Oregon Administrative Code

411-360-0250 License Conditions (1) The Department may attach conditions to a license that limit, restrict, or specify other criteria for operation of an AFH-DD. The type of condition attached to an AFH-DD license must directly relate to the risk of harm or potential risk of harm…

411-360-0260 Civil Penalties (1) A civil penalty of not less than $100 and not more than $250 per violation, except as otherwise provided in this rule, is imposed on a licensee for a general violation of these rules. (2) A civil penalty of up to $500, unless otherwise required by…

411-360-0270 Denial, Revocation or Non-renewal of License (1) The Department denies, revokes, or refuses to renew a license where it finds: (a) There has been imminent danger to the health or safety of individuals or substantial failure to comply with these rules; (b) There is su…

411-360-0275 Suspension (1) The Department may suspend a license for reasons of abuse, neglect, or exploitation of an individual if: (a) An immediate threat to the health, safety, or welfare of any individual exists; (b) There is evidence of abuse, neglect, or exploitation of any…

411-360-0280 Criminal Penalties (1) Operating an AFH-DD without a license is punishable as a Class C misdemeanor pursuant to ORS 443.991(5). (2) Refusing to allow the Department access and inspection to the AFH-DD or access to the AFH-DD regarding fire safety by state and local f…

411-360-0290 Enjoinment of Operation The Department may commence an action to enjoin operation of an AFH pursuant to ORS 443.775(8): (1) When an AFH-DD is operated without a valid license; or (2) After notice of revocation or suspension has been given, a reasonable time for place…

411-360-0300 Zoning An AFH-DD is a residential use of property for zoning purposes. An AFH-DD is a permitted use in any residential zone, including a residential zone that allows a single family dwelling, and in any commercial zone that allows a single-family dwelling. No city or…

411-360-0310 Public Information (1) The Department maintains current information on all licensed AFH-DD's and makes that information available to prospective individuals, the individuals' families, and other interested members of the public. (2) The information includes: (a) The …

411-370-0010 Definitions and Acronyms for Provider Enrollment 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 370. If a word or term is defined differently in OAR…

411-370-0020 Provider Requirements (1) These rules cover all programs and services of the Department’s community services programs for recipients with developmental disabilities (hereinafter referred to as community services programs). All providers seeking payment from the Depar…

411-370-0030 Provider Enrollment (1) For the purpose of this rule, all providers of community services programs, authorized to utilize the eXPRS, SFMA, or MMIS, and licensed or certified by Department rules, or otherwise qualified by program-specific rules, prior to July 1, 2011 …

411-370-0040 Variances (1) The Department may grant a variance to these rules based upon a demonstration by the provider that an alternative method or different approach provides equal or greater effectiveness and does not adversely impact the welfare, health, safety, or rights o…

411-375-0000 Purpose (1) The rules in OAR chapter 411, division 375 establish the standards and procedures governing independent providers and the fiscal services provided on behalf of individuals who employ or contract with an independent provider. (2) Independent providers prov…

411-375-0010 Definitions and Acronyms In addition to the following definitions, OAR 411-317-0000 includes general definitions for words and terms frequently used in OAR chapter 411, division 375. If a word or term is defined differently in OAR 411-317-0000, the definition in this…

411-375-0020 Qualifications, Exclusions, and Enrollment Responsibilities for Independent Providers (1) QUALIFICATIONS. An independent provider who is qualified to provide services must meet the following requirements: (a) Be at least 18 years of age. (b) Have approval to work bas…

411-375-0035 Documentation and Reporting Requirements (1) SERVICE AGREEMENT. (a) An independent provider may not provide services to an individual without a completed and authorized Service Agreement. For independent providers who are not personal support workers, the signature o…

411-375-0040 Fiscal and Accountability Responsibility (1) DIRECT SERVICE PAYMENTS. The Department, case management entity, or contracted fiscal intermediary makes payment to an independent provider on behalf of an individual for all services. (a) Payment is considered full paymen…

