reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 925 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, PRESCRIPTION DRUG AFFORDABILITY BOARD › Division 100 - Procedural Rules › Section 925-100-0001 - Model Rules for Rulemaking

Current through Register Vol. 63, No. 7, July 1, 2024
The Model Rules for Rulemaking, OAR 137-001-0005  through
				137-001-0100, in effect on Jan. 1, 2008, adopted by the Oregon Department of
				Justice under ORS 183.341, are adopted as the
				rules of procedure for rulemaking actions of the Prescription Drug
				Affordability Board. The full text of the Model Rules is available from the
				Department of Justice, the Prescription Drug Affordability Board, or on the
				Oregon State Archives website at
				https://arcweb.sos.state.or.us/pages/rules/oars_100/oar_137/137_001.html.
Statutory/Other Authority: ORS
				  646A.693 - 646A.697
Statutes/Other Implemented: ORS
				  183.325 -
				  183.410
Oregon Administrative Rules › Chapter 925 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, PRESCRIPTION DRUG AFFORDABILITY BOARD › Division 100 - Procedural Rules › Section 925-100-0002 - Notice of Rulemaking

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Except when
			 adopting a temporary rule, the Prescription Drug Affordability Board will give
			 prior public notice of the proposed adoption, amendment, or repeal of any rule
			 by:
(a) Publishing notice of the proposed
			 rulemaking action in the Secretary of State's Oregon Bulletin at least 21 days
			 before the effective date of the rule;
(b) Notifying interested people and
			 organizations on the Prescription Drug Affordability Board's notification lists
			 of proposed rulemaking actions under ORS
			 183.335; and
(c) Providing notice to legislators as
			 required by ORS 183.335(15).
Oregon Administrative Rules › Chapter 925 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, PRESCRIPTION DRUG AFFORDABILITY BOARD › Division 100 - Procedural Rules › Section 925-100-0003 - Public Records Requests

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Oregon's Public
			 Records Law (ORS 192) provides that every person has a right to inspect any
			 public records of a public body, except records that are exempt from
			 disclosure.
(2) A public record
			 request may be submitted in person, by U.S. Mail, fax or by email to the
			 Prescription Drug Affordability Board (Board). The written request must
			 include:
(a) The name and address of the
			 person requesting the public record;
(b) The telephone number or other contact
			 information of the person requesting the public record;
(c) A sufficiently detailed description of
			 the record(s) requested to allow the Board to search for and identify
			 responsive records; and the
(d)
			 Date and signature of the person requesting the public record.
Oregon Administrative Rules › Chapter 925 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, PRESCRIPTION DRUG AFFORDABILITY BOARD › Division 200 - Prescription Drug Affordability Review › Section 925-200-0010 - Selecting Prescription Drugs for Affordability Reviews

Current through Register Vol. 63, No. 7, July 1, 2024
The Prescription Drug Affordability Board (PDAB) will select
				from the list of eligible prescription drugs, provided by the Department of
				Consumer and Business Services pursuant to ORS 646A.694, a subset of drugs to
				prioritize for an affordability review under OAR 925-200-0020  by considering
				the following for the selection of prescription drugs:
(1) Whether any prescription drugs are on
			 each of the insurer reported top 25 lists under ORS 743.025.
(2) Whether the prescription drug is included
			 in the manufacturer new drug report or price increase report under ORS 646A.689 for the previous calendar year.
(3)
			 Historical and current manufacturer drug price increases, based on wholesale
			 acquisition cost (WAC) information. For drugs with multiple nation drug codes
			 (NDC), a measure of central tendency will be used for a price
			 comparison.
(4) The date of U.S.
			 Food and Drug Administration (FDA) approval of the prescription drug and
			 whether the prescription drug was approved through an expedited pathway.
			 Expedited approval includes fast track, priority review, accelerated approval,
			 and breakthrough therapy designation. For brand-name drugs and biological
			 products, whether there are any approved and marketed generic drugs or
			 biosimilar drugs for the specific brand-name drug or biological
			 product.
(5) Where there are
			 therapeutic alternatives, the cost and availability of potential
			 alternatives.
(6) Whether the
			 prescription drugs have a patent expiration or data exclusivity expiration
			 within 18 months.
(7) For insulin
			 drugs marketed in the U.S. and available in Oregon, criteria for selection may
			 include, but not limited to, those products with the highest insurer reported:
(a) Overall spend;
(b) Per-patient spend; and
(c) Patient out-of-pocket cost.
Oregon Administrative Rules › Chapter 925 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, PRESCRIPTION DRUG AFFORDABILITY BOARD › Division 200 - Prescription Drug Affordability Review › Section 925-200-0020 - Conducting an Affordability Review

