NON-DISCRIMINATION. An individual may not be denied services in an AFH-DD or
otherwise discriminated against on the basis of race, color, religion, sex,
gender identity, sexual orientation, national origin, marital status, age,
disability, source of income, duration of Oregon residence, or other protected
classes under federal and Oregon Civil Rights laws.
ELIGIBILITY. An individual who enters an
AFH-DD is subject to eligibility as described in this section.
To be eligible for services in an AFH-DD,
an individual must meet the following requirements:
Be an Oregon resident who meets the
residency requirements in OAR 461-120-0010
(i) A Medicaid Title XIX benefit package
through OSIPM or HSD medical programs; or
(ii) A benefit package through the Healthier
Oregon medical program.
Be determined eligible for:
Developmental disabilities services by
the CDDP of the county of origin as described in OAR 411-320-0080
(ii) Services for Aging and People with
Disabilities as described in OAR chapter 411, division 015.
Not receive other Department-funded in-home, community living support, or other
services in another residential setting.
Individuals receiving Medicaid Title XIX
through HSD medical programs for services in a nonstandard living arrangement
as defined in OAR 461-001-0000
are subject to the requirements in the same
manner as if they were requesting these services under OSIPM, including the
The equity value of a home which exceeds
the limits as set forth in OAR 461-145-0220
A provider considering an individual for
entry into the AFH-DD must:
notification to the local CDDP of the intended entry prior to the individual
moving into the AFH-DD.
prior authorized to provide Medicaid-funded services to the individual if the
individual is not private pay.
Receive written permission from the Department prior to:
(i) An individual under age 18 moving into an
AFH-DD with individuals age 18 or older; or
(ii) An individual 18 or older moving into an
AFH-DD with individuals under the age of 18.
(D) Gather sufficient information to make an
informed decision about the provider's ability to safely and adequately support
provider must participate in an entry meeting with an individual's case manager
prior to delivering services to the individual for services to be funded in the
Prior to or upon an
entry, a provider must demonstrate diligent efforts to acquire the following
individual information from the referring case management entity:
(A) A copy of the eligibility determination
(B) A statement
indicating the safety skills, including the ability of the individual to
evacuate from a building when warned by a signal device and adjust water
temperature for bathing and washing.
(C) A brief written history of any behavioral
challenges, including supervision and support needs.
A medical history and information on
health care supports that includes (when available):
(i) The results of the most recent physical
(ii) The results of any
(iii) A record
(iv) A record of
known communicable diseases and allergies; and
(v) A record of major illnesses and
written record of any current or recommended medications, treatments, diets,
and aids to physical functioning.
(F) A copy of the most recent functional
needs assessment and previous functional needs assessment if the needs of the
individual have changed over time.
(G) Copies of protocols, the risk tracking
record, and any support documentation (if available).
(H) Copies of documents relating to the
guardianship, conservatorship, health care representation, power of attorney,
court orders, probation and parole information, or any legal restrictions on
the rights of the individual (if applicable).
(I) Copies of medical decision-making
documents, such as an Advance Directive and Portable Order for Life-Sustaining
Treatment (POLST), if applicable.
(J) Written documentation that the individual
is participating in out of residence activities, including public school
enrollment for individuals under 21 years of age.
(K) Written documentation to explain why
preferences of the individual may not be implemented.
(L) A copy of the most recent Functional
Behavior Assessment, Positive Behavior Support Plan, ISP or Service Agreement,
Nursing Service Plan, and Individualized Education Program (if
(d) If an
individual is being admitted from the family home of the individual and the
information required in subsection (c) of this section is not available, the
provider must assess the individual upon entry for issues of immediate health
or safety and document a plan to secure the remaining information no later than
30 calendar days after entry. The plan must include a written justification as
to why the information is not available.
(e) A provider retains the right to deny
entry of any individual if the provider determines the support needs of the
individual may not be met by the provider or for any other reason not
specifically prohibited by these rules.
(f) An AFH-DD may not be used as a site for
foster care for children, adults from other agencies, or any other type of
shelter or day care without the written approval of the Department.
VOLUNTARY TRANSFERS AND EXITS.
(a) A provider must promptly notify an
individual's case manager if the individual gives notice of the intent to exit
or abruptly exits services. An individual is not required to give notice to a
provider if the individual chooses to exit the AFH-DD.
(b) A provider must notify an individual's
case manager prior to the voluntary transfer or exit of an individual from the
AFH-DD or services, even when the individual enters into another AFH-DD
operated by the same provider.
