Or. Admin. Code § 411-016-0300 - AAA Case Management, Data Collection, Records, and Reporting
(1) CASE
MANAGEMENT.
(a) Type A and Type B contract
AAAs will provide services case management to OPI-M cases without full Medicaid
medical benefits.
(b) The
Department may make exceptions to subsection (a) if the individual has an
ongoing relationship with the AAA.
(c) Type A and Type B contract AAAs may
provide services case management to individuals receiving Medicare Savings
Programs.
(d) The Department's
local office or the Type B transfer AAA will provide case management services
to individuals eligible for full Medicaid medical benefits.
(2) DATA COLLECTION.
(a) The collection of required program and
fiscal records and data associated with OPI-M must be on forms and data systems
as approved by the Department.
(b)
Each AAA and service provider must collect and maintain required data on
eligible individuals receiving authorized services as required by the
Department, including required Race, Ethnicity, Language and Disability (REALD)
and Sexual Orientation and Gender Identity/Expression (SOGIE) data when Oregon
ACCESS or other state data systems can include the data.
(c) All authorized service data collected on
eligible individuals, supported by OPI-M must contain the individual's Social
Security Number and date of birth.
(3) RECORDS.
(a) Each AAA must maintain all records,
documents, and accounting procedures that reflect all administrative costs,
program support costs, direct service costs, and service case management costs
expended on OPI-M. These records must be retained for not less than seven
years.
(b) Each AAA must make these
records available upon request to the Department or to those duly authorized by
the Department.
(4)
FISCAL AND PROGRAM REPORTING:
(a) Fiscal and
program reports must be completed on forms provided by the
Department.
(b) Fiscal and program
reports must be submitted to the Department by the specified due
dates.
(c) Fiscal and program
reports must, at a minimum, include:
(A)
Current cumulative expenditures;
(B) Administrative costs;
(C) Program support costs;
(D) Services case management costs;
and
(E) Demographic, social,
medical, physical, functional, and financial data as required by the Department
in the Department's Client Assessment/Planning System (CA/PS) and in the Oregon
ACCESS database.
(5) CONFIDENTIALITY. The use or disclosure by
any party of any information concerning a recipient of authorized services
described in these rules, for any purpose not directly connected with the
administration of the responsibilities of the Department, AAA, or service
provider is prohibited except with written consent of the recipient, or the
individual's representative. Disclosure of recipient information must meet
Department requirements.
(6)
COMMUNICATION. The AAA must respond to communication and OPI-M referrals for
services from APD within five business days. Responses to communication from
eligible individuals and their representatives must also occur within five
business days.
(7) OTHER
INFORMATION. AAAs will provide other information required under the OPI-M and
1115 Demonstration Waiver, including the Special Terms and Conditions, approved
by the Centers for Medicare & Medicaid Services or by Department policy on
OPI-M waiver administration.
Notes
Statutory/Other Authority: ORS 410.070
Statutes/Other Implemented: ORS 410.060, 410.070, 410.480 & 414.065
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