Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 318 - INDIVIDUAL RIGHTS, COMPLAINTS, NOTIFICATION OF PLANNED ACTION, AND CONTESTED CASE HEARINGS FOR DEVELOPMENTAL DISABILITIES SERVICES › Section 411-318-0005 - Definitions and Acronyms

Current through Register Vol. 63, No. 7, July 1, 2024
In addition to the following definitions and acronyms, OAR
				411-317-0000 includes general
				definitions for words and terms frequently used in OAR chapter 411, division
				318. If a word or term is defined differently in OAR
				411-317-0000, the definition in
				this rule applies.
(1) "CDDP" means
			 "Community Developmental Disabilities Program" as defined in OAR
			 411-317-0000.
(2) "Claimant" means the person directly
			 impacted by an action that is the subject of a hearing request.
(3) "Complainant" means an individual, as
			 defined in OAR 411-317-0000, or an individual's
			 representative.
(4) "Complaint"
			 means a complainant expresses dissatisfaction with a case management entity or
			 provider, in their preferred language, and requests a formal
			 response.
(5) "Complaint Form"
			 means the form used to file a complaint (form 0946).
(6) "Complaint Investigation" means the
			 investigation of a non-abuse related complaint that has been made to the
			 Department or a local program.
(7)
			 "Complaint Log" means a list of complaint-related information.
(8) "Continuing Services" means the
			 continuation of a developmental disabilities service following the request for
			 a hearing. Services continue until a Final Order is issued.
(9) "DD Administrative Hearing Request" means
			 the form used to request an administrative hearing to contest an action related
			 to developmental disabilities services (form 0443DD).
(10) "Denial" means a rejection of a request
			 for a developmental disabilities service or for an increase in a developmental
			 disabilities service. A denial of a Medicaid service requires a Notification of
			 Planned Action.
(11) "Department"
			 means the Oregon Department of Human Services, including the Office of
			 Developmental Disabilities Services.
(12) "Department Hearing Representative"
			 means a person authorized by the Department to represent the Department in a
			 hearing as described in OAR
			 411-001-0510.
(13) "Department Staff" means a person
			 employed by the Department who is knowledgeable in a particular subject
			 matter.
(14) "Exit" means
			 termination or discontinuance of a Department-funded developmental disabilities
			 service.
(15) "eXPRS" means the
			 Department's electronic payment and reporting system.
(16) "Good Cause" means an excusable mistake,
			 surprise, excusable neglect (which may include neglect due to a significant
			 cognitive or health issue), circumstances beyond the control of a claimant,
			 reasonable reliance on the statement of Department staff or an adverse provider
			 relating to procedural requirements, [or due to] fraud, misrepresentation, or
			 other misconduct of the Department or a party adverse to a claimant.
(17) "Hearing" means a contested case hearing
			 subject to OAR 137-003-0501 through
			 137-003-0700, which results in a
			 Final Order.
(18) "Informal
			 Conference" means the discussion between a claimant, the claimant's
			 representative, Department staff, and a Department hearing representative that
			 is held prior to a hearing to address any matters pertaining to the hearing, as
			 described in OAR 411-318-0025. An administrative
			 law judge does not participate in an informal conference. An informal
			 conference may result in resolution of the issue.
(19) "Involuntary Reduction" means a provider
			 has made the decision to reduce services provided to an individual without
			 prior approval from the individual.
(20) "Involuntary Transfer" means a provider
			 has made the decision to transfer an individual to another setting operated by
			 the same provider without prior approval from the individual.
(21) "Local Program" means the case
			 management entity, provider organization, or other certified, licensed, or
			 endorsed provider or agency that contracts with the Department to provide
			 developmental disabilities services, including services to an individual
			 associated with a complaint.
(22)
			 "Notice of Involuntary Reduction, Transfer, or Exit" means:
(a) Notice of Exit or Transfer for
			 Residential Settings (form 0719R).
(b) Notice of Exit, Suspension, or Reduction
			 for Community Living and Supported Living Services (form 0719C).
(c) Notice of Exit, Suspension, Transfer, or
			 Reduction for Day Support Activities and Employment Services (form
			 0719E).