Notification and authorization of the voluntary transfer or exit of the
individual must be documented in the record for the individual.
(d) A provider is responsible for the
provision of services until an individual exits the AFH-DD when the exit is a
voluntary exit from the home.
INVOLUNTARY REDUCTIONS, TRANSFERS, AND
A provider must only reduce
services, transfer, or exit an individual involuntarily for one or more of the
(A) The behavior of the
individual poses an imminent risk of danger to self or others.
(B) The individual experiences a medical
emergency that results in the individual requiring substantially increased
ongoing support that the provider is unable to meet.
(C) The service needs of the individual
exceed the ability of the provider.
(D) The individual fails to pay for services
or room and board, and payment is not available from Medicaid or other
provider's license for the AFH-DD is suspended, revoked, not renewed, or
provider's Medicaid provider enrollment agreement or contract has been
(G) The conditions are
met for an immediate exit as described in section (9) of this rule.
NOTICE OF INVOLUNTARY
REDUCTION, TRANSFER, OR EXIT. A provider must not reduce services, transfer, or
exit an individual involuntarily without giving advance written notice 30
calendar days prior to the reduction, exit or transfer. The notice of
involuntary reduction, transfer or exit must be provided to the individual and
the individual's legal or designated representative (as applicable) and case
manager, except in the case of a medical emergency or when an individual is
engaging in behavior that poses an immediate danger to self and others as
described in subsection (c) of this section.
The written notice must be provided on
the applicable Department form and include:
(i) The reason for the reduction, transfer,
or exit; and
(ii) The right of the
individual to a hearing as described in section (6) of this rule.
(B) A notice is not required when
an individual requests the reduction, transfer, or exit.
(c) A provider may give advance written
notice less than 30 calendar days prior to an exit or transfer only in a
medical emergency or when an individual is engaging in behavior that poses an
imminent danger to self or others in the AFH-DD and undue delay in moving the
individual increases the risk of harm. The notice must be provided to the
individual and the individual's legal or designated representative (as
applicable) and case manager immediately upon the provider's determination of
the need for a reduction, transfer, or exit.
(d) A provider must demonstrate through
documentation, attempts to resolve the reason for the involuntary reduction,
transfer, or exit, including consideration of alternatives to the reduction,
transfer, or exit and engagement of the case manager in this process.
(e) A provider is responsible for the
provision of services until the date of reduction, transfer, or exit identified
in the notice, or when an individual requests a hearing, until the hearing is
An individual must be given the
opportunity for a hearing under ORS chapter 183 and OAR 411-318-0030
an involuntary reduction, transfer, or exit, except when a provider's license
is revoked, not renewed, voluntarily surrendered, or the provider's Medicaid
contract is terminated.
(b) If an
individual requests a hearing within 15 calendar days after the date of the
notice and requests continuation of services, the individual must receive the
same services until the hearing is resolved.
(c) When an individual has been given written
notice less than 30 calendar days in advance of a reduction, transfer, or exit
as described in section (5)(c) of this rule and the individual has requested a
hearing, the provider must reserve the room of the individual and deliver
services according to the individual's needs until receipt of the Final
An individual or their
legal or designated representative may request an expedited hearing as
described in OAR 411-318-0030
EXIT MEETING. A provider must participate
in an exit meeting before any decision to exit an individual is made, unless
the exit meeting is waived in accordance with OAR 411-415-0080
CLOSURE. A provider must notify the
Department and case management entity in writing prior to announcing a
voluntary closure of the AFH-DD to individuals and the legal representatives of
the individuals (as applicable).
provider must give each individual, the legal representative of the individual
(as applicable), and the case management entity written notice 30 calendar days
in advance of the planned closure, except in circumstances where undue delay
might jeopardize the health, safety, or welfare of the individuals, provider,
(b) If a provider
has more than one AFH-DD, the individuals may not be transferred from one
AFH-DD to another AFH-DD without providing each individual, the legal
representative of the individual (as applicable), and the case management
entity written notice 30 calendar days in advance of the planned closure,
unless prior approval is given and agreement obtained from the individuals, the
legal representative of the individuals (as applicable), and the case
management entity, or when undue delay might jeopardize the health, safety, or
well-being of the individuals, provider, or caregivers.
