Division 328

Link to law: http://arcweb.sos.state.or.us/pages/rules/oars_400/oar_411/411_328.html
Published: 2015

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 328

SUPPORTED LIVING SERVICES FOR ADULTS
WITH INTELLECTUAL OR DEVELOPMENTAL DISABILITIES
411-328-0550
Statement of Purpose
(1) The rules in OAR chapter 411, division
328 prescribe standards for providers that support individuals with intellectual
or developmental disabilities in a supported living setting.
(2) Supported living provides
the opportunity for an individual to live in the residence of his or her choice
within the community with recognition that the needs and preferences of the individual
may change over time. The levels of support for the individual are based upon individual
needs and preferences as identified in a functional needs assessment and defined
in an Individual Support Plan. Such services may include up to 24 hours per day
of paid supports that are provided in a manner that protects the dignity of the
individual.
(3) These rules ensure that
providers meet basic management, programmatic, health and safety, and human rights
regulations for adults receiving services funded by the Department in supported
living settings. The provider is responsible for developing and implementing policies
and procedures that ensure that the requirements of these rules are met and ensuring
services comply with all applicable local, state, and federal laws and regulations.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0550
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, f. 12-27-13, cert. ef.
12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-328-0560
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 328:
(1) "Abuse" means "abuse
of an adult" as defined in OAR 407-045-0260.
(2) "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.
(3) "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.
(4) "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.
(5) "Behavior Support Services"
mean the services consistent with positive behavioral theory and practice that are
provided to assist with behavioral challenges due to the intellectual or developmental
disability of an individual that prevents the individual from accomplishing ADL,
IADL, health-related tasks, and provides cognitive supports to mitigate behavior.
Behavior support services are provided in the home or community.
(6) "Board of Directors"
means "board of directors" as defined in OAR 411-323-0020.
(7) "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.
(8) "CDDP" means "community
developmental disability program" as defined in OAR 411-320-0020.
(9) "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 supported living setting.
(10) "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.
(11) "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.
(12) "Department" means the
Department of Human Services.
(13) "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.
(14) "Developmental Disability"
means "developmental disability" as defined in OAR 411-320-0020 and described in
OAR 411-320-0080.
(15) "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.
(16) "Endorsement" means
the authorization to provide services in a supported living 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.
(17) "Entry" means admission
to a Department-funded developmental disability service.
(18) "Executive Director"
means the person designated by a board of directors or corporate owner that is responsible
for the administration of services in a supported living setting.
(19) "Exit" means termination
or discontinuance of a Department-funded developmental disability service by a Department
licensed or certified provider.
(20) "Functional Needs Assessment":
(a) Means the comprehensive
assessment or reassessment 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 adult is known as the Adult Needs Assessment (ANA). Effective
December 31, 2014, the Department incorporates Version C of the ANA into these rules
by this reference. The ANA is maintained by the Department at: http://www.dhs.state.or.us/spd/tools/dd/ANAadultInhome.xls.
A printed copy of a blank ANA may be obtained by calling (503) 945-6398 or writing
to the Department of Human Services, Developmental Disabilities, ATTN: Rules Coordinator,
500 Summer Street NE, E-48, Salem, OR 97301.
(21) "Guardian" means the
person or agency appointed and authorized by a court to make decisions about services
for an individual.
(22) "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.
(23) "Hearing" means a contested
case hearing subject to OAR 137-003-0501 to 137-003-0070, which results in a Final
Order.
(24) "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.
(25) "Independence" means
the extent to which an individual exerts control and choice over his or her own
life.
(26) "Individual" means 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.
(27) "Individual Profile"
means the written profile that describes an individual entering into a supported
living setting. The profile may consist of materials or assessments generated by
a provider or other related agencies, consultants, family members, or the legal
or designated representative of the individual (as applicable).
(28) "Intellectual Disability"
means "intellectual disability" as defined in OAR 411-320-0020 and described in
411-320-0080.
(29) "Involuntary Reduction"
means a provider has made the decision to reduce services provided to an individual
without prior approval from the individual.
(30) "Involuntary Transfer"
means a provider has made the decision to transfer an individual without prior approval
from the individual.
