Oregon Administrative Code

413-090-0370 Payment Method (1) A CF 598 (Authorization and Vendor Invoice) must be completed in accordance with instruction and presented to the vendor. (2) The CF 598 will authorize a maximum amount; however, the vendor may only bill the Department for the actual amount of purc…

413-090-0380 Children in Non-Reimbursed Placement at Oregon State Hospital and Other Non-Reimbursed Providers (1) The Department has established a procedure to provide personal allowances for children who are in custody of the Department and are placed in a non-reimbursed placeme…

413-090-0400 Funeral and Burial Expenses (1) The Department may pay reasonable and appropriate expenses for services listed in section (3) of this rule only when: (a) The deceased child or young adult was: (A) In the legal custody of the Department at the time of death; or (B) An…

413-090-0405 Definitions Definitions for OAR 413-090-0400 to 413-090-0430 are in OAR 413-090-0000. Statutory/Other Authority: ORS 418.005 Statutes/Other Implemented: ORS 418.005 History: CWP 13-2015, f. & cert. ef. 8-4-15 CWP 11-2003, f. & cert. ef. 1-7-03

413-095-0000 Definitions Unless the context dictates otherwise, the following definitions, and those in OAR 410-170-0020, apply to OAR chapter 413, division 095. (1) “Absent day” means a calendar day: (a) Either the BRS client is: (A) Enrolled but not physically present in the BR…

413-095-0010 Administration of the BRS Program BRS contractors and BRS providers that provide services to a child in the care or custody of the Department of Human Services or one of the federally recognized Oregon tribes must comply with the requirements in the BRS program gener…

413-095-0020 Purpose The purpose of the Behavior Rehabilitation Services (BRS) Program is to remediate the BRS client's debilitating psychosocial, emotional, and/or behavioral disorders by providing services such as behavioral intervention, counseling, and skills-training. Servic…

413-095-0030 BRS Provider Requirements (1) In addition to the requirements in OAR 410-170-0030, the BRS contractor and the BRS provider providing services and placement-related activities to a BRS client in the care or custody of the Department or one of the federally-recognized …

413-095-0040 Prior Authorization for the BRS Program; Appeal Rights (1) BRS program eligibility. (a) The Department may provide prior authorization for the BRS program for a child who: (A) Meets the requirements in OAR 410-170-0040(2)(a)(A) to (C); and (B) Is in the care or custo…

413-095-0050 BRS Placement-Related Activities for a Department BRS Contractor and BRS Provider (1) A BRS contractor and BRS provider must provide facilities, personnel, materials, equipment, supplies and services, and transportation related to placement-related activities. (a) Cl…

413-095-0060 Billing and Payment for Services and Placement-Related Activities (1) Billable care day: (a) The BRS contractor is compensated for billable care day services and placement-related activities rates on a fee-for-service basis in accordance with OAR 410-170-0110. (b) Th…

413-095-0070 When a Child or Young Adult Placed with a BRS Program is Missing (1) When a BRS client is missing, the BRS contractor or BRS provider must immediately report information about the missing BRS client to the following: (a) Law enforcement; (b) The National Center for M…

413-095-0080 Compliance Reviews and Remedies (1) The BRS contractor must cooperate, and ensure its BRS providers cooperate, with program compliance reviews or audits conducted by any federal, state or local governmental agency or entity related to the BRS program including, but n…

413-100-0000 Purpose The purpose of these rules, OAR 413-100-0000 to 413-100-0345, is to describe the Department's responsibilities and criteria for making the following determinations, which are used to ensure proper federal reimbursement: (1) Title IV-E eligibility for children…

413-100-0005 Definitions The following definitions apply to OAR 413-100-0000 to 413-100-0345: (1) "AFDC" means the Aid to Families with Dependent Children program as it existed on July 16, 1996, excluding changes implemented by the Oregon Options Waiver. (2) "Candidate for foster…

413-100-0015 Application for Title IV-E Foster Care Funds (1) A child for whom the Department has responsibility for placement and care must be referred by the Department to a Title IV-E Specialist for a Title IV-E eligibility determination. (2) A child who has been determined a …

