24 Hour Residential Services For Children And Adults With Developmental Disabilities


Published: 2015

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The Oregon Administrative Rules contain OARs filed through November 15, 2015

 

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DEPARTMENT OF HUMAN SERVICES,

AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES




 

DIVISION 325
24 HOUR RESIDENTIAL SERVICES FOR CHILDREN AND ADULTS WITH DEVELOPMENTAL DISABILITIES

411-325-0010
Statement of Purpose
The rules in OAR chapter 411, division
325 prescribe standards, responsibilities, and procedures for 24-hour residential
programs providing services to individuals with intellectual or developmental disabilities.
These rules also prescribe the standards and procedures by which the Department
of Human Services licenses a 24-hour residential program to provide residential
care and training to individuals with intellectual or developmental disabilities.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0020
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 325:
(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) "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 these rules.
(b) For an adult, "abuse"
as defined in OAR 407-045-0260.
(3) "Adult" means an individual
who is 18 years or older with an intellectual or developmental disability.
(4) "Agency" means "provider"
as defined in this rule.
(5) "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.
(6) "Apartment" means "24-hour
residential setting" as defined in this rule.
(7) "Appeal" means the process
under ORS chapter 183 that a provider may use to petition a civil penalty.
(8) "Applicant" means a person,
agency, corporation, or governmental unit who applies for a license to operate a
residential home providing comprehensive services in a 24-hour residential program.
(9) "Baseline Level of Behavior"
means the frequency, duration, or intensity of a behavior, objectively measured,
described, and documented prior to the implementation of an initial or revised Behavior
Support Plan. The baseline level of behavior serves as the reference point by which
the ongoing efficacy of an ISP is to be assessed. A baseline level of behavior is
reviewed and reestablished at least yearly, at the time of an ISP team meeting.
(10) "Behavior Data Collection
System" means the methodology specified within a Behavior Support Plan that directs
the process for recording observations, interventions, and other support provision
information critical to the analysis of the efficacy of the Behavior Support Plan.
(11) "Behavior Data Summary"
means the document composed by a provider to summarize episodes of protective physical
intervention. The behavior data summary serves as a substitution for the requirement
of an incident report for each episode of protective physical intervention.
(12) "Board of Directors"
means "board of directors" as defined in OAR 411-323-0020.
(13) "Brokerage" means "Brokerage"
as defined in OAR 411-340-0020.
(14) "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.
(15) "CDDP" means "community
developmental disability program" as defined in OAR 411-320-0020.
(16) "Certificate" means
the document issued by the Department to a provider that certifies the provider
is eligible under the rules in OAR chapter 411, division 323 to receive state funds
for the provision of services in an endorsed 24-hour residential setting.
(17) "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.
(18) "Child" means an individual
who is less than 18 years of age that has a provisional determination of an intellectual
or developmental disability.
(19) "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.
(20) "Competency Based Training
Plan" means the written description of the process of the provider for providing
training to newly hired staff. At a minimum, the Competency Based Training Plan:
(a) Addresses health, safety,
rights, values and personal regard, and the mission of the provider; and
(b) Describes competencies,
training methods, timelines, how competencies of staff are determined and documented,
including steps for remediation, and when a competency may be waived by a provider
to accommodate the specific circumstances of a staff member.
(21) "Condition" means a
provision attached to a new or existing certificate, endorsement, or license that
limits or restricts the scope of the certificate, endorsement, or license or imposes
additional requirements on the provider.
(22) "Crisis" means "crisis"
as defined in OAR 411-320-0020.
(23) "Denial" means the refusal
of the Department to issue a certificate, endorsement, or license to operate a 24-hour
residential setting because the Department has determined the provider or the home
is not in compliance with these rules or the rules in OAR chapter 411, division
323.
(24) "Department" means the
Department of Human Services.
(25) "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.
(26) "Developmental Disability"
means "developmental disability" as defined in OAR 411-320-0020 and described in
OAR 411-320-0080.
(27) "Direct Nursing Service"
means the provision of individual-specific advice, plans, or interventions by a
nurse at a home based on the nursing process as outlined by the Oregon State Board
of Nursing. Direct nursing service differs from administrative nursing services.
Administrative nursing services include non-individual-specific services, such as
quality assurance reviews, authoring health-related agency policies and procedures,
or providing general training for staff.
(28) "Director" means the
Director of the Department of Human Services, Office of Developmental Disability
Services or Office of Licensing and Regulatory Oversight, or the designee of the
Director.
(29) "Domestic Animals" means
the animals domesticated so as to live and breed in a tame condition, such as dogs,
cats, and domesticated farm stock.
(30) "Duplex" means "24-hour
residential setting" as defined in this rule.
(31) "Educational Surrogate"
means the person who acts in place of the parent of a child in safeguarding the
rights of the child in the public education decision-making process:
(a) When the parent of the
child cannot be identified or located after reasonable efforts;
(b) When there is reasonable
cause to believe that the child has a disability and is a ward of the state; or
(c) At the request of the
parent of the child or young adult student.
(32) "Endorsement" means
the authorization to provide services in a 24-hour residential setting that is issued
by the Department to a certified provider that has met the qualification criteria
outlined in these rules and the rules in OAR chapter 411, division 323.
(33) "Entry" means admission
to a Department-funded developmental disability service.
(34) "Executive Director"
means the person designated by a board of directors or corporate owner responsible
for the administration of services in a 24-hour residential setting.
(35) "Exit" means termination
or discontinuance of a Department-funded developmental disability service by a Department
licensed or certified provider.
(36) "Functional Needs Assessment":
(a) Means the comprehensive
assessment or re-assessment that:
(A) Documents physical, mental,
and social functioning;
(B) Identifies risk factors
and support needs; and
(C) Determines the service
level.
(b) The functional needs
assessment for an individual less than 18 years of age receiving, or targeted to
receive, services in a 24-hour residential setting for children is known as the
Support Needs Assessment Profile (SNAP). The Department incorporates the SNAP into
these rules by this reference. The SNAP is maintained by the Department at http://www.oregon.gov/dhs/dd/rebar/pages/assess-afc.aspx.
(c) The functional needs
assessment for an individual 16 years of age and older receiving, or targeted to
receive, services in a 24-hour residential setting for adults is known as the Supports
Intensity Scale (SIS). The Department incorporates the SIS into these rules by this
reference.
(d) A printed copy may be
obtained by calling (503) 945-6398 or writing the Department of Human Services,
Developmental Disabilities, ATTN: Rules Coordinator, 500 Summer Street NE, E-48,
Salem, OR 97301.
(37) "Guardian" means the
parent of 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.
(38) "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.
(39) "Hearing" means a contested
case hearing subject to OAR 137-003-0501 to 137-003-0070, which results in a Final
Order.
(40) "Home" means "24-hour
residential setting" as defined in this rule.
(41) "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.
(42) "Independence" means
the extent to which an individual exerts control and choice over his or her own
life.
(43) "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 exercise the rights
of the individual
(44) "Individualized Education
Program" means the written plan of instructional goals and objectives developed
in conference with an individual less than 21 years of age, the parent or legal
representative of the individual (as applicable), teacher, and a representative
of the public school district.
(45) "Intellectual Disability"
means "intellectual disability" as defined in OAR 411-320-0020 and described in
OAR 411-320-0080.
(46) "Involuntary Reduction"
means a provider has made the decision to reduce the services provided to an individual
without prior approval from the individual.
(47) "Involuntary Transfer"
means a provider has made the decision to transfer an individual without prior approval
from the individual.
(48) "ISP" means "Individual
Support Plan". An ISP includes 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
driven by the individual. The ISP reflects services and supports 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.
(49) "ISP Team" means a team
composed of an individual receiving services and the legal or designated representative
of the individual (as applicable), services coordinator, and others chosen by the
individual, such as providers and family members.
(50) "Legal Representative"
means a person who has the legal authority to act for an individual.
(a) For a child, the legal
representative is the parent of the child unless a court appoints another person
or agency to act as the guardian of the child.
(b) For an adult, the legal
representative is the attorney at law who has been retained by or for the adult,
the power of attorney for the adult, or the person or agency authorized by a court
to make decisions about services for the adult.
(51) "License" means a document
granted by the Department to an applicant who is in compliance with the requirements
of these rules and the rules in OAR chapter 411, division 323.
(52) "Licensee" means the
person or organization to whom a certificate, endorsement, and license is granted.
(53) "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, and that restricts freedom of movement or access to the body of
the individual.
(54) "Medicaid Agency Identification
Number" means the numeric identifier assigned by the Department to a provider following
the enrollment of the provider as described in OAR chapter 411, division 370.
(55) "Medicaid Performing
Provider Number" means the numeric identifier assigned by the Department to an entity
or person following the enrollment of the entity or person to deliver Medicaid funded
services as described in OAR chapter 411, division 370. The Medicaid Performing
Provider Number is used by the rendering provider for identification and billing
purposes associated with service authorizations and payments.
(56) "Modified Diet" means
the texture or consistency of food or drink is altered or limited, such as no nuts
or raw vegetables, thickened fluids, mechanical soft, finely chopped, pureed, or
bread only soaked in milk.
(57) "Natural Support" means:
(a) For a child, the parental
responsibilities and the voluntary resources available to the child from the relatives,
friends, neighbors, and the community of the child that are not paid for by the
Department.
(b) For an adult, the voluntary
resources available to an adult from the relatives, friends, significant others,
neighbors, roommates, and the community of the adult that are not paid for by the
Department.
(58) "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.
(59) "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.
(60) "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.
(61) "Oregon Core Competencies"
means:
(a) The list of skills and
knowledge required for newly hired staff in the areas of health, safety, rights,
values and personal regard, and the mission of the provider; and
(b) The associated timelines
in which newly hired staff must demonstrate the competencies.
(62) "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.
(63) "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.
(64) "Protective Physical
Intervention" means any manual physical holding of, or contact with, an individual
that restricts freedom of movement.
(65) "Provider" means a public
or private community agency or organization that provides recognized developmental
disability services and is certified and endorsed by the Department to provide these
services under these rules and the rules in OAR chapter 411, division 323.
(66) "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.
(67) "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.
