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DEPARTMENT OF HUMAN SERVICES,

AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES




 

DIVISION 320
COMMUNITY DEVELOPMENTAL DISABILITY PROGRAM

411-320-0010
Statement of Purpose
The rules in OAR chapter 411, division
320 prescribe general administrative standards for the operation of a community
developmental disability program (CDDP).
(1) A CDDP providing developmental
disability services under a contract with the Department is required to meet the
basic management, programmatic, and health, safety, and human rights regulations
in the management of the community service system for individuals with intellectual
or developmental disabilities.
(2) These rules prescribe
the standards by which the Department provides services operated by the CDDP, including
but not limited to eligibility determination, case management, adult protective
services, and crisis diversion services.
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 9-2009, f. & cert.
ef. 7-13-09; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13
411-320-0020
Definitions
Unless the context indicates otherwise,
the following definitions and the definitions in OAR 411-317-0000 apply to the rules
in OAR chapter 411, division 320:
(1) "24-Hour Residential
Setting" means a comprehensive residential home licensed by the Department under
ORS 443.410 to provide residential care and training to individuals with intellectual
or developmental disabilities.
(2) "ABAS" means Adaptive
Behavior Assessment System.
(3) "ABES" means Adaptive
Behavior Evaluation Scale.
(4) "Abuse" means:
(a) For a child:
(A) "Abuse" as defined in
ORS 419B.005; and
(B) "Abuse" as defined in
OAR 407-045-0260 when a child resides in a 24-hour residential setting licensed
by the Department as described in OAR chapter 411, division 325.
(b) For an adult, "abuse"
as defined in OAR 407-045-0260.
(5) "Abuse Investigation"
means the reporting and investigation activities as required by OAR 407-045-0300
and any subsequent services or supports necessary to prevent further abuse as required
by 407-045-0310.
(6) "Adaptive Behavior" means
the degree to which an individual meets the standards of personal independence and
social responsibility expected for age and culture group. Other terms used to describe
adaptive behavior include, but are not limited to, adaptive impairment, ability
to function, daily living skills, and adaptive functioning. Adaptive behaviors are
everyday living skills including, but not limited to, walking (mobility), talking
(communication), getting dressed or toileting (self-care), going to school or work
(community use), and making choices (self-direction).
(a) Adaptive behavior is
measured by normed, standardized tests administered by a licensed clinical or school
psychologist, or a doctor of medicine or doctor of osteopathic medicine with specific
training and experience in test interpretation of adaptive behavior scales for individuals
with intellectual or developmental disabilities. Adaptive behavior assessments include:
(A) Adaptive Behavior Assessment
System (ABAS);
(B) Adaptive Behavior Evaluation
Scale (ABES);
(C) Vineland Adaptive Behavior
Scale (VABS);
(D) Scales of Independent
Behavior-Revised (SIB-R); or
(E) Other assessments that
are designed to measure adaptive behavior standardized and normed to a population
consistent with the population of the applicant or approved by the Department of
Human Services, Office of Developmental Disability Services (ODDS).
(b) DOMAIN SCORES. Adaptive
behavior domain scores are identified on the following assessments of adaptive behavior:
(A) The ABAS and ABES are:
(i) Conceptual;
(ii) Practical; and
(iii) Social.
(B) The VABS are:
(i) Socialization;
(ii) Daily living skills;
(iii) Communication; and
(iv) Motor.
(C) The SIB-R are:
(i) Personal living skills;
(ii) Social interaction and
communication skills;
(iii) Community living skills;
and
(iv) Motor skills.
(c) COMPOSITE SCORE. The
adaptive behavior composite score is the overall score which results from summing
two or more domain scores on a given adaptive behavior assessment.
(d) SKILLED AREAS. Skilled
areas are a particular assessed score. The skilled areas on the ABAS or ABES are
the only skilled areas used for the purposes of OAR 411-320-0080 and include scaled
scores in:
(A) Communication;
(B) Functional academics;
(C) Self-direction;
(D) Leisure;
(E) Social;
(F) Community use;
(G) Home and school living;
(H) Self-care;
(I) Health and safety; and
(J) Work.
(e) "Significant impairment"
in adaptive behavior means:
(A) A composite score of
at least two standard deviations below the norm;
(B) Two or more domain scores
as identified in subsection (b) of this section are at least two standard deviations
below the norm; or
(C) Two or more skilled areas
as identified in subsection (d) of this section are at least two standard deviations
below the norm.
(7) "Administrator Review"
means the Director of the Department reviews a decision upon request, including
the documentation related to the decision, and issues a determination.
(8) "Alternative Resources"
mean possible resources, not including developmental disability services, for the
provision of supports to meet the needs of an individual. Alternative resources
include, but are not limited to, private or public insurance, vocational rehabilitation
services, supports available through the Oregon Department of Education, or other
community supports.
(9) "Annual Plan" means the
written summary a services coordinator completes for an individual who is not enrolled
in waiver or Community First Choice state plan services. An Annual Plan is not an
ISP and is not a plan of care for Medicaid purposes.
(10) “Annual Review”
means the annual review of the level of care determination.
(11) "Background Check" means
a criminal records check and abuse check as defined in OAR 407-007-0210.
(12) "Behavior Support Plan"
means the written strategy based on person-centered planning and a functional assessment
that outlines specific instructions for a provider to follow in order to reduce
the frequency and intensity of the challenging behaviors of an individual and to
modify the behavior of the provider, adjust environment, and teach new skills.
(13) "Behavior Support Services"
mean the services consistent with positive behavioral theory and practice that are
provided to assist with behavioral challenges due to the intellectual or developmental
disability of an individual that prevents the individual from accomplishing ADL,
IADL, health-related tasks, and provides cognitive supports to mitigate behavior.
Behavior support services are provided in the home or community.
(14) "Brokerage" means "Brokerage"
as defined in OAR 411-340-0020.
(15) "Career Development
Plan" means the part of an ISP that identifies:
(a) The employment goals
and objectives for an individual;
(b) The services and supports
needed to achieve those goals;
(c) The people, agencies,
and providers assigned to assist the individual to attain those goals;
(d) The obstacles to the
individual working in an individualized job in an integrated employment setting;
and
(e) The services and supports
necessary to overcome those obstacles.
(16) "Case Management" means
the functions performed by a services coordinator or personal agent. Case management
includes, but is not limited to, determining service eligibility, developing a plan
of authorized services, and monitoring the effectiveness of services and supports.
(17) "Case Management Contact"
means a reciprocal interaction between a services coordinator and an individual
or the legal or designated representative of the individual (as applicable).
(18) "CDDP" means "community
developmental disability program". A CDDP is the entity that is responsible for
plan authorization, delivery, and monitoring of services for individuals who are
not enrolled in a Brokerage. A CDDP operates in a specific geographic service area
of the state under a contract with the Department, LMHA, or other entity as contracted
by the Department.
(19) "Chemical Restraint"
means the use of a psychotropic drug or other drugs for punishment or to modify
behavior in place of a meaningful behavior or treatment plan.
(20) "Child" means an individual
who is less than 18 years of age that has a provisional determination of an intellectual
or developmental disability.
(21) "Choice" means the expression
of preference, opportunity for, and active role of an individual in decision-making
related to services received and from whom including, but not limited to, case management,
providers, services, and service settings. Individuals are supported in opportunities
to make changes when so expressed. Choice may be communicated through a variety
of methods, including orally, through sign language, or by other communication methods.
(22) "Choice Advising" means
the impartial sharing of information to individuals with intellectual or developmental
disabilities provided by a person that meets the qualifications in OAR 411-320-0030(4)(c)
about:
(a) Case management;
(b) Service options;
(c) Service setting options;
and
(d) Provider types.
(23) "CIIS" means "children's
intensive in-home services". CIIS include the services described in:
(a) OAR chapter 411, division
300 for the Children's Intensive In-Home Services, Behavior Program;
(b) OAR chapter 411, division
350 for Medically Fragile Children's Services; and
(c) OAR chapter 411, division
355 for the Medically Involved Children's Program.
(24) "CMS" means Centers
for Medicare and Medicaid Services.
(25) "Completed Application"
means an application required by the Department that:
(a) Is filled out completely,
signed, and dated. An applicant who is unable to sign may sign with a mark, witnessed
by another person; and
(b) Contains documentation
required to make an eligibility determination as outlined in OAR 411-320-0080(1)(a)(B).
(26) "Composite Score" means
the score identified by an assessment of adaptive behavior as described in the definition
for "adaptive behavior".
(27) "Comprehensive Services"
means developmental disability services and supports that include 24-hour residential
services and attendant care provided in a licensed home, foster home, or through
a supported living program. Comprehensive services are regulated by the Department
alone or in combination with an associated Department-regulated program for employment.
Comprehensive services are in-home services provided to an individual with an intellectual
or developmental disability when the individual receives case management services
from a CDDP. Comprehensive services do not include support services for adults with
intellectual or developmental disabilities enrolled in Brokerages.
(28) "County of Origin" means:
(a) For an adult, the county
of residence for the adult; and
(b) For a child, the county
where the jurisdiction of guardianship exists.
(29) "Crisis" means:
(a) A situation as determined
by a qualified services coordinator that may result in civil court commitment under
ORS 427.215 to 427.306 and for which no appropriate alternative resources are available;
or
(b) Risk factors described
in OAR 411-320-0160(2) are present for which no appropriate alternative resources
are available.
(30) "Crisis Diversion Services"
mean short-term services provided for up to 90 days or on a one-time basis, directly
related to resolving a crisis, and provided to, or on behalf of, an individual eligible
to receive crisis supports.
(31) "Crisis Plan" means
the document generated by the CDDP or Regional Crisis Diversion Program that justifies
and authorizes crisis supports and expenditures for an individual receiving crisis
diversion services provided under these rules.
(32) "Current Documentation"
means documentation relating to the intellectual or developmental disability of
an individual in regards to the functioning of the individual within the last three
years. Current documentation may include, but is not limited to, an ISP, Annual
Plan, Behavior Support Plan, required assessments, educational records, medical
assessments related to the intellectual or developmental disability of an individual,
psychological evaluations, and assessments of adaptive behavior.
(33) "Department" means the
Department of Human Services.
(34) "Designated Representative"
means any adult, such as a parent, family member, guardian, advocate, or other person,
who is chosen by an individual or the legal representative of the individual, not
a paid provider for the individual, and authorized by the individual or the legal
representative of the individual to serve as the representative of the individual
or the legal representative of the individual in connection with the provision of
funded supports. An individual or a legal representative of the individual is not
required to appoint a designated representative.
(35) "Developmental Disability
(DD)" means a neurological condition that:
(a) Originates before an
individual is 22 years of age or 18 years of age for an intellectual disability;
(b) Originates in and directly
affects the brain and has continued, or is expected to continue, indefinitely;
(c) Constitutes significant
impairment in adaptive behavior as diagnosed and measured by a qualified professional
as described in OAR 411-320-0080;
(d) Is not primarily attributed
to other conditions including, but not limited to, a mental or emotional disorder,
sensory impairment, motor impairment, substance abuse, personality disorder, learning
disability, or Attention Deficit Hyperactivity Disorder (ADHD); and
(e) Requires training and
support similar to an individual with an intellectual disability as described in
OAR 411-320-0080.
(36) "Director" means the
Director of the Department of Human Services, Office of Developmental Disability
Services or the designee of the Director.
(37) "Domain Score" means
the score identified by an assessment of adaptive behavior as described in the definition
for "adaptive behavior".
(38) "Eligibility Determination"
means a decision by the CDDP or by the Department regarding the eligibility of a
person for developmental disability services pursuant to OAR 411-320-0080 and is
either a decision that a person is eligible or ineligible for developmental disability
services.
(39) "Eligibility Specialist"
means an employee of the CDDP, or other agency, that contracts with the county or
Department to determine eligibility for developmental disability services.
(40) "Entry" means admission
to a Department-funded developmental disability service.
(41) "Exit" means termination
or discontinuance of a Department-funded developmental disability service by a Department
licensed or certified provider.
(42) "Functional Needs Assessment"
means the comprehensive assessment or reassessment appropriate to the specific program
in which an individual is enrolled that:
(a) Documents physical, mental,
and social functioning;
(b) Identifies risk factors
and support needs; and
(c) Determines the service
level.
(43) "Guardian" means the
parent for an individual less than 18 years of age or the person or agency appointed
and authorized by a court to make decisions about services for an individual.
(44) "Health Care Representative"
means:
(a) A health care representative
as defined in ORS 127.505; or
(b) A person who has authority
to make health care decisions for an individual under the provisions of OAR chapter
411, division 365.
(45) "Hearing" means a contested
case hearing subject to OAR 137-003-0501 to 137-003-0700, which results in a Final
Order.
(46) "History" means, for
the purposes of an eligibility determination as defined in this rule, necessary
evidence of an intellectual disability prior to 18 years of age or an other developmental
disability prior to 22 years of age, including previous assessments and medical
evaluations prior to the date of eligibility determination for developmental disability
services.
(47) "Home" means the primary
residence of an individual that is not under contract with the Department to provide
services to the individual as a certified foster home or licensed or certified residential
care facility, assisted living facility, nursing facility, or other residential
support program site. For a child, a home may include a foster home funded by Child
Welfare.
(48) "IEP" means "Individualized
Education Program". An IEP is the written plan of instructional goals and objectives
developed in conference with an individual, the parent or legal representative of
an individual (as applicable), teacher, and a representative of the public school
district.
(49) "Imminent Risk" means:
(a) An adult who is in crisis
and shall be civilly court-committed to the Department under ORS 427.215 to 427.306
within 60 days without the use of crisis diversion services; or
(b) A child who is in crisis
and shall require out-of-home placement within 60 days without the use of crisis
diversion services.
(50) "Incident Report" means
the written report of any injury, accident, act of physical aggression, use of protective
physical intervention, or unusual incident involving an individual.
(51) "Independence" means
the extent to which an individual exerts control and choice over his or her own
life.
(52) "Individual" means a
child or an adult with an intellectual or developmental disability applying for,
or determined eligible for, Department-funded services. Unless otherwise specified,
references to individual also include the legal or designated representative of
the individual, who has the ability to act for the individual and to exercise the
rights of the individual.
(53) "Informal Adaptive Behavior
Assessment" means:
(a) Observations of impairment
in adaptive behavior recorded in the progress notes for an individual by a services
coordinator or a trained eligibility specialist with at least two years of experience
working with individuals with intellectual or developmental disabilities; or
(b) A standardized measurement
of adaptive behavior, such as a Vineland Adaptive Behavior Scale (VABS) or Adaptive
Behavior Assessment System (ABAS), that is administered and scored by a social worker
or other professional with a graduate degree and specific training and experience
in individual assessment, administration, and test interpretation of adaptive behavior
scales for individuals with intellectual or developmental disabilities.
(54) "Intake" means the activity
of completing the DD Intake Form (SDS 0552) and necessary releases of information
prior to the submission of a completed application to the CDDP.
(55) "Integration" as defined
in ORS 427.005 means:
(a) Use by individuals with
intellectual or developmental disabilities of the same community resources that
are used by and available to other people;
(b) Participation by individuals
with intellectual or developmental disabilities in the same community activities
in which people without disabilities participate, together with regular contact
with people without disabilities; and
(c) Residence by individuals
with intellectual or developmental disabilities in homes or in home-like settings
that are in proximity to community resources, together with regular contact with
people without disabilities in the community.
(56) "Intellectual Disability
(ID)" means significantly subaverage general intellectual functioning defined as
full scale intelligence quotients (IQs) 70 and under as measured by a qualified
professional and existing concurrently with significant impairment in adaptive behavior
directly related to an intellectual disability as described in OAR 411-320-0080
that is manifested during the developmental period prior to 18 years of age. Individuals
with a valid full scale IQ of 71-75 may be considered to have an intellectual disability
if there is also significant impairment in adaptive behavior as diagnosed and measured
by a licensed clinical or school psychologist as described in OAR 411-320-0080.
(57) "Intellectual Functioning"
means functioning as assessed by one or more of the individually administered general
intelligence tests developed for the purpose of measuring intelligence. For purposes
of making eligibility determinations, intelligence tests do not include brief intelligence
measurements.
(58) "Involuntary Reduction"
means a provider has made the decision to reduce services provided to an individual
without prior approval from the individual.
(59) "Involuntary Transfer"
means a provider has made the decision to transfer an individual without prior approval
from the individual.
(60) "IQ" means intelligence
quotient.
(61) "ISP" means "Individual
Support Plan". An ISP includes the written details of the supports, activities,
and resources required for an individual to achieve and maintain personal goals
and health and safety. The ISP is developed at least annually to reflect decisions
and agreements made during a person-centered process of planning and information
gathering that is driven by the individual. The ISP reflects services and supports
that are important for the individual to meet the needs of the individual identified
through a functional needs assessment as well as the preferences of the individual
for providers, delivery, and frequency of services and supports. The ISP is the
plan of care for Medicaid purposes and reflects whether services are provided through
a waiver, the Community First Choice state plan, natural supports, or alternative
resources. The ISP includes the Career Development Plan.
(62) "ISP Team" means a team
composed of an individual receiving services, the legal or designated representative
of the individual (as applicable), services coordinator, and others chosen by the
individual, such as providers and family members.
(63) "Legal Representative":
(a) For a child means the
parent of a child unless a court appoints another person or agency to act as the
guardian of the child.
(b) For an adult means an
attorney at law who has been retained by or for an adult individual, a power of
attorney for the adult individual, or a person or agency authorized by a court to
make decisions about services for an adult individual.
(64) "Level of Care" means
an individual meets the following institutional level of care for an intermediate
care facility for individuals with intellectual or developmental disabilities:
(a) The individual has an
intellectual disability or a developmental disability as defined in this rule and
meets the eligibility criteria in OAR 411-320-0080 for developmental disability
services; and
(b) The individual has a
significant impairment in one or more areas of adaptive behavior as determined in
OAR 411-320-0080.
(65) "Licensed Medical Practitioner"
means any of the following licensed professionals:
(a) Medical Doctor (MD);
(b) Doctor of Osteopathic
Medicine (DO);
(c) Licensed Clinical Psychologist
(Ph.D or Psy.D);
(d) Nurse Practitioner (NP);
(e) Physician Assistant (PA);
or
(f) Naturopathic Doctor (ND).
(66) "LMHA" means "local
mental health authority". The LMHA is:
(a) The county court or board
of county commissioners of one or more counties that operate a CDDP;
(b) The tribal council in
the case of a Native American reservation;
(c) The board of directors
of a public or private corporation if the county declines to operate or contract
for all or part of a CDDP; or
(d) The advisory committee
for the CDDP covering a geographic service area when managed by the Department.
(67) "Management Entity"
means the CDDP or private corporation that operates the Regional Crisis Diversion
Program, including acting as the fiscal agent for regional crisis diversion funds
and resources.
(68) "Mandatory Reporter":
(a) Means any public or private
official as defined in OAR 407-045-0260 who:
(A) Comes in contact with
a child with or without an intellectual or developmental disability and has reasonable
cause to believe the child has suffered abuse, or comes in contact with any person
whom the public or private official has reasonable cause to believe abused the child,
regardless of whether or not the knowledge of the abuse was gained in the official
capacity of the public or private official.
(B) While acting in an official
capacity, comes in contact with an adult with an intellectual or developmental disability
and has reasonable cause to believe the adult has suffered abuse, or comes in contact
with any person whom the public or private official has reasonable cause to believe
abused the adult.
(b) Nothing contained in
ORS 40.225 to 40.295 affects the duty to report imposed by this definition, except
that a psychiatrist, psychologist, clergy, attorney, or guardian ad litem appointed
under 419B.231 is not required to report if the communication is privileged under
40.225 to 40.295.
(69) "Mechanical Restraint"
means any mechanical device, material, object, or equipment attached or adjacent
to the body of an individual that the individual cannot easily remove or easily
negotiate around that restricts freedom of movement or access to the body of the
individual.
(70) "Monitoring" means
the periodic review of the implementation of services identified in an ISP or Annual
Plan and the quality of services delivered by other organizations.
(71) "Motor Impairment" means
impairment in the ability to move caused by trauma, disease, or any condition affecting
the muscular-skeletal system, spinal cord, or sensory or motor nerves.
(72) "Natural Supports" means
the parental responsibilities for a child and the voluntary resources available
to an individual from the relatives, friends, significant others, neighbors, roommates,
and the community of the individual that are not paid for by the Department.
