For the purpose of this rule, "supervisor" means an employee of
a CME who provides management level oversight of an assessor and is trained and
qualified to conduct an Oregon Needs Assessment (ONA) according to OAR chapter
411, division 425.
(1) An ONA must be
conducted according to the standards described in OAR chapter 411, division
425.
(2) A Case Management Entity
(CME) must assure an individual has an initial ONA from an assessor or
supervisor prior to receiving Community First Choice state plan or waiver
services.
(3) The Department may
require an ONA to be completed by an assessor employed or identified by the
Department.
(4) For each individual
who has an authorized Individual Support Plan (ISP), a CME must assure an ONA
is conducted by:
(a) An assessor or
supervisor:
(A) For each individual who has
not had a functional needs assessment using the ONA when a functional needs
assessment or Intermediate Care Facility for Individuals with Intellectual
Disabilities (ICF/IID) Level of Care determination is required.
(B) Any time there may be a significant
change in an individual's support needs.
(C) At a frequency or at specific ages as
determined by the Department.
(D)
Upon a request for reassessment by an individual or the individual's legal or
designated representative.
(E) When
a child who has been determined to be eligible for developmental disabilities
services according to OAR
411-320-0080 and is enrolled to
the Medically Involved Children's Program or Medically Fragile Children's
Program and will be turning 18 in the next year and expects to receive
Community First Choice state plan or waiver services as an adult.
(b) A case manager, an assessor,
or a supervisor, when none of the conditions in subsection (a) of this section
are present.
(5) Only a
person who meets the qualification and training requirements for an assessor
described in OAR
411-425-0035 and is employed by
a CME or the Department as a certified assessor may change a response to an
item in an ONA that contributes to any of the scores identified in OAR
411-450-0060(7)(c).
(6) Each individual whose services are
authorized in an ISP must have a completed ONA.
(7) An ONA must be completed:
(a) Not more than 12 months from a previously
completed ONA, ICF/IID Level of Care determination, or functional needs
assessment.
(b) Within 45 calendar
days from the date an individual, or as applicable their legal or designated
representative, requests a new ONA.
(c) Within 45 calendar days from the date the
CME identifies that the support needs of an individual may have changed
significantly, and the change is expected to last at least 90 calendar
days.
(8) No fewer than
14 calendar days prior to conducting an ONA, the CME must mail a notice of the
assessment process to the individual to be assessed. The notice must include a
description and explanation of the assessment process and an explanation of the
process for appealing the results of the assessment.
(9) No fewer than 14 calendar days from the
completion of an ONA for an individual, the CME must inform the individual of
their service group and the hour allocation for in-home services.
(10) An assessment for State Plan Personal
Care must be completed by a case manager as described in OAR chapter 411,
division 455.
Notes
Or. Admin. Code §
411-415-0060
APD
28-2016, f. & cert. ef.
6/29/2016; APD 35-2016(Temp), f.
8-31-16, cert. ef. 9-1-16 thru 2-27-17;
APD
2-2017, f. 2-21-17, cert. ef.
2/28/2017; APD 23-2018, temporary amend filed
07/02/2018, effective 07/02/2018 through 12/27/2018;
APD
46-2018, amend filed 12/28/2018, effective
12/28/2018;
APD
23-2023, amend filed 12/21/2023, effective
1/1/2024
Statutory/Other Authority: ORS
409.050,
427.104,
427.105,
427.115,
427.154,
430.662 &
430.212
Statutes/Other Implemented: 430.662, 427.005-427.154,
430.212, 430.215, 430.610, 430.620, 430.664 & ORS
409.010