OAR 411-034-0010
Definitions
(1)
“AAA” means “Area Agency on Aging” as defined in this rule.(2)
“Adult” means any person at least 18 years of age.(3)
“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 terms AAA and Area Agency on Aging are inclusive of both Type A and Type B Area Agencies on Aging as defined in ORS 410.040 (Definitions for ORS 410.040 to 410.300, 410.320 and 410.619) and described in ORS 410.210 (Area agency advisory councils) to 410.300 (Transfer of state employees to type B agency).(4)
“Assistance” means an individual requires help from another person with the personal care or supportive services described in OAR 411-034-0020 (State Plan Personal Care Services). Assistance may include cueing, hands-on, monitoring, reassurance, redirection, set-up, standby, or support as defined in OAR 411-015-0005 (Definitions). Assistance may also require verbal reminding to complete one of the tasks described in OAR 411-034-0020 (State Plan Personal Care Services).(5)
“Assistive Devices” means any category of durable medical equipment, mechanical apparatus, electrical appliance, or instrument of technology used to assist and enhance an individual’s independence in performing any task described in OAR 411-034-0020 (State Plan Personal Care Services).(6)
“Assistive Supports” means the aid of service animals, general household items, or furniture used to assist and enhance an individual’s independence in performing any task described in OAR 411-034-0020 (State Plan Personal Care Services).(7)
“Background Check” means a criminal records check and abuse check as defined in OAR 407-007-0210 (Definitions).(8)
“Case Management” means the functions performed by a case manager, services coordinator, personal agent, or manager. Case management includes determining service eligibility, developing a plan of authorized services, and monitoring the effectiveness of services.(9)
“Case Manager” means a Department employee or an employee of the Department’s designee, services coordinator, or personal agent who assesses the service needs of individuals, determines eligibility, and offers service choices to eligible individuals. A case manager authorizes and implements an individual’s plan for services and monitors the services delivered.(10)
“Central Office” means the unit within the Department responsible for program and policy development and oversight.(11)
“Child” means an individual who is less than 18 years of age.(12)
“Community Developmental Disability Program (CDDP)” means the Department’s designee that is responsible for plan authorization, delivery, and monitoring of services for individuals with intellectual or developmental disabilities according to OAR chapter 411, division 320.(13)
“Contracted In-Home Care Agency” means an incorporated entity or equivalent, licensed in accordance with OAR chapter 333, division 536 that provides hourly contracted in-home services to individuals receiving services through the Department or Area Agency on Aging.(14)
“Cost Effective” means being responsible and accountable with Department resources. This is accomplished by offering less costly alternatives when providing choices that adequately meet an individual’s service needs. Those choices consist of all available service options, the utilization of assistive devices or assistive supports, natural supports, architectural modifications, and alternative service resources (defined in OAR 411-015-0005 (Definitions)). Less costly alternatives may include resources not paid for by the Department.(15)
“Delegated Nursing Task” means a registered nurse (RN) authorizes an unlicensed person (defined in OAR 851-047-0010) to provide a nursing task normally requiring the education and license of an RN. In accordance with OAR 851-047-0000 (Rule Summary, Statement of Purpose and Intent), OAR 851-047-0010, and OAR 851-047-0030 (Delegation of Special Tasks of Client/Nursing Care), the RN’s written authorization of a delegated nursing task includes assessing a specific eligible individual, evaluating an unlicensed person’s ability to perform a specific nursing task, teaching the nursing task, and supervising and re-evaluating the individual and the unlicensed person at regular intervals.(16)
“Department” means the Department of Human Services.(17)
“Designee” means an organization with which the Department contracts or has an interagency agreement.(18)
“Developmental Disability” as defined in OAR 411-320-0020 (Definitions and Acronyms) and described in OAR 411-320-0080 (Application and Eligibility Determination).(19)
“Disability” means a physical, cognitive, or emotional impairment which, for an individual, constitutes or results in a functional limitation in one or more of the activities of daily living defined in OAR 411-015-0006 (Activities of Daily Living (ADL)).(20)
“Division” means:(a)
Oregon Health Authority, Addictions and Mental Health Division (AMHD);(b)
Department of Human Services, Aging and People with Disabilities Division (APD);(c)
