Or. Admin. R. 410-141-3740

Current through Register Vol. 63, No. 6, June 1, 2024

Section 410-141-3740 - Traditional Health Workers

(1) The Authority requires that all CCO members based on their health needs must have access to certified traditional health workers (THWs) who are part of the member's care team in clinical and community-based settings to ensure members have improved access to appropriate services. The THWs, as a part of the member's care team, must participate in processes affecting the member's care and service needs. THW is defined in OAR 410-180-0305.

(2) CCOs shall develop and implement a plan for integrating and utilizing THWs, in accordance with this rule and the CCO contract:

(a) THW integration and utilization plans shall include:

(A) Information on THW access and usage for CCO members;

(B) Benchmarks and measurement of baseline data for integration and utilization of THWs;

(C) Evaluations of the CCO's progress in reaching those benchmarks.

(b) THW integration and utilization plans shall be submitted to OHA as required under the contract.

(3) CCOs shall establish, based on OHA's and the Traditional Health Worker Commission guidelines, a THW payment grid that includes alternative and sustainable payment strategies. Each CCO shall provide its THW Payment Grid to OHA. OHA will then post each CCOs Payment Grid to make them publicly available.

(4) CCOs shall designate a THW liaison, who shall serve as the central point of contact for THW integration.

Or. Admin. R. 410-141-3740

DMAP 56-2019, adopt filed 12/17/2019, effective 1/1/2020

Statutory/Other Authority: ORS 413.042, 414.615, 414.625, 414.635 & 414.651

Statutes/Other Implemented: ORS 414.610 - 414.685