OAR 409-036-0010
Definitions

The following definitions apply to OAR 409-036-0000 (Purpose and Scope) to OAR 409-036-0150 (Data Sharing):
(1) “Authority” means the Oregon Health Authority.
(2) “Board” means the Oregon Health Policy Board.
(3) “Carrier” means a medical professional liability insurer holding a valid certificate of authority from the Director of the Department of Consumer and Business Services (DCBS) that authorizes the transaction of insurance as defined in ORS 731.066 (“Authorized,” “unauthorized” insurer) and 731.072 (“Certificate of authority,” “license”), and does not include DCBS-listed insurers pursuant to ORS 735.300 (Purpose of ORS 735.300 to 735.365) to 735.365 (Short title) and 735.400 (Purposes of ORS 735.400 to 735.495) to 735.495 (Short title).
(4) “Clinical Psychologist” means an individual licensed to practice psychology pursuant to ORS 675.010 (Definitions for ORS 675.010 to 675.150) to 675.090 (Application of ORS 675.010 to 675.150).
(5) “Clinical Social Worker” means an individual licensed to practice clinical social work pursuant to ORS 675.510 (Definitions for ORS 675.510 to 675.600) to 675.600 (Duties of board).
(6) "DCBS” means the Department of Consumer and Business Services.
(7) “Dentist” means any individual licensed to practice dentistry pursuant to ORS 679.010 (Definitions).
(8) “Eligible provider” means a practitioner in Oregon delivering health care services to patients in Oregon. The Authority may determine eligible professions based upon the most recent assessment of health care professional need. Eligible provider types will be published on the Office’s program’s webpage.
(9) “Essential health care services” means medical, dental or behavioral health services that have been determined to be necessary to support the health of the population of the community.
(10) “Expanded Practice Dental Hygienist” means an individual licensed to practice dental hygiene with an expanded practice dental hygienist permit issued under ORS 680.200 (Issuing expanded practice permit).
(11) “Licensed Professional Counselor” has the meaning given that term in ORS 675.705 (Definitions for ORS 675.715 to 675.835).
(12) “Marriage and Family Therapist or Professional Counselor” has the meaning given that term in ORS 675.705 (Definitions for ORS 675.715 to 675.835).
(13) “Medical assistance” has the meaning given that term in ORS 414.025 (Definitions for ORS chapters 411, 413 and 414).
(14) “Medicare” means medical coverage provided under Title XVIII of the Social Security Act.
(15) “Naturopathic Physician” means an individual licensed pursuant to ORS 685.010 (Definitions) to 685.135 (Certificate of special competency in natural childbirth).
(16) “Nurse Practitioner” means any individual licensed pursuant to ORS 678.375 (Nurse practitioners).
(17) “Office” means the Office of Rural Health has the meaning given that term in ORS 442.475 (Office of Rural Health).
(18) “Pharmacist” has the meaning given that term in ORS 689.005 (Definitions).
(19) “Physician” means any individual licensed pursuant to ORS 677.100 (Qualifications of applicant for license) to 677.228 (Automatic lapse of license for failure to pay registration fee or report change of location).
(20) “Physician Assistant” means any individual licensed pursuant to ORS 677.495 (Definitions for ORS 677.495 to 677.535) to 677.545.
(21) “Practice full-time” means working at a minimum of 32 hours per week spent providing direct patient care, averaged over the month for a minimum of 45 weeks per service year. The Authority shall consider patient charting a component of offering direct patient care. The Authority may consider telehealth as direct patient care when the receiving site (location of the patient) is located in Oregon.
(22) “Practice part-time” means working a minimum of 16 hours per week spent providing direct patient care, averaged over the month for a minimum of 45 weeks per service year. The Authority shall consider patient charting a component of offering direct patient care. The Authority may consider telehealth as direct patient care when the receiving site (location of the patient) is located in Oregon.
(23) “Program” means the Health Care Incentive Program.
(24) Qualified Mental Health Associate means a mental health professional that meets the following minimum qualifications:
(a) Bachelor’s degree in a behavioral sciences field; or
(b) A combination of at least three years relevant work, education, training or experience; and
(c) Demonstrates the competency necessary to communicate effectively; understand mental health assessment, treatment and service terminology and apply these concepts; provide psychosocial skills development; implement interventions as assigned on an individual plan of care; and provide behavior management and case management duties.
(25) A qualified mental health professional (QMHP) is a licensed behavioral health practitioner or any other person who holds any of the following educational degrees and meets the following minimum qualifications:
(a) Graduate degree in psychology;
(b) Bachelor’s degree in nursing and licensed by the State of Oregon;
(c) Graduate degree in social work;
(d) Graduate degree in a behavioral science field;
(e) Graduate degree in recreational, music, or art therapy;
(f) Bachelor’s degree in occupational therapy and licensed by the State of Oregon; and
(g) Whose education and experience demonstrate the competency to identify precipitating events; gather histories of mental and physical disabilities, alcohol and drug use, past mental health services and criminal justice contacts; assess family, social and work relationships; conduct a mental status examination; document a multiaxial DSM diagnosis; write and supervise an individual plan of care; conduct a mental health assessment and provide individual, family or group therapy within the scope of their training.
(26) “Qualifying loan” means one or more government or commercial loans received solely to cover the cost of post-baccalaureate health professional training or, in the case of an expanded practice dental hygienist and Behavioral Health Loan Repayment incentive applicants, undergraduate educational training. This does not include credit card loans, lines of credit, and personal loans.
(27) “Qualifying practice site” means:
(a) A rural hospital as defined in ORS 442.470 (Definitions for ORS 442.470 to 442.507) serving Medicaid and Medicare patients in no less than the same proportion of such patients in the county or other service area as determined by the Authority, up to a maximum requirement of 50 percent of patient mix for Medicare and Medicaid combined;
(b) A federally certified Rural Health Clinic serving Medicaid and Medicare patients in no less than the same proportion of such patients in the county or other service area as determined by the Authority, up to a maximum requirement of 50 percent of patient mix for Medicare and Medicaid combined;
(c) A federally qualified Community Health Center serving Medicaid and Medicare patients in no less than the same proportion of such patients in the county or other service area as determined by the Authority, up to a maximum requirement of 50 percent of patient mix for Medicare and Medicaid combined; or
(d) A site other than those listed above that:
(A) Provides essential health care services to patients in an area approved as a medical, dental or mental Health Professional Shortage Area (HPSA) as defined by the federal Health Resources and Services Administration or ranking below the Areas of Unmet Health Care Need median as determined by the Office;
(B) Serves Medicaid and Medicare patients in no less than the same proportion of such patients in the county or other service area as determined by the Authority, up to a maximum requirement of 50 percent of patient mix for Medicare and Medicaid combined, when a majority of providers are eligible for reimbursement from these programs for health services provided;
(C) Has a majority of providers at the site eligible for reimbursement from both Medicare and Medicaid. If a majority of providers at the site are not eligible for reimbursement from both programs, the site is qualified as long as the site serves either Medicaid or Medicare patients in no less the same proportion of such patients in the county or other service area as determined by the Authority;
(D) Provides essential health care services to an underserved population, as determined by the Authority; or
(E) Serves Medicaid and/or uninsured patients in a Community Based, Residential, or Day treatment setting, as determined by the Authority.
(28) “Telehealth” means the provision of health services from a distance using electronic communications.

Source: Rule 409-036-0010 — Definitions, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=409-036-0010.

Last Updated

Jun. 24, 2021

Rule 409-036-0010’s source at or​.us