(31) "ISP" means "Individual
Support Plan". An ISP includes the written details of the supports, activities,
and resources required for an individual to achieve and maintain personal goals
and health and safety. The ISP is developed at least annually to reflect decisions
and agreements made during a person-centered process of planning and information
gathering that is driven by the individual. The ISP reflects services and supports
that are important for the individual to meet the needs of the individual identified
through a functional needs assessment as well as the preferences of the individual
for providers, delivery, and frequency of services and support. 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.
(32) "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.
(33) "Legal Representative"
means an attorney at law who has been retained by or for an individual, a power
of attorney for an individual, or a person or agency authorized by a court to make
decisions about services for an individual.
(34) "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.
(35) "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.
(36) "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.
(37) "Natural Supports" mean
the voluntary resources available to an individual from the relatives, friends,
significant others, neighbors, roommates, and the community of the individual that
are not paid for by the Department.
(38) "Needs Meeting" means
a process in which an ISP team identifies the services and supports an individual
needs to live in his or her own home and makes a determination as to the feasibility
of creating such services.
(39) "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.
(40) "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
used to maintain health and safety.
(41) "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.
(42) "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.
(43) "Positive Behavioral
Theory and Practice" means a proactive approach to behavior and behavior interventions
that:
(a) Emphasizes the development
of functional alternative behavior and positive behavior intervention;
(b) Uses the least intrusive
intervention possible;
(c) Ensures that abusive
or demeaning interventions are never used; and
(d) Evaluates the effectiveness
of behavior interventions based on objective data.
(44) "Protective Physical
Intervention" means any manual physical holding of, or contact with, an individual
that restricts freedom of movement.
(45) "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.
(46) "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.
(47) "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.
(48) "Services Coordinator"
means "services coordinator" as defined in OAR 411-320-0020.
(49) "Supported Living" means
the endorsed setting that provides the opportunity for individuals to live in the
residence of their own choice within the community. Supported living is not grounded
in the concept of "readiness" or in a "continuum of services model" but rather provides
the opportunity for individuals to live where they want, with whom they want, for
as long as they desire, with a recognition that needs and desires may change over
time.
(50) "These Rules" mean the
rules in OAR chapter 411, division 328.
(51) "Transfer" means movement
of an individual from one service setting to another service setting administered
or operated by the same provider.
(52) "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.
(53) "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.
(54) "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, 430.662
Stats. Implemented: ORS 430.610,
430.662, 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0560
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 25-2009(Temp), f. 12-31-09, cert.
ef. 1-1-10 thru 6-30-10; SPD 5-2010, f. 6-29-10, cert. ef. 7-1-10; SPD 19-2011(Temp),
f. & cert. ef. 7-1-11 thru 12-28-11; SPD 1-2012, f. & cert. ef. 1-6-12;
SPD 24-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13; SPD 59-2013, 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
411-328-0570
Program Management
(1) CERTIFICATION, ENDORSEMENT, AND
ENROLLMENT. To provide services in a supported living setting, the provider must
have:
(a) A certificate and an
endorsement to provide services in a supported living setting 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
area where services shall be delivered in a supported living setting, a Medicaid
Performing Provider Number assigned by the Department as described in OAR chapter
411, division 370.
(2) INSPECTIONS AND INVESTIGATIONS.
The provider must allow inspections and investigations as described in OAR 411-323-0040.
(3) MANAGEMENT AND PERSONNEL
PRACTICES. The provider must comply with the management and personnel practices
as described in OAR 411-323-0050.
(4) PERSONNEL FILES AND QUALIFICATION
RECORDS. The provider must maintain written documentation of six hours of pre-service
training prior to supervising individuals that includes mandatory abuse reporting
training and training on individual profiles, Transition Plans, and ISPs.
(5) CONFIDENTIALITY OF RECORDS.
The provider must ensure the confidentiality of the records for individuals as described
in OAR 411-323-0060.
(6) DOCUMENTATION REQUIREMENTS.
Unless stated otherwise, all entries required by these rules 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 five years.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0570
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 5-2011(Temp), f. & cert. ef.
2-7-11 thru 8-1-11; SPD 13-2011, f. & cert. ef. 7-1-11; SPD 19-2011(Temp), f.
