Or. Admin. Code § 411-016-0040
Current through Register Vol. 64, No. 1, January 1, 2025
Section 411-016-0040 - Service Plan Hours(1) Through a person-centered planning process with the individual, the Services Case Manager (SCM) authorizes hours to address the individual's unmet needs or to support the unpaid caregiver relationship.(2) A service plan may have no more than a maximum total of 40 hours of in-home services including both ADL and IADL hours, per pay period.(3) Hours are authorized to meet assessed ADL/IADL needs as defined in OAR 411-015-0006 and OAR 411-015-0007.(4) Hours should reflect only the minimum necessary for health and safety that supplement supports provided by natural supports and alternative service resources. The hours authorized must be documented in the service plan form.(5) For households with two or more eligible individuals receiving any combination of Medicaid funded or Oregon Project Independence in-home services, the service plan for each individual must avoid duplication of services.(6) Hours authorized for assessed needs are paid at the rates in accordance with OAR 411-027-0170 for In-Home Care Agencies and for Homecare Workers at rates published on the current rate schedule or the current collective bargaining agreement between the Department of Administrative Services on behalf of the State of Oregon and the Oregon Homecare Commission and Service Employees International Union, Local 503, Oregon Public Employees Union.(7) A provider may not receive payment from the Department for more than the total amount of in-home services hours authorized by the AAA or the Department on the service plan authorization form under any circumstances. All service payments must be prior authorized by a SCM or AAA or Department designated staff.(8) Payment by the Department for In-Home services hours are only made for the tasks described in OAR 411-015-0006 and OAR 411-015-0007 as ADL or IADL tasks. Services must be authorized to meet the needs of an eligible individual and may not be provided to benefit an entire household.(9) Respite hours may be authorized to replace an unpaid caregiver or natural supports providing ADL or IADL care who are temporarily unavailable to provide assistance. Respite hours must be included in the 40 in-home services hours limit.Or. Admin. Code § 411-016-0040
APD 22-2024, temporary adopt filed 05/20/2024, effective 5/31/2024 through 11/26/2024; APD 64-2024, adopt filed 11/20/2024, effective 11/22/2024Statutory/Other Authority: ORS 410.070
Statutes/Other Implemented: ORS 410.060, 410.070 & 414.065