reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 20 - ADULT PROTECTIVE SERVICES-GENERAL › Section 411-020-0120 - Facility Investigation, Documentation, and Notification

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Facility
			 investigations shall be objective, professional, and complete.
(2) A facility investigation shall be
			 conducted and documented when a resident of a facility licensed by APD is
			 reported to have been abused by a licensee, staff member, contractor or
			 volunteer of the facility.
(3)
			 Facility investigations may also occur when a facility resident is reported to
			 have been abused by an alleged perpetrator not employed, contracted or
			 supervised by the facility, to determine whether the licensee or facility staff
			 failed to protect the resident.
(4)
			 In completing a facility investigation, the APS worker must:
(a) Identify the alleged victim, the alleged
			 perpetrators, and any parties reported to have information relevant to proving
			 or disproving the allegation.
(b)
			 Conduct interviews with the parties described in section (a) above to gather
			 all relevant available evidence. Interviews shall be in person and unannounced
			 whenever possible. All interviews must be private unless the individual being
			 interviewed requests the presence of someone else. Any individuals listening to
			 the interview must be advised of the confidential nature of the
			 investigation.
(c) Obtain and
			 review any available and relevant documentary or physical evidence.
(d) Gather and include evidence relevant to
			 determining the conduct of the alleged perpetrators and severity of the risk or
			 outcome to the alleged victim.
(e)
			 The Department may photograph, or cause to have photographed, any alleged
			 victim for the purposes of preserving evidence of the alleged victim's
			 condition observed at the time of the investigation. The photographs shall be
			 considered records and subject to confidentiality rules.
(f) Create additional investigatory aids,
			 such as maps or drawings, that may aid in proving or disproving the
			 allegations.
(g) Maintain a record
			 of interviews and evidentiary review, in notes, recordings, photographs,
			 scanned documents, or other appropriate means.
(h) Determine the facts of the case based on
			 a fair and objective review of the available relevant evidence; and
(i) Conclude whether the preponderance
			 (majority) of the evidence indicates that abuse was substantiated or
			 unsubstantiated, that the evidence is inconclusive, or that the investigation
			 should be closed administratively without a determination.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 20 - ADULT PROTECTIVE SERVICES-GENERAL › Section 411-020-0121 - Administrative Closure

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Administrative closure is a mechanism by which a DHS supervisor or designee may
			 close an assigned investigation without the investigation reaching a conclusion
			 as to if abuse or self-neglect occurred.
(2) Administrative closure is applicable only
			 for specific administrative purposes when it is not feasible to reach an
			 evidentiary conclusion. It is not intended to replace "inconclusive" or
			 "unsubstantiated" findings, which are evidence-based conclusions. As
			 appropriate, protective services of assessment and intervention must be
			 provided.
(3) To qualify for
			 administrative closure, an investigation must be completed to the extent
			 necessary to determine that one or more of the following situations exist:
(a) The basis for assigning and conducting
			 the investigation is discovered to be invalid, because:
(A) The alleged victim does not meet
			 eligibility criteria under these rules.
(B) Additional information is discovered that
			 clearly indicates the report of abuse or self-neglect does not meet criteria
			 for an abuse investigation.
(C) The
			 alleged perpetrator is deceased or a minor.
(D) The reported abuse or self-neglect would
			 clearly lead to a repeat investigation. To qualify, the situation must be the
			 same abuse type, substantially the same allegations and involve the same
			 alleged victim and perpetrators as a currently open or a previous
			 investigation. A new assessment of the alleged victim must also indicate that
			 there has been no significant change in the alleged victim's capacity or risk
			 level since the previous investigation.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 20 - ADULT PROTECTIVE SERVICES-GENERAL › Section 411-020-0123 - Accessing Protected Health Information, including Records