Current through Register Vol. 63, No. 7, July 1, 2024
The Prescription Drug Affordability Board (PDAB) will conduct
				an affordability review on the prioritized subset of prescription drugs,
				selected under OAR 925-200-0010  to identify nine prescription drugs and at
				least one insulin product that may create affordability challenges for health
				care systems or high out-of-pocket costs for patients in Oregon.
(1) PDAB will conduct an affordability review
			 by considering, to the extent practicable, the following criteria set forth in
			 ORS 646A.694:
(a) Whether the prescription
			 drug has led to health inequities in communities of color;
(b) The number of residents in this state
			 prescribed the prescription drug;
(c) The price for the prescription drug sold
			 in this state;
(d) The estimated
			 average monetary price concession, discount or rebate the manufacturer provides
			 to health insurance plans in this state or is expected to provide to health
			 insurance plans in this state, expressed as a percentage of the price for the
			 prescription drug under review;
(e)
			 The estimated total amount of the price concession, discount or rebate the
			 manufacturer provides to each pharmacy benefit manager registered in this state
			 for the prescription drug under review, expressed as a percentage of the
			 prices;
(f) The estimated price for
			 therapeutic alternatives to the drug that are sold in this state;
(g) The estimated average price concession,
			 discount or rebate the manufacturer provides or is expected to provide to
			 health insurance plans and pharmacy benefit managers in this state for
			 therapeutic alternatives;
(h) The
			 estimated costs to health insurance plans based on patient use of the drug
			 consistent with the labeling approved by the United States Food and Drug
			 Administration and recognized standard medical practice;
(i) The impact on patient access to the drug
			 considering standard prescription drug benefit designs in health insurance
			 plans offered in this state;
(j)
			 The relative financial impacts to health, medical or social services costs as
			 can be quantified and compared to the costs of existing therapeutic
			 alternatives;
(k) The estimated
			 average patient copayment or other cost-sharing for the prescription drug in
			 this state;
(l) Any information a
			 manufacturer chooses to provide; and
(m) A prescription drug that is designated by
			 the United States Food and Drug Administration (FDA), under  21 U.S.C. 360bb, as
			 a drug for a rare disease or condition is not subject to an affordability
			 review.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 1 - PROCEDURAL RULES › Section 943-001-0000 - Model Rules of Procedure

Current through Register Vol. 63, No. 7, July 1, 2024
The Oregon Health Authority adopts the Attorney
				General Model Rules applicable to rulemaking, effective January 1,
				2010, with the exception of OAR 137-001-0080.
The full text of the Attorney General's Model Rules
				  of Procedure is available from the office of the Attorney General or
				  the Oregon Health Authority.
Stat. Auth.: ORS
				  183.341 &
				  413.042
Stats. Implemented: ORS
				  183.341 &
				  413.042
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 1 - PROCEDURAL RULES › Section 943-001-0005 - Notice of Proposed Rulemaking and Adoption of Temporary Rules

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Except as provided in ORS
			 183.335(7) or
			 (12) or
			 183.341, before
			 permanently adopting, amending, or repealing an administrative rule,
			 the Authority shall give notice of the intended action:
(a) To legislators specified in ORS
			 183.335(15)
			 at least 49 days before the effective date of the rule;
(b) To persons on the interested
			 parties lists described in section (2) of this rule for the pertinent
			 OAR chapter or pertinent subtopics or programs within an OAR chapter
			 at least 28 days before the effective date of the rule;
(c) In the Secretary of State's
			 Bulletin referred to in ORS
			 183.360 at least 21
			 days before the effective date of the rule;
(d) To other persons, agencies, or
			 organizations that the Authority is required to provide an
			 opportunity to comment pursuant to state statute or federal law or as
			 a requirement of receiving federal funding, at least 28 days before
			 the effective date of the rule;
(e) To the Associated Press and the
			 Capitol Press Room at least 28 days before the effective date of the
			 rule; and
(f) In addition
			 to the above, the Authority may send notice of intended action to
			 other persons, agencies, or organizations that the Authority, in its
			 discretion, believes to have an interest in the subject matter of the
			 proposed rule at least 28 days before the effective date of the
			 rule.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 1 - PROCEDURAL RULES › Section 943-001-0007 - Delegation of Rulemaking Authority

Current through Register Vol. 63, No. 7, July 1, 2024
Any officer or employee of the Oregon Health
				Authority who is identified on a completed Delegation of Authority
				form signed by the Director or Deputy Director of the Authority and
				filed with the Secretary of State, Administrative Rules Unit, is
				vested with the authority to adopt, amend, repeal, or suspend
				administrative rules as provided on that form until the delegation is
				revoked by the Director or Deputy Director of the Authority, or the
				person leaves employment with the Authority.
Stat. Auth: ORS
				  183.341 &
				  413.042
Stats. Implemented: ORS
				  183.330,
				  183.335, &
				  183.341
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 1 - PROCEDURAL RULES › Section 943-001-0009 - Lay Representation in Contested Case Hearings