(73) "Nursing Service Plan"
means the plan that is developed by a registered nurse based on an initial nursing
assessment, reassessment, or an update made to a nursing assessment as the result
of a monitoring visit.
(a) The Nursing Service Plan
is specific to an individual and identifies the diagnoses and health needs of the
individual and any service coordination, teaching, or delegation activities.
(b) The Nursing Service Plan
is separate from the ISP as well as any service plans developed by other health
professionals.
(74) "OAAPI" means the Department
of Human Services, Office of Adult Abuse Prevention and Investigation.
(75) "OHP" means Oregon Health
Plan.
(76) "OHP Plus" means only
the Medicaid benefit packages provided under OAR 410-120-1210(4)(a) and (b). This
excludes individuals receiving Title XXI benefits.
(77) "OIS" means "Oregon
Intervention System". OIS is the system of providing training of elements of positive
behavior support and non-aversive behavior intervention. OIS uses principles of
pro-active support and describes approved protective physical intervention techniques
that are used to maintain health and safety.
(78) "Older Adult" means
an adult at least 65 years of age.
(79) "OSIPM" means "Oregon
Supplemental Income Program-Medical" as described in OAR 461-001-0030. OSIPM is
Oregon Medicaid insurance coverage for individuals who meet the eligibility criteria
described in OAR chapter 461.
(80) "Person-Centered Planning":
(a) Means a timely and formal
or informal process driven by an individual, includes people chosen by the individual,
ensures the individual directs the process to the maximum extent possible, and the
individual is enabled to make informed choices and decisions consistent with 42
CFR 441.540:
(b) Person-centered planning
includes gathering and organizing information to reflect what is important to and
for the individual and to help:
(A) Determine and describe
choices about personal goals, activities, services, providers, service settings,
and lifestyle preferences;
(B) Design strategies and
networks of support to achieve goals and a preferred lifestyle using individual
strengths, relationships, and resources; and
(C) Identify, use, and strengthen
naturally occurring opportunities for support at home and in the community.
(c) The methods for gathering
information vary, but all are consistent with the cultural considerations, needs,
and preferences of the individual.
(81) "Personal Agent" means
"personal agent" as defined in OAR 411-340-0020.
(82) "Positive Behavioral
Theory and Practice" means a proactive approach to behavior and behavior interventions
that:
(a) Emphasizes the development
of functional alternative behavior and positive behavior intervention;
(b) Uses the least intrusive
intervention possible;
(c) Ensures that abusive
or demeaning interventions are never used; and
(d) Evaluates the effectiveness
of behavior interventions based on objective data.
(83) "Productivity" as defined
in ORS 427.005 means regular engagement in income-producing work, preferable competitive
employment with supports and accommodations to the extent necessary, by an individual
that is measured through improvements in income level, employment status, or job
advancement or engagement by an individual in work contributing to a household or
community.
(84) "Program" means "provider"
as defined in this rule.
(85) "Progress Note" means
a written record of an action taken by a services coordinator in the provision of
case management, administrative tasks, or direct services to support an individual.
A progress note may also be a recording of information related to the services,
support needs, or circumstances of the individual which is necessary for the effective
delivery of services.
(86) "Protective Services"
mean the necessary actions offered to an individual as soon as possible to prevent
subsequent abuse or exploitation of the individual, to prevent self-destructive
acts, or to safeguard the person, property, and funds of the individual.
(87) "Protective Physical
Intervention" means any manual physical holding of, or contact with, an individual
that restricts freedom of movement.
(88) "Provider" means a person,
agency, organization, or business selected by an individual that provides recognized
Department-funded services and is approved by the Department or other appropriate
agency to provide Department-funded services.
(89) "Psychotropic Medication"
means a medication the prescribed intent of which is to affect or alter thought
processes, mood, or behavior including, but not limited to, anti-psychotic, antidepressant,
anxiolytic (anti-anxiety), and behavior medications. The classification of a medication
depends upon its stated, intended effect when prescribed.
(90) "Qualified Professional"
means, for the purposes of OAR 411-320-0080, any of the following licensed professionals
trained to make a diagnosis of a specific intellectual or developmental disability:
(a) Licensed clinical psychologist
(Ph.D., Psy.D.);
(b) Medical doctor (MD);
(c) Doctor of Osteopathic
Medicine (DO); or
(d) Nurse Practitioner (NP).
(91) "Quality Management
Strategy" means the Department Quality Assurance Plan for meeting the CMS waiver
quality assurances as required and defined by 42 CFR 441.301 and 441.302 and State
Plan K option quality assurances as required and defined by 42 CFR 441.585.
(92) "Region" means a group
of Oregon counties defined by the Department that have a designated management entity
to coordinate regional crisis and backup services and be the recipient and administration
of funds for those services.
(93) "Regional Crisis Diversion
Program" means the regional coordination of the management of crisis diversion services
for a group of designated counties that is responsible for the management of the
following developmental disability services:
(a) Crisis intervention services;
(b) Evaluation of requests
for new or enhanced services for certain groups of individuals eligible for developmental
disability services; and
(c) Other developmental disability
services that the counties compromising the region agree are delivered more effectively
or automatically on a regional basis.
(94) "Relief Care" means
the intermittent services that are provided on a periodic basis for the relief of,
or due to the temporary absence of, a person normally providing supports to an individual.
(95) "Resident" means an
individual that meets the residency requirements in OAR 461-120-0010.
(96) "School Aged" means
the age at which an individual is old enough to attend kindergarten through high
school.
(97) "Self-Determination"
means a philosophy and process by which individuals with intellectual or developmental
disabilities are empowered to gain control over the selection of services and supports
that meet their needs. The basic principles of self-determination are:
(a) Freedom. The ability
for an individual, together with freely-chosen family and friends, to plan a life
with necessary services rather than purchasing a predefined program;
(b) Authority. The ability
for an individual, with the help of a social support network if needed, to control
resources in order to purchase services;
(c) Autonomy. The arranging
of resources and personnel, both formal and informal, that assists an individual
to live a life in the community rich in community affiliations; and
(d) Responsibility. The acceptance
of a valued role of an individual in the community through competitive employment,
organizational affiliations, personal development, and general caring for others
in the community, as well as accountability for spending public dollars in ways
that are life-enhancing for the individual.
(98) "Self-Direction" means
that an individual has decision-making authority over services and takes direct
responsibility for managing services with the assistance of a system of available
supports that promotes personal choice and control over the delivery of waiver and
state plan services.
(99) "Sensory Impairment"
means loss or impairment of sight or hearing from any cause, including involvement
of the brain.
(100) "Service Element" means
a funding stream to fund programs or services including, but not limited to, foster
care, 24-hour residential, case management, supported living, support services,
crisis diversion services, in-home comprehensive supports, or family support.
(101) "Service Record" means
the combined information related to an individual in accordance with OAR 411-320-0070.
(102) "Services Coordinator"
means an employee of a CDDP or other agency that contracts with the county or Department
who provides case management services including, but not limited to, planning, procuring,
coordinating, and monitoring services. A services coordinator acts as the proponent
for individuals with intellectual or developmental disabilities and is the person-centered
plan coordinator of an individual as defined in the Community First Choice state
plan.
(103) "SIB-R" means Scales
of Independent Behavior-Revised.
(104) "Significantly Subaverage"
means a score on a test of intellectual functioning that is two or more standard
deviations below the mean for the test.
(105) "Skilled Areas" means
a particular assessed score as described in the definition for "adaptive behavior".
(106) "SSI" means Supplemental
Security Income.
(107) "Support Services"
means "support services" as defined in OAR 411-340-0020.
(108) "These Rules" mean
the rules in OAR chapter 411, division 320.
(109) "Transfer" means movement
of an individual from one service site to another service site administered or operated
by the same provider.
(110) "Transition Plan" means
the ISP describing necessary services and supports for an individual upon entry
to a new service setting. The Transition Plan is approved by a services coordinator
and includes a summary of the services necessary to facilitate adjustment to the
services offered, the supports necessary to ensure health and safety, and the assessments
and consultations necessary for further ISP development.
(111) "U.S. Citizen" means
an individual that meets the criteria in OAR 461-120-0110. A U.S. Citizen includes:
(a) An individual born in
the United States, Puerto Rico, Guam, Northern Mariana Islands, Virgin Islands,
American Samoa, or Swains Island;
(b) A foreign-born child
less than 18 years of age residing in the United States with his or her birth or
adoptive parents, at least one of whom is a U.S. citizen by birth or naturalization;
(c) An individual granted
citizenship status by Immigration and Naturalization Services (INS);
(d) A qualified non-citizen
as described in OAR 461-120-0125;
(e) A citizen of Puerto Rico,
Guam, Virgin Islands, or Saipan, Tinian, Rota, or Pagan of the Northern Mariana
Islands;
(f) A national from American
Samoa or Swains Island; or
(g) An alien who is a victim
of a severe form of trafficking in persons under section 107(b)(a)(A) of the Victims
of Trafficking and Violence Protection Act of 2000 (22 U.S.C. 7101 to 7112).
(112) "Unusual Incident"
means any incident involving an individual that includes serious illness or an accident,
death, injury or illness requiring inpatient or emergency hospitalization, a suicide
attempt, a fire requiring the services of a fire department, an act of physical
aggression, or any incident requiring an abuse investigation.
(113) "VABS" means Vineland
Adaptive Behavior Scale.
(114) "Variance" means the
temporary exception from a regulation or provision of these rules that may be granted
by the Department as described in OAR 411-320-0200.
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 25-2009(Temp), f. 12-31-09, cert. ef.
1-1-10 thru 6-30-10; SPD 5-2010, f. 6-29-10, cert. ef. 7-1-10; SPD 6-2010(Temp),
f. 6-29-10, cert. ef. 7-4-10 thru 12-31-10; SPD 28-2010, f. 12-29-10, cert. ef.
1-1-11; SPD 31-2011, f. 12-30-11, cert. ef. 1-1-12; SPD 22-2013(Temp), f. &
cert. ef. 7-1-13 thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD
23-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14,
cert. ef. 12-28-14

411-320-0030
Organization and Program Management
(1) ORGANIZATION AND INTERNAL MANAGEMENT.
Each service provider of community developmental disability services funded by the
Department must have written standards governing the operation and management of
the CDDP. Such standards must be up to date, available upon request, and include:
(a) An up-to-date organization
chart showing lines of authority and responsibility from the LMHA to the CDDP manager
and the components and staff within the CDDP;
(b) Position descriptions
for all staff providing community developmental disability services;
(c) Personnel policies and
procedures concerning:
(A) Recruitment and termination
of employees;
(B) Employee compensation
and benefits;
(C) Employee performance
appraisals, promotions, and merit pay;
(D) Staff development and
training;
(E) Employee conduct, including
the requirement that abuse of an individual by an employee, staff, or volunteer
of the CDDP is prohibited and is not condoned or tolerated; and
(F) Reporting of abuse, including
the requirement that any employee of the CDDP is to report incidents of abuse when
the employee comes in contact with and has reasonable cause to believe that an individual
has suffered abuse. Notification of mandatory reporting status must be made at least
annually to all employees and documented on forms provided by the Department.
(2) MANAGEMENT PLAN. The
CDDP must maintain a current management plan assigning responsibility for the program
management functions and duties described in this rule. The management plan must:
(a) Consider the unique organizational
structure, policies, and procedures of the CDDP;
(b) Assure that the functions
and duties are assigned to people who have the knowledge and experience necessary
to perform them, as well as ensuring that the functions are implemented; and
(c) Reflect implementation
of minimum quality assurance activities described in OAR 411-320-0045 that support
the Department's Quality Management Strategy for meeting CMS' waiver quality assurances
as required by 42 CFR 441.301 and 441.302.
(3) PROGRAM MANAGEMENT.
(a) Staff delivering developmental
disability services must be organized under the leadership of a designated CDDP
manager and receive clerical services sufficient to perform their required duties.
(b) The LMHA, public entity,
or the public or private corporation operating the CDDP must designate a full-time
employee who must, on at least a part-time basis, be responsible for management
of developmental disability services within a specific geographic service area.
(c) In addition to other
duties as may be assigned in the area of developmental disability services, the
CDDP must at a minimum develop and assure:
(A) Implementation of plans
as may be needed to provide a coordinated and efficient use of resources available
to serve individuals;
(B) Maintenance of positive
and cooperative working relationships with legal and designated representatives,
families, service providers, support services brokerages, the Department, local
government, and other state and local agencies with an interest in developmental
disability services;
(C) Implementation of programs
funded by the Department to encourage pursuit of defined program outcomes and monitor
the programs to assure service delivery that is in compliance with related contracts
and applicable local, state, and federal requirements;
(D) Collection and timely
reporting of information as may be needed to conduct business with the Department,
including but not limited to information needed to license foster homes, collect
federal funds supporting services, and investigate complaints related to services
or suspected abuse; and
(E) Use of procedures that
attempt to resolve complaints involving individuals or organizations that are associated
with developmental disability services.
(4) QUALIFIED STAFF. Each
CDDP must provide a qualified CDDP manager, services coordinator, eligibility specialist,
and abuse investigator specialist for adults with intellectual or developmental
disabilities, or have an agreement with another CDDP to provide a qualified eligibility
specialist and abuse investigator specialist for adults with intellectual or developmental
disabilities.
(a) CDDP MANAGER.
(A) The CDDP manager must
have knowledge of the public service system for developmental disability services
in Oregon and at least:
(i) A bachelor's degree in
behavioral science, social science, health science, special education, public administration,
or human service administration and a minimum of four years experience with at least
two of those years of experience in developmental disability services that provided
recent experience in program management, fiscal management, and staff supervision;
or
(ii) Six years of experience
with staff supervision; or
(iii) Six years of experience
in technical or professional level staff work related to developmental disability
services.
(B) On an exceptional basis,
the CDDP may hire a person who does not meet the qualifications in subsection (A)
of this section if the county and the Department have mutually agreed on a training
and technical assistance plan that assures that the person quickly acquires all
needed skills and experience.
(C) When the position of
a CDDP manager becomes vacant, an interim CDDP manager must be appointed to serve
until a permanent CDDP manager is appointed. The CDDP must request a variance as
described in section (7) of this rule if the person appointed as interim CDDP manager
does not meet the qualifications in subsection (A) of this section and the term
of the appointment totals more than 180 days.
(b) CDDP SUPERVISOR. The
CDDP supervisor (when designated) must have knowledge of the public service system
for developmental disability services in Oregon and at least:
(A) A bachelor's degree or
equivalent course work in a field related to management such as business or public
administration, or a field related to developmental disability services may be substituted
for up to three years required experience; or
(B) Five years of experience
in staff supervision or five years of experience in technical or professional level
staff work related to developmental disability services.
(c) SERVICES COORDINATOR.
The services coordinator must have knowledge of the public service system for developmental
disability services in Oregon and at least:
(A) A bachelor's degree in
behavioral science, social science, or a closely related field; or
(B) A bachelor’s degree
in any field and one year of human services related experience, such as work providing
assistance to individuals and groups with issues such as economical disadvantages,
employment, abuse and neglect, substance abuse, aging, disabilities, prevention,
health, cultural competencies, or housing; or
(C) An associate’s
degree in a behavioral science, social science, or a closely related field and two
years of human services related experience, such as work providing assistance to
individuals and groups with issues such as economical disadvantages, employment,
abuse and neglect, substance abuse, aging, disabilities, prevention, health, cultural
competencies, or housing; or
(D) Three years of human
services related experience, such as work providing assistance to individuals and
groups with issues such as economical disadvantages, employment, abuse and neglect,
substance abuse, aging, disabilities, prevention, health, cultural competencies,
or housing.
(d) ELIGIBILITY SPECIALIST.
The eligibility specialist must have knowledge of the public service system for
developmental disability services in Oregon and at least:
(A) A bachelor's degree in
behavioral science, social science, or a closely related field; or
(B) A bachelor’s degree
in any field and one year of human services related experience; or
(C) An associate’s
degree in behavioral science, social science, or a closely related field and two
years of human services related experience; or
(D) Three years of human
services related experience.
(e) ABUSE INVESTIGATOR SPECIALIST.
The abuse investigator specialist must have at least:
(A) A bachelor's degree in
human science, social science, behavioral science, or criminal science and two years
of human services, law enforcement, or investigative experience; or
(B) An associate's degree
in human science, social science, behavioral science, or criminal science and four
years of human services, law enforcement, or investigative experience.
(5) EMPLOYMENT APPLICATION.
An application for employment at the CDDP must inquire whether an applicant has
had any founded reports of child abuse or substantiated abuse.
(6) BACKGROUND CHECKS.
(a) Any employee, volunteer,
advisor of the CDDP, or any subject individual defined by OAR 407-007-0210, including
staff who are not identified in this rule but use public funds intended for the
operation of the CDDP, who has or shall have contact with a recipient of CDDP services,
must have an approved background check in accordance with OAR 407-007-0200 to 407-007-0370
and ORS 181.534.
(A) Effective July 28, 2009,
the CDDP may not use public funds to support, in whole or in part, any employee,
volunteer, advisor of the CDDP, or any subject individual defined by OAR 407-007-0210,
who shall have contact with a recipient of CDDP services and who has been convicted
of any of the disqualifying crimes listed in OAR 407-007-0275.
(B) Effective July 28, 2009,
a person does not meet the qualifications described in this rule if the person has
been convicted of any of the disqualifying crimes listed in OAR 407-007-0275.
(C) Any employee, volunteer,
advisor of the CDDP, or any subject individual defined by OAR 407-007-0210 must
self-report any potentially disqualifying condition as described in OAR 407-007-0280
and OAR 407-007-0290. The person must notify the Department or the Department's
designee within 24 hours.
(b) Subsections (A) and (B)
of section (a) do not apply to employees who were hired prior to July 28, 2009 that
remain in the current position for which the employee was hired.
(7) VARIANCE. The CDDP must
submit a written variance request to the Department prior to employing a person
not meeting the minimum qualifications in section (4) of this rule. A variance request
may not be requested for sections (5) and (6) of this rule. The written variance
request must include:
(a) An acceptable rationale
for the need to employ a person who does not meet the minimum qualifications in
section (4) of this rule; and
(b) A proposed alternative
plan for education and training to correct the deficiencies.
(A) The proposal must specify
activities, timelines, and responsibility for costs incurred in completing the alternative
plan.
(B) A person who fails to
complete the alternative plan for education and training to correct the deficiencies
may not fulfill the requirements for the qualifications.
(8) STAFF DUTIES.
(a) SERVICES COORDINATOR
DUTIES. The duties of the services coordinator must be specified in the employee's
job description and at a minimum include:
(A) The delivery of case
management services to individuals as described in OAR 411-320-0090;
(B) Assisting the CDDP manager
in monitoring the quality of services delivered within the county; and
(C) Assisting the CDDP manager
in the identification of existing and insufficient service delivery resources or
options.
(b) ELIGIBILITY SPECIALIST
DUTIES. The duties of the eligibility specialist must be specified in the employee's
job description and at a minimum include:
(A) Completing intake and
eligibility determination for individuals applying for developmental disability
services;
(B) Completing eligibility
redetermination for individuals requesting continuing developmental disability services;
and
(C) Assisting the CDDP manager
in the identification of existing and insufficient service delivery resources or
options.
(c) ABUSE INVESTIGATOR SPECIALIST
DUTIES. The duties of the abuse investigator specialist must be specified in the
employee's job description and at a minimum include:
(A) Conducting abuse investigation
and protective services for adult individuals with intellectual or developmental
disabilities enrolled in, or previously eligible and voluntarily terminated from,
developmental disability services;
(B) Assisting the CDDP manager
in monitoring the quality of services delivered within the county; and
(C) Assisting the CDDP manager
in the identification of existing and insufficient service delivery resources or
options.
(9) STAFF TRAINING. Qualified
staff of the CDDP must maintain and enhance their knowledge and skills through participation
in education and training. The Department provides training materials and the provision
of training may be conducted by the Department or CDDP staff, depending on available
resources.
(a) CDDP MANAGER TRAINING.
The CDDP manager must participate in a basic training sequence and be knowledgeable
of the duties of the staff they supervise and the developmental disability services
they manage. The basic training sequence is not a substitute for the normal procedural
orientation that must be provided by the CDDP to the new CDDP manager.