(68) "Revocation" means the
action taken by the Department to rescind a certificate, endorsement, or license
after the Department has determined that a provider is not in compliance with these
rules or the rules in OAR chapter 411, division 323.
(69) "Service Level" means
the amount of services determined necessary by a functional needs assessment and
made available to meet the identified support needs of an individual.
(70) "Services Coordinator"
means "services coordinator" as defined in OAR 411-320-0020.
(71) "Special Diet" means
the specially prepared food or particular types of food that are specific to the
medical condition or diagnosis of an individual and in support of an evidence-based
treatment regimen. Examples include, but are not limited to, low calorie, high fiber,
diabetic, low salt, lactose free, or low fat diets. A special diet does not include
a diet where extra or additional food is offered without the order of a physician
but may not be eaten, such as offering prunes each morning at breakfast or including
fresh fruit with each meal.
(72) "Substantiated" means
an abuse investigation has been completed by the Department or the designee of the
Department and the preponderance of the evidence establishes the abuse occurred.
(73) "Suspension" means an
immediate temporary withdrawal of the approval to operate a 24-hour residential
setting after the Department determines a provider or 24-hour residential setting
is not in compliance with one or more of these rules or the rules in OAR chapter
411, division 323.
(74) "These Rules" mean the
rules in OAR chapter 411, division 325.
(75) "Transfer" means movement
of an individual from one home to another home administered or operated by the same
provider.
(76) "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.
(77) "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.
(78) "Variance" means the
temporary exception from a regulation or provision of these rules that may be granted
by the Department upon written application by a provider.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; 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 19-2011(Temp), f. & cert. ef. 7-1-11 thru 12-28-11; SPD 1-2012, f. &
cert. ef. 1-6-12; SPD 23-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13; SPD
58-2013, f. 12-27-13, cert. ef. 12-28-13; APD 24-2014(Temp), f. & cert. ef.
7-1-14 thru 12-28-14; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-325-0025
Program Management
(1) CERTIFICATION, ENDORSEMENT, AND
ENROLLMENT. To provide 24-hour residential services, a service provider must have:
(a) A certificate and an
endorsement to provide 24-hour residential services as set forth in OAR chapter
411, division 323;
(b) A Medicaid Agency Identification
Number assigned by the Department as described in OAR chapter 411, division 370;
and
(c) For each specific geographic
service area where 24-hour residential services shall be delivered, a Medicaid Performing
Provider Number assigned by the Department as described in OAR chapter 411, division
370.
(2) INSPECTIONS AND INVESTIGATIONS.
The service provider must allow inspections and investigations as described in OAR
411-323-0040.
(3) MANAGEMENT AND PERSONNEL
PRACTICES. The service provider must comply with the management and personnel practices
as described in OAR 411-323-0050.
(4) COMPETENCY BASED TRAINING
PLAN. The service provider must have and implement a Competency Based Training Plan
that meets, at a minimum, the competencies and timelines set forth in the Department's
Oregon Core Competencies.
(5) GENERAL STAFF QUALIFICATIONS.
Any staff member providing direct assistance to individuals must:
(a) Have knowledge of individuals'
ISP's and all medical, behavioral, and additional supports required for the individuals;
and
(b) Have met the basic qualifications
in the service provider's Competency Based Training Plan. The service provider must
maintain written documentation kept current that the staff member has demonstrated
competency in areas identified by the service provider's Competency Based Training
Plan as required by OAR 411-325-0025(4) of this rule, and that is appropriate to
their job description.
(6) CONFIDENTIALITY OF RECORDS.
The service provider must ensure all individuals' records are confidential as described
in OAR 411-323-0060.
(7) DOCUMENTATION REQUIREMENTS.
All entries required by these rules, unless stated otherwise must:
(a) Be prepared at the time,
or immediately following the event being recorded;
(b) Be accurate and contain
no willful falsifications;
(c) Be legible, dated, and
signed by the person making the entry; and
(d) Be maintained for no
less than three years.
Stat. Auth. ORS 409.050, 410.070, 443.450,
& 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 19-2011(Temp),
f. & cert. ef. 7-1-11 thru 12-28-11; SPD 1-2012, f. & cert. ef. 1-6-12
411-325-0030
Issuance of License
(1) No person, agency, or governmental
unit acting individually or jointly with any other person, agency, or governmental
unit shall establish, conduct, maintain, manage, or operate a residential home providing
24-hour support services without being licensed for each home.
(2) No license is transferable
or applicable to any location, home, agency, management agent, or ownership other
than that indicated on the application and license.
(3) The Department issues
a license to an applicant found to be in compliance with these rules. The license
is in effect for two years from the date issued unless revoked or suspended.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0040
Application for Initial License
(1) At least 30 days prior to anticipated
licensure, an applicant must submit an application and required non-refundable fee.
The application is provided by the Department and must include all information requested
by the Department.
(2) The application must
identify the number of beds the residential home is presently capable of operating
at the time of application, considering existing equipment, ancillary service capability,
and the physical requirements as specified by these rules. For purposes of license
renewal, the number of beds to be licensed may not exceed the number identified
on the license to be renewed unless approved by the Department.
(3) The initial application
must include a copy of any lease agreements or contracts, management agreements
or contracts, and sales agreements or contracts, relative to the operation and ownership
of the home.
(4) The initial application
must include a floor plan of the home showing the location and size of rooms, exits,
smoke alarms, and extinguishers.
(5) If a scheduled, onsite
licensing inspection reveals that an applicant is not in compliance with these rules
as attested to on the Licensing Onsite Inspection Checklist, the onsite licensing
inspection may be rescheduled at the Department's convenience.
(6) Applicants may not admit
any individual to the home prior to receiving a written confirmation of licensure
from the Department.
(7) If an applicant fails
to provide complete, accurate, and truthful information during the application and
licensing process, the Department may cause initial licensure to be delayed or may
deny or revoke the license.
(8) Any applicant or person
with a controlling interest in an agency is considered responsible for acts occurring
during, and relating to, the operation of such home for the purpose of licensing.
(9) The Department may consider
the background and operating history of each applicant and each person with a controlling
ownership interest when determining whether to issue a license.
(10) When an application
for initial licensure is made by an applicant who owns or operates other licensed
homes or facilities in Oregon, the Department may deny the license if the applicant's
existing home or facility is not, or has not been, in substantial compliance with
the Oregon Administrative Rules.
(11) Separate licenses are
not required for separate buildings located contiguously and operated as an integrated
unit by the same management.
(12) A residential home may
not admit an individual whose service needs exceed the classification on the home's
license without prior written consent of the Department.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0050
License Expiration, Termination of Operations,
License Return
(1) Unless revoked, suspended, or terminated
earlier, each license to operate a residential home expires two years following
the date of issuance.
(2) If the operation of a
home is discontinued for any reason, the license is considered to have been terminated.
(3) Each license is considered
void immediately if the operation of a home is discontinued by voluntary action
of the licensee or if there is a change in ownership.
(4) The license must be returned
to the Department immediately upon suspension or revocation of the license or when
operation is discontinued.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0060
Conditions on License
The Department may attach conditions
to a license that limit, restrict, or specify other criteria for operation of a
home. The type of condition attached to a license must directly relate to the risk
of harm or potential risk of harm to individuals.
(1) The Department may attach
a condition to a license upon a finding that:
(a) Information on the application
or initial inspection requires a condition to protect the health, safety, or welfare
of individuals;
(b) A threat to the health,
safety, or welfare of an individual exists;
(c) There is reliable evidence
of abuse, neglect, or exploitation;
(d) The home is not being
operated in compliance with these rules; or
(e) The provider is licensed
to provide services for a specific person only and further placements may not be
made into that home or facility.
(2) Conditions that the Department
may impose on a license include, but are not limited to:
(a) Restricting the total
number of individuals to whom a provider may provide services;
(b) Restricting the total
number of individuals within a licensed classification level based upon the capability
and capacity of the provider and staff to meet the health and safety needs of all
individuals;
(c) Restricting the type
of support and services within a licensed classification level based upon the capability
and capacity of the provider and staff to meet the health and safety needs of all
individuals;
(d) Requiring additional
staff or staff qualifications;
(e) Requiring additional
training;
(f) Restricting the provider
from allowing a person on the premises who may be a threat to the health, safety,
or welfare of an individual;
(g) Requiring additional
documentation; or
(h) Restricting entry.
(3) The Department issues
a written notice to the provider when the Department imposes conditions to a license.
The written notice of conditions includes the conditions imposed by the Department,
the reason for the conditions, and the opportunity to request a hearing under ORS
chapter 183. Conditions take effect immediately upon issuance of the written notice
of conditions or at a later date as indicated on the notice and are a Final Order
of the Department unless later rescinded through the hearing process. The conditions
imposed remain in effect until the Department has sufficient cause to believe the
situation which warranted the condition has been remedied.
(4) The provider may request
a hearing in accordance with ORS Chapter 183 and this rule upon receipt of written
notice of conditions. The request for a hearing must be in writing.
(a) The provider must request
a hearing within 21 days from the receipt of the written notice of conditions.
(b) In addition to, or in
lieu of a hearing, a provider may request an administrative review as described
in section (5) of this rule. The request for an administrative review must be in
writing. The administrative review does not diminish the right of the provider to
a hearing.
(5) ADMINISTRATIVE REVIEW.
(a) In addition to the right
to a hearing, a provider may request an administrative review by the Director of
the Department for imposition of conditions. The request for an administrative review
must be in writing.
(b) The Department must receive
a written request for an administrative review within 10 business days from the
receipt of the notice of conditions. The provider may submit, along with the written
request for an administrative review, any additional written materials the provider
wishes to have considered during the administrative review.
(c) The determination of
the administrative review is issued in writing within 10 business days from the
receipt of the written request for an administrative review, or by a later date
as agreed to by the provider.
(d) The provider may request
a hearing if the decision of the Department is to affirm the condition. The request
for a hearing must be in writing. The Department must receive the written request
for a hearing within 21 days from the receipt of the original written notice of
conditions.
(6) The provider may send
a written request to the Department to remove a condition if the provider believes
the situation that warranted the condition has been remedied.