Current through Register Vol. 63, No. 7, July 1, 2024
(1)  Contested case hearings are conducted in accordance with
				the Attorney General's model rules at OAR 137-003-0501  to 0700, except as
				otherwise specified in the program rules. Subject to the approval of the
				Attorney General, an officer or employee of the Oregon Health Authority
				(Authority) is authorized to appear on behalf of the agency in the following
				types of hearings conducted by the Authority:
(a)  Eligibility and termination determinations related to
				medical assistance coverage.
(b)  Suspension, reduction, or denial of medical assistance
				services, prior authorization, or medical management decisions.
(c)  Enrollment or disenrollment decisions related to managed
				care plans.
(d)  Eligibility for or termination of health insurance premium
				assistance, or determination of subsidy levels.
(e)  Provider issues including provider enrollment or denial of
				enrollment, overpayment determinations, audits, and sanctions.
(f)  Other administrative actions including criminal background
				checks, hardship waivers related to medical assistance, client overpayments
				related to medical assistance.
(g)  Oregon State Hospital's involuntary administration of a
				significant procedure to a patient or resident.
(h)  The denial, recertification, suspension, or revocation of
				forensic mental health evaluator certifications.
(i)  Administrative commitment and transfer extension hearings
				of Oregon Youth Authority youth and Oregon Department of Corrections
				adults-in-custody to Oregon State Hospital.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 1 - PROCEDURAL RULES › Section 943-001-0010 - Oregon Health Authority

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Effective June 26, 2009, 2009
			 Or. Laws Chapter 595 (House Bill 2009) created the Oregon Health
			 Authority and transferred to the Oregon Health Authority certain
			 duties, functions, and powers of:
(a) The Department of
			 Administrative Services (DAS) related to the Public Employees'
			 Benefit Board (PEBB) and the Oregon Educators Board (OEBB);
(b) The Department of Consumer and
			 Business Services (DCBS) related to the Oregon Medical Insurance Pool
			 Board (OMIP);
(c) The
			 Office of Private Health Partnerships (OPHP); and
(d) The Department of Human
			 Services (DHS) with respect to health and health care. The
			 transferred subject areas of DHS are generally described in Section
			 19(1)(a), Or. Laws Chapter 595 (House Bill 2009) as including but not
			 limited to:
(A) Developing the
			 policies for and the provision of publicly funded medical care and
			 medical assistance in Oregon;
(B) Ensuring the promotion and
			 protection of public health and the licensing of health care
			 facilities;
(C)
			 Developing the policies for and the provision of mental health
			 treatment and treatment for substance use disorders;
(D) Administering the Oregon
			 Prescription Drug Program; and
(E) Establishing responsibility for
			 the Office for Oregon Health Policy and Research and all functions of
			 the office.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 1 - PROCEDURAL RULES › Section 943-001-0015 - Transition Period Roles and Responsibilities

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Effective June 26, 2009, to maintain business continuity for the
			 duties, functions, and powers transferred to the Oregon Health
			 Authority, the agencies listed in OAR 943-001-0010(1)(a)-(d)  shall
			 continue to exercise their former duties, functions, and powers,
			 subject to the supervision and oversight of the Oregon Health
			 Authority, until superseded, by operational transfer, either in whole
			 or in part, to the Oregon Health Authority, as follows:
(a) All rules shall remain in
			 effect and ongoing rule filing processes may continue.
(b) All program administration,
			 policies, and procedures remain in effect and may continue to be
			 developed and implemented.
(c) Any judicial or administrative
			 action, proceeding, contested case hearing, or administrative review
			 matters, or new action, proceeding, or matter involving or relating
			 to the duties or powers transferred to the Oregon Health Authority
			 shall continue.
(d)
			 Rights and obligations legally incurred under contracts, leases, and
			 business transactions shall remain legally valid.
(e) Contract, grant, and business
			 transaction procurement and administration duties, functions, and
			 powers shall remain in effect and may continue.
(f) Any statutory obligations for
			 taxes, assessments, fees, charges, or payments shall continue to be
			 paid to or reimbursed by the appropriate agency.
(g) Any former statutorily required
			 findings, determinations, or recommendations to be made by the
			 agencies shall continue to be made by the agencies.
(h) Any former statutorily required
			 filings, notices or service of papers, applications, notices or other
			 documents to be mailed, provided to, or served on the agencies shall
			 continue to be mailed, provided to, or served on the agencies and the
			 agencies shall retainresponsibility to take any appropriate actions
			 to protect the interests of the state concerning or arising from any
			 filings, notices, or service.
(A)
			 Mailing or service of notices or documents on the agencies shall be
			 considered notice to the Oregon Health Authority. For example, any
			 notice sent to the Department of Human Services Estate Administration
			 Unit for purposes of ORS
			 113.145,
			 114.525 and
			 130.370 shall be
			 considered notice to the Oregon Health Authority.
(B) Any filings, notices, or
			 service made to the Oregon Health Authority may be transmitted by the
			 Oregon Health Authority to the appropriate agency.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 1 - PROCEDURAL RULES › Section 943-001-0020 - Oregon Health Authority Shared Service and Cooperative Relationships with Department of Human Services