(A) The orientation provided
by the CDDP to a new CDDP manager must include:
(i) An overview of developmental
disability services and related human services within the county;
(ii) An overview of the Department's
rules governing the CDDP;
(iii) An overview of the
Department's licensing and certification rules for service providers;
(iv) An overview of the enrollment
process and required documents needed for enrollment into the Department's payment
and reporting systems;
(v) A review and orientation
of Medicaid, SSI, Social Security Administration, home and community-based waiver
and state plan services, OHP, and the individual support planning processes; and
(vi) A review (prior to having
contact with individuals) of the CDDP manager's responsibility as a mandatory reporter
of abuse, including abuse of individuals with intellectual or developmental disabilities,
individuals with mental illness, older adults, individuals with physical disabilities,
and children.
(B) The CDDP manager must
attend the following trainings endorsed or sponsored by the Department within the
first year of entering into the position:
(i) Case management basics;
and
(ii) ISP training.
(C) The CDDP manager must
continue to enhance his or her knowledge, as well as maintain a basic understanding
of developmental disability services and the skills, knowledge, and responsibilities
of the staff they supervise.
(i) Each CDDP manager must
participate in a minimum of 20 hours per year of additional Department-sponsored
training or other training in the areas of intellectual or developmental disabilities.
(ii) Each CDDP manager must
attend trainings to maintain a working knowledge of system changes in the area the
CDDP manager is managing or supervising.
(b) CDDP SUPERVISOR TRAINING.
The CDDP supervisor (when designated) must participate in a basic training sequence
and be knowledgeable of the duties of the staff they supervise and of the developmental
disability services they manage. The basic training sequence is not a substitute
for the normal procedural orientation that must be provided by the CDDP to the new
CDDP supervisor.
(A) The orientation provided
by the CDDP to a new CDDP supervisor must include:
(i) An overview of developmental
disability services and related human services within the county;
(ii) An overview of the Department's
rules governing the CDDP;
(iii) An overview of the
Department's licensing and certification rules for service providers;
(iv) An overview of the enrollment
process and required documents needed for enrollment into the Department's payment
and reporting systems;
(v) A review and orientation
of Medicaid, SSI, Social Security Administration, home and community-based waiver
and state plan services, OHP, and the individual support planning processes; and
(vi) A review (prior to having
contact with individuals) of the CDDP supervisor's responsibility as a mandatory
reporter of abuse, including abuse of individuals with intellectual or developmental
disabilities, individuals with mental illness, older adults, individuals with physical
disabilities, and children.
(B) The CDDP supervisor must
attend the following trainings endorsed or sponsored by the Department within the
first year of entering into the position:
(i) Case management basics;
and
(ii) ISP training.
(C) The CDDP supervisor must
continue to enhance his or her knowledge, as well as maintain a basic understanding
of developmental disability services and the skills, knowledge, and responsibilities
of the staff they supervise.
(i) Each CDDP supervisor
must participate in a minimum of 20 hours per year of additional Department-sponsored
training or other training in the areas of intellectual or developmental disabilities.
(ii) Each CDDP supervisor
must attend trainings to maintain a working knowledge of system changes in the area
the CDDP supervisor is managing or supervising.
(c) SERVICES COORDINATOR
TRAINING. The services coordinator must participate in a basic training sequence.
The basic training sequence is not a substitute for the normal procedural orientation
that must be provided by the CDDP to the new services coordinator.
(A) The orientation provided
by the CDDP to a new services coordinator must include:
(i) An overview of the role
and responsibilities of a services coordinator;
(ii) An overview of developmental
disability services and related human services within the county;
(iii) An overview of the
Department's rules governing the CDDP;
(iv) An overview of the Department's
licensing and certification rules for service providers;
(v) An overview of the enrollment
process and required documents needed for enrollment into the Department's payment
and reporting systems;
(vi) A review and orientation
of Medicaid, SSI, Social Security Administration, home and community-based waiver
and state plan services, OHP, and the individual support planning processes for
the services they coordinate; and
(vii) A review (prior to
having contact with individuals) of the services coordinator's responsibility as
a mandatory reporter of abuse, including abuse of individuals with intellectual
or developmental disabilities, individuals with mental illness, older adults, individuals
with physical disabilities, and children.
(B) The services coordinator
must attend the following trainings endorsed or sponsored by the Department within
the first year of entering into the position:
(i) Case management basics;
and
(ii) ISP training (for services
coordinators providing services to individuals in comprehensive services).
(C) The services coordinator
must continue to enhance his or her knowledge, as well as maintain a basic understanding
of developmental disability services and the skills, knowledge, and responsibilities
necessary to perform the position. Each services coordinator must participate in
a minimum of 20 hours per year of Department-sponsored training or other training
in the areas of intellectual or developmental disabilities.
(d) ELIGIBILITY SPECIALIST
TRAINING. The eligibility specialist must participate in a basic training sequence.
The basic training sequence is not a substitute for the normal procedural orientation
that must be provided by the CDDP to the new eligibility specialist.
(A) The orientation provided
by the CDDP to a new eligibility specialist must include:
(i) An overview of eligibility
criteria and the intake process;
(ii) An overview of developmental
disability services and related human services within the county;
(iii) An overview of the
Department's rules governing the CDDP;
(iv) An overview of the Department's
licensing and certification rules for service providers;
(v) An overview of the enrollment
process and required documents needed for enrollment into the Department's payment
and reporting systems;
(vi) A review and orientation
of Medicaid, SSI, Social Security Administration, home and community-based waiver
and state plan services, and OHP; and
(vii) A review (prior to
having contact with individuals) of the eligibility specialist's responsibility
as a mandatory reporter of abuse, including abuse of individuals with intellectual
or developmental disabilities, individuals with mental illness, older adults, individuals
with physical disabilities, and children.
(B) The eligibility specialist
must attend and complete eligibility core competency training within the first year
of entering into the position and demonstrate competency after completion of core
competency training. Until completion of eligibility core competency training, or
if competency is not demonstrated, the eligibility specialist must consult with
another trained eligibility specialist or consult with a Department diagnosis and
evaluation coordinator when making eligibility determinations.
(C) The eligibility specialist
must continue to enhance his or her knowledge, as well as maintain a basic understanding
of the skills, knowledge, and responsibilities necessary to perform the position.
(i) Each eligibility specialist
must participate in Department-sponsored trainings for eligibility on an annual
basis.
(ii) Each eligibility specialist
must participate in a minimum of 20 hours per year of Department-sponsored training
or other training in the areas of intellectual or developmental disabilities.
(e) ABUSE INVESTIGATOR SPECIALIST
TRAINING. The abuse investigator specialist must participate in core competency
training. Training materials are provided by OAAPI. The core competency training
is not a substitute for the normal procedural orientation that must be provided
by the CDDP to the new abuse investigator specialist.
(A) The orientation provided
by the CDDP to a new abuse investigator specialist must include:
(i) An overview of developmental
disability services and related human services within the county;
(ii) An overview of the Department's
rules governing the CDDP;
(iii) An overview of the
Department's licensing and certification rules for service providers;
(iv) A review and orientation
of Medicaid, SSI, Social Security Administration, home and community-based waiver
and state plan services, OHP, and the individual support planning processes; and
(v) A review (prior to having
contact with individuals) of the abuse investigator specialist's responsibility
as a mandatory reporter of abuse, including abuse of individuals with intellectual
or developmental disabilities, individuals with mental illness, older adults, individuals
with physical disabilities, and children.
(B) The abuse investigator
specialist must attend and pass core competency training within the first year of
entering into the position and demonstrate competency after completion of core competency
training. Until completion of core competency training, or if competency is not
demonstrated, the abuse investigator specialist must consult with OAAPI prior to
completing the abuse investigation and protective services report.
(C) The abuse investigator
specialist must continue to enhance his or her knowledge, as well as maintain a
basic understanding of the skills, knowledge, and responsibilities necessary to
perform the position. Each abuse investigator specialist must participate in quarterly
meetings held by OAPPI. At a minimum, one meeting per year must be attended in person.
(f) ATTENDANCE. The CDDP
manager must assure the attendance of the CDDP supervisor (when designated), services
coordinator, eligibility specialist, and abuse investigator specialist at Department-mandated
training.
(g) DOCUMENTATION. The CDDP
must keep documentation of required training in the personnel files of the individual
employees including the CDDP manager, CDDP supervisor (when designated), services
coordinator, eligibility specialist, abuse investigator specialist, and other employees
providing services to individuals.
(10) ADVISORY COMMITTEE.
Each CDDP must have an advisory committee.
(a) The advisory committee
must meet at least quarterly.
(b) The membership of the
advisory committee must be broadly representative of the community with a balance
of age, sex, ethnic, socioeconomic, geographic, professional, and consumer interests
represented. Membership must include advocates for individuals as well as individuals
and the individuals' families.
(c) The advisory committee
must advise the LMHA, CDDP director, and CDDP manager on community needs and priorities
for services, and assist in planning, reviewing, and evaluating services, functions,
duties, and quality assurance activities described in the CDDP's management plan.
(d) When the Department or
a private corporation is operating the CDDP, the advisory committee must advise
the LMHA, CDDP director, and CDDP manager on community needs and priorities for
services, and assist in planning, reviewing, and evaluating services, functions,
duties, and quality assurance activities described in the CDDP's management plan.
(e) The advisory committee
may function as the disability issues advisory committee as described in ORS 430.625
if so designated by the LMHA.
(11) NEEDS ASSESSMENT, PLANNING,
AND COORDINATION. Upon the Department's request, the CDDP must assess local needs
for services to individuals and must submit planning and assessment information
to the Department.
(12) CONTRACTS.
(a) If the CDDP, or any of
the CDDPs services as described in the Department's contract with the LMHA, is not
operated by the LMHA, there must be a contract between the LMHA and the organization
operating the CDDP or the services, or a contract between the Department and the
operating CDDP. The contract must specify the authorities and responsibilities of
each party and conform to the requirements of the Department's rules pertaining
to contracts or any contract requirement with regard to operation and delivery of
services.
(b) The CDDP may purchase
certain services for an individual from a qualified service provider without first
providing an opportunity for competition among other service providers if the service
provider is selected by the individual or the individual's family or legal or designated
representative (as applicable).
(A) The service provider
selected must also meet Department certification or licensing requirements to provide
the type of service to be contracted.
(B) There must be a contract
between the service provider and the CDDP that specifies the authorities and responsibilities
of each party and conforms to the requirements of the Department's rules pertaining
to contracts or any contract requirement with regard to operation and delivery of
services.
(c) When a CDDP contracts
with a public agency or private corporation for delivery of developmental disability
services, the CDDP must include in the contract only terms that are substantially
similar to model contract terms established by the Department. The CDDP may not
add contractual requirements, including qualifications for contractor selection
that are nonessential to the services being provided under the contract. The CDDP
must specify in contracts with service providers that disputes arising from these
limitations must be resolved according to the complaint procedures contained in
OAR 411-320-0170. For purposes of this rule, the following definitions apply:
(A) "Model contract terms
established by the Department" means all applicable material terms and conditions
of the omnibus contract, as modified to appropriately reflect a contractual relationship
between the service provider and CDDP and any other requirements approved by the
Department as local options under procedures established in these rules.
(B) "Substantially similar
to model contract terms" means that the terms developed by the CDDP and the model
contract terms require the service provider to engage in approximately the same
type activity and expend approximately the same resources to achieve compliance.
(C) "Nonessential to the
services being provided" means requirements that are not substantially similar to
model contract terms developed by the Department.
(d) As a local option, the
CDDP may impose a requirement on a public agency or private corporation delivering
developmental disability services under a contract with the CDDP that is in addition
to or different from requirements specified in the omnibus contract if all of the
following conditions are met:
(A) The CDDP has provided
the affected contractors with the text of the proposed local option as it is to
appear in the contract. The proposed local option must include:
(i) The date upon which the
local option is to become effective; and
(ii) A complete written description
of how the local option is to improve individual independence, productivity, or
integration or the protection of individual health, safety, or rights;
(B) The CDDP has sought input
from the affected contractors concerning ways the proposed local option impacts
individual services;
(C) The CDDP, with assistance
from the affected contractors, has assessed the impact on the operations and financial
status of the contractors if the local option is imposed;
(D) The CDDP has sent a written
request for approval of the proposed local option to the Department's director that
includes:
(i) A copy of the information
provided to the affected contractors;
(ii) A copy of any written
comments and a complete summary of oral comments received from the affected contractors
concerning the impact of the proposed local option; and
(iii) The text of the proposed
local option as it is to appear in contracts with service providers, including the
proposed date upon which the requirement is to become effective.
(E) The Department has notified
the CDDP that the new requirement is approved as a local option for that program;
and
(F) The CDDP has advised
the affected contractors of their right and afforded them an opportunity to request
mediation as provided in these rules before the local option is imposed.
(e) The CDDP may add contract
requirements that the CDDP considers necessary to ensure the siting and maintenance
of residential facilities in which individual services are provided. These requirements
must be consistent with all applicable state and federal laws and regulations related
to housing.
(f) The CDDP must adopt a
dispute resolution policy that pertains to disputes arising from contracts with
service providers funded by the Department and contracted through the CDDP. Procedures
implementing the dispute resolution policy must be included in the contract with
any such service provider.
(13) FINANCIAL MANAGEMENT.
(a) There must be up-to-date
accounting records for each developmental disability service accurately reflecting
all revenue by source, all expenses by object of expense, and all assets, liabilities,
and equities. The accounting records must be consistent with generally accepted
accounting principles and conform to the requirements of OAR 309-013-0120 to 309-013-0220.
(b) There must be written
statements of policy and procedure as are necessary and useful to assure compliance
with any Department administrative rules pertaining to fraud and embezzlement and
financial abuse or exploitation of individuals.
(c) Billing for Title XIX
funds must in no case exceed customary charges to private pay individuals for any
like item or service.
(14) POLICIES AND PROCEDURES.
There must be such other written and implemented statements of policy and procedure
as necessary and useful to enable the CDDP to accomplish its service objectives
and to meet the requirements of the contract with the Department, these rules, and
other applicable standards and rules.
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 25-2009(Temp), f. 12-31-09, cert. ef.
1-1-10 thru 6-30-10; SPD 2-2010(Temp), f. & cert. ef. 3-18-10 thru 6-30-10;
SPD 5-2010, f. 6-29-10, cert. ef. 7-1-10; SPD 27-2010Temp), f. & cert. ef. 12-1-10
thru 5-30-11; SPD 11-2011, f. & cert. ef. 6-2-11; SPD 22-2013(Temp), f. &
cert. ef. 7-1-13 thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13
411-320-0040
Program Responsibilities
The CDDP must ensure the provision of
the following services and system supports.
(1) ACCESS TO SERVICES.
(a) In accordance with the
Civil Rights Act of 1964 (codified as 42 USC 2000d et seq.), any person may not
be denied community developmental disability services on the basis of race, color,
creed, gender, national origin, or duration of residence. CDDP contractors must
comply with Section 504 of the Rehabilitation Act of 1973 (codified as 29 USC 794
and as implemented by 45 CFR Section 84.4) that states in part, "No qualified person
must, on the basis of handicap, be excluded from participation in, be denied benefits
of, or otherwise be subjected to discrimination under any program or activity that
receives or benefits from federal financial assistance".
(b) Any individual determined
eligible for developmental disability services by the CDDP must also be eligible
for other community developmental disability services unless entry to the service
is subject to diagnostic or developmental disability category or age restrictions
based on predetermined criteria or contract limitations.
(2) COORDINATION OF COMMUNITY
SERVICES. Planning and implementation of services for individuals served by the
CDDP must be coordinated between components of the CDDP, other local and state human
service agencies, and any other providers as appropriate for the needs of the individual.
(3) CASE MANAGEMENT SERVICES.
The CDDP must provide case management services to individuals who are eligible for
and desire services.
(a) The CDDP may provide
case management to individuals who are waiting for a determination of eligibility
and reside in the county at the time they apply.
(b) Case management may be
provided directly by the CDDP or under a contract between the CDDP and a provider
of case management services.
(c) If an individual is receiving
services in more than one county, the county of origin must be responsible for case
management services unless otherwise negotiated and documented in writing with the
mutually agreed upon conditions.
(d) Case management services
require an impartial point of view to fulfill the necessary functions of planning,
procuring, monitoring, and protective services. Except as allowed under subsection
(e) of this section, the case management program must be provided under an organizational
structure that separates case management from other direct services for individuals.
This separation may take one of the following forms:
(A) The CDDP may provide
case management and subcontract for delivery of other direct services through one
or more different organizations; or
(B) The CDDP may subcontract
for delivery of case management through an unrelated organization and directly provide
the other services or further subcontract these other direct services through organizations
that are not already under contract to provide case management services.
(e) The CDDP or other organization
that provides case management services may also provide other direct services under
one or more of the following circumstances:
(A) The CDDP coordinates
the delivery of family support services for children less than 18 years of age living
in the family home or comprehensive in-home supports for adults.
(B) The CDDP determines that
an organization providing direct services is no longer able to continue providing
services or the organization providing direct services is no longer willing or able
to continue providing services and no other organization is able or willing to continue
operations on 30 days' notice.
(C) In order to develop new
or expanded direct services for geographic service areas or populations because
other local organizations are unwilling or unable to provide appropriate services.
(f) If the CDDP intends to
perform direct services other than family support services or comprehensive in-home
support, a variance must be prior authorized by the Department.
(A) It is assumed that the
CDDP provides family support services or comprehensive in-home supports described
in subsection (e)(A) of this section. If the CDDP does not provide one or both of
these services, the CDDP must submit a written variance request to the Department
for prior approval that describes how the services are going to be provided.
(B) If the circumstances
described in subsection (e)(B) of this rule exist, the CDDP must propose a plan
to the Department for review, including action to assume responsibility for case
management services and the mechanism for addressing potential conflict of interest.
(C) If the CDDP providing
case management services delivers other services as allowed under subsection (e)(C)
of this section, the CDDP must submit a written variance request to the Department
for prior approval that includes the action to assume responsibility for case management
services and the mechanism for addressing potential conflict of interest.
(g) If the CDDP providing
case management services delivers other services as allowed under subsections (e)(B)
and (e)(C) of this section, the CDDP must solicit other organizations to assume
responsibility for delivery of these other services through a request for proposal
(RFP) at least once every two years. When an RFP is issued, a copy of the RFP must
be sent to the Department. The Department must be notified of the results of the
solicitation, including the month and year of the next solicitation if there are
no successful applicants.
(h) If the CDDP wishes to
continue providing case management and other direct services without conducting
a solicitation as described in subsection (g) of this section, the CDDP must submit
a written variance request to the Department for prior approval that describes how
conflict of roles are to be managed within the CDDP.
(i) If the CDDP also operates
a Brokerage, the CDDP must submit a written variance request to the Department for
prior approval that includes the mechanism for addressing potential conflict of
interest.
(4) FAMILY SUPPORT SERVICES.
The CDDP must ensure the availability of a program for family support services in
accordance with OAR chapter 411, division 305.
(5) ABUSE AND PROTECTIVE
SERVICES.
(a) The CDDP must assure
that abuse investigations for adults with intellectual or developmental disabilities
are appropriately reported and conducted by trained staff according to statute and
administrative rules. When there is reason to believe a crime has been committed,
the CDDP must report to law enforcement.
(b) The CDDP must report
any suspected or observed abuse of a child directly to the Department or local law
enforcement.
(6) FOSTER HOMES. The CDDP
must recruit applicants to operate foster homes and maintain forms and procedures
necessary to license or certify foster homes. The CDDP must maintain copies of the
following records:
(a) Initial and renewal applications
for a foster home;
(b) All inspection reports
completed by the CDDP, including required annual renewal inspection and any other
inspections;
(c) General information about
the foster home;
(d) Documentation of references,
classification information, credit check (if necessary), background check, and training
for providers and substitute caregivers;
(e) Documentation of foster
care exams for adult foster home providers;
(f) Correspondence;
(g) Any meeting notes;
(h) Financial records;
(i) Annual agreement or contract;
(j) Legal notices and final
orders for rule violations, conditions, denials, or revocations (if any); and
(k) Copies of the annual
license or certificate for the foster home.
(7) CONTRACT MONITORING.
The CDDP must monitor all community developmental disability subcontractors to assure
that:
(a) Services are provided
as specified in the contract between the CDDP and the Department; and
(b) Services are in compliance
with these rules and other applicable Department rules.
(8) INFORMATION AND REFERRAL.
The CDDP must provide information and referral services to individuals, families
of individuals, and interested others.
(9) AGENCY COORDINATION.
The CDDP must assure coordination with other agencies to develop and manage resources
within the county or region to meet the needs of individuals.
(10) SERVICE DELIVERY COMPLAINTS.
