Or. Admin. Code § 411-323-0020 - Definitions and Acronyms
In addition to the following definitions, OAR 411-317-0000 includes general definitions for words and terms frequently used in OAR chapter 411, division 323. If a word or term is defined differently in OAR 411-317-0000, the definition in this rule applies.
(1) "Advisory
Letter" means a written notification from the Department that informs an agency
of a violation, or possible violation, and requirements to correct the
violation or offer evidence that there is no violation.
(2) "Agency" means a public or private
community organization that is formed to deliver developmental disabilities
services and is certified and endorsed by the Department under these rules
that:
(a) Is in business to provide supports
for individuals eligible to receive developmental disabilities
services.
(b) Provides supports for
individuals through employees, contractors, or volunteers.
(c) Receives compensation to recruit,
supervise, and pay the people who provides support for the
individuals.
(3) "Agency
Application" is the form required by the Department to apply for Medicaid
certification.
(4) "Applicant"
means:
(a) A person or legal entity who
applies for certification or endorsement to operate an agency delivering
services to individuals with intellectual or developmental
disabilities.
(b) A person with an
ownership interest in, or is identified as the executive director of, an
agency, entity, or governmental unit that applies for certification or
endorsement to deliver program services to individuals with intellectual or
developmental disabilities.
(5) "Audit" means an inspection completed by
a Certified Public Accountant using standards and accepted practices of
accounting.
(6) "Board of
Directors" means the group of people formed to set policy and give directions
to an agency designed to provide services to individuals with intellectual or
developmental disabilities. A board of directors may include local advisory
boards used by multi-state organizations.
(7) "CDDP" means "Community Developmental
Disabilities Program" as defined in OAR
411-317-0000.
(8) "Certificate" means the document issued
by the Department to an agency that certifies the agency is qualified to seek
endorsement to deliver a program service.
(9) "Complete Application" means the
submission of all information and documentation required by the Department to
make a decision to approve or deny a certificate described in OAR
411-323-0030(3)(b)
or endorsement described in OAR
411-323-0030(4)(b).
(10) "Denial" means the refusal, after
submission of an application, by the Department to issue a certificate or
endorsement.
(11) "DOJ MFCU" means
the Oregon Department of Justice, Medicaid Fraud Control Unit.
(12) "Endorsement" means the authorization of
an agency with a current certificate to deliver a program service.
(13) "Executive Director" means the person
designated by the board of directors or entity of an agency that is responsible
for the administration of the services delivered by the agency.
(14) "Informal Conference" means the
discussion between the Department and an applicant or an agency that is held
prior to a hearing to address any matters pertaining to the hearing. An
administrative law judge does not participate in an informal
conference.
(15) "Initial
Application" means an application for a certificate following a period of no
less than twelve months when an applicant did not hold a current
certificate.
(16) "ISP" means
"Individual Support Plan"" as defined in OAR
411-317-0000.
(17) "Managing Employee" means a general
manager, business manager, administrator, director, or other individual who
exercises operational or managerial control over, or who directly or indirectly
conducts the day-to-day operation of an entire organization or agency or the
operations of the agency within Oregon.
(18) "ODDS" means the Oregon Department of
Human Services, Office of Developmental Disabilities Services.
(19) "OTIS" means the Oregon Department of
Human Services, Office of Training, Investigations, and Safety.
(20) "Ownership Interest" means, as defined
in 42 CFR
455.101, the possession of equity in the
capital, the stock, or the profits of the disclosing entity as determined by
42 CFR
455.102.
(21) "Ownership or Control Interest" means a
person or entity that:
(a) Has an ownership
interest totaling 5 percent or more in a disclosing entity;
(b) Has an indirect ownership interest equal
to 5 percent or more in a disclosing entity;
(c) Has a combination of direct and indirect
ownership interests equal to 5 percent or more in a disclosing
entity;
(d) Owns an interest of 5
percent or more in any mortgage, deed of trust, note, or other obligation
secured by the disclosing entity if that interest equals at least 5 percent of
the value of the property or assets of the disclosing entity;
(e) Is an officer or director of a disclosing
entity that is organized as an entity;
(f) Is a partner in a disclosing entity that
is organized as a partnership; or
(g) Is a member of the board of directors of
the disclosing entity.
(22) "Plan of Correction" means a document
developed by an agency that describes the actions the agency will take to
correct violations and specifies the date by which those violations will be
corrected.
(23) "Program Rules"
mean the following rules:
(a) OAR chapter 411,
division 304 for professional behavior services.
(b) OAR chapter 411, division 325 for 24-hour
residential programs and settings.
(c) OAR chapter 411, division 328 for
supported living programs.
(d) OAR
chapter 411, division 345 for employment services.
(e) OAR chapter 411, division 348 for host
home programs and settings.
(f) OAR
chapter 411, division 380 for direct nursing services.
(g) OAR chapter 411, division 450 for
community living supports delivered by a standard model agency as defined in
OAR 411-450-0020.
(h) OAR chapter 411, division 450, excluding
OAR 411-450-0090, for community
living supports delivered by a community living supports agency as defined in
OAR 411-450-0020.
(24) "Program Service" means a
service delivered by an agency as described in:
(a) OAR chapter 411, division 304 for
professional behavior services.
(b)
OAR chapter 411, division 325 for 24-hour residential programs and
settings.
(c) OAR chapter 411,
division 328 for supported living programs.
(d) OAR chapter 411, division 345 for
employment services.
(e) OAR
chapter 411, division 348 for host home programs and settings.
(f) OAR chapter 411, division 380 for direct
nursing services.
(g) OAR chapter
411, division 450 for community living supports delivered by a standard model
agency as defined in OAR
411-450-0020.
(h) OAR chapter 411, division 450, excluding
OAR 411-450-0090, for community
living supports delivered by a community living supports agency as defined in
OAR 411-450-0020.
(25) "Provider Enrollment
Agreement" means the agreement between the Department and a qualified Medicaid
provider to deliver services to a Medicaid eligible individual for
compensation.
(26) "Revocation"
means the action taken by the Department to rescind a certificate or
endorsement in accordance with OAR
411-323-0033(3).
(27) "Serious Incident" is defined in OAR
411-317-0000.
(28) "Serious Violation Letter" means a
written notification from the Department that informs an agency of a violation
which poses a substantial risk to health and safety to any person and the
necessary steps for correcting the violations as determined by the
Department.
(29) "Support Document"
means a written strategy intended to mitigate an identified risk. Support
documents include, but are not limited to, protocols and professional behavior
support plans.
(30) "Suspension"
means an immediate temporary withdrawal of the:
(a) Certificate to operate an agency after
the Department determines that the agency is not in compliance with these rules
or the corresponding program rules; or
(b) Endorsement for an agency to operate a
program after the Department determines that the agency is not in compliance
with these rules or the corresponding program rules.
(31) "These Rules" mean the rules in OAR
chapter 411, division 323.
(32)
"Violation" means a determination by the Department or Oregon Health Authority
that an agency is not in compliance with any of the following:
(a) An Oregon statutory
requirement.
(b) A rule in OAR
chapter 411, division 323.
(c) A
program rule that corresponds to a program service to which an agency is
endorsed.
(d) A federal regulation
applicable to the provision of developmental disabilities services program or
health care services program.
(e)
The Provider Enrollment Agreement.
Notes
Statutory/Other Authority: ORS 409.050, 427.104, 430.662 & SB 1548 (2022 OR Law, Ch. 91)
Statutes/Other Implemented: ORS 409.010, 427.007, 427.104, 430.215, 430.610, 430.662 & SB 1548 (2022 OR Law, Ch. 91)
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