Current through Register Vol. 63, No. 7, July 1, 2024
(1)  The Oregon Health Authority (Authority) will cooperate and
				collaborate with the Department of Human Services (Department) in order to
				effectively coordinate services to individuals, families and communities and
				realize operational efficiencies in the administration of services that are
				shared between them ("shared services").
(2)  For all the programs, functions, and duties with respect to
				health or health care (generally described in Oregon Laws 2009, chapter 595,
				section 19(1)(a)), transferred to the Authority from the Department
				("transferred program") or for shared services, the Authority declares
				that:
(a)  All transferred program rules shall remain in effect until
				superceded by adoption of Authority rules or adoption of rules by the Authority
				coordinating shared services with the Department.
(b)  All transferred program administration, policies, and
				procedures remain in effect pending the completion of review and adoption by
				the Authority or adoption of such policies and procedures related to
				coordination of shared services with the Department.
(c)  Any judicial or administrative action, proceeding,
				contested case hearing, or administrative review matters, or new action,
				proceeding, or matter involving or relating to the duties or powers transferred
				to the Authority are the responsibility of the Authority.
(d)  Rights and obligations legally incurred under transferred
				program contracts, leases, and business transactions remain legally valid and
				are the responsibility of the Authority.
(e)  Statutorily required filings, notices or service of papers,
				applications, notices or other documents to be mailed, provided to, or served
				on the Authority shall be mailed, provided to, or served on the Authority. Any
				notices required by ORS 113.145, 114.525, 115.003 and 130.370 to be sent to the
				Authority may be consolidated with similar notices to the Department and sent
				to the Estate Administration Unit of the Department. Any notices required by
				ORS 416.530 to be sent to the Authority may be consolidated with similar
				notices to the Department and sent to the Personal Injury Lien Unit of the
				Department Any consolidated notice shall be considered notice to the Authority
				as long as the Authority's interest or claim in the matter is identified in the
				notice consistent with requirements in applicable statute.
(f)  A reference to an Administrator or Assistant Director in
				any transferred program rule of the Authority means the Director of the
				Authority's program that is covered by that chapter of the Oregon
				Administrative Rules or the Authority's program specified in the rule.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 3 - PUBLIC RECORD FEES › Section 943-003-0000 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
The following definitions apply to Oregon
				Administrative Rule 943-003-0010  unless otherwise indicated:
(1) "Authority" means the Oregon
			 Health Authority.
(2)
			 "Designee" means any officer or employee of the Authority, appointed
			 by the Director to respond to requests for reduction or waiver of
			 fees for public records of the Authority.
(3) "Director" means the Director
			 of the Authority.
(4)
			 "Person" means any natural person, corporation, partnership, firm, or
			 association.
(5)
			 "Photocopy(ing)" means a photograph, microphotograph and any other
			 reproduction on paper or film in any scale, or the process of
			 reproducing, in the form of a photocopy, a public record.
(6) "Public record" includes any
			 writing that contains information relating to the conduct of the
			 public's business that is prepared, owned, used or retained by the
			 Authority regardless of physical form or characteristics.
(7) "Requestor" means a person
			 requesting inspection, copies, or other reproduction of a public
			 record of the Authority.
(8) "Writing" means handwriting,
			 typewriting, printing, photographing and every means of recording,
			 including letters, words, pictures, sounds, or symbols, or
			 combination thereof, and all papers, maps, files, facsimiles or
			 electronic recordings. It includes information stored on computer
			 tape, microfiche, photographs, films, tape or videotape or that is
			 maintained in a machine readable or electronic form.
Stat. Auth: ORS
				  192.430,
				  413.042
Stats. Implemented: ORS192.430 &
				  192.440
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 3 - PUBLIC RECORD FEES › Section 943-003-0010 - Fees for Inspection or Copies of Public Records and Oregon Health Authority Publications; Other Services

