Or. Admin. Code § 410-120-2030

Current through Register Vol. 63, No. 12, December 1, 2024

Section 410-120-2030 - HRSN Provider Qualifications

(1) MCEs shall ensure that all contracted HRSN Service Providers meet the specific provider qualifications necessary for providing the HRSN Services for which they have contracted. Contracted HRSN Service Providers must:

(a) Maintain an active business registration with the Oregon Secretary of State.

(b) Be accessible to Members, including having the operating hours and the staff necessary to meet the Members' needs.

(c) Demonstrate their ability or experience to effectively serve at least one of the Authority's Priority Populations (defined in ORS 413.256).

(d) Demonstrate they employ or contract with administrative and service delivery staff, who are, as reasonably determined by the MCE, qualified to perform and fulfill the responsibilities of their jobs.

(e) Demonstrate they provide professional, culturally and linguistically appropriate, responsive and trauma-informed services, which includes the ability to:

(A) Supply:

(I) language interpretation and translation services to those Members who have limited English proficiency, and

(II) American Sign Language (ASL) services for to those Members who require ASL in order to communicate; and

(B) Respond to the cultural needs of the diverse populations they serve by performing services in accordance with National CLAS Standards.

(f) Provide documentation that demonstrates a history of responsible financial administration via recent annual financial reports, an externally conducted audit, or other similar documentation.

(g) Meet readiness standards defined by the Authority. Compliance with readiness standards may be made by attestation or including in the HRSN Service Provider contracts their agreement and ability to comply with all of the following:

(A) Reporting and oversight requirements established by the Authority or the MCE or, as applicable, both;

(B) All laws relating to information privacy and security applicable to their business;

(C) Compliance with the credentialing obligations described in OAR 410-141-3510;

(D) All obligations related to participating in the Closed Loop Referral process (documented acceptance/denial of referrals and confirmation/incomplete services/reporting); and

(E) Invoicing for HRSN Services as agreed upon in their contract with the MCE to provide HRSN Services.

(h) Comply with oversight requirements established by the Authority, or the MCE, (or both as applicable), and all laws relating to privacy and security that are applicable to their business.

(i) Be enrolled as a Medicaid HRSN Service Provider as required under OAR 410-120-1260.

(j) Not be delegated any responsibility for HRSN Service authorization or Service Planning.

(2) It is preferred that MCEs contract with HRSN Service Providers providing Climate-Related Supports that are capable of both delivering and installing Climate-Related Devices. In the event an HRSN Service Provider does not provide installation services, MCEs shall ensure installation services are also performed by a different qualified HRSN Services Provider or HRSN Vendor(s).

(3) In addition to ensuring compliance with the requirements set out in section (1) of this rule, MCEs and, as applicable, the Authority shall further ensure that HRSN Service Providers providing Housing-Related Supports meet the following domain and service-specific provider qualifications as set forth in the HRSN Housing Specific Provider Qualifications Table 1, which is included in this rule. All HRSN Housing Related Support Service Providers must also:

(a) Have knowledge of principles, methods, and procedures of the HRSN housing services, or comparable services, that are relevant for the HRSN Housing Related Supports Services they have contracted to provide.

(b) Be trained and credentialed, if applicable, to provide the specific HRSN Housing-Related Supports Service they have contracted to provide. MCEs have the right, based on their reasonable discretion, to determine the appropriate level of training or licensure required for each HRSN Service Provider with which they contract.

(4) In addition to ensuring compliance with the requirements set out in section (1) of this rule, MCEs and, as applicable, the Authority shall further ensure that HRSN Service Providers providing Nutrition-Related Supports meet the domain and service-specific provider qualifications identified in Table 2 included in this rule. All HRSN Nutrition Related Supports Service Providers must also:

(a) Have knowledge of principles, methods and procedures of the HRSN Nutrition Services, or comparable services, that are relevant for the services they have contracted to provide, which includes meeting the HRSN-Authorized Members' nutritional needs.

(b) Comply with best practice guidelines, industry standards, and all applicable federal, state, and local laws governing food safety standards.

(c) Be trained and accredited, to the extent appropriate or required (or both) based on the applicable nutrition industry standard, to provide the specific service. MCEs have the right, based on their reasonable discretion, to determine the appropriate level of training or licensure required for each contracted provider of a HRSN nutrition service, as long as they ensure providers are contractually required to act in accordance with nutrition-related national guidelines, such as the Dietary Guidelines for Americans, or evidence-based practice guidelines for specific chronic diseases and conditions. Depending on the specific service being provided, appropriate training and credentialing may entail:

(A) Relevant training(s) (e.g., webinar courses provided by SNAP-Ed, CDC-approved training for the National Diabetes Prevention Program Lifestyle Coach position, or other trainings from accredited nutrition organizations); or

(B) Certification (e.g., Certified Nutrition & Wellness Educator by the American Association of Family & Consumer Sciences); or

(C) Licensure (e.g., licensed dietitian).

(d) Have the ability to meet the diverse needs of HRSN-Authorized Members' personal and cultural dietary preferences.

(e) Have the capacity to provide services on a one-time, daily, weekly, or monthly basis, depending on the specific service's permitted frequency and Member's preference.

(f) If a nutrition service is administered through depositing funds electronically to a debit card to be used by the HRSN-Authorized Member, the HRSN Service Provider must have the ability to administer and coordinate the service, which may require engaging directly with, or through a Health Care Interpreter, HRSN-Authorized Members to explain the service, having relationships with food retailers that shall accept payment, and monitoring and overseeing use of the cards.

(5) In addition to ensuring compliance with the requirements set out in section (1) of this rule, MCEs and, as applicable, the Authority, must further ensure that all HRSN Outreach and Engagement Service Providers meet the following domain specific qualifications:

(a) Have knowledge of principles, methods, and procedures of the HRSN Outreach and Engagement services, or comparable services for which they have contracted, which includes, connecting HRSN-Authorized Members to benefits and services other than HRSN Services.

(b) Have the capacity to carry out the responsibilities outlined in the HRSN Outreach and Engagement service descriptions in Table 8 in OAR 410-120-2005. MCEs shall have the right, using their reasonable discretion, to determine whether an HRSN Service Provider has the skills, education, or experience to necessary for providing HRSN Outreach and Engagement Services.

(c) Have experience, training, or knowledge of all of the following:

(A) Cultural specificity and responsiveness approaches;

(B) Community outreach and engagement best practices;

(C) Basic eligibility and enrollment policies and practices for OHP, the HRSN program, and Federal and state entitlements and benefits including SNAP, WIC, TANF, Social Security, Social Security Disability, and Veterans Affairs benefits, and federal and state housing programs;

(D) Local community resources for supporting basic needs such as access to shower, laundry, shelter, and food;

(E) Excellent oral communication skills with the ability to explain complex information to individuals-including those in the Authority's HRSN Priority Populations - in an understandable, trauma-informed, and culturally responsive way; and

(F) Ability to maintain strict confidentiality and handle sensitive information appropriately.

Or. Admin. Code § 410-120-2030

DMAP 130-2024, adopt filed 10/24/2024, effective 11/1/2024

To view attachments referenced in rule text, click here to view rule.

Statutory/Other Authority: ORS 413.042

Statutes/Other Implemented: 414.572, 414.605, 414.665, 414.719 & 414.632