Or. Admin. Code § 411-455-0050

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

Section 411-455-0050 - Services

(1) SPPC services must be delivered by a qualified provider who meets the standards described in OAR 411-455-0060 and in accordance with an individual's ISP or Annual Plan and included in the Service Agreement (form 4606).

(2) SPPC services include assistance with the following ADL, IADL, and delegated nursing tasks:

(a) ADL tasks:

(A) Bathing - assisting an individual cleanse the body (in bathtub, bed bath, shower), wash hair, shave, care for nails, and use assistive devices when necessary to get in and out of the bathtub or shower.

(B) Dressing - assisting an individual put on, fasten, and take off all clothing items, braces, and artificial limbs. Dressing includes getting and replacing items from an individual's storage area in the immediate environment.

(C) Toileting and maintaining continence - assisting an individual to and from the bathroom, on and off toilet, commode, bedpan, urinal, or other assistive device used for urinary and bowel elimination. Toileting includes cleansing after elimination and adjusting clothing as necessary. Maintaining continence includes cleansing urinary catheter, emptying catheter drainage bag, maintaining bowel care, and changing and replacing incontinence products, including ostomy care or ileostomy bags.

(D) Mobility, transfers, and repositioning - assisting an individual with ambulation, transfers, and repositioning with or without assistive devices. Mobility, transfers, and repositioning includes turning or adjusting padding for physical comfort or pressure relief and encouraging or assisting with range-of-motion exercises.

(E) Eating - assisting an individual with feeding or fluid intake by any means from a device into the body. Eating includes monitoring to prevent choking or aspiration.

(b) IADL tasks:

(A) Personal hygiene - doing or assisting an individual do activities such as securing clothing, combing or brushing hair, shaving, nail care, foot care, skin care, mouth care, and oral hygiene.

(B) Light housekeeping and laundry - doing or helping an individual do housekeeping tasks related to the individual's needs and necessary to maintain the individual in a healthy and safe living environment. Task examples include cleaning surfaces and floors, making the individual's bed, cleaning dishes, taking out the garbage, and dusting. Laundry means doing or helping to do laundry or clean the individual's clothing, bedding, and other linens.

(C) Grocery shopping - planning and shopping for basic needs and necessary household items or assisting an individual with those tasks.

(D) Meal preparation - providing or assisting an individual with healthy meal planning and preparation, and ensuring the individual follows a special diet, as needed.

(E) Transportation - assisting an individual get to and from necessary appointments and community activities through available means of transportation. Transportation does not include mileage reimbursement.

(F) Using the telephone - performing or assisting an individual use the telephone to arrange for necessary appointments and to make desired phone calls.

(G) Medication management - assisting with medications that are ordinarily self-administered. Assistance includes administering medication, observing to ensure the individual takes medication as ordered, documenting and monitoring any notable side effects, and refilling prescription in a timely manner. Medication management also includes assisting with the use, maintaining and cleaning of in-home equipment such as oxygen equipment, as well as administering oxygen, monitoring the individual's condition, and ordering and maintaining necessary supplies.

(H) Money management - performing or assisting an individual with budgeting, making payments for monthly expenses, and using personal funds for desired items and activities.

(c) Delegated nursing tasks as defined in these rules and as described in OAR chapter 411, division 048 and in accordance with the Expenditure Guidelines as defined in OAR 411-317-0000. For individuals less than 21 years of age, services shall be provided as determined medically necessary as defined in OAR 410-120-0000, and prior authorized by the Department.

(3) Payment may not be made for any of the following excluded services:

(a) Mileage reimbursement;

(b) Social companionship;

(c) Child care (described in OAR chapter 414, division 300, 350, and 205), adult day services (described in OAR chapter 411, division 066), respite, or baby-sitting services;

(d) Medicaid home delivered meals (described in OAR chapter 411, division 040);

(e) Care, grooming, or feeding of pets or other animals; or

(f) Yard work, gardening, or home repair.

Or. Admin. Code § 411-455-0050

APD 1-2019, temporary adopt filed 01/07/2019, effective 01/08/2019 through 07/05/2019; APD 22-2019, adopt filed 06/28/2019, effective 7/1/2019

Statutory/Other Authority: ORS 409.050, 427.104 & 430.662

Statutes/Other Implemented: ORS 427.007, 430.610, 430.620 & 430.662-430.670