(c) A provider must return the AFH-DD license
to the Department if the AFH-DD closes prior to the expiration of the
An individual who was admitted on or
after July 1, 2014 may be moved without advance notice if all of the following
(A) The provider was not notified
prior to the entry of the individual to the AFH-DD that the individual is on
probation, parole, or post-prison supervision after being convicted of a sex
(B) The provider learns that
the individual is on probation, parole, or post-prison supervision after being
convicted of a sex crime; and
The individual presents a current risk of harm to another individual, staff, or
visitor in the AFH-DD as evidenced by:
Current or recent sexual inappropriateness, aggressive behavior of a sexual
nature, or verbal threats of a sexual nature; or
(ii) Current communication from the State
Board of Parole and Post-Prison Supervision, Department of Corrections, or
community corrections agency parole or probation officer that the Static 99
score for the individual or other assessment indicates a probable sexual
re-offense risk to others in the AFH-DD.
(b) Prior to the move, the provider must
contact the Central Office of the Department by telephone to review the
criteria in subsection (a) of this section. The Department shall respond within
one business day of contact by the AFH-DD. The parole or probation officer of
the Department of Corrections must be included in the review, if available. The
Department shall advise the AFH-DD provider if rule criteria for immediate exit
are not met. The Department shall assist in locating placement
(c) A written move-out
notice must be completed on form 0719DD. The form must be filled out in its
entirety and a copy of the notice must be delivered in person to the individual
or if applicable the legal representative of the individual. Where an
individual lacks capacity and there is no legal representative, a copy of the
notice to move-out must be immediately faxed to the State Long Term Care
(d) Prior to the move,
the AFH-DD licensee must orally review the notice and the right to object with
the individual, or as applicable the legal representative of the individual,
and determine if a hearing is requested. A request for hearing does not delay
the exit. The AFH-DD must immediately telephone the Central Office of the
Department when a hearing is requested. The hearing must be held within five
business days of the exit of the individual. An informal conference may not be
held prior to the hearing.
COMMUNITY LIVING SUPPORTS.
Community living supports may be provided
to one or more individuals if the addition of the individual receiving
community living supports in the AFH-DD does not cause the capacity of the
AFH-DD as determined by OAR 411-360-0060
to exceed five. Relief care may not be
provided for more than 14 consecutive days to a single individual without prior
approval from the Department.
The provider must have information sufficient to provide for the health and
safety of an individual receiving community living supports that includes the
(A) Medications provided in a
container labeled from a pharmacy or in the original container labeled from the
(B) A list of
medications, administration times, and self-administration information as
needed. Administration of medication must be documented on a MAR;
Basic summary sheet for the individual
that includes the following:
(i) The name of
the physician or health care provider of the individual and the phone number
for the physician or health care provider;
(ii) The name of the emergency contact person
of the individual and the phone number for the emergency contact;
(iii) List of supports related to food and
drink (textures, special diets, allergies, preferences);
(iv) List of supports related to health
(v) List of supports
related to safety, including ability to adjust water temperature; and
(vi) List of supports related to challenging
(c) On the first relief care visit of an
individual, the provider must practice and document a fire drill immediately
upon the arrival of the individual. For subsequent relief care visits, the
provider must review the fire evacuation procedures with the individual and
document the review.
(d) No use of
PRN (as needed) psychotropic medications is allowed.
Or. Admin. R.
SPD 3-2005, f. 1-10-05,
cert. ef 2-1-05; SPD 13-2010, f. 6-30-10, cert. ef. 7-1-10; SPD 25-2011(Temp),
f. & cert. ef. 12-1-11 thru 5-29-12; SPD 29-2011(Temp), f. & cert. ef.
12-30-11 thru 5-29-12; SPD 5-2012, f. & cert. ef. 5-29-12; SPD 34-2013, f.
& cert. ef. 9-27-13; APD 29-2014(Temp), f. & cert. ef. 7-1-14 thru
47-2014, f. 12-26-14, cert. ef.
12/28/2014; APD 30-2015(Temp), f. 12-31-15,
cert. ef. 1-1-16 thru 6-28-16;
21-2016, f. & cert. ef.
31-2018, minor correction filed 08/15/2018, effective
39-2019, amend filed 10/29/2019, effective
34-2022, temporary amend filed 07/01/2022, effective
7/1/2022 through 12/27/2022;
53-2022, amend filed 12/14/2022, effective
Statutory/Other Authority: ORS
443.775 & 443.790
Statutes/Other Implemented: ORS
443.705-443.825, 443.875 & 443.991