reglab/housing_qa huggingface dataset:
OR Rev Stat § 414.665 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.665 - Traditional health workers utilized by coordinated care organizations; rules.

(1) As used in this section, "traditional health worker" includes any of the following: (a) A community health worker. (b) A personal health navigator. (c) A peer wellness specialist. (d) A peer support specialist. (e) A doula. (f) A tribal traditional health worker. (2) In consultation with the Traditional Health Workers Commission established under ORS 413.600, the Oregon Health Authority, for purposes related to the regulation of traditional health workers, shall adopt by rule: (a) The qualification criteria, including education and training requirements, for the traditional health workers utilized by coordinated care organizations; (b) Appropriate professional designations for supervisors of the traditional health workers; and (c) Processes by which other occupational classifications may be approved to supervise the traditional health workers. (3) The criteria and requirements established under subsection (2) of this section: (a) Must be broad enough to encompass the potential unique needs of any coordinated care organization; (b) Must meet requirements of the Centers for Medicare and Medicaid Services to qualify for federal financial participation; and (c) May not require certification by the Home Care Commission. [2011 c.602 §11; 2013 c.752 §4; 2017 c.618 §5; 2021 c.514 §3]
OR Rev Stat § 414.667 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.667 - Definition for ORS 414.667 to 414.669.

As used in ORS 414.667, 414.668 and 414.669, "doula" means an individual who meets criteria for a doula adopted by the Oregon Health Authority in accordance with ORS 414.665. [2017 c.281 §2]
OR Rev Stat § 414.668 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.668 - Access to doula services.

A coordinated care organization shall make information about how to access doula services available on a website operated by or on behalf of the coordinated care organization and shall provide the information in print whenever a printed explanation of benefits is available. [2017 c.281 §4]
OR Rev Stat § 414.669 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.669 - Payment for doula services.

The Oregon Health Authority, in coordination with the Traditional Health Workers Commission, shall in each even-numbered year review, and revise if necessary, any rates of reimbursement for doulas. When reviewing and revising rates of reimbursement, the authority shall consider factors including retention of doulas, access to culturally specific doulas and evidence-based factors and empirical studies related to the cost-effectiveness of services provided by doulas. [Formerly 414.768] Note: Sections 6 and 8, chapter 281, Oregon Laws 2017, provide: Sec. 6. (1) The Oregon Health Authority shall provide to the Oregon Health Policy Board and the Oregon Public Health Advisory Board, and shall make available free of charge on the primary website operated by or on behalf of the authority, a report on the status of doulas in this state. The report must include, but not be limited to, information on: (a) The number of claims for reimbursement of doulas submitted to the authority and the percentage of those claims that are reimbursed; (b) Any barriers experienced by doulas to accessing the claims process; (c) The annual increase or decrease in the number of doulas listed on a registry managed by the authority; (d) The demographics of the registry of doulas managed by the authority; (e) Doula training or certification programs offered in this state; (f) The relationship between the registry of doulas managed by the authority and the perceived doula workforce need; and (g) Recommendations on achieving cultural specificity goals for doula services. (2) The authority shall provide the report required by subsection (1) of this section annually beginning on September 15, 2018. [2017 c.281 §6] Sec. 8. Section 6 of this 2017 Act is repealed on January 1, 2024. [2017 c.281 §8]
OR Rev Stat § 414.672 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.672 - Tribal-based practices for mental health and substance abuse prevention, counseling and treatment.

A medical assistance program shall consider tribal-based practices for mental health and substance abuse prevention, counseling and treatment services for members who are Native American or Alaska Native as equivalent to evidence-based practices for purposes of meeting standards of care and shall reimburse for those tribal-based practices. [2019 c.364 §6]
OR Rev Stat § 414.679 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.679

[2011 c.602 §12; 2015 c.389 §11; 2019 c.280 §9; renumbered 414.607 in 2019]
OR Rev Stat § 414.685 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.685

[2011 c.602 §15; 2017 c.17 §34; renumbered 414.619 in 2019]
OR Rev Stat § 414.686 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.686 - Health assessments for foster children.

