OAR Chapter 418 — Department of Human Services, Home Care Commission

Division 10 PURPOSE AND RULEMAKING

Or. Admin. R. 418-010-0010 Purpose

(1) In accordance with Article XV, Section 11 of the Oregon State Constitution, the Commission ensures the high quality of homecare services by working cooperatively with area agencies and state and local agencies to accomplish the following:

(a) Establish qualifications for homecare and personal support workers with the advice and consent of the Department of Human Services (DHS) and Oregon Health Authority (OHA);

(b) Provide training opportunities for homecare and personal support workers; and seniors and individuals experiencing disabilities who employ homecare or personal support workers;

(d) Provide routine, emergency, and substitute referrals of homecare and personal support workers;

(e) Enter into contracts with public and private organizations and individuals for the purpose to obtain or develop training materials and curriculum or other services as may be needed by the Commission;

(f) Serve as employer of record for collective bargaining with homecare and personal support workers;

(g) Select workers’ compensation coverage on behalf of a senior or individual experiencing disability who hires a homecare or personal support worker through a publicly funded program; and

(h) Train and certify homecare or personal support workers who desire to become certified community health workers or personal health navigators and meet eligibility criteria and ensure Coordinated Care Organizations honor employment terms and conditions of Community Health Workers and Personal Health Navigator established by the Commission.

(2) The rules in Oregon Administrative Rules (OAR) Chapter 418 establish procedures for the Commission to fulfill its mission to ensure high quality, comprehensive homecare services are provided for seniors and individuals with disabilities who receive services from homecare and personal support workers who they hire and are paid with public funds.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.602
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Or. Admin. R. 418-010-0020 Rulemaking

The Commission adopts the Attorney General Model Rules applicable to rulemaking, effective on November 1, 2014, with the exception of 137-001-0080.

History

Statutory/Other Authority: ORS 183.341 & 410.602
Statutes/Other Implemented: ORS 183.341 & 410.602
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Or. Admin. R. 418-010-0030 Notice of Proposed Rulemaking and Adoption of Temporary Rules

(1) Except as provided in ORS 183.335(7), (12), or 183.341, before permanently adopting, amending, or repealing an administrative rule, the Commission shall give notice of the intended action:

(a) To legislators specified in ORS 183.335(15) at least 49 days before the effective date of the rule;

(b) To Individuals in the interested parties lists described in section (2) of this rule for the pertinent OAR chapter or pertinent subtopics or programs within an OAR chapter at least 28 days before the effective date of the rule;

(c) In the Secretary of State's Bulletin referred to in ORS 183.360 at least 21 days before the effective date of the rule;

(d) To other individuals, agencies, or organizations the Commission is required to provide an opportunity to comment pursuant to state statute or federal law or as a requirement of receiving federal funding, at least 28 days before the effective date of the rule;

(e) To the Associated Press and the Capitol Press Room at least 28 days before the effective date of the rule; and

(f) In addition to the above, the Commission may send notice of intended action to other individuals, agencies, or organizations the Commission, in its discretion, believes to have an interest in the subject matter of the proposed rule at least 28 days before the effective date of the rule.

(2) Pursuant to ORS 183.335(8), the Commission shall maintain an interested parties list for each OAR chapter of rules for which the Commission has administrative responsibility, and an interested parties list for subtopics or programs within those chapters. An individual, group, or entity that desires to be placed on such a list to receive notices regarding proposed permanent adoption, amendment, or repeal of a rule must make such a request in writing or by electronic mail to the rules coordinator for the chapter. The request must include either a mailing address or an electronic mail address to which notices may be sent, if requested.

(3) Notices under this rule may be sent by use of hand delivery, state shuttle, postal mail, electronic mail, or facsimile. The Commission recognizes state shuttle as mail and may use this means to notify other state agencies. An email notification under section (1) of this rule may consist of any of the following:

(a) An email that attaches the Notice of Proposed Rulemaking or Notice of Proposed Rulemaking Hearing and Statement of Need and Fiscal Impact.

(b) An email that includes a link within the body of the email, allowing direct access online to the Notice of Proposed Rulemaking or Notice of Proposed Rulemaking Hearing and Statement of Need and Fiscal Impact.

(c) An email with specific instructions within the body of the email, usually including an electronic Universal Resource Locator (URL) address, to find the Notice of Proposed Rulemaking or Notice of Proposed Rulemaking Hearing and Statement of Need and Fiscal Impact.

(d) The Commission may use facsimile as an added means of notification, if necessary. Notification by facsimile under section (1) of this rule shall include the Notice of Proposed Rulemaking or Notice of Proposed Rulemaking Hearing and Statement of Need and Fiscal Impact, or specific instructions to locate these documents online.

(e) The Commission shall honor all written requests that notification be sent by postal mail instead of electronically if a mailing address is provided.

(4) If the Commission adopts or suspends a temporary rule, the Commission shall notify:

(a) Legislators specified in ORS 183.335(15);

(b) Individuals on the interested parties list described in section (2) of this rule for the pertinent OAR chapter or pertinent subtopics or programs within an OAR chapter;

(c) Other individuals, agencies, or organizations the Commission is required to notify pursuant to state statute or federal law or as a requirement of receiving federal funding;

(d) The Associated Press and the Capitol Press Room;

(e) In addition to the above, the Commission may send notice to other persons, agencies, or organizations the Commission, in its discretion, believes to have an interest in the subject matter of the temporary rulemaking; and

(f) In lieu of providing a copy of the rule or rules as proposed with the notice of intended action or notice concerning the adoption of a temporary rule, the Commission may state how and where a copy may be obtained on paper, by electronic mail, or from a specified web site.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 183.330, 183.335, 183.341 & 410.602
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Or. Admin. R. 418-010-0040 Delegation of Rulemaking Authority

Any member or employee of the Commission who is identified on a completed Delegation of Authority form signed by the Executive Director or Chair of the Commission and filed with the Secretary of State, Administrative Rules Unit, is vested with the authority to adopt, amend, repeal, or suspend administrative rules as provided on that form until such delegation is revoked by the Executive Director or Chair of the Commission, or the person leaves employment with the Commission.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 183.325 & 410.602
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Division 20 OREGON HOME CARE COMMISSION FUNCTIONS

Or. Admin. R. 418-020-0010 Definitions

(1) "Active" means an active homecare, personal support worker, or personal care attendant who has:

(a) A current provider number;

(b) Worked and been paid with public funds in any of the past 12 months as a homecare or personal support worker or personal care attendant;

(d) Met the orientation and core training requirements of the program for which the provider is enrolled.

(2) "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 term is 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.

(3) "Assessment" means a tool used to evaluate a provider’s knowledge of information learned during trainings required for Oregon Home Care Commission certifications as described in OAR 418-020-0030(3)(b) through (f).

(4) "Background Check" means a criminal records check and abuse check under OAR chapter 407, division 7.

(5) "Case Management Entity" has the meaning as defined in OAR 411-317-0000.

(6) "Case Manager" means an employee of a service delivery office who is responsible for determining service eligibility, offering service choices to eligible individuals, developing a plan of authorized services, and monitoring the effectiveness of services and supports. This term includes service coordinators and personal agents, as described in OAR chapter 411, division 317.

(7) "CMS' Core Competencies" means the set of 12 core competencies developed by the Center for Medicare and Medicaid Services (CMS) for the direct care workforce. The 12 competencies are found in Appendix E of the "The Roadmap of Core Competencies for the Direct Services Workforce" published at: https://www.medicaid.gov/sites/default/files/2019-12/dsw-core-competencies-final-set-2014.pdf.

(8) "Collective Bargaining Agreement" or "CBA" means the ratified Collective Bargaining Agreement between the Oregon Home Care Commission and the Service Employees International Union, Local 503. The Collective Bargaining Agreement is maintained on the Commission’s website at: https://www.oregon.gov/odhs/providers-partners/homecare-workforce/Pages/default.aspx.

(9) "Commission" means the Oregon Home Care Commission established and operated pursuant to Article XV, Section 11, of the Oregon Constitution, and ORS 410.595 to 410.625.

(10) "Commissioner" means one of the nine members of the Home Care Commission appointed by the Governor and confirmed by the Senate as provided in ORS 171.562 and 171.565. Five members are either older adults or individuals with disabilities who are receiving or who have received homecare services. One member is appointed to represent each of the following entities, or a successor entity, for as long as a comparable entity exists:

(a) Governor's Commission on Senior Services.

(b) Oregon Department of Human Services.

(d) Oregon Association of Area Agencies on Aging and Disabilities.

(11) "Common Law Employer" means the employer of record responsible for the duties described in OAR 411-375-0055.

