For purposes of these rules:
(1) "Activities of Daily Living" (ADL) means
those personal functional activities required by an individual for continued
well being, health and safety. For the purposes of these rules, ADLs consist of
eating, dressing/grooming, bathing/personal hygiene, mobility (ambulation and
transfer), elimination (bowel and bladder management) and
Income" means the income for all household members after deductions for
household medical expenses as defined in OAR
"Administrative Costs" means those expenses associated with the overall
operation of the Oregon Project Independence (OPI) Program that are not
directly attributed to a service. These costs can include, but are not limited
to, costs associated with accounting services, indirect program costs, facility
(4) "Adult Day
Service" means a structured comprehensive program designed to meet the needs of
functionally and/or adults with cognitive impairments. Adult day service
provides individually planned service, supervision, social and related support
services, and health monitoring in a protective setting during any part of a
day, but less than 24-hour care.
(5) "Advisory Council" means an advisory
council of the authorized Agencies on Aging.
"Alzheimer's Disease and Other Related
Disorders" means a progressive and degenerative neurological disease that is
characterized by dementia including the insidious onset of symptoms of
short-term memory loss, confusion, behavior changes and personality changes. It
includes dementia caused from any one of the following disorders:
(a) Multi-Infarct Dementia (MID);
(b) Normal Pressure Hydrocephalus
(c) Inoperable Tumors of the
(h) Uncommon Dementia
such as Pick's Disease, Wilson's Disease, and Progressive Supranuclear Palsy;
(i) All other related disorders
recognized by the National Alzheimer's Association.
(7) "Area Agency" means the agency designated
by the Department as an Area Agency on Aging that is charged with the
responsibility to provide a comprehensive and coordinated system of services to
seniors and those individuals with disabilities in a planning and service area.
For purposes of these rules, the term "Area Agency" (AAA) is inclusive of both
Type A and B Area Agencies on Aging as defined in ORS
410.040 to 410.350.
(8) "Area Plan" means the approved plan for
providing authorized services under Oregon Project Independence.
(9) "Assisted Transportation" means escort
services that provide assistance to a person who has difficulties (physical or
cognitive) using regular vehicular transportation.
(10) "Authorized Service" means any service
designated by the Department and these rules to be eligible for Oregon Project
Management" means a service designed to individualize and integrate social and
health care options for or with a person being served. Its goal is to provide
access to an array of service options to assure appropriate levels of service
and to maximize coordination in the service delivery system. Case management
must include four general components: access, assessment, service
implementation, and monitoring.
(12) "Case Management Costs" means those
expenses associated with individualizing and integrating social and health care
options for or with a person receiving a service. Cost elements should include
time spent with the individual, travel to and from an individual's home,
mandated training time, case recording, reporting, time spent arranging for and
coordinating services for the individual, supervision and staffing time related
to an individual, and time spent in the initial assessment of a person who does
not become an OPI individual.
"Case Manager" means an SPD/AAA employee who assesses the service needs on an
applicant or eligible individual, determines eligibility and offers service
choices to eligible individuals. The Case Manager authorizes and implements the
service plan and monitors the services delivered.
(14) "Chore Service" means assistance with
heavy housework, yard work or sidewalk maintenance for persons who need
assistance with these activities to assure safety.
(15) "Client-Employed Provider Program" (CEP)
refers to the program wherein the provider is directly employed by the eligible
individual and provides hourly services. In some aspects of the
employer/employee relationship, the Department of Human Services acts as an
agent for the client-employer. These functions are clearly described in OAR
chapter 411, division 031.
"Community Support Resources", "Natural Supports" or "Natural Support System"
means the resources available to an individual from their relatives, friends,
significant others, neighbors, roommates and the community. Services provided
by natural supports are resources not paid for by the Department or
(17) "Contracted In-Home
Service" means a service provided through a contractor that consists of
assistance with activities of daily living and self-management tasks.
"Contracted In-Home Care Agency" means
an incorporated entity or equivalent, licensed in accordance with OAR
that provides hourly contracted in-home
service to individuals of the Department or Area Agency on Aging.
(19) "Department of Administrative Services"
means the Department of Administrative Services for the State of
(20) "Department" means the
Department of Human Services, Seniors and People with Disabilities Division,
unless otherwise specifically defined.
(21) "Department of Revenue" means the Oregon
Department of Revenue.
"Diagnosed" means, for purposes of these rules, that the individual's physician
has reason to believe and indicates that the individual has Alzheimer's Disease
or a Related Disorder.
Service Costs" means those expenses for direct labor that are attributable to
an eligible individual-related service. For example, the direct service cost of
home care is the cost of time actually spent providing home care services in
the home. Other direct service costs are those that are directly attributable
to an individual-related function.