411-375-0045 Overpayments (1) An overpayment is any payment made by the Department or case management entity to an independent provider that is more than the independent provider is permitted to receive under DHS rules. An independent provider may only receive payment for a numbe…

411-375-0050 Benefits and Secondary Expenses for Personal Support Workers (1) The only benefits available to personal support workers are negotiated in the Collective Bargaining Agreement and provided in Oregon Revised Statute. The Collective Bargaining Agreement does not include…

411-375-0055 Standards for Common Law Employers for Personal Support Workers (1) A common law employer is required when a personal support worker is selected by an individual, or as applicable their legal or designated representative, to deliver supports. Only one common law empl…

411-375-0070 Inactivation and Termination of Independent Providers (1) An independent provider is not paid for work performed while their provider number is inactivated, inactivated in an emergency, or terminated. (2) STANDARD INACTIVATION. The Department may inactivate a provide…

411-375-0080 Hearing Rights (1) EXCLUSIONS. The following are excluded from the hearings process described in this rule: (a) Terminations based on a background check. The independent provider has the right to a hearing in accordance with OAR 407-007-0200 through 407-007-0370. (b)…

411-380-0010 Statement of Purpose (1) The rules in OAR chapter 411, division 380 establish standards and procedures for the provision of direct nursing services for adults with intellectual or developmental disabilities and complex health management support needs. These rules def…

411-380-0020 Definitions and Acronyms In addition to the following definitions, OAR 411-317-0000 includes general definitions for words and terms frequently used in OAR chapter 411, division 380. If a word or term is defined differently in OAR 411-317-0000, the definition in this…

411-380-0030 Eligibility and Limitations for Direct Nursing Services (1) NON-DISCRIMINATION. An individual may not be denied direct nursing services or otherwise discriminated against on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin…

411-380-0040 Complaints, Notifications of Planned Actions, and Hearings (1) INDIVIDUAL COMPLAINTS. Complaints by or on behalf of individuals must be addressed in accordance with OAR 411-318-0015. (2) NOTIFICATION OF PLANNED ACTION. In the event that direct nursing services are de…

411-380-0050 Direct Nursing Service Requirements (1) DIRECT NURSING SERVICES CRITERIA. The Department uses the Direct Nursing Services Criteria at the following times: (a) For initial eligibility of direct nursing services. (b) As part of annual ISP planning, but no longer than 1…

411-380-0060 Qualifications for Providers of Direct Nursing Services (1) Direct nursing services may be delivered by the following enrolled Medicaid providers: (a) A self-employed LPN or RN licensed under ORS 678.021 that may also be an adult foster home provider or family member…

411-380-0065 Standards for Direct Nursing Services Agencies (1) CERTIFICATION, ENDORSEMENT, AND ENROLLMENT. In addition to completing the provider enrollment requirements in OAR 411-380-0060, a direct nursing services agency must also have the following: (a) A certificate and end…

411-380-0070 Provider Disenrollment and Termination (1) Enrolled Medicaid providers may be denied enrollment, terminated, or prohibited from providing direct nursing services for any of the following: (a) Violation of any part of these rules. (b) A founded report of child abuse o…

411-380-0080 Provider Documentation and Records (1) Documentation of direct nursing services must be written in an accurate, timely, thorough, and clear manner. (2) Documentation must comply with OAR chapter 851 and must include all of the following: (a) The name of the individua…

411-380-0090 Provider Billing and Payment (1) AUTHORIZATION OF HOURS. Authorization for direct nursing service hours are: (a) Based on acuity levels from the Direct Nursing Services Criteria and documented on an individual's Direct Nursing Service Criteria Memo. (b) Authorized in…

411-390-0100 Statement of Purpose (1) The rules in OAR chapter 411, division 390 prescribe standards by which a health care advocate may be appointed for an adult with an intellectual or developmental disability. (2) The Department recognizes the individual rights described in OA…

