Or. Admin. Code § 411-034-0010 - Definitions
Unless the context indicates otherwise, the following definitions apply to the rules in OAR chapter 411, division 034:
(1) "Activity of Daily Living (ADLs)" means
those personal functional activities required by an individual for continued
well-being, which are essential for health and safety. ADLs for these rules
means Basic Personal Hygiene, Medication and Oxygen Management, Mobility,
Toileting, Nutrition and Nursing Services.
(2) "Adult" means any person at least 18
years of age.
(3) "Alternative
Service Resources" means other possible resources for the provision of services
to meet an individual's needs. Alternative service resources include, but are
not limited to, natural supports, risk intervention services, Older Americans
Act programs, or other community supports. Alternative service resources are
not paid by Medicaid.
(4) "Area
Agency on Aging (AAA)" means the Department designated agency charged with the
responsibility to provide a comprehensive and coordinated system of services to
older adults and adults with disabilities in a planning and service area. The
terms AAA and Area Agency on Aging are inclusive of both Type A and Type B Area
Agencies on Aging as defined in ORS
410.040 and described in ORS
410.210 to
410.300.
(5) "Assistance" means an individual requires
help from another person with the personal care or supportive services
described in OAR 411-034-0020.
(6) "Assistance Types" mean assistance from
another person in the form of hands-on assistance (actually performing a
personal care task for a person) or cueing (redirecting) so that the person
performs the task by themselves. Other types of assistance may be defined in
specific ADLs or IADLs. Specific assistance types include:
(a) "Cueing" means giving verbal or visual
clues during an activity to help an individual complete the activity without
hands-on assistance.
(b) "Hands-on"
means a provider physically performs all or parts of an activity because an
individual is unable to do so.
(c)
"Monitoring" means a provider must observe an individual to determine if
intervention is needed.
(d)
"Reassurance" means to offer an individual encouragement and support.
(e) "Redirection" means to divert an
individual to another more appropriate activity.
(f) "Set-up" means getting personal effects,
supplies, or equipment ready so that an individual may perform an
activity.
(g) "Stand-by" means a
provider is at the side of an individual ready to step in and take over the
task if the individual is unable to complete the task independently.
(h) "Support" means to enhance the
environment to enable an individual to be as independent as possible.
(7) "Assistive Devices" means any
category of durable medical equipment, mechanical apparatus, electrical
appliance, or instrument of technology used to assist and enhance an
individual's independence in performing any task described in OAR
411-034-0020.
(8) "Assistive Supports" means the aid of
service animals, general household items, or furniture used to assist and
enhance an individual's independence in performing any task described in OAR
411-034-0020.
(9) "Case Management" means the functions
required to determine service eligibility, developing a plan of authorized
services, and monitoring the effectiveness of services.
(10) "Case Manager" means a Department
employee or an employee of the Department's designee who assesses the service
needs of individuals, determines eligibility, and offers service choices to
eligible individuals. A case manager authorizes and implements an individual's
plan for services and monitors the services delivered.
(11) "Central Office" "CO" means the unit
within the Department responsible for program and policy development and
oversight.
(12) "Child" means an
individual who is less than 18 years of age.
(13) "Cognition" refers to how the individual
is able to use information, make decisions, and ensure their daily needs are
met.
(14) "Community Developmental
Disability Program (CDDP)" means the Department's designee that is responsible
for plan authorization, delivery, and monitoring of services for individuals
with intellectual or developmental disabilities according to OAR chapter 411,
division 320.
(15) "Cost Effective"
means being responsible and accountable with Department resources.
(16) "Delegated Nursing Task" means a
registered nurse (RN) authorizes an unlicensed person (defined in OAR
851-047-0010) to provide a
nursing task normally requiring the education and license of an RN.
(17) "Department" means the Oregon Department
of Human Services.
(18) "Designee"
means an organization with which the Department contracts or has an interagency
agreement.
(20) "Disability" means a physical,
cognitive, or emotional impairment which, for an individual, constitutes or
results in a functional limitation in one or more of the activities of daily
living in these rules.
(21)
"Grocery Shopping" means Grocery Shopping - perform or assist individual in
planning for and purchasing basic needs and household items.
(22) "Guardian" for the purpose of these
rules means a person or agency appointed and authorized by the courts to make
decisions about services for an individual.
(23) "Healthier Oregon" is an OHP Plus
equivalent benefit (410-120-1210(4)(h))
for individuals described in
461-135-1080.