(12) "Community Health Worker" means an individual, as defined in ORS 414.025, who assists members of the community to improve their health and increase the capacity of the community to achieve wellness and meet the health care needs of its residents.

(13) "Competency Evaluation" means a tool to measure a provider’s mastery of the information learned during orientation and mandatory trainings.

(14) "Consumer" or "Consumer-Employer" means an individual eligible for in-home and community-based services.

(15) "Consumer-Employer Training Services" means activities described in OAR 411-035-0090 that empower and inform consumer-employers, authorized representatives of consumer-employers, or a consumer's common law employer regarding their rights, roles, and responsibilities as employers of homecare or personal support workers or personal care attendants. The consumer-employer training services program is known as Employer Resource Connection.

(16) "Consumer Authorized Representative" means an individual assigned by a consumer, or designated by a consumer's legal representative, to act as the consumer's decision-maker in matters pertaining to planning and implementing an in-home service plan or individual support plan.

(17) "Continuing Education" means Commission approved training mandated on an ongoing basis. Continuing education is separate from orientation or core training.

(18) "Core Training" means the mandated training, or series of trainings, required for providers.

(19) "Credential" means time-limited approval by ODHS or OHA for an individual to provide services as a provider, which includes a start date, designated by a service delivery office, no earlier than the individual's most recent background check and signed provider enrollment agreement, and an end date no later than 24 months from the provider’s most recent background check. This is also referred to as an approved to work credential.

(20) "Cultural Competency" is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals to enable effective work in cross-cultural situations.

(21) "Department" or "ODHS" means the Oregon Department of Human Services.

(22) "Enrolled" means an individual has met the initial enrollment requirements to become a Medicaid approved homecare or personal support worker or personal care attendant and has been issued a provider number.

(23) "Enrollment Agreement" means the program-specific document a person must complete to be approved to provide services as a provider.

(24) "Enhanced Homecare Worker" means a homecare worker, as defined in these rules, who is certified by the Commission to provide medically-driven services and supports, as defined in OAR 411-031-0020 to consumers who have been assessed by a case manager as needing the services and supports.

(25) "Enhanced Personal Support Worker" means a personal support worker, as defined in these rules, who is certified by the Commission to provide services to consumers who require advanced medically-driven services and supports as defined in OAR 411-375-0010 or behaviorally-driven services and supports as defined in OAR 411-375-0010 and identified through a functional needs assessment.

(26) "Exceptional Homecare Worker" means a homecare worker, as defined in these rules, who is certified by the Commission to provide services for consumer-employers whose service plan indicates the need for awake staff at least 16 hours a day and who have exceptional behavioral needs as defined in OAR 411-031-0020(27), as assessed by a case manager as needing the services and supports.

(27) "Exceptional Personal Support Worker" means a personal support worker, as defined in these rules, who is certified by the Commission to provide services for consumers who require staff to be awake more than 20 hours in a 24-hour period and who require extensive medically-driven services and supports as defined in OAR 411-375-0010 or behaviorally-driven services and supports as defined in OAR 411-375-0010, beyond the enhanced services provided by an enhanced personal support worker, as assessed by a functional needs assessment.

(28) "Functional Needs Assessment" means the comprehensive assessment tool defined in OAR 411-317-0000.

(29) "Grievance" means a formal allegation of acts, omissions, applications, or interpretations that are believed to be violations of the terms or conditions of the Collective Bargaining Agreement.

(30) "Homecare Worker" means a provider, as defined and described in OAR chapter 411, division 31, who is directly employed by a consumer or a consumer's authorized representative, to provide hourly services to the consumer.

(31) "Incumbent Worker" means a person who enrolled as a provider prior to September 1, 2021.

(32) "Independent Choices Program" means the program described in OAR chapter 411, division 30, which is a self-directed in-home services program where a participant is given a cash benefit to purchase goods and services that are identified in the participant's service plan and prior approved by Aging and People with Disabilities (APD) or an AAA.

(33) "Individual" means an older adult, an adult with a disability, or a child with a disability applying for or eligible for services. The term "individual" is synonymous with "client" and "consumer".

(34) "Individual Support Plan" or "ISP" means the plan defined in OAR 411-317-0000.

(35) "Mastery" means a provider has achieved the specific learning objectives of a training.

(36) "OHA" means the Oregon Health Authority.

(37) "Oregon Intervention System Certification" or "OIS" certification means a system of training to people who work with designated individuals to provide elements of positive behavioral support and non-aversive behavioral intervention.

(38) "Orientation" means a mandatory Commission-approved presentation for providers that provides essential information required to provide safe and person-centered services and supports and comply with applicable program rules.

(39) “Personal Care Attendant” means a provider enrolled by OHA who is hired to provide personal care services to an individual with a behavioral health condition or disability who resides in their own home.

(40) "Personal Support Worker" means, for the purpose of these rules, a provider enrolled by ODHS who is hired or selected by an individual with a developmental disability, their designated common law employer, or proxy to provide services in the individual’s home and community.

(41) "Program" means a program governed by Oregon Administrative Rules and administered by ODHS or OHA that authorizes services provided through public funding in an individual's home or in the community.

(42) "Provider" means a homecare or personal support worker or personal care attendant who is eligible to be hired by a consumer-employer, a consumer's authorized representative, or the consumer's common law employer, to provide services authorized in the consumer's service plan in the individual's home or in the community.

(43) "Provider Number" means an identifying number issued to each homecare and personal support worker or personal care attendant who is enrolled as a provider through ODHS or OHA.

(44) "Refresher training" means a 12-hour course for incumbent workers that educates providers on the core competencies.

(45) "Registry" means an online tool approved by the Commission and used exclusively to match qualified Medicaid enrolled providers available for work with individuals receiving in-home services through APD, ODDS, or OHA-HSD who are seeking to hire providers.

(46) "Respite Worker" means a paid provider who provides services in place of a family caregiver or other member of a consumer's natural support system who typically provides unpaid services.

(47) "Restricted Provider Number" means a number assigned by ODHS or OHA to a provider who has restrictions placed on the worker's provider enrollment.

(48) "Service Delivery Office" means an APD or AAA office, case management entity, or Community Mental Health Program office that is responsible for case management and authorization of publicly funded services provided by providers.

(49) "Service Plan" means a written plan of authorized services provided in an individual's home or in the community, developed in accordance with ODHS or OHA rules and policies, or an Individual Support Plan.

(50) "State Plan Personal Care Services" means the assistance with personal care and supportive services provided for an individual by a provider.

(51) "Stipend" means an amount of money granted to a provider in accordance with Commission requirements described in OAR 418-020-0030(1)(b).

(52) "Substitute Worker" means a provider who provides services in place of a provider who is unavailable.

(53) "These Rules" mean the rules in OAR chapter 418, division 20.

(54) "Worker" means a "Homecare Worker," "Personal Support Worker," or “Personal Care Attendant.”

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.600, 410.603, 410.605, 410.606, 410.608 & 410.612
HCC 1-2024, amend filed 01/24/2024, effective 02/01/2024
HCC 2-2022, amend filed 10/12/2022, effective 10/14/2022
HCC 1-2020, amend filed 12/18/2020, effective 01/01/2021
HCC 1-2019, amend filed 06/21/2019, effective 07/01/2019
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Or. Admin. R. 418-020-0020 Qualifications for Homecare and Personal Support Workers and Personal Care Attendants

(1) Minimum Qualifications.

(a) Submit a complete application and provider enrollment agreement.

(b) Pass an ODHS background check and cooperate with a recheck every two years or when requested.

(c) Be capable of performing essential functions to safely provide necessary services or be capable of learning essential functions to safely provide necessary services.

(d) Be 18 years of age or older.

(e) Attend orientation.

(f) Complete mandated core training within specified timelines.

(g) Complete and pass mandated orientation and core training competency evaluations.

(h) Complete mandated continuing education within the specified timelines.

(i) Meet applicable provider enrollment requirements outlined in OAR chapter 411, division 31 (homecare workers), OAR chapter 411, division 375 (personal support workers), or OAR chapter 410, division 172 (personal care attendants).

(2) Provider Orientation. Orientation must:

(a) Occur on a frequent basis to prevent delays in a provider’s enrollment or continued employment as a provider.

(b) Include a presentation and materials created or approved by the Commission and ODHS or OHA.

(A) Abuse and mandatory reporting.

(B) Confidentiality.

(D) Medication safety.

(E) Preventing Medicaid fraud.

(F) Providing person-centered services.

(G) Universal precautions and infection control.

(H) Provider requirements, roles, and responsibilities.