Current through Register Vol. 63, No. 7, July 1, 2024
Protected health information from a health care provider may be
				obtained during an APS investigation either from a mandatory reporter
				performing that reporter's duties required by Oregon statute or as
				follows:
(1) DISCLOSURE BY HEALTH CARE
			 PROVIDER. A health care provider may disclose, in accordance with
			 45
			 CFR 164.512(j), protected
			 health information to APS to prevent or lessen a serious and imminent threat to
			 the health or safety of a person or the public if the health care provider, in
			 good faith, believes the disclosure is necessary to prevent or lessen the
			 threat. APS may request protected health information during a self-neglect or
			 abuse investigation under this provision to prevent or lessen a serious and
			 imminent threat.
(2) COMMUNITY
			 ABUSE INVESTIGATION. During an APS investigation into abuse in a
			 community-based setting where the process under section (1) of this rule does
			 not apply or is declined by the health care provider:
(a) CONSENT BY ALLEGED VICTIM. APS may obtain
			 an alleged victim's protected health information for an APS investigation with
			 the alleged victim's consent.
(b)
			 DECLINED CONSENT. If an alleged victim can make an informed choice and declines
			 to consent to APS obtaining protected health information, APS may not obtain
			 the alleged victim's protected health information beyond the information a
			 mandatory reporter is required to disclose.
(c) ALLEGED VICTIM INCAPABLE OF CONSENT. If
			 an alleged victim is an older adult and does not have the ability to make an
			 informed choice to consent to APS obtaining the alleged victim's protected
			 health information, and the alleged victim does not have a fiduciary or legal
			 representative that consents to APS accessing the alleged victim's protected
			 health information, or when the fiduciary or legal representative is an alleged
			 perpetrator and refuses to consent to APS accessing the alleged victim's
			 protected health information, then the following procedure must be followed in
			 order for APS to obtain the protected health information:
(A) APS must request that the appropriate law
			 enforcement agency submit a written request to the health care provider to
			 allow the law enforcement agency to inspect and copy, or otherwise obtain, the
			 protected health information.
(B)
			 APS shall inform the law enforcement agency that the written request must state
			 that an investigation into abuse is being conducted under ORS
			 124.070 (elder abuse) or ORS
			 441.650 (nursing facility
			 resident abuse).
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 20 - ADULT PROTECTIVE SERVICES-GENERAL › Section 411-020-0126 - Accessing Financial Records

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Financial records may be obtained from a financial institution during an APS
			 investigation into alleged abuse.
(2) DEFAULT STANDARD. APS may not request
			 financial records from a financial institution unless one of the following
			 exceptions applies and the corresponding procedures are followed:
(a) CUSTOMER AUTHORIZATION. APS may request
			 and receive financial records from a financial institution when the customer
			 authorizes such disclosure in accordance with ORS
			 192.593. The authorization must:
(A) Be in writing, signed, and dated by the
			 customer.
(B) Identify with detail
			 the records authorized to be disclosed.
(C) Name the Department or Area Agency on
			 Aging to whom disclosure is authorized.
(D) Contain notice to the customer that the
			 customer may revoke such authorization at any time in writing.
(E) Inform the customer as to the reason for
			 such request and disclosure.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 20 - ADULT PROTECTIVE SERVICES-GENERAL › Section 411-020-0130 - APS Risk Management

Current through Register Vol. 63, No. 7, July 1, 2024
(1) APS
			 risk management is the process by which APS provides short-term active
			 assessment and intervention to an alleged victim.
(2) Referral to APS risk management is
			 appropriate:
(a) After the abuse and
			 self-neglect investigation is completed.
(b) When the alleged victim would benefit
			 from protective services, but the situation does not meet criteria for an
			 investigation and all of the following apply:
(A) Assessment indicates the alleged victim
			 is at risk of serious harm.
(B) The
			 alleged victim is eligible for Adult Protective Services under OAR
			 411-020-0015.
(C) Continued protective services may reduce
			 the risk of harm.
(D) There is no
			 other source of case management or protective services available to the alleged
			 victim.
(c) When
			 otherwise directed by APD or AAA executive management to respond to reported
			 serious harm of a vulnerable adult.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 25 - INFORMATION AND REFERRAL SERVICES › Section 411-025-0000 - Information and Referral Service

Current through Register Vol. 63, No. 7, July 1, 2024
Information and Referral Service is defined as a service to be
				provided by the Seniors and People with Disabilities Division to adults 18
				years of age and older who request information and referrals regarding
				community, medical, and social resources which might be available to meet their
				need for such resources. Information and Referral Service:
(1) Shall be provided to persons who request
			 such service or to persons who request such service in behalf of other
			 persons.
(2) Shall be available
			 without regard to a person's eligibility for public assistance.
(3) Shall be available to the extent that the
			 sharing of such information does not violate any state or federal law or rule
			 regarding confidentiality.
(4)
			 Shall include a follow-up with those community, medical, and social resources
			 which provide or make available such services to meet the person's
			 request.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 26 - GUARDIANSHIPS AND CONSERVATORSHIPS › Section 411-026-0000 - Purpose and Scope

