Or. Admin. Code § 411-318-0030

Current through Register Vol. 64, No. 1, January 1, 2025

Section 411-318-0030 - Contested Case Hearings for Provider Notices of Involuntary Reductions, Transfers, or Exits

(1) This rule applies to involuntary reductions, transfers, or exits by a provider, including a licensed or certified provider organization, who has a contract with the Department, CDDP, or Brokerage. This rule does not apply to providers who have a direct employer-employee relationship with an individual or an individual's employer representative.

(2) An individual must be given the opportunity to dispute an involuntary reduction, transfer, or exit by requesting a hearing as provided in ORS chapter 183.

(3) An individual or the individual's representative may request a hearing either orally or in writing when the individual and the individual's representative receives a Notice of Involuntary Reduction, Transfer, or Exit (form 0719R, 0719C, 0719E).

(a) To request a hearing in writing:

(A) The individual or the individual's representative must complete the Administrative Hearing Request included with the Notice of Involuntary Reduction, Transfer, or Exit (form 0719R, 719C, 0719E) and submit the form to the Office of Developmental Disabilities Services (ODDS) as described on the form; or

(B) The individual or the individual's representative may meet with a staff person of the CDDP, Brokerage, or Department to complete the Administrative Hearing Request included with the Notice of Involuntary Reduction, Transfer, or Exit (form 0719R, 0719C, 0719E). After meeting with the individual or the individual's representative, the CDDP, Brokerage, or Department must submit the form to ODDS within three business days. A copy of the form must be mailed to the individual and the individual's representative.

(b) To request a hearing orally, the individual or the individual's representative must orally express the desire for a hearing to a staff person of the CDDP, Brokerage, or Department. Upon receipt of an oral request for a hearing, the CDDP, Brokerage, or Department must complete the Administrative Hearing Request included with the Notice of Involuntary Reduction, Transfer, or Exit (form 0719R, 0719C, 0719E) and submit the form to ODDS within one business day. A copy of the form must be mailed to the individual and the individual's representative.

(4) Upon receipt of the Administrative Hearing Request form for a Notice of Involuntary Reduction, Transfer, or Exit, ODDS shall:

(a) Refer the hearing request to the Office of Administrative Hearings within five business days from the receipt of the hearing request.

(b) Assist the claimant or the claimant's representative in gathering and submitting exhibits.

(c) Act as a liaison between the Office of Administrative Hearings and the CDDP or Brokerage responsible for the claimant's services.

(5) The Office of Administrative Hearings communicates directly with a claimant and the claimant's representative regarding informal conference dates, hearing dates, and the Final Order as described in OAR chapter 137, division 003.

(6) If an individual or an individual's representative requests a hearing within 15 calendar days from the issuance of a Notice of Involuntary Reduction, Transfer, or Exit, the individual must continue to receive the same services until receipt of a Final Order.

(7) When an individual has been given less than 30 calendar days advanced written Notice of Involuntary Reduction, Transfer, or Exit due to a medical emergency or because the individual is engaging in behavior that poses an imminent danger to self or others, and the individual or the individual's representative has requested a hearing as described in this rule, their provider must continue to provide services to the individual until receipt of a Final Order.

(8) An individual or the individual's representative may request an expedited hearing according to OAR 411-318-0025(5) when:

(a) The request for a hearing is more than 15 calendar days following the issuance of the Notice of Involuntary Reduction, Transfer, or Exit and the individual requests to continue to receive the same services until receipt of the Final Order; or

(b) The individual has been given less than 30 calendar days advanced written Notice of Involuntary Reduction, Transfer, or Exit, and the individual has not been allowed to remain in the setting.

Or. Admin. Code § 411-318-0030

APD 22-2014(Temp), f. & cert. ef. 7-1-14 thru 12-28-14; APD 40-2014, f. 12-26-14, cert. ef. 12/28/2014; APD 46-2019, amend filed 10/29/2019, effective 11/1/2019; APD 35-2022, minor correction filed 07/22/2022, effective 7/22/2022; APD 26-2024, amend filed 06/05/2024, effective 6/10/2024

Statutory/Other Authority: ORS 409.050, 427.104, 427.107 & 430.662

Statutes/Other Implemented: ORS 183.411-183.471, 409.010, 427.007, 427.101, 427.104, 427.107, 427.109, 430.215, 430.610 & 430.662