(7) Conditions must be posted
with the license in a prominent location and be available for inspection at all
times.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 19-2011(Temp),
f. & cert. ef. 7-1-11 thru 12-28-11; SPD 1-2012, f. & cert. ef. 1-6-12;
SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13; APD 24-2014(Temp), f. & cert.
ef. 7-1-14 thru 12-28-14; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-325-0070
Renewal of License
(1) A license is renewable upon submission
of an application to the Department and the payment of the required non-refundable
fee, except that no fee is required of a governmental owned home.
(2) Filing of an application
and required fee for renewal before the date of expiration extends the effective
date of expiration until the Department takes action upon such application. If the
renewal application and fee are not submitted prior to the expiration date, the
home or facility is treated as an unlicensed home subject to civil penalties as
described in OAR 411-325-0460.
(3) The Department shall
conduct a licensing review of the home prior to the renewal of the license. The
review shall be unannounced, conducted 30-120 days prior to expiration of the license,
and review compliance with these rules.
(4) The Department may not
renew a license if the home is not in substantial compliance with these rules or
if the State Fire Marshal or the State Fire Marshal's authorized representative
has given notice of noncompliance pursuant to ORS 479.220.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0090
Change of Ownership, Legal Entity, Legal
Status, Management Corporation
(1) The service provider must notify
the Department in writing of any pending change in ownership or legal entity, legal
status, or management corporation.
(2) A new license is required
upon change in ownership, legal entity, or legal status. The service provider must
submit a license application and required fee at least 30 days prior to change in
ownership, legal entity, or legal status.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0110
Variances
(1) The Department may grant a variance
to these rules based upon a demonstration by the provider that an alternative method
or different approach provides equal or greater effectiveness and does not adversely
impact the welfare, health, safety, or rights of the individuals or violate state
or federal laws.
(2) The provider requesting
a variance must submit a written application to the CDDP that contains the following:
(a) The section of the rule
from which the variance is sought;
(b) The reason for the proposed
variance;
(c) The alternative practice,
service, method, concept, or procedure proposed; and
(d) If the variance applies
to the services for an individual, evidence that the variance is consistent with
the currently authorized ISP for the individual.
(3) The CDDP must forward
the signed variance request form to the Department within 30 days from the receipt
of the request indicating the position of the CDDP on the proposed variance.
(4) The request for a variance
is approved or denied by the Department. The decision of the Department is sent
to the provider, the CDDP, and to all relevant Department programs or offices within
30 days from the receipt of the variance request.
(5) The provider may request
an administrative review of the denial of a variance request. The Department must
receive a written request for an administrative review within 10 business days from
the receipt of the denial. The provider must send a copy of the written request
for an administrative review to the CDDP. The decision of the Director is the final
response from the Department.
(6) The duration of the variance
is determined by the Department.
(7) The provider may implement
a variance only after written approval from the Department.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 1-2012, f. & cert. ef. 1-6-12; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13; APD 24-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14;
APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-325-0120
Medical Services
(1) The provider must have and implement
written policies and procedures that maintain and protect the physical health of
individuals. The policies and procedures must address the following:
(a) Individual health care;
(b) Medication administration;
(c) Medication storage;
(d) Response to emergency
medical situations;
(e) Nursing service provision,
if provided;
(f) Disposal of medications;
and
(g) Early detection and prevention
of infectious disease.
(2) INDIVIDUAL HEALTH CARE.
(a) An individual must receive
care that promotes the health and well-being of the individual as follows:
(A) The provider must ensure
the individual has a primary physician or health care provider whom the individual
has chosen from among qualified providers;
(B) Provisions must be made
for a secondary physician or clinic in the event of an emergency;
(C) The provider must ensure
that an individual receives a medical evaluation by a qualified health care provider
no fewer than every two years or as recommended by a physician;
(D) The provider must monitor
the health status and physical conditions of the individual and take action in a
timely manner in response to identified changes or conditions that may lead to deterioration
or harm;
(b) A written, signed order
from a physician or qualified health care provider is required prior to the usage
or implementation of all of the following:
(A) Prescription medications;
(B) Non-prescription medications
except over the counter topical;
(C) Treatments other than
basic first aid;
(D) Modified or special diets;
(E) Adaptive equipment; and
(F) Aids to physical functioning.
(c) The provider must implement
the order of a physician or qualified health care provider.
(d) The provider must maintain
records on each individual to aid physicians, licensed health professionals, and
the provider in understanding the medical history of the individual. Such documentation
must include:
(A) A list of known health
conditions, medical diagnoses, known allergies, and immunizations;
(B) A record of visits to
licensed health professionals that include documentation of the consultation and
any therapy provided; and
(C) A record of known hospitalizations
and surgeries.
(3) MEDICATION.
(a) All medications must
be:
(A) Kept in their original
containers;
(B) Labeled by the dispensing
pharmacy, product manufacturer, or physician, as specified per the written order
of a physician or qualified health care provider; and
(C) Kept in a secured locked
container and stored as indicated by the product manufacturer.
(b) All medications and treatments
must be recorded on an individualized medication administration record (MAR). The
MAR must include:
(A) The name of the individual;
(B) A transcription of the
written order of a physician or qualified health care provider, including the brand
or generic name of the medication, prescribed dosage, frequency, and method of administration;
(C) For topical medications
and treatments without the order of a physician or qualified health care provider,
a transcription of the printed instructions from the package;
(D) Times and dates of administration
or self-administration of the medication;
(E) Signature of the person
administering the medication or the person monitoring the self-administration of
the medication;
(F) Method of administration;
(G) An explanation of why
a PRN (i.e., as needed) medication was administered;
(H) Documented effectiveness
of any PRN (i.e., as needed) medication administration;
(I) An explanation of any
medication administration irregularity; and
(J) Documentation of any
known allergy or adverse drug reaction.
(c) Self-administration of
medication.
(A) The ISP for individuals
who independently self-administer medications must include a plan for the periodic
monitoring and review of the self-administration of medications.
(B) The provider must ensure
that individuals able to self-administer medications keep the medications in a secure
locked container unavailable to other individuals residing in the same residence
and store them as recommended by the product manufacturer.
(d) PRN (i.e., as needed)
orders are not allowed for psychotropic medication.
(e) Safeguards to prevent
adverse effects or medication reactions must be utilized and include:
(A) Whenever possible, obtaining
all prescription medication for an individual, except samples provided by a health
care provider, from a single pharmacy which maintains a medication profile for the
individual;
(B) Maintaining information
about the desired effects and side effects of each medication;
(C) Ensuring that medications
prescribed for one individual are not administered to, or self-administered by,
another individual or staff member; and
(D) Documentation in the
record for an individual of the reason all medications are not provided through
a single pharmacy.
(f) All unused, discontinued,
outdated, recalled, and contaminated medications must be disposed of in a manner
designed to prevent the illegal diversion of the medication. A written record of
the disposal of the medication must be maintained and include documentation of:
(A) Date of disposal;
(B) Description of the medication,
including dosage strength and amount being disposed;
(C) Individual for whom the
medication was prescribed;
(D) Reason for disposal;
(E) Method of disposal;
(F) Signature of the person
disposing of the medication; and
(G) For controlled medications,
the signature of a witness to the disposal.
(4) DIRECT NURSING SERVICES.
When direct nursing services are provided to an individual, the provider must:
(a) Coordinate with the registered
nurse and the ISP team to ensure that the nursing services being provided are sufficient
to meet the health needs of the individual; and
(b) Implement the Nursing
Service Plan, or appropriate portions therein, as agreed upon by the ISP team and
the registered nurse.
(5) DELEGATION AND SUPERVISION
OF NURSING TASKS. Nursing tasks must be delegated by a registered nurse to a provider
in accordance with the rules of the Oregon State Board of Nursing in OAR chapter
851, division 47.
(6) When the medical, behavioral,
or physical needs of an individual change to a point that they may not be met by
the provider, the services coordinator must be notified immediately and notification
must be documented.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13; APD 24-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14;
APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-325-0130
Food and Nutrition
(1) The service provider must provide
access to a well balanced diet in accordance with the U.S. Department of Agriculture.
(2) For an individual with
a physician or health care provider ordered modified or special diet, the service
provider must:
(a) Have menus for the current
week that provide food and beverages that consider the individual's preferences
and are appropriate to the modified or special diet; and
(b) Maintain documentation
that identifies how modified texture or special diets are prepared and served for
the individual.
(3) At least three meals
must be made available or arranged for daily.
(4) Foods must be served
in a form consistent with an individual's needs and provide opportunities for choices
in food selection.
(5) Unpasteurized milk and
juice or home canned meats and fish may not be served or stored in the home.
(6) Adequate supplies of
staple foods for a minimum of one week and perishable foods for a minimum of two
days must be maintained on the premises.
(7) Food must be stored,
prepared, and served in a sanitary manner.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0140
Physical Environment
(1) All floors, walls, ceilings, windows,
furniture, and fixtures must be kept in good repair, clean, and free from odors.
Walls, ceilings, and floors must be of such character to permit frequent washing,
cleaning, or painting.
(2) The water supply and
sewage disposal must meet the requirements of the current rules of the Oregon Health
Authority governing domestic water supply.
(3) A public water supply
must be utilized if available. If a non-municipal water source is used, a sample
must be collected yearly by the service provider, sanitarian, or a technician from
a certified water-testing laboratory. The water sample must be tested for coliform
bacteria and action taken to ensure potability. Test records must be retained for
three years.
(4) Septic tanks or other
non-municipal sewage disposal systems must be in good working order. Incontinence
garments must be disposed of in closed containers.
(5) The temperature within
the home must be maintained within a normal comfort range. During times of extreme
summer heat, the service provider must make reasonable effort to keep individuals
comfortable using ventilation, fans, or air conditioning.
(6) Screening for workable
fireplaces and open-faced heaters must be provided.
(7) All heating and cooling
devices must be installed in accordance with current building codes and maintained
in good working order.
(8) Handrails must be provided
on all stairways.
(9) Swimming pools, hot tubs,
saunas, or spas must be equipped with safety barriers and devices designed to prevent
injury and unsupervised access.
(10) Sanitation for household
pets and other domestic animals must be adequate to prevent health hazards. Proof
of current rabies vaccinations and any other vaccinations that are required for
the pet by a licensed veterinarian must be maintained on the premises. Pets not
confined in enclosures must be under control and may not present a danger or health
risk to individuals residing at the home or the individuals' guests.