The CDDP must implement procedures to address individual or family complaints regarding
service delivery that have not been resolved using the complaint procedures (informal
or formal) of the CDDP subcontractor. The complaint procedures must be consistent
with the requirements in OAR 411-318-0015.
(11) COMPREHENSIVE IN-HOME
SUPPORTS. The CDDP must ensure the availability of comprehensive in-home supports
in accordance with OAR chapter 411, division 330.
(12) EMERGENCY PLANNING.
The CDDP must ensure the availability of a written emergency procedure and disaster
plan for meeting all civil or weather emergencies and disasters. The emergency procedure
and disaster plan must be immediately available to the CDDP manager and employees.
The emergency procedure and disaster plan must:
(a) Be integrated with the
county emergency preparedness plan, where appropriate;
(b) Include provisions on
coordination with all developmental disability service provider agencies in the
county and any Department offices, as appropriate;
(c) Include provisions for
identifying individuals most vulnerable; and
(d) Include any plans for
health and safety checks, emergency assistance, and any other plans that are specific
to the type of emergency.
[Publications: Publications referenced
are available from the agency.]
Stat. Auth.: ORS 409.050
& 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 22-2013(Temp), f. & cert. ef. 7-1-13
thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD 23-2014(Temp),
f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14, cert. ef. 12-28-14
411-320-0045
Quality Assurance Responsibilities
(1) Each CDDP must draft a local CDDP
management plan as described in OAR 411-320-0030 that supports the Department's
Quality Management Strategy for meeting CMS' six waiver quality assurances, as required
and defined by 42 CFR 441.301 and 441.302. CMS' six waiver assurances are:
(a) Administrative authority;
(b) Level of care;
(c) Qualified service providers;
(d) Service plans;
(e) Health and welfare; and
(f) Financial accountability.
(2) Each CDDP must implement,
maintain, and monitor minimum quality assurance activities, as required by the Department
and set forth in section (3) of this rule. CDDPs may conduct additional quality
assurance activities that consider local community needs and priorities for services
and the unique organizational structure, policies, and procedures of the CDDP.
(3) The CDDP must conduct,
monitor, and report the outcomes and any remediation as a result of the following
Department required activities:
(a) Individual case file
reviews;
(b) Customer satisfaction
surveys administered at least every two years;
(c) Service provider file
reviews;
(d) Analysis of SERT (Serious
Event Review Team) system data which may include:
(A) Review by service provider,
location, reason, status, outcome, and follow-up;
(B) Identification of trends;
(C) Review of timely reporting
of abuse allegations; and
(D) Coordination of delivery
of information requested by the Department, such as the Serious Event Review Team
(SERT).
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 9-2009, f. &
cert. ef. 7-13-09; SPD 27-2010Temp), f. & cert. ef. 12-1-10 thru 5-30-11; SPD
11-2011, f. & cert. ef. 6-2-11; ; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13
411-320-0050
Management of Regional Services
(1) INTERGOVERNMENTAL AGREEMENT. The
management entity for a group of counties to deliver crisis diversion services,
community training, quality assurance activities, or other services, must have an
intergovernmental agreement with each affiliated CDDP.
(2) REGIONAL PLAN. The CDDP
or private corporation acting as the management entity for the region must prepare,
in conjunction with affiliated CDDP's, a plan detailing the services that are to
be administered regionally. The regional plan must be updated when needed and submitted
to the Department for approval. The regional plan must include:
(a) A description of how
services are to be administered;
(b) An organizational chart
and staffing plan; and
(c) A detailed budget, on
forms provided by the Department.
(3) IMPLEMENTATION. The CDDP
or private corporation acting as the management entity for the region must work
in conjunction with the affiliated CDDP's to implement the regional plan as approved
by the Department, within available resources.
(4) MANAGEMENT STANDARDS.
The region, through the management entity and the affiliated CDDP partners, must
maintain compliance with the management standards outlined in OAR 411-320-0030 and
this rule.
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13
411-320-0060
Individual Rights
(1) The CDDP must have and implement
written policies and procedures that protect the individual rights described in
section (4) of this rule.
(2) Upon entry into case
management and request and annually thereafter, the individual rights described
in section (4) of this rule must be provided to an individual and the legal or designated
representative of an individual.
(3) The individual rights
described in this rule apply to all individuals eligible for or receiving developmental
disability services. A parent or guardian may place reasonable limitations on the
rights of a child.
(4) While receiving developmental
disability services, an individual has the right to:
(a) Be free and protected
from abuse or neglect and to report any incident of abuse or neglect without being
subject to retaliation;
(b) Be free from seclusion,
unauthorized training or treatment, protective physical intervention, chemical restraint,
or mechanical restraint and assured that medication is administered only for the
clinical needs of the individual as prescribed by a health care provider unless
an imminent risk of physical harm to the individual or others exists and only for
as long as the imminent risk continues;
(c) Individual choice for
an adult to consent to or refuse treatment unless incapable and then an alternative
decision maker must be allowed to consent to or refuse treatment for the adult.
For a child, the parent or guardian of the child must be allowed to consent to or
refuse treatment, except as described in ORS 109.610 or limited by court order;
(d) Informed, voluntary,
written consent prior to receiving services, except in a medical emergency or as
otherwise permitted by law;
(e) Informed, voluntary,
written consent prior to participating in any experimental programs;
(f) A humane service environment
that affords reasonable protection from harm, reasonable privacy in all matters
that do not constitute a documented health and safety risk to the individual, and
access and the ability to engage in private communications with any public or private
rights protection program, services coordinator, personal agent, and others chosen
by the individual through personal visits, mail, telephone, or electronic means;
(g) Contact and visits with
legal and medical professionals, legal and designated representatives, family members,
friends, advocates, and others chosen by the individual, except where prohibited
by court order;
(h) Participate regularly
in the community and use community resources, including recreation, developmental
disability services, employment services, school, educational opportunities, and
health care resources;
(i) For individuals less
than 21 years of age, access to a free and appropriate public education, including
a procedure for school attendance or refusal to attend;
(j) Reasonable and lawful
compensation for performance of labor, except personal housekeeping duties;
(k) Manage his or her own
money and financial affairs unless the right has been taken away by court order
or other legal procedure;
(l) Keep and use personal
property, personal control and freedom regarding personal property, and a reasonable
amount of personal storage space;
(m) Adequate food, housing,
clothing, medical and health care, supportive services, and training;
(n) Seek a meaningful life
by choosing from available services, service settings, and providers consistent
with the support needs of the individual identified through a functional needs assessment
and enjoying the benefits of community involvement and community integration:
(A) Services must promote
independence and dignity and reflect the age and preferences of the individual;
and
(B) The services must be
provided in a setting and under conditions that are most cost effective and least
restrictive to the liberty of the individual, least intrusive to the individual,
and that provide for self-directed decision-making and control of personal affairs
appropriate to the preferences, age, and identified support needs of the individual;
(o) An individualized written
plan for services created through a person-centered planning process, services based
upon the plan, and periodic review and reassessment of service needs;
(p) Ongoing opportunity to
participate in the planning of services in a manner appropriate to the capabilities
of the individual, including the right to participate in the development and periodic
revision of the plan for services, the right to be provided with a reasonable explanation
of all service considerations through choice advising, and the right to invite others
chosen by the individual to participate in the plan for services;
(q) Request a change in the
plan for services and a reassessment of service needs;
(r) A timely decision upon
request for a change in the plan for services;
(s) Advance written notice
of any action that terminates, suspends, reduces, or denies a service or request
for service and notification of other available sources for necessary continued
services;
(t) A hearing to challenge
an action that terminates, suspends, reduces, or denies a service or request for
service;
(u) Exercise all rights set
forth in ORS 426.385 and 427.031 if the individual is committed to the Department;
(v) Be informed at entry
to a case management service and annually thereafter of the rights guaranteed by
this rule, the contact information for the protection and advocacy system described
in ORS 192.517(1), the procedures for reporting abuse, and the procedures for filing
complaints, reviews, or requests for hearings if services have been or are proposed
to be terminated, suspended, reduced, or denied;
(w) Have these rights and
procedures prominently posted in a location readily accessible to individuals and
made available to representatives of the individual;
(x) Be encouraged and assisted
in exercising all legal, civil, and human rights accorded to other citizens of the
same age, except when limited by a court order;
(y) Be informed of and have
the opportunity to assert complaints as described in OAR 411-318-0015 with respect
to infringement of the rights described in this rule, including the right to have
such complaints considered in a fair, timely, and impartial complaint procedure
without any form of retaliation or punishment; and
(z) Freedom to exercise all
rights described in this rule without any form of reprisal or punishment.
(5) The rights described
in this rule are in addition to, and do not limit, all other statutory and constitutional
rights that are afforded all citizens including, but not limited to, the right to
exercise religious freedom, vote, marry, have or not have children, own and dispose
of property, and enter into contracts and execute documents unless specifically
prohibited by law.
(6) An individual who is
receiving developmental disability services has the right under ORS 430.212 and
OAR 411-320-0090 to be informed that a family member has contacted the Department
to determine the location of the individual and to be informed of the name and contact
information of the family member, if known.
(7) The rights described
in this rule may be asserted and exercised by an individual, the legal representative
of an individual, and any representative designated by an individual.
(8) Nothing in this rule
may be construed to alter any legal rights and responsibilities between a parent
and child.
(9) A guardian is appointed
for an adult only as is necessary to promote and protect the well-being of the adult.
A guardianship for an adult must be designed to encourage the development of maximum
self-reliance and independence of the adult, and may be ordered only to the extent
necessitated by the actual mental and physical limitations of the adult. An adult
for whom a guardian has been appointed is not presumed to be incompetent. An adult
with a guardian retains all legal and civil rights provided by law, except those
that have been expressly limited by court order or specifically granted to the guardian
by the court. Rights retained by an adult include, but are not limited to, the right
to contact and retain counsel and to have access to personal records. (ORS 125.300).
Stat. Auth.: ORS 409.050, 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.662-695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 5-2006, f. 1-25-06,
cert. ef. 2-1-06; SPD 9-2009, f. & cert. ef. 7-13-09; SPD 22-2013(Temp), f.
& cert. ef. 7-1-13 thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13;
APD 23-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14,
cert. ef. 12-28-14
411-320-0070
Service Records
(1) CONFIDENTIALITY. The service record
for an individual must be kept confidential in accordance with ORS 179.505, 192.515,
192.517, 192.553, and any Department rules or policies pertaining to individual
service records.
(2) INFORMATION SHARING.
Pertinent clinical, financial eligibility, and legal status information concerning
an individual supported by the CDDP must be made available to other CDDPs responsible
for the services of the individual, consistent with state statutes and federal laws
and regulations concerning confidentiality and privacy.
(3) RECORD REQUIREMENTS.
In order to meet Department and federal record documentation requirements, the CDDP,
through the employees of the CDDP, must maintain a service record for each individual
who receives services from the CDDP.
(a) Information contained
in the service record must include:
(A) Documentation of any
initial referral to the CDDP for services;
(B) The application for developmental
disability services. The application for developmental disability services must
be completed prior to an eligibility determination and must be on the application
form required by the Department or transferred onto CDDP letterhead;
(C) Sufficient documentation
to conform to Department eligibility requirements, including notices of eligibility
determination;
(D) Documentation of the
initial intake interview or home assessment, as well as any subsequent social service
summaries;
(E) Documentation of the
functional needs assessment defining the support needs for ADL, IADL and other health-related
tasks;
(F) Documentation of initial,
annual, and requested choice advising;
(G) Documentation of the
request for support services and the selection of an available Brokerage within
the geographic service area of the CDDP;
(H) Referral information
or documentation of referral materials sent to a provider or another CDDP;
(I) Progress notes written
by a services coordinator as described in section (4) of this rule;
(J) Medical information,
as appropriate;
(K) Entry and exit meeting
documentation into any comprehensive service, including any transition plans, crisis
diversion plans, or other plans developed as a result of the meeting;
(L) ISP or Annual Plans,
including documentation that the plan is authorized by a services coordinator;
(M) Copies of any incident
reports initiated by a CDDP representative for any unusual incident that occurred
at the CDDP or in the presence of the CDDP representative;
(N) Documentation of a review
of unusual incidents received from providers. Documentation of the review of unusual
incidents must be made in progress notes and a copy of the incident report must
be placed in the file of the individual. If applicable, information must be electronically
entered into the SERT system and referenced in progress notes;
(O) Documentation of Medicaid
eligibility, if applicable;
(P) The initial and annual
level of care determination on a form prescribed by the Department;
(i) For individuals receiving
CIIS or 24-hour residential services for children, the CDDP must maintain a current
copy of the annual level of care determination or reflect documentation of attempts
to obtain a current copy.
(ii) Once an individual is
enrolled in a Brokerage, the CDDP must maintain a copy of the initial level of care
determination form completed by the CDDP and any annual reviews completed by the
CDDP; and
(Q) Legal records, such as
guardianship papers, civil commitment records, court orders, and probation and parole
information (as appropriate).
(b) An information sheet
or reasonable alternative must be kept current and reviewed at least annually for
each individual receiving case management services from the CDDP enrolled in comprehensive
services, family support services, or living with family or independently. Information
must include:
(A) The name of the individual,
current address, date of entry into the CDDP, date of birth, gender, marital status
(for individuals 18 or older), religious preference, preferred hospital, medical
prime number and private insurance number (where applicable), and guardianship status;
and
(B) The name, address, and
telephone number of:
(i) For an adult, the legal
or designated representative, family, and other significant person of the individual
(as applicable), and for a child, the parent or guardian and education surrogate
(if applicable);
(ii) The primary care provider
and clinic preferred by the individual;
(iii) The dentist preferred
by the individual;
(iv) The school, day program,
or employer of the individual (if applicable);
(v) Other agency representatives
providing services to the individual; and
(vi) Any court ordered or
legal representative authorized contacts or limitations from contact for individuals
living in a foster home, supported living program, or 24-hour residential setting.
(4) PROGRESS NOTES. Progress
notes must include documentation of the delivery of case management services provided
to an individual by a services coordinator. Progress notes must be recorded chronologically
and documented consistent with CDDP policies and procedures. All late entries must
be appropriately documented. At a minimum, progress notes must include:
(a) The month, day, and year
the services were rendered and the month, day, and year the entry was made if different
from the date services were rendered;
(b) The name of the individual
receiving service;
(c) The name of the CDDP,
the person providing the services (i.e., the signature and title of the services
coordinator), and the date the entry was recorded and signed;
(d) The specific services
provided and actions taken or planned, if any;
(e) Place of service. Place
of service means the county where the CDDP or agency providing case management services
is located, including the address. The place of service may be a standard heading
on each page of the progress notes; and
(f) For notes pertaining
to meetings with or discussions about the individual, the names of other participants,
including the titles and agency representation of the participants, if any.
(5) RETENTION OF RECORDS.
The CDDP must have a record retention plan for all records relating to the provision
of, and contracts for, CDDP services that is consistent with this rule and OAR 166-150-0055.
The record retention plan must be made available to the public or the Department
upon request.
(a) Financial records, supporting
documents, and statistical records must be retained for at least three years after
the close of the contract period or until the conclusion of the financial settlement
process with the Department, whichever is longer.
(b) Individual service records
must be kept for seven years after the date of the death of an individual, if known.
If the case is closed, inactive, or the date of death is unknown, the individual
service record must be kept for 70 years.
(c) Copies of annual ISPs
must be kept for 10 years.
(6) TRANSFER OF RECORDS.
In the event an individual moves from one county to another county in Oregon, the
complete service record for an individual as described in section (3) of this rule
must be transferred to the receiving CDDP within 30 days of transfer. The sending
CDDP must ensure that the service record required by this rule is maintained in
permanent record and transferred to the CDDP having jurisdiction for the services
for the individual. The sending CDDP must retain the following information to document
that services were provided to the individual while enrolled in CDDP services:
(a) Documentation of eligibility
for developmental disability services received while enrolled in services through
the CDDP, including waiver or state plan eligibility;
(b) Service enrollment and
termination forms;
(c) CDDP progress notes;
(d) Documentation of services
provided to the individual by the CDDP; and
(e) Any required documentation
necessary to complete the financial settlement with the Department.
[Publications: Publications referenced
are available from the agency.]
Stat. Auth.: ORS 409.050
& 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 22-2013(Temp), f. & cert. ef. 7-1-13
thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD 41-2014, f. 12-26-14,
cert. ef. 12-28-14
411-320-0080
Application and Eligibility Determination
(1) APPLICATION.
(a) To apply for developmental
disability services:
(A) An applicant or the legal
representative of the applicant must submit a completed application as defined in
OAR 411-320-0020 to the CDDP in the county of origin as defined in OAR 411-320-0020;
(B) The CDDP must receive
all documentation required to make an eligibility determination as defined in OAR
411-320-0020. Documentation includes, but is not limited to:
(i) School psychological
or comprehensive evaluations since entry into school;
(ii) Medical assessments
related to a disability, mental health condition, or physical impairment;
(iii) Psychological evaluations
or comprehensive evaluations through private health insurance or other programs;
(iv) Neurological evaluations
completed through any entity;
(v) Records from all residential
or psychiatric facilities;
(vi) Records completed through
application process for other governmental benefits; and
(vii) Administrative medical
examinations and reports, as defined in OAR 410-120-0000, determined necessary and
authorized by the eligibility specialist.
(C) The applicant or the
legal representative of the applicant must provide documentation of U.S. citizenship
as defined in OAR 411-320-0020; and
(D) The applicant must reside
in Oregon or if the applicant is less than 18 years of age, the applicant and the
legal representative of the applicant must reside in Oregon.
(b) The CDDP may stop the
intake process if the documents listed in subsection (a)(B) of this section are
not submitted within 90 days of the date that the CDDP received the signed and dated
Intake Form (SDS 0552). If the CDDP stops the intake process, written notice of
the information needed to determine eligibility or a withdrawal letter must be sent
to the person identified on the Intake Form (SDS 0552) as the person seeking services
and the legal representative of the person seeking services.
(c) The CDDP must consider
an application if the criteria in subsection (a) of this section are met. If the
criteria in subsection (a) of this section are not met, the CDDP shall deny the
application by sending a Notification of Planned Action (SDS 0947).
(d) Upon receipt of a completed
application, the CDDP must provide an applicant the Department required Notification
of Rights (form SDS 0948) within 10 business days.
(e) A new application may
not be required if the file for an individual has been closed for less than 12 months
following a closure, denial, or termination and the individual meets all of the
criteria in subsection (a) of this section.
(f) The CDDP must identify
whether an applicant receives any income.
(A) The CDDP must refer all
applicants not currently receiving an OHP Plus benefit package to the local Medicaid
office for OHP Plus application and benefit determination.
(B) The CDDP must refer an
applicant less than 18 years of age to Social Security if the CDDP identifies that
the applicant may qualify for Social Security benefits.
(2) ELIGIBILITY SPECIALIST.
Each CDDP must identify at least one qualified eligibility specialist to act as
a designee of the Department for purposes of making an eligibility determination.
The eligibility specialist must meet performance qualifications and training expectations
for determining developmental disability eligibility according to OAR 411-320-0030.
(3) INTELLECTUAL DISABILITY.
A history of an intellectual disability as defined in OAR 411-320-0020 and significant
impairment in adaptive behavior as described in OAR 411-320-0020 must be evident
prior to the 18th birthday of an individual for the individual to be eligible for
developmental disability services.
(a) Diagnosing an intellectual
disability is done by measuring intellectual functioning and adaptive behavior as
assessed by standardized tests administered by a licensed clinical or school psychologist
with specific training and experience in test interpretation of intellectual functioning
and adaptive behavior scales for individuals with intellectual disabilities.
(A) For individuals who have
consistent and valid Full Scale IQ results of 65 and less, no assessment of adaptive
behavior may be needed if current documentation supports eligibility.
(B) For individuals who have
a valid Full Scale IQ or equivalent composite score results of 66-75, verification
of an intellectual disability requires an assessment of adaptive behavior.
(C) A General Ability Index
result must be used in place of a Full Scale IQ score to determine eligibility if
a licensed clinical or school psychologist determines that the General Ability Index
is a more valid measure of overall intelligence when compared to the Full Scale
IQ score.
(D) A Specific Index IQ result
must be used in place of a Full Scale IQ score to determine eligibility if a licensed
clinical or school psychologist determines that the Specific Index IQ is a more
valid measure of overall intelligence when compared to the Full Scale IQ score.
