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 411-318-0020 - Notification of Planned Action

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 An individual and the representative of the individual must receive a written
			 Notification of Planned Action in the event a developmental disabilities
			 service is denied, reduced, suspended, or terminated.
(2) The Notification of Planned Action must
			 be on the form prescribed by the Department (form 0947). The Notification of
			 Planned Action must include all the following:
(a) The specific date the Notification of
			 Planned Action is mailed or hand delivered to the individual and the
			 representative of the individual.
(b) The effective date of the denial,
			 reduction, suspension, or termination.
(A)
			 For a denial of service, the effective date is the same date the Notification
			 of Planned Action is mailed or hand delivered to the individual and the
			 representative of the individual.
(B) For a reduction, suspension, or
			 termination of service, the effective date is:
(i) For a Notification of Planned Action
			 mailed or hand delivered on or before the 18th of the month, the end of the
			 calendar month in which the Notification of Planned Action is mailed or hand
			 delivered to the individual and the representative of the individual, if
			 applicable; or
(ii) For a
			 Notification of Planned Action mailed or hand delivered on or after the 19th of
			 the month, the end of the calendar month following the month in which the
			 Notification of Planned Action is mailed or hand delivered to the individual
			 and the representative of the individual, if applicable; or
(iii) No fewer than 10 calendar days after
			 the date the Notification of Planned Action is mailed or hand delivered to the
			 individual and the representative of the individual, if applicable.
(c) The specific service
			 or unit of service to be denied, reduced, suspended, or terminated.
(d) The rationale for the denial, reduction,
			 suspension, or termination, including a reference to the specific reports,
			 documents, or other information relied on in making the determination. For an
			 action taken based on the result of a completed Oregon Needs Assessment for the
			 determination of meeting ICF/IID Level of Care, the Notification of Planned
			 Action must identify the specific questions, and responses to those questions,
			 related to the areas of major life activity, identified in OAR
			 411-317-0000 for ICF/IID Level
			 of Care, in which an individual does not demonstrate significant
			 impairment.
(e) The specific
			 sections of the rules or statutes upon which the determination is
			 based.
(f) Notification that the
			 documents relied upon may be reviewed by the individual or the representative
			 of the individual.
(g)
			 Notification that if the individual or the representative of the individual
			 disagrees with the determination to deny, reduce, suspend, or terminate a
			 service, the individual has the right to request a hearing, or the
			 representative of the individual has the right to request a hearing on the
			 behalf of the individual, as provided in ORS chapter 183 and OAR
			 411-318-0025. The notification
			 of the right to a hearing must include all the following:
(A) The timeline for requesting a
			 hearing.
(B) How to request a
			 hearing.
(C) The right to receive
			 assistance from the local program in completing and submitting a request for
			 hearing.
(D) The right of the
			 individual to receive continuing services at the same level until a Final Order
			 has been issued or, at the request of the individual or the representative of
			 the individual, or until the individual has exhausted the appeals processes
			 identified in OAR 411-318-0025.
(E) Notification of the time frame within
			 which the individual or the representative of the individual must request
			 continuing services.
(F)
			 Notification of how, when, and where the individual or the representative of
			 the individual may request continuing services.
(G) Notification that the individual may be
			 required to repay the Department for any continuing services received during
			 the hearing process if the Final Order upholds the determination to reduce,
			 suspend, or terminate the services.