Or. Admin. Code § 411-035-0015

Current through Register Vol. 63, No. 11, November 1, 2024

Section 411-035-0015 - Eligibility for Supplemental K State Plan Services

To be eligible for any Medicaid Supplemental K State Plan services defined in this division, consumers must:

(1) Be eligible for Medicaid long term care services and supports as described in OAR 411-015-0010 through 411-015-0100.

(2) Not have natural supports or other services available in the community that would meet the identified need.

(3) Not be eligible for the item through Medicare, other Medicaid programs, or other medical coverage.

(4) Have an identified need in their person-centered service plan that:

(a) Supports the desires and goals of the consumer receiving services and increases a consumer's independence;

(b) Reduces a consumer's need for assistance from another person; or

(c) Maintains a consumer's health and safety.

(5) Be provided the choice to accept or deny the service being offered.

(6) Have a completed service assessment that reflects the current needs of the consumer.

(7) To be considered an eligible request, when possible, three bids are required from providers. Consumers should work with their case manager to obtain bids. Bids may not include comparative pricing done through the internet. Bids are required for:

(a) Assistive Technology;

(b) Chore Services;

(c) Environmental Modifications; and

(d) Transition Services - Moving Costs.

Or. Admin. Code § 411-035-0015

APD 16-2014, f. & cert. ef. 6-4-14; APD 9-2015, f. 3-30-15, cert. ef. 4/3/2015; APD 34-2019, amend filed 09/27/2019, effective 10/1/2019

Statutory/Other Authority: 410.070 & ORS 409.050

Statutes/Other Implemented: ORS 409.050, 410.040, 410.090, 410.210 to 410.300 & 441.520