Or. Admin. Code § 411-318-0030 - Contested Case Hearings for Provider Notices of Involuntary Reductions, Transfers, or Exits
(1) This rule
applies to involuntary reductions, transfers, or exits by a provider, including
a licensed or certified provider organization, who has a contract with the
Department, CDDP, or Brokerage. This rule does not apply to providers who have
a direct employer-employee relationship with an individual or an individual's
employer representative.
(2) An
individual must be given the opportunity to dispute an involuntary reduction,
transfer, or exit by requesting a hearing as provided in ORS chapter
183.
(3) An individual or the
individual's representative may request a hearing either orally or in writing
when the individual and the individual's representative receives a Notice of
Involuntary Reduction, Transfer, or Exit (form 0719R, 0719C, 0719E).
(a) To request a hearing in writing:
(A) The individual or the individual's
representative must complete the Administrative Hearing Request included with
the Notice of Involuntary Reduction, Transfer, or Exit (form 0719R, 719C,
0719E) and submit the form to the Office of Developmental Disabilities Services
(ODDS) as described on the form; or
(B) The individual or the individual's
representative may meet with a staff person of the CDDP, Brokerage, or
Department to complete the Administrative Hearing Request included with the
Notice of Involuntary Reduction, Transfer, or Exit (form 0719R, 0719C, 0719E).
After meeting with the individual or the individual's representative, the CDDP,
Brokerage, or Department must submit the form to ODDS within three business
days. A copy of the form must be mailed to the individual and the individual's
representative.
(b) To
request a hearing orally, the individual or the individual's representative
must orally express the desire for a hearing to a staff person of the CDDP,
Brokerage, or Department. Upon receipt of an oral request for a hearing, the
CDDP, Brokerage, or Department must complete the Administrative Hearing Request
included with the Notice of Involuntary Reduction, Transfer, or Exit (form
0719R, 0719C, 0719E) and submit the form to ODDS within one business day. A
copy of the form must be mailed to the individual and the individual's
representative.
(4) Upon
receipt of the Administrative Hearing Request form for a Notice of Involuntary
Reduction, Transfer, or Exit, ODDS shall:
(a)
Refer the hearing request to the Office of Administrative Hearings within five
business days from the receipt of the hearing request.
(b) Assist the claimant or the claimant's
representative in gathering and submitting exhibits.
(c) Act as a liaison between the Office of
Administrative Hearings and the CDDP or Brokerage responsible for the
claimant's services.
(5)
The Office of Administrative Hearings communicates directly with a claimant and
the claimant's representative regarding informal conference dates, hearing
dates, and the Final Order as described in OAR chapter 137, division
003.
(6) If an individual or an
individual's representative requests a hearing within 15 calendar days from the
issuance of a Notice of Involuntary Reduction, Transfer, or Exit, the
individual must continue to receive the same services until receipt of a Final
Order.
(7) When an individual has
been given less than 30 calendar days advanced written Notice of Involuntary
Reduction, Transfer, or Exit due to a medical emergency or because the
individual is engaging in behavior that poses an imminent danger to self or
others, and the individual or the individual's representative has requested a
hearing as described in this rule, their provider must continue to provide
services to the individual until receipt of a Final Order.
(8) An individual or the individual's
representative may request an expedited hearing according to OAR
411-318-0025(5)
when:
(a) The request for a hearing is more
than 15 calendar days following the issuance of the Notice of Involuntary
Reduction, Transfer, or Exit and the individual requests to continue to receive
the same services until receipt of the Final Order; or
(b) The individual has been given less than
30 calendar days advanced written Notice of Involuntary Reduction, Transfer, or
Exit, and the individual has not been allowed to remain in the
setting.
Notes
Statutory/Other Authority: ORS 409.050, 427.104, 427.107 & 430.662
Statutes/Other Implemented: ORS 183.411-183.471, 409.010, 427.007, 427.101, 427.104, 427.107, 427.109, 430.215, 430.610 & 430.662
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