411-390-0120 Definitions In addition to the following definitions, OAR 411-317-0000 includes general definitions for words and terms frequently used in OAR chapter 411, division 390. If a word or term is defined differently in OAR 411-317-0000, the definition in this rule applies…

411-390-0140 Limits on Rule (1) These rules do not impair or supersede Oregon's existing laws relating to any of the following: (a) Any requirement of notice to others of proposed health care. (b) The standard of care required of a health care provider in the administration of he…

411-390-0160 Health Care Decisions (1) INDIVIDUAL. An individual is entitled to make their own health care decisions unless the individual is determined to be incapable as defined in OAR 411-390-0120. (2) GUARDIAN. For an individual who has a guardian with health care decision-ma…

411-390-0180 Authority and Responsibility of a Health Care Advocate (1) When making a health care decision for an individual, a health care advocate must first consider any preference indicated by the individual by any means of communication (verbal or nonverbal) and attempt to m…

411-390-0200 Limits on Authority (1) A health care advocate may not make a health care decision related to any of the following: (a) Convulsive treatment. (b) Psychosurgery. (c) Sterilization. (d) Abortion. (e) Withholding or withdrawing of a life-sustaining treatment. (f) Withho…

411-390-0220 Safeguards (1) When an individualized written service plan team is discussing the appointment of a health care advocate for an individual, or discussing an individual's significant medical treatment or procedure, the individual and any advocate named to the individua…

411-415-0010 Statement of Purpose (1) The rules in OAR chapter 411, division 415 prescribe standards, responsibilities, and procedures for the delivery of case management services to individuals with intellectual or developmental disabilities. (2) Providers of case management ser…

411-415-0020 Definitions and Acronyms for Case Management Services In addition to the following definitions, OAR 411-317-0000 includes general definitions for words and terms frequently used in OAR chapter 411, division 415. If a word or term is defined differently in OAR 411-317…

411-415-0030 Eligibility for Case Management Services - Entry, Exit, Transfers (1) An individual may not be denied case management services or otherwise discriminated against on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin, marital…

411-415-0040 Case Manager Staff Requirements (1) CASE MANAGER QUALIFICATIONS. A case manager must have knowledge of the public service system for developmental disabilities services in Oregon and at least one of the following: (a) A bachelor's degree in behavioral science, social…

411-415-0050 Standards for Case Management Services (1) A Case Management Entity (CME) must apply the principles of self-determination, person-centered practices, diversity, equity, and inclusion to the provision of case management services. (2) A CME must ensure that a case mana…

411-415-0055 Abuse and Serious Incident Management for Case Management Entities (1) A CME must record all serious incidents related to an individual enrolled in developmental disabilities services using the CAM system. (a) All reports of abuse and serious incidents must be entere…

411-415-0060 Assessment Activities For the purpose of this rule, "supervisor" means an employee of a CME who provides management level oversight of an assessor and is trained and qualified to conduct an Oregon Needs Assessment (ONA) according to OAR chapter 411, division 425. (1)…

411-415-0070 Service Planning for Developmental Disabilities Services This rule prescribes standards for the development and implementation of an Individual Support Plan (ISP) or Annual Plan. (1) An ISP must meet the following requirements: (a) Be developed using a person-centere…

411-415-0080 Accessing Developmental Disabilities Services (1) A case management entity is required to: (a) Provide assistance in finding and arranging resources, services, and supports. When an individual or the individual's legal or designated representative chooses to receive …

411-415-0090 Case Management Contact and Monitoring of Services (1) CASE MANAGEMENT CONTACT. (a) Every individual who has an ISP must have a case management contact no less than once every three months. (A) The purpose of a case management contact must be to assure one of the fol…

411-415-0100 Specialized Services in a Nursing Facility An individual residing in a nursing facility determined to require specialized services, as described in OAR 411-070-0043, must have an annual plan for specialized services incorporated with a plan of care by the nursing fac…