(I) Other information ODHS or the Commission deems appropriate for the professionalization of the provider workforce.

(J) The Commission reserves the right to remove training topics listed in OAR 418-020-0020(3)(c)(A) through (I) if it is deemed necessary.

(d) Be culturally-appropriate for applicants of all language abilities.

(A) If orientation is not available in the applicant’s preferred language, interpreter services shall be made available.

(B) Orientation presentation and materials shall be culturally appropriate and accessible to applicants in their preferred language. Reasonable efforts shall be made to accommodate language requests when there is adequate demand for the presentation and materials in the preferred language.

(e) Provide reasonable accommodations in accordance with Title II of the Americans with Disabilities Act for applicants who experience a disability.

(f) Allow the Union to make presentations to potential members at orientations, at a mutually agreeable time, in accordance with the current collective bargaining agreement.

(g) Effective September 1, 2021, an applicant is required to complete a minimum of a four-hour orientation, or online equivalency, and pass a competency evaluation prior to the issuance of a provider number and shall not be authorized to work until complete.

(A) An applicant may be granted an exception to begin working prior to attending orientation and passing a competency evaluation under the following circumstances:

(i) The applicant is selected by a specific consumer-employer or common law employer and the applicant's delayed enrollment poses an immediate risk to the individual's health and safety;

(ii) Orientation is not readily accessible; and

(iii) The applicant has met the enrollment criteria described in OAR 418-020-0020(1)(a) through (i).

(B) Requests for exceptions shall be submitted to the Oregon Home Care Commission by the local APD or AAA service delivery office or case management entity for approval.

(i) The Commission shall approve or deny the request within one business day.

(ii) If an exception is approved by the Oregon Home Care Commission, the provider shall attend orientation within 120 days of enrollment. Providers who fail to attend orientation within the specified timeline shall not be authorized to work.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.603, 410.604 & OL 2018 ch. 75
HCC 2-2022, amend filed 10/12/2022, effective 10/14/2022
HCC 1-2020, amend filed 12/18/2020, effective 01/01/2021
HCC 1-2019, amend filed 06/21/2019, effective 07/01/2019
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Or. Admin. R. 418-020-0030 Provider Training

(1) Training is offered by the Commission to providers statewide to enhance provider skills and cultural competence, as well as the quality of services provided to consumer-employers in their home or in the community.

(a) Training is provided without charge to providers, consumer-employers, consumer-representatives, appropriate service delivery staff, and the staff of adult foster homes licensed under OAR chapter 411, division 50.

(b) Stipends for actual hours in attendance at Commission-sponsored classes may be available to providers who have provided publicly funded services in any of the three months before training or during the month of the training. The Commission determines:

(A) The amount of a stipend and may provide a stipend for each eligible class once in a 12-month period.

(B) Which classes are approved for stipends for providers.

(2) Public Availability of Training. When classes are not filled, members of the public may attend, after registering and paying training fees determined by the Commission. Members of the public are not eligible for stipends.

(3) Certifications for Providers.

(a) Cardio Pulmonary Resuscitation (CPR) and First Aid Certification:

(A) The Commission pays for CPR and First Aid training for active providers who meet the qualifications established by the Commission.

(B) Providers must submit a written request to the Commission for authorization to attend CPR and First Aid training paid for by the Commission.

(D) For a CPR and First Aid Certification to apply towards any of the OHCC Certifications or the CPR and First Aid pay differential, the certification must come from an accredited program with a demonstration of skills.

(E) Providers are responsible for tracking their CPR and First Aid end date and ensure the renewal is completed timely.

(b) Professional Development Certification. To be eligible for Professional Development Certification, providers must:

(A) Have an active, unrestricted provider number.

(B) Complete core, safety, and elective training classes and pass training specific assessments.

(C) Have a current Adult CPR and First Aid Certification that includes a demonstration of skills prior to and throughout the certification period.

(D) Submit an application.

(E) Certification may be renewed by completing the requirements found in OAR 418-020-0030(3)(b)(A) through (D) between the 13th and 24th month of the certification period.

(F) Providers who have an unexpired Oregon Certified Nursing Assistant (CNA) certification, and provide proof of certification, may substitute their CNA certification in place of the safety-type and elective courses and corresponding assessments required for the initial professional development certification process. Providers with a CNA certification must meet the requirements in OAR 418-020-0030(3)(b)(E) to renew their professional development certification.

(A) To be certified as an enhanced homecare worker, a homecare worker must:

(i) Have an active, unrestricted provider number.

(ii) Have and maintain a current CPR and First Aid Certification that includes a demonstration of skills.

(iii) Meet one of the following criteria:

(I) Have a Professional Development Certification.

(II) Complete a Readiness Assessment.

(iv) Submit an application.

(v) Once accepted, successfully complete enhanced homecare worker coursework and assessments.

(B) Enhanced homecare workers are eligible for an enhanced hourly service payment rate only when providing services for a consumer-employer assessed by ODHS as having enhanced needs.

(i) Maintain an active homecare worker credential and current Adult CPR and First Aid Certification that includes a demonstration of skills.

(ii) Complete required enhanced certification courses before the end of the 24-month certification period.

(d) Enhanced Personal Support Worker Certification.

(A) To be certified as an enhanced personal support worker, a personal support worker must:

(i) Have an active, unrestricted provider number.

(ii) Have and maintain a current CPR and First Aid Certification that includes a demonstration of skills.

(iii) Meet one of the following criteria:

(I) Have a Professional Development Certification.

(II) Complete a Readiness Assessment.

(III) Currently work for a consumer transitioning out of the CIIS program.

(iv) Submit an application.

(v) Once accepted, successfully complete enhanced personal support worker coursework and pass assessments.

(B) Enhanced personal support workers are eligible for an enhanced hourly service payment rate only when providing services for a consumer-employer assessed by a case management entity as having enhanced needs.

(i) Maintain an active personal support worker credential and current CPR and First Aid Certification that includes a demonstration of skills.

(ii) Complete required enhanced certification courses before the end of the 24-month certification period.

(e) Exceptional Homecare Worker Certification:

(A) To be certified as an exceptional homecare worker, a homecare worker must:

(i) Successfully complete required exceptional homecare worker coursework and pass course assessments.

(ii) Have and maintain a CPR and First Aid Certification that includes a demonstration of skills.

(B) For ongoing exceptional homecare worker certification, a homecare worker must:

(i) Maintain an active homecare worker credential.

(ii) Complete requirements for recertification before the end of the 24-month certification period.

(iii) Maintain a CPR and First Aid Certification that includes a demonstration of skills.

(C) Exceptional homecare workers are eligible for an exceptional service payment rate only when providing services for a consumer-employer assessed by a case management entity as having exceptional needs.

(f) Exceptional Personal Support Worker Certification:

(A) To be certified as an exceptional personal support worker, a personal support worker must:

(i) Have and maintain a valid enhanced personal support worker certification as described in this rule.

(ii) Submit an application.

(iii) Have a current Oregon Intervention System general or parent level certification, as appropriate.

(iv) If accepted, complete required exceptional personal support worker coursework and pass course assessments.

(B) For ongoing exceptional personal support worker certification, a personal support worker must:

(i) Maintain an active personal support worker credential, CPR and First Aid Certification that includes a demonstration of skills, and Oregon Intervention System certification.

(ii) Complete requirements for recertification before the end of the 24-month certification period.

(C) Exceptional personal support workers are eligible for an exceptional service payment rate only when providing services for a consumer-employer assessed by a case management entity as having exceptional needs.

(g) Community Health Worker Certification:

(A) To be certified as a community health worker, a provider worker must:

(i) Have an active, unrestricted provider number.

(ii) Have a current professional development certification.

(iii) Have and maintain a current CPR and First Aid Certification that includes a demonstration of skills.

(iv) Submit an application.

(v) Complete required community health worker certification courses.

(B) For ongoing community health worker certification, a provider must:

(i) Maintain an active provider credential and have a current CPR and First Aid Certification that includes a demonstration of skills.

(ii) Complete 20 hours of required training approved by the Commission within the 24-month certification period.

(iii) Have and maintain professional development certification.

(h) Ventilator Dependent Quadriplegia Certification.

(A) This certification is available to homecare workers. To obtain ventilator dependent quadriplegia certification, a homecare worker must:

(i) Have an active, unrestricted provider number.

(ii) Have and maintain a current CPR and First Aid Certification that includes a demonstration of skills.

(iii) Once accepted, successfully complete all ventilator dependent quadriplegia certification coursework.

