Or. Admin. Code § 411-435-0060

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

Section 411-435-0060 - Developmental Disabilities - Waiver Ancillary Services

(1) The following ancillary services are available through a 1915(c) waiver, as defined in OAR 411-317-0000:

(a) Environmental safety modifications as described in section (3) of this rule.

(b) Family training as described in section (4) of this rule.

(c) Specialized medical supplies as described in section (5) of this rule.

(d) Vehicle modifications as described in section (6) of this rule.

(2) Environmental safety modifications, family training, and specialized medical supplies may also be available through family support funds within the service limits described in OAR 411-305-0230.

(3) ENVIRONMENTAL SAFETY MODIFICATIONS.

(a) To be eligible for environmental safety modifications, an individual must not be enrolled in a residential program, unless the enrollment is in a supported living program described in OAR chapter 411, division 328 and the dwelling is not a provider owned, controlled, or operated setting.

(b) Fencing may not exceed 200 linear feet without the Department's approval.

(c) Environmental safety modifications exclude the following:

(A) Large gates, such as automobile gates.

(B) Adaptations or improvements to the home not directly connected to an individual's identified needs.

(C) Adaptations adding to the total square footage of the home.

(D) Adaptations prohibited by local codes and ordinances or neighborhood Covenants, Conditions, and Restrictions (CCR).

(d) Environmental safety modifications must relate to an individual's health, welfare, or safety or increase an individual's independence in their home.

(e) Department approval is required for environmental safety modification expenditures over $5,000 per plan year and funded through a 1915(c) waiver.

(A) A case manager must request Department approval for additional expenditures prior to expenditure.

(B) Department approval is based on an individual's service and support needs and goals and the Department's determination of appropriateness and cost-effectiveness.

(C) Separate environmental safety modification projects that cumulatively total up to over $5,000 in a plan year must be submitted to the Department for review.

(f) Environmental safety modifications must be completed by a state licensed contractor with a minimum of $1,000,000 liability insurance. Any modification requiring a permit must be inspected by a local inspector and certified as in compliance with local codes. A contractor must have the certificate prior to payment.

(g) Payment to the contractor is withheld until the work meets specifications.

(h) A scope of work must be completed for each identified environmental safety modification project. All contractors submitting bids must be given the same scope of work.

(i) For all environmental safety modifications, a minimum of three written bids are required from providers meeting the qualifications in OAR 411-435-0080. When it is not reasonable to obtain three written bids, exceptions to this requirement may be granted by the Department.

(j) A case manager must assure the processes outlined in the Expenditure Guidelines are followed for contractor bids and the awarding of work.

(k) All dwellings must be in good repair and have sound structure to safely support the environmental safety modification.

(l) The identified home may not be in foreclosure or the subject of legal proceedings regarding ownership.

(m) Environmental safety modifications must only be completed to an individual's primary residence.

(n) Environmental safety modifications are subject to Department requirements regarding material and construction practices based on industry standards for safety, liability, and durability, as referenced in building codes, materials, manuals, and industry and risk management publications.

(o) RENTAL PROPERTY.

(A) Environmental safety modifications to a rental property may not substitute or duplicate services otherwise the responsibility of the landlord as outlined in the landlord tenant laws, the Americans with Disabilities Act, or the Fair Housing Act.

(B) Environmental safety modifications made to a rental structure must have written authorization from the owner of the rental property prior to the start of the work.

(C) The Department does not fund work to restore a rental property to the condition it was in prior to the installation of an environmental modification.

(4) FAMILY TRAINING.

(a) To be eligible to access family training, an individual must not be enrolled in a residential program.

(b) Family training services include the following:

(A) Instruction about supports, medications, and use of equipment specified in an individual's ISP or Annual Plan.

(B) Information, education, and training about an individual's disability, medical, or behavioral conditions.

(C) Registration fees for organized conferences and workshops specifically related to an individual's intellectual or developmental disability or an individual's identified, specialized, medical, or behavioral support needs.

(c) Family training services exclude the following:

(A) Mental health counseling, medical treatment, or therapy.

(B) Training for a paid provider, including a paid family member.

(C) Legal fees.

(D) Training for a family member to carry out educational activities in lieu of school.

(E) Vocational training for family members.

(F) Paying for training to carry out activities or interventions the Department deems to constitute abuse of an individual.

(G) Travel, food, and lodging expenses.

(5) SPECIALIZED MEDICAL SUPPLIES. Specialized medical supplies include, but are not limited to:

(a) Various medical items, such as incontinence, nutrition, and infection control supplies.

(b) Supplies necessary to the proper functioning of life support equipment.

(c) Supplies that address physical conditions.

(d) Supplies necessary for the continued operation of augmentative communication devices or systems.

(6) VEHICLE MODIFICATIONS.

(a) To be eligible to access vehicle modifications, an individual must not be enrolled in a residential program.

(b) Vehicle modifications may only be made to the vehicle primarily used by an individual to meet the individual's unique needs.

(c) Vehicle modifications may include a lift, interior alterations to seats, head and leg rests, belts, special safety harnesses, other unique modifications to keep an individual safe in the vehicle, and the upkeep and maintenance of a modification made to the vehicle.

(d) Vehicle modifications exclude the following:

(A) Adaptations or improvements to a vehicle that are of general utility.

(B) The purchase or lease of a vehicle.

(C) Routine vehicle maintenance and repair.

(e) Department approval is required for vehicle modification expenditures over $5,000 per plan year and funded through a 1915(c) waiver.

(A) A case manager must request Department approval for additional expenditures prior to expenditure.

(B) Approval is based on an individual's service and support needs and goals and the Department's determination of appropriateness and cost-effectiveness.

(C) Separate vehicle modification projects that cumulatively total up to over $5,000 in a plan year must be submitted to the Department for review.

(f) Vehicle modifications must meet applicable standards of manufacture, design, and installation.

Or. Admin. Code § 411-435-0060

APD 20-2016, f. & cert. ef. 6/29/2016; APD 36-2016(Temp), f. 8-31-16, cert. ef. 9-1-16 thru 2-27-17; APD 6-2017, 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 59-2022, amend filed 12/23/2022, effective 12/27/2022; 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 & 430.662

Statutes/Other Implemented: ORS 409.010, 427.007, 427.101, 427.104, 430.215, 430.610 & 430.662