Department of Human Services,
Seniors and People with Disabilities Division Chapter 411
Caption: Eligibility and Entry and Exit
Standards for Support Services for Adults with Developmental Disabilities
Order No.: SPD 21-2011(Temp)
Filed with Sec. of
Certified to be
Effective: 8-31-11 thru 12-28-11
Rules Amended: 411-340-0100, 411-340-0110
Rules Suspended: 411-340-0100(T)
Subject: The Department of Human Services (Department) is
temporarily amending the support services for adults with developmental
disabilities rules in OAR chapter 411, division 340 to make the receipt of
support services contingent on eligibility for the federally approved Support
Services Waiver in most cases. Prior to this, eligibility for the Support
Services Waiver was not a requirement for support services
rulemaking requires that all individuals not eligible for the Support Services
Waiver exit brokerage services after September 30, 2011. This eligibility
change was included in the 2011-2013 Legislatively Approved Budget for the
Rules Coordinator: Christina Hartman—(503) 945-6398
Eligibility for Support Service
(1) NON-DISCRIMINATION. Individuals determined eligible
according to section (2) of this rule may not be denied brokerage services or
otherwise discriminated against on the basis of age, diagnostic or disability
category, race, color, creed, national origin, citizenship, income, or duration
of Oregon residence.
(2) ELIGIBILITY. The CDDP of an individual’s county of
residence may find the individual eligible for a brokerage when:
(a) The individual is an Oregon resident who has been
determined eligible for developmental disability services by the CDDP; AND
(b) The individual is an adult living in the
individual’s own home or family home and not receiving other Division-paid
in-home or community living support other than State Medicaid Plan services;
(c) The individual is not enrolled in comprehensive
(d) At the time of initial enrollment in the brokerage,
the individual is not receiving short-term services from the Division because
the individual is eligible for, and at imminent risk of, civil commitment under
ORS chapter 427.215 through 427.306; AND
(e) The individual or the individual’s legal
representative has chosen to use a brokerage for assistance with design and
management of personal supports; AND
(f) The individual is an adult eligible for enrollment
in the Support Services Waiver according to OAR 461-135-0750; OR
(g) The individual turns eighteen years old and:
(A) Meets the Level of Care that qualifies the
individual for enrollment to the Support Services Waiver; and
(B) Had been enrolled in the Children’s Intensive
In-home Services (CIIS) Program up to the individual’s 18th birthday.
(3) CONCURRENT SERVICES. Individuals are not eligible
for service by more than one brokerage unless the concurrent service:
(a) Is necessary to affect transition from one
brokerage to another;
(b) Is part of a collaborative plan between the
affected brokerages; and
Hist.: MHD 9-2001(Temp), f.
8-30-01, cert. ef. 9-1-01 thru 2-27-02; MHD 5-2002, f. 2-26-02 cert. ef.
2-27-02; Renumbered from 309-041-1840, SPD 22-2003, f. 12-22-03, cert. ef.
12-28-03; SPD 8-2008, f. 6-27-08, cert. ef. 6-29-08; SPD 8-2009, f. & cert.
ef. 7-1-09; SPD 18-2011(Temp), f. & cert. ef. 7-1-11 thru 12-28-11; SPD
21-2011(Temp), f. & cert. ef. 8-31-11 thru 12-28-11
Standards for Support Service
Brokerage Entry and Exit
(1) The brokerage must make accurate, up-to-date
information about the brokerage available to individuals referred for services.
This information must include:
(a) A declaration of brokerage philosophy;
(b) A brief description of the services provided by the
brokerage, including typical timelines for activities;
(c) A description of processes involved in using the
services, including application and referral, assessment, planning, and
(d) A declaration of brokerage employee
responsibilities as mandatory abuse reporters;
(e) A brief description of individual responsibilities
for use of public funds;
(f) An explanation of individual rights, including an
individual’s right to:
(A) Choose a brokerage from among Division contracted
brokerages in an individual’s county of residence that is serving less than the
total number of individuals specified in the brokerage’s current contract with
(B) Choose a personal agent among those available in
the selected brokerage;
(C) Select providers among those willing, available,
and qualified according to OAR 411-340-0160, 411-340-0170, and 411-340-0180 to
provide supports authorized through the ISP;
(D) Direct the services of providers; and
(E) Raise and resolve concerns about brokerage
services, including specific rights to notification and hearing for Medicaid
recipients according to OAR 411-340-0060(3) when services covered under
Medicaid are denied, terminated, suspended, or reduced.