(24) "Eligibility Determination" means the
process of deciding if a prospective individual meets the requirements
necessary to receive authorized services under Oregon Project
(25) "Exception or
Variances" means that an agency or individual contractor or subcontractor is
not required to meet one or more specific requirements of these
(26) "Fee-based case
management" means a service for which a fee is assessed for case management for
an individual who would otherwise be ineligible for OPI services. Fee-based
case management services include service planning and coordination, service
plan implementation, service plan monitoring and reassessment.
(27) "Fiscal Records and Data" means all
information pertaining to the financial operation of an agency or
(28) "Gross Income" means
household income from salaries, interest and dividends, pensions, Social
Security, railroad retirement benefits, and any other income prior to any
(29) "Health Services"
means the Department of Human Services, Health Services.
(30) "Home Care or Homemaker Services" means
all those ADL or IADL in-home services necessary to help individuals achieve
the greatest degree of independent functioning.
"Homecare Worker" means a provider, as
described in OAR 411-030-0020
, who is directly employed by the
eligible individual via the Client Employed Provider Program, and who provides
hourly services to eligible individuals. Homecare Workers also include
providers in the Spousal Pay Program.
(32) "Home Delivered Meal" means a meal paid
from OPI funds and delivered to an eligible individual who is receiving at
least case management services.
"Home Health Agency" means a licensed
(in accordance with OAR 333-027-0000
through 0170), public or private agency
providing coordinated home health services on a home visiting basis. Home
health agencies provide skilled nursing services in at least one of the
following therapeutic services: Physical therapy; Occupational therapy; Speech
Therapy; or Home health aide services.
(34) "Home Health Service" means items and
services furnished to an individual by a home health agency, or by others under
arrangement with such agency, on a visiting basis in a place of temporary or
permanent residence used as the individual's home for the purpose of
maintaining that individual at home.
(35) "Household" means the individual, spouse
and any dependents as defined by the Internal Revenue Service.
(36) "Hourly Services" means the in-home
services, including activities of daily living and self-management tasks, that
are provided at regularly scheduled times. None of these hours are exempt from
federal or state minimum wage or overtime laws.
(37) "Information and Assistance" means a
service that provides current information on opportunities and services
available within their communities; assesses the problems and capacities of the
individuals; links individuals to the opportunities and services and, to the
maximum extent feasible, ensures the individual receives the services needed
and is aware of the opportunities available by establishing adequate follow-up
(a) Incurred for a common or joint
purpose benefiting more than one cost objective, and
(b) Not readily assignable to the cost
objectives specifically benefited, without effort disproportionate to the
results achieved. The term "indirect cost," as used herein, applies to costs of
this type originating in the grantee department, as well as those incurred by
other departments in supplying goods, services, and facilities. To facilitate
equitable distribution of indirect expenses, to the cost objectives served, it
may be necessary to establish a number of pools of indirect costs. Indirect
cost pools should be distributed to benefited cost objectives on bases that
will produce an equitable result in consideration of relative benefits
Services" means those services that assist an individual to stay in his or her
(40) "Institution" means
any state, community or private hospital and any nursing facility.
"Instrumental Activities of Daily Living
(IADL)" or "Self Management Tasks" consist of housekeeping, including laundry,
shopping, transportation, medication management and meal preparation as
described in OAR 411-015-0007
"Personal Care Service" means in-home services provided to maintain,
strengthen, or restore an individual's functioning in their own home when an
individual is dependent in one or more ADLs, or when an individual requires
assistance for ADL needs. Assistance can be provided either by a contracted
agency or by a Homecare worker paid in accordance with the collectively
Records and Data" means any information of a non-fiscal nature.
(44) "Program Support Costs" means those
expenses associated with managing the services provided either through contract
or directly by the Area Agency on Aging, that are attributable to a specific
(45) "Provider" means the
individual who actually renders the service.
(46) "Registered Nurse Services" mean
services provided by a registered nurse on a short-term or intermittent basis
that include but are not limited to: interviewing the individual and, when
appropriate, other relevant parties; assessing the individual's ability to
perform tasks; preparing a service plan that includes treatment needed by the
individual; monitoring medication; training and educating providers around the
provisions of the service plan.
(47) "Respite" means paid temporary services
to provide relief for families or other caregivers who are unpaid. In-home and
out-of-home respite may be provided on an hourly or daily basis, including
24-hour respite service for several consecutive days. Range of tasks to be
provided may include: supervision, companionship and personal services usually
provided by the primary caregiver.
(48) "Seniors and People with Disabilities
Division" means the Seniors and People with Disabilities Division of the
Department of Human Services.
"Service Provider" means any agency or program that provides one or more
authorized services under Oregon Project Independence.
(50) "Service Determination" means the
process of determining the proper authorized service for each eligible
(51) "Service Need"
means those functions or activities for which the individual requires the
support of the Department or Area Agency on Aging.
(52) "Service Priority" means the order in
which the Department determines individuals to be eligible for the Oregon
Project Independence program.