Or. Admin. Code § 410-120-2005
Current through Register Vol. 63, No. 11, November 1, 2024
Section 410-120-2005 - HRSN Service Eligibility; Identifying HRSN Eligible Members, HRSN Outreach and Engagement Services(1) A Member authorized to receive HRSN Services so long as they meet the definition of HRSN Eligible in OAR 410-120-0000 and all other eligibility requirements applicable to the specific HRSN Service and, as applicable, HRSN Service Category, requested by the Member, all of which are identified in Tables 3 through 9 of this rule.(2) A Member is not eligible for an HRSN Service if they are already receiving the same service from a different state, local, or federal agency, organization, or entity. (a) In addition, a Member is not eligible for an HRSN Service if they do not meet all other eligibility criteria for the specific HRSN Service requested, all of which are identified in Tables 3 through 9 of this rule.(b) If a Member is receiving a similar service as the requested HRSN, the requested HRSN Services may be provided to the Member so long as they meet all eligibility criteria for the requested HRSN Service and the amount and duration of the HRSN Services is in an amount that may fill the gaps of or otherwise supplement the deficiencies in the similar service the Member is receiving.(3) Identifying Members Potentially Eligible for HRSN Services. The MCE and the Authority shall ensure multiple pathways for Members to be identified as potentially eligible for HRSN Services. Pathways for identifying potentially eligible Members for HRSN Services at a minimum must include the following: (a) Proactively identifying Members who can be Presumed HRSN Eligible through a review of the MCE or Authority's encounter and claims data;(b) Contracting with HRSN Service Providers to conduct HRSN Outreach and Engagement (O&E) to identify Members;(c) Engaging with and receiving HRSN Requests (outlined in OAR 410-120-2010) from HRSN Connectors (defined in OAR 410-120-0000), including HRSN Service Providers;(d) Regardless of whether a contractual relationship exists, conducting proactive outreach to HRSN Service Providers, especially HRSN Housing Service Providers, for the purpose of encouraging communication with Members who may be eligible for and benefit from HRSN Services; and(e) Accepting Members' Self-Attestations or referrals.(4) HRSN Outreach and Engagement Services and Compensation.(a) MCEs, the Authority, and HRSN Service Providers shall provide the HRSN Outreach and Engagement Services (HRSN O&E Services) described in Table 8 of this rule to Members who are eligible for HRSN Services and to Members who are Presumed HRSN Eligible as identified in Table 9 of this Rule and defined in OAR 410-120-0000.(b) HRSN Service Providers must be compensated by the MCE, or, as applicable the Authority for providing HRSN O&E Services when provided to: (A) HRSN Eligible Members, or(B) Members who are confirmed to be enrolled in OHP (FFS or an MCE) and are Presumed HRSN Eligible Members as defined in OAR 410-120-0000.Or. Admin. Code § 410-120-2005
DMAP 130-2024, adopt filed 10/24/2024, effective 11/1/2024Statutory/Other Authority: ORS 413.042
Statutes/Other Implemented: 414.572, 414.605, 414.665, 414.719 & 414.632