& cert. ef. 7-1-11 thru 12-28-11; SPD 1-2012, f. & cert. ef. 1-6-12; SPD
59-2013, f. 12-27-13, cert. ef. 12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-328-0620
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 program effectiveness and does not
adversely impact the welfare, health, safety, or rights of 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 of 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 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0620
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 1-2012, f. & cert. ef. 1-6-12;
SPD 59-2013, f. 12-27-13, cert. ef. 12-28-13; APD 42-2014, f. 12-26-14, cert. ef.
12-28-14
411-328-0630
Medical Services
(1) The medical records for individuals
must be kept confidential as described in OAR 411-323-0060.
(2) The provider must provide
sufficient oversight and guidance to ensure that the health and medical needs of
the individuals are adequately addressed.
(3) Written health and medical
supports must be developed as required for an individual and integrated into a Transition
Plan or ISP. The plan must be based on a functional needs assessment of the health
and medically related support needs and preferences of the individual and updated
annually or as significant changes occur.
(4) 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) Early detection and prevention
of infectious disease;
(b) Emergency medical intervention;
(c) Treatment and documentation
of illness and health care concerns; and
(d) Obtaining, administering,
storing, and disposing of prescription and non-prescription drugs, including self-administration
of medication.
(5) The provider must ensure
an individual has a primary physician or health care provider whom the individual
has chosen from among qualified providers.
(6) Provisions must be made
for a secondary physician, health care provider, or clinic in the event of an emergency.
(7) 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 health care provider. Evidence
of the medical evaluation must be placed in the record for the individual and must
address:
(a) Current health status;
(b) Changes in health status;
(c) Recommendations, if any,
for further medical intervention;
(d) Any remedial and corrective
action required and the date of action;
(e) Restrictions on activities
due to medical limitations; and
(f) Prescribed medications,
treatments, special diets, and therapies.
(8) 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.
(9) Before the entry of an
individual, the provider must obtain the most complete medical profile available
for the individual, including:
(a) The results of most recent
physical exam;
(b) Results of any dental
evaluation;
(c) A record of immunizations;
(d) A record of known communicable
diseases and allergies; and
(e) A summary of the medical
history of the individual, including chronic health concerns.
(10) The provider must ensure
that all medications, treatments, and therapies:
(a) Have a written order
or a copy of a written order signed by a physician or qualified health care provider
before any medication, prescription, or non-prescription is administered to, or
self-administered by, an individual unless otherwise indicated by an ISP team in
the written health and medical support section of the ISP or Transition Plan for
the individual; and
(b) Be followed per written
orders.
(11) PRN (as needed) orders
are not allowed for psychotropic medication.
(12) The drug regimen of
an individual on prescription medication must be reviewed and evaluated by a physician
or physician designee no less often than every 180 days unless otherwise indicated
by an ISP team in the written health and medical support section of the ISP or Transition
Plan for the individual.
(13) All prescribed medications
and treatments must be self-administered unless contraindicated by an ISP team or
physician. For an individual who requires assistance in the administration of his
or her own medication, the following must be met:
(a) The ISP team must recommend
that the individual receive assistance with taking his or her own medication;
(b) There must be a written
training program for the self-administration of medication unless contraindicated
by the ISP team; and
(c) There must be a written
record of medications and treatments that documents that the orders of a physician
are being followed.
(14) The ISP for an individual
who independently self-administers medication must include a plan for the periodic
monitoring or review of the self-administration of medication.
(15) The provider must assist
an individual with the use of a prosthetic device as ordered.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0630
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 19-2011(Temp), f. & cert. ef.
7-1-11 thru 12-28-11; SPD 1-2012, f. & cert. ef. 1-6-12; SPD 59-2013, f. 12-27-13,
cert. ef. 12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-328-0640
Dietary
(1) The provider is responsible for
providing the support and guidance as identified in individuals ISPs to ensure that
individuals are provided access to a nutritionally adequate diet.
(2) Written dietary supports
must be developed as required by an ISP team and integrated into a Transition Plan
or ISP. The plan must be based on a review and identification of the dietary service
needs and preferences of an individual and updated annually or as significant changes
occur.
(3) The provider must have
and implement policies and procedures related to maintaining adequate food supplies
and meal planning, preparation, service, and storage.
