Or. Admin. Code § 411-016-0040 - Service Plan Hours
(1) Through
a person-centered planning process with the individual, the Services Case
Manager (SCM) authorizes hours to address the individual's unmet needs or to
support the unpaid caregiver relationship.
(2) A service plan may have no more than a
maximum total of 40 hours of in-home services including both ADL and IADL
hours, per pay period.
(3) Hours
are authorized to meet assessed ADL/IADL needs as defined in OAR
411-015-0006 and OAR
411-015-0007.
(4) Hours should reflect only the minimum
necessary for health and safety that supplement supports provided by natural
supports and alternative service resources. The hours authorized must be
documented in the service plan form.
(5) For households with two or more eligible
individuals receiving any combination of Medicaid funded or Oregon Project
Independence in-home services, the service plan for each individual must avoid
duplication of services.
(6) Hours
authorized for assessed needs are paid at the rates in accordance with OAR
411-027-0170 for In-Home Care
Agencies and for Homecare Workers at rates published on the current rate
schedule or the current collective bargaining agreement between the Department
of Administrative Services on behalf of the State of Oregon and the Oregon
Homecare Commission and Service Employees International Union, Local 503,
Oregon Public Employees Union.
(7)
A provider may not receive payment from the Department for more than the total
amount of in-home services hours authorized by the AAA or the Department on the
service plan authorization form under any circumstances. All service payments
must be prior authorized by a SCM or AAA or Department designated
staff.
(8) Payment by the
Department for In-Home services hours are only made for the tasks described in
OAR 411-015-0006 and OAR
411-015-0007 as ADL or IADL
tasks. Services must be authorized to meet the needs of an eligible individual
and may not be provided to benefit an entire household.
(9) Respite hours may be authorized to
replace an unpaid caregiver or natural supports providing ADL or IADL care who
are temporarily unavailable to provide assistance. Respite hours must be
included in the 40 in-home services hours limit.
Notes
Statutory/Other Authority: ORS 410.070
Statutes/Other Implemented: ORS 410.060, 410.070 & 414.065
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