Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 31 - HOMECARE WORKERS ENROLLED IN THE CONSUMER-EMPLOYED PROVIDER PROGRAM › Section 411-031-0040 - Consumer-Employed Provider Program

Current through Register Vol. 63, No. 7, July 1, 2024
The Consumer-Employed Provider Program contains systems and
				payment structure for consumers to employ care providers to meet their assessed
				ADL and IADL needs. The structure assumes a provider is required for ADLs and
				IADLs during specific periods of time. Except as indicated, the criteria in
				this rule apply to workers called Homecare Workers:
(1) EMPLOYMENT RELATIONSHIP. The relationship
			 between a provider and a consumer-employer is that of employee and employer. A
			 homecare worker is not permitted to be a representative (see OAR
			 411-031-0020) or make service
			 plan related decisions for a consumer-employer for whom the homecare worker
			 currently provides paid services.
(2) HOMECARE WORKER JOB DESCRIPTIONS. A
			 consumer-employer or consumer-employer's representative is responsible for
			 creating and maintaining a job description for a potential provider consistent
			 with the services authorized by the consumer's case manager. Only service needs
			 and tasks authorized by the Department shall be paid. The Department does not
			 pay for natural support.
(3)
			 HOMECARE WORKER BENEFITS. Benefits are determined and offered by an outside
			 trust. The Department does not provide benefits directly to homecare workers.
			 Homecare workers are not state employees.
(4) CONSUMER-EMPLOYER ABSENCES. Services from
			 a homecare worker must be prior authorized when a consumer-employer is
			 hospitalized. Services from a homecare worker are not authorized when a
			 consumer-employer is receiving treatment in a mental health, substance abuse
			 treatment facility or any licensed 24-hour care setting. Services from a
			 homecare worker are not authorized for payment when a consumer-employer is
			 incarcerated.
(5) SELECTION OF
			 HOMECARE WORKER. A consumer-employer or consumer-employer's representative
			 carries primary responsibility for locating, interviewing, screening, and
			 hiring their own employees. Subject to Case Manager approval, the
			 consumer-employer or consumer-employer's representative has the right to employ
			 any person who successfully meets the provider enrollment standards described
			 in section (8) of this rule. The Department or AAA office determines whether a
			 potential homecare worker may be enrolled and paid for by the
			 Department.
(6) EMPLOYMENT
			 AGREEMENT. A consumer-employer or consumer-employer's representative
			 establishes an employer-employee relationship with a person at any time after
			 the homecare workers Employment Eligibility Verification form (Form I-9) from
			 the Department of Homeland Security, U.S. Citizenship and Immigration Services
			 have been completed, identification photocopied, and the homecare worker has
			 received authorization to work from the Department. A homecare worker cannot
			 start work and will not receive payment for services performed until after the
			 Department has verified that a person meets the provider enrollment standards
			 described in section (8) of this rule, has an active provider enrollment number
			 and the Department has notified both the employer and homecare worker in
			 writing that payment by the Department is authorized.
(7) TERMS OF EMPLOYMENT. A consumer-employer
			 or consumer-employer's representative must establish terms of an employment
			 relationship with an employee at the time of hire. The terms of employment may
			 include work scheduling, absence reporting, and the specific tasks authorized
			 on the employee's task list. Termination of the employment relationship and the
			 grounds for termination of employment are determined by a consumer-employer or
			 consumer-employer's representative. A consumer-employer or consumer-employer's
			 representative has the right to terminate an employment relationship with a
			 homecare worker at any time and for any reason.
(8) PROVIDER ENROLLMENT.
(a) ENROLLMENT STANDARDS. A homecare worker
			 must meet all of the following standards to be enrolled with the Department's
			 Consumer-Employed Provider Program and may not work, or claim payment for
			 service unless they meet the following criteria:
(A) Agree to maintain a drug-free
			 workplace;
(B) Complete the
			 background check process described in OAR
			 407-007-0200 to
			 407-007-0370 with an outcome of
			 approved or approved with restrictions;
(C) Demonstrate the skills, knowledge, and
			 ability to perform, or to learn to perform, the required work;
(D) Possess current U.S. employment
			 authorization that has been verified by the Department or AAA;
(E) Be 18 years of age or older;
(F) Complete an orientation and pass a
			 competency evaluation per OAR
			 418-020-0035(6);
(G) Complete Core Training and pass a
			 competency evaluation per OAR
			 418-020-0035(6);
(H) Complete continuing education training
			 requirements as established by the Oregon Home Care Commission and participate
			 in trainings by deadlines established per OAR
			 418-020-0035;
(I) Must be free of CMS or OIG
			 exclusions;
(J) Maintain an active
			 Provider Enrollment Application and Agreement;
(K) Is not an employee of Aging and People
			 with Disabilities, Area Agency on Aging, the Office of Administrative Hearings,
			 Oregon Health Authority Health Systems Division, Oregon Department of Human
			 Services Background Check Unit, Oregon Eligibility Partnership (OEP), Oregon
			 Department of Human Services Self Sufficiency Program (SSP), the Oregon Home
			 Care Commission, or a provider to a participant of the independent choices
			 program, as defined in OAR
			 411-030-0100.
(L) Have a social security number or tax
			 identification number that matches the homecare worker's legal name, as
			 verified by the Internal Revenue Service or Social Security
			 Administration.