Stat. Auth.:ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0640
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, f. 12-27-13, cert. ef.
12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-328-0650
Physical Environment
(1) All floors, walls, ceilings, windows,
furniture, and fixtures must be maintained.
(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) Each residence must have:
(a) A kitchen area for the
preparation of hot meals; and
(b) A bathroom containing
a properly operating toilet, handwashing sink, and a bathtub or shower.
(4) Each residence must be
adequately heated and ventilated.
Stat. Auth.:ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; Renumbered from 309-041-0650 by SPD 17-2009, f. & cert. ef.
12-9-09; SPD 59-2013, f. 12-27-13, cert. ef. 12-28-13; APD 42-2014, f. 12-26-14,
cert. ef. 12-28-14
411-328-0660
General Safety
(1) The provider must employ means for
protecting the health and safety of the individuals which:
(a) Are not unduly restrictive;
(b) May include risks but
do not inordinately affect the health, safety, and welfare of the individuals; and
(c) Are used by other people
in the community.
(2) Written safety supports
must be developed as required by an ISP team and integrated into a Transition Plan
or ISP. The plan must:
(a) Be based on a review
and identification of the safety needs and preferences of an individual;
(b) Be updated annually or
as significant changes occur; and
(c) Identify how the individual
evacuates his or her residence, specifying at a minimum the routes to be used and
the level of assistance needed.
(3) The provider must have
and implement policies and procedures that provide for the safety of individuals
and for responses to emergencies and disasters.
(4) The need for emergency
evacuation procedures and documentation thereof must be assessed and determined
by an ISP team.
(5) An operable smoke alarm
must be available in each bedroom and in a central location on each floor.
(6) An operable class 2A10BC
fire extinguisher must be easily accessible in each residence.
(7) First aid supplies must
be available in each residence.
(8) An operable flashlight
must be available in each residence.
(9) The provider must provide
necessary adaptations to ensure fire safety for sensory and physically impaired
individuals.
(10) Bedrooms must meet minimum
space requirements (single 60 square feet, double 120 square feet with beds located
three feet apart).
(11) Sleeping rooms must
have at least one window that opens from the inside without special tools and provides
a clear opening through which an individual is able to exit.
(12) Emergency telephone
numbers must be available at the residence of each individual and include:
(a) The telephone numbers
of the local fire, police department, and ambulance service, if not served by a
911 emergency service; and
(b) The telephone number
of the Executive Director or the designee of the Executive Director, emergency physician,
and other people to be contacted in case of an emergency.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0660
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, f. 12-27-13, cert. ef.
12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-328-0680
Staffing Requirements
(1) The provider must provide responsible
people or an agency that is on-call and available to individuals by telephone at
all times.
(2) The provider must provide
staff appropriate to the number and needs of individuals receiving services as specified
in their ISPs.
(3) Each provider must meet
all requirements for staff ratios as specified by contract requirements.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670

Hist.: MHD 5-1992, f. 8-21-92, cert. ef. 8-24-92; Renumbered
from 309-041-0680 by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, f. 12-27-13,
cert. ef. 12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-328-0690
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 address, home phone number, date of entry, date of birth,
gender, marital status, social security number, social security beneficiary account
number, religious preference, preferred hospital, and where applicable, the number
of the Disability Services Office (DSO) or the Multi-Service Office (MSO) of the
Department 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);
(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 day program or employer
of the individual (if any);
(f) The services coordinator
of the individual; and
(g) Other agencies and representatives
providing services and supports to the individual.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0690
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, f. 12-27-13, cert. ef.
12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-328-0700
Incident Reports and Emergency Notifications
(1) An incident report, as defined in
OAR 411-328-0560, must be placed in the record for an individual upon injury, accident,
act of physical aggression, or unusual incident. The incident report must include:
(a) Conditions prior to,
or leading to, the incident;
(b) A description of the
incident;
(c) Staff response at the
time; and
(d) Follow-up to be taken
to prevent a recurrence of the incident.
(2) A copy of all incident
reports must be sent or made electronically available to the services coordinator
within five business days of the incident.
(3) Upon request of the legal
representative, a copy of the incident report must be sent or made electronically
available to the legal representative within five business days of the incident.