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Authority may charge a fee
			 reasonably calculated to reimburse the Authority for the cost of
			 making public records available:
(a)
			 Costs include but are not limited to:
(A) The services and supplies used
			 in making the records available;
(B) The time spent locating the
			 requested records, reviewing the records, and redacting, or
			 separating material exempt from disclosure;
(C) Supervising a person's
			 inspection of original documents;
(D) Copying records;
(E) Certifying copies of
			 records;
(F) Summarizing,
			 compiling, or organizing the public records to meet the person's
			 request;
(G) Searching
			 for and reviewing records even if the records subsequently are
			 determined to be exempt from disclosure;
(H) Postal and freight charges for
			 shipping the copies of the public records, sent first class or bulk
			 rate based on weight;
(I)
			 Indirect costs or third party charges associated with copying and
			 preparing the public records; and
(J) Costs associated with
			 electronic retrieval of records.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0000 - Purpose and Applicability

Current through Register Vol. 63, No. 7, July 1, 2024
(1) These rules establish the
			 Oregon Health Authority (Authority) policy of non-discrimination and
			 a process for reporting and investigating complaints of
			 discrimination based on protected class, in accordance with state and
			 federal law, including but not limited to Title VI of the Civil
			 Rights Act of 1964 (Title VI), the Americans with Disabilities Act of
			 1990 (ADA as amended), Section 504 of the Rehabilitation Act of 1973.
(2) These rules do not
			 apply when the:
(a) Authority's
			 Office of Equity and Inclusion (OEI) has determined that the report
			 of discrimination does not involve an allegation of discrimination
			 based on protected class status.
(b) Allegation of discrimination
			 based on protected class status is against an entity other than the
			 Authority or an Authority contractor or subcontractor.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 "Alternate format communication" means printed material converted to
			 a style allowing individuals with disabilities to achieve effective
			 communication.
(2)
			 "Auxiliary aids or services" mean devices or services that allow
			 individuals with hearing, cognitive or speech impairments to achieve
			 effective communication.
(3) "Client" means any individual
			 receiving services, seeking services or information, or who is the
			 intended recipient of Authority services.
(4) "Contractor" means any entity
			 with which the Authority has an agreement or contract to provide
			 services using federal funds to clients.
(5) "Direct threat" means a
			 significant risk to the health or safety of others. A direct threat
			 is one that:
(a) Cannot be
			 eliminated or reduced to an acceptable level through the provision of
			 auxiliary aids or services or through reasonably modifying policies,
			 practices or processes.
(b) Is identified through an
			 individual assessment that relies on current medical evidence, or the
			 best available objective evidence that shows:
(A) The nature, duration and
			 severity of the risk;
(B) The probability that a
			 potential injury will actually occur; and
(C) Whether reasonable
			 modifications of policies, practices or processes will lower or
			 eliminate the risk.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0010 - Non-Discrimination Policy

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Authority shall not, either
			 directly or through another entity, discriminate against any
			 individual, or harass, exclude from participation, or deny the
			 benefit of programs, services or activities because the individual
			 belongs to a protected class.
(2) The Authority shall not
			 discriminate against an individual in the granting of licenses and
			 certificates because the individual is part of a protected class.
(3) The Authority shall
			 not apply criteria, standards, or practices that screen out or tend
			 to screen out individuals in a protected class from fully and equally
			 enjoying any goods, programs, services, or activities unless:
(a) The criteria can be shown to be
			 necessary for providing those goods, programs, services or
			 activities; or
(b) The
			 Authority determines the screening or exclusion identifies a direct
			 threat to the health or safety of others.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0015 - Illegal Drug Use

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Except as provided in OAR
			 943-005-0015(2), this rule does not prohibit discrimination against
			 an individual based on that individual's current illegal use of
			 drugs.
(2) The Authority
			 shall not deny services to an eligible individual based on the
			 individual's current illegal use of drugs when the requested or
			 provided services are in connection with drug rehabilitation or other
			 health services related to the individual's current illegal use of
			 drugs.
(3) A drug
			 rehabilitation or treatment program may deny participation to an
			 individual who engages in illegal use of drugs while that individual
			 is in the program.
(4) A
			 program may adopt reasonable drug testing policies designed to ensure
			 that an individual who has illegally used drugs in the past is not
			 now using drugs illegally.
(5) A psychoactive substance use
			 disorder resulting from current illegal use of drugs is not a
			 disability under these rules.
Stat. Auth.: ORS
				  413.042
Stats. Implemented: ORS
				  413.042
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0020 - Reasonable Modifications

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Unless the Authority Director
			 or the Director's designee determines in writing that a modification
			 or alteration will fundamentally alter the nature or benefit of the
			 program, service or activity, or create an undue administrative or
			 financial burden, the Authority shall:
(a) Make reasonable modifications
			 to the policies, practices or processes of a program, service or
			 activity when the modifications are necessary to avoid discrimination
			 based on disability.
(b)
			 Provide aids and services or alternate format communications to
			 individuals with disabilities where necessary to ensure an equal
			 opportunity to participate in, and enjoy the benefits of a program,
			 service, or activity.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0025 - Requesting a Reasonable Modification

