec. (3) thru (13) Renumbered to 309-014-0005 thru 309-014-0040 MHD 39, f. 5-20-76, cert. ef. 6-11-76
309-014-0010 Purpose of a Community Mental Health Program The purpose of a CMHP is to provide a system of appropriate, accessible, coordinated, effective, efficient safety net services to meet the mental health needs of the citizens of the community. Statutory/Other Authority: ORS 413.042 & 430.640 Statutes/Other Implemented: ORS 430.610 – 430.640 History: MHS 23-2016, f. & cert. ef. 12-1-16 MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00 MHD 14-1982, f. & ef. 7-7-82, Renumbered from 309-014-0000(4) MHD 39, f. 5-20-76, ef. 6-11-76
309-014-0015 Division Responsibility for Community Addictions and Mental Health The Division shall assist the local mental health authority in establishing and operating community mental health services and shall integrate such services with other mental health system components in the state by: (1) Assessing needs for community mental health services in the state. (2) Identifying priorities among needs and preparing state plans for community mental health disability services. (3) Conducting the Division's activities in the least costly and most efficient manner so that delivery of services to the mentally or emotionally disturbed, alcohol abuser, alcoholic, drug abuser and drug-dependent persons shall be effective, coordinated and integrated with other services within the Oregon Health Authority. (4) Obtaining resources and contracting with local mental health authorities for the operation of community mental health safety net service. (5) Subject to the availability of funds, providing public information, program consultation, technical assistance, and training concerning community mental health services. Statutory/Other Authority: ORS 413.042 & 430.640 Statutes/Other Implemented: ORS 430.610 – 430.640 History: MHS 23-2016, f. & cert. ef. 12-1-16 MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00 MHD 14-1982, f. & cert. ef. 7-7-82, Renumbered from 309-014-0000(4) & (7) MHD 39, f. 5-20-76, cert. ef. 6-11-76
309-014-0020 Program Director Qualifications (1) The CMHP Director shall be a full time employee of the local mental health authority or the public or private corporation operating the community mental health program; (2) The CMHP Director shall meet the following requirements: (a) Hold at least a master's degree in a behavioral, social, health science, special education, public administration, or human service administration; and (b) Have a minimum of five years of experience in human services programs, two of which are in community mental health and two of which are program managerial experience in human services; and (c) Present references documenting experience, training, and ability to manage a community mental health program. (3) When the position of community mental health program director becomes vacant, an interim director shall be appointed to serve until a permanent director is appointed. Statutory/Other Authority: ORS 413.042 & 430.640 Statutes/Other Implemented: ORS 430.610 – 430.640 History: MHS 23-2016, f. & cert. ef. 12-1-16 MHD 13-2000, f. 9-15-00, cert. ef. 9-16-00 MHD 8-2000(Temp), f. 3-20-00, cert. ef. 3-21-00 thru 9-16-00 MHD 14-1982, f. & cert. ef. 7-7-82, Renumbered from 309-014-0000(5), (6), (9), (10) & (12) MHD 39, f. 5-20-76, cert. ef. 6-11-76
309-014-0021 Management Functions (1) In addition to other duties as may be assigned in the area of developmental disability services, the CMHP shall, at a minimum, assure the following duties are performed: (a) Develop plans as may be needed to provide a coordinated and efficient use of resources available to serve people with developmental disabilities; (b) Develop positive and cooperative working relationships with families, advocates, service providers, the Division, and other state and local agencies with an interest in developmental disability services; (c) Assure collection and timely reporting of information as may be needed to conduct business with the Division, including but not limited to information needed to license foster homes, to collect federal funds supporting services, and to investigate complaints related to services or suspected individual abuse; and (2) Management Plan. The CMHP shall maintain a plan assigning responsibility for the management functions and duties described in this section. The community mental health program shall assure that the functions and duties are assigned to people who have the knowledge and experience necessary to perform them. Statutory/Other Authority: ORS 413.042 & 430.640 Statutes/Other Implemented: ORS 430.610 – 430.640 History: MHS 23-2016, f. & cert. ef. 12-1-16
309-014-0022 Contracts (1) In keeping with the principles of family support expressed in ORS 417.342, and notwithstanding 430.670(2) or 291.047(3), an entity operating a CMHP may purchase services for an individual from a service provider without first providing an opportunity for competition among other service providers if the service provider is selected by the individual, the individual’s family or the individual’s guardian, as long as the service provider has been approved by the Division to provide such service. (2) Limit on contract requirements. When a CMHP contracts with a public agency or private corporation for delivery of developmental disability services, the CMHP shall include in the contract only terms that are substantially similar to model contract terms established by the Division. The CMHP may not add contractual requirements, including qualifications for contractor selection, which are nonessential to the service element(s) being provided under the contract. The CMHP shall specify in contracts with service providers that disputes, which arise from these limitations, shall be resolved according to procedures contained in these rules. For purposes of this section, the following definitions apply: (a) "Model contract terms established by the Division" means all applicable material terms and conditions of the omnibus contract, as modified to appropriately reflect a contractual relationship between the service provider and the CMHP, and any other requirements approved by the Division as local options under procedures established in these rules. (b) "Substantially similar to model contract terms" means that the terms developed by the CMHP and the model contract terms require the service provider to engage in approximately the same type activity and expend approximately the same resources to achieve compliance. (c) "Nonessential to the service element(s) being provided" means requirements that are not substantially similar to model contract terms developed by the Division. Statutory/Other Authority: ORS 413.042 & 430.640 Statutes/Other Implemented: ORS 430.610 – 430.640 History: MHS 23-2016, f. & cert. ef. 12-1-16