Behavioral Health Personal Care Attendant Program
(1)Behavioral health personal care attendant services are essential services that enable an individual to move into or remain in his or her own home. Behavioral health personal care attendant services are provided in accordance with an individual’s authorized plan for services by a QMHA or QMHP as defined in OAR 309-019-0105 (Definitions):
(a)Behavioral health personal care attendant services are provided directly to an eligible individual and are not meant to provide respite or other services to an individual’s natural support system. Behavioral health personal care attendant services may not be implemented for the purpose of benefiting an individual’s family members or the individual’s household in general;
(b)Behavioral health personal care attendant services are limited to 20 hours per month per eligible individual;
(c)To meet an extraordinary personal care need, an individual, representative, or legal representative may request an exception to the 20-hour per month limitation. An exception shall be requested through the local community mental health program or agency contracted with the Authority serving the individual. The Division has up to 45 days upon receipt of an exception request to determine whether an individual’s assessed personal care needs warrant exceeding the 20-hour per month limitation.
(2)Personal care services include:
(a)Basic personal hygiene, providing or assisting an individual with such needs as bathing (tub, bed bath, shower), washing hair, grooming, shaving, nail care, foot care, dressing, skin care, mouth care, and oral hygiene;
(b)Toileting, bowel, or bladder care, assisting to and from bathroom, on and off toilet, commode, bedpan, urinal, or other assistive device used for toileting, changing incontinence supplies, following a toileting schedule, cleansing an individual or adjusting clothing related to toileting, emptying a catheter drainage bag or assistive device, ostomy care, and bowel care;
(c)Mobility, transfers, or repositioning, assisting an individual with ambulation or transfers with or without assistive devices, turning an individual or adjusting padding for physical comfort or pressure relief, and encouraging or assisting with range-of-motion exercises;
(d)Nutrition, preparing meals and special diets, assisting with adequate fluid intake or adequate nutrition, assisting with food intake (feeding), monitoring to prevent choking or aspiration, assisting with special utensils, cutting food, and placing food, dishes, and utensils within reach for eating;
(e)Medication or oxygen management, assisting with ordering, organizing, and administering oxygen or prescribed medications (including pills, drops, ointments, creams, injections, inhalers, and suppositories), monitoring for choking while taking medications, assisting with the administration of oxygen, maintaining clean oxygen equipment, and monitoring for adequate oxygen supply;
(f)Delegated nursing tasks, as defined in OAR 411-034-0010 (Definitions).
(3)When any of the services listed in section (2) of this rule are essential to the health, safety, and welfare of an individual and the individual is receiving personal care paid by the Division, the following support services may also be provided:
(a)Housekeeping tasks necessary to maintain the individual in a healthy and safe environment, including cleaning surfaces and floors, making the individual’s bed, cleaning dishes, taking out the garbage, dusting, and gathering and washing soiled clothing and linens. Only the housekeeping activities related to the individual’s needs may be considered in housekeeping;
(b)Arranging for necessary medical appointments including help scheduling appointments and arranging medical transportation services (described in OAR chapter 410, division 136) and assistance with mobility and transfers or cognition in getting to and from appointments or to an office within a medical clinic or center;
(c)Observing the individual’s health status and reporting any significant changes to physicians, health care professionals, or other appropriate persons;
(d)First aid and handling of emergencies, including responding to medical incidents related to conditions such as seizures, spasms, or uncontrollable movements where assistance is needed by another individual and responding to an individual’s call for help during an emergent situation or for unscheduled needs requiring immediate response; and
(e)Cognitive assistance or emotional support provided to an individual by another person due to confusion, dementia, behavioral symptoms, or mental or emotional disorders. Cognitive assistance or emotional support includes helping the individual cope with change and assisting the individual with decision-making, reassurance, orientation, memory, or other cognitive symptoms.
(4)Payment may not be made for any of the following excluded services:
(f)Day care, adult day services (described in OAR chapter 411, division 066), respite, or baby-sitting services;
(g)Medicaid home delivered meals (described in OAR chapter 411, division 040);
(h)Care, grooming, or feeding of pets or other animals; or
(i)Yard work, gardening, or home repair.
Rule 410-172-0780 — Behavioral Health Personal Care Attendant Program,