413-100-0060 Title IV-E Reimbursable Placements Reimbursable Placements Types. The out-of-home placement types listed in sections (1) and (2) meet the Title IV-E definition of a reimbursable placement. The out-of-home placement type listed in section (3) is reimbursable by Title …

413-100-0065 Title IV-E Reimbursable Payments (1) Title IV-E foster care maintenance payments for a child or young adult in foster care may cover expenses listed in the following subsections: (a) The cost for and the cost of providing food, clothing, shelter, daily supervision, s…

413-100-0075 Eligibility Status Each Title IV-E eligibility determination must result in an eligibility status based on the following criteria: (1) Eligible and Reimbursable. The child or young adult is determined to have met all the Title IV-E eligibility requirements and is in …

413-100-0080 Effective Date (1) When completing an initial determination pursuant to OAR 413-100-0125 to 413-100-0240, the child’s Title IV-E eligibility status will be effective the first day of placement. (2) When completing an annual redetermination pursuant to OAR 413-100-027…

413-100-0090 Correcting Eligibility A child’s eligibility must be corrected when any of the following circumstances occur: (1) Financial information for the eligibility unit is obtained. (2) Information becomes available that proves the denial of the child’s initial Title IV-E el…

413-100-0110 Eligibility End Date (1) Foster Care. Title IV-E foster care eligibility must end when a child or young adult is discharged from foster care for any of the following reasons: (a) The date the Department ceases to have responsibility for the placement and care of the …

413-100-0125 Initial Determination Requirements To be eligible for Title IV-E at the time of removal, a child must meet all the following requirements: (1) U.S. citizenship, as required by OAR 413-100-0210. (2) Age, as required by OAR 413-100-0230. (3) Removal from the home of th…

413-100-0135 Removal Requirements (1) Specified relative requirements. To meet Title IV-E eligibility requirements, the child must have lived at some point during the six months prior to removal with a specified relative. (2) Removal requirements for a child age 17 or younger. To…

413-100-0150 Determining Parental Deprivation Deprivation of parental support in relation to the removal home exists in any of the following circumstances: (1) Either parent of a child is deceased. (2) One or both parents are absent from the home as described by one of the follow…

413-100-0160 Determining Financial Need (1) At the time of the initial Title IV-E determination, the Department must review the income and resources available to the eligibility unit during the eligibility month to determine whether the child would have been eligible for AFDC und…

413-100-0170 Determining Resources A child is not Title IV-E eligible if in the eligibility month all resources available to the eligibility unit that are not excluded by Department rules in effect on July 16, 1996, exceed the resource limit. (1) The resource limit for an eligibi…

413-100-0180 Earned Income of Students (1) The earned income of a child or young adult who has a GED or high school diploma and is included in the eligibility unit is counted when determining Title IV-E eligibility. (2) Earned income is not counted for: (a) A child, 18 years old …

413-100-0210 U.S. Citizenship and Qualified Non-citizens A Title IV-E eligible child or young adult must be: (1) A United States citizen; or (2) A qualified non-citizen is defined by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), P.L. 104-19…

413-100-0230 Age Requirements To be Title IV-E eligible, a child or young adult must be: (1) A child at the time of removal. (2) At redetermination: (a) A child; or (b) A young adult, who meets one of the following requirements: (A) Completing his or her secondary education or a …

413-100-0240 Judicial Finding Requirements for Title IV-E Eligibility (1) Reasonable efforts determination. The Title IV-E agency must make reasonable efforts to maintain the family unit and prevent the unnecessary removal of a child from his or her home; to affect the safe reuni…

413-100-0270 Redetermination Requirements (1) The Department must complete an annual redetermination no later than 12 months from the date the child is considered to have entered foster care, and every 12 months thereafter, for the duration of the child or young adult's substitut…

413-100-0320 Consolidated Omnibus Reconciliation Act (COBRA) and Title XIX Medicaid (1) The COBRA of 1985, PL 99-272 enacted on April 7, 1986, permits a Title IV-E eligible child in paid substitute care or receiving adoption assistance to receive Title XIX Medicaid coverage from …

