Or. Admin. Code § 418-040-0060

Current through Register Vol. 63, No. 12, December 1, 2024

Section 418-040-0060 - Homecare Choice Program Service Rate

(1) The Commission shall establish the service rate charged to program participants for homecare services at a level expected to generate total revenue sufficient to reimburse up to 107 percent of the costs associated with the program. The rate equals the actual costs incurred plus seven percent of the cost of administering the program and may include, but is not limited to:

(a) Homecare Choice Provider wages, taxes, and benefits:

(A) Federal Unemployment Tax Act (FUTA);

(B) State Unemployment Tax Authority (SUTA);

(C) Workers' Compensation Assessment;

(D) Health insurance; and

(E) Paid time off.

(b) Homecare Choice Program staff wages, taxes, and benefits:

(A) Federal Unemployment Tax Act (FUTA);

(B) State Unemployment Tax Authority (SUTA);

(C) Public Employee's Retirement contribution;

(D) Pension bond contribution;

(E) Social security tax;

(F) Workers' compensation assessment;

(G) Mass transit tax; and

(H) Flexible benefits.

(c) Homecare Choice Program service and supply expenses:

(A) Office expenses;

(B) Publicity and publications;

(C) Professional services;

(D) Registry maintenance and expansion;

(E) Legal fees;

(F) Cost allocation fees;

(G) Translation fees;

(H) Americans with Disabilities Act (ADA) accommodation requests;

(I) Credit card processing fees;

(J) Fiscal intermediary administration fees; and

(K) Workers' compensation premiums.

(d) Any other activities undertaken to ensure:

(A) The quality of Homecare Choice providers;

(B) The adequacy of homecare services being provided; and

(C) Costs of other administrative expenses associated with the program are covered.

(2) The service payment rate is set forth in the participant enrollment agreement between the program and participant. Information about the rate shall be available from the Commission and posted online at www.oregon.gov/DHS/Seniors-Disabilities/HCC/Pages/Homecare-Choice-Program.aspx.

(3) If additional revenue is needed to sufficiently cover program costs, the Commission reserves the right to modify the service rate at any time. To modify the service rate, the Commission will give 30-days advance written notice to program participants.

(4) If the Commission determines adjusting the service rate will not generate sufficient revenue to pay the costs of the program, the Commission may suspend the program following 30-days advance written notice to participants and providers. If the program is suspended, the Commission shall report to the Legislative Assembly, no later than 30 days after the suspension begins. The report must include the following information:

(a) The reason for the suspension;

(b) Any costs incurred that exceed the revenue generated by program payments; and

(c) Any additional costs during the remainder of the biennium that the suspension occurs in that are anticipated to exceed the revenue generated by program payments.

Or. Admin. Code § 418-040-0060

HCC 1-2016, f. 6-13-16, cert. ef. 6/20/2016

Stat. Auth.: ORS 410.602

Stats. Implemented: ORS 410.595-625