(g) Indication that additional information about the
brokerage is available on request. The additional information must include but
not be limited to:
(A) A description of the brokerage’s organizational
(B) A description of any contractual relationships the
brokerage has in place or may establish to accomplish the brokerage functions
required by rule; and
(C) A description of the relationship between the
brokerage and the brokerage’s Policy Oversight Group.
(2) The brokerage must make information required in
section (1) of this rule available using language, format, and presentation
methods appropriate for effective communication according to individuals’ needs
(3) ENTRY INTO BROKERAGE SERVICES.
(a) To enter brokerage services:
(A) An individual must be determined by the CDDP to be
eligible for brokerage services according to OAR 411-340-0100(2);
(B) The individual or the individual’s legal
representative must choose to receive services from a selected brokerage; and
(C) The individual must be enrolled to the Support
Services Waiver unless eligibility for support services is based upon OAR
(b) The Division may implement guidelines that govern
entries when the Division has determined that such guidelines are prudent and
necessary for the continued development and implementation of support services.
(c) The brokerage may not accept individuals for entry
beyond the total number of individuals specified in its current contract with
(4) EXIT FROM A BROKERAGE.
(a) An individual must exit a brokerage:
(A) At the written request of the individual or the
individual’s legal representative to end the service relationship;
(B) No less than 30 days after the brokerage has served
written notice of intent to terminate services, when the individual either
cannot be located or has not responded to repeated attempts by brokerage staff
to complete ISP development and monitoring activities, and does not respond to
the notice of intent to terminate;
(C) Whenever the individual’s emergent status exceeds
270 consecutive days;
(D) Upon entry into a comprehensive service; or
(E) When the individual is incarcerated or in a medical
hospital, psychiatric hospital, or convalescent center and it is determined
that the individual will not return home, or will not return home after 90
(F) After September 30, 2011 when the individual does
not meet the eligibility criteria for the Support Services Waiver under OAR
461-135-0750, except that:
(i) An individual who has applied for a disability
determination from the Social Security Administration, and has applied for
Medicaid in Oregon, on or before May 1, 2011, may remain enrolled in support
services until a disability determination is made and eligibility for OSIP-M
(Oregon Supplemental Income Program Medical) is determined. An appeal of a
previous denial of disability from the Social Security Administration does not
constitute an application.
(ii) An individual who has an active application with
the Division’s Presumptive Medicaid Disability Determination Team dated on or
before July 15, 2011 may remain enrolled in brokerage services until a
disability determination is made.
(G) After ten days when an individual is eligible for
support services based on OAR 411-340-0100(2)(g) and:
(i) The individual does not apply for a disability
determination and OSIP-M within 10 business days of the individual’s 18th
(ii) The Social Security Administration or the
Division’s Presumptive Medicaid Disability Determination Team finds that an
individual does not have a qualifying disability; OR
(iii) The individual is determined by the State of
Oregon to be ineligible for OSIP-M.
(b) Any individual being exited from a brokerage must
be given written notice of the intent to terminate service at least 10 days
prior to the termination regardless of Medicaid status.
(c) An individual who exits support services as a
result of the application of section (4)(a)(F) of this rule may not receive
continuation of benefits pending a contested case hearing if a hearing is
requested to contest the decision to exit from support services.
(d) Each brokerage must have policies and procedures
for notifying the CDDP of an individual’s county of residence when that
individual plans to exit, or exits, brokerage services. Notification method,
timelines, and content must be based on agreements between the brokerage and
CDDP’s of each county in which the brokerage provides services.
Hist.: MHD 9-2001(Temp), f.
8-30-01, cert. ef. 9-1-01 thru 2-27-02; MHD 5-2002, f. 2-26-02 cert. ef.
2-27-02; MHD 4-2003(Temp); f. & cert. ef. 7-1-03 thru 12-27-03; Renumbered
from 309-041-1850, SPD 22-2003, f. 12-22-03, cert. ef. 12-28-03; SPD 32-2004,
f. & cert. ef. 10-25-04; SPD 8-2005, f. & cert. ef. 6-23-05; SPD
17-2006, f. 4-26-06, cert. ef. 5-1-06; SPD 8-2008, f. 6-27-08, cert. ef.
6-29-08; SPD 8-2009, f. & cert. ef. 7-1-09; SPD 21-2011(Temp), f. &
cert. ef. 8-31-11 thru 12-28-11
Notes 1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2010.