(11) All measures necessary
must be taken to prevent the entry of rodents, flies, mosquitoes, and other insects.
(12) The interior and exterior
of the residence must be kept free of litter, garbage, and refuse.
(13) Any work undertaken
at a residence, including but not limited to demolition, construction, remodeling,
maintenance, repair, or replacement must comply with all applicable state and local
building, electrical, plumbing, and zoning codes appropriate to the individuals
served.
(14) Service providers must
comply with all applicable legal zoning ordinances pertaining to the number of individuals
receiving services at the home.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0150
General Safety
(1) All toxic materials, including but
not limited to poisons, chemicals, rodenticides, and insecticides must be:
(a) Properly labeled;
(b) Stored in the original
container separate from all foods, food preparation utensils, linens, and medications;
and
(c) Stored in a locked area
unless the Risk Tracking records for all individuals residing in the home document
that there is no risk present.
(2) All flammable and combustible
materials must be properly labeled, stored, and locked in accordance with state
fire code.
(3) For children, knives
and sharp kitchen utensils must be locked unless otherwise determined by a documented
ISP team decision.
(4) Window shades, curtains,
or other covering devices must be provided for all bedroom and bathroom windows
to assure privacy.
(5) Hot water in bathtubs
and showers may not exceed 120 degrees Fahrenheit. Other water sources, except the
dishwasher, may not exceed 140 degrees Fahrenheit.
(6) Sleeping rooms on ground
level must have at least one window that opens from the inside without special tools
that provides a clear opening of not less than 821 square inches, with the least
dimension not less than 22 inches in height or 20 inches in width. Sill height may
not be more than 44 inches from the floor level. Exterior sill heights may not be
greater than 72 inches from the ground, platform, deck, or landing. There must be
stairs or a ramp to ground level. Those homes previously licensed having a minimum
window opening of not less than 720 square inches are acceptable unless through
inspection it is deemed that the window opening dimensions present a life safety
hazard.
(7) Sleeping rooms must have
60 square feet per individual with beds located at least three feet apart.
(8) Operative flashlights,
at least one per floor, must be readily available to staff in case of emergency.
(9) First-aid kits and first-aid
manuals must be available to staff within each home in a designated location. First
aid kits must be locked if, after evaluating any associated risk, items contained
in the first aid kit present a hazard to individuals living in the home. First aid
kits containing any medication including topical medications must be locked.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 1-2012, f. &
cert. ef. 1-6-12; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0170
Staffing Requirements
(1) Each residence must provide staff
appropriate to the number of individuals served as follows:
(a) Each home serving five
or fewer individuals must provide at a minimum one staff on the premises when individuals
are present; and
(b) Each home serving five
or fewer individuals in apartments must provide at a minimum one staff on the premises
of the apartment complex when individuals are present; and
(c) Each home serving six
or more individuals must provide a minimum of one staff on the premises for every
15 individuals during awake hours and one staff on the premises for every 15 individuals
during sleeping hours, except residences licensed prior to January 1, 1990; and
(d) Each home serving children,
for any number of children, must provide at a minimum one awake night staff on the
premises when children are present.
(2) A home is granted an
exception to the staffing requirements in sections (1)(a), (1)(b), and (1)(c) for
adults to be home alone when the following conditions have been met:
(a) No more than two adults
are to be left alone in the home at any time without on staff supervision;
(b) The amount of time any
adult individual may be left alone may not exceed five hours within a 24-hour period
and an adult individual may not be responsible for any other adult individual or
child in the home or community;
(c) An adult individual may
not be left home alone without staff supervision between the hours of 11:00 P.M.
and 6:00 A.M.;
(d) The adult individual
has a documented history of being able to do the following safety measures or there
is a documented ISP team decision agreeing to an equivalent alternative practice:
(A) Independently call 911
in an emergency and give relevant information after calling 911;
(B) Evacuate the premises
during emergencies or fire drills without assistance in three minutes or less;
(C) Knows when, where, and
how to contact the service provider in an emergency;
(D) Before opening the door,
check who is there;
(E) Does not invite strangers
to the home;
(F) Answer the door appropriately;
(G) Use small appliances,
sharp knives, kitchen stove, and microwave safely;
(H) Self-administer medications,
if applicable;
(I) Safely adjust water temperature
at all faucets; and
(J) Safely takes a shower
or bathe without falling.
(e) There is a documented
ISP team decision annually noting team agreement that the adult individual meets
the requirements of subsection (d) of this section.
(3) If at any time an adult
individual is unable to meet the requirements in section (2)(d)(A)-(J) of this rule,
the service provider may not leave the adult individual alone without supervision.
In addition, the service provider must notify the adult individual's services coordinator
within one working day and request that the ISP team meet to address the adult individual's
ability to be left alone without supervision.
(4) Each home must meet all
requirements for staff ratios as specified by contract requirements.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0180
Individual Summary Sheets
The provider must maintain a current
one to two page summary sheet for each individual receiving services from the provider.
The record must include:
(1) The name of the individual
and his or her current and previous address, date of entry into the home, date of
birth, gender, marital status (for individuals 18 or older), religious preference,
preferred hospital, medical prime number and private insurance number ( if applicable),
and guardianship status; and
(2) The name, address, and
telephone number of:
(a) The legal or designated
representative, family, and other significant person of the individual (as applicable),
and for a child, the parent and educational surrogate (if applicable);
(b) The primary care provider
and clinic preferred by the individual;
(c) The dentist preferred
by the individual;
(d) The identified pharmacy
preferred by the individual;
(e) The school, day program,
or employer of the individual (if applicable);
(f) The services coordinator
of the individual and Department representative for Department direct contracts;
and
(g) Other agencies and representatives
providing services and supports to the individual.
(3) For children under the
age 18, any court ordered or legal representative authorized contacts or limitations
must also be included on the individual summary sheet.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-325-0185
Emergency Information
(1) A provider must maintain emergency
information for each individual receiving services from the home in addition to
the individual summary sheet described in OAR 411-325-0180.
(2) The emergency information
must be kept current and must include:
(a) The name of the individual;
(b) The name, address, and
telephone number of the provider;
(c) The address and telephone
number of the home where the individual lives;
(d) The physical description
of the individual, which may include a picture and the date the picture was taken,
and identification of:
(A) The race, gender, height,
weight range, hair, and eye color of the individual; and
(B) Any other identifying
characteristics that may assist in identifying the individual if the need arises,
such as marks or scars, tattoos, or body piercings.
(e) Information on the abilities
and characteristics of the individual including:
(A) How the individual communicates;
(B) The language the individual
uses or understands;
(C) The ability of the individual
to know and take care of bodily functions; and
(D) Any additional information
that may assist a person not familiar with the individual to understand what the
individual may do for him or herself.
(f) The health support needs
of the individual, including:
(A) Diagnosis;
(B) Allergies or adverse
drug reactions;
(C) Health issues that a
person needs to know when taking care of the individual;
(D) Special dietary or nutritional
needs, such as requirements around the textures or consistency of foods and fluids;
(E) Food or fluid limitations
due to allergies, diagnosis, or medications the individual is taking that may be
an aspiration risk or other risk for the individual;
(F) Additional special requirements
the individual has related to eating or drinking, such as special positional needs
or a specific way foods or fluids are given to the individual;
(G) Physical limitations
that may affect the ability of the individual to communicate, respond to instructions,
or follow directions; and
(H) Specialized equipment
needed for mobility, positioning, or other health-related needs.
(g) The emotional and behavioral
support needs of the individual, including:
(A) Mental health or behavioral
diagnosis and the behaviors displayed by the individual; and
(B) Approaches to use when
dealing with the individual to minimize emotional and physical outbursts.
(h) Any court ordered or
legal representative authorized contacts or limitations;
(i) The supervision requirements
of the individual and why; and
(j) Any additional pertinent
information the provider has that may assist in the care and support of the individual
if a natural or man-made disaster occurs.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 11-2008, f. &
cert. ef. 9-11-08; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13; APD 42-2014, f.
12-26-14, cert. ef. 12-28-14
411-325-0190
Incident Reports and Emergency Notifications
(1) An incident report, as defined in
OAR 411-325-0020, must be placed in an individual's record and include:
(a) Conditions prior to or
leading to the incident;
(b) A description of the
incident;
(c) Staff response at the
time; and
(d) Administrative review
to include the follow-up to be taken to prevent a recurrence of the incident.
(2) A copy of all unusual
incident reports must be sent to the individual's services coordinator within five
working days of the unusual incident. Upon request of the individual's legal representative,
copies of unusual incident reports must be sent to the legal representative within
five working days of the incident. Such copies must have any confidential information
about other individuals removed or redacted as required by federal and state privacy
laws. Copies of unusual incident reports may not be provided to an individual's
legal representative when the report is part of an abuse or neglect investigation.
(3) The service provider
must notify the CDDP immediately of an incident or allegation of abuse falling within
the scope of OAR chapter 407, division 045.
(a) When an abuse investigation
has been initiated, the Department or the Department's designee must provide notice
to the service provider according to OAR chapter 407, division 045.
(b) When an abuse investigation
has been completed, the Department or the Department's designee must provide notice
of the outcome of the investigation according to OAR chapter 407, division 045.
(c) When a service provider
receives notification of a substantiated allegation of abuse of an adult as defined
in OAR 407-045-0260, the service provider must provide written notification immediately
to:
(A) The person found to have
committed abuse;
(B) Residents of the home;
(C) Residents’ services
coordinators; and
(D) Residents’ legal
representatives.
(d) The service provider's
written notification must include:
(A) The type of abuse as
defined in OAR 407-045-0260;
(B) When the allegation was
substantiated; and
(C) How to request a copy
of the redacted Abuse Investigation and Protective Services Report.
(e) The service provider
must have policies and procedures to describe how the service provider implements
notification of substantiated abuse as listed in subsections (3)(c) and (d) of this
section.
(4) In the case of a serious
illness, injury, or death of an individual, the service provider must immediately
notify:
(a) The individual's legal
representative or conservator, parent, next of kin, designated representative, or
other significant person;
(b) The CDDP; and
(c) Any agency responsible
for, or providing services to, the individual.