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 Department of Human Services (Department), Seniors and People with Disabilities
			 Division (Division) has the authority and responsibility to provide protective
			 services to older adults, age 65 or older, and adults with physical
			 disabilities. For the purpose of providing protective services and
			 administration of services under ORS Chapter 410, the Division may request
			 protections from a court under ORS Chapter 125 for an individual who is
			 functionally incapacitated or financially incapable.
(2) The Division's scope when requesting
			 protections under ORS Chapter 125 includes:
(a) Subject to contractual limitations and
			 budgetary constraints, the Division may pay towards the costs of the petition
			 and the protective proceeding under ORS Chapter 125 when there are no other
			 available resources, or when less restrictive interventions are not available,
			 to protect an older adult or an adult with physical disabilities.
(b) For a protective proceeding, or in the
			 case of an existing protective order issued under ORS Chapter 125, the Division
			 may inform and provide confidential information to the court to prevent or
			 lessen a serious and imminent risk to health and safety of an older adult or
			 adult with physical disabilities. The Division may also provide information
			 about the fiduciary for the purpose of the petition or to report abuse when
			 there is substantiated abuse or a failure to protect by the
			 fiduciary.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 26 - GUARDIANSHIPS AND CONSERVATORSHIPS › Section 411-026-0010 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
For purposes of these rules, the following definitions
				apply:
(1) "Area Agency on Aging
			 (AAA)" means the agency designated by the Department with responsibility to
			 provide a comprehensive and coordinated system of service to older adults or
			 adults with disabilities in a designated planning and service area.
(2) "Central Office" means the office of the
			 Division that provides statewide support for the local offices.
(3) "Confidential Information" means any
			 health, mental health, financial, substantiated abuse, and legal information
			 that is designated as Department confidential or protected information by
			 federal and state statutes or rule.
(4) "Conservator" means a person who has
			 fiduciary duty and is appointed by a court to administer the financial and
			 property resources of a protected individual under ORS Chapter 125.
(5) "Court" means any court in Oregon having
			 probate jurisdiction or a judge thereof.
(6) "Department" means the Department of
			 Human Services (DHS).
(7)
			 "Disability" means any chronic physical or cognitive condition, such as
			 acquired brain damage or dementia that significantly interferes with an
			 individual's ability to protect his or herself from harm, abuse, neglect, or
			 exploitation.
(8) "Division" means
			 the Department of Human Services, Seniors and People with Disabilities
			 Division.
(9) "Fiduciary" means a
			 guardian or conservator appointed under the provisions of ORS Chapter 125. A
			 fiduciary may be:
(a) Temporary in which the
			 powers given in the protective order last generally 30 days and may be granted
			 immediately in an emergency;
(b)
			 Limited in which only specific powers (not all powers) are granted in the
			 protective order; and
(c) Full in
			 which all or a substantial amount of powers are granted in the protective
			 order. Full guardianship and conservatorships are generally long
			 term.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 26 - GUARDIANSHIPS AND CONSERVATORSHIPS › Section 411-026-0020 - Eligibility for State Payment

Current through Register Vol. 63, No. 7, July 1, 2024
When a protective order is the appropriate action to protect an
				individual, the Division may pay towards the costs of the proceeding for a
				protective order for an individual who:
(1) Is age 65 years or older or is age 18 or
			 older with a physical disability;
(2) Is functionally incapacitated or
			 financially incapable;
(3) Is
			 unable to make informed choices because he or she lacks the ability to
			 understand the current situation, understand the options available and their
			 likely consequences, and reasonably choose from among those options and
			 communicate the choice;
(4) Is in
			 imminent and serious danger of harm to health, safety, or loss of property or
			 resources;
(5) Has no means,
			 family, or other person or entity able to pay for the protective proceeding, or
			 family or other person or entity that has the ability or willingness to
			 petition for the responsibility for the safety and welfare of the
			 individual;
(6) Shall benefit
			 directly from having a guardian or conservator; and
(7) All available lesser restrictive options
			 to protect his or her health and safety are exhausted or are not
			 feasible.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 26 - GUARDIANSHIPS AND CONSERVATORSHIPS › Section 411-026-0030 - Screening

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The local
			 office shall complete a screening of the individual for whom a guardian or
			 conservator is sought. The screening shall:
(a) Provide specific objective evidence of
			 functional incapacitation or financial incapability;
(b) Address whether the individual's ability
			 to receive and evaluate information effectively or communicate decisions is
			 impaired to such an extent that he or she presently lacks the essential
			 requirements for:
(A) His or her health or
			 safety; or
(B) Managing his or her
			 financial resources.
(c)
			 If a conservatorship is not required with a guardianship, determine if the
			 guardian or other person or entity needs to exercise powers over the
			 individual's resources;
(d)
			 Demonstrate that a protective order is necessary to prevent or lessen a serious
			 and imminent threat of harm to the individual; and
(e) Recommend the most appropriate type of
			 protective order, as follows:
(A) Temporary
			 order (emergency order) when there is an imminent and serious danger that needs
			 immediate action.
(B) Limited order
			 when the incapacitated individual needs some but not all decisions to be made
			 by someone else.
(C) Full order
			 when it is demonstrated that long-term and substantial decision-making is
			 needed for the continuing care, comfort, and maintenance of the incapacitated
			 individual.
(D) Other protective
			 orders that may be a less restrictive option.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 26 - GUARDIANSHIPS AND CONSERVATORSHIPS › Section 411-026-0050 - Assignment of Attorney