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Requests for reasonable
			 modification to a program, service, or activity may be made to
			 Authority staff either verbally, by completing the Request for
			 Reasonable Modification form, or in any manner otherwise acceptable
			 to the Authority.
(2)
			 When the Authority receives a request for reasonable modification,
			 the Authority shall:
(a) Make a
			 determination about any additional documentation needed and request
			 the documentation.
(b)
			 Communicate with the individual requesting the reasonable
			 modification about the process, additional required documentation and
			 the possibility of acceptable alternate modifications.
(c) Authority staff shall consider
			 the requester a partner, communicating routinely and respectfully in
			 an effort to achieve a swift and satisfactory resolution to requests
			 for reasonable modification.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0030 - Reporting Discrimination and Available Remedies

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Any individual, or individual's
			 representative, who believes an individual has been discriminated
			 against, harassed, excluded from participation or denied the benefit
			 of programs, services, or activities because the individual is a
			 member of a protected class may file a report of discrimination based
			 on protected class.
(a) The
			 Authority shall accept anonymous reports and investigate them to the
			 extent possible.
(b) The
			 Authority shall maintain confidentiality when conducting
			 investigations to the extent possible.
(c) The Authority shall ask the
			 reporter or affected individual to sign a release of information
			 indicating authorization for the Authority to access information to
			 assist the investigation.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0040 - Request for Reconsideration

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When the investigation of a
			 report of discrimination or harassment is complete, the individual
			 who filed the report of discrimination or harassment, the aggrieved
			 individual, or the person accused of discrimination or harassment may
			 submit a written request for reconsideration within 20 days of the
			 date the closing notice is issued.
(2) Written requests for
			 reconsideration must be dated and submitted to the Authority's
			 Director's Office.
(3)
			 The Director or Director's designee shall issue a final written
			 response to the request for reconsideration.
Stat. Auth.: ORS
				  413.042
Stats. Implemented: ORS
				  413.042
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0050 - Data Collection

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OEI shall maintain records
			 related to reports of alleged discrimination and harassment including
			 data on the:
(a) Number of reports
			 received.
(b) Types of
			 discrimination or harassment alleged.
(c) Location of the alleged
			 discrimination.
(d)
			 Resolution status of individual reports.
(e) Number of requests for
			 reconsideration.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0060 - Authority Contractors and Subcontractors

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Authority contractors and subcontractors shall:
(a) Comply with all applicable
			 state and federal statutes and rules.
(b) Designate an individual to
			 serve as the Authority contact for tracking and compliance purposes.
(c) Establish
			 non-discrimination and reasonable modifications policies similar to
			 those described in these rules.
(d) Establish written processes for
			 documenting and resolving reports of discrimination, harassment, and
			 requests for reasonable modification.
(e) Provide a copy of their
			 non-discrimination policies and processes to OEI upon request.
(f) Maintain records
			 related to reports of alleged discrimination and harassment
			 substantially similar to the data collection requirements established
			 by these rules and provide them to the Authority upon request.
(g) Retain these records
			 for at least three years.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 5 - INDIVIDUAL RIGHTS › Section 943-005-0070 - Implementation and Training

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OEI shall develop a plan to
			 communicate the Authority's non-discrimination rules and associated
			 policies and processes to individuals who interact with the
			 Authority, including regular and temporary employees, volunteers,
			 contractors and subcontractors and clients.
(2) OEI shall coordinate the
			 Authority's civil rights compliance activities.
(3) All Authority employees shall
			 receive training regarding this policy that includes:
(a) Information about where to find
			 these rules and associated policies; and
(b) An opportunity to ask questions
			 and have their questions answered.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 7 - CRIMINAL HISTORY CHECKS › Section 943-007-0001 - Background Checks