(1) A coordinated care organization shall provide an initial health assessment on any child enrolled in the coordinated care organization who is in the custody of the Department of Human Services no later than 60 days after the date that the Oregon Health Authority notifies the coordinated care organization that the child has been taken into the department’s custody. The assessment must be performed in accordance with metrics established by the metrics and scoring subcommittee created in ORS 414.638. (2) If a child has not received an initial health assessment by the date specified in subsection (1) of this section, the coordinated care organization shall act affirmatively to locate the child and make arrangements for an initial health assessment. [2017 c.277 §2]
OR Rev Stat § 414.688 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.688 - Commission established; membership.

(1) As used in this section: (a) "Practice of pharmacy" has the meaning given that term in ORS 689.005. (b) "Retail drug outlet" has the meaning given that term in ORS 689.005. (2) The Health Evidence Review Commission is established in the Oregon Health Authority, consisting of 13 members appointed by the Governor in consultation with professional and other interested organizations, and confirmed by the Senate, as follows: (a) Five members must be physicians licensed to practice medicine in this state who have clinical expertise in the areas of family medicine, internal medicine, obstetrics, perinatal health, pediatrics, disabilities, geriatrics or general surgery. One of the physicians must be a doctor of osteopathic medicine, and one must be a hospital representative or a physician whose practice is significantly hospital-based. (b) One member must be a dentist licensed under ORS chapter 679 who has clinical expertise in general, pediatric or public health dentistry. (c) One member must be a public health nurse. (d) One member must be a behavioral health representative who may be a social services worker, alcohol and drug treatment provider, psychologist or psychiatrist. (e) Two members must be consumers of health care who are patient advocates or represent the areas of indigent services, labor, business, education or corrections. (f) One member must be a complementary or alternative medicine provider who is a chiropractic physician licensed under ORS chapter 684, a naturopathic physician licensed under ORS chapter 685 or an acupuncturist licensed under ORS chapter 677. (g) One member must be an insurance industry representative who may be a medical director or other administrator. (h) One member must be a pharmacy representative who engages in the practice of pharmacy at a retail drug outlet. (3) No more than six members of the commission may be physicians either in active practice or retired from practice. (4) Members of the commission serve for a term of four years at the pleasure of the Governor. A member is eligible for reappointment. (5) Members are not entitled to compensation, but may be reimbursed for actual and necessary travel and other expenses incurred by them in the performance of their official duties in the manner and amounts provided for in ORS 292.495. Claims for expenses shall be paid out of funds available to the Oregon Health Authority for purposes of the commission. [2011 c.720 §22; 2017 c.409 §10]
OR Rev Stat § 414.689 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.689 - Members; meetings.

(1) The Health Evidence Review Commission shall select one of its members as chairperson and another as vice chairperson, for terms and with duties and powers the commission determines necessary for the performance of the functions of the offices. (2) A majority of the members of the commission constitutes a quorum for the transaction of business. (3) The commission shall meet at least four times per year at a place, day and hour determined by the chairperson. The commission also shall meet at other times and places specified by the call of the chairperson or of a majority of the members of the commission. (4) The commission may use advisory committees or subcommittees whose members are appointed by the chairperson of the commission subject to approval by a majority of the members of the commission. The advisory committees or subcommittees may contain experts appointed by the chairperson and a majority of the members of the commission. The conditions of service of the experts will be determined by the chairperson and a majority of the members of the commission. (5) The Oregon Health Authority shall provide staff and support services to the commission. [2011 c.720 §23; 2015 c.318 §22]
OR Rev Stat § 414.690 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.690 - Prioritized list of health services.

