Or. Admin. Code § 410-173-0050

Current through Register Vol. 63, No. 10, October 1, 2024

Section 410-173-0050 - HCBS Community Based Integrated Supports

(1) Community-Based Integrated Supports (CBIS) are services and supports offered to Individuals that require assistance in the acquisition, retention, or improvement with life management, socialization skills and community engagement and community integration and engagement to maintain their maximum level of functioning and integration within the broader community, to the same degree as Individuals who do not access Medicaid 1915(i) CBIS. These services are provided face-to-face as chosen by the Individual and as described and approved in the Individual's PCSP and include:

(a) Supervision, support, training, and assistance necessary for an individual to develop, maintain or improve skills and competencies necessary to function as independently as possible in the following areas:

(A) Independent living skills

(B) Behavior management skills;

(C) Self-Advocacy skills;

(D) Financial literacy;

(E) Social skills;

(F) Communication skills;

(G) Therapeutic activities; and

(H) Community integration, access and inclusion.

(b) Home and Community-Based skill reintegration service. These services support and individual to re-build the skills and complete tasks for themselves rather than completing the task for an individual;

(c) Case management, service coordination, peer delivered services programs, and programs and resources managed by the IQA and directed by the individual through person-centered service planning, to include:

(A) Identification of back-up plans as needed to mitigate health and safety risks to the individual or others; and

(B) Identify procedures to follow when the primary provider is unable to deliver approved services.

(2) CBIS are delivered consistent with the amount, duration, and scope of services identified in the PCSP, demonstrated through documentation as identified in OAR 410-173-0045.

(3) CBIS shall be provided in the following settings, as identified in the PCSP:

(a) Community;

(b) Individual's own or family home.

(4) CBIS shall be provided by the following provider types who meet the qualifications defined in OAR Chapter 309 Division 019, OAR Chapter 410 Division 172, or OAR Chapter 950 Division 060:

(a) RTH providers;

(b) RTF providers;

(c) QMHP;

(d) QMHA;

(e) Recovery Assistant or Mentor;

(f) Certified Peer Support Specialist or Peer Wellness Specialist, including family and youth support and wellness specialists, meeting the qualifications described in OAR chapter 309 division 019 and shall meet the requirements in OAR chapter 950 division 060 for certification and continuing education; and

(g) Mental Health Intern.

(5) Provision of CBIS is allowed for eligible Individuals who are being temporarily served in an acute care hospital setting to enable direct care workers or other home and community-based providers to accompany Individuals to acute care hospital setting;

(a) CBIS shall be focused on providing personal, behavioral and communication supports not otherwise provided in an acute care hospital;

(b) The service may only be delivered in the acute care hospital setting for up to thirty (30) days;

(c) Identified in an Individual's person-centered service plan;

(d) Provided to meet needs of the Individual that are not met through the provision of hospital services;

(e) Not be a substitute for services that the hospital is obligated to provide through its conditions of participation or under Federal or State law, or under another applicable requirement; and

(f) Designed to ensure smooth transitions between acute care settings and home and community-based settings, and to preserve the Individual's functional abilities.

Or. Admin. Code § 410-173-0050

DMAP 12-2019, temporary adopt filed 05/21/2019, effective 06/01/2019 through 11/27/2019; DMAP 46-2019, adopt filed 11/07/2019, effective 11/26/2019; DMAP 42-2023, minor correction filed 05/24/2023, effective 5/24/2023; DMAP 44-2023, minor correction filed 05/25/2023, effective 5/25/2023; DMAP 42-2024, amend filed 02/14/2024, effective 2/29/2024

Statutory/Other Authority: ORS 413.032, 413.042, 426.495, 430.610 & 430.630

Statutes/Other Implemented: ORS 413.032, 413.042, 426.495, 430.610 & 430.630