(B) Homecare workers with ventilator dependent quadriplegia certification are eligible for an hourly service payment rate only when providing services for a consumer-employer assessed by ODHS as having ventilator dependent quadriplegia needs.

(i) Maintain an active homecare worker credential and current Adult CPR and First Aid Certification that includes a demonstration of skills.

(ii) Complete required ventilator dependent quadriplegia certification courses between the 13th and 24th month of the certification period.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.603, 410.604, 410.625 & OL 2018 ch. 75
HCC 1-2024, amend filed 01/24/2024, effective 02/01/2024
HCC 2-2022, amend filed 10/12/2022, effective 10/14/2022
HCC 1-2019, amend filed 06/21/2019, effective 07/01/2019
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Or. Admin. R. 418-020-0035 Mandatory Training and Competency Evaluations - Effective 9/1/2021

(1) Training curriculum shall be reviewed and approved by the Commission prior to use at mandatory training.

(2) Mandatory training shall be geographically accessible in all areas of the state.

(3) Mandatory training shall be culturally appropriate for providers of all language abilities.

(a) If a training is not available in the provider’s preferred language, interpreter services shall be made available.

(b) Training materials shall be culturally appropriate and accessible to providers in their preferred language. Reasonable efforts shall be made to accommodate language requests when there is adequate demand for the materials in the preferred language.

(c) Reasonable accommodations shall be provided in accordance with Title II of the Americans with Disabilities Act for providers who experience a disability.

(4) Mandatory core training.

(a) Effective September 1, 2021, providers are required to complete eight hours of core training within 120 days of enrolling as a Medicaid provider.

(b) Providers are exempt from 418-020-0035(4)(a) if they have a current certification awarded by the Commission as described in 418-020-0030(3) and continue to meet the on-going certification requirements.

(A) Safety and emergency measures.

(B) Understanding requirements for providers paid with Medicaid funds.

(D) Understanding how to support the physical and emotional needs of the individual receiving services.

(E) Managing medications.

(F) Providing personal care and assistance with activities of daily living.

(d) In addition to the core training topics described in OAR 418-020-0035(4)(c)(A) through (F), ODHS and the Commission may establish other training topics deemed appropriate for the professionalization of this workforce.

(5) Continuing education.

(a) Providers with an approved to work end date of March 1, 2026, or later, are required to complete 12 hours of continuing education by the end of the provider’s 24-month approved to work credential on an ongoing basis.

(b) Providers are exempt from 418-020-0035(5)(a) if they have a current certification awarded by the Commission as described in 418-020-0030(3) and continue to meet the on-going certification requirements.

(d) Providers who complete continuing education courses between April 1, 2023, and March 1, 2026, will receive training credit toward the initial continuing education requirements in 418-020-0035(5)(a).

(6) Orientation and core training competency evaluations.

(a) Competency evaluations shall be based on the CMS Direct Service Workforce Core Competencies.

(b) Competency evaluations shall measure a provider’s mastery of the skills and knowledge acquired through training.

(c) Providers enrolled on or after September 1, 2021, shall complete competency evaluations after the completion of orientation and core training.

(d) Providers enrolled on or after September 1, 2021, must pass competency evaluations to receive credit for completing orientation and core training.

(e) Competency evaluations shall be available in a manner that accommodates a provider’s literacy skills and preferred language.

(f) The methodology and standards used for competency evaluations must be reviewed and approved by the Oregon Home Care Commission.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.603, 410.604, 410.625 & OL 2018 ch. 75
HCC 1-2024, amend filed 01/24/2024, effective 02/01/2024
HCC 1-2023, temporary amend filed 08/22/2023, effective 08/25/2023 through 02/20/2024
HCC 2-2022, amend filed 10/12/2022, effective 10/14/2022
HCC 1-2022, temporary amend filed 04/22/2022, effective 04/22/2022 through 10/18/2022
HCC 1-2020, amend filed 12/18/2020, effective 01/01/2021
HCC 1-2019, adopt filed 06/21/2019, effective 07/01/2019

Or. Admin. R. 418-020-0040 Consumer-Employer Training Services

The Commission offers voluntary training services to consumer-employers, consumers' authorized representatives, and consumers' common law employers on how to manage employer responsibilities. These services are referred to as Employer Resource Connection.

(1) To be eligible for the consumer-employer training program, an individual must be receiving Medicaid funded in-home services through DHS or OHA or services through the Oregon Project Independence program. An individual's authorized representative or common law employer is eligible to receive consumer-employer training services.

(2) Consumer-employer training services are provided by individuals or entities under contract with the Commission and meet the qualifications described in OAR 411-035-0095.

(3) Services are designed to meet consumer-employer needs and are provided in a culturally competent manner. Consumer-employer training is based on the needs and preferences of the consumer-employer and topics are related to the employer responsibilities described in OAR 411-030-0040(4)(a) and OAR 411-375-0055(5)(b).

(4) Consumer-employer training services shall meet the requirements outlined in OAR 411-035-0090.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.603, 410.604
HCC 1-2019, amend filed 06/21/2019, effective 07/01/2019
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Or. Admin. R. 418-020-0050 Registry

The Commission approves the use of an online matching system of qualified and active providers to provide routine, emergency, and substitute referrals to consumer-employers.

(1) Service Delivery Office Responsibilities. Staff will provide information about the matching system to new consumer-employers upon their being approved and set up for services and supports.

(2) Service delivery staff may refer consumer-employers, consumers' authorized representatives, or consumers' common law employers needing assistance with using the online matching system to the Employer Resource Connection consumer training services program for additional help.

(3) Referral Requirements. For a provider’s name to appear in the matching system, a provider must have an active, unrestricted provider number. It is strongly encouraged that a provider also:

(a) Maintain a complete, accurate profile.

(b) Have a working telephone number and email address.

(d) Update changes to availability, telephone number, or other information when changes occur.

(4) Appropriate Use. The purpose of the matching system is for individual consumer-employers, or persons authorized to act on behalf of consumers to find qualified providers.

(5) Inappropriate Employer Use. Employer profiles or help wanted advertisements placed for purposes other than for individual searches as described in this rule are not authorized.

(6) Inappropriate Use by Providers. Providers may not use the matching system for purposes other than its intended use. Providers may not:

(a) Use the matching system to refer other providers or contact other providers.

(b) Use the Commission's name on business cards or other promotional materials.

(c) Represent themselves in print, electronic, or social media as employees of the Commission, ODHS, OHA, or any service delivery office.

(7) Violations of OAR 418-020-0050(6) by providers shall be investigated by the Commission.

(a) Sanctions may be imposed for non-compliance with these rules. Depending on severity and recurrence of violation, a sanction may include one or more of the following actions:

(A) Written warning.

(B) Suspension of availability for referral on the matching system for a prescribed period.

(D) The requirement to attend Commission-sponsored trainings.

(b) Depending on the severity of allegations of misconduct or inappropriate use, the Commission may suspend availability for referral during investigation.

(c) Notice of Sanction. If the Commission imposes a sanction, the Commission shall attempt to serve a notice of sanction upon the provider by regular mail based on the last contact information provided by the provider, or, if requested by the recipient of the notice, by electronic mail. The Notice of Sanction shall comply with OAR chapter 137, division 3 and OAR chapter 411, division 1, as applicable.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.603, 410.604 & 410.606
HCC 1-2024, amend filed 01/24/2024, effective 02/01/2024
HCC 2-2022, amend filed 10/12/2022, effective 10/14/2022
HCC 1-2019, amend filed 06/21/2019, effective 07/01/2019
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Or. Admin. R. 418-020-0060 Workers’ Compensation

(1) The Commission elects workers' compensation coverage on behalf of consumer-employers who employ providers.

(2) Consumer-employers and consumer representatives must:

(a) Sign required documents for a provider to receive workers' compensation coverage.

(b) Report provider injuries to the Commission as soon as becoming aware of a provider’s injury.

(3) Service delivery office staff shall:

(a) Collect from each consumer-employer, at time of eligibility for services, appropriate signed workers' compensation documents.

(b) Report injuries immediately to the Commission.

(c) Respond to requests for information from the Commission and workers' compensation carrier when providers report injuries and when claims are filed.

(4) The Commission shall:

(a) Assist providers who are injured while performing service plan authorized tasks with filing claims.

(b) Work as the agent of consumer-employers while providing information to the insurance carrier's claims adjusters, attorneys, return-to-work specialists, and vocational rehabilitation administrators.

(5) Providers injured while providing authorized services must:

(a) Report work injuries as soon as becoming aware of injuries to the:

(A) Consumer-employer, consumer's authorized representative, or the consumer's common law employer;

(B) Case manager; and

(b) Cooperate with the Commission and workers' compensation carrier by providing all required documents and returning phone calls timely.

