1. (1) "Abuse" means "abuse" as defined in OAR 411-020-0002 (Adult Protective Services).
2. (2) "Activities of Daily Living (ADL)" means those personal, functional activities as defined in OAR 411-015-0006.
3. (3) “Administrator” means the person designated by the Licensee through an employment agreement to be responsible for the daily operations and maintenance of the Agency with Choice.
4. (4) “Agency with Choice” means an organization licensed by the Department that provides self-directed Agency with Choice Services for compensation to Individuals primarily at the Individual’s home and their community.
5. (5) “Agency with Choice Services” means services provided to Individuals by an Agency with Choice operating within a Self-Directed Service Delivery Model and include those services as specified in these rules. Agency with Choice services do not include nursing procedures or tasks that require nursing delegation or teaching as defined in OAR chapter 851, division 047.
6. (6) "Applicant" means the person, entity, or governmental organization who applies for an Agency with Choice (license).
7. (7) "Area Agency on Aging (AAA)" means the Department designated agency responsible for providing a comprehensive and coordinated system of services to Individuals in a planning and service area. The term Area Agency on Aging is inclusive of both Type A and Type B Area Agencies on Aging as defined in ORS 410.040 and described in ORS 410.210 to 410.300.

8. (8) “Authorized Representative” may include one of the following for the purpose of these rules:

   1. (a) “Legal Representative” means a person who has been legally designated by court order to make financial or health care decisions on behalf of another Individual. The Legal Representative only has authority to act within the scope and limits of their authority as designated by the court or other agreement. For the purpose of these rules, and Authorized Representatives and Legal Representatives are synonymous unless otherwise indicated.
   2. (b) A person designated by an Individual or the Individual’s legal representative to act on behalf of the Individual in making decisions on matters pertaining to the planning and implementation of an in-home Service Plan.
   3. (c) In no instance may an “Authorized Representative” be a paid Direct Support Worker of Home and Community Based Services (HCBS) nor an employee of the Agency with Choice for an Individual for whom they provide services. The Department shall verify the Authorized Representative is not providing paid services as contained within this section.
9. (9) “Back Up Plan” means a plan developed by the Individual or Individual’s Authorized Representative in coordination with the Agency with Choice to ensure uninterrupted Services and Supports in the event of planned or unplanned absences of the Direct Support Worker or in case of an emergency. The Back Up Plan should include the name and contact information and the specific ways in which the backup will support the Individual.
10. (10) “Background Check” means a background records check as defined in OAR 407-007-0010, ORS 409.025, and 409.027 that includes a final fitness determination that the Subject Individual is fit to hold a position and have direct access to or otherwise provide care and services necessary for the health, welfare, maintenance, or protection of an Individual.
11. (11) “Case Manager” or "CM" means a Department employee or an employee of the Department's designee that meets the minimum qualifications in OAR 411-028-0040 who is responsible for service eligibility, assessment of need, offering service choices to eligible Individuals, Person-Centered Service Planning, service authorization and implementation, and evaluation of the effectiveness of Medicaid home and community-based services.
12. (12) “Change of Condition” means an Individual’s care needs, health or functioning have changed to the point that additional or different supports may be necessary.
13. (13) "Change of Ownership" means adding or removing one or more owners which constitutes a change of more than five percent interest in Agency with Choice ownership.
14. (14) “Complaint” means dissatisfaction relating to an Agency with Choice expressed by the Individual or their Authorized Representative.
15. (15) “Cultural Competence” means the ability to interact effectively with people from different cultures, languages, races and other backgrounds.
16. (16) "Department" means the Oregon Department of Human Services (ODHS), The Office of Aging and People with Disabilities.
17. (17) “Direct Support Worker (DSW)” means a person employed by an Agency with Choice, to assist Individuals with activities of daily living, Instrumental Activities of Daily Living and health related tasks as defined in the Individual’s Service Plan and further denoted in the DSW’s job description as required by Section 411-039-0130 (3) of these rules. Direct support worker does not mean a homecare worker, or a personal support worker as defined in ORS 410.600.