If a copy of the incident report is sent or made electronically available to the
legal representative of an individual, any confidential information about other
individuals must be removed or redacted as required by federal and state privacy
laws. A copy of an incident report may not be provided to the legal representative
of an individual when the report is part of an abuse or neglect investigation.
(4) The provider must notify
the CDDP immediately if an incident or allegation falls within the scope of abuse
as defined in OAR 407-045-0260. When an abuse investigation has been initiated,
the CDDP must ensure that either the services coordinator or the provider also immediately
notifies the legal or designated representative of the individual (as applicable).
The parent, next of kin, or other significant person of the individual may also
be notified unless the individual requests the parent, next of kin, or other significant
person not be notified about the abuse investigation or protective services, or
notification has been specifically prohibited by law.
(5) In the case of a serious
illness, injury, or death of an individual, the provider must immediately notify:
(a) The legal or designated
representative, parent, next of kin, and other significant person of the individual
(as applicable);
(b) The CDDP; and
(c) Any other agency responsible
for the individual.
(6) In the case of an individual
who is missing beyond the timeframes established by the ISP team, the provider must
immediately notify:
(a) The designated representative
of the individual;
(b) The legal representative
of the individual, if any, or nearest responsible relative;
(c) The local police department;
and
(d) The CDDP.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0700
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, 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
411-328-0710
Vehicles and Drivers
(1) A provider that owns or operates
a vehicle that transports individuals must:
(a) Maintain the vehicle
in safe operating condition;
(b) Comply with the laws
of the Department of Motor Vehicles;
(c) Maintain insurance coverage
on the vehicle and all authorized drivers; and
(d) Carry a first aid kit
in the vehicle.
(2) A driver operating a
vehicle to transport individuals must meet all applicable requirements of the Department
of Motor Vehicles.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0710
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, f. 12-27-13, cert. ef.
12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-328-0715
Financial Rights
(1) Written individual financial supports
must be developed as required by an ISP team and integrated into a Transition Plan
or ISP. The plan must be based on a review and identification of the financial support
needs and preferences of an individual and be updated annually or as significant
changes occur.
(2) The provider must have
and implement written policies and procedures related to the oversight of the financial
resources for individuals.
(3) The provider must reimburse
an individual for any funds that are missing due to the theft or mismanagement on
the part of any staff of the provider, or of any funds within the custody of the
provider that are missing. Reimbursement must be made to the individual within 10
business days from the verification that funds are missing.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 3-1997, f. &
cert. ef. 2-7-97; Renumbered from 309-041-0715 by SPD 17-2009, f. & cert. ef.
12-9-09; SPD 59-2013, f. 12-27-13, cert. ef. 12-28-13; APD 42-2014, f. 12-26-14,
cert. ef. 12-28-14
411-328-0720
Individual Rights, Complaints, Notification
of Planned Action, and Hearings
(1) INDIVIDUAL RIGHTS.
(a) A provider must protect
the rights of individuals described in subsection (c) 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 (c) of this
section must be provided to an individual and the legal or designated representative
of the individual.
(c) 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 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 individual;
(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, 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, day support activities, 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.
(d) 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.
(e) 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.
(f) 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.
(g) 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 of a developmental disability service 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 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0720
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, 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
411-328-0750
Personalized Plans
(1) The decision to support an individual
so that the individual may live in and maintain his or her own home requires significant
involvement from the individual and the ISP team for the individual. In supported
living, this process is characterized by a functional needs assessment and a series
of team meetings or discussions to determine what personalized supports the individual
needs to live in his or her own home, a determination as to the feasibility of creating
such supports, and the development of a written plan that describes services the
individual must receive upon entry into supported living.
(2) NEEDS MEETING. An ISP
team must meet to discuss the projected service needs of an individual prior to
the individual receiving services in a supported living setting. The needs meeting
must:
(a) Review information related
to the health and medical, safety, dietary, financial, social, leisure, staff, mental
health, and behavioral support needs and preferences of the individual;
(b) Include the individual,
any potential providers, and other ISP team members;
(c) As part of a functional
needs assessment, identify the supports required for the individual to live in his
or her own home; and
(d) Discuss the selection
of potential providers based on the service needs of the individual.