(c) Keep the consumer-employer, consumer-representative, or consumer's common law employer informed regarding work restrictions resulting from injuries at work, medical appointments, and return to work dates.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.606, 410.625 & 656.039
HCC 2-2022, amend filed 10/12/2022, effective 10/14/2022
HCC 1-2019, amend filed 06/21/2019, effective 07/01/2019
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Division 30 PUBLIC CONTRACTING AND PROCUREMENT

Or. Admin. R. 418-030-0000 Application

The rules contained in OAR chapter 418, division 30 govern the public contracting of the Oregon Home Care Commission. In addition to these rules, the Commission is subject to ORS Chapters 279A, 279B and 279C.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.604 & 410.625
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Or. Admin. R. 418-030-0010 Procurement Authority

(1) The Commission may:

(a) Enter into contracts with public and private organizations and individuals for the purpose of obtaining or developing training materials and curriculum or other services as may be needed by the Commission;

(b) Contract for services, lease, acquire, hold, own, encumber, insure, sell, replace, deal in and with, and dispose of real and personal property in its own name; and

(c) Enter into an interagency agreement or contract with any state agency for the performance of the Commission's duties or the leasing of office space.

(2) The Commission delegates to the executive director the authority to act on behalf of the Commission to carry out its duties and responsibilities, including but not limited to, entering into contracts or agreements.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 279A.065, 279A.070, 410.604 & 410.625
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Or. Admin. R. 418-030-0020 Adoption of Oregon Health Authority Rules

The Oregon Home Care Commission adopts the rules in OAR chapter 943, division 60, except for rules and definitions which are not applicable to the work of the Commission authorized in ORS 410.595–410.625 as follows:

(1) Each instance of “Oregon Health Authority” or “Authority” means “Oregon Home Care Commission” or “Commission.”

(2) The following rules, and subparts thereof, are not applicable:

(a) 943-060-0010, definitions (2)(a) and (c), (3)(a) through (o), and (8);

(b) 943-060-0020;

(d) 943-0060-0080;

(e) 943-060-0090; and

(f) 943-060-0110(1), (11), and (12).

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.604 & 410.625
HCC 1-2014, f. 11-26-14, cert. ef. 12-1-14

Division 40 HOMECARE CHOICE PROGRAM

Or. Admin. R. 418-040-0000 Purpose

The rules in OAR chapter 418, division 40 establish the rules for the Homecare Choice Program administered by the Oregon Home Care Commission. The purpose of the program is to provide private pay individuals with access to the Commission's statewide Registry to hire employees to provide in-home services and to assist participants in meeting the legal responsibilities of being a household employer.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.595-625
HCC 1-2016, f. 6-13-16, cert. ef. 6-20-16
HCC 1-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16

Or. Admin. R. 418-040-0010 Definitions

(1) "Abuse" means "abuse" as defined in OAR 407-045-0260, 411-020-0002, 413-015-0115, and OAR 943-045-0250.

(2) "Active" means a homecare or personal support worker has a current provider number and has worked and been paid with public funds in any of the past 12 months as a homecare or personal support worker.

(3) "Activities of Daily Living (ADLs)" means daily self-care activities such as eating and feeding, dressing, grooming, bathing, personal hygiene, mobility and movement, toileting and elimination, cognitive and emotional support, and communication.

(4) "Background Check" means a criminal records and abuse check conducted in accordance with OAR chapter 407, division 007.

(5) "Chargeback" means a reversal of a credit card charge after an individual successfully disputes a program charge on his or her credit card.

(6) "Commission" means the Oregon Home Care Commission established and operated pursuant to Article XV, Section 11, of the Oregon Constitution and ORS 410.595 to 410.625.

(7) "Communication" means assistance that enables an individual to communicate with another person.

(8) "Companionship" means engaging a participant in social, physical, and mental activities and includes, but is not limited to, conversation, reading, games, hobbies, crafts, and accompanying the participant during social activities and outings. Companionship also means being present to monitor safety and well-being or to protect an individual who requires assistance in caring for him or herself.

(9) "Continuing Education" means specific minimum education requirements defined by the Commission.

(10) "Credit Card Refund" means a refund of an unused account balance that is credited to the same credit card that originated the payment.

(11) "Department" means the Department of Human Services (DHS).

(12) "Enrollment Agreement" means the program-specific document an individual must complete to be approved to participate in the Homecare Choice Program.

(13) "FICA" is the acronym for the Social Security payroll taxes collected under authority of the Federal Insurance Contributions Act.

(14) "Fiscal Improprieties" means a provider committed financial misconduct involving a participant's money, property, or benefits. Fiscal improprieties include, but are not limited to:

(a) Financial exploitation, as defined in OAR 407-045-0260 and OAR 411-020-0002;

(b) Borrowing money from the participant;

(d) Having a participant purchase items for the provider;

(e) Forging a participant's signature;

(f) Falsifying payment records;

(g) Claiming payment for hours not worked; or

(h) Other similar acts intentionally committed for financial gain.

(15) "Fiscal Intermediary" means an entity that provides fiscal intermediary services that support all programmatic, policy, and financial aspects of the Homecare Choice Program. Fiscal Intermediary services include, but are not limited to, enrollment functions, processing payroll, and paying state and federal taxes on behalf of participants.

(16) "FUTA" is the acronym for Federal Unemployment Tax Assessment, which is a United States payroll (or employment) tax imposed by the federal government on both employees and employers.

(17) "Guardian" means the parent of an individual less than 18 years of age or a person who has been appointed by a court to make personal, health, or other decisions for a functionally incapacitated individual under ORS chapter 125.

(18) "Homecare Choice Provider" means a person who has met the enrollment standards described in OAR 418-040-0040(1)(a)(A)–(N) and is authorized to provide services to program participants.

(19) "Homecare Worker" means a homecare worker as defined in OAR 411-031-0020.

(20) "Imminent Danger" means there is reasonable cause to believe an individual's life or physical, emotional, or financial well-being is in danger if an intervention is not immediately initiated.

(21) "Individual" means a person enrolled as a participant in the Homecare Choice Program. The term "individual" is synonymous with "consumer-employer" and "participant."

(22) "Instrumental Activities of Daily Living" means self-management activities, other than activities of daily living, required by an individual to live independently at home and includes housekeeping, laundry, meal preparation, shopping and errands, transportation, medication assistance, medication reminding, assistance with oxygen, and arranging for medical appointments.

(23) "Medication Assistance" means helping a participant with one or more steps in the process of taking medication including, but not limited to, opening medications containers, helping the participant self-administer his or her own medications, and assisting the participant with one or more steps of medication administration at the participant's direction.

(24) "Medication Reminding" means providing a participant with an audio, visual, or verbal reminder to take his or her medications when a participant is able to direct services.

(25) "Non-Sufficient Fund Fee" means the charge an individual pays if a payment check is denied or is unable to be processed by the individual's banking institution due to lack of sufficient funds to pay the check.

(26) "OHA" means the Oregon Health Authority.

(27) "Orientation" means an introduction to the Homecare Choice Program and a review of basic expectations and requirements for Homecare Choice providers.

(28) "Payment Method" means the financial instrument used to pay for services.

(29) "Personal Support Worker" means a personal support worker as defined in OAR 410-172-0190 and 411-375-0010.

(30) "Prepayment" means the advance payment of two weeks of service hours multiplied by the service rate.

(31) "Program" means the Homecare Choice Program governed by these rules and administered by the Oregon Home Care Commission.

(32) "Program Service Rate" means the hourly rate for homecare services established by the Home Care Commission and charged to Homecare Choice Program participants.

(33) "Provider" means Homecare Choice provider as defined in these rules.

(34) "Provider Number" means an identifying number issued to each homecare and personal support worker enrolled as a provider through DHS or OHA.

(35) "Readiness Assessment" means a tool used to evaluate whether a provider can demonstrate understanding of basic skills and processes determined to be foundational concepts needed to work successfully with participants.

(36) "Refund" means a return of the unused balance of a participant's prepayment.

(37) "Registry" means the Commission's online listing of Homecare Choice providers who are available to work.

(38) "Relief Care" means the temporary provision of services with the primary purpose of relieving the individual's caregiver.

(39) "Representative" means a person designated by a participant, or the participant's legal guardian, who is authorized to assist with the program enrollment process, fulfilling consumer-employer responsibilities, and directing homecare services.

(40) "Self-Assessment" means an assessment tool completed by a Homecare Choice Program participant, or the representative of a participant, to evaluate the capacity and willingness of the participant or the participant's representative, to effectively manage and direct homecare services provided to the participant and to fulfill consumer-employer responsibilities. The self-assessment identifies the participant's need for the specific services that are included in the participant's service plan.