18. (18) “Drug-Free Workplace” means the Agency with Choice ensures Direct Support Workers:

    1. (a) Are prohibited from using or being under the influence of alcohol, inhalants, or drugs, including prescription and over-the-counter medications that prevents duties from being performed; or
    2. (b) Are prohibited from manufacturing, possessing, selling, offering to sell, trade, or use illegal drugs while providing services to an Individual, or while in the Individual’s home.
19. (19) “Electronic Visit Verification (EVV)” means a system under which visits conducted as part of the Service Plan are electronically verified at the time of service, and meets the requirements specified the 21st Century Cures Act enacted as Public Law 114-225, United States Code 42 U.S.C 241(d)(4).
20. (20) “Formal Complaint” means a formal filing with the Department that alleges the Agency with Choice Agency has not adhered to a material aspect of the Agency with Choice statute or administrative rules.
21. (21) “Grievance” means a formal, written dissatisfaction submitted by an Individual or Authorized Representative regarding the failure of an Agency with Choice to follow required rules, policies, or services.
22. (22) “Individual” means a person receiving Agency with Choice Services and supports who is approved for home and community-based services by the Department as defined in OAR 411-015-0005.
23. (23) "Instrumental Activities of Daily Living (IADL)" means those activities defined in OAR 411-15-0007.
24. (24) "Investigative Authority" means the local APD office, or local AAA office that contracts with the Department to receive and investigate alleged Abuse and assess protective services under OAR chapter 411, division 20.
25. (25) “Licensee” means the person or entity who has been issued an Agency with Choice license.
26. (26) “Management Experience”, means verifiable experience, history in the administration, supervision, or management in a health-related or long-term services, and supports field. This includes, at a minimum, hiring, assigning, evaluating, promoting and responsibility for implementing disciplinary actions.

27. (27) “Mandatory Reporter” means any public or private official who is required by state Abuse statutes to report alleged Abuse to the Department, or law enforcement agency as it applies to a:

    1. (a) "Child" defined in ORS 419B.005;
    2. (b) "Child in Care" as defined in ORS 418.257;
    3. (c) "Adult" with developmental disabilities or mental illness as defined in ORS 430.735; or
    4. (d) "Elderly Person" or a "Person with a Disability" as those terms as defined in ORS 124.005.
28. (28) "The Office of Aging and People with Disabilities (APD)” means the program area of The Office of Aging and People with Disabilities, within the Oregon Department of Human Services.
29. (29) "Person-Centered Service Plan” or “Service Plan" means the details of the supports, desired outcomes, activities, and resources required for an Individual to achieve and maintain personal goals, health, and safety, as described in OAR 411-004-0030. The Case Manager completes the Person-Centered Service Plan directed and agreed by the Individual, or Individual’s representative.
30. (30) "Professional Experience" means having verifiable work history as a licensed or certified nurse, nursing assistant, medication aide, physician, physical or occupational therapist or having received the professional development certificate from the Oregon Home Care Commission or other verifiable work experience from other states. The license or certificate must be current and in good standing.
31. (31) "Provider Enrollment Agreement" refers to the agreements between the Department and a qualified Medicaid provider to receive a provider agency number and deliver services for compensation.

32. (32) "Qualified Trainer" means a person who:

    1. (a) Has Professional Experience providing Direct Support Workers, homecare workers, certified nursing assistants or other relevant caregivers with the necessary skills and information necessary to provide competent, quality care, and is approved by the Department to Direct Support Worker; and
    2. (b) Is designated by an Agency with Choice to conduct Direct Support Worker training on behalf of the Agency with Choice, including but not limited to orientation, mandatory training and continuing education training required by these rules.
33. (33) “Self-directed Service Delivery Model” for the purpose of these rules means an Individual is supported by an Agency with Choice that functions as the employer (defined in ORS 411.375) of Direct Support Workers recruited by the Individual and provides financial management services and tasks in place of the Individual. The Individual chooses, trains and directs the tasks and work priorities of the Direct Support Workers who will provide their services and is considered a co-employer with the Agency with Choice.
34. (34) “Services and Supports” means the ADLs, IADLs, and health-related needs as described in the Individual’s Service Plan.
35. (35) “Subject Individual (SI)” means an individual whom an Agency with Choice must conduct a Background Check and BCU may conduct a criminal records and Abuse check, and from whom BCU may require fingerprints for the purpose of conducting a criminal records check and an Abuse check. An SI includes all staff and volunteers working for or with the Agency with Choice.

Statutory/Other Authority

Or Laws 2024, ch. 37

Statutes/Other Implemented

ORS 124.050 & Or Laws 2024, ch. 37

History

APD 17-2025, adopt filed 12/10/2025, effective 12/15/2025