Current through Register Vol. 63, No. 7, July 1, 2024
Central office shall establish a list of contracted attorneys
				to be used by the Department to pursue guardianships, conservatorships, and
				probate matters. Central office shall nominate an attorney from the list to be
				the petitioning attorney. The attorney names shall be placed on a geographical
				list and, unless circumstances require otherwise, be assigned on a rotating
				basis. Central office may assign a specific attorney in limited circumstances
				that require a specialized legal need.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 26 - GUARDIANSHIPS AND CONSERVATORSHIPS › Section 411-026-0060 - Request and Authorization for Payment

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The local office shall submit to the
			 central office a request for payment for a protective proceeding. Payment may
			 be for attorney fees for the preparation of a petition to the court and the
			 protective proceeding including paid court fees and court visitor fees. The
			 request shall use forms and procedures established by central office.
(2) The local office shall vigorously pursue
			 any means for private, pro-bono, or another agency payment of the protective
			 proceeding before requesting payment from the Division.
(3) The Division shall not authorize payment
			 for guardianship proceedings solely for the provision of medical care or
			 hospitalization.
(4) The local
			 office shall make reasonable efforts to identify and provide the petitioning
			 attorney with any information about existing fiduciaries including but not
			 limited to an agent for power of attorney, health care representative (advanced
			 directives), guardian, conservator, trustee, or representative payee.
(5) The local office shall make reasonable
			 efforts to identify and provide the petitioning attorney with the names and
			 addresses of interested parties that are required to receive notice under
			 Oregon law.
(6) When payment for a
			 requested guardianship or conservatorship is recommended, the central office
			 shall authorize payment by nominating an attorney who has a contract with the
			 Department for protective proceedings and probate matters. The local office
			 shall then contact the attorney and provide the information necessary to
			 petition the court. To be paid through his or her contract with the Department,
			 the attorney must submit a detailed invoice to central office for attorney
			 fees, court fees, and court visitor fees. Payment shall be limited to the
			 amount set forth in the contract.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 26 - GUARDIANSHIPS AND CONSERVATORSHIPS › Section 411-026-0070 - Disclosure of Information

Current through Register Vol. 63, No. 7, July 1, 2024
(1) In
			 the absence of an individual's authorization for disclosure, a local office may
			 disclose the individual's confidential information or information about the
			 fiduciary or proposed fiduciary when the disclosure is ordered by a court or
			 is:
(a) Reasonably necessary to prevent or
			 lessen a serious and imminent threat to the individual's health or safety;
			 and
(b) The minimum amount of
			 information to sufficiently achieve the legal requirements of the petition and
			 the protective proceeding and to adequately report abuse to the
			 court.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 26 - GUARDIANSHIPS AND CONSERVATORSHIPS › Section 411-026-0080 - Estate Administration