(3) TRANSITION PLAN. The
individual, provider, and other ISP team members must participate in an entry meeting
prior to the initiation of services. The outcome of the entry meeting must be a
written Transition Plan that takes effect upon entry. The Transition Plan must:
(a) Address the health and
medical, safety, dietary, financial, staffing, mental health, and behavioral support
needs and preferences of the individual as required by the ISP team;
(b) Indicate who is responsible
for providing the supports described in the Transition Plan;
(c) Be based on the list
of supports identified in the functional needs assessment and consultation required
by the ISP team; and
(d) Be developed and approved
by the ISP team and available at the service site.
(4) INDIVIDUAL SUPPORT PLAN
(ISP).
(a) 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.
(b) The ISP or attached documents
must include:
(A) The name of the individual
and the name of the legal or designated representative of the individual (as applicable);
(B) A description of the
supports required that is consistent with the support needs identified in the assessment
of the individual;
(C) The projected dates of
when specific supports are to begin and end;
(D) A list of personal, community,
and alternative resources that are available to the individual and how the resources
may be applied to provide the required supports. Sources of support may include
waiver services, Community First Choice state plan services, other state plan services,
state general funds, or natural supports;
(E) The manner in which services
are delivered and the frequency of services;
(F) Provider type;
(G) The setting in which
the individual resides as chosen by the individual;
(H) The strengths and preferences
of the individual;
(I) Individually identified
goals and desired outcomes;
(J) The services and supports
(paid and unpaid) to assist the individual to achieve identified goals and the providers
of the services and supports, including voluntarily provided natural supports;
(K) The risk factors and
the measures in place to minimize the risk factors, including back up plans;
(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.
(c) As of July 1, 2014, a
Career Development Plan must be attached to an ISP in accordance with OAR 411-345-0160.
(5) INDIVIDUAL PROFILE.
(a) The provider must develop
a written profile within 90 days of entry. The profile is used to train new staff.
The profile must include information related to the history or personal highlights,
lifestyle and activity choices and preferences, social network and significant relationships,
and other information that helps describe an individual.
(b) The profile must be composed
of written information generated by the provider. The profile may include:
(A) Reports of assessments
or consultations;
(B) Historical or current
materials developed by the CDDP or nursing facility;
(C) Material and pictures
from the family and friends of the individual;
(D) Newspaper articles; and
(E) Other relevant information.
(c) The profile must be maintained
at the service site and updated as significant changes occur.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0750
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, 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
411-328-0760
Behavior Support
(1) The provider must have and implement
a written policy for behavior support that utilizes individualized positive behavioral
theory and practice and prohibits abusive practices.
(2) The provider must inform
an individual and, as applicable, the legal or designated representative of the
individual, of the behavior support policy and procedures at the time of entry and
as changes occur.
(3) A decision to develop
a plan to alter a behavior must be made by the ISP team. Documentation of the ISP
team decision must be maintained by the provider.
(4) The behavior consultant
or a trained staff member 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 frequency, duration, and intensity of the behavior (as
applicable);
(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.
(5) The Behavior Support
Plan must include:
(a) An individualized summary
of the needs, preferences, and relationships of the individual;
(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.
(6) Providers must maintain
the following additional documentation for implementation of a Behavior Support
Plan:
(a) Written evidence that
the individual, the legal representative of the individual (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.
Stat. Auth.: ORS 409.050, 430.662
Stats. Implemented: ORS 430.610,
430.662, 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0760
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, 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
411-328-0770
Protective Physical Intervention
(1) The 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 or others is at risk, the ISP team has authorized the procedures
as documented by the decision of the ISP team, the procedures are documented in
the ISP, and the procedures 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 licensed health care provider if absolutely necessary during the conduct
of a specific medical or surgical procedure or for the protection of the individual
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 personnel file for
the staff person.
(3) The 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 record
for the individual.
