OAR 413-090-0150
Payment Determination

(1)

Payment for the personal care services identified in the personal care services plan is based on the eligible child or young adult’s personal care services at a level of personal care payment that corresponds to the needs identified in the personal care services assessment and is determined by the Department. The levels of personal care are set forth in Exhibit 4.

(a)

If the eligible child or young adult qualifies as Level 1 (moderate care), the payment is a maximum of $ 231.00 per month based on the days within the month the child or young adult is eligible for and receives personal care services.

(b)

If the eligible child or young adult qualifies as Level 2 (intermediate care), the payment is a maximum of $ 461.00 per month based on the days within the month the child or young adult is eligible for and receives personal care services.

(c)

If the eligible child or young adult qualifies as Level 3 (advanced care), the payment is a maximum of $ 692.00 per month based on the days within the month the child or young adult is eligible for and receives personal care services.

(d)

If the eligible child or young adult qualifies as Level 4 (intensive care), the payment is an amount authorized by the Department, based on the days within the month the child or young adult is eligible for and receives personal care services and on the intensity and frequency of the personal care services in conjunction with all other medical services provided for the child or young adult.

(2)

Payment for personal care services is calculated based on the number of days personal care services were provided to the eligible child or young adult.

(3)

Except as provided in section (4) of this rule, payment for personal care services is authorized by the Department when the personal care services assessment is completed and the contract registered nurse, program nurse consultant or manager has verified that the provider is a qualified provider.

(4)

If the referral for a personal care services assessment was delayed, the program nurse consultant or manager may authorize payment before the assessment is completed when personal care services were provided by a qualified provider and there is documentation of the child’s or young adult’s personal care needs.

[ED. NOTE: To view attachments referenced in rule text, click here to view rule.]

Source: Rule 413-090-0150 — Payment Determination, https://secure.sos.state.or.us/oard/view.action?ruleNumber=413-090-0150.

413‑090‑0000
Definitions 413‑090‑0005
Purpose 413‑090‑0010
Authorized Payments 413‑090‑0021
Periodic Review of Eligibility for Level of Care Payments 413‑090‑0030
Payment for Temporary Absences from Family Foster Care 413‑090‑0040
Payments During Adoptive Supervision 413‑090‑0050
Out-of-State Payment to a Certified Family Moving to Another State 413‑090‑0051
Department Review of Foster Care Payment Rates 413‑090‑0100
Purpose 413‑090‑0110
Definitions 413‑090‑0120
Scope of Services 413‑090‑0130
Personal Care Services Eligibility 413‑090‑0133
Conducting a Personal Care Services Assessment 413‑090‑0135
Provider Eligibility 413‑090‑0136
Developing the Personal Care Services Plan 413‑090‑0140
Periodic Review of Personal Care Services Eligibility 413‑090‑0150
Payment Determination 413‑090‑0210
Termination of Personal Care Services and Payments 413‑090‑0300
Purpose 413‑090‑0310
Definition 413‑090‑0320
Policy 413‑090‑0330
Clothing 413‑090‑0340
Transportation 413‑090‑0355
Payments Eligible for Title IV-E 413‑090‑0365
Education Costs Not Eligible for Title IV-E 413‑090‑0370
Payment Method 413‑090‑0380
Children in Non-Reimbursed Placement at Oregon State Hospital and Other Non-Reimbursed Providers 413‑090‑0400
Funeral and Burial Expenses 413‑090‑0405
Definitions

California:	Codes
Colorado:	C.R.S.
Nevada:	NRS
New York:	Laws
Oregon:	OAR, ORS
Texas:	Statutes
World:	Rome Statute, International Dictionary

OAR 413-090-0150 Payment Determination

(1)

(a)

(b)

(c)

(d)

(2)

(3)

(4)

OAR 413-090-0150
Payment Determination