(5) In the case of an individual
who is away from the residence without support beyond the time frames established
by the ISP team, the service provider must immediately notify:
(a) The individual's legal
or designated representative or nearest responsible relative (as applicable);
(b) The local police department;
and
(c) The CDDP.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; 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 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0200
Transportation
(1) Service providers, including employees
and volunteers who own or operate vehicles that transport individuals, must:
(a) Maintain the vehicle
in safe operating condition;
(b) Comply with Department
of Motor Vehicles laws;
(c) Maintain or assure insurance
coverage including liability, on all vehicles and all authorized drivers; and
(d) Carry a first aid kit
in the vehicle.
(2) When transporting, the
driver must ensure that all individuals use seat belts. Individual car or booster
seats must be used for transporting all children as required by law. When transporting
individuals in wheel chairs, the driver must ensure that wheel chairs are secured
with tie downs and that individuals wear seat belts.
(3) Drivers operating vehicles
that transport individuals must meet applicable Department of Motor Vehicles requirements
as evidenced by a driver's license.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0220
Individual Furnishings
(1) Bedroom furniture must be provided
or arranged for each individual and include:
(a) A bed including a frame
unless otherwise documented by an ISP team decision, a clean comfortable mattress,
a waterproof mattress cover if the individual is incontinent, and a pillow;
(b) A private dresser or
similar storage area for personal belongings that is readily accessible to the individual;
and
(c) A closet or similar storage
area for clothing that is readily accessible to the individual.
(2) Two sets of linens must
be provided or arranged for each individual and include:
(a) Sheets and pillowcases;
(b) Blankets appropriate
in number and type for the season and the individual's comfort; and
(c) Towels and washcloths.
(3) Each individual must
be assisted in obtaining personal hygiene items in accordance with individual needs
and items must be stored in a sanitary and safe manner.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0230
Emergency Plan and Safety Review
(1) Providers must provide the emergency
plan and safety review requirements as described in this rule.
(2) EMERGENCY PLANNING.
(a) Providers must post the
following emergency telephone numbers in close proximity to all phones used by staff.
(A) The telephone numbers
of the local fire, police department, and ambulance service, if not served by a
911 emergency services; and
(B) The telephone number
of the executive director, emergency physician, and additional people to be contacted
in the case of an emergency.
(b) If an individual regularly
accesses the community independently, the provider must provide the information
to the individual about appropriate steps to take in an emergency, such as emergency
contact telephone numbers, contacting police or fire personnel, or other strategies
to obtain assistance.
(3) Providers must develop,
maintain, update, and implement a written emergency plan for the protection of all
individuals in the event of an emergency or disaster.
(a) The emergency plan must:
(A) Be practiced at least
annually. The emergency plan practice may consist of a walk-through of the duties
or a discussion exercise dealing with a hypothetical event, commonly known as a
tabletop exercise.
(B) Consider the needs of
the individuals being served and address all natural and human-caused events identified
as a significant risk for the home, such as a pandemic or an earthquake.
(C) Include provisions and
sufficient supplies, such as sanitation supplies, to shelter in place, when unable
to relocate, for at least three days under the following conditions:
(i) Extended utility outage;
(ii) No running water;
(iii) Inability to replace
food or supplies; and
(iv) Staff unable to report
as scheduled.
(D) Include provisions for
evacuation and relocation that identifies:
(i) The duties of staff during
evacuation, transporting, and housing of individuals, including instructions to
staff to notify the Department, local office, or designee of the plan to evacuate
or the evacuation of the home as soon as the emergency or disaster reasonably allows;
(ii) The method and source
of transportation;
(iii) Planned relocation
sites that are reasonably anticipated to meet the needs of the individuals in the
home;
(iv) A method that provides
a person unknown to the individual the ability to identify each individual by name
and to identify the name of the supporting provider for the individual; and
(v) A method for tracking
and reporting to the Department, local office, or designee, the physical location
of each individual until a different entity resumes responsibility for the individual.
(E) Address the needs of
the individuals, including provisions to provide:
(i) Immediate and continued
access to medical treatment with the evacuation of the individual summary sheets
described in OAR 411-325-0180 and the emergency information described in OAR 411-325-0185
and other information necessary to obtain care, treatment, food, and fluids for
the individuals.
(ii) Continued access to
life-sustaining pharmaceuticals, medical supplies, and equipment during and after
an evacuation and relocation;
(iii) Behavior support needs
anticipated during an emergency; and
(iv) Adequate staffing to
meet the life-sustaining and safety needs of the individuals.
(b) The provider must instruct
and provide training about the duties and responsibilities for implementing the
emergency plan to all staff.
(c) The provider must re-evaluate
and revise the emergency plan at least annually or when there is a significant change
in the home.
(d) The emergency plan summary
must be sent to the Department annually and upon change of ownership.
(e) Applicable parts of the
emergency plan must coordinate with each applicable employment provider to address
the possibility of an emergency or disaster during work hours.
(4) A documented safety review
must be conducted quarterly to ensure that each home is free of hazards. The provider
must keep the quarterly safety review reports for three years and must make them
available upon request by the CDDP or the Department.
Stat. Auth. ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 11-2008, f. & cert. ef. 9-11-08; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-325-0240
Assessment of Fire Evacuation Assistance
(1) The service provider must assess,
within 24 hours of an individual's entry to the home, the individual's ability to
evacuate the home in response to an alarm or simulated emergency.
(2) The service provider
must document the level of assistance needed by each individual to safely evacuate
the home and the documentation must be maintained in the individual's entry records.
Stat. Auth. ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0250
Fire Drill Requirements and Fire Safety
(1) The service provider must conduct
unannounced evacuation drills when individuals are present, one per quarter each
year with at least one drill per year occurring during the hours of sleep. Drills
must occur at different times during day, evening, and night shifts with exit routes
being varied based on the location of a simulated fire.
(2) Written documentation
must be made at the time of the fire drill and kept by the service provider for
at least two years following the drill. Fire drill documentation must include:
(a) The date and time of
the drill or simulated drill;
(b) The location of the simulated
fire and exit route;
(c) The last names of all
individuals and staff present on the premises at the time of the drill;
(d) The type of evacuation
assistance provided by staff to individuals' as specified in each individual's safety
plan;
(e) The amount of time required
by each individual to evacuate or staff simulating the evacuation; and
(f) The signature of the
staff conducting the drill.
(3) Smoke alarms or detectors
and protection equipment must be inspected and documentation of inspections maintained
as recommended by the local fire authority or State Fire Marshal.
(4) The service provider
must provide necessary adaptations to ensure fire safety for sensory and physically
impaired individuals.
Stat. Auth. ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0260
Individual Fire Evacuation Safety Plans
(1) For individuals who are unable to
evacuate the residence within the required evacuation time or who with concurrence
of the ISP team request not to participate in fire drills, the service provider
must develop a written fire safety and evacuation plan that includes the following:
(a) Documentation of the
risk to the individual's medical, physical condition, and behavioral status;
(b) Identification of how
the individual evacuates his or her residence, including level of support needed;
(c) The routes to be used
to evacuate the residence to a point of safety;
(d) Identification of assistive
devices required for evacuation;
(e) The frequency the plan
is to be practiced and reviewed by the individual and staff;
(f) The alternative practices;
(g) Approval of the plan
by the individual's legal or designated representative (as applicable), case manager,
and the service provider's executive director; and
(h) A plan to encourage future
participation.
(2) The service provider
must maintain documentation of the practice and review of the safety plan by the
individual and the staff.
Stat. Auth. ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0270
Fire Safety Requirements for Homes on a
Single Property or on Contiguous Property Serving Six or More Individuals
(1) The home must provide safety equipment
appropriate to the number and level of individuals served and meet the requirements
of the State of Oregon Structural Specialty and Fire Code as adopted by the state:
(a) Each home housing six
or more but fewer than 11 individuals or each home that houses five or fewer individuals
but is licensed as a single facility due to the total number of individuals served
per the license or meets the contiguous property provision, must meet the requirements
of a SR 3.3 occupancy and must:
(A) Provide and maintain
permanent wired smoke alarms from a commercial source with battery back-up in each
bedroom and at a point centrally located in the corridor or area giving access to
each separate sleeping area and on each floor;
(B) Provide and maintain
a 13D residential sprinkler system as defined in the National Fire Protection Association
standard; and
(C) Have simple hardware
for all exit doors and interior doors that may not be locked against exit that has
an obvious method of operation. Hasps, sliding bolts, hooks and eyes, double key
deadbolts, and childproof doorknobs are not permitted. Any other deadbolts must
be single action release so as to allow the door to open in a single operation.
(b) Each home housing 11
or more but fewer than 17 individuals must meet the requirements of a SR 3.2 occupancy.
(c) Each home housing 17
or more individuals must meet the requirements of a SR 3.1 occupancy.
(2) The number of individuals
receiving services may not exceed the licensed capacity, except that one additional
individual may receive relief care services not to exceed two weeks. Relief care
supports may not violate the safety and health sections of these rules.
(3) The service provider
may not admit individuals functioning below the level indicated on the license for
the home.
Stat. Auth. ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 11-2008, f. &
cert. ef. 9-11-08; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0280
Fire Safety Requirements for Homes or Duplexes
Serving Five or Fewer Individuals
(1) The home or duplex must be made
fire safe.
(a) A second means of egress
must be provided.
(b) A class 2A10BC fire extinguisher
that is easily accessible must be provided on each floor in the home or duplex.
(c) Permanent wired smoke
alarms from a commercial source with battery back up in each bedroom and at a point
centrally located in the corridor or area giving access to each separate sleeping
area and on each floor must be provided and maintained.
(d) A 13D residential sprinkler
system in accordance with the National Fire Protection Association Code must be
provided and maintained. Homes or duplexes rated as "Prompt" facilities per Chapter
3 of the 2000 edition NFPA 101 Life Safety Code are granted an exception from the
residential sprinkler system requirement.
(e) Hardware for all exit
doors and interior doors must be simple hardware that may not be locked against
exit and must have an obvious method of operation. Hasp, sliding bolts, hooks and
eyes, double key deadbolts, and childproof doorknobs are not permitted. Any other
deadbolts must be single action release so as to allow the door to open in a single
operation.