Area Agencies on Aging (AAA);(d)
Department of Human Services, Self-Sufficiency Programs (SSP);(e)
Department of Human Services, Office of Developmental Disability Services (ODDS);(f)
Community Developmental Disability Programs (CDDP); and(g)
Support Services Brokerages.(21)
“Fiscal Improprieties” means a homecare or personal support worker committed financial misconduct involving an individual’s money, property, or benefits.(a)
Fiscal improprieties include, but are not limited to, financial exploitation, borrowing money from an individual, taking an individual’s property or money, having an individual purchase items for the homecare or personal support worker, forging an individual’s signature, falsifying payment records, claiming payment for hours not worked, or similar acts intentionally committed for financial gain.(b)
Fiscal improprieties do not include the exchange of money, gifts, or property between a homecare or personal support worker whose employer is a relative unless an allegation of financial exploitation, as defined in OAR 411-020-0002 (Definitions) or OAR 407-045-0260 (Adult Developmental Disabilities Abuse Rules: Definitions), has been substantiated based on an adult protective services investigation.(22)
“Guardian” means a parent for an individual less than 18 years of age or a person or agency appointed and authorized by the courts to make decisions about services for an individual.(23)
“Homecare Worker” means a provider as described in OAR 411-031-0040 (Consumer-Employed Provider Program), directly employed by an individual to provide hourly in-home services to the eligible consumer.(a)
The term homecare worker includes:(A)
A consumer-employed provider in the Spousal Pay and Oregon Project Independence Programs;(B)
A consumer-employed provider that provides State Plan personal care services; and(C)
A relative providing Medicaid in-home services to an individual living in the relative’s home.(b)
The term homecare worker does not include an Independent Choices Program provider or a personal support worker enrolled through Developmental Disability Services or the Addictions and Mental Health Division.(24)
“Individual” means the person applying for or determined eligible for State Plan personal care services.(25)
“Intellectual Disability” as defined in OAR 411-320-0020 (Definitions and Acronyms) and described in OAR 411-320-0080 (Application and Eligibility Determination).(26)
“Lacks the Skills, Knowledge, and Ability to Adequately or Safely Perform the Required Work” means a homecare or personal support worker does not possess the skills to perform services needed by individuals receiving services from the Department. The homecare or personal support worker may not be physically, mentally, or emotionally capable of providing services to individuals. The homecare or personal support worker’s lack of skills may put individuals at risk because the homecare or personal support worker fails to perform, or learn to perform, the duties needed to adequately meet the needs of the individuals.(27)
“Legal Representative” means:(a)
For a child, the parent or step-parent unless a court appoints another person or agency to act as the guardian; and(b)
For an adult:(A)
A spouse;(B)
A family member who has legal custody or legal guardianship according to ORS 125.005 (Definitions), 125.300 (In general), 125.315 (General powers and duties of guardian), and 125.310 (Letters of guardianship);(C)
An attorney at law who has been retained by or for an individual; or(D)
A person or agency authorized by the courts to make decisions about services for an individual.(28)
“Long Term Care Community Nursing” means the nursing services described in OAR chapter 411, division 048.(29)
“Medicaid OHP Plus Benefit Package” means only the Medicaid benefit packages provided under OAR 410-120-1210 (Medical Assistance Benefit Packages and Delivery System)(4)(a) and (b). This excludes individuals receiving Title XXI benefits.(30)
“Natural Support” means resources and supports (e.g. relatives, friends, significant others, neighbors, roommates, or the community) who are willing to voluntarily provide services to an individual without the expectation of compensation. Natural supports are identified in collaboration with the individual and the potential “natural support”. The natural support is required to have the skills, knowledge, and ability to provide the needed services and supports.(31)
“Older Adult” means any person at least 65 years of age.(32)
“Ostomy” means assistance that an individual needs with a colostomy, urostomy, or ileostomy tube or opening used for elimination.(33)
“Personal Agent” means a person who is a case manager for the provision of case management services, works directly with individuals and the individuals’ legal or designated representatives and families to provide or arrange for support services as described in OAR chapter 411, division 340, meets the qualifications set forth in OAR 411-340-0150 (Standards for Administration and Operations), and is a trained employee of a support services brokerage or a person who has been engaged under contract to the brokerage to allow the brokerage to meet responsibilities in geographic areas where personal agent resources are severely limited.(34)