(1) The Health Evidence Review Commission shall regularly solicit testimony and information from stakeholders representing consumers, advocates, providers, carriers and employers in conducting the work of the commission. (2) The commission shall actively solicit public involvement through a public meeting process to guide health resource allocation decisions. (3) The commission shall develop and maintain a list of health services ranked by priority, from the most important to the least important, representing the comparative benefits of each service to the population to be served. The list must be submitted by the commission pursuant to subsection (5) of this section and is not subject to alteration by any other state agency. (4) In order to encourage effective and efficient medical evaluation and treatment, the commission: (a) May include clinical practice guidelines in its prioritized list of services. The commission shall actively solicit testimony and information from the medical community and the public to build a consensus on clinical practice guidelines developed by the commission. (b) May include statements of intent in its prioritized list of services. Statements of intent should give direction on coverage decisions where medical codes and clinical practice guidelines cannot convey the intent of the commission. (c) Shall consider both the clinical effectiveness and cost-effectiveness of health services, including drug therapies, in determining their relative importance using peer-reviewed medical literature as defined in ORS 743A.060. (5) The commission shall report the prioritized list of services to the Oregon Health Authority for budget determinations by July 1 of each even-numbered year. (6) The commission shall make its report during each regular session of the Legislative Assembly and shall submit a copy of its report to the Governor, the Speaker of the House of Representatives and the President of the Senate. (7) The commission may alter the list during the interim only as follows: (a) To make technical changes to correct errors and omissions; (b) To accommodate changes due to advancements in medical technology or new data regarding health outcomes; (c) To accommodate changes to clinical practice guidelines; and (d) To add statements of intent that clarify the prioritized list. (8) If a service is deleted or added during an interim and no new funding is required, the commission shall report to the Speaker of the House of Representatives and the President of the Senate. However, if a service to be added requires increased funding to avoid discontinuing another service, the commission shall report to the Emergency Board to request the funding. (9) The prioritized list of services remains in effect for a two-year period beginning no earlier than October 1 of each odd-numbered year. [2011 c.720 §24]
OR Rev Stat § 414.694 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.694 - Commission review of covered reproductive health services.

The Health Evidence Review Commission shall review the coverage described in ORS 743A.067 (2) and, no later than November 1 of each even-numbered year, report to the interim committees of the Legislative Assembly related to health any recommended changes to the coverage described in ORS 743A.067 (2) based upon the latest clinical research. [2017 c.721 §9] Note: 414.694 was enacted into law by the Legislative Assembly but was not added to or made a part of ORS chapter 414 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
OR Rev Stat § 414.695 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.695 - Medical technology assessment.

(1) As used in this section and ORS 414.698: (a) "Medical technology" means medical equipment and devices, medical or surgical procedures and techniques used by health care providers in delivering medical care to individuals, and the organizational or supportive systems within which medical care is delivered. (b) "Medical technology assessment" means evaluation of the use, clinical effectiveness and cost of a technology in comparison with its alternatives. (2) The Health Evidence Review Commission shall develop a medical technology assessment process. The Oregon Health Authority shall direct the commission with regard to medical technologies to be assessed and the timing of the assessments. (3) The commission shall appoint and work with an advisory committee whose members have the appropriate expertise to conduct a medical technology assessment. (4) The commission shall present its preliminary findings at a public hearing and shall solicit testimony and information from health care consumers. The commission shall give strong consideration to the recommendations of the advisory committee and public testimony in developing its assessment. (5) To ensure that confidentiality is maintained, identification of a patient or a person licensed to provide health services may not be included with the data submitted under this section, and the commission shall release such data only in aggregate statistical form. All findings and conclusions, interviews, reports, studies, communications and statements procured by or furnished to the commission in connection with obtaining the data necessary to perform its functions is confidential pursuant to ORS 192.338, 192.345 and 192.355. [2011 c.720 §25] Note: 414.695 to 414.701 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 414 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
OR Rev Stat § 414.698 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.698 - Comparative effectiveness of medical technologies.

(1) The Health Evidence Review Commission shall conduct comparative effectiveness research of medical technologies selected in accordance with ORS 414.695. The commission may conduct the research by comprehensive review of the comparative effectiveness research undertaken by recognized state, national or international entities. The commission may consider evidence relating to prescription drugs that is relevant to a medical technology assessment but may not conduct a drug class evidence review or medical technology assessment solely of a prescription drug. The commission shall disseminate the research findings to health care consumers, providers and third-party payers and to other interested stakeholders. (2) The commission shall develop or identify and shall disseminate evidence-based health care guidelines for use by providers, consumers and purchasers of health care in Oregon. (3) The Oregon Health Authority shall vigorously pursue health care purchasing strategies that adopt the research findings described in subsection (1) of this section and the evidence-based health care guidelines described in subsection (2) of this section. [2011 c.720 §26] Note: See note under 414.695.
OR Rev Stat § 414.701 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.701 - Commission may not rely solely on comparative effectiveness research.