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An
			 individual who receives public assistance through the Department, who is
			 financially incapable, and whose assets need protection, recovery, or for whom
			 disposition of excess property is needed to maintain eligibility for services
			 or benefits, may be referred to the Department's Estate Administration Unit for
			 nomination of a conservator under this rule. The local office shall use forms
			 and procedures established by the Department's Estate Administration
			 Unit.
(2) In determining whether or
			 not a conservatorship should be pursued, the Department's Estate Administration
			 Unit shall consider, including but not limited to, the following factors:
(a) Whether the individual is receiving
			 public assistance from the Department.
(b) Whether the individual is financially
			 incapable.
(c) The cost
			 effectiveness of pursuing a conservatorship including but not limited to:
(A) The likelihood that the assets of the
			 conservatorship estate shall be sufficient to cover expenses and be a benefit
			 to the client; or
(B) The ability
			 to successfully retrieve assets that may have already been conveyed to another
			 person or entity can be successfully retrieved.
(d) The availability of an appropriate
			 conservator or entity to manage the financial affairs of the
			 individual.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 27 - PAYMENT LIMITATIONS IN HOME AND COMMUNITY-BASED SERVICES › Section 411-027-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) "AAA" means
			 "Area Agency on Aging" as defined in this rule.
(2) "Activities of Daily Living (ADL)" mean
			 those personal, functional activities required by an individual for continued
			 well-being, which are essential for health and safety. Activities include
			 eating, dressing and grooming, bathing and personal hygiene, mobility,
			 elimination, and cognition.
(3)
			 "Aging and People with Disabilities (APD)" means the program area of Aging and
			 People with Disabilities, within the Department of Human Services.
(4) "Area Agency on Aging (AAA)" means the
			 Department designated agency charged with the responsibility to provide a
			 comprehensive and coordinated system of services to older adults and adults
			 with disabilities in a planning and service area. The term Area Agency on Aging
			 is inclusive of both Type A and Type B Area Agencies on Aging as defined in ORS
			 410.040 and described in ORS
			 410.210-300.
(5) "Assessment" or "Reassessment" means an
			 assessment as defined in OAR
			 411-015-0008.
(6) "Assistive Devices" means any category of
			 durable medical equipment, mechanical apparatus, electrical appliance, or
			 instrument of technology, service animals, general household items, or
			 furniture used to assist and enhance an individual's independence in performing
			 any activity of daily living.
(7)
			 "CA/PS" means the "Client Assessment and Planning System" as defined in this
			 rule.
(8) "Case Manager" means an
			 employee of the Department or Area Agency on Aging, who assesses the service
			 needs of an applicant, determines eligibility, and offers service choices to
			 the eligible individual. The case manager authorizes and implements the service
			 plan and monitors the services delivered.
(9) "Central Office" means the unit within
			 the Department responsible for program and policy development and
			 oversight.
(10) "Client Assessment
			 and Planning System (CA/PS)":
(a) Is the
			 single entry data system used for --
(A)
			 Completing a comprehensive and holistic assessment;
(B) Surveying an individual's physical,
			 mental, and social functioning; and
(C) Identifying risk factors, individual
			 choices and preferences, and the status of service needs.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 27 - PAYMENT LIMITATIONS IN HOME AND COMMUNITY-BASED SERVICES › Section 411-027-0020 - Payment Limitations in Home and Community-Based Services

Current through Register Vol. 63, No. 7, July 1, 2024
(1) PAYMENT FOR
			 SERVICES.
(a) Service payments under these
			 rules are limited to services provided under Oregon's Medicaid State Plan K
			 Option for individuals served through the Department's Aging and People with
			 Disabilities program area.
(b) Home
			 and community-based services include, but are not limited to:
(A) In-home services (consumer-employed
			 providers and contracted in-home care agencies).
(B) Residential care facility
			 services.
(C) Assisted living
			 facility services.
(D) Adult foster
			 home services.
(E) Specialized
			 living services.
(F) Adult day
			 services.
(G) Home-delivered
			 meals.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 27 - PAYMENT LIMITATIONS IN HOME AND COMMUNITY-BASED SERVICES › Section 411-027-0025 - Payment for Residential Care Facility and Adult Foster Home Services

Current through Register Vol. 63, No. 7, July 1, 2024
The Department reimburses for services provided to individuals
				residing in a residential care facility or an adult foster home according to
				the following:
(1) SERVICE PAYMENT.
			 The provider must agree to accept an amount determined pursuant to OAR
			 461-155-0270 for room and board
			 and a service payment determined by the Department pursuant to OAR
			 411-027-0020 or
			 411-027-0050 as payment in full
			 for all services rendered to an individual.
(2) SERVICE RATES. Service rates are based on
			 an individual's level of impairment and assessed need for services as
			 documented in CA/PS. Service eligibility levels are assigned based on the
			 degree of assistance an individual requires with activities of daily living and
			 certain procedures that must be performed by a provider.
(a) A base rate is paid for all individuals
			 in accordance with the rate schedule.
(b) Additional add-on payments are made for
			 individuals whose assessed needs meet add-on criteria. Add-on payments are paid
			 in accordance with the rate schedule.
(A) If
			 an individual is eligible for one add-on payment, an add-on payment is made in
			 addition to the base payment.
(B)
			 If an individual is eligible for two add-on payments, a total of two add-on
			 payments are made in addition to the base payment.
(C) If an individual is eligible for three
			 add-on payments, a total of three add-on payments are made in addition to the
			 base payment.
(D) An individual
			 that is eligible for Extended Waiver Eligibility, as defined and authorized in
			 OAR 411-015-0030 is not eligible for
			 an add-on payment.
(c)
			 Eligibility for add-on payments is made based on individual needs as documented
			 in CA/PS. An individual is eligible for an add-on payment if:
(A) The individual is full assist in mobility
			 or eating or elimination;
(B) The
			 individual demonstrates behavior that pose a risk to the individual or to
			 others and the provider must consistently intervene to supervise or redirect;
			 or
(C) The individual's medical
			 treatments, as selected and documented in CA/PS, require daily observation and
			 monitoring with oversight by a licensed healthcare professional, no less than
			 quarterly, and the facility has trained staff to provide such service and does
			 provide the service.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 27 - PAYMENT LIMITATIONS IN HOME AND COMMUNITY-BASED SERVICES › Section 411-027-0050 - Exceptions to Payment Limitations in Home and Community-Based Services

