1. (1) Providers of 1915(i) HCBS shall meet the following qualifications for each type of service they are providing as described in this rule and:

   1. (a) Meet all necessary provider qualifications, including relevant experience, as outlined in: OAR chapter 309, division 019; chapter 309, division 035, division 040, OAR chapter 410, division 172; and OAR chapter 950, division 060; and
   2. (b) Be enrolled by the Division as a Medicaid provider as outlined in OAR 410-120-1260.

2. (2) AFH providers shall:

   1. (a) Be 21 years of age or older;
   2. (b) Comply with the 1915(i) HCBS setting qualities identified in OAR 410-173-0035;
   3. (c) Participate in the person-centered planning process as described in OAR 410-173-0025;
   4. (d) Document the services as outlined in OAR 410-173-0045; and
   5. (e) Comply with OAR Chapter 309, Division040, rules governing Adult Foster Homes.

3. (3) Residential Treatment Facility (RTF) and Residential Treatment Homes (RTH) providers shall:

   1. (a) Be at least 18 years of age;
   2. (b) Comply with the 1915(i) HCBS setting qualities identified in OAR 410-173-0035;
   3. (c) Participate in the person-centered planning process as described in OAR 410-173-0025;
   4. (d) Document the services as outlined in OAR 410-173-0045; and
   5. (e) Comply with OAR Chapter, 309 Division 035 rules governing Residential Treatment Facilities and Residential Treatment Homes for Adults with Mental Health Disorders.
4. (5) Outpatient behavioral health providers of 1915(i) HCBS shall comply with the qualifications and competencies outlined in OAR 309-019-0125, 309-035-0135, 309-040-0360. Providers exempt from licensure or registration per ORS 675.090(f), 675.523(3), or 675.825(c) shall be employed by or contracted with a provider organization certified by the Authority under ORS 430.610 to 430.695 as described in OAR 410-172-0660.

5. (6) 1915(i) HCBS providers, as identified above, shall adhere to the following provider qualifications:

   1. (a) Demonstrate by background, skills and abilities the capability to safely and adequately provide the services authorized, in the judgment of the Authority or its designee;
   2. (b) Maintain a drug-free workplace: and be approved through the criminal history check process described in OAR Chapter 407, Division007 and OAR Chapter 943 Division 007;
   3. (c) Not be the eligible Individual's spouse or another legally responsible relative;
   4. (d) Be authorized to work or operated in the United States, in accordance with U.S. Department of Homeland Security, Bureau of Citizenship and Immigration rules;
   5. (e) Complete criminal history background checks and re-checks in accordance with OAR Chapter 407 Division 007. A provider’s failure to complete a new criminal history check authorization shall result in the inactivation of the provider enrollment. Once inactivated, a provider must reapply and meet the standards described in this rule to have their provider enrollment reactivated; and
   6. (f) Not be included on any US Office of Inspector General Exclusion lists.

Statutory/Other Authority

ORS 124.050-124.095, 409.040, 413.032, 413.042, 413.071, 413.085, 414.025, 426.500, 443.738, ORS 409.050, 427.104 & 430.662

Statutes/Other Implemented

ORS 124.050-124.095, 409.040, 413.032, 413.042, 413.071, 413.085, 414.025, 426.500, 443.738, ORS 427.007, 430.610, 430.620 & 430.662 – 430.670

History

DMAP 42-2024, amend filed 02/14/2024, effective 02/29/2024
DMAP 46-2019, adopt filed 11/07/2019, effective 11/26/2019
DMAP 12-2019, temporary adopt filed 05/21/2019, effective 06/01/2019 through 11/27/2019