(E) If an individual is not
able to participate in an intelligence test due to intellectual disability, a statement
of intellectual disability must be documented by a qualified professional and an
adaptive behavior assessment demonstrating a composite score of at least two standard
deviations below the mean must be completed.
(b) Impairment of adaptive
behavior must be directly related to an intellectual disability and cannot be primarily
attributed to other conditions, including but not limited to a mental or emotional
disorder, sensory impairment, motor impairment, substance abuse, personality disorder,
learning disability, or ADHD.
(c) The condition and impairment
must continue, or be expected to continue, indefinitely.
(4) OTHER DEVELOPMENTAL DISABILITY.
A history of an other developmental disability as defined in OAR 411-320-0020 and
significant impairment in adaptive behavior as described in OAR 411-320-0020 must
be evident prior to the 22nd birthday of an individual for the individual to be
eligible for developmental disability services.
(a) Diagnosing an other developmental
disability requires a medical or clinical diagnosis of a developmental disability
by a qualified professional and significant impairment in adaptive behavior as assessed
by standardized tests administered by a licensed clinical or school psychologist,
or a doctor of medicine or doctor of osteopathic medicine with specific training
and experience in test interpretation of adaptive behavior scales.
(A) Other developmental disabilities
include autism, cerebral palsy, epilepsy, or other neurological disabling conditions
that originate in and directly affect the brain.
(B) The individual must require
training and support similar to that required by an individual with an intellectual
disability, which means the individual has a composite or domain score that is at
least two standard deviations below the mean, as measured on a standardized assessment
of adaptive behavior administered by a licensed clinical or school psychologist,
or a doctor of medicine or doctor of osteopathic medicine with specific training
and experience in test interpretation of adaptive behavior scales.
(b) Significant impairment
of adaptive behavior must be directly related to an other developmental disability
and cannot be primarily attributed to other conditions including, but not limited
to, a mental or emotional disorder, sensory impairment, motor impairment, substance
abuse, personality disorder, learning disability, or ADHD.
(c) The condition and impairment
must continue, or be expected to continue, indefinitely.
(5) ELIGIBILITY FOR CHILDREN
LESS THAN 7 YEARS OF AGE.
(a) Eligibility determinations
for children less than 7 years of age must be based on documentation that is no
more than one year old.
(A) The documentation must
include:
(i) A valid standardized-and-normed
early-childhood assessment, completed by a professional with at least a master's
degree and training to administer early childhood assessments, which demonstrates
the functioning of the child is at least two standard deviations below the mean
in two or more areas of the adaptive behavior described in paragraph (B) of this
subsection; or
(ii) When a standardized-and-normed
early-childhood assessment is not available or not completed within one year, a
medical statement by a licensed medical practitioner that confirms the presence
of an other developmental disability that: is a neurological condition or syndrome;
originates in and directly affects the brain; and causes or is likely to cause impairment
in at least two or more areas of the adaptive behavior described in paragraph (B)
of this subsection.
(B) Areas of adaptive behavior
include:
(i) Adaptive, self-care,
or self-direction;
(ii) Receptive and expressive
language or communication;
(iii) Learning or cognition;
(iv) Gross and fine motor;
or
(v) Social.
(C) The impairment, condition,
or syndrome cannot be primarily attributed to other conditions including, but not
limited to, a mental or emotional disorder, sensory impairment, motor impairment,
substance abuse, personality disorder, learning disability, or ADHD.
(D) The condition and impairment
must continue, or be expected to continue, indefinitely.
(b) REDETERMINATION OF ELIGIBILITY.
(A) Eligibility for children
less than 7 years of age is always provisional.
(i) Redetermination for school
aged eligibility for a child who was originally determined eligible as a child less
than 7 years of age using a standardized and normed early childhood assessment as
described in subsection (b)(A)(i) of this section must be completed no later than
the child’s 9th year birthdate.
(ii) Redetermination for
school aged eligibility for a child who was originally determined eligible as a
child less than 7 years of age using a medical statement by a licensed medical practitioner
as described in subsection (b)(A)(ii) of this section must be completed no later
than the child’s 7th year birthdate.
(B) Any time there is evidence
that contradicts an eligibility determination, the Department or the designee of
the Department may redetermine eligibility or obtain additional information, including
securing an additional evaluation for clarification purposes.
(C) The CDDP must notify
a child and the legal representative of the child any time that a redetermination
of eligibility is needed. Notification of the redetermination and the reason for
the review of eligibility must be in writing and sent prior to the eligibility redetermination.
(6) ELIGIBILITY FOR SCHOOL
AGED CHILDREN. Eligibility for school aged children as defined in OAR 411-320-0020
is always provisional.
(a) Eligibility determinations
for school aged children must be completed on children who are at least 5 years
of age and who have had school aged testing completed.
(b) Eligibility determinations
for school aged children may be completed:
(A) Up to age 18 for school
aged children who are provisionally eligible based on a condition of an intellectual
disability; and
(B) Up to age 22 for school
aged children who are provisionally eligible based on a condition of an other developmental
disability.
(c) Eligibility determinations
for school aged children must include:
(A) Documentation of an intellectual
disability and significant impairment in adaptive behavior as described in section
(3) of this rule; or
(B) A diagnosis and documentation
of an other developmental disability and significant impairment in adaptive behavior
as described in section (4) of this rule.
(d) Eligibility determinations
for school aged children must be based on documentation that is no more than three
years old.
(e) REDETERMINATION OF ELIGIBILITY.
(A) Any time there is evidence
that contradicts an eligibility determination, the Department or the designee of
the Department may redetermine eligibility or obtain additional information, including
securing an additional evaluation for clarification purposes.
(B) The CDDP must notify
a school aged child and the legal representative of the child any time that a redetermination
of eligibility is needed. Notification of the redetermination and the reason for
the review of eligibility must be in writing and sent prior to the eligibility redetermination.
(f) REDETERMINATION OF SCHOOL
AGED CHILDREN FOR ADULT ELIGIBLITY.
(A) Redetermination of school
aged children for adult eligibility must be completed:
(i) Between the ages of 16
and 18 if school aged eligibility was determined based on an intellectual disability
as described in section (3) of this rule; or
(ii) Between the ages of
20 and 22 if school aged eligibility was determined based on an other developmental
disability as described in section (4) of this rule.
(B) The documentation of
an intellectual disability or an other developmental disability must include for
individuals less than 22 years of age, information no more than three years old.
(C) If school aged eligibility
was determined based on an intellectual disability as described in section (3) of
this rule, an intellectual functioning assessment may be used to determine adult
eligibility. An adult intellectual functioning assessment completed within the last
three years is not needed if the school aged child has:
(i) More than one completed
intellectual functioning assessment and all full scale IQ scores are 65 or less
as described in section (3)(a)(A) of this rule;
(ii) Impairment in adaptive
behavior as identified in section (3) of this rule; and
(iii) Current documentation
that supports eligibility.
(D) If school aged eligibility
was determined based on an other developmental disability as described in section
(4) of this rule, the following criteria must be met:
(i) A current medical or
clinical diagnosis of an other developmental disability is required unless all of
the following are met:
(I) Documentation of an other
developmental disability by a qualified professional as described in section (4)
of this rule;
(II) Impairment in adaptive
behavior that continues to be directly related to the other developmental disability;
(III) Current documentation
that continues to support eligibility; and
(IV) No other medical or
mental or emotional disorder.
(ii) If an individual has
additional medical or mental or emotional disorders a new assessment may be required.
(iii) An informal adaptive
behavior assessment as defined in OAR 411-320-0020 may be completed if all of the
following apply:
(I) An assessment of adaptive
behavior is required in order to redetermine eligibility;
(II) An assessment of adaptive
behavior has already been completed by a licensed school or clinical psychologist;
and
(III) The school aged child
has obvious significant impairment in adaptive behavior.
(7) ELIGIBILITY FOR ADULTS.
(a) Eligibility for adults
must include:
(A) Documentation of an intellectual
disability and significant impairment in adaptive behavior as described in section
(3) of this rule; or
(B) Documentation of an other
developmental disability and significant impairment in adaptive behavior as described
in section (4) of this rule.
(b) Documentation for an
adult eligibility determination must include:
(A) Information no more than
three years old for individuals less than 22 years of age; or
(B) Information obtained
after the 17th birthday of an individual for individuals 22 years of age and older.
(c) INTELLECTUAL FUNCTIONING
ASSESSMENT.
(A) An intellectual functioning
assessment completed on or after the age of 16 may be used to determine adult eligibility.
(B) An adult Intellectual
Functioning Assessment may not be needed if an individual has:
(i) More than one completed
intellectual functioning assessment and all full scale IQ scores are 65 or less
as described in section (3)(a)(A) of this rule; and
(ii) Significant impairment
in adaptive behavior as identified in section (3) of this rule.
(C) An adult intellectual
functioning assessment may not be needed if an individual has a diagnosis and documentation
of an other developmental disability as described in section (4) of this rule.
(d) REDETERMINATION OF ELIGIBILITY.
(A) Any time there is evidence
that contradicts an eligibility determination, the Department or the designee of
the Department may redetermine eligibility or obtain additional information, including
securing an additional evaluation for clarification purposes.
(B) The CDDP must notify
an individual and if applicable the legal representative of the individual any time
that a redetermination of eligibility is needed. Notification of the redetermination
and the reason for the review of eligibility must be in writing and sent prior to
the eligibility redetermination.
(C) In the event the eligibility
of an adult requires a redetermination, the redetermination must be completed as
described in subsections (a), (b), and (c) of this section.
(8) ABSENCE OF DATA IN DEVELOPMENTAL
YEARS.
(a) In the absence of sufficient
data during the developmental years, current data may be used if:
(A) There is no evidence
of head trauma;
(B) There is no evidence
or history of significant mental or emotional disorder; or
(C) There is no evidence
or history of substance abuse.
(b) If there is evidence
or a history of head trauma, significant mental or emotional disorder, or substance
abuse, then a clinical impression by a qualified professional regarding how the
functioning of the individual may be impacted by the identified condition must be
obtained in order to determine if the significant impairment in adaptive behavior
is directly related to a developmental disability and not primarily related to a
head trauma, significant mental or emotional disorder, or substance abuse.
(9) SECURING EVALUATIONS.
In the event that an eligibility specialist has exhausted all local resources to
secure the necessary evaluations for an eligibility determination, the Department
or the designee of the Department shall assist in obtaining additional testing if
required to complete the eligibility determination.
(10) PROCESSING ELIGIBILITY
DETERMINATIONS. The CDDP in the county of origin is responsible for making the eligibility
determination.
(a) The CDDP must work in
collaboration with the individual or the legal representative of the individual
to gather historical records related to the intellectual or developmental disability
of an individual during intake in order to complete an application for services.
(b) During intake, the CDDP
must gather enough information and documentation in order to accept a completed
application for developmental disability services within 90 days of the date of
intake, except in the following circumstances:
(A) The CDDP is unable to
obtain a complete application because the individual or the legal representative
of the individual does not collaborate with the Eligibility Specialist or fails
to execute an action necessary to obtain a completed application;
(B) There is an emergency
beyond the control of the CDDP; or
(C) More time is needed to
obtain additional records by the CDDP, the individual, or the legal representative
of the individual.
(c) Upon receipt of the completed
application, as defined in OAR 411-320-0020, the CDDP must make an eligibility determination
unless the following applies and is documented in the progress notes for an individual:
(A) The individual or the
legal representative of the individual voluntarily withdraws the application for
the individual;
(B) The individual dies;
or
(C) The individual cannot
be located.
(d) The CDDP may not use
the time frames established in subsection (b) of this section as:
(A) A waiting period before
determining eligibility; or
(B) A reason for denying
eligibility.
(11) NOTICE OF ELIGIBILITY
DETERMINATION. The CDDP, within 10 days from the receipt of a completed application,
must send or hand deliver a written notification (notice) of the eligibility determination.
The notice must be on the following forms prescribed by the Department:
(a) The Notice of Eligibility
Determination (form SDS 5103); or
(b) The Notification of Planned
Action (form SDS 0947).
(12) REQUESTING A HEARING.
An individual or the legal representative of an individual may request a hearing
as described in OAR 411-318-0025 if the individual or the legal representative of
the individual disagrees with the eligibility determination or redetermination made
by the CDDP.
(13) TRANSFERABILITY OF ELIGIBILITY
DETERMINATION. An eligibility determination made by one CDDP must be honored by
another CDDP when an individual moves from one county to another.
(a) The receiving CDDP must
notify the individual and if applicable the legal representative of the individual
on forms prescribed by the Department that a transfer of services to a new CDDP
has taken place within 10 days of the enrollment date identified on the Developmental
Disability Enrollment Form (SDS 0337).
(b) The receiving CDDP must
continue services for the individual as soon as it is determined that the individual
is residing in the county of the receiving CDDP.
(c) The receiving CDDP must
ensure verification of the eligibility of the individual for developmental disability
services in the form of the following:
(A) Statement of an eligibility
determination;
(B) Notification of eligibility
determination; and
(C) Evaluations and assessments
supporting eligibility.
(d) In the event that the
items in subsection (c) of this section cannot be located, written documentation
from the sending CDDP verifying eligibility and enrollment in developmental disability
services may be used. Written verification may include documentation from the electronic
payment system of the Department.
(e) If the receiving CDDP
receives information that suggests the individual is not eligible for developmental
disability services, the receiving CDDP may complete a redetermination. The CDDP
that determined the individual was eligible for developmental disability services
may be responsible for the services authorized on the basis of that eligibility
determination.
(f) If an individual submits
an application for developmental disability services and discloses that he or she
has previously received developmental disability services in another CDDP and the
termination of case management services as described in OAR 411-320-0100(3) occurred
within the past 12 months, the eligibility determination from the other CDDP shall
transfer as outlined in this section of the rule.
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 6-2010(Temp), f. 6-29-10, cert. ef.
7-4-10 thru 12-31-10; SPD 28-2010, f. 12-29-10, cert. ef. 1-1-11; SPD 31-2011, f.
12-30-11, cert. ef. 1-1-12; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD 23-2014(Temp),
f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14, cert. ef. 12-28-14
411-320-0090
Case Management Program Responsibilities
(1) AVAILABILITY. As required by these
rules, the CDDP must assure the availability of a services coordinator to meet the
service needs of an individual and any emergencies or crisis. The assignment of
the services coordinator must be appropriately documented in the service record
for an individual and the CDDP must accurately report enrollment in the Department
payment and reporting systems.
(2) POLICIES AND PROCEDURES.
The CDDP must adopt written procedures to assure that the delivery of services meet
the standards in section (4) of this rule.
(a) The CDDP must have procedures
for the ongoing involvement of individuals and their requested family member or
other representative in the planning and review of consumer satisfaction with the
delivery of case management or direct services provided by the CDDP.
(b) Copies of the procedures
for planning and review of case management services, consumer satisfaction, and
complaints must be maintained on file at the CDDP offices. The procedures must be
available to:
(A) CDDP employees who work
with individuals;
(B) Individuals who are receiving
services from the CDDP and the families of individuals;
(C) Legal or designated representatives
(as applicable) and providers of individuals; and
(D) The Department.
(3) NOTICE OF SERVICES. The
CDDP must inform the individuals, and as applicable the family members and legal
or designated representatives of the individuals, of the minimum case management
services that are set out in section (4) of this rule.
(4) MINIMUM STANDARDS FOR
CASE MANAGEMENT SERVICES.
(a) The CDDP must ensure
that eligibility for services is determined as described in OAR 411-320-0080 by
an eligibility specialist trained in accordance with OAR 411-320-0030.
(b) A services coordinator
must maintain documentation of the referral process of an individual to a provider
and if applicable, include the reason the provider preferred by the individual declined
to deliver services to the individual.
(c) The CDDP must apply the
principles of self-determination to provision of case management services.
(d) An Annual Plan for an
individual receiving case management services through the CDDP must be developed
and reviewed in accordance with OAR 411-320-0120.
(e) Program services must
be authorized in accordance with OAR 411-320-0120.
(f) Services coordinators
must monitor services and supports for all individuals enrolled in case management
services through the CDDP in accordance with the standards described in OAR 411-320-0130.
(g) If an individual loses
OSIPM or OHP Plus eligibility and the individual is receiving case management services
through the CDDP, a services coordinator must assist the individual in identifying
why OSIPM or OHP Plus eligibility was lost and whenever possible, assist the individual
in reestablishing eligibility for OSIPM or OHP Plus. The services coordinator must
document efforts taken to assist the individual in reestablishing OSIPM or OHP Plus
eligibility in the service record for the individual.
(h) Entry, exit, reductions
in benefits or services, and transfers from comprehensive services must be in accordance
with OAR 411-320-0110.
(i) Crisis diversion services
for an individual receiving case management services through a CDDP must be assessed,
identified, planned, monitored, and evaluated by a services coordinator in accordance
with OAR 411-320-0160.
(j) Abuse investigations
and protective services for adults must be provided as described in OAR 407-045-0250
to 407-045-0360 and include investigating complaints of abuse, writing investigation
reports, and monitoring the implementation of report recommendations.
(k) Civil commitment services
must be provided in accordance with ORS 427.215 to 427.306.
(l) Through choice advising,
the CDDP must describe case management and other service delivery options within
the geographic service area provided to all individuals receiving case management
from the CDDP.
(A) Choice advising must
occur at least 6 months before the18th birthday of a child.
(B) An individual newly determined
eligible for developmental disability services must receive choice advising prior
to or concurrent with the initial level of care determination
(C) An individual moving
into a county with an existing eligibility determination who is not enrolled in
support services must receive choice advising within 10 days of the move or of the
CDDP learning of the move.
(D) Choice advising must
be provided initially and at least annually thereafter. Annual choice advising must
include informing the individual of the right to request access to other available
services. Documentation of the discussion must be included in the service record
for the individual.
(E) If an individual is not
eligible for Community First Choice state plan or waiver services, initial choice
advising must inform the individual of the right to access case management from
the CDDP or a Brokerage.
(m) A services coordinator
must coordinate services with the child welfare (CW) caseworker assigned to a child
to ensure the provision of required supports from the Department, CDDP, and CW.
(n) A services coordinator
may attend IEP planning meetings or other transition planning meetings for a child
when the services coordinator is invited to participate by the family or guardian
of the child.
(A) The services coordinator
may, to the extent resources are available, assist the family of the child in accessing
critical non-educational services that the child or the family of the child may
need.
(B) Upon request and to the
extent possible, the services coordinator may act as a proponent for the child or
the family of the child at IEP meetings.
(C) The services coordinator
must participate in transition planning by attending IEP meetings or other transition
planning meetings for students 16 years of age or older, or until the student is
no longer enrolled in CDDP case management, to discuss the transition of the individual
to adult living and work situations unless the attendance of the services coordinator
is refused by the parent or guardian of the child or the individual if the individual
is 18 years or older.
(o) The CDDP must ensure
that all individuals eligible for and receiving developmental disability services
are enrolled in the Department payment and reporting systems. The county of origin
must enroll the individual into the Department payment and reporting systems for
all developmental disability service providers except in the following circumstances:
(A) The Department completes
the enrollment or termination form for children entering or leaving a licensed 24-hour
residential setting that is directly contracted with the Department.
(B) The Department completes
the Department payment and reporting systems enrollment, termination, and billing
forms for children entering or leaving CIIS.
(C) The Department completes
the enrollment, termination, and billing forms as part of an interagency agreement
for purposes of billing for crisis diversion services by a region.
(p) When appropriate, a services
coordinator must facilitate referrals to nursing facilities as described in OAR
411-070-0043.
(q) A services coordinator
must coordinate and monitor the specialized services provided to an eligible individual
living in a nursing facility in accordance with OAR 411-320-0150.
(r) A services coordinator
must ensure that all serious events related to an individual are reported to the
Department using the SERT system. The CDDP must ensure that there is monitoring
and follow-up on both individual events and system trends.
(s) When a services coordinator
completes a level of care determination, the services coordinator must ensure that
OHP Plus and OSIPM eligible individuals are:
(A) Offered and advised of
all services available for which they are eligible including, but not limited to,
the choice of institutional or community based care, home and community-based waiver
and Community First Choice state plan services;
(B) Provided a Notification
of Rights (form SDS 0948); and
(C) Have a completed level
of care determination that is reviewed annually or at any time there is a significant
change in factors that contribute to the level of care assessment.
(t) A services coordinator
must participate in the appointment of the health care representative of an individual
as described in OAR chapter 411, division 365.