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Service payment
			 exceptions may only be granted if the Department determines:
(a) The individual has service needs,
			 documented in the service plan, that warrant a service payment exception;
			 and
(b) The provider actually
			 provides the exceptional service.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 27 - PAYMENT LIMITATIONS IN HOME AND COMMUNITY-BASED SERVICES › Section 411-027-0075 - Special Payment Contracts

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 The Department may authorize three different types of special payment contract
			 arrangements.
(a) Supplemented Program
			 Contract. A supplemented program contract pays a rate in excess of the rate
			 schedule to providers in return for additional services delivered to target
			 populations.
(b) Consistent
			 Revenue Contract. A consistent revenue contract allows a payment rate based on
			 average facility case mix. The contracted rate is in the range allowed by the
			 rate schedule and is based on individual needs.
(c) Specific Needs Setting Contract. A
			 specific needs setting contract pays a rate in excess of the rate schedule to
			 providers who care for a group of individuals all of whose service needs exceed
			 the service needs encompassed in the base payment and all add-ons.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 27 - PAYMENT LIMITATIONS IN HOME AND COMMUNITY-BASED SERVICES › Section 411-027-0125 - Distressed Provider Relief Fund

Current through Register Vol. 63, No. 7, July 1, 2024
The Department may authorize a payment to a Medicaid Assisted
				Living Facility, Residential Care Facility or Memory Care (Endorsed Units Only)
				who meet the criteria described in OAR chapter 411, division 029. The
				Department will prioritize payments based on available funding and maintains
				sole authority to determine which providers will receive funding.
Statutory/Other Authority: ORS
				  410.070
Statutes/Other Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 27 - PAYMENT LIMITATIONS IN HOME AND COMMUNITY-BASED SERVICES › Section 411-027-0150 - Repayment of Premium Deposits for Workers' Compensation

Current through Register Vol. 63, No. 7, July 1, 2024
Those providers on whose behalf the Department made a Workers'
				Compensation premium deposit in accordance with OAR 411-027-0010 (suspended
				2-8-91 and repealed 5-1-91) shall repay the deposit amount to the Department at
				such time that the need for the deposit no longer exists. The Department shall
				consider the need for the deposit no longer exists when certain conditions
				occur. Such conditions include, but are not limited to:
(1) The provider sells, transfers, or
			 otherwise goes out of business;
(2) The provider enters into bankruptcy;
(3) The provider's Workers'
			 Compensation insurer no longer requires the deposit; or
(4) The Department owes monies to a nursing
			 facility at the time of each annual settlement. Such monies shall be applied
			 against the premium deposit amount until such time the total deposit is
			 recovered.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 27 - PAYMENT LIMITATIONS IN HOME AND COMMUNITY-BASED SERVICES › Section 411-027-0160 - Enhanced Wage Add-on Program

Current through Register Vol. 63, No. 7, July 1, 2024
(1) For the
			 purposes of this rule, Home and Community Based Services (HCBS) providers refer
			 to Assisted Living Facilities, Residential Care Facilities, Memory Care
			 (Endorsed Units Only) and In-Home Agencies. Effective January 1, 2023, this
			 rule includes Adult Day Services providing full day services.
(2) ESTABLISHMENT. The Department establishes
			 the Enhanced Wage Add-on Program (Program). The Program is designed to support
			 Home and Community Based Services (HCBS) providers with retention of caregivers
			 by paying a starting wage of $15 per hour for all caregivers, with an increase
			 to $15.50 per hour by the second year of the 2021-2023 biennium (July 1,
			 2022).
(3) The Department will
			 provide additional compensation to HCBS providers who meet the criteria
			 contained in paragraph (4). Such compensation shall be an add-on of 10% of the
			 Medicaid rate, as authorized in OAR
			 411-027-0170, during the
			 effective dates of the Program. A HCBS provider may be eligible to apply
			 between October 1, 2021 and June 30, 2023.
(4) CRITERIA. Criteria must be met in order
			 for a HCBS provider to be eligible for the Enhanced Wage Add-on Program. The
			 HCBS provider shall submit documentation supporting that it provides a starting
			 wage of $15 per hour or more for all caregivers, escalating up to $15.50 per
			 hour or more by the second year of the 2021-2023 biennium (July 1, 2022).
			 Sufficient documentation shall be submitted to the Department with the required
			 form referenced in paragraph (6) and shall include at least one of the
			 following:
(a) A copy of a collective
			 bargaining agreement or addendums with such provisions;
(b) Amended policies that includes the wages
			 for direct caregivers during the period of the Program;
(c) Notification to caregivers of wages
			 during the period of the Program;
(d) Payroll records demonstrating rates of
			 pay for caregivers equal to or higher than $15.50 per hour; or
(e) Written communication to staff with wage
			 criteria that includes reference to the Legislature establishing a wage add-on
			 to Medicaid rates for the purpose of supporting caregiver wages in partnership
			 with the Oregon Department of Human Services, the Oregon Health Care
			 Association, SEIU Local 503, and other senior care advocates.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 27 - PAYMENT LIMITATIONS IN HOME AND COMMUNITY-BASED SERVICES › Section 411-027-0170 - Rate Schedule for Home and Community-Based Services

