Or. Admin. Code § 411-415-0020

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

Section 411-415-0020 - Definitions and Acronyms for Case Management Services

In addition to the following definitions, OAR 411-317-0000 includes general definitions for words and terms frequently used in OAR chapter 411, division 415. If a word or term is defined differently in OAR 411-317-0000, the definition in this rule applies.

(1) "ADL" means "Activities of Daily Living" as defined in OAR 411-317-0000.

(2) "Affiliated Entity" means an individual, a trust or estate, a partnership, a corporation (including associations, joint stock companies, and insurance companies), or a political subdivision or instrumentality (including a municipal corporation of a state), that has an incident of ownership in a case management entity. For the purposes of this definition:

(a) "Incident of Ownership" means an ownership interest, an indirect ownership interest, or a combination of direct and indirect ownership interests.

(b) "Indirect Ownership Interest" means an ownership interest in an entity that has an ownership interest in another entity. Indirect ownership interest includes an ownership interest in an entity that has an indirect ownership interest in another entity.

(c) "Ownership Interest" means the possession of equity in the capital, stock, or profits of an entity.

(3) "Case Management Contact" means a reciprocal interaction between a case manager and an individual or the individual's legal or designated representative (as applicable).

(4) "Case Management Services" mean the functions performed by a case manager that are funded by the Department. Case management services include, but are not limited to, the following:

(a) Assessment of support needs.

(b) Developing an Individual Support Plan or Annual Plan that may include authorized services.

(c) Information and referral for services.

(d) Monitoring the effectiveness of services and supports.

(5) "Case Manager" means a person who delivers case management services or person-centered service planning for and with individuals, meets the qualifications in OAR 411-450-0040, and is employed as one of the following:

(a) A personal agent by a Brokerage.

(b) A services coordinator by a Community Developmental Disabilities Program.

(c) A services coordinator by the Department.

(6) "CDDP" means "Community Developmental Disabilities Program" as defined in OAR 411-317-0000 and described in OAR chapter 411, division 320.

(7) "Children's Extraordinary Needs (CEN) Program" is defined in OAR 411-440-0020 and described in OAR chapter 411, division 440.

(8) "Choice Advising" means the unbiased sharing of information with an individual about case management entities, providers, services, or setting options by a representative of a case management entity. Choice advising is delivered:

(a) Using language, format, and presentation methods appropriate for effective communication; and

(b) According to the needs and abilities of the individual receiving services and the people important in supporting the individual.

(9) "CIIS" means "Children's Intensive In-Home Services" as defined in OAR 411-317-0000 and described in OAR chapter 411, division 300.

(10) "Client Child" is defined in OAR 411-440-0020 for the Children's Extraordinary Needs Program.

(11) "CME" means "Case Management Entity" as defined in OAR 411-317-0000. A CME includes the following:

(a) A Community Developmental Disabilities Program.

(b) A Brokerage.

(c) CIIS.

(d) The Children's Residential Program of the Department.

(12) "County of Origin" is defined in OAR 411-320-0020.

(13) "Geographic Service Area" means the area within Oregon where a case management entity is approved to provide developmental disabilities services. The geographic service area for a Community Developmental Disabilities Program is the county.

(14) "IADL" means "Instrumental Activities of Daily Living" as defined in OAR 411-317-0000.

(15) "ICF/IID Level of Care" means institutional level of care for an intermediate care facility for individuals with intellectual disabilities. ICF/IID Level of Care is further defined in OAR 411-317-0000.

(16) "IEP" means "Individualized Education Program" as defined in OAR 411-317-0000.

(17) "Initial ISP" means the first Individual Support Plan:

(a) For an individual who is newly entered into case management services; or

(b) Following a period when an individual did not have an authorized Individual Support Plan.

(18) "Initial Level of Care" means the first level of care determination:

(a) For an individual who is newly accessing Community First Choice (K Plan) or 1915(c) waiver services; or

(b) Following a period when an individual was not determined to meet level of care.

(19) "Initial ONA" means the first Oregon Needs Assessment:

(a) For an individual who is newly accessing Community First Choice (K Plan) or waiver services; or

(b) Following a period when an individual did not have a current Oregon Needs Assessment.

(20) "ISP" means "Individual Support Plan" as defined in OAR 411-317-0000.

(21) "Level of Care" includes "ICF/IID Level of Care", "Hospital Level of Care", or "Nursing Facility Level of Care", as defined in OAR 411-317-0000.

(22) "OHP" means "Oregon Health Plan" as defined in OAR 410-120-0000.

(23) "ONA" means "Oregon Needs Assessment" as defined in OAR 411-317-0000 and described in OAR 411-425-0055.

(24) "Parent Provider" is defined in OAR 411-440-0020 for the Children's Extraordinary Needs Program.

(25) "SSI" means "Supplemental Security Income" as defined in OAR 411-317-0000.

(26) "These Rules" mean the rules in OAR chapter 411, division 415.

(27) "Transition Period" means the first 60 calendar days after an individual enters a new program type, setting, or case management entity.

Or. Admin. Code § 411-415-0020

APD 28-2016, f. & cert. ef. 6/29/2016; APD 35-2016(Temp), f. 8-31-16, cert. ef. 9-1-16 thru 2-27-17; APD 2-2017, f. 2-21-17, cert. ef. 2/28/2017; APD 23-2018, temporary amend filed 07/02/2018, effective 07/02/2018 through 12/27/2018; APD 46-2018, amend filed 12/28/2018, effective 12/28/2018; APD 5-2023, amend filed 05/01/2023, effective 5/1/2023; APD 25-2024, temporary amend filed 05/31/2024, effective 5/31/2024 through 11/26/2024; APD 60-2024, amend filed 10/25/2024, effective 10/25/2024

Statutory/Other Authority: ORS 409.050, 427.104, 427.105, 427.115, 427.154, 427.191, 430.212, 430.662 & 430.731

Statutes/Other Implemented: ORS 409.010, 427.005-427.154, 427.191, 430.212, 430.215, 430.610, 430.620, 430.662, 430.664 & 430.731-430.768