Current through Register Vol. 63, No. 7, July 1, 2024
Employees, volunteers, providers and contractors for
				the Oregon Health Authority (Authority) are subject to background
				checks and screening to determine if they have a history of specific
				criminal or abusive behavior identified in federal or state law or
				rules such that they should not be allowed to work, volunteer, be
				employed, or otherwise perform in positions covered by these
				rules.
(1) The Authority
			 adopts and incorporates by reference the rules established in: OAR
			 407-007-0000  to 0075 and 407-007-0090  to 0100 (Employees, Volunteers
			 and Contractors) for those matters that involve employees,
			 volunteers, or contractors of the Authority, except as otherwise
			 provided in this rule.
(2) The Authority adopts and
			 incorporates by reference the rules established in: OAR 407-007-0200  to 407-007-0320; and 407-007-0340  to 407-007-0370  (Providers) for
			 those matters that involve any entity or agency licensed, certified,
			 registered, or otherwise regulated by the Authority, except as
			 otherwise provided in this rule.
(3) The Authority adopts and
			 incorporates by reference the rules established in OAR 407-007-0400  to 407-007-0460  for those matters that involve abuse checks for
			 Authority employees, volunteers, and applicants for employment or
			 volunteer positions, except as otherwise provided in this
			 rule.
(4) The Authority
			 adopts and incorporates by reference the rules established in OAR
			 407-007-0600  to 407-007-0640  (Long Term Care Registry) for those
			 matters that involve any entity or agency licensed, certified,
			 registered, or otherwise regulated by the Authority, except as
			 otherwise provided in this rule.
(5) Any reference to any rule from
			 OAR 407-007-0000  to 407-007-0100  or from 407-007-0400  to 407-007-0640  in rules or contracts of the Authority are deemed to be references to
			 the requirements of this rule, and shall be construed to apply to
			 employees, volunteers, or contractors of the Authority.
(6) References in OAR 407-007-0000  to 407-007-0640  to the Department of Human Services (Department) or
			 to the Authority shall be construed to be references to either or
			 both agencies.
(7) The
			 Authority authorizes the Department to act on its behalf in carrying
			 out background checks and screening associated with the
			 administration of programs or activities administered by the
			 Authority.
Statutory/Other Authority: ORS
				  413.042,
				  181A.195,
				  181A.200  & 413.036
Statutes/Other Implemented: ORS
				  183.341,
				  413.036  & 443.004
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 7 - CRIMINAL HISTORY CHECKS › Section 943-007-0335

Current through Register Vol. 63, No. 7, July 1, 2024
Statutory/Other Authority: ORS
				  413.036  & 413.042
Statutes/Other Implemented: ORS
				  413.036  & 183.341
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 7 - CRIMINAL HISTORY CHECKS › Section 943-007-0501 - Contesting a Final Fitness Determination

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An SI
			 may contest an adverse fitness determination pursuant to OAR
			 407-007-0320. In this rule, an adverse fitness determination
			 includes:
(a) A final fitness
			 determination of denied or approved with restrictions pursuant to OAR
			 407-007-0320; or
(b) A
			 mandatory exclusion pursuant to federal law and OAR 407-007-0279  if
			 hearing rights are allowed by federal law.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 12 - RESTRICTING ACCESS TO OREGON HEALTH AUTHORITY PREMISES AND EMPLOYEES › Section 943-012-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
The following definitions apply to OAR 943-012-0005 through 943-012-0025:
(1)
			 "Authority" means the Oregon Health Authority.
(2) "Division" means every
			 individual organizational unit within the Authority.
(3) "Employee" means individuals
			 acting in the course and scope of their duties who are on the State
			 of Oregon payroll, contract employees, employees of temporary service
			 agencies, and volunteers. It also includes employees of other
			 government or social service agencies who, at the time they are
			 accompanying an Authority employee on Authority business, are the
			 target of conduct described in OAR 943-012-0010.
(4) "Premises" means any land,
			 building, facility, and other property owned, leased, or in the
			 possession of, and used or controlled by the Authority. When the
			 Authority occupies space in a building occupied by multiple tenants,
			 the definition includes the common areas of the building used by all
			 tenants such as, but not limited to, restrooms, hallways, and food
			 service areas.
(5)
			 "Restriction of Access" means the Authority has limited an
			 individual's access to specific Authority premises, employees, or
			 methods of communication.
(6) "Weapon" includes, but is not
			 limited to:
(a) A dangerous or
			 deadly weapon as defined in ORS
			 161.015;
(b) Any other object or substance
			 used in a manner that compromises the safety of Authority employees
			 or visitors on Authority premises;
(c) An imitation or replica of any
			 of the above.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 12 - RESTRICTING ACCESS TO OREGON HEALTH AUTHORITY PREMISES AND EMPLOYEES › Section 943-012-0010 - Prohibited Conduct

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Conduct that may result in
			 restriction of access includes, but is not limited to the following:
(a) Causing or threatening to cause
			 physical injury to Authority employees or visitors;
(b) Engaging in actions which
			 compromise the safety or health of Authority employees or
			 visitors;
(c) Causing or
			 threatening to cause harm to the family or property of an employee or
			 visitors through written, electronic, or verbal
			 communication;
(d)
			 Causing or threatening to cause damage to Authority
			 premises;
(e) Bringing a
			 deadly or dangerous weapon onto the Authority's premises, unless
			 authorized by ORS chapter 166 to carry a handgun;
(f) Displaying, attempting, or
			 threatening to use any weapon, on or off Authority premises, that
			 compromises the safety of Authority employees or visitors;
(g) Engaging in harassing conduct
			 as defined in ORS
			 166.065.
(h) Engaging in telephonic
			 harassment as defined in ORS
			 166.090.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 12 - RESTRICTING ACCESS TO OREGON HEALTH AUTHORITY PREMISES AND EMPLOYEES › Section 943-012-0015 - Continuation of Eligible Services