“Personal Care” means the functional activities described in OAR 411-034-0020 (State Plan Personal Care Services) that an individual requires for continued well-being.(35)
“Personal Support Worker” means:(a)
A provider:(A)
Who is hired by an individual with an intellectual or developmental disability or the individual’s representative;(B)
Who receives money from the Department for the purpose of providing services to the individual in the individual’s home or community; and(C)
Whose compensation is provided in whole or in part through the Department or community developmental disability program.(b)
This definition of personal support worker is intended to reflect the term as defined in ORS 410.600 (Definitions for ORS 410.595 to 410.625).(36)
“Provider” or “Qualified Provider” means a homecare worker or personal support worker that meets the qualifications in OAR 411-034-0050 (Provider Qualifications) that performs State Plan personal care services.(37)
“Provider Enrollment” means a homecare worker’s or personal support worker’s authorization to work as a provider employed by an eligible individual, representative, or legal representative for the purpose of receiving payment for services authorized by the Department. Provider enrollment includes the issuance of a Medicaid provider number.(38)
“Provider Number” means an identifying number issued to each homecare or personal support worker who is enrolled as a provider through the Department.(39)
“Relative” means a person, excluding an individual’s spouse, who is related to the individual by blood, marriage, or adoption.(40)
“Representative” means:(a)
A person appointed by an individual or legal representative to participate in service planning on the individual’s behalf that is either the individual’s guardian or natural support with longstanding involvement in assuring the individual’s health, safety and welfare; and(b)
For the purpose of obtaining State Plan personal care services through a homecare or personal support worker, the person selected by an individual or the individual’s legal representative to act on the individual’s behalf to provide the employer responsibilities described in OAR 411-034-0040 (Employer-Employee Relationship).(41)
“Respite” means services for the relief of a person normally providing supports to an individual unable to care for him or herself.(42)
“Service Need” means the assistance with personal care and supportive services needed by an individual receiving Department services.(43)
“Service Period” means, for individuals served by --(a)
APD or an AAA, two consecutive workweeks for a total of 14 days.(b)
A CDDP or a Support Services Brokerage, a calendar month.(44)
“Service Plan” or “Service Authorization” means an individual’s written plan for services that identifies:(a)
The individual’s qualified provider who is to deliver the authorized services;(b)
The date when the provision of services is to begin; and(c)
The maximum hours per service period of personal care and supportive services authorized by the Department or the Department’s designee.(45)
“Services Coordinator” means an employee of a community developmental disability program or other agency that contracts with the county or Department, who is selected to plan, procure, coordinate, and monitor an individual’s plan for services, and to act as a proponent for individuals with intellectual or developmental disabilities.(46)
“State Plan Personal Care Services” means the assistance with personal care and supportive services described in OAR 411-034-0020 (State Plan Personal Care Services) provided to an individual by a homecare worker or personal support worker. The assistance may include cueing, hands-on, monitoring, reassurance, redirection, set-up, standby, or support as defined in OAR 411-015-0005 (Definitions). The assistance may also require verbal reminding to complete one of the personal care tasks described in OAR 411-034-0020 (State Plan Personal Care Services).(47)
“Sub-Acute Care Facility” means a care center or facility that provides short-term rehabilitation and complex medical services to an individual with a condition that does not require acute hospital care but prevents the individual from being discharged to his or her home.(48)
“Support Services Brokerage” means an entity, or distinct operating unit within an existing entity, that uses the principles of self-determination to perform the functions associated with planning and implementation of support services for individuals with intellectual or developmental disabilities.(49)
“These Rules” mean the rules in OAR chapter 411, division 034.
Source:
Rule 411-034-0010 — Definitions, https://secure.sos.state.or.us/oard/view.action?ruleNumber=411-034-0010.