(2) A home or duplex is granted
an exception to the requirements in sections (1)(c) and (d) of this rule under the
following circumstances:
(a) All individuals residing
in the home or duplex have demonstrated the ability to respond to an emergency alarm
with or without physical assistance from staff to the exterior and away from the
home or duplex in three minutes or less, as evidenced by three or more consecutive
documented fire drills;
(b) Battery operated smoke
alarms with a 10 year battery life and hush feature have been installed in accordance
with the manufacturer's listing, in each bedroom, adjacent hallways, common living
areas, basements, and in two-story homes or duplexes at the top of each stairway.
Ceiling placement of smoke alarms is recommended. If wall mounted, smoke alarms
must be mounted as per the manufacturer's instructions. Alarms must be equipped
with a device that warns of low battery condition when battery operated. All smoke
alarms are to be maintained in functional condition; and
(c) A written fire safety
evacuation plan is implemented that assures that staff assist all individuals in
evacuating the premises safely during an emergency or fire as documented by fire
drill records.
(3) The number of individuals
receiving services at the home or duplex may not exceed the maximum capacity of
five individuals, including individuals receiving relief care services. An individual
may receive relief care services not to exceed two weeks. Relief care services may
not violate the safety and health sections of these rules.
Stat. Auth. ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 11-2008, f. & cert. ef. 9-11-08; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0290
Fire Safety Requirements for Apartments
Serving Five or Fewer Individuals
(1) The apartment must be made fire
safe by:
(a) Providing and maintaining
in each apartment, battery-operated smoke alarms with a 10-year life in each bedroom
and in a central location on each floor;
(b) Providing first floor
occupancy apartments. Individuals who are able to exit in three minutes or less
without assistance may be granted a variance from the first floor occupancy requirement;
(c) Providing a class 2A10BC
portable fire extinguisher easily accessible in each apartment;
(d) Providing access to telephone
equipment or intercom in each apartment usable by the individual receiving services;
and
(e) Providing constantly
usable unblocked exits from the apartment and apartment building.
(2) The number of individuals
receiving services at the apartment may not exceed the maximum capacity of five
including relief care services. An individual may receive relief care services not
to exceed two weeks. Relief care services may not violate the safety and health
sections of these rules.
Stat. Auth. ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0300
Individual Rights, Complaints, Notification
of Planned Action, and Hearings
(1) INDIVIDUAL RIGHTS.
(a) A provider must protect
the rights of individuals described in subsection (d) of this section and encourage
and assist individuals to understand and exercise these rights.
(b) Upon entry and request
and annually thereafter, the individual rights described in subsection (d) of this
section must be provided to an individual and the legal or designated representative
of the individual.
(c) 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.
(d) 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:
(i) Services must promote
independence and dignity and reflect the age and preferences of the individual;
and
(ii) 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 the start
of services 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.
(e) 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.
(f) 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.
(g) 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.
(h) Nothing in this rule
may be construed to alter any legal rights and responsibilities between a parent
and child.
(i) 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).
(2) COMPLAINTS.
(a) Complaints by or on behalf
of individuals must be addressed in accordance with OAR 411-318-0015.
(b) Upon entry 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).
(3) 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.
(4) 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 or OAR 411-318-0030 for an involuntary reduction, transfer,
or exit.
(c) Upon entry 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, 443.450 &
443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13; APD 24-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14;
APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-325-0340
Behavior Support
(1) The service provider must have and
implement a written policy for behavior support that utilizes individualized positive
behavior support techniques and prohibits abusive practices.
(2) A decision to develop
a plan to alter a person's behavior must be made by the ISP team. Documentation
of the ISP team decision must be maintained by the service provider.
(3) The service provider
must conduct a functional behavioral assessment of the behavior that is based upon
information provided by one or more people who know the individual. The functional
behavioral assessment must include:
(a) A clear, measurable description
of the behavior, including (as applicable) frequency, duration, and intensity of
the behavior;
(b) A clear description and
justification of the need to alter the behavior;
(c) An assessment of the
meaning of the behavior, including the possibility that the behavior is one or more
of the following:
(A) An effort to communicate;
(B) The result of a medical
condition;
(C) The result of a psychiatric
condition; or
(D) The result of environmental
causes or other factors.
(d) A description of the
context in which the behavior occurs; and
(e) A description of what
currently maintains the behavior.
(4) The Behavior Support
Plan must include:
(a) An individualized summary
of the individual's needs, preferences, and relationships;
(b) A summary of the function
of the behavior, as derived from the functional behavioral assessment;
(c) Strategies that are related
to the function of the behavior and are expected to be effective in reducing problem
behaviors;
(d) Prevention strategies,
including environmental modifications and arrangements;
(e) Early warning signals
or predictors that may indicate a potential behavioral episode and a clearly defined
plan of response;
(f) A general crisis response
plan that is consistent with (OIS);
(g) A plan to address post
crisis issues;
(h) A procedure for evaluating
the effectiveness of the Behavior Support Plan, including a method of collecting
and reviewing data on frequency, duration, and intensity of the behavior;
(i) Specific instructions
for staff who provide support to follow regarding the implementation of the Behavior
Support Plan; and
(j) Positive behavior supports
that includes the least intrusive intervention possible.
(5) Providers must maintain
the following additional documentation for implementation of a Behavioral Support
Plan:
(a) Written evidence that
the individual and the individual's parent (if applicable), legal or designated
representative (if applicable), and the ISP team are aware of the development of
the Behavior Support Plan and any objections or concerns have been documented;
(b) Written evidence of the
ISP team decision for approval of the implementation of the Behavior Support Plan;
and
(c) Written evidence of all
informal and positive strategies used to develop an alternative behavior.
(6) The service provider
must inform each individual, and as applicable the individual's parent or legal
or designated representative, of the behavior support policy and procedures at the
time of entry to the home and as changes occur.
Stat. Auth.: ORS 409.050, 410.070, 443.450
& 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0350
Protective Physical Intervention
(1) A service provider must only employ
protective physical intervention techniques that are included in the current approved
OIS curriculum or as approved by the OIS Steering Committee. Protective physical
intervention techniques must only be applied:
(a) When the health and safety
of the individual and others are at risk and the ISP team has authorized the procedures
in a documented ISP team decision that is included in the ISP and uses procedures
that are intended to lead to less restrictive intervention strategies;
(b) As an emergency measure
if absolutely necessary to protect the individual or others from immediate injury;
or
(c) As a health related protection
ordered by a physician if absolutely necessary during the conduct of a specific
medical or surgical procedure or for the individual's protection during the time
that a medical condition exists.
(2) Staff supporting an individual
must be trained by an instructor certified in OIS when the individual has a history
of behavior requiring protective physical intervention and the ISP team has determined
there is probable cause for future application of protective physical intervention.
Documentation verifying OIS training must be maintained in the staff person's personnel
file.
(3) The service provider
must obtain the approval of the OIS Steering Committee for any modification of standard
OIS protective physical intervention techniques. The request for modification of
a protective physical intervention technique must be submitted to the OIS Steering
Committee and must be approved in writing by the OIS Steering Committee prior to
the implementation of the modification. Documentation of the approval must be maintained
in the individual's record.
(4) Use of protective physical
intervention techniques that are not part of an approved plan of behavior support
in emergency situations must:
(a) Be reviewed by the service
provider's executive director or the executive director's designee within one hour
of application;
(b) Be used only until the
individual is no longer an immediate threat to self or others;
(c) Submit an incident report
to the CDDP services coordinator or other Department designee (if applicable) and
the individual's legal representative (if applicable), no later than one working
day after the incident has occurred; and
(d) Prompt an ISP team meeting
if emergency protective physical intervention is used more than three times in a
six-month period.
(5) Any use of protective
physical intervention must be documented in an incident report, excluding circumstances
described in section (7) of this rule. The report must include:
(a) The name of the individual
to whom the protective physical intervention was applied;
(b) The date, type, and length
of time the protective physical intervention was applied;
(c) A description of the
incident precipitating the need for the use of the protective physical intervention;
(d) Documentation of any
injury;
(e) The name and position
of the staff member applying the protective physical intervention;
(f) The name and position
of the staff witnessing the protective physical intervention;
(g) The name and position
of the person providing the initial review of the use of the protective physical
intervention; and
(h) Documentation of an administrative
review including the follow-up to be taken to prevent a recurrence of the incident
by the service provider's executive director or the executive director's designee
who is knowledgeable in OIS, as evident by a job description that reflects this
responsibility.
(6) A copy of the incident
report must be forwarded within five working days of the incident to the CDDP services
coordinator and the individual's legal representative (when applicable).
(a) The services coordinator
or the Department designee (when applicable) must receive complete copies of incident
reports.
(b) Copies of incident reports
may not be provided to a legal representative or other service providers when the
report is part of an abuse or neglect investigation.
(c) Copies provided to a
legal representative or other service provider must have confidential information
about other individuals removed or redacted as required by federal and state privacy
laws.
(d) All protective physical
interventions resulting in injuries must be documented in an incident report and
forwarded to the CDDP services coordinator or other Department designee (if applicable)
within one working day of the incident.
(7) Behavior data summary.
(a) The service provider
may substitute a behavior data summary in lieu of individual incident reports when:
(A) There is no injury to
the individual or others;
(B) The intervention utilized
is not a protective physical intervention;
(C) There is a formal written
functional assessment and a written Behavioral Support Plan;
(D) The individual's Behavior
Support Plan defines and documents the parameters of the baseline level of behavior;
(E) The protective physical
intervention technique and the behavior for which the protective physical intervention
techniques are applied remain within the parameters outlined in the individual's
Behavior Support Plan and the OIS curriculum;
(F) The behavior data collection
system for recording observations, interventions, and other support information
critical to the analysis of the efficacy of the Behavior Support Plan is also designed
to record the items described in sections (5)(a)-(c) and (e)-(h) of this rule; and
(G) There is written documentation
of an ISP team decision that a behavior data summary has been authorized for substitution
in lieu of incident reports.
(b) A copy of the behavior
data summary must be forwarded every 30 days to the CDDP services coordinator or
other Department designee (if applicable) and the individual's legal representative
(if applicable).
Stat. Auth.: ORS 409.050, 410.070, 443.450
& 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0360
Psychotropic Medications and Medications
for Behavior
(1) Psychotropic medications and medications
for behavior must be:
(a) Prescribed by a physician
or health care provider through a written order; and
(b) Monitored by the prescribing
physician or health care provider, ISP team, and provider for desired responses
and adverse consequences.