(24) "Homecare Worker" means a provider
directly employed by an individual to provide hourly in-home services to the
eligible consumer per the criteria in the CEP program described in OAR
411-031-0020.
(25) "In-Home Care Agency" means an
incorporated entity or equivalent, licensed in accordance with OAR chapter 411,
division 033 and chapter 333, division 536 that provides hourly contracted
in-home services to individuals receiving services through the Department or
Area Agency on Aging.
(26)
"Individual" means the person applying for or determined eligible for State
Plan personal care services.
(27)
"Instrumental Activities of Daily Living (IADLs)" means certain day-to-day
activities or tasks associated with an independent lifestyle. These are not
considered to be essential for basic functioning but are regarded as important
for maintaining day-to-day quality of life and relative independence. IADLs
include housework, laundry, transportation, grocery shopping, using the
telephone or other communication equipment, and money management.
(29) "Legal Representative" means a person
who has the legal authority to act for an individual. The legal representative
only has authority to act within the scope and limits of his or her authority
as designated by the court or other agreement. Legal representatives acting
outside of his or her authority or scope must meet the definition of designated
representative.
(a) For an individual under
the age of 18, the parent, unless a court appoints another person or agency to
act as the guardian.
(b) For an
individual 18 years of age or older, a guardian appointed by a court order or
an agent legally designated as the health care representative, where the court
order or the written designation provide authority for the appointed or
designated person to make the decisions indicated where the term "legal
representative" is used in this rule.
(30) "Long Term Care Community Nursing" means
the nursing services described in OAR chapter 411, division 048.
(31) "Natural Support" means resources and
supports (e.g., relatives, friends, significant others, neighbors, roommates,
or the community) who are willing to voluntarily provide services to an
individual without the expectation of compensation. Natural supports are
identified in collaboration with the individual and the potential "natural
support". The natural support is required to have the skills, knowledge, and
ability to provide the needed services and supports.
(32) "Older Adult" means any person at least
65 years of age.
(33) "Ostomy"
means assistance that an individual needs with a colostomy, urostomy, or
ileostomy tube or opening used for elimination.
(34) "Personal Care" means the functional
activities described in OAR
411-034-0020(2)
that an individual requires for continued well-being.
(35) "Provider" or "Qualified Provider" means
a homecare worker that meets the qualifications in OAR chapter 418, division
020 or an In-Home Care Agency that meets the qualifications in OAR chapter 411,
division 033 that performs State Plan personal care services.
(36) "Relative" means a person, excluding an
individual's spouse, who is related to the individual by blood, marriage, or
adoption.
(37) "Representative"
means:
(a) A person appointed by an
individual or legal representative to participate in service planning on the
individual's behalf that is either the individual's guardian or natural support
with longstanding involvement in assuring the individual's health, safety and
welfare; and
(b) For the purpose of
obtaining State Plan personal care services through a homecare or personal
support worker, the person selected by an individual or the individual's legal
representative to act on the individual's behalf to provide the employer
responsibilities described in OAR
411-034-0040.
(c) A HCW may not act as a consumer-employer
representative for an individual who employs them.
(38) "Respite" means services for the relief
of a person normally providing supports to an individual unable to care for him
or herself.
(39) "Service Need"
means the assistance with personal care and supportive services needed by an
individual receiving Department services.
(40) "Service Period" means two consecutive
workweeks for a total of 14 days.
(41) "Service Plan" or "Service
Authorization" means an individual's written plan for services that identifies:
(a) The individual's qualified provider who
is to deliver the authorized services;
(b) The date when the provision of services
is to begin; and
(c) The maximum
hours per service period of personal care services authorized by the Department
or the Department's designee.
(42) "State Plan Personal Care Services"
means the assistance with personal care, ADLs and IADLs described in OAR
411-034-0020 provided to an
individual by a homecare worker or In-Home Care Agency.
(43) "Sub-Acute Care Facility" means a care
center or facility that provides short-term rehabilitation and complex medical
services to an individual with a condition that does not require acute hospital
care but prevents the individual from being discharged to his or her
home.
(44) "Using the telephone"
means assisting the individual in the use of any communication related
technology.
(45) "These Rules" mean
the rules in OAR chapter 411, division 034.
Notes
Statutory/Other Authority: ORS 410.070
Statutes/Other Implemented: ORS 410.020, 410.070, 410.710 & 411.675
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