OAR 410-172-0790
Eligibility for Behavioral Health Personal Care Attendant Services

(1)

To be eligible for Behavioral Health personal care attendant services, an individual shall:

(a)

Demonstrate the need for assistance from a qualified provider due to a disabling behavioral health condition with personal care services and meet the eligibility criteria described in this rule;

(b)

Be a current recipient of a Medicaid OHP full benefit package.

(2)

An individual is not eligible to receive Behavioral Health personal care attendant services if:

(a)

The individual is receiving personal care services from a licensed 24-hour residential services program (such as an adult foster home, residential treatment home, or residential treatment facility);

(b)

The individual is in a prison, hospital, sub-acute care facility, nursing facility, or other medical institution;

(c)

The individual’s assessed service needs are being met under other Medicaid-funded home and community-based service options of the individual’s choosing.

(3)

Behavioral health personal care attendant services are not intended to replace routine care commonly needed by an infant or child typically provided by the infant’s or child’s parent.

(4)

Behavioral health personal care attendant services may not be used to replace other non-Medicaid governmental services.

(5)

The Authority may close the eligibility and authorization for Behavioral Health personal care attendant services if an individual fails to:

(a)

Employ a provider that meets the requirements in this rule;

(b)

Receive personal care from a qualified provider paid by the Authority for 30 continuous calendar days or longer.

(6)

Behavioral health personal care attendant services may not duplicate other Medicaid services.

(7)

Individuals eligible for Behavioral Health personal care attendant services as described shall apply through the local community mental health program or agency contracted with AMH.

Source: Rule 410-172-0790 — Eligibility for Behavioral Health Personal Care Attendant Services, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=410-172-0790.

410‑172‑0600
Acronyms and Definitions 410‑172‑0610
Provider Enrollment 410‑172‑0620
Documentation Standards 410‑172‑0630
Medically Appropriate 410‑172‑0640
Behavioral Health Services Fee Schedule 410‑172‑0650
Prior Authorization 410‑172‑0660
Rehabilitative Behavioral Health Services 410‑172‑0670
Substance Use Disorder Treatment Services 410‑172‑0680
Residential Treatment Services for Children 410‑172‑0690
Admission Procedure for Residential Treatment Services for Children 410‑172‑0695
Intensive In-Home Behavioral Health Treatment Services for Youth (IIHBT) 410‑172‑0705
Residential Rate Standardization 410‑172‑0710
Residential Personal Care 410‑172‑0720
Prior Authorization and Re-Authorization for Residential Treatment 410‑172‑0730
Payment Limitations for Behavioral Health Services 410‑172‑0745
Exception Criteria for Facial Gender Confirmation Surgery (FGCS) 410‑172‑0760
Applied Behavior Analysis 410‑172‑0770
Individual Eligibility for Applied Behavioral Analysis Treatment 410‑172‑0780
Behavioral Health Personal Care Attendant Program 410‑172‑0790
Eligibility for Behavioral Health Personal Care Attendant Services 410‑172‑0800
Personal Care Attendant Employer-Employee Relationship 410‑172‑0810
Personal Care Attendant Qualifications 410‑172‑0820
Provider Termination 410‑172‑0830
Personal Care Attendant Service Assessment, Authorization, and Monitoring 410‑172‑0840
Personal Care Attendant Payment Limitations 410‑172‑0850
Telemedicine for Behavioral Health 410‑172‑0860
Billing for Dual Eligible Individuals
Last Updated

Jun. 8, 2021

Rule 410-172-0790’s source at or​.us