(u) A services coordinator
must coordinate with other state, public, and private agencies regarding services
to individuals.
(v) The CDDP must ensure
that a services coordinator is available to provide or arrange for comprehensive
in-home supports for adults as described in OAR chapter 411, division 330, in-home
supports for children as described in OAR chapter 411, division 308, or family supports
as described in OAR chapter 411, division 305 as required to meet the support needs
of eligible individuals. This includes:
(A) Providing assistance
in planning supports;
(B) Providing assistance
in finding and arranging resources and supports;
(C) Providing education and
technical assistance to make informed decisions about support needs and providers;
(D) Arranging fiscal intermediary
services;
(E) Arranging employer-related
supports; and
(F) Providing assistance
with monitoring and improving the quality of supports.
(5) SERVICE PRIORITIES. If
it becomes necessary for the CDDP to prioritize the availability of case management
services, the CDDP must request and have approval of a variance prior to implementation
of any alternative plan. If the CDDP is not able to reasonably anticipate the need
for the variance, the CDDP has 15 business days to submit the variance request to
the Department. The variance request must:
(a) Document the reason the
service prioritization is necessary, including any alternatives considered;
(b) Detail the specific service
priorities being proposed; and
(c) Provide assurances that
the basic health and safety of individuals continues to be addressed and monitored.
(6) FAMILY RECONNECTION.
The CDDP and a services coordinator must provide assistance to the Department when
a family member is attempting to reconnect with an individual who was previously
discharged from Fairview Training Center or Eastern Oregon Training Center or an
individual who is currently receiving developmental disability services.
(a) If a family member contacts
the CDDP for assistance in locating an individual, the CDDP must refer the family
member to the Department. A family member may contact the Department directly.
(b) The Department shall
send the family member a Department form requesting further information to be used
in providing notification to the individual. The form shall include the following
information:
(A) Name of requestor;
(B) Address of requestor
and other contact information;
(C) Relationship to individual;
(D) Reason for wanting to
reconnect; and
(E) Last time the family
had contact.
(c) The Department shall
determine:
(A) If the individual was
previously a resident of Fairview Training Center or Eastern Oregon Training Center;
(B) If the individual is
deceased or living;
(C) Whether the individual
is currently or previously enrolled in Department services; and
(D) The county in which services
are being provided, if applicable.
(d) Within 10 business days
from the receipt of the request, the Department shall notify the family member if
the individual is enrolled or no longer enrolled in Department services.
(e) If the individual is
enrolled in Department services, the Department shall send the completed family
information form to the individual and the services coordinator.
(f) If the individual is
deceased, the Department shall follow the process for identifying the personal representative
of the individual as provided for in ORS 192.526.
(A) If the personal representative
and the requesting family member are the same, the Department shall inform the personal
representative that the individual is deceased.
(B) If the personal representative
is different from the requesting family member, the Department shall contact the
personal representative for permission before sharing information about the individual
with the requesting family member. The Department must make a good faith effort
to find the personal representative and obtain a decision concerning the sharing
of information as soon as practicable.
(g) When an individual is
located, the services coordinator when the individual is enrolled in case management
or the CDDP in conjunction with the personal agent when the individual is enrolled
in a Brokerage, must facilitate a meeting with the individual to discuss and determine
if the individual wishes to have contact with the family member.
(A) The services coordinator
or the CDDP in conjunction with the personal agent, as applicable, must assist the
individual in evaluating the information to make a decision regarding initiating
contact, including providing the information from the form and any relevant history
with the family member that may support contact or present a risk to the individual.
(B) If the individual does
not have a legal or designated representative or is unable to express his or her
wishes, the ISP team of the individual must be convened to review factors and choose
the best response for the individual after evaluating the situation.
(h) If the individual wishes
to have contact, the individual or ISP team designee may directly contact the family
member to make arrangements for the contact.
(i) If the individual does
not wish to have contact, the services coordinator or the CDDP in conjunction with
the personal agent (as applicable) must notify the Department. The Department shall
inform the family member in writing that no contact is requested.
(j) The notification to the
family member regarding the decision of the individual must be within 60 business
days from the receipt of the information form from the family member.
(k) The decision by the individual
is not appealable.
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 18-2011(Temp), f. & cert. ef. 7-1-11
thru 12-28-11; SPD 27-2011, f. & cert. ef. 12-28-11; SPD 22-2013(Temp), f. &
cert. ef. 7-1-13 thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD
23-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14,
cert. ef. 12-28-14
411-320-0100
Coordination of Services
(1) DESIGNATION OF A SERVICES COORDINATOR
OR PERSONAL AGENT.
(a) When an individual chooses
case management services through a personal agent, the CDDP must send referral information
to the appropriate Brokerage within 10 days following the decision of the individual
unless a later date is mutually agreed upon by the individual, the Brokerage, and
the CDDP. If there is no available Brokerage capacity, the individual may receive
case management through the CDDP and receive other available chosen supports until
Brokerage capacity becomes available.
(b) When an individual chooses
case management services through a services coordinator, the CDDP must designate
a services coordinator within five days following the decision of the individual.
(c) When an individual is
enrolled in a Brokerage and moves from one CDDP geographic service area to another
CDDP geographic service area, the new CDDP must enroll the individual in the Department
payment and reporting systems.
(2) CHANGE OF CASE MANAGEMENT
PROVIDER.
(a) The CDDP must keep the
change of services coordinators to a minimum unless the individual requests the
change of services coordinators. If the CDDP changes the assignment of a services
coordinator, the CDDP must notify the individual, the legal or designated representative
of the individual (as applicable), and all current providers within 10 business
days of the change. The notification must be in writing and include the name, telephone
number, and address of the new services coordinator.
(b) The individual receiving
services may request a new services coordinator within the same CDDP or request
case management services from a Brokerage.
(A) The CDDP must develop
standards and procedures that support timely response to requests for a change of
a services coordinator or when referring case management services to a Brokerage.
(B) If another services coordinator
is assigned by the CDDP as the result of a request by the individual, the CDDP must
notify the individual, the legal or designated representative of the individual
(as applicable), and all current providers within 10 business days of the change.
The notification must be in writing and include the name, telephone number, and
address of the new services coordinator.
(3) TERMINATION OF CASE MANAGEMENT
SERVICES.
(a) A services coordinator
retains responsibility for providing case management services to an individual until
the responsibility is terminated in accordance with this rule, until another services
coordinator is designated, or until the individual is enrolled in support services.
A CDDP must terminate case management services when any of the following occur:
(A) An individual or the
legal representative of an individual delivers a signed written request that case
management services be terminated or such a request is made by telephone and documented
in the service record for the individual. An individual may refuse contact by a
services coordinator as well as the involvement of the services coordinator at an
ISP meeting, unless the services are mandatory as described in section (5) of this
rule.
(B) The individual dies.
(C) The individual is determined
to be ineligible for developmental disability services in accordance with OAR 411-320-0080.
(D) The individual moves
out of state or to another county in Oregon. If an individual moves to another county,
case management services must be referred and transferred to the new county, unless
an individual requests otherwise and both the referring CDDP and the CDDP in the
new county mutually agree. In the case of a child moving into a foster home or 24-hour
residential setting, the county of parental residency or court jurisdiction must
retain case management responsibility.
(E) An individual cannot
be located after repeated attempts by letter and telephone or other means as appropriate
to the individual.
(F) An individual is unavailable
to participate in planning for a return to community living due to incarceration.
(b) If an individual is being
terminated from services for any reason listed in subsection (a) of this section,
except in the case of the death of the individual, the CDDP must issue a Notification
of Planned Action consistent with OAR 411-318-0020 to notify the individual of the
intent of the CDDP to terminate services.
(4) TERMINATION FROM DEPARTMENT
PAYMENT AND REPORTING SYSTEMS.
(a) The CDDP must terminate
an individual in the Department payment and reporting systems when:
(A) The individual or the
legal representative of the individual delivers a signed written request to the
Brokerage requesting support services be terminated. An individual who declines
support services but wishes to continue receiving developmental disability services
through the CDDP is terminated from the Brokerage but is not terminated from developmental
disability services;
(B) The individual dies;
(C) The individual is determined
to be ineligible for developmental disability services in accordance with OAR 411-320-0080;
(D) The individual moves
out of state or to another county in Oregon. If an individual moves to another county,
developmental disability services must be referred and transferred to the new county,
unless an individual requests otherwise and both the referring CDDP and the CDDP
in the new county mutually agree; or
(E) Notification from the
Brokerage that an individual cannot be located after repeated attempts by letter
and telephone.
(b) The CDDP retains responsibility
for maintaining enrollment in the Department payment and reporting systems for individuals
enrolled in support services until the responsibility is terminated as described
in this section of this rule.
(5) MANDATORY SERVICES. An
individual in developmental disability services must accept the following services:
(a) Case management provided
by a services coordinator or personal agent;
(b) Abuse investigations;
(c) The presence of a services
coordinator (when applicable) at Department-funded program entry, exit, or transfer
meetings, or transition planning meetings required for entry or exit to adult services,
including support services and in-home comprehensive supports;
(d) Monitoring of provider
programs (when applicable) in accordance with OAR 411-320-0130; and
(e) Services coordinator
access to the service record.
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 22-2013(Temp), f. & cert. ef. 7-1-13
thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD 23-2014(Temp),
f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14, cert. ef. 12-28-14
411-320-0110
Entry and Exit Requirements
(1) ENTRY TO A DEPARTMENT-FUNDED DEVELOPMENTAL
DISABILITY PROGRAM.
(a) The Department authorizes
entry for children into residential programs, CIIS, and the Stabilization and Crisis
Unit. A services coordinator must make referrals for entry and participate in all
entry meetings for children in residential programs, CIIS, and the Stabilization
and Crisis Unit.
(b) Entry to all other Department-funded
programs for individuals must be coordinated and authorized by a services coordinator
in accordance with these rules.
(2) LICENSED OR CERTIFIED
RESIDENTIAL PLACEMENT SETTING OPTIONS. In accordance with ORS 427.121, a services
coordinator must present at least three appropriate licensed or certified residential
placement setting options, including at least two different types of licensed or
certified residential settings, to an adult individual eligible to receive services
in a licensed or certified residential setting prior to the initial placement of
the adult individual into a licensed or certified residential setting. The services
coordinator is not required to present the licensed or certified residential placement
setting options if:
(a) The services coordinator
demonstrates that three appropriate licensed or certified residential placement
settings or two different types of licensed or certified residential placement settings
are not available within the geographic area where the adult individual wishes to
reside;
(b) The adult individual
selects a licensed or certified residential placement setting option and waives
the right to be presented with other licensed or certified residential placement
setting options; or
(c) The adult individual
is at imminent risk to health or safety in the current licensed or certified residential
placement setting.
(3) WRITTEN INFORMATION REQUIRED.
Prior to the entry of an individual into comprehensive services, a services coordinator,
or the designee of the services coordinator, must provide available and sufficient
written information necessary to meet the support needs of an individual to the
provider for the individual.
(a) The written information
must be provided in a timely manner and include:
(A) A copy of the eligibility
determination document;
(B) A statement indicating
safety skills, including the ability of the individual to evacuate from a building
when warned by a signal device and adjust water temperature for bathing and washing;
(C) A brief written history
of any behavioral challenges, including supervision and support needs;
(D) A medical history and
information on health care supports that includes (when available):
(i) The results of the most
recent physical exam;
(ii) The results of any dental
evaluation;
(iii) A record of immunizations;
(iv) A record of known communicable
diseases and allergies; and
(v) A record of major illnesses
and hospitalizations.
(E) A written record of any
current or recommended medications, treatments, diets, and aids to physical functioning;
(F) A copy of the most recent
needs assessment. If the needs of an individual have changed over time, the previous
needs assessments must also be provided;
(G) Copies of protocols,
the risk tracking record, and any support documentation (if applicable);
(H) Copies of documents relating
to the guardianship or conservatorship, health care representation, power of attorney,
court orders, probation and parole information, or any other legal restrictions
on the rights of the individual (if applicable);
(I) Written documentation
to explain why preferences or choices of the individual may not be honored at that
time;
(J) Written documentation
that the individual is participating in out-of-residence activities, including public
school enrollment for individuals less than 21 years of age; and
(K) A copy of the most recent
Behavior Support Plan and assessment, ISP, Nursing Service Plan, IEP, and mental
health treatment plan (if applicable).
(b) If the individual is
being admitted from the family home and the information required in subsection (a)
of this section is not available, the services coordinator must ensure that the
provider assesses the individual upon entry for issues of immediate health or safety.
(A) The services coordinator
must document a plan to secure the information listed in subsection (a) of this
section no later than 30 days after entry.
(B) The plan must include
a written justification as to why the information is not available and a copy must
be given to the provider at the time of entry.
(c) If the individual is
being admitted from comprehensive services, the information listed in subsection
(a) of this section must be made available prior to entry.
(d) If an individual is admitted
to a program for crisis diversion services for a period not to exceed 30 days, subsection
(a) of this section does not apply.
(4) ENTRY MEETING. Prior
to the date of entry of an individual into a Department-funded comprehensive service,
the ISP team must meet to review referral material in order to determine appropriateness
of placement. The members of the ISP team are determined according to OAR 411-320-0120.
Findings of the entry meeting must be recorded in the service record for the individual
and distributed to the ISP team members. The findings of the entry meeting must
include, at a minimum:
(a) The name of the individual
proposed for services;
(b) The date of the entry
meeting;
(c) The date determined to
be the date of entry;
(d) Documentation of the
participants included in the entry meeting;
(e) Documentation of the
pre-entry information required by section (3)(a) of this rule;
(f) Documentation of the
decision to serve the individual requesting services; and
(g) A written Transition
Plan completed by the services coordinator that is in effect for no longer than
60 days that includes all medical, behavior, and safety supports needed by the individual.
(5) TRANSFER OR EXIT FROM
DEPARTMENT-FUNDED PROGRAMS.
(a) The CDDP must authorize
all transfers or exits from Department-funded developmental disability services.
(b) The Department authorizes
all transfers or exits from services directly contracted with the Department for
24-hour residential settings for children, CIIS, and the Stabilization and Crisis
Unit.
(c) In accordance with ORS
427.121, a services coordinator must present at least three appropriate licensed
or certified residential placement setting options, including at least two different
types of licensed or certified residential settings, to an adult individual receiving
services in a licensed or certified residential setting prior to transferring the
adult individual from one placement setting to another placement setting. The services
coordinator is not required to present the licensed or certified residential placement
setting options if:
(A) The services coordinator
demonstrates that three appropriate licensed or certified residential placement
settings or two different types of licensed or certified residential placement settings
are not available within the geographic area where the adult individual wishes to
reside;
(B) The adult individual
selects a licensed or certified residential placement setting option and waives
the right to be presented with other licensed or certified residential placement
setting options; or
(C) The adult individual
is at imminent risk to health or safety in the current licensed or certified residential
placement setting.
(d) Prior to the transfer
or exit date of an individual, the ISP team must meet to review the transfer or
exit and to plan and coordinate any services necessary during or following the transfer
or exit. The members of the ISP team are determined according to OAR 411-320-0120.
(6) EXIT MEETING. A meeting
of the ISP team must precede any decision to exit an individual. Findings of the
exit meeting must be recorded in the service record for the individual and include,
at a minimum:
(a) The name of the individual
considered for exit;
(b) The date of the exit
meeting;
(c) Documentation of the
participants included in the exit meeting;
(d) Documentation of the
circumstances leading to the proposed exit;
(e) Documentation of the
discussion of the strategies to prevent the exit of the individual from services,
unless the individual is requesting the exit;
(f) Documentation of the
decision regarding the exit of the individual, including verification of the voluntary
decision to exit or a copy of the Notice of Involuntary, Reduction, Transfer, or
Exit; and
(g) The written plan for
services for the individual after the exit.
(7) TRANSFER MEETING. A meeting
of the ISP team must precede any decision to transfer an individual. Findings of
the transfer meeting must be recorded in the service record for the individual and
include, at a minimum:
(a) The name of the individual
considered for transfer;
(b) The date of the transfer
meeting;
(c) Documentation of the
participants included in the transfer meeting;
(d) Documentation of the
circumstances leading to the proposed transfer;
(e) Documentation of the
alternatives considered instead of transfer;
(f) Documentation of the
reasons any preferences of the individual, or as applicable the legal or designated
representative or family members of the individual, may not be honored;
(g) Documentation of the
decision regarding the transfer, including verification of the voluntary decision
to transfer or a copy of the Notice of Involuntary Reduction, Transfer, or Exit;
and
(h) The written plan for
services for the individual after transfer.
(8) ENTRY TO SUPPORT SERVICES.
(a) Referrals of eligible
individuals to a Brokerage must be made in accordance with OAR 411-340-0110. Referrals
must be made in accordance with Department guidelines and the Department-mandated
application and referral form must be used.
(b) The CDDP of the county
of origin may find an individual eligible for services from a Brokerage when:
(A) The individual is an
Oregon resident who has been determined eligible for developmental disability services
by the CDDP;
(B) The individual is an
adult living in his or her own home or family home;
(C) At the time of initial
entry to the Brokerage, the individual is not enrolled in comprehensive services;
(D) At the time of initial
entry to the Brokerage, the individual is not receiving crisis diversion services
from the Department because the individual does not meet one or more of the crisis
risk factors listed in OAR 411-320-0160; and
(E) The individual or the
legal representative of the individual has chosen to use a Brokerage for assistance
with design and management of personal supports.
(c) An eligible individual
must be entered into a Brokerage within 10 days of requesting support services and
selecting an available Brokerage within the geographic service area of the CDDP,
unless a later date is mutually agreed upon by the individual, the Brokerage, and
the CDDP.
(d) The services coordinator
must communicate with the Brokerage staff and provide all relevant information upon
request and as needed to assist Brokerage staff in developing an ISP that best meets
the support needs of the individual including:
(A) A current application
or referral on the Department-mandated application or referral form;
(B) A completed level of
care determination, if present;
(C) A copy of a current functional
needs assessment, if present;
(D) A copy of the eligibility
determination;
(E) Copies of financial eligibility
information;
(F) Copies of any legal documents,
such as guardianship papers, conservatorship, civil commitment status, probation
and parole, etc.;
(G) Copies of relevant progress
notes; and
(H) A copy of any current
plans.
[ED. NOTE: Forms referenced
are available from the agency.]
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 18-2011(Temp), f. & cert. ef. 7-1-11
thru 12-28-11; SPD 27-2011, f. & cert. ef. 12-28-11; SPD 22-2013(Temp), f. &
cert. ef. 7-1-13 thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD
23-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14,
cert. ef. 12-28-14
411-320-0120
Service Planning
(1) PRINCIPLES FOR SERVICE PLANNING.
This rule prescribes standards for the development and implementation of an ISP
or Annual Plan. An ISP or Annual Plan must:
(a) Be developed in a manner
consistent with the principles of self-determination;
(b) Be developed using a
person-centered process and in a manner that addresses issues of independence, integration,
and productivity;
(c) Enhance the quality of
life of the individual with intellectual or developmental disabilities; and
(d) Be consistent with the
following principles:
(A) Personal control and
family participation. While the service system reflects the value of family member
participation in the planning process, adult individuals have the right to make
informed choices about the level of family member participation. It is the intent
of this rule to fully support the provision of education about personal control
and decision-making to individuals who are receiving services.
(B) Choice and preferences.
The planning process is critical in determining the preferences of an individual
and the family of the individual for services and supports. The preferences of the
individual and the family of the individual must serve to guide the ISP team. The
active participation of the individual and input must be facilitated throughout
the planning process.
(C) Barriers. The planning
process is designed to identify the types of services and supports necessary to
achieve the preferences of an individual and the family of the individual, identify
the barriers to providing those preferred services, and develop strategies for reducing
the barriers.
(D) Health and safety. The
planning process must also identify strategies to assist an individual in the exercise
of the rights of the individual. This may create tensions between the freedom of
choice and interventions necessary to protect the individual from harm. The ISP
team must carefully nurture the exercise of the rights of the individual while being
equally sensitive to protecting the health and safety of the individual.
(E) Children in alternate
living situations. When planning for children in 24-hour residential settings or
foster care, maintaining family connections is an important consideration. The following
must apply:
(i) Unless contraindicated,
there must be a goal for family reunification;
(ii) The number of moves
or transfers must be kept to a minimum; and
(iii) If the placement of
a child is distant from the family of the child, the services coordinator must continue
to seek a placement that brings the child closer to the family.
(2) LEVEL OF CARE DETERMINATION.