(2) When medication is first
prescribed and annually thereafter, the provider must obtain a signed balancing
test from the prescribing health care provider using the Department Balancing Test
Form (form SDS 4110) or by inserting the required form content into forms maintained
by the provider. Providers must present the physician or health care provider with
a full and clear description of the behavior and symptoms to be addressed, as well
as any side effects observed.
(3) The provider must keep
signed copies of the Balancing Test Forms required in section (2) of this rule in
the medical record for the individual for seven years.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400-455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-325-0370
Individuals' Personal Property
(1) The service provider must prepare
and maintain an accurate individual written record of personal property that has
significant or monetary value to each individual as determined by a documented ISP
team or legal representative decision.
(2) The record must include:
(a) The description and identifying
number, if any;
(b) Date of inclusion in
the record;
(c) Date and reason for removal
from the record;
(d) Signature of staff making
each entry; and
(e) A signed and dated annual
review of the record for accuracy.
Stat. Auth.: ORS 409.050, 410.070, 443.450
& 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0380
Handling and Managing Individuals' Money
(1) The service provider must have and
implement written policies and procedures for the handling and management of individuals'
money. Such policies and procedures must provide for:
(a) The individual to manage
his or her own funds unless the ISP documents and justifies limitations to self-management;
(b) Safeguarding of an individual's
funds;
(c) Individuals receiving
and spending their money; and
(d) Taking into account an
individual's interests and preferences.
(2) For those individuals
not yet capable of managing their own money, as determined by the ISP Risk Tracking
Record or the individual's legal representative, the service provider must prepare
and maintain an accurate written record for each individual of all money received
or disbursed on behalf of or by the individual. The record must include:
(a) The date, amount, and
source of income received;
(b) The date, amount, and
purpose of funds disbursed; and
(c) Signature of the staff
making each entry.
(3) The service provider
must reimburse the individual any funds that are missing due to theft or mismanagement
on the part of any staff member of the home or for any funds within the custody
of the service provider that are missing. Such reimbursement must be made within
10 working days of the verification that funds are missing.
Stat. Auth.: ORS 409.050, 410.070, 443.450
& 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0390
Entry, Exit, and Transfer
(1) NON-DISCRIMINATION. An individual
considered for Department-funded services may not be discriminated against because
of race, color, creed, age, disability, national origin, gender, religion, duration
of Oregon residence, method of payment, or other forms of discrimination under applicable
state or federal law.
(2) QUALIFICATIONS FOR DEPARTMENT-FUNDED
SERVICES. An individual who enters a 24-hour residential setting is subject to eligibility
as described in this section.
(a) To be eligible for services
in a 24-hour residential setting, an individual must:
(A) Be an Oregon resident;
(B) Be eligible for OHP Plus;
(C) Be determined eligible
for developmental disability services by the CDDP of the county of origin as described
in OAR 411-320-0080;
(D) Meet the level of care
as defined in OAR 411-320-0020; and
(E) Be an individual who
is not receiving other Department-funded in-home or community living support.
(b) To be eligible for Department-funded
relief care, an individual must:
(A) Meet the criteria in
subsection (a)(A)–(D) of this section;
(B) Be referred by a CDDP
or Brokerage; and
(C) Not be receiving services
in a supported living setting as described in OAR chapter 411, division 328.
(c) TRANSFER OF ASSETS.
(A) As of October 1, 2014,
an individual receiving medical benefits under OAR chapter 410, division 200 requesting
Medicaid coverage for services in a nonstandard living arrangement (see OAR 461-001-0000)
is subject to the requirements of the rules regarding transfer of assets (see 461-140-0210
to 461-140-0300) in the same manner as if the individual was requesting these services
under OSIPM. This includes, but is not limited to, the following assets:
(i) An annuity evaluated
according to OAR 461-145-0022;
(ii) A transfer of property
when an individual retains a life estate evaluated according to OAR 461-145-0310;
(iii) A loan evaluated according
to OAR 461-145-0330; or
(iv) An irrevocable trust
evaluated according to OAR 461-145-0540;
(B) When an individual is
considered ineligible due to a disqualifying transfer of assets, the individual
must receive a notice meeting the requirements of OAR 461-175-0310 in the same manner
as if the individual was requesting services under OSIPM.
(3) ENTRY.
(a) The Department authorizes
the entry of children into 24-hour residential settings and stabilization and crisis
units.
(b) The CDDP services coordinator
authorizes entry into 24-hour residential settings, except in the cases of residential
services for children and stabilization and crisis units.
(4) DOCUMENTATION UPON ENTRY.
(a) Prior to or upon an entry
ISP team meeting, a provider must acquire the following individual information:
(A) A copy of the eligibility
determination document;
(B) A statement indicating
the 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 the 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 available);
(H) Copies of documents relating
to the guardianship, 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
that the individual is participating in out of residence activities, including public
school enrollment for individuals less than 21 years of age;
(J) Written documentation
to explain why preferences or choices of the individual may not be honored at that
time; and
(K) A copy of the most recent
Behavior Support Plan and assessment, ISP, Nursing Service Plan, and Individualized
Education Program (if available).
(b) If an individual is being
admitted from the family home of the individual and the information required in
subsection (a) of this section is not available, the provider must assess the individual
upon entry for issues of immediate health or safety and document a plan to secure
the remaining information no later than 30 days after entry. The plan must include
a written justification as to why the information is not available.
(5) ENTRY MEETING. An entry
ISP team meeting must be conducted prior to the onset of services to an individual.
The findings of the entry meeting must be recorded in the file for the individual
and 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 (4)(a) of this rule;
(f) Documentation of the
decision to serve the individual requesting services; and
(g) The written Transition
Plan for no longer than 60 days that includes all medical, behavior, and safety
supports needed by the individual.
(6) VOLUNTARY TRANSFERS AND
EXITS.
(a) A provider must promptly
notify a services coordinator if an individual gives notice of the intent to exit
or abruptly exits services.
(b) A provider must notify
a services coordinator prior to the voluntary transfer or exit of an individual
from services.
(c) Notification and authorization
of the voluntary transfer or exit of the individual must be documented in the record
for the individual.
(d) A provider is responsible
for the provision of services until an individual exits the home.
(7) INVOLUNTARY REDUCTIONS,
TRANSFERS, AND EXITS.
(a) A provider must only
reduce, transfer, or exit an individual involuntarily for one or more of the following
reasons:
(A) The behavior of the individual
poses an imminent risk of danger to self or others;
(B) The individual experiences
a medical emergency;
(C) The service needs of
the individual exceed the ability of the provider;
(D) The individual fails
to pay for services; or
(E) The certification or
endorsement for the provider described in OAR chapter 411, division 323 is suspended,
revoked, not renewed, or voluntarily surrendered or the license for the home is
suspended, revoked, not renewed, or voluntarily surrendered.
(b) NOTICE OF INVOLUNTARY
REDUCTION, TRANSFER, OR EXIT. A provider must not reduce services, transfer, or
exit an individual involuntarily without 30 days advance written notice to the individual,
the legal or designated representative of the individual (as applicable), and the
services coordinator, except in the case of a medical emergency or when an individual
is engaging in behavior that poses an imminent danger to self or others in the home
as described in subsection (c) of this section.
(A) The written notice must
be provided on the Notice of Involuntary Reduction, Transfer, or Exit form approved
by the Department and include:
(i) The reason for the reduction,
transfer, or exit; and
(ii) The right of the individual
to a hearing as described in subsection (e) of this section.
(B) A Notice of Involuntary
Reduction, Transfer, or Exit is not required when an individual requests the reduction,
transfer, or exit.
(c) A provider may give less
than 30 days advance written notice only in a medical emergency or when an individual
is engaging in behavior that poses an imminent danger to self or others in the home.
The notice must be provided to the individual, the legal or designated representative
of the individual (as applicable), and the services coordinator immediately upon
determination of the need for a reduction, transfer, or exit.
(d) A provider is responsible
for the provision of services until an individual exits the home.
(e) HEARING RIGHTS. An individual
must be given the opportunity for a hearing under ORS chapter 183 and OAR 411-318-0030
to dispute an involuntary reduction, transfer, or exit. If an individual requests
a hearing, the individual must receive the same services until the hearing is resolved.
When an individual has been given less than 30 days advance written notice of a
reduction, transfer, or exit as described in subsection (c) of this section and
the individual has requested a hearing, the provider must reserve the room of the
individual until receipt of the Final Order.
(8) EXIT MEETING.
(a) An ISP team must meet
before any decision to exit and individual is made. Findings of the exit meeting
must be recorded in the file 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) Documentation of the
proposed plan for services after the exit.
(b) Requirements for an exit
meeting may be waived if an individual is immediately removed from the home under
the following conditions:
(A) The individual requests
an immediate move from the home; or
(B) The individual is removed
by legal authority acting pursuant to civil or criminal proceedings other than detention
for an individual less than 18 years of age.
(9) TRANSFER MEETING. An
ISP team must meet to discuss any proposed transfer of an individual before any
decision to transfer is made. Findings of the transfer meeting must be recorded
in the file 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 of the individual, parent, or family members, 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 after the transfer.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 23-2013(Temp),
f. & cert. ef. 7-1-13 thru 12-28-13; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13;
APD 24-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 42-2014, f. 12-26-14,
cert. ef. 12-28-14
411-325-0410
Relief Care Services
(1) All individuals considered for relief
care services funded through 24-hour residential services must:
(a) Be referred by the CDDP
or Department;
(b) Be determined to have
an intellectual or developmental disability by the Department or the Department's
designee; and
(c) Not be discriminated
against because of race, color, creed, age, disability, national origin, duration
of Oregon residence, method of payment, or other forms of discrimination under applicable
state or federal law.
(2) The individual, service
provider, legal or designated representative (as applicable), parent, and family
or other ISP team members (as available) must participate in an entry meeting prior
to the initiation of relief care services. The meeting may occur by phone and the
CDDP or Department must ensure that any critical information relevant to the individual's
health and safety, including physicians' orders, is made immediately available.
