OAR 413-050-0430
Other Medical Payments
(1)
Drug and alcohol assessments for persons not eligible for Title XIX or the Oregon Health Plan.(2)
A one-time emergency medical need for children in the custody of the Department that have been returned home. This is limited to children of low-income families not eligible for medical services through the Department.(3)
Therapy for Children in Substitute Care, if recommended by a licensed psychiatrist or psychologist who evaluated the child, and the type of therapy and/or the therapist recommended is unavailable from the local mental health clinic or through the mental health plan (MHO) in which the child is enrolled. The therapist must be enrolled with DMAP or, failing that, there must be a signed contract in place prior to the therapy being provided. Funding availability will be determined by the SDA Manager or Designee (who may want to consult with the Assistant Field Administrator or the Medical Assistance Resource Coordinator to determine that there are no other resources available for funding).(4)
Consultation with a licensed or registered provider regarding the case or treatment planning for a specific child. Field staff’s consultation with licensed experts in human behavior offers an alternative to costly individual evaluations for families or children who are experiencing severe medical, behavioral or emotional problems. Frequently, the case record contains information accumulated over time which a consultant, trained to evaluate and interpret such data, can assess to assist the agency in developing or managing a timely and well-focused case plan.(5)
Medical care for children in detention. ORS 418.034 (Department responsible for costs of medical care of certain children in detention or lockup facilities) mandates payment of the cost of medical care for the child in detention, including emergency medical care, if the child is in custody of the Department. “Medical care” means emergency medical care or medical care for a medical condition that existed prior to the child’s being held in a juvenile detention facility or in a local correctional facility or lockup.(6)
Evaluations of parents when required by the Department for casework planning to determine the parents’ emotional stability, intellectual capacity, parenting capacity or maturity. These may include medical, psychiatric, psychological evaluations or drug and alcohol assessments. This does not include ongoing treatment or services. Payment from “Other Medical” for the above services will not be made for parents in permanent planning cases or for parents who are Medicaid eligible through the Oregon Health Plan.(7)
Parent/child and/or sibling interaction evaluation.(8)
Protective service physical examinations authorized for the purpose of the legal investigation only and when out-of-home care is not a consideration.
Source:
Rule 413-050-0430 — Other Medical Payments, https://secure.sos.state.or.us/oard/view.action?ruleNumber=413-050-0430.