INDIVIDUAL-DIRECTED GOODS AND SERVICES. Individual-directed goods and services are available through the Medically Involved Children's Waiver, Medically Fragile (Hospital) Model Waiver, and Behavioral (ICF/IID) Model Waiver.

1. (1) Only a child who meets the general eligibility criteria in OAR 411-435-0030 and enrolled in CIIS may access individual-directed goods and services.
2. (2) Individual-directed goods and services provide equipment and supplies not otherwise available through another source, such as waiver services or state plan services.
3. (3) Authorization of individual directed goods and services must be based on an assessed need.
4. (4) Individual-directed goods and services must directly address the disability related need of a child identified in their ISP.

5. (5) Individual-directed goods and services must:

   1. (a) Decrease the need for other Medicaid services;
   2. (b) Promote inclusion of a child in the community; or
   3. (c) Increase the safety of a child in the family home.

6. (6) Individual-directed goods and services may not be:

   1. (a) Otherwise available through another source, such as waiver services or state plan services;
   2. (b) Experimental or prohibited treatment; or
   3. (c) Goods or services that are normally purchased by a family for a typically developing child of the same age.
7. (7) Individual-directed goods and services purchased must be the most cost-effective option available to meet the needs of the child.

Statutory/Other Authority

ORS 409.050, 427.104 & 430.662

Statutes/Other Implemented

ORS 427.007, 427.104, 430.610, 430.620 & 430.662-430.670

History

APD 47-2019, amend filed 10/29/2019, effective 11/01/2019
APD 46-2018, amend filed 12/28/2018, effective 12/28/2018
APD 23-2018, temporary amend filed 07/02/2018, effective 07/02/2018 through 12/27/2018
APD 6-2017, f. 2-21-17, cert. ef. 2-28-17
APD 36-2016(Temp), f. 8-31-16, cert. ef. 9-1-16 thru 2-27-17
APD 20-2016, f. & cert. ef. 6-29-16