(41) "Service Period" means the 14 consecutive days of each provider pay period.

(42) "Service Plan" means a written document that details a participant's self-identified service needs.

(43) "SUTA" is the acronym for State Unemployment Tax Assessment. State unemployment taxes are paid by employers to finance the unemployment benefit system that exists in each state.

(44) "These Rules" mean the rules in OAR chapter 418, division 040.

(45) "Unacceptable Background Check" means a check that produces information related to the person's background that precludes the person from being a provider in the Homecare Choice Program for the following reasons:

(a) The person applying to be a provider has been disqualified under OAR 407-007-0275;

(b) A background check and fitness determination has been conducted resulting in a "denied" status as defined in OAR 407-007-0210; or

(c) A background check and fitness determination has been conducted resulting in an "approved with restrictions" status as defined in OAR 407-007-0210.

(46) "Work week" means the period of time that begins on 12:00 a.m. on Sunday and ends on 11:59 p.m. Saturday.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.595-625
HCC 1-2016, f. 6-13-16, cert. ef. 6-20-16
HCC 1-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16

Or. Admin. R. 418-040-0020 Participant Eligibility

(1) In order to enroll as a participant in the Homecare Choice Program, an individual, or the individual's representative, must:

(a) Complete a self-assessment developed by the Oregon Home Care Commission.

(b) Enter into a written service plan with a Homecare Choice provider before the commencement of services.

(d) Be able to comply with state and federal wage and tax laws and recordkeeping requirements by completing, submitting, and retaining necessary documents provided by the fiscal intermediary contracted by the Commission.

(e) Complete a Homecare Choice Program enrollment agreement.

(f) Provide information, when requested, for workers' compensation claims related to the individual's provider.

(g) Be able and willing to effectively manage and direct homecare services by performing the functions of an employer, including:

(A) Locating, screening, and hiring a qualified provider.

(B) Evaluating whether the provider has the skills and abilities to meet the individual's specific service needs.

(D) Supervising and training the provider.

(E) Scheduling the providers' work, leave, and coverage.

(F) Tracking the hours worked and validating the authorized hours were completed by the provider.

(G) Recognizing, discussing, and attempting to correct any performance deficiencies with the provider.

(H) Discharging an unsatisfactory provider.

(2) An individual becomes ineligible to participate in the Homecare Choice Program when:

(a) The individual, or individual's representative, fails to pay for services in advance.

(b) The individual, or the individual's representative, fails to maintain an account balance equal to one service period.

(c) The individual, or the individual's representative, is unable or unwilling to effectively manage and direct homecare services by failing to meet the requirements outlined in OAR 418-040-0020(1)(g)(A)–(H).

(d) The individual, or the individual's representative, is unable or unwilling to comply with state and federal wage and tax laws or recordkeeping requirements by failing to complete, submit, and retain necessary documents provided by a fiscal intermediary contracted with the Oregon Home Care Commission.

(e) Dangerous conditions in the individual's service setting jeopardize the health or safety of the individual or provider, and the individual, or the individual's representative, is unable or unwilling to implement necessary safeguards to minimize the dangers.

(f) Services are not able to be provided safely or adequately by the provider based on:

(A) The extent of the participant's service needs; or

(B) The choices or preferences of the participant or the participant's representative.

(3) Participants determined to be ineligible for continued participation in the Homecare Choice Program will be sent written notice 10 days in advance of the proposed action.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.595-625
HCC 1-2016, f. 6-13-16, cert. ef. 6-20-16
HCC 1-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16

Or. Admin. R. 418-040-0030 Services

(1) Services available through the Homecare Choice Program are intended to support a participant in the participant's home and in the community. Services are identified by the participant through a self-assessment developed by the Oregon Home Care Commission.

(2) The program is responsible to review the results of an individual's self- assessment with the participant or the participant's representative and provide information about the scope of services offered through the program, the long-term care services and supports not available through the program, and other community resources that are available to individuals seeking long-term care services and supports.

(3) The service plan is determined by the participant based on the participant's self-assessment and the participant or the participant's representative determines the number of purchased service hours per service period.

(4) Services are performed by providers enrolled in the Homecare Choice Program based on the service plan. Providers are selected by the participant from the Oregon Home Care Commission's Registry.

(5) Services available through the Homecare Choice Program include assistance with:

(a) Activities of Daily Living (ADLs).

(b) Instrumental Activities of Daily Living (IADLs).

(d) Companionship.

(e) Relief Care.

(6) Assistance with tasks related to the following activities are not available through the Homecare Choice Program:

(a) Case management. Case management means an ongoing process that includes:

(A) Assessing a participant's service needs.

(B) Evaluating the options and services required to meet the participant's needs.

(D) Coordinating services and referrals.

(E) Conducting risk assessments.

(F) Monitoring.

(b) Chore services and yard work.

(A) Chore services are services intended to ensure the individual's home is safe and allows for independent living.

(B) Chore services include:

(i) Heavy housecleaning;

(ii) Removal of hazardous debris or dirt from the home or yard; and

(iii) Moving heavy furniture.

(d) Money management.

(e) Moving.

(f) Medical and nursing services.

(g) Purchasing services and supplies, such as home delivered meals, emergency response systems, adaptive equipment, and personal protective equipment.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.595-625
HCC 1-2016, f. 6-13-16, cert. ef. 6-20-16
HCC 1-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16

Or. Admin. R. 418-040-0040 Provider Qualifications

(1) Provider Enrollment:

(a) ENROLLMENT STANDARDS. To be enrolled as a provider in the Homecare Choice Program a provider must meet the following standards:

(A) Submit a completed application and provider enrollment agreement to the Oregon Home Care Commission.

(B) Possess an active, unrestricted homecare or personal support worker provider number issued by DHS or OHA.

(C) Have completed the background check process described in OAR 407-007-0200 to 407-007-0370 as a homecare or personal support worker with an outcome of approved. A background recheck must occur at least every two years or sooner, if requested.

(D) Complete Homecare Choice Program orientation.

(E) Be 18 years of age or older without exception.

(F) Possess a Social Security Number that matches the individual's legal name, as verified by the Internal Revenue Service or Social Security Administration.

(G) Be legally eligible to work in the United States.

(H) Have sufficient communication and language skills to enable him or her to perform duties and interact effectively with participants and Commission staff.

(I) Be capable of performing essential functions to safely provide necessary services or be capable of learning essential functions to safely provide necessary services, as determined by the individual or his or her representative.

(J) Immediately report abuse or suspected abuse to DHS.

(K) Maintain confidentiality and safeguard the participant and the participant's family's information.

(L) Not be listed on the Health and Human Services, Office of Inspector General or the U.S. General Services Administration's Exclusion lists.

(M) Complete and pass an on-line readiness assessment. The readiness assessment includes, but is not limited to, concepts on:

(i) Effective communication skills;

(ii) Professional boundaries;

(iii) Preventing fraud and abuse;

(iv) Problem solving;

(v) Universal precautions and disease prevention;

(vi) Proper body mechanics; and

(vii) Medication safety.

(b) DENIAL OF PROVIDER ENROLLMENT. The Oregon Home Care Commission may deny an application for provider enrollment in the Homecare Choice Program when:

(A) The applicant has a history of violating protective service and abuse rules in OAR chapter 407, division 45, OAR chapter 411 division 20, OAR chapter 413, division 15, or OAR chapter 943, division 45.

(B) The applicant has an unacceptable background check.

(D) The applicant is listed on the Health and Human Services, Office of Inspector General or the U.S. General Services Administration's Exclusion lists.

(E) The applicant has committed fiscal improprieties.

(F) The Oregon Home Care Commission has information that enrolling the applicant as a provider may put vulnerable individuals at risk.

(G) The applicant's Social Security Number does not match the applicant's legal name, as verified by the Internal Revenue Service or Social Security Administration.

(H) The applicant is not capable of performing essential functions to safely provide necessary services or is not capable of learning essential functions to safely provide necessary services.

(I) The applicant does not have sufficient communication and language skill to enable him or her to perform duties and interact effectively with participants and Commission staff.

(J) The applicant does not complete and pass a readiness assessment.

(c) VIOLATIONS RESULTING IN TERMINATION OF PROVIDER ENROLLMENT. The Oregon Home Care Commission may terminate a provider enrolled in the Homecare Choice Program in the following circumstances:

(A) The provider's enrollment as a homecare worker has been terminated based on violations described in OAR 411-031-0050.