The outcome of the meeting must be a written Relief Care Plan that takes effect
upon entry and is available on site. The Relief Care Plan must:
(a) Address the individual's
health, safety, and behavioral support needs;
(b) Indicate who is responsible
for providing the supports described in the Relief Care Plan; and
(c) Specify the anticipated
length of stay at the home up to 14 days.
(3) Exit meetings are waived
for individuals receiving relief care services.
(4) Individuals receiving
relief care services do not have appeal rights regarding entry, exit, or transfer.
Stat. Auth.:ORS 409.050, 410.070, 443.450
& 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0420
Crisis Services
(1) All individuals considered for crisis
services funded through 24-hour residential services must:
(a) Be referred by the CDDP
or Department;
(b) Be determined to have
an intellectual or developmental disability by the Department or the Department's
designee;
(c) Be determined to be eligible
for developmental disability services as defined in OAR 411-320-0080; and
(d) Not be discriminated
against because of race, color, creed, age, disability, national origin, duration
of Oregon residence, method of payment, or other forms of discrimination under applicable
state or federal law.
(2) Individuals receiving
support services under OAR chapter 411, division 340 and receiving crisis services
must have a Support Services Plan of Care and a Crisis Addendum upon entry to the
home.
(3) An ISP is required for
individuals not enrolled in support services. Individuals not enrolled in support
services receiving crisis services for less than 90 consecutive days must have an
ISP on entry that addresses any critical information relevant to the individual's
health and safety, including current physicians' orders.
(4) Individuals not enrolled
in support services receiving crisis services for 90 days or more must have a completed
Risk Tracking Record and an ISP that addresses all identified health and safety
supports as noted in the Risk Tracking Record.
(5) Entry meetings are required
for individuals receiving crisis services.
(6) Exit meetings are required
for individuals receiving crisis services.
(7) Individuals receiving
crisis services do not have appeal rights regarding entry, exit, or transfer.
Stat. Auth.: ORS 409.050, 410.070, 443.450
& 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0430
Individual Support Plan
(1) An ISP must be developed and approved
by an ISP team consistent with OAR 411-320-0120 and reviewed and updated as necessary
within 60 days of implementation of the Transition Plan, as changes occur, and annually
thereafter.
(2) The following information
must be collected and summarized prior to the ISP meeting:
(a) Personal Focus Worksheet;
(b) Risk Tracking Record;
(c) Necessary protocols or
plans that address health, behavioral, safety, and financial supports as identified
on the Risk Tracking Record;
(d) A Nursing Service Plan,
if applicable, including but not limited to those tasks required by the Risk Tracking
Record;
(e) Other documents required
by the ISP team; and
(f) The functional needs
assessment.
(3) A completed ISP must
be documented on the Department required form and include the following:
(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 an 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;
(l) The identity of the person
responsible for case management and monitoring the ISP;
(m) A provision to prevent
unnecessary or inappropriate care; and
(n) The alternative settings
considered by the individual.
(4) 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) The provider must maintain
documentation of implementation of each support and services specified in sections
(2)(c) to (2)(e) of this rule in the ISP for the individual. This documentation
must be kept current and be available for review by the individual, the legal representative
of the individual, CDDP, and Department representatives.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400-455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 1-2012, f. &
cert. ef. 1-6-12; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13; APD 24-2014(Temp),
f. & cert. ef. 7-1-14 thru 12-28-14; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-325-0440
Children’s Direct Contracted Services
Any documentation or information required
for children's direct contracted developmental disability services to be submitted
to the CDDP services coordinator must also be submitted to the Department's residential
services coordinator assigned to the home.
Stat. Auth.: ORS 409.050, 410.070, 443.450
& 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 23-2013(Temp),
f. & cert. ef. 7-1-13 thru 12-28-13; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13
411-325-0460
Civil Penalties
(1) For purposes of imposing civil penalties,
24-hour residential settings licensed under ORS 443.400 to 443.455 and 443.991(2)
are considered to be long-term care facilities subject to ORS 441.705 to 441.745.
(2) The Department issues
the following schedule of penalties applicable to 24-hour residential settings as
provided for under ORS 441.705 to 441.745:
(a) Violations of any requirement
within any part of the following rules may result in a civil penalty up to $500
per day for each violation not to exceed $6,000 for all violations for any licensed
24-hour residential setting within a 90-day period:
(A) 411-325-0025(3), (4),
(5), (6), and (7);
(B) 411-325-0120(2), and
(4);
(C) 411-325-0130;
(D) 411-325-0140;
(E) 411-325-0150;
(F) 411-325-0170;
(G) 411-325-0190;
(H) 411-325-0200;
(I) 411-325-0220(1), and
(2);
(J) 411-325-0230;
(K) 411-325-0240, 0250, 0260,
0270, 0280, and 0290;
(L) 411-325-0300, 0340, and
0350;
(M) 411-325-0360;
(N) 411-325-0380;
(O) 411-325-0430(3) and (4);
and
(P) 411-325-0440.
(b) Civil penalties of up
to $300 per day per violation may be imposed for violations of any section of these
rules not listed in subsection (a)(A) to (a)(N) of this section if a violation has
been cited on two consecutive inspections or surveys of a 24-hour residential setting
where such surveys are conducted by an employee of the Department. Penalties assessed
under this section of this rule may not exceed $6,000 within a 90-day period.
(3) Monitoring occurs when
a 24-hour residential setting is surveyed, inspected, or investigated by an employee
or designee of the Department or an employee or designee of the Office of State
Fire Marshal.
(4) In imposing a civil penalty
pursuant to the schedule published in section (2) of this rule, the Department considers
the following factors:
(a) The past history of the
provider incurring a penalty in taking all feasible steps or procedures necessary
or appropriate to correct any violation;
(b) Any prior violations
of statutes or rules pertaining to 24-hour residential settings;
(c) The economic and financial
conditions of the provider incurring the penalty; and
(d) The immediacy and extent
to which the violation threatens or threatened the health, safety, or well-being
of individuals.
(5) Any civil penalty imposed
under ORS 443.455 and 441.710 becomes due and payable when the provider incurring
the penalty receives a notice in writing from the Director of the Department. The
notice referred to in this section of this rule is sent by registered or certified
mail and includes:
(a) A reference to the particular
sections of the statute, rule, standard, or order involved;
(b) A short and plain statement
of the matters asserted or charged;
(c) A statement of the amount
of the penalty or penalties imposed; and
(d) A statement of the right
of the services provider to request a hearing.
(6) The person representing
the provider to whom the notice is addressed has 20 days from the date of mailing
of the notice in which to make a written application for a hearing before the Department.
(7) All hearings are conducted
pursuant to the applicable provisions of ORS Chapter 183.
(8) If the provider notified
fails to request a hearing within 20 days, an order may be entered by the Department
assessing a civil penalty.
(9) If, after a hearing,
the provider is found to be in violation of a license, rule, or order listed in
ORS 441.710(1), an order may be entered by the Department assessing a civil penalty.
(10) A civil penalty imposed
under ORS 443.455 or 441.710 may be remitted or reduced upon such terms and conditions
as the Director of the Department considers proper and consistent with individual
health and safety.
(11) If the order is not
appealed, the amount of the penalty is payable within 10 days after the order is
entered. If the order is appealed and is sustained, the amount of the penalty is
payable within 10 days after the court decision. The order, if not appealed or sustained
on appeal, constitutes a judgment and may be filed in accordance with the provisions
of ORS 183.745. Execution may be issued upon the order in the same manner as execution
upon a judgment of a court of record.
(12) A violation of any general
order or Final Order pertaining to a 24-hour residential setting issued by the Department
is subject to a civil penalty in the amount of not less than $5 and not more than
$500 for each and every violation.
(13) Judicial review of civil
penalties imposed under ORS 441.710 are provided under ORS 183.480, except that
the court may, in its discretion, reduce the amount of the penalty.
(14) All penalties recovered
under ORS 443.455 and 441.710 to 441.740 are paid into the State Treasury and credited
to the General Fund.
Stat. Auth.: ORS 409.050, 443.450, 443.455
Stats. Implemented: ORS 443.400-455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 19-2011(Temp),
f. & cert. ef. 7-1-11 thru 12-28-11; SPD 1-2012, f. & cert. ef. 1-6-12;
SPD 1-2012, f. & cert. ef. 1-6-12; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13;
APD 24-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 42-2014, f. 12-26-14,
cert. ef. 12-28-14
411-325-0470
License Denial, Suspension, Revocation,
Refusal to Renew
(1) The Department shall deny, suspend,
revoke, or refuse to renew a license where the Department finds there has been substantial
failure to comply with these rules or where the State Fire Marshal or the State
Fire Marshal's representative certifies there is failure to comply with all applicable
ordinances and rules relating to safety from fire.
(2) The Department shall
suspend the home license where imminent danger to health or safety of individuals
exists.
(3) The Department shall
deny, suspend, revoke, or refuse to renew a license where it finds that a provider
is on the current Centers for Medicare and Medicaid Services list of excluded or
debarred providers.
(4) Revocation, suspension,
or denial is done in accordance with the rules of the Department and ORS Chapter
183.
(5) Failure to disclose requested
information on the application or provision of incomplete or incorrect information
on the application constitutes grounds for denial or revocation of the license.
(6) The Department shall
deny, suspend, revoke, or refuse to renew a license if the licensee fails to implement
a plan of correction or comply with a final order of the Department imposing an
administrative sanction, including the imposition of a civil penalty.
Stat. Auth.: Stat. Auth.: ORS 409.050,
443.450 & 443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; SPD 25-2004, f. 7-30-04, cert. ef. 8-1-04; SPD 58-2013, f. 12-27-13,
cert. ef. 12-28-13
411-325-0480
Criminal Penalties
(1) Violation of any provision of ORS
443.400 to 443.455 is a Class B misdemeanor.
(2) Violation of any provision
of ORS 443.881 is a Class C misdemeanor.
Stat. Auth.: ORS 409.050, 443.450 &
443.455
Stats. Implemented: ORS 443.400
- 443.455
Hist.: SPD 25-2003, f. 12-29-03,
cert. ef. 1-1-04; ; SPD 58-2013, f. 12-27-13, cert. ef. 12-28-13

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contained in the Administrative Order filed at the Archives Division,
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published version are satisfied in favor of the Administrative Order.
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