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The effective
			 monthly rates for July 1, 2023 to June 30, 2024 are as follows:
(a) Residential Care Facilities:
(A) Base - $2,279.00.
(B) Base plus 1 add-on - $2,722.00.
(C) Base plus 2 add-ons -
			 $3,165.00.
(D) Base plus 3 add-ons
			 - $3,608.00.
(E) Hourly Exception
			 Rate - $19.21 per hour.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 28 - CASE MANAGEMENT SERVICES › Section 411-028-0000 - Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The rules in
			 OAR chapter 411, division 028 ensure case management services support the
			 independence, empowerment, dignity, and human potential of older adult
			 individuals and adult individuals with disabilities with the purpose of helping
			 the individuals reside in their own home or in a community-based setting.
(2) Case management services are a
			 component of an individual's comprehensive, person-centered plan for
			 services.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 28 - CASE MANAGEMENT SERVICES › Section 411-028-0020 - Scope of Case Management Services

Current through Register Vol. 63, No. 7, July 1, 2024
(1) DIRECT CASE MANAGEMENT SERVICES. Direct
			 case management services are provided by a case manager or higher level staff,
			 who communicates directly with an individual or the individual's
			 representative. Direct case management services may occur by phone call,
			 face-to-face contact, or email. Direct case management services do not include
			 contact with collateral contacts unless the collateral contact is the
			 individual's authorized representative. Direct case management services
			 include:
(a) An assessment as described in
			 OAR 411-015-0008.
(b) Service Plan development and review as
			 described in OAR 411-015-0008.
(c) Service options choice counseling as
			 described in OAR 411-030-0050.
(d) Risk assessment and monitoring:
(A) Identifying and documenting risks;
(B) Working with an individual to
			 eliminate or reduce risks;
(C)
			 Developing and implementing a Risk Mitigation Plan;
(D) Monitoring risks over time; and
(E) Making adjustments to an
			 individual's Service Plan as needed.
(e) Diversion activities. This means
			 assisting an individual with finding alternatives to nursing facility
			 admission.
(f) Other program
			 coordination. This means helping an individual navigate or coordinate with
			 other social, health, and assistance programs.
(g) Crisis response and intervention. This
			 means assisting an individual with problem resolution.
(h) Service provision issues. This means
			 assisting an individual with problem solving to resolve issues that occur with
			 providers, services, or hours that don't meet the individual's needs.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 28 - CASE MANAGEMENT SERVICES › Section 411-028-0030 - Eligibility for Case Management Services

Current through Register Vol. 63, No. 7, July 1, 2024
To be eligible for case management services a person must:
(1) Be 18 years of age or older;
(2) Be eligible for OSIP-M; and
(3) Meet the functional impairment
			 level within the service priority levels currently served by the Department as
			 outlined in OAR 411-015-0010 and OAR
			 411-015-0015.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 28 - CASE MANAGEMENT SERVICES › Section 411-028-0040 - Qualified Case Manager

