HOME DELIVERED MEALS
Medicaid Funded Home Delivered Meals
(1) Home delivered meals, exclusive of those funded through the Older Americans Act or Oregon Project Independence, constitute a service that is provided as part of Medicaid home and community-based services to assist an individual to remain in his or her own home.
(2) Payment for meals delivered to an individual at his or her home may be provided when other plans do not appear feasible and home delivered meals are determined by the Department's local unit to be more appropriate for the individual's needs than nursing facility services. The cost for these meals is calculated into the individual's service plan in conjunction with in-home services provided by a consumer-employed provider or a home care agency.
(3) All requests for Medicaid-funded home delivered meals must be referred to the Department's local unit.
(4) The Department/AAA case manager is responsible for establishing, authorizing, purchasing, and monitoring a plan for home-delivered meals.
(5) Individuals who are required to make a monthly payment under OAR 461-185-0050 in order to remain eligible for Medicaid home and community-based services must have the home-delivered meal costs calculated in conjunction with the in-home service provider costs.
(a) To remain eligible for Medicaid home and community-based services, pay-in individuals are responsible for payment of authorized home-delivered meals received up to their specified monthly pay-in amount. Individual payments due for meal services are to be included as part of the monthly sum sent to the Department's pay-in unit rather than making any direct payments to the meal provider.
(b) The Department is responsible for direct payments made to providers for all authorized home-delivered meals to individuals receiving Medicaid home and community-based services. Direct payment from the Department includes meals paid through the individual's monthly pay-in and for meals that exceed the individual's total monthly liability.
(6) For individuals whose meals are delivered through an Older Americans Act meal service program, which also contracts as a Medicaid home delivered meals provider:
(a) Individuals receiving home-delivered meals authorized and paid for by the Department must be officially informed by the case manager that there is no obligation to make any voluntary or suggested donation for this service. However, if the individual chooses to make a voluntary donation, there is no restriction from doing so.
(b) If the individual has a monthly payment to the Department under OAR 461-185-0050 in order to remain eligible for services, the individual must meet the criteria in both subsections (5) and (6)(a) of this rule.
(c) An individual who meets the criteria in subsections (2) or (5) of this rule and is age 65 or older, may choose to receive meals through the Older Americans Act (OAA) meal service program and may make voluntary donations. For individuals required to make a monthly payment under OAR 461-185-0050, these donations may not be credited toward the pay-in liability. In turn, OAA meal programs are not mandated to provide home-delivered meals to individuals age 65 and older receiving Medicaid home and community-based services unless the agency is a Medicaid-contracted meal provider and the meals are authorized and paid for by the Department.
Stat. Auth.: ORS 410.070, 411.060 &
Stats. Implemented: ORS 410.070
Hist.: SSD 11-1982, f. & ef. 10-1-82; SPD 12-2004, f. & cert. ef. 6-1-04; SPD 26-2011(Temp), f. & cert. ef. 12-20-11 thru 6-13-12; Administrative correction, 6-27-12; SPD 14-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13; SPD 44-2013, f. 12-13-13, cert. ef. 12-15-13
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