"Other Medical" payments are not federally matchable and are
paid out of General Fund dollars. "Other Medical" is to be used for required
medical services for a child in ODHS care and custody by court order or
voluntary placement or custody agreement either in or out of substitute care,
or parents or other adults identified in the child's case record. "Other
Medical" is only to be used if the service is not available through Mental
Health or DMAP as a Medicaid covered service. Payments from "Other Medical" may
be made in the following situations:
(1) Drug and alcohol assessments for persons
not eligible for Title XIX or the Oregon Health Plan.
(2) A one-time emergency medical need for
children in the custody of the Department that have been returned home. This is
limited to children of low-income families not eligible for medical services
through the Department.
(3) Therapy
for Children in Substitute Care, if recommended by a licensed psychiatrist or
psychologist who evaluated the child, and the type of therapy and/or the
therapist recommended is unavailable from the local mental health clinic or
through the CCO in which the child is enrolled. The therapist must be enrolled
with DMAP or, failing that, there must be a signed contract in place prior to
the therapy being provided. Funding availability will be determined by the
District Manager or Designee (who may want to consult with the Medical
Assistance Resource Coordinator to determine that there are no other resources
available for funding).
(4) Medical
care for children in detention. ORS
418.034 mandates payment of the
cost of medical care for the child in detention, including emergency medical
care, if the child is in custody of the ODHS. "Medical care" means emergency
medical care or medical care for a medical condition that existed prior to the
child's being held in a juvenile detention facility or in a local correctional
facility or lockup.
(5) Evaluations
of parents when required by the Department for casework planning to determine
the parents' emotional stability, intellectual capacity, parenting capacity or
maturity. These may include medical, psychiatric, psychological evaluations or
drug and alcohol assessments. This does not include ongoing treatment or
services. Payment from "Other Medical" for the above services will not be made
for parents in permanent planning cases or for parents who are Medicaid
eligible through the Oregon Health Plan (OHP). Evaluations will be reimbursed
at the current established DMAP rates.
(6) Parent/child and/or sibling interaction
evaluations reimbursed at the current established rates.
Notes
Or. Admin. Code
§
413-050-0430
SCF 6-1995, f. 12-22-95,
cert. ef. 1-29-95; SOSCF 40-2001, f. 12-31-01, cert. ef. 1-1-02; CWP 13-2003,
f. & cert. ef. 1-9-03;
CWP
13-2024, amend filed 05/08/2024, effective
5/10/2024
Statutory/Other Authority: ORS
418.005 &
409.050
Statutes/Other Implemented: ORS
418.005 & Title
XIX