(a) A services coordinator
must assure that an individual has a level of care determination prior to accessing
Community First Choice state plan or waiver services. The level of care determination
must be made using a Department prescribed form. An initial ISP authorizing Community
First Choice state plan or waiver services must be completed no later than the end
of the month following the month in which the level of care determination was made
or no later than 45 days from the level of care determination.
(b) A services coordinator
must assure that a level of care determination is reviewed for every individual
enrolled in a comprehensive service:
(A) Within 12 months from
the previous Annual Review,
(i) This review must be completed
no later than 12 months from the Diagnosis and Evaluation Coordinator (D & E
Coordinator) approval date.
(ii) The annual review date
may be reset for a date earlier than 12 months from the D & E Coordinator approval
date, but not later than 12 months from the D & E Coordinator review date.
(B) No earlier than 60 days
prior to the renewal of the ISP.
(C) Any time there is a significant
change in a condition that qualified the individual for the level of care.
(c) The level of care assessment
must be documented in a progress note in the service record for the individual.
(d) A level of care determination
may be made by a services coordinator or a personal agent.
(3) FUNCTIONAL NEEDS ASSESSMENT.
A services coordinator or personal agent must complete a functional needs assessment
initially and at least annually for each individual who has or is expected to have
an ISP.
(a) The functional needs
assessment must be completed:
(A) Not more than 45 days
from the date that the individual submitted a completed application or the date
the CDDP learns of the eligibility of the individual for OHP Plus or OSIPM;
(B) Prior to the development
of an initial ISP;
(C) Within 60 days prior
to the annual renewal of an ISP; and
(D) Within 45 days from the
date an individual requests a new functional needs assessment.
(b) An adult who is enrolled
in comprehensive in-home supports as described in OAR chapter 411, division 330
or a child who is enrolled in in-home supports as described in OAR chapter 411,
division 308 must participate in a functional needs assessment and provide information
necessary to complete the functional needs assessments and reassessments within
the time frame required by the Department.
(A) Failure to participate
in the functional needs assessment or provide information necessary to complete
the functional needs assessment or reassessment within the applicable time frame
results in the denial of service eligibility. In the event service eligibility is
denied, a written Notification of Planned Action must be provided as described in
OAR 411-320-0175 and OAR chapter 411, division 318.
(B) The Department may allow
additional time if circumstances beyond the control of the individual prevent timely
participation in the functional needs assessment or timely submission of information
necessary to complete the functional needs assessment or reassessment.
(c) No fewer than 14 days
prior to conducting a functional needs assessment, the CDDP must mail a notice of
the assessment process to the individual to be assessed. The notice must include
a description and explanation of the assessment process and an explanation of the
process for appealing the results of the assessment.
(4) INDIVIDUAL SUPPORT PLANS
(ISP). Individuals enrolled in waiver or Community First Choice state plan services
must have an ISP.
(a) A services coordinator
and ISP team must develop the ISP with an individual within 90 days of the submission
of a completed application by the individual and at least annually thereafter.
(b) Upon the request for
a new functional needs assessment by an individual, a services coordinator must
revise the ISP for the individual as needed if a revision of the ISP is requested
by the individual. The revision of the ISP must be completed within 30 days from
the new functional needs assessment. The revised ISP must be developed with the
individual, the legal or designated representative of the individual (as applicable),
and other invited ISP team members.
(c) Not more than two weeks
after authorization, the CDDP must provide a copy of the most current ISP to the
individual, the legal or designated representative of the individual (as applicable),
and others as identified by the individual.
(d) PERSON-CENTERED ISP REQUIREMENTS.
The person-centered ISP must reflect the services and supports that are important
for the individual to meet the needs of the individual identified through a Department
approved assessment, as well as what is important to the individual with regard
to preferences for the delivery of such services and supports. Commensurate with
the level of need of the individual and the scope of services and supports, the
ISP must include:
(A) The name of the individual
and the name of the legal or designated representative of the individual (as applicable);
(B) A description of the
supports required that is consistent with the support needs identified in the assessment
of the individual;
(C) The projected dates of
when specific supports are to begin and end;
(D) A list of personal, community,
and alternative resources that are available to the individual and how the resources
may be applied to provide the required supports. Sources of support may include
waiver services, Community First Choice state plan services, other state plan services,
state general funds, or natural supports;
(E) The manner in which services
are delivered and the frequency of services;
(F) Provider type;
(G) The setting in which
the individual resides as chosen by the individual;
(H) The strengths and preferences
of the individual;
(I) Individually identified
goals and desired outcomes;
(J) The services and supports
(paid and unpaid) to assist the individual to achieve identified goals and the providers
of the services and supports, including voluntarily provided natural supports;
(K) The risk factors and
the measures in place to minimize the risk factors, including back up plans for
assistance with support and service needs;
(L) The identity of the person
responsible for case management and monitoring the ISP;
(M) A provision to prevent
unnecessary or inappropriate services; and
(N) The alternative settings
considered by the individual.
(e) The ISP for an individual
must be finalized and agreed to in writing by the individual, the legal or designated
representative of the individual (as applicable), and others invited by the individual
including, but not limited to, providers or other family members.
(f) The ISP must be made
available using language, format, and presentation methods appropriate for effective
communication according to the needs and abilities of the individual receiving services
and the people important in supporting the individual.
(g) A services coordinator
must track the ISP timelines and coordinate the resolution of complaints and conflicts
arising from ISP discussions.
(h) An ISP must be developed,
implemented, and authorized as follows:
(A) FOSTER CARE AND 24-HOUR
RESIDENTIAL SETTINGS.
(i) A services coordinator
must attend and assure that an annual ISP meeting is held for individuals receiving
services in foster care or 24-hour residential settings and any associated settings
for employment.
(ii) A services coordinator
must facilitate the ISP with an individual receiving services through foster care
or a 24-hour residential setting and any associated setting for employment.
(iii) If a child is in a
24-hour residential setting directly contracted with the Department, the ISP for
the child is coordinated by Department staff.
(iv) A services coordinator
must ensure that the ISP for an individual receiving services through foster care
or a 24-hour residential setting is developed and updated in accordance with Department
guidelines.
(B) SUPPORTED LIVING. A services
coordinator must ensure the development of an annual ISP for an adult receiving
services in a supported living setting and any associated setting for employment.
(i) The services coordinator
must coordinate with the individual, and as applicable the family or legal or designated
representative of the individual, in the development of an annual ISP.
(ii) The ISP for an adult
receiving services in a supported living setting and any associated setting for
employment must include the information described in subsection (d) of this section.
(C) COMPREHENSIVE IN-HOME
SUPPORTS FOR ADULTS. A services coordinator must ensure the development of an annual
ISP for an individual receiving comprehensive in-home supports.
(i) The services coordinator
must coordinate with the individual, and as applicable the family or legal or designated
representative of the individual, in the development of an annual ISP.
(ii) The ISP for an individual
receiving comprehensive in-home supports must include the information described
in subsection (d) of this section and be in accordance with OAR 411-330-0050.
(i) As of July 1, 2014, a
Career Development Plan must be attached to the ISP of an adult in accordance with
OAR 411-345-0160.
(5) ANNUAL PLANS. Individuals
enrolled in developmental disability services not accessing waiver or Community
First Choice state plan services must have an Annual Plan.
(a) A services coordinator
must complete an Annual Plan within 60 days of the enrollment of an individual into
case management services, and annually thereafter if the individual is not enrolled
in any waiver or Community First Choice state plan services.
(b) An Annual Plan must be
developed as follows:
(A) For an adult, a written
Annual Plan must be documented as an Annual Plan or as a comprehensive progress
note in the service record for the individual and consist of:
(i) A review of the current
living situation of the individual;
(ii) A review of any personal
health, safety, or behavioral concerns;
(iii) A summary of the support
needs of the individual; and
(iv) Actions to be taken
by the services coordinator and others.
(B) For a child receiving
family support services, a services coordinator must coordinate with the child and
the family or guardian of the child in the development of an Annual Plan. The Annual
Plan for a child receiving family support services must be in accordance with OAR
411-305-0080.
(6) PLANS FOR IN-HOME SUPPORTS
FOR CHILDREN. For a child receiving in-home supports, a services coordinator must
coordinate with the child and the family or guardian of the child in the development
of the an ISP or Annual Plan. The ISP or Annual Plan for a child receiving in-home
supports must be in accordance with OAR chapter 411, division 308 and sections (3)
and (4) of this rule, as applicable.
(7) PLAN FORMATS. An ISP
or Annual Plan developed at an annual or update meeting must be conducted in a manner
specified by the Department and on forms required by the Department. In the absence
of a Department-mandated form, the CDDP with the affected providers may develop
an ISP format that conforms to the rules for the provider and provides for an integrated
plan across the funded developmental disability service settings.
(8) PLAN UPDATES. An ISP
or Annual Plan must be kept current. A services coordinator, the residential services
coordinator for the Department for children in 24-hour residential settings directly
contracted with the Department, and CIIS services coordinators for children served
through the CIIS waiver must ensure that a current ISP or Annual Plan is authorized
and maintained for each individual receiving services.
(a) The ISP or Annual Plan
must be kept in the service record for an individual.
(b) ISP or Annual Plan updates
must occur as required by this rule and any rules governing the operation of the
service.
(c) When there is a significant
change, the ISP or Annual Plan must be updated.
(9) ISP REVIEWS. An ISP must
be reviewed and revised:
(a) No more than 30 days
following a new functional needs assessment;
(b) At least every 12 months;
(c) When the circumstances
or needs of an individual change significantly; and
(d) At the request of an
individual.
(10) TRANSITION PLAN REVIEWS.
A Transition Plan must be reviewed and updated as necessary to make it consistent
with section (4) of this rule no more than 60 days from the date of entry to a service
setting.
(11) TEAM PROCESS IN SERVICE
AND SUPPORT PLANNING. This section applies to an ISP developed for an individual
in comprehensive services:
(a) An ISP for an individual
in comprehensive services is developed at least by the individual, the legal or
designated representative of the individual (as applicable), and the services coordinator.
Others may be included as a part of the ISP team at the invitation of the individual.
The ISP team assigns responsibility for obtaining or providing services to meet
the identified needs of the individual.
(A) Membership on the ISP
team must at least conform to this rule and any relevant provider rules. An individual
may include additional participants, friends, or significant others on the ISP team.
(B) The individual may raise
an objection to the inclusion of a particular person or provider on the ISP team.
When the individual raises objections to a person, the ISP team must respect the
request of the individual. In order to assure adequate planning, provider representatives
are necessary informants to the ISP team.
(b) An ISP developed by an
ISP team must respect and honor individual choice in the development of a meaningful
plan.
(c) In circumstances where
an individual is unable to express his or her opinion or choice using words, behaviors,
or other means of communication and the individual does not have a legal or designated
representative, the ISP team is empowered to make a decision on behalf of the individual.
(d) No one member of an ISP
team has the authority to make decisions for the ISP team.
(e) Consensus amongst ISP
team members is prioritized. When consensus may not be reached, majority agreement
is used. For purposes of reaching a majority agreement, a provider, family member,
CDDP, or designated representative are considered as one member of the ISP team.
(f) Any objections to decisions
of the ISP team by a member of the ISP team must be documented in the ISP.
(g) The legal or designated
representative of an individual directing services for the individual (as applicable)
may not also be a paid provider for the individual.
(h) An ISP is authorized
by a services coordinator using a person-centered planning process and with agreement
by the individual and the legal or designated representative of the individual (as
applicable).
(i) An individual or the
legal representative of the individual retains the right to consent to treatment
and training and to note any specific areas of the ISP that they object to and wish
to file a complaint.
(j) ISP team members must
inform the services coordinator whenever there are significant needs or changes
or there is a crisis or potential for a crisis. The services coordinator must reconvene
the ISP team if ISP adjustments are required due to a significant change in the
support needs or desired goals of an individual.
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 22-2013(Temp), f. & cert. ef. 7-1-13
thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD 23-2014(Temp),
f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14, cert. ef. 12-28-14
411-320-0130
Case Management Contact, Site Visits, and
Monitoring of Services
(1) CASE MANAGEMENT CONTACT. Every individual
who has an ISP must have a case management contact no less than once every three
months. Individuals with significant health and safety risks as identified in the
ISP must have more frequent case management contact. At least one case management
contact per year must be face to face. If an individual agrees, other case management
contact may be made by telephone or by other interactive methods. The outcome of
the case management contact must be recorded in the progress notes. The purpose
of the case management contact is:
(a) To assure known health
and safety risks are adequately addressed;
(b) To assure that the support
needs of an individual have not significantly changed; and
(c) To assure that an individual
is satisfied with the current supports.
(2) SITE VISITS.
(a) The CDDP must ensure
that site visits are conducted at each child or adult foster home, each 24-hour
residential setting, and each employment site licensed or certified and endorsed
(as applicable) by the Department to serve individuals with intellectual or developmental
disabilities.
(A) The CDDP must establish
a quarterly schedule for site visits to each child or adult foster home and each
24-hour residential setting.
(B) The CDDP must establish
an annual schedule for site visits to each employment site. If a visit to an integrated
employment site disrupts the work occurring, a mutually agreed upon location for
the site visit must be arranged.
(b) The CDDP must establish
an annual schedule for visits with individuals receiving services in a supported
living setting. If an individual opposes a visit to his or her home, a mutually
agreed upon location for the visit must be arranged.
(c) Site visits may be increased
for any of the following reasons including, but not limited to:
(A) Increased certified and
licensed capacity;
(B) New individuals receiving
services;
(C) Newly licensed or certified
and endorsed provider;
(D) An abuse investigation;
(E) A serious event;
(F) A change in the management
or staff of the licensed or certified and endorsed site;
(G) An ISP team request;
(H) Individuals receiving
services are also receiving crisis diversion services; or
(I) Significant change in
the functioning of an individual who receives services at the site.
(d) The CDDP must develop
a procedure for the conduct of the site visits.
(e) The CDDP must document
site visits and provide information concerning the site visits to the Department
upon request.
(f) If there are no Department-funded
individuals at the site, a visit by the CDDP is not required.
(g) When a provider is a
Department-contracted and licensed, certified, and endorsed 24-hour residential
setting for children and the children's residential services coordinator for the
Department is assigned to monitor services, the children's residential services
coordinator and the CDDP shall coordinate the site visit. If the site visit is made
by Department staff, Department staff shall provide the results of the site visit
to the local services coordinator.
(h) The Department may conduct
site visits on a more frequent basis than described in this section based on program
needs.
(3) MONITORING OF SERVICES:
A services coordinator must conduct monitoring activities using the framework described
in this section.
(a) For all individuals receiving
case management at a CDDP with an ISP that authorizes waiver or Community First
Choice state plan services, an ongoing review of the ISP must determine whether
the actions identified by the ISP team are being implemented by the provider and
others. The review of an ISP must include an assessment of the following:
(A) Are services being provided
as described in the ISP and do the services result in the achievement of the identified
action plans?
(B) Are the personal, civil,
and legal rights of the individual protected in accordance with these rules?
(C) Are the personal desires
of the individual, and as applicable the legal or designated representative or family
of the individual, addressed?
(D) Do the services provided
for in the ISP continue to meet what is important to, and for, the individual?
(E) Do identified goals remain
relevant and are the goals supported and being met?
(b) For an individual who
is not enrolled in a Brokerage and who resides in a 24-hour residential setting,
supported living setting, foster care, or is receiving employment services, the
monitoring of services may be combined with the site visits described in section
(2) of this rule. In addition:
(A) During a one year period,
the services coordinator must review, at least once, services specific to health,
safety, and behavior, using questions established by the Department.
(B) A semi-annual review
of the process by which an individual accesses and utilizes funds must occur, using
questions established by the Department. The services coordinator must determine
whether financial records, bank statements, and personal spending funds are correctly
reconciled and accounted for.
(i) The financial review
standards for 24-hour residential settings are described in OAR 411-325-0380.
(ii) The financial review
standards for adult foster homes are described in OAR 411-360-0170.
(iii) Any misuse of funds
must be reported to the CDDP and the Department. The Department determines whether
a referral to the Medicaid Fraud Control Unit is warranted.
(C) The services coordinator
must monitor reports of serious and unusual incidents.
(c) For an individual receiving
employment services, the services coordinator must also assess the progress of the
individual toward a path to employment.
(d) The frequency of service
monitoring must be determined by the needs of an individual. Events identified in
section (2)(c) of this rule provide indicators that may potentially increase the
need for service monitoring.
(e) For an individual receiving
only case management services and not enrolled in any other funded developmental
disability services, the services coordinator must make contact with the individual
at least once annually.
(A) Whenever possible, annual
contact must be made in person. If annual contact is not made in person, a progress
note in the service record must document how contact was achieved.
(B) The services coordinator
must document annual contact in the Annual Plan as described in OAR 411-320-0120.
(C) If the individual has
any identified high-risk medical issue including, but not limited to, risk of death
due to aspiration, seizures, constipation, dehydration, diabetes, or significant
behavioral issues, the services coordinator must maintain contact in accordance
with planned actions as described in the Annual Plan.
(D) Any follow-up activities
must be documented in a progress note.
(E) If state plan personal
care services as described in OAR 411-034-0070 are authorized in an Annual Plan,
the services must be monitored as described in OAR 411-034-0070.
(4) MONITORING FOLLOW-UP.
A services coordinator and the CDDP are responsible for ensuring the appropriate
follow-up to monitoring of services, except in the instance of children in 24-hour
residential settings directly contracted with the Department when the Department
conducts the follow-up.
(a) If the services coordinator
determines that comprehensive services are not being delivered as agreed in the
ISP or Annual Plan for an individual or that the service needs of an individual
have changed since the last review, the services coordinator must initiate action
to update the ISP or Annual Plan of the individual.
(b) If there are concerns
regarding the ability of a provider to provide services, the CDDP, in consultation
with the services coordinator, must determine the need for technical assistance
or other follow-up activities, such as coordination or provision of technical assistance,
referral to the CDDP manager for consultation or corrective action, requesting assistance
from the Department for licensing or other administrative support, or meeting with
the executive director or board of directors of the provider.
(5) DEPARTMENT NOTIFICATION.
In addition to conducting abuse or other investigations as necessary, the CDDP must
notify the Department when:
(a) A provider demonstrates
substantial failure to comply with any applicable licensing, certification, or endorsement
rules for Department-funded programs;
(b) The CDDP finds a serious
and current threat endangering the health, safety, or welfare of individuals in
a program for which an immediate action by the Department is required; or
(c) Any individual receiving
Department-funded developmental disability services dies. Notification must be made
to the Director of the Department within one business day of the death. Entry must
be made into the Serious Event Review System according to Department guidelines.
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.662-695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 27-2010(Temp), f. & cert. ef. 12-1-10
thru 5-30-11; SPD 11-2011, f. & cert. ef. 6-2-11; SPD 22-2013(Temp), f. &
cert. ef. 7-1-13 thru 12-28-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD
23-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14,
cert. ef. 12-28-14
411-320-0140
Abuse Investigations and Protective Services
(1) GENERAL DUTIES. For the purpose
of conducting abuse investigations and provision of protective services for adults,
the CDDP is the designee of the Department. Each CDDP must conduct abuse investigations
and provide protective services or arrange for the conduct of abuse investigations
and the provision of protective services through cooperation and coordination with
other CDDPs and when applicable, support services brokerages.
(a) Investigations must be
done in accordance with OAR 407-045-0290.
(b) If determined necessary
or appropriate, the Department may conduct an investigation itself rather than allow
the CDDP to investigate the alleged abuse or the Department may conduct an investigation
in addition to the investigation by the CDDP. Under such circumstances, the CDDP
must receive authorization from the Department before conducting any separate investigation.
(2) ELIGIBILITY. Unless otherwise
directed by the Department, the CDDP must investigate allegations of abuse of individuals
with intellectual or developmental disabilities who are:
(a) Eighteen years of age
or older; and
(b) Receiving case management
services; or
(c) Receiving any Department-funded
services for individuals; or
(d) Previously determined
eligible for developmental disability services and voluntarily terminated from services
in accordance with OAR 411-320-0100.
(3) ABUSE INVESTIGATIONS.
The CDDP must have and implement written protocols that describe the conduct of
an abuse investigation, a risk assessment, implementation of any actions, and the
report writing process. Abuse investigations must be conducted in accordance with
OAR 407-045-0250 to 407-045-0360.
(4) COORDINATION WITH OTHER
AGENCIES. The CDDP must cooperate and coordinate investigations and protective services
with other agencies that have authority to investigate allegations of abuse for
adults or children.