The Health Evidence Review Commission, in ranking health services or developing guidelines under ORS 414.690 or in assessing medical technologies under ORS 414.698, and the Pharmacy and Therapeutics Committee, in considering a recommendation for a drug to be included on any preferred drug list or on the Practitioner-Managed Prescription Drug Plan, may not rely solely on the results of comparative effectiveness research. [2011 c.720 §26a] Note: See note under 414.695.
OR Rev Stat § 414.704 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.704 - Advisory committee.

The Health Evidence Review Commission shall consult with an advisory committee in determining priorities for mental health care and chemical dependency. The advisory committee shall include mental health and chemical dependency professionals who provide inpatient and outpatient mental health and chemical dependency care. [Formerly 414.730]
OR Rev Stat § 414.706 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.706 - Persons eligible for medical assistance; rules.

Within available funds and subject to the rules of the Oregon Health Authority, medical assistance shall be provided to an individual who is a resident of this state and who: (1) Is receiving a category of aid; (2) Would be eligible for a category of aid but is not receiving a category of aid; (3) Is required by federal law to be included in the state’s medical assistance program in order for that program to qualify for federal funds; and (4) Is not described in subsection (3) of this section but for whom federal funding is available under Title XIX or XXI of the Social Security Act. [2003 c.735 §3; 2009 c.867 §37; 2011 c.602 §41; 2013 c.688 §77]
OR Rev Stat § 414.709 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.709 - Adjustment of population of eligible persons in event of insufficient resources prohibited.

If insufficient resources are available during a biennium, the population of eligible persons receiving health services may not be reduced below the population of eligible persons approved and funded in the legislatively adopted budget for the Oregon Health Authority for the biennium. [2003 c.735 §4a; 2009 c.595 §321; 2013 c.688 §78]
OR Rev Stat § 414.710 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.710 - Services not subject to prioritized list.

The following services are not subject to ORS 414.690: (1) Nursing facilities, institutional and home- and community-based waivered services funded through the Department of Human Services; and (2) Services to children who are wards of the Department of Human Services by order of the juvenile court and services to children and families for health care or mental health care through the department. [1989 c.836 §3; 1991 c.67 §107; 1991 c.753 §5; 1993 c.815 §17; 1997 c.581 §25; 1999 c.1084 §52; 2005 c.381 §17; 2007 c.70 §195; 2009 c.595 §322; 2009 c.867 §45; 2011 c.720 §145]
OR Rev Stat § 414.717 (2021)
2021 Oregon Revised Statutes|Volume : 11 - Juvenile Code, Human Services|Chapter 414 - Medical Assistance|Section 414.717 - Palliative care program; rules.

(1) As used in this section: (a) "Interdisciplinary team" means a group composed of the following individuals who are trained or certified in palliative care: (A) A case manager who is a registered nurse licensed under ORS 678.010 to 678.410; (B) A medical social worker; and (C) A physician or other primary care provider. (b) "Palliative care services" includes: (A) Palliative care assessment; (B) Advanced care planning including a discussion regarding completing a POLST; (C) Case management and care coordination provided by a registered nurse in an interdisciplinary team; (D) Pain and symptom management; (E) Mental health and medical social work services; (F) Twenty-four hour clinical telephone support; (G) Spiritual care services; and (H) Other services prescribed by the Oregon Health Authority by rule. (c) "POLST" has the meaning given that term in ORS 127.663. (d) "Residential care facility" has the meaning given that term in ORS 443.400. (e) "Skilled nursing facility" has the meaning given that term in ORS 442.015. (2) The authority shall administer a program to provide palliative care services through coordinated care organizations. The authority shall adopt by rule the eligibility requirements and provider qualifications for the program including but not limited to all of the following: (a) A patient qualifies for palliative care services under the program if the patient: (A) Has been diagnosed with a serious illness with a life-limiting prognosis that negatively impacts the patient’s quality of life or the quality of life of the patient’s caregiver; and (B) Palliative care is ordered by the patient’s physician or other primary care provider. (b) The palliative care services, as determined and provided by an interdisciplinary team, must be provided in the patient’s choice of residence. (c) A provider of palliative care services under the program and a coordinated care organization shall determine the reimbursement paid for services by mutual agreement. (3) A residential care facility or a skilled nursing facility is not subject to the rules adopted by the authority under subsection (2) of this section in the provision or arrangement of palliative care services for residents of the facilities. [2021 c.462 §1] Note: 414.717 was enacted into law by the Legislative Assembly but was not added to or made a part of ORS chapter 414 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.