Current through Register Vol. 63, No. 7, July 1, 2024
Staff working for the Department or the Department's designee
				must meet the following requirements to provide case management services:
(1) A bachelor's degree in a
			 behavioral science, social science, or a closely related field; or
(2) A bachelor's degree in any field and one
			 year of human services related experience that may include providing assistance
			 to people and groups with issues such as economical disadvantages, employment
			 barriers and shortages, abuse and neglect, substance abuse, aging,
			 disabilities, prevention, health, cultural competencies, or inadequate housing;
			 or
(3) An associate's degree in a
			 behavioral science, social science, or a closely related field and two years of
			 human services related experience that may include providing assistance to
			 people and groups with issues such as economical disadvantages, employment
			 barriers and shortages, abuse and neglect, substance abuse, aging,
			 disabilities, prevention, health, cultural competencies, or inadequate housing;
			 or
(4) Three years of human
			 services related experience that may include providing assistance to people and
			 groups with issues such as economical disadvantages, employment barriers and
			 shortages, abuse and neglect, substance abuse, aging, disabilities, prevention,
			 health, cultural competencies, or inadequate housing.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 28 - CASE MANAGEMENT SERVICES › Section 411-028-0050 - Frequency of Case Management Services

Current through Register Vol. 63, No. 7, July 1, 2024
A case manager who meets the requirements in OAR
				411-028-0040 must provide the
				following case management services to an eligible individual receiving Medicaid
				home and community-based services:
(1) A direct case management service as
			 described in OAR 411-028-0020 must be provided to
			 an eligible individual no less than once in each calendar quarter.
(2) An indirect case management service must
			 be provided in every calendar month a direct case management service was not
			 provided.
Stat. Auth.: ORS
				  410.070
Stats. Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 29 - COMMUNITY-BASED CARE DISTRESSED PROVIDER RELIEF FUND › Section 411-029-0000 - Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
The purpose of this division is to establish requirements for
				the application, approval, distribution, and oversight of the Community-Based
				Care (CBC) Distressed Provider Relief Fund (Fund). This Fund provides a
				financial assistance grant to CBCs who are experiencing financial hardships and
				contemplating closure.
Statutory/Other Authority: ORS
				  410.070
Statutes/Other Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 29 - COMMUNITY-BASED CARE DISTRESSED PROVIDER RELIEF FUND › Section 411-029-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 "Community-Based Care (CBC)" means:
(a) An
			 Assisted Living Facility licensed under rules contained in Oregon
			 Administrative Rule chapter 411, division 054; or
(b) A Residential Care Facility licensed
			 under rules contained in Oregon Administrative Rule chapter 411, division 054;
			 or
(c) A Memory Care Facility
			 (Endorsed Units only) licensed under rules contained in Oregon Administrative
			 Rule chapter 411, division 057.
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 29 - COMMUNITY-BASED CARE DISTRESSED PROVIDER RELIEF FUND › Section 411-029-0010 - Community-Based Care Distressed Provider Relief Fund

Current through Register Vol. 63, No. 7, July 1, 2024
(1) ESTABLISHMENT. The Oregon Department of
			 Human Services (Department) establishes the CBC Distressed Provider Relief
			 Fund. The Fund will prioritize financial assistance grants to CBC facilities
			 who meet the criteria described in OAR
			 411-029-0020.
(2) TIMELINESS. Initial applications for the
			 CBC Distressed Provider Relief Fund must be submitted to the Department during
			 the open application submission timeframe as announced by the Department. The
			 Department may announce subsequent application periods through policy guidance
			 or provider alert if funding remains after the initial application.
Statutory/Other Authority: ORS
				  410.070
Statutes/Other Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 29 - COMMUNITY-BASED CARE DISTRESSED PROVIDER RELIEF FUND › Section 411-029-0020 - Criteria

Current through Register Vol. 63, No. 7, July 1, 2024
The Department will accept completed applications from CBCs
				that are able to confirm a Financial Hardship and whom have a valid Medicaid
				provider number. Prioritization will be given to facilities as described in OAR
				411-029-0025.
Statutory/Other Authority: ORS
				  410.070
Statutes/Other Implemented: ORS
				  410.070
Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 29 - COMMUNITY-BASED CARE DISTRESSED PROVIDER RELIEF FUND › Section 411-029-0025 - Prioritization of Applications

Current through Register Vol. 63, No. 7, July 1, 2024
The Department will prioritize funding based on following
				criteria:
(1) Facilities who meet the
			 definition of Essential Facility;
(2) Facilities with high Medicaid Occupancy
			 on a date specified by the Department;
(3) Facilities who are actively in the
			 process of closing or are at a significant risk of closing their facility due
			 to a Financial Hardship;
(4)
			 Facilities that can demonstrate the potential for viability with a cash
			 assistance grant; and
(5)
			 Facilities with demonstrated regulatory record of ensuring patient
			 safety.
(6) The Department retains
			 the right to approve or deny any application within available funding based on
			 the Department's determination of the most at risk facilities.
Statutory/Other Authority: ORS
				  410.070
Statutes/Other Implemented: ORS
				  410.070