(4) Use of protective physical
intervention techniques that are not part of an approved Behavior Support Plan in
emergency situations must:
(a) Be reviewed by the Executive
Director or the designee of the Executive Director within one hour of application;
(b) Be only used until the
individual is no longer an immediate threat to self or others;
(c) Result in the submission
of an incident report to the services coordinator or other Department designee (if
applicable) and the legal representative of the individual (if applicable), no later
than one business day after the incident has occurred ; and
(d) Prompt an ISP 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 protective physical intervention;
(d) Documentation of any
injury;
(e) The name and the position
of the staff member applying the protective physical intervention;
(f) The name and position
of any staff member 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 a review
by the Executive Director or the designee of the Executive Director who is knowledgeable
in OIS, as evident by a job description that reflects this responsibility. The review
must include the follow-up to be taken to prevent a recurrence of the incident.
(6) A copy of the incident
report must be sent or made electronically available within five business days of
the incident to the services coordinator and the legal representative of the individual
(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 provider when the report
is part of an abuse or neglect investigation.
(c) Copies sent or made electronically
available to a legal representative or other 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
sent or made electronically available to the services coordinator or other Department
designee (if applicable) within one business day of the incident.
(7) BEHAVIOR DATA SUMMARY.
(a) The 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) There is a formal written
functional behavioral assessment and a written Behavior Support Plan;
(C) The Behavior Support
Plan defines and documents the parameters of the baseline level of behavior;
(D) The protective physical
intervention techniques and the behavior for which the protective physical intervention
techniques are applied remain within the parameters outlined in the Behavior Support
Plan and OIS curriculum; and
(E) 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 section (5)(a)-(c) and (e)-(h) of this rule.
(b) A copy of the behavior
data summary must be forwarded or made electronically available every 30 days to
the services coordinator or other Department designee (if applicable) and the legal
representative of the individual (if applicable).
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0770
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, 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
411-328-0780
Psychotropic Medications and Medications
for Behavior
(1) Psychotropic medications and medications
for behavior must be:
(a) Prescribed by a physician
through a written order; and
(b) Included in the ISP.
(2) The use of psychotropic
medications and medications for behavior must be based on the decision of a physician
that the harmful effects without the medication clearly outweigh the potentially
harmful effects of the medication. Providers must present the physician with a full
and clear written description of the behavior and symptoms to be addressed, as well
as any side effects observed, to enable the physician to make this decision.
(3) Psychotropic medications
and medications for behavior must be:
(a) Monitored by the prescribing
physician, ISP team, and provider for desired responses and adverse consequences;
and
(b) Reviewed to determine
the continued need and lowest effective dosage in a carefully monitored program.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0780
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 59-2013, f. 12-27-13, cert. ef.
12-28-13; APD 42-2014, f. 12-26-14, cert. ef. 12-28-14
411-328-0790
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 supported living is subject to eligibility as
described in this section.
(a) To be eligible for supported
living, 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;
(E) Be an individual who
is not receiving other Department-funded in-home or community living support;
(F) Have access to the financial
resources to afford living expenses, such as food, utilities, rent, and other housing
expenses; and
(G) Be eligible for Community
First Choice state plan services.
(b) 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 OAR
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) 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
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 restriction on
the rights of the individual (if applicable);
(I) Written documentation
to explain why preferences or choices of the individual may not be honored at that
time;
(J) A copy of the most recent
ISP and Behavior Support Plan and assessment (if available);
(K) Information related to
the lifestyle, activities, and other choices and preferences; and
(L) Documentation of financial
resources.
(b) 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 subsection (a) of this section;
(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.
(4) 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.
(5) 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.
(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 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 (d) 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. 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) 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 service availability
for the individual until receipt of the Final Order.
(6) EXIT MEETING.
(a) An ISP team must meet
before any decision to exit an 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 services under
the following conditions:
(A) The individual requests
an immediate removal from services; or
(B) The individual is removed
by legal authority acting pursuant to civil or criminal proceedings.
(7) 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 or family members of the individual, may not be honored;
(g) Documentation of the
decision regarding the transfer, including verification of the voluntary decision
to transfer or a copy of the Notice of Involuntary Reduction, Transfer, or Exit;
and
(h) The written plan for
services after the transfer.
Stat. Auth.: ORS 409.050 &430.662
Stats. Implemented: ORS 430.610,
430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92,
cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0790
by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 24-2013(Temp), f. & cert. ef.
7-1-13 thru 12-28-13; SPD 59-2013, 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

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