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An individual whose access has
			 been restricted by the Authority shall continue to be provided
			 services for which the individual meets program eligibility
			 requirements by an alternate and effective method of communication as
			 determined by the Authority.
(2) Alternate methods may include
			 telephone, electronic mail, written communication, meeting at a
			 designated secure site, or through the individual's
			 representative.
Stat. Auth.: ORS
				  413.042
Stats. Implemented: ORS
				  413.042,
				  654.010
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 12 - RESTRICTING ACCESS TO OREGON HEALTH AUTHORITY PREMISES AND EMPLOYEES › Section 943-012-0020 - Notification

Current through Register Vol. 63, No. 7, July 1, 2024
(1) If
			 the Authority determines that it is necessary to restrict access or
			 the methods of communication because of prohibited conduct, the
			 individual will be provided written notification, signed by the
			 assistant director or deputy assistant director of the affected
			 division, and sent by certified mail or other traceable means. The
			 notice shall describe the following:
(a) Conduct giving rise to the
			 restrictions;
(b) The
			 specific premises or parts of premises from which the individual is
			 excluded; or the forms of communication which are
			 restricted;
(c) The
			 alternate method by which services may be obtained;
(d) Contact information for
			 services or appointment scheduling;
(e) The availability of the review
			 process, including notification that individuals with disabilities
			 are entitled to request modification;
(f) The potential criminal
			 consequences for violating the notice of restriction of access;
			 and
(g) The law
			 enforcement agency being notified.
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 12 - RESTRICTING ACCESS TO OREGON HEALTH AUTHORITY PREMISES AND EMPLOYEES › Section 943-012-0025 - Authority Review

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Authority shall establish
			 an internal review process to ensure that a notice of restriction of
			 access is warranted prior to issuing a written notice of restriction
			 of access.
(2) Following
			 the Authority's issuance of a notice of restriction of access, the
			 recipient of the notice may request review of the Authority's
			 determination. The request must be submitted to the office of the
			 Director of the Authority. The request must be in writing and
			 submitted, by mail or personal delivery, within 15 business days of
			 the date of issuance of the notice of restriction of access. If the
			 request is submitted by mail, it must be postmarked within 15
			 business days. No particular format is required for the request for
			 review; however, the individual should include specific grounds for
			 requesting the review.
(3) Upon receipt of a request for
			 review, the Director or an assistant director shall review the
			 request and issue a written decision. The review may include an
			 informal conference. The decision shall be issued within ten days of
			 receipt of the request for review.
(4) The Authority's decision is
			 final.
(5) If the
			 Authority's decision rules in favor of the individual, the restricted
			 individual's access restriction shall be immediately lifted. If the
			 decision is unfavorable to the restricted individual, the restricted
			 individual may seek further review after six months have lapsed since
			 the date of issuance by following the process described in this
			 rule.
Stat. Auth.: ORS
				  413.042
Stats. Implemented: ORS
				  413.042,
				  654.010
Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 14 - PRIVACY AND CONFIDENTIALITY › Section 943-014-0000 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
The following definitions apply to OAR 943-014-0000  to
				943-014-0070:
(1) "Administrative
			 Hearing" means an oral proceeding before an administrative law judge in a
			 contested case hearing.
(2)
			 "Authority" means the Oregon Health Authority.
(3) "Authority Workforce" means employees,
			 volunteers, trainees, and other persons whose conduct, in the performance of
			 work for the Authority, is under the direction and control of the Authority,
			 whether or not they are paid by the Authority.
(4) "Authorization" means permission from an
			 individual or his or her personal representative giving the Authority, and
			 others named on the form, authorization to obtain, release or use information
			 about the individual from third parties for specified purposes or to disclose
			 information to a third party specified by the individual.
(5) "Business Associate" means an individual
			 or entity performing any function or activity on behalf of the Authority
			 involving the use or disclosure of protected health information (PHI) and is
			 not a member of the Authority's workforce.
(a)
			 "Function or activity" includes but is not limited to program administration,
			 claims processing or administration, data analysis, utilization review, quality
			 assurance, billing, legal, actuarial, accounting, consulting, data processing,
			 management, administrative, accreditation, financial services, and similar
			 services for which the Authority may contract or obtain by interagency
			 agreement, if access to PHI is involved.
(b) Business associates do not include
			 licensees or providers unless the licensee or provider also performs some
			 function or activity on behalf of the Authority.