Or. Admin. Code § 411-066-0005

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

Section 411-066-0005 - Definitions

(1) "Activities of Daily Living (ADL)" means those personal, functional activities required by an individual for continued well-being, which are essential for health and safety. Activities include eating, dressing and grooming, bathing and personal hygiene, mobility elimination, and cognition as described in OAR 411-015-0006.

(2) "Adult Day Services (ADS) Program" means a community-based group program designed to meet the needs of adults with functional impairments through service plans as defined in (23) of this rule. These structured, comprehensive, non-residential programs provide health, social, and related support services in a protective setting for less than 24 hours per day.

(3) "Aging and People with Disabilities (APD)" means the Aging and People with Disabilities program within the Department of Human Services.

(4) "Area Agency on Aging (AAA)" means the Department-designated agency charged with the responsibility to provide a comprehensive and coordinated system of services to older adults and adults with disabilities in a planning and service area. The term Area Agency on Aging is inclusive of both Type A and Type B Area Agencies on Aging as defined in ORS 410.040 to 410.30.

(5) "Background Check" means a criminal background check and abuse check under OAR chapter 407, division 007.

(6) "Case Manager (CM)" means a Department employee, or an employee of the Department's designee, that meets the minimum qualifications in OAR 411-028-0040 and who is responsible for service eligibility, assessment of need, offering service choices to eligible individuals, person-centered service planning, service authorization and implementation, and evaluation of the effectiveness of Medicaid-funded home and community-based services.

(7) "Certification" means to certify the individual adult day services program by measuring the ability of the adult day services program to meet the DHS, APD standards set forth in these rules.

(8) "Department" means the Department of Human Services (DHS).

(9) "Deputy Director" means the Deputy Director of the DHS, APD program, or that person's designee.

(10) "Exception" means an approval of a service plan granted to a specific individual that meets policy criteria allowing ADS attendance while living in an adult foster home.

(11) "Food Handler" means those persons involved in the supervision, preparation, or service of food in a restaurant or food service facility licensed under ORS 624.020 or 624.320. This includes, but is not limited to:

(a) Managers;

(b) Cooks;

(c) Wait staff;

(d) Dishwashers;

(e) Bartenders; and

(f) Bus persons.

(12) "Group" means:

(a) A program with 10 or more enrolled participants;

(b) Adult day services programs just beginning, with plans to enroll 10 or more participants; or

(c) The enrolled participants in a certified adult day services program.

(13) "Initial Screening" means a screening required by the adult day service program that is conducted to evaluate a prospective participant's service requests and needs before accepting the individual for service. The extent of the screening needs to determine the ability of the program to meet the requests and needs of a participant based on the agency's overall service capability.

(14) "Long-Term Care Facilities (LTC)" means nursing facilities, residential care facilities, assisted-living facilities, and adult foster homes.

(15) "Mandatory Reporter" means all public or private officials as stated in ORS 124.050 - 124.095 are to report suspected abuse or neglect of a child, an older adult, a person with a physical disability, or the resident of a licensed care facility to the Department or to a law enforcement agency as required by OAR 411-020-0002.

(16) "Medicaid Performing Provider Number" means the numeric identifier assigned to an entity or person by the Department, following enrollment to deliver Medicaid-funded services as described in these rules. The Medicaid Performing Provider Number is used by the rendering provider for identification and billing purposes associated with service authorizations and payments.

(17) "Participant" means a person who is eligible and is receiving services in an adult day services program.

(18) "Person-Centered Service Plan" means the details of the supports, desired outcomes, activities, and resources required for a participant to achieve and maintain personal goals, health, and safety, as described in OAR 411-004-0030. The case manager completes the person-centered service plan. The person-centered service plan is the Medicaid Plan of Care.

(19) "Provider Enrollment Application and Agreement" refers to the conditions and agreements for being enrolled as a provider with the DHS, APD and to receive a provider number.

(20) "Rate Schedule" means the Medicaid reimbursement rate schedule maintained by the Department in OAR 411-027-0170.

(21) "Registry" means the registration database of all adult day services programs maintained by DHS, APD.

(22) "Representative" is a person either appointed by an individual to participate in service planning on the individual's behalf or an individual's natural support with longstanding involvement in assuring the individual's health, safety, and welfare.

(23) "Service Plan" means a written, individualized plan for the delivery of services by the ADS, developed by the ADS in conjunction with the individual or the individual's legal representative, DHS, or AAA case manager. The service plan:

(a) Reflects the individual's capabilities, choices, and if applicable, measurable goals, and managed risk issues; and

(b) Defines the division of responsibility in the implementation of the services.

(24) "Subject Individual (SI)" means an individual from whom the authorized agency, districts, and qualified entities conduct a criminal records check.

Or. Admin. Code § 411-066-0005

SSD 12-1992, f. & cert. ef. 12-1-92; SDSD 4-1999, f. & cert. ef. 3-15-99; SPD 6-2007(Temp), f. & cert. ef. 5-15-07 thru 11-11-07; SPD 19-2007, f. & cert. ef. 11-7-07; APD 10-2019, amend filed 02/13/2019, effective 2/15/2019

Statutory/Other Authority:ORS 409.050, 410.070, 410.490, 410.495, 413.085

Statutes/Other Implemented:ORS 410.485 - 410.495