(B) The provider's enrollment as a personal support worker has been terminated based on violations described in OAR 410-172-0200 or 411-375-0070.

(i) Being impaired by alcohol, inhalants, prescription drugs, or other drugs, including over-the-counter medications, while responsible for the care of a participant, in the participant's home, or transporting the participant; or

(ii) Manufacturing, possessing, selling, offering to sell, trading, or personally using illegal drugs while providing authorized services to a participant or while in the participant's home.

(D) The provider has a founded or substantiated allegation of abuse as described in OAR chapter 407, division 045, OAR chapter 411, division 20, OAR chapter 413, division 15, or OAR chapter 943, division 45.

(E) The provider fails to provide services as required.

(F) The provider lacks the ability or willingness to maintain confidentiality and safeguard the participant and the participant's family's information.

(G) The provider has an unacceptable background check.

(H) The provider has repeatedly demonstrated he or she is unable or unwilling to safely provide necessary services.

(I) The provider has repeatedly engaged in any of the following behaviors:

(i) Unscheduled late arrival to work or absences from work that are unsatisfactory to the participant or neglect the participant’s service needs; or

(ii) Inviting unwelcome guests or pets into a participant's home, resulting in dissatisfaction or inattention to the participant's required service needs.

(J) The provider commits fiscal improprieties.

(K) The provider is listed on the Health and Human Services, Office of Inspector General or the U.S. General Services Administration's Exclusion lists.

(L) The provider fails to provide a Social Security Number that matches the provider's legal name, as verified by the Internal Revenue Service or Social Security Administration.

(d) INACTIVATION OF PROVIDER ENROLLMENT. A Homecare Choice provider's enrollment may be inactivated when his or her homecare or personal support worker enrollment has been inactivated for reasons described in OAR chapter 411, division 31 or OAR chapter 411, division 375.

(A) Homecare Choice providers will be notified in writing of the reason for inactivation and the actions required to maintain eligibility as a provider in the Homecare Choice Program.

(B) A Homecare Choice provider who fails to restore his or her homecare or personal support worker enrollment to active status within 30 days of inactivation will not be eligible to participate in the Homecare Choice Program until his or her homecare or personal support worker enrollment is restored to active status.

(2) Registry referrals.

(a) To be available for referral on the Registry, the provider must:

(A) Have an active, unrestricted provider number.

(B) Meet the Commission's annual continuing education requirements as a homecare worker or personal support worker.

(D) Maintain a complete and accurate profile.

(E) Update his or her profile information every 30 days.

(F) Have a valid telephone number.

(G) Have a valid email address.

(H) Authorize the release of contact information to perspective participants.

(b) If a provider does not meet the requirements in subsection (2)(a), the provider will not be eligible for referral on the Registry until the requirements of (2)(a) are met.

(3) A provider is responsible to review qualification requirements and background check due dates and take appropriate action to prevent lapse.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.595-625
HCC 1-2016, f. 6-13-16, cert. ef. 6-20-16
HCC 1-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16

Or. Admin. R. 418-040-0050 Participant and Provider Employment Relationship

(1) The relationship between a provider and a program participant is that of employee and employer. Participants are required to meet the employer responsibilities described in OAR 418-040-0020(1)(g)(A)–(H).

(2) Homecare Choice providers are not state employees and are not entitled to state funded benefits, including participation in the Public Employees Retirement System or the Oregon Public Service Retirement Plan.

(3) Participants must establish the terms of an employment relationship with a provider at the time of hire.

(a) The terms of employment may include dismissal or resignation notice, work scheduling, absence reporting, and whether sleeping arrangements or meals are provided to employees.

(b) A participant has the right to terminate an employment relationship with a provider at any time and for any reason.

(4) Unless permission has been granted through the court, a participant's legal guardian may not be paid as the individual's Homecare Choice provider and serve as the employer.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.595-625
HCC 1-2016, f. 6-13-16, cert. ef. 6-20-16
HCC 1-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16

Or. Admin. R. 418-040-0060 Homecare Choice Program Service Rate

(1) The Commission shall establish the service rate charged to program participants for homecare services at a level expected to generate total revenue sufficient to reimburse up to 107 percent of the costs associated with the program. The rate equals the actual costs incurred plus seven percent of the cost of administering the program and may include, but is not limited to:

(a) Homecare Choice Provider wages, taxes, and benefits:

(A) Federal Unemployment Tax Act (FUTA);

(B) State Unemployment Tax Authority (SUTA);

(D) Health insurance; and

(E) Paid time off.

(b) Homecare Choice Program staff wages, taxes, and benefits:

(A) Federal Unemployment Tax Act (FUTA);

(B) State Unemployment Tax Authority (SUTA);

(D) Pension bond contribution;

(E) Social security tax;

(F) Workers' compensation assessment;

(G) Mass transit tax; and

(H) Flexible benefits.

(A) Office expenses;

(B) Publicity and publications;

(D) Registry maintenance and expansion;

(E) Legal fees;

(F) Cost allocation fees;

(G) Translation fees;

(H) Americans with Disabilities Act (ADA) accommodation requests;

(I) Credit card processing fees;

(J) Fiscal intermediary administration fees; and

(K) Workers' compensation premiums.

(d) Any other activities undertaken to ensure:

(A) The quality of Homecare Choice providers;

(B) The adequacy of homecare services being provided; and

(2) The service payment rate is set forth in the participant enrollment agreement between the program and participant. Information about the rate shall be available from the Commission and posted online at www.oregon.gov/DHS/Seniors-Disabilities/HCC/Pages/Homecare-Choice-Program.aspx.

(3) If additional revenue is needed to sufficiently cover program costs, the Commission reserves the right to modify the service rate at any time. To modify the service rate, the Commission will give 30-days advance written notice to program participants.

(4) If the Commission determines adjusting the service rate will not generate sufficient revenue to pay the costs of the program, the Commission may suspend the program following 30-days advance written notice to participants and providers. If the program is suspended, the Commission shall report to the Legislative Assembly, no later than 30 days after the suspension begins. The report must include the following information:

(a) The reason for the suspension;

(b) Any costs incurred that exceed the revenue generated by program payments; and

(c) Any additional costs during the remainder of the biennium that the suspension occurs in that are anticipated to exceed the revenue generated by program payments.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.595-625
HCC 1-2016, f. 6-13-16, cert. ef. 6-20-16
HCC 1-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16

Or. Admin. R. 418-040-0070 Suspension or Reduction of Homecare Choice Program Referrals

If the Commission, with the assistance of DHS, determines the available provider workforce is inadequate to meet the needs of those who qualify for Medicaid funded in-home services, the Commission may suspend or reduce the number of provider referrals under the Homecare Choice Program.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.595-625
HCC 1-2016, f. 6-13-16, cert. ef. 6-20-16
HCC 1-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16

Or. Admin. R. 418-040-0080 Fiscal Responsibilities

(1) Oregon Home Care Commission Fiscal Responsibilities.

(a) The Commission shall establish the Homecare Choice provider wage rate.

(b) The Commission may contract with a fiscal intermediary for the following responsibilities:

(A) Making payments to Homecare Choice providers on behalf of participants for services rendered. Payment is considered payment in full.

(B) Acting on behalf of participants, by applying applicable Federal Insurance Contributions Act (FICA) regulations, to:

(i) Withhold Homecare Choice provider contributions from payments; and

(ii) Submit participant contributions, and the amounts withheld from provider payments, to the Social Security Administration.

(C) Applying standard income tax withholding practices in accordance with 26 CFR 31 and withholding state and federal income taxes on all payments to Homecare Choice providers.

(c) The Commission will issue a refund of a participant's unused service payment after all expenses of the participant have been paid. The portion of the service payment intended to reimburse the Commission for its costs shall not be refunded.

(A) Refunds may only be issued to the individual who authorized the original payment.

(B) Refunds shall not be issued in cash.

(d) The Commission is not a trustee and has no fiduciary obligation to the participant or payer with respect to advance service payments.

(e) Advance payments may be comingled with other advance payments from participants in the Homecare Choice Program, but will be accounted for separately in the records of the Commission. The participant, or payer, is not entitled to any interest earnings on the funds and no interest will be credited to the participant or payer, or paid in the event of a refund.

(f) The state will honor a garnishment or attachment of the participant's or payer's advance payment in the event it is served with a writ.

(g) If funds are not available to pay a provider because the Commission is required to hold or transfer funds under a legal proceeding involving the participant, or payer, participant's participation in the Homecare Choice program will be terminated as provided for in OAR 418-040-0020.

(2) Homecare Choice Participant Fiscal Responsibilities.