(5) INITIAL COMPLAINTS. Initial
complaints must immediately be submitted electronically, using the Department's
system for reporting serious events.
(6) CONFLICT OF INTEREST.
The CDDP may not investigate allegations of abuse made against employees of the
CDDP. Abuse investigations of CDDP staff are conducted by the Department or a CDDP
not subject to an actual or potential conflict of interest.
(7) NOTIFICATION. Upon the
initiation and completion of an abuse investigation, the CDDP must comply with the
notification requirements as described in OAR 407-045-0290 and OAR 407-045-0320.
(8) REPORTS. The CDDP must
complete an abuse investigation and protective service report according to OAR 407-045-0320.
A copy of the final abuse investigation and protective services report must be provided
to the Department within five working days of the report’s completion and
approval by OAAPI. Abuse investigation and protective service reports must be maintained
by the CDDP in accordance with OAR 407-045-0320.
(9) DISCLOSURE. The CDDP
must disclose an abuse investigation and protective services report and related
documents as described in OAR 407-045-0330.
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 25-2009(Temp), f. 12-31-09, cert. ef.
1-1-10 thru 6-30-10; SPD 5-2010, f. 6-29-10, cert. ef. 7-1-10: SPD 57-2013, f. 12-27-13,
cert. ef. 12-28-13
411-320-0150
Specialized Services in a Nursing Home
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 facility.
(1) A services coordinator
must coordinate with the individual, the individual’s legal representative,
the staff of the nursing facility, and other service providers, as appropriate,
to provide or arrange the specialized services. The plan for specialized services
must include:
(a) The name of the service
provider;
(b) A description of the
specialized services to be provided;
(c) The number of hours of
service per month;
(d) A description of how
the services must be tracked; and
(e) A description of the
process of communication between the specialized service provider and the nursing
facility in the event of unusual incidents, illness, absence, and emergencies.
(2) A services coordinator
must complete an annual review of the plan for specialized services or when there
has been a significant change in the individual's level of functioning. The review
must conform to OAR 411-320-0130(2)(b).
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.610 - 430.695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 9-2009, f. & cert.
ef. 7-13-09; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13
411-320-0160
Crisis Diversion Services
(1) CRISIS DIVERSION SERVICES. The CDDP
must, in conjunction with the regional partners of the CDDP, provide crisis diversion
services for adults and children with intellectual or developmental disabilities
who are enrolled in developmental disability services and are eligible for crisis
diversion services as described in section (3) of this rule and experiencing a crisis
risk factor.
(2) CRISIS RISK FACTORS.
An individual is in crisis when one or more of the following risk factors are present:
(a) An individual is not
receiving necessary supports to address life-threatening safety skill deficits;
(b) An individual is not
receiving necessary supports to address life-threatening issues resulting from behavioral
or medical conditions;
(c) An individual currently
engages in self-injurious behavior serious enough to cause injury that requires
professional medical attention;
(d) An individual undergoes,
or is at imminent risk of undergoing, loss of caregiver due to caregiver inability
to provide supports;
(e) An individual experiences
a loss of home due to a protective service action; or
(f) An individual is not
receiving the necessary supports to address significant safety risks to others including,
but not limited to:
(A) A pattern of physical
aggression serious enough to cause injury;
(B) Fire-setting behaviors;
or
(C) Sexually aggressive behaviors
or a pattern of sexually inappropriate behaviors.
(3) ELIGIBILITY FOR CRISIS
DIVERSION SERVICES. The CDDP must ensure the determination of the eligibility of
individuals to receive crisis diversion services and must ensure eligibility information
is made available to ISP team members upon request and to Regional Crisis Diversion
Programs upon each referral. An individual is eligible for crisis diversion services
when:
(a) The individual is enrolled
in developmental disability services;
(b) A crisis exists as described
in section (2) of this rule;
(c) There are no appropriate
alternative resources available;
(d) The crisis is not primarily
related to a significant mental or emotional disorder or substance abuse; and
(e) The individual meets
at least one of the following criteria:
(A) The adult is court committed
to the Department under ORS 427.215 through 427.306.
(B) The adult meets one of
the crisis risk factors as described in section (2) of this rule.
(C) The child is at imminent
risk of out of home placement.
(D) The child is in need
of out of home placement.
(E) The child requires supports
to return home from out of home placement.
(4) FUNDS FOR CRISIS DIVERSION
SERVICES.
(a) Funds for crisis diversion
services must not supplant existing funding.
(b) Purchased goods or services
must only be those necessary to resolve the crisis.
(c) Crisis diversion services
must only be used when no appropriate alternative resources are available to resolve
the crisis situation. The CDDP or the Regional Crisis Diversion Program administering
the crisis diversion service, in consultation with the ISP team, must determine
the appropriateness of alternative resources based on consideration of individual
support needs, proximity to actively involved family members, access to other necessary
resources, and cost effectiveness.
(5) ALLOWABLE SHORT-TERM
EXPENDITURES. Crisis diversion expenditures are allowed when the following criteria
are met:
(a) The services and expenditures
are minimally necessary to address the imminent health and safety risks associated
with the support need of the individual;
(b) The expenditures are
limited to those services and items the individual would otherwise have access to
via the Community First Choice state plan, except that funding is not immediately
accessible to fund such services;
(c) The region or case management
entity has conducted a needs assessment of the individual; and
(d) Expenditures are in alignment
with the expenditure guidelines or in accordance with the associated needs assessment
tool for residential service settings.
(6) SERVICE LIMITATIONS.
The following expenditures must not be made with crisis diversion services funds:
(a) Household appliances;
(b) Services covered under
existing provider contracts with the CDDP or Department;
(c) Health care services
covered by Medicaid, Medicare, or private medical insurance;
(d) Services provided by
the parent of a child or the spouse of an adult;
(e) Funding for items or
services when the individual has resources available to meet the identified needs;
(f) Services or purchases
prohibited in program rules; and
(g) Services or purchases
that exceed the expenditure guidelines or rate determined by the individual needs
assessment.
(7) SERVICE AUTHORIZATION.
The CDDP or Regional Crisis Diversion Program must authorize the utilization of
crisis diversion services.
(a) Prior to initiating crisis
diversion services, the CDDP or the Regional Crisis Diversion Program must document
the eligibility of an individual for crisis diversion services, the alternative
resources considered, and why those resources were not appropriate or available.
This assures that crisis diversion services are utilized only when no appropriate
alternative resources are available.
(b) The CDDP or the Regional
Crisis Diversion Program must authorize services that exceed 90 days duration and
document the authorization in writing within the service record for the individual.
(c) The Department must authorize
adaptations or alterations of fixed property that exceed $5,000. Authorization by
the Department is based upon the recommendation of the CDDP or the Regional Crisis
Diversion Program.
(d) The Department may, at
the discretion of the Department, exercise authority under ORS 427.300 to direct
any individual who is court committed to the Department under ORS 427.290 to the
facility best able to provide services and supports to the individual. The Department
shall consult with any CDDP, the Regional Crisis Diversion Program, or provider
affected by this decision, prior to placement of the individual.
(8) ADMINISTRATION OF CRISIS
DIVERSION SERVICES. The CDDP and the Regional Crisis Diversion Program must operate
under policies and procedures that assure internal management control of expenditures.
Policies and procedures must be written and include at least the following:
(a) Identification of people
or positions within the organization authorized to approve expenditures;
(b) Description of limits
on those authorities and procedures for management reviews; and
(c) Description of procedures
to disburse and account for funds.
(9) MONITORING OF CRISIS
DIVERSION SERVICES.
(a) The CDDP must monitor
the delivery of crisis diversion services as specified in the crisis plan and the
plan of care for the individual. Monitoring must be done through contact with the
individual, any providers, and the family of the individual. The monitoring contact
must include the collection of information regarding supports provided and progress
toward outcomes that are identified in the crisis plan. Monitoring must be documented
in the service record for the individual.
(b) The CDDP must coordinate
with providers or other ISP team members to evaluate the impact of crisis diversion
services upon the individual and must ensure needed changes are recommended to the
ISP team.
(c) The Department may monitor
crisis diversion services through reports received pursuant to sections (10) and
(11) of this rule and OAR 411-320-0180.
(10) RECORD KEEPING AND REPORTING
PROCEDURES.
(a) The CDDP or the Regional
Crisis Diversion Program must ensure the crisis plan is developed in partnership
with the ISP team and the following written information is maintained within the
crisis plan:
(A) Identifying information
about the individual, including name, address, age, and name of parent or legal
representative (as applicable);
(B) Description of the circumstances
for which crisis diversion services were requested to clearly specify how the individual
is eligible to receive crisis diversion services;
(C) Description of resources
used or alternatives considered prior to the request for crisis funds and why the
resources or alternatives were not appropriate or were not available in meeting
the needs of the individual in addressing the crisis;
(D) Description of the goods
and services requested to be purchased or provided specific to addressing the crisis,
including:
(i) The frequency of the
provision or purchase of goods or services;
(ii) The duration of the
provision or purchase of goods or services; and
(iii) The costs of the goods
or services to be provided or purchased.
(E) Description of the outcome
to be achieved, including identification of benchmarks that may be used to determine
whether the outcome has been achieved and maintained.
(b) The CDDP must ensure
the documentation of the ISP team approved modifications to the ISP for the individual
that outline how the crisis is to be addressed through the use of crisis diversion
services.
(c) The CDDP must ensure
the documentation of monitoring contacts described in section (9)(a) of this rule.
(d) The CDDP must maintain
a current copy of the level of care determination when an individual eligible for
crisis diversion services is receiving home and community-based waiver or Community
First Choice state plan services, or as otherwise instructed by the Department.
(11) REPORTING REQUIREMENTS.
The CDDP or Regional Crisis Diversion Program must report, using the accepted Department
payment and reporting systems, the following information to the Department by the
tenth business day of the month following each month in which crisis diversion services
were provided and paid:
(a) Individuals for whom
crisis diversion services were provided;
(b) Individual services provided
and paid; and
(c) Total cost by type of
service.
Stat. Auth.: ORS 409.050, 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.662-695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13;
APD 41-2014, f. 12-26-14, cert. ef. 12-28-14
411-320-0170
Contractor Disputes
(1) When a dispute exists between a
CDDP and a subcontracted provider regarding the terms of the contract or the interpretation
of administrative rule and local dispute resolution efforts have been unsuccessful,
either party may request assistance from the Department in mediating the dispute.
(a) The parties must demonstrate
a spirit of cooperation, mutual respect, and good faith in all aspects of the mediation
process. Mediation must be conducted as follows:
(A) The party requesting
mediation must send a written request to the Director of the Department, the CDDP
Director, and the Executive Director of the provider, unless other people are named
as official contact people in the specific rule or contract under dispute. The request
must describe the nature of the dispute and identify the specific rule or contract
provisions that are central to the dispute.
(B) Department staff shall
arrange the first meeting of the parties at the earliest possible date. The agenda
for the first meeting shall include:
(i) Consideration of the
need for services of an outside mediator. If the services of an unbiased mediator
are desired, agreement shall be made on arrangements for obtaining these services;
(ii) Development of rules
and procedures that shall be followed by all parties during the mediation; and
(iii) Agreement on a date
by which mediation shall be completed, unless extended by mutual agreement.
(C) Unless otherwise agreed
to by all parties:
(i) Each party shall be responsible
for the compensation and expenses of their own employees and representatives; and
(ii) Costs that benefit the
group, such as services of a mediator, rental of meeting space, purchase of snack
food and beverage, etc. shall be shared equally by all parties.
(b) A written statement documenting
the outcome of the mediation must be prepared. This statement must consist of a
brief written statement signed by all parties or separate statements from each party
declaring their position on the dispute at the conclusion of the mediation process.
In the absence of written statements from other parties, the Department shall prepare
the final report. A final report on each mediation must be retained on file at the
Department.
(2) A provider may appeal
the imposition of a disputed term or condition in the contract if the provider believes
that the contract offered by the CDDP contains terms or conditions that are not
substantially similar to those established by the Department in the model contract.
The appeal of the imposition of the disputed terms or conditions must be in writing
and sent to the Director of the Department within 30 days after the effective date
of the contract requirement.
(a) A copy of the notice
of appeal must be sent to the CDDP. The notice of appeal must include:
(A) A copy of the contract
and any pertinent contract amendments;
(B) Identification of the
specific terms that are in dispute; and
(C) A complete written explanation
of the dissimilarity between terms.
(b) Upon receipt of the notice
of appeal, the CDDP must suspend enforcement of compliance with any contract requirement
under appeal by the provider until the appeal process is concluded.
(c) The Director of the Department
must offer to mediate a solution in accordance with the procedure outlined in sections
(1)(a) and (1)(b) of this rule.
(A) If a solution cannot
be mediated, the Director of the Department shall declare an impasse through written
notification to all parties and immediately appoint a panel to consider arguments
from both parties. The panel must include, at a minimum:
(i) A representative from
the Department;
(ii) A representative from
another CDDP; and
(iii) A representative from
another provider organization.
(B) The panel must meet with
the parties, consider the respective arguments, and send written recommendations
to the Director of the Department within 45 business days after an impasse is declared,
unless the Director of the Department grants an extension.
(C) If an appeal requiring
panel consideration has been received from more than one contractor, the Department
may organize materials and discussion in any manner deemed necessary, including
combining appeals from multiple contractors, to assist the panel in understanding
the issues and operating efficiently.
(D) The Director of the Department
must notify all parties of his or her decision within 15 business days from the
receipt of the recommendations of the panel. The decision of the Department is final.
The CDDP must take immediate action to amend contracts as needed to comply with
the decision.
(d) Notwithstanding subsection
(c) of this section, the Director of the Department has the right to deny the appeal
or a portion of the appeal if, upon receipt and review of the notice of appeal,
the Director of the Department finds that the contract language being contested
is identical to the current language in the county financial assistance agreement
with the Department.
(e) The CDDP or the contractor
may request an expedited appeal process that provides a temporary resolution if
it can be shown that the time needed to follow procedures to reach a final resolution
would cause imminent risk of serious harm to individuals or organizations.
(A) The request must be made
in writing to the Director of the Department. The request must describe the potential
harm and level of risk that shall be incurred by following the appeal process.
(B) The Department must notify
all parties of the decision to approve an expedited appeal process within two business
days.
(C) If an expedited process
is approved, the Department shall notify all parties of the decision concerning
the dispute within three additional business days. The decision resulting from an
expedited appeal process shall be binding, but temporary, pending completion of
the appeal process. All parties must act according to the temporary decision until
notified of a final decision.
Stat. Auth.: ORS 409.050, 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.662-695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 16-2005(Temp), f.
& cert. ef. 11-23-05 thru 5-22-06; SPD 5-2006, f. 1-25-06, cert. ef. 2-1-06;
SPD 9-2009, f. & cert. ef. 7-13-09; SPD 27-2010(Temp), f. & cert. ef. 12-1-10
thru 5-30-11; Administrative correction 6-28-11; SPD 57-2013, f. 12-27-13, cert.
ef. 12-28-13; APD 23-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014,
f. 12-26-14, cert. ef. 12-28-14
411-320-0175
Individual Complaints, Notification of
Planned Action, and Hearings
(1) INDIVIDUAL COMPLAINTS.
(a) The CDDP must have and
implement written policies and procedures for individual complaints in accordance
with OAR 411-318-0015.
(b) Complaints by or on behalf
of individuals must be addressed in accordance with OAR 411-318-0015.
(c) Upon entry into case
management and request and annually thereafter, the policy and procedures for complaints
must be explained and provided to an individual and the legal or designated representative
of the individual (as applicable).
(2) NOTIFICATION OF PLANNED
ACTION. In the event that a developmental disability service is denied, reduced,
suspended, or terminated, a written advance Notification of Planned Action (form
SDS 0947) must be provided as described in OAR 411-318-0020.
(3) HEARINGS.
(a) Hearings must be addressed
in accordance with ORS chapter 183 and OAR 411-318-0025.
(b) An individual may request
a hearing as provided in ORS chapter 183 and OAR 411-318-0025 for a denial, reduction,
suspension, or termination of a developmental disability service or OAR 411-318-0030
for an involuntary reduction, transfer, or exit.
(c) Upon entry into case
management and request and annually thereafter, a notice of hearing rights and the
policy and procedures for hearings must be explained and provided to an individual
and the legal or designated representative of the individual (as applicable).
Stat. Auth.: ORS 409.050, 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.662-695
Hist.: SPD 9-2009, f. &
cert. ef. 7-13-09; SPD 6-2010(Temp), f. 6-29-10, cert. ef. 7-4-10 thru 12-31-10;
SPD 28-2010, f. 12-29-10, cert. ef. 1-1-11; SPD 30-2011(Temp), f. 12-30-11, cert.
ef. 1-1-12 thru 6-29-12; SPD 8-2012, f. 6-27-12, cert. ef. 6-30-12; SPD 6-2013,
f. & cert. ef. 4-2-13; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD 23-2014(Temp),
f. & cert. ef. 7-1-14 thru 12-28-14; APD 41-2014, f. 12-26-14, cert. ef. 12-28-14
411-320-0180
Inspections and Investigations
(1) All services covered by these rules
must allow the following types of investigations and inspections:
(a) Quality assurance, certification,
and on-site inspections;
(b) Complaint investigations;
and
(c) Abuse investigations.
(2) The Department, the Department's
designee, or proper authority must perform all inspections and investigations.
(3) Any inspection or investigation
may be unannounced.
(4) A plan of correction
must be submitted to the Department for any non-compliance found during an inspection
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 427.005,
427.007 & 430.610 – 430.670
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 9-2009, f. & cert. ef. 7-13-09; SPD 57-2013, f. 12-27-13,
cert. ef. 12-28-13
411-320-0190
Program Review
(1) The Department may review the CDDP
implementation of these rules as provided in OAR 411-320-0180 at least every two
years or more frequently as needed to ensure compliance.
(2) Following a Department
review, the Department shall issue a report to the CDDP identifying areas of compliance
and areas in need of improvement.
(3) If, following a review,
the CDDP is not in substantial compliance with these rules, the CDDP must respond
to a plan of improvement within 45 days from the receipt of the plan of improvement
or in the time specified by the Department. The Department may conduct additional
reviews as necessary to ensure improvement measures have been achieved. The Department
may offer, or the CDDP may request, technical assistance or training.
Stat. Auth.: ORS 409.050, 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.662-695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 9-2009, f. & cert.
ef. 7-13-09; SPD 28-2011, f. 12-28-11, cert. ef. 1-1-12; SPD 57-2013, f. 12-27-13,
cert. ef. 12-28-13; APD 41-2014, f. 12-26-14, cert. ef. 12-28-14
411-320-0200
Variances
(1) A variance that does not adversely
impact the welfare, health, safety, or rights of individuals or violate state or
federal laws may be granted to the CDDP if there is a lack of resources to meet
the standards required in these rules and the alternative services, methods, concepts,
or procedures proposed shall result in services or systems that meet or exceed the
standards in these rules. All variances must be submitted to the Department and
approved by the Department prior to implementation.
(2) The CDDP requesting a
variance must submit a written application to the Department that contains the following:
(a) The section of the rule
from which the variance is sought;
(b) The reason for the proposed
variance;
(c) A description of the
alternative practice, service, method, concept, or procedure proposed, including
how the health and safety of individuals receiving services shall be protected to
the extent required by these rules;
(d) A plan and timetable
for compliance with the section of the rule from which the variance is sought; and
(e) Signed documentation
from the CDDP reflecting the justification for the proposed variance.
(3) The request for a variance
is approved or denied by the Department. The decision of the Department is sent
to the CDDP within 45 days from the receipt of the variance request by the Department.
(4) The CDDP may request
an administrator review of the denial of a variance request by sending a written
request for review to the Director. The decision of the Director is the final response
from the Department.
(5) The Department determines
the duration of the variance.
(6) The CDDP may implement
a variance only after written approval from the Department. The intergovernmental
agreement is amended to the extent that the variance changes a term in that agreement.
Stat. Auth.: ORS 409.050, 430.662
Stats. Implemented: ORS 427.005,
427.007, 430.610, 430.620, 430.662-695
Hist.: SPD 24-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 28-2004, f. & cert. ef. 8-3-04; SPD 9-2009, f. & cert.
ef. 7-13-09; SPD 57-2013, f. 12-27-13, cert. ef. 12-28-13; APD 41-2014, f. 12-26-14,
cert. ef. 12-28-14

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