413-100-0335 Title IV-E Adoption Assistance Eligibility Determination (1) A child is not eligible for Title IV-E adoption assistance when: (a) The child is not a citizen or resident of the United States; and (b) The child was adopted outside of the United States or was brought in…

413-100-0345 Guardianship Assistance Eligibility (1) To be eligible for Title IV-E guardianship assistance, the child and prospective guardian must meet the eligibility requirements as described in OAR 413-070-0917. (2) The Title IV-E guardianship assistance determination must be…

413-100-0400 Purpose The purpose of OAR 413-100-0400 to 413-100-0530 is to set forth policies and criteria the Department uses to determine eligibility for: (1) Medical assistance under Title XIX of the Social Security Act for a child or young adult in substitute care and in the …

413-100-0410 Definitions As used in OAR 413-100-0400 to 413-100-0530: (1) "Adjudication" means the legal process by which a child or young adult is under a court's jurisdiction as a result of having engaged in delinquent behavior and not having a legal guardian that could be resp…

413-100-0420 Child Welfare Title XIX Medicaid Program Eligible Populations Only the following children and young adults may be eligible for Child Welfare Title XIX Medicaid: (1) A child or young adult in substitute care, which may include: (a) A child or young adult in foster car…

413-100-0430 Eligibility Determination for a Child or Young Adult in Substitute Care Except as provided in OAR 413-100-0435(7), the following policies apply to a child or young adult in substitute care: (1) Before a child or young adult in substitute care may receive a medical ca…

413-100-0432 Payments for Services Provided in Emergency Situations When a Child or Young Adult is Not Enrolled in Title XIX Medicaid Payment may be made for emergency medical services only for a child or young adult in the Department’s care or custody. The payment is made from t…

413-100-0435 Title XIX Medicaid Eligibility for a Child or Young Adult Receiving Adoption Assistance or Guardianship Assistance (1) The Child Welfare Post Adoption Program will determine and maintain Child Welfare Title XIX Medicaid eligibility for the following children and youn…

413-100-0445 Youth in Detention (1) Except as provided in section (2) of this rule, an individual held in a county or state juvenile detention facility is ineligible for Child Welfare Title XIX Medicaid or General Assistance medical coverage. (2) An individual held in a county or…

413-100-0451 Interstate Compact for the Placement of Children (ICPC) and Interstate Compact on Adoption and Medical Assistance (ICAMA) (1) The Children’s Medical Unit will determine and maintain Title XIX Medicaid eligibility for a child or young adult placed in Oregon from anoth…

413-100-0455 Out-of-State Placements (1) The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) provides for Child Welfare Title XIX Medicaid coverage in the state of residence for a child or young adult receiving Title IV-E foster care payments. (2) A child or young …

413-100-0460 Citizenship and Non-Citizens (1) To be eligible for medical assistance under Child Welfare Title XIX Medicaid, the child or young adult must meet the requirements of one of the following subsections: (a) Be a United States citizen. (b) Be a qualified non-citizen unde…

413-100-0530 Compliance (1) The Department is responsible for compliance with the requirements of the Office of Management and Budget, OMB Circular A-133, available at: http://www.whitehouse.gov/omb/circulars/a133_compliance_supplement_2011. (2) All cases to be reviewed by state …

413-100-0800 Child Support Referrals (1) The parents of a child in a paid substitute care placement may be required to make monthly child support payments to the state until one of the following occurs: (a) The child is reunified with the parent. (b) The child turns 18 or as long…

413-100-0810 Child Support Arrears Owed to Department (1) Child support arrears resulting from nonpayment during an episode of Department custody will be assigned and payments disbursed as prescribed by law. (2) Any child support arrears owed to the Department after termination o…

413-100-0820 Handling DCS Case Information (1) The Department may obtain an absent parent's place of residence and demographic information from a child support case to be used for the administration of Department programs. This information may be entered in the Department’s elect…

413-100-0830 Paternity and Parentage Establishment The Department will refer substitute care cases to DCS for establishment of parentage under any of the following circumstances: (1) Only one parent is listed on the child’s birth record; or (2) The Department has not begun the pa…