(a) Participants shall pay the Commission in advance for homecare services. Services may not commence until payment is received and verified by the Commission.

(b) Upon enrollment in the program, participants must submit an initial prepayment to cover two service periods. The amount of the prepayment is calculated by multiplying the program service rate by the number of anticipated service hours for each service period. Thereafter, participants must submit a prepayment equal to the current service period, while enrolled in the program, and maintain an account balance equal to a two-week service period.

(A) If the account balance does not equal an amount necessary to pay the hours to be worked in the current service period, the participant must submit additional funds to restore the balance to the required level.

(B) If the participant increases the number of purchased hours per service period after the initial prepayment is established, the on-going prepayment must also be increased to equal the current service period.

(D) Advance payments may be considered part of the participant's or payer's estate in the event of a bankruptcy and subject to the automatic stay, or in the event of participant's death, will be refunded to the participant's estate, less any administrative fee due to the Commission.

(c) The participant is subject to the U.S. Department of Labor Fair Labor Standards Act and may elect to have a provider work more than 40 hours per week. The purchase of service hours that exceed 40 hours per week for an individual provider is considered overtime and shall be calculated in the pre-payment.

(A) The overtime rate equals one and one-half of the provider's hourly wage rate plus the increased cost of any payroll taxes as a result of overtime.

(B) In the event of unanticipated overtime, the additional cost will be deducted from the participant's account balance and the account balance must be replenished in the next service payment.

(d) Acceptable payment methods for services include, credit or debit card transactions, personal checks, certified checks, cashier's checks, and money orders.

(A) As allowed by law, the Commission may charge a Non-Sufficient Fund fee if the participant's personal check is not processed by his or her issuing bank due to insufficient funds.

(B) Participants must provide an alternate form of payment method if the credit card used to purchase services is invalid or if a personal check is returned due to insufficient funds.

(C) If a participant challenges program charges on the participant's credit card and the charges are found to be valid after a chargeback investigation, the participant must pay by personal check, cashier's check, or money order for the disputed charges.

(e) Participants must submit payment to the Commission for mileage reimbursement for providers that use his or her personal vehicle for authorized service related transportation.

(A) Providers are reimbursed at the mileage reimbursement rate determined by the participant.

(B) The Commission, participant, and DHS are not responsible for vehicle damage when a provider uses his or her personal motor vehicle.

(C) The Commission, participant, and DHS are not responsible for personal injury sustained when a provider uses his or her personal vehicle, except as may be covered under workers' compensation.

(3) Homecare Choice Provider Fiscal Responsibilities. Homecare Choice providers:

(a) Must comply with state and federal wage and tax laws by completing, submitting, and retaining necessary documents provided by a fiscal intermediary contracted by the Commission.

(b) Must not accept any additional compensation for hours of work that were compensated by the Homecare Choice Program.

(c) Must only claim payment for authorized services provided that have been validated by participants with whom they are employed.

(d) Shall not claim payment for services delivered by another individual.

(e) Are responsible for the completion and accuracy of timekeeping records and all submitted claims.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.595-625
HCC 1-2016, f. 6-13-16, cert. ef. 6-20-16
HCC 1-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16

Or. Admin. R. 418-040-0090 Provider Termination and Hearing Rights

(1) The Commission delegates authority to the Executive Director of the Oregon Home Care Commission to act on behalf of the Commission for the purposes of making decisions related to a provider's eligibility to provide services under the Homecare Choice Program. This includes:

(a) Provider enrollment;

(b) Denial or revocation of provider enrollment; and

(2) When a Homecare Choice provider is terminated based on violations described in OAR 418-040-0040(1)(c)(A) - (L), the Commission shall issue a written notice to the provider.

(a) The written notice must include:

(A) The effective date of the termination.

(B) An explanation of the reason for terminating the provider enrollment.

(D) The provider's right to a contested case hearing and where to file the hearing request.

(b) For terminations based on substantiated protective services allegations, the notice may only contain the information allowed by law. In accordance with ORS 124.075, 124.085, 124.090, OAR 407-045-0330, 411-020-0030, 413-015-0485, and 943-045-0330, complainants, witnesses, the name of the alleged victim, and protected health information may not be disclosed.

(3) BURDEN OF PROOF. The Commission has the burden of proving the allegations of the complaint by a preponderance of the evidence. Evidence submitted for the administrative hearing is governed by OAR 137-003-0610.

(4) IMMEDIATE TERMINATION. The Commission may immediately terminate a provider's enrollment on the date the violation is discovered, before the outcome of the administrative review, when an alleged violation presents imminent danger to current or future participants. In order for a provider's hearing request to be timely, any hearing request must be filed with the Commission within 10 business days from the date of the notice.

(5) TERMINATIONS PENDING APPEAL. When a violation does not present imminent danger to current or future participants, the provider's enrollment may not be terminated during the first 10 business days after the termination notice. In order for a provider's hearing request to be timely, any hearing request must be filed with the Commission within 10 business days from the date of the notice. If the provider appeals in writing before the deadline for the appeal, the enrollment may not be terminated until the conclusion of the contested case proceeding.

(6) TERMINATION IF NO APPEAL FILED. The decision of the Commission's Executive Director becomes final if the Homecare Choice provider does not appeal within 10 business days from the date of the notice of the decision.

(7) CONTESTED CASE PROCESS. A Homecare Choice provider may request an administrative hearing after the conclusion of the administrative review process if the provider continues to dispute the decision to terminate his or her enrollment in the Homecare Choice Program.

(a) A request for hearing must be filed with the Commission within 10 business days of the date of the written notice from the Commission.

(b) When the Commission or the Department refers a contested case under these rules to the Office of Administrative Hearings, the referral will indicate whether the Commission is authorizing a proposed order, a proposed and final order, or a final order.

(c) Subject to approval of the Attorney General, an officer or employee of the Department or the Commission, is authorized to appear on behalf of the Commission for hearings conducted by the Office of Administrative Hearings related to provider enrollment, denial, or revocation of provider enrollment, and provider sanctions. Contested case hearings and the use of lay representation in contested case hearings related to this rule shall be in accordance with OAR chapter 411, division 001.

(d) No additional hearing rights have been granted to Homecare Choice providers by this rule other than the right to a hearing on the Commission's decision to terminate the individual's provider enrollment.

History

Statutory/Other Authority: ORS 410.602
Statutes/Other Implemented: ORS 410.595-625
HCC 1-2016, f. 6-13-16, cert. ef. 6-20-16
HCC 1-2015(Temp), f. 12-31-15, cert. ef. 1-1-16 thru 6-28-16

OAR Chapter 418 — Department of Human Services, Home Care Commission

Division 10 PURPOSE AND RULEMAKING

Or. Admin. R. 418-010-0010 Purpose

Or. Admin. R. 418-010-0020 Rulemaking

Or. Admin. R. 418-010-0030 Notice of Proposed Rulemaking and Adoption of Temporary Rules

Or. Admin. R. 418-010-0040 Delegation of Rulemaking Authority

Division 20 OREGON HOME CARE COMMISSION FUNCTIONS

Or. Admin. R. 418-020-0010 Definitions

Or. Admin. R. 418-020-0020 Qualifications for Homecare and Personal Support Workers and Personal Care Attendants

Or. Admin. R. 418-020-0030 Provider Training

Or. Admin. R. 418-020-0035 Mandatory Training and Competency Evaluations - Effective 9/1/2021

Or. Admin. R. 418-020-0040 Consumer-Employer Training Services

Or. Admin. R. 418-020-0050 Registry

Or. Admin. R. 418-020-0060 Workers’ Compensation

Division 30 PUBLIC CONTRACTING AND PROCUREMENT

Or. Admin. R. 418-030-0000 Application

Or. Admin. R. 418-030-0010 Procurement Authority

Or. Admin. R. 418-030-0020 Adoption of Oregon Health Authority Rules

Division 40 HOMECARE CHOICE PROGRAM

Or. Admin. R. 418-040-0000 Purpose

Or. Admin. R. 418-040-0010 Definitions

Or. Admin. R. 418-040-0020 Participant Eligibility

Or. Admin. R. 418-040-0030 Services

Or. Admin. R. 418-040-0040 Provider Qualifications

Or. Admin. R. 418-040-0050 Participant and Provider Employment Relationship

Or. Admin. R. 418-040-0060 Homecare Choice Program Service Rate

Or. Admin. R. 418-040-0070 Suspension or Reduction of Homecare Choice Program Referrals

Or. Admin. R. 418-040-0080 Fiscal Responsibilities

Or. Admin. R. 418-040-0090 Provider Termination and Hearing Rights

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