Or. Admin. Code § 411-415-0060

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

Section 411-415-0060 - Assessment Activities

For the purpose of this rule, "supervisor" means an employee of a CME who provides management level oversight of an assessor and is trained and qualified to conduct an Oregon Needs Assessment (ONA) according to OAR chapter 411, division 425.

(1) An ONA must be conducted according to the standards described in OAR chapter 411, division 425.

(2) A Case Management Entity (CME) must assure an individual has an initial ONA from an assessor or supervisor prior to receiving Community First Choice state plan or waiver services.

(3) The Department may require an ONA to be completed by an assessor employed or identified by the Department.

(4) For each individual who has an authorized Individual Support Plan (ISP), a CME must assure an ONA is conducted by:

(a) An assessor or supervisor:

(A) For each individual who has not had a functional needs assessment using the ONA when a functional needs assessment or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) Level of Care determination is required.

(B) Any time there may be a significant change in an individual's support needs.

(C) At a frequency or at specific ages as determined by the Department.

(D) Upon a request for reassessment by an individual or the individual's legal or designated representative.

(E) When a child who has been determined to be eligible for developmental disabilities services according to OAR 411-320-0080 and is enrolled to the Medically Involved Children's Program or Medically Fragile Children's Program and will be turning 18 in the next year and expects to receive Community First Choice state plan or waiver services as an adult.

(b) A case manager, an assessor, or a supervisor, when none of the conditions in subsection (a) of this section are present.

(5) Only a person who meets the qualification and training requirements for an assessor described in OAR 411-425-0035 and is employed by a CME or the Department as a certified assessor may change a response to an item in an ONA that contributes to any of the scores identified in OAR 411-450-0060(7)(c).

(6) Each individual whose services are authorized in an ISP must have a completed ONA.

(7) An ONA must be completed:

(a) Not more than 12 months from a previously completed ONA, ICF/IID Level of Care determination, or functional needs assessment.

(b) Within 45 calendar days from the date an individual, or as applicable their legal or designated representative, requests a new ONA.

(c) Within 45 calendar days from the date the CME identifies that the support needs of an individual may have changed significantly, and the change is expected to last at least 90 calendar days.

(8) No fewer than 14 calendar days prior to conducting an ONA, the CME must mail a notice of the assessment process to the individual to be assessed. The notice must include a description and explanation of the assessment process and an explanation of the process for appealing the results of the assessment.

(9) No fewer than 14 calendar days from the completion of an ONA for an individual, the CME must inform the individual of their service group and the hour allocation for in-home services.

(10) An assessment for State Plan Personal Care must be completed by a case manager as described in OAR chapter 411, division 455.

Or. Admin. Code § 411-415-0060

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 23-2023, amend filed 12/21/2023, effective 1/1/2024

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

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