Secretary of State home | State Archives home

800 Summer St NE Salem OR 97310
503 373 0701 | Mon-Fri: 8am-4:45pm

Oregon State Archives

The Oregon Administrative Rules contain OARs filed through April 15, 2013

QUESTIONS ABOUT THE CONTENT OR MEANING OF THIS AGENCY'S RULES?
CLICK HERE TO ACCESS RULES COORDINATOR CONTACT INFORMATION

DEPARTMENT OF HUMAN SERVICES,
AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES

DIVISION 328

SUPPORTED LIVING SERVICES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES

411-328-0550

Statement of Purpose, Mission Statement, and Statutory Authority

(1) Purpose. These rules prescribe standards by which the Seniors and People with Disabilities Division approves programs that provide supported living services for individuals with developmental disabilities.

(2) Mission Statement. The overall mission of the Seniors and People with Disabilities Division, Office of Developmental Disability Services is to provide support services that enhance the quality of life of persons with developmental disabilities.

(a) Supported living services are a key element in the service delivery system and are critical to achieving this mission.

(b) The goal of supported living is to assist individuals to live in their own homes, in their own communities.

(c) The term "Supported Living" refers to a service which provides the opportunity for persons with developmental disabilities to live in the residence of their choice within the community with recognition that needs and preferences may change over time. Levels of support are based upon individual needs and preferences as defined in the Individual Support Plan. Such services may include up to 24 hours per day of paid supports which are provided in a manner that protects individuals' dignity.

(d) The service provider is responsible for developing and implementing policies and procedures and/or plans that ensure that the requirements of this rule are met.

(e) In addition, the service provider must ensure services comply with all applicable local, state and federal laws and regulations.

(f) The purpose of this rule is to ensure that the service provider meets basic management, programmatic, health and safety, and human rights regulations for those individuals receiving supported living services funded by the Seniors and People with Disabilities Division.

(3) Statutory Authority. These rules are authorized by ORS 409.050 and 410.070 and carry out the provisions of 430.610, 430.630, and 430.670.

411-328-0560

Definitions

(1) "Abuse" means abuse of an adult as defined in OAR 407-045-0260.

(2) "Abuse Investigation and Protective Services" means reporting and investigation activities as required by OAR 407-045-0300 and any subsequent services or supports necessary to prevent further abuse as required in OAR 407-045-0310.

(3) "Administration of Medication" means the act of placing a medication in or on an individual's body by a staff member who is responsible for the individual's care.

(4) "Adult" means an individual 18 years or older with developmental disabilities.

(5) "Advocate" means a person other than paid staff who has been selected by the individual or by the individual's legal representative to help the individual understand and make choices in matters relating to identification of needs and choices of services, especially when rights are at risk or have been violated.

(6) "Aid to Physical Functioning" means any special equipment prescribed for an individual by a physician, therapist, or dietician that maintains or enhances the individual's physical functioning.

(7) "Annual Individual Support Plan (ISP) Meeting" means an annual meeting, facilitated by a services coordinator of the community developmental disability program and attended by the individual served, agency representatives who provide service to the individual, the individual's guardian, if any, relatives of the individual, or other persons, such as an advocate, as appropriate. The purpose of the meeting is to determine needs, coordinate services and training, and develop an ISP.

(8) "Board of Directors" mean a group of persons formed to set policy and give directions to a service provider that provides residential services to individuals with developmental disabilities. A board of directors includes local advisory boards used by multi-state organizations.

(9) "Certificate" means a document issued by the Department to a service provider that certifies the service provider is eligible under the rules in OAR chapter 411, division 323 to receive state funds for the provision of endorsed supported living services.

(10) "Choice" means the individual's expression of preference, opportunity for, and active role in decision-making related to the selection of assessments, services, service providers, goals and activities, and verification of satisfaction with these services. Choice may be communicated verbally, through sign language, or by other communication methods.

(11) "Community Developmental Disability Program (CDDP)" means an entity that is responsible for the planning and delivery of services for individuals with developmental disabilities according to OAR chapter 411, division 320. A CDDP operates in a specific geographic service area of the state under a contract with the Department, local mental health authority, or other entity as contracted by the Department.

(12) "Complaint Investigation" means an investigation of any complaint that has been made to a proper authority that is not covered by an abuse investigation.

(13) "Controlled Substance" means any drug classified as Schedules 1 through 5 under the Federal Controlled Substance Act.

(14) "Department" means the Department of Human Services (DHS). The term "Department" is synonymous with "Division (SPD)".

(15) "Developmental Disability" means a neurological condition that originates in the developmental years, that is likely to continue, and significantly impacts adaptive behavior as diagnosed and measured by a qualified professional as described in OAR 411-320-0080.

(16) "Director" means the Director of the Department's Office of Developmental Disability Services, or that person's designee.

(17) "Endorsement" means authorization to provide supported living services issued by the Department to a certified service provider that has met the qualification criteria outlined in these rules and the rules in OAR chapter 411, division 323.

(18) "Entry" means the admission to a Department-funded developmental disability service.

(19) "Executive Director" means the person designated by a board of directors or corporate owner that is responsible for the administration of supported living services.

(20) "Exit" means either termination from a Department-funded developmental disability service provider or transfer from one Department-funded service provider to another.

(21) "Founded Reports" means the Department's or Law Enforcement Authority's (LEA) determination, based on the evidence, that there is reasonable cause to believe that conduct in violation of the child abuse statutes or rules has occurred and such conduct is attributable to the person alleged to have engaged in the conduct.

(22) "Health Care Provider" means a person or health care facility licensed, certified, or otherwise authorized or permitted by Oregon law to administer health care in the ordinary course of business or practice of a profession.

(23) "Incident Report" means a written report of any injury, accident, acts of physical aggression, or unusual incident involving an individual.

(24) "Independence" means the extent to which individuals with developmental disabilities exert control and choice over their own lives.

(25) "Individual" means a person with developmental disabilities for whom services are planned and provided.

(26) "Individual Profile" means a written profile that describes the individual entering into supported living. The profile may consist of materials or assessments generated by the service provider or other related agencies, consultants, family members, or advocates.

(27) "Individual Support Plan (ISP)" means the written details of the supports, activities, and resources required for an individual to achieve personal goals. The type of service supports needed, how supports are delivered, and the frequency of provided supports are included in the ISP. The ISP is developed at minimum annually to reflect decisions and agreements made during a person-centered process of planning and information gathering. The ISP is the individual's Plan of Care for Medicaid purposes.

(28) "Individual Support Plan (ISP) Team" means a team composed of the individual served, agency representatives who provide service to the individual (if appropriate for in-home supports), the guardian (if any), the services coordinator, and family or other persons requested to develop the ISP.

(29) "Integration" as defined in ORS 427.005 means:

(a) The use by individuals with developmental disabilities of the same community resources used by and available to other persons;

(b) Participation by individuals with developmental disabilities in the same community activities in which persons without a developmental disability participate, together with regular contact with persons without a developmental disability; and

(c) Individuals with developmental disabilities reside in homes or home-like settings that are in proximity to community resources and foster contact with persons in their community.

(30) "Legal Representative" means the parent, if the individual is under age 18, unless the court appoints another person or agency to act as guardian. For those individuals over the age of 18, a legal representative means an attorney at law who has been retained by or for the individual or a person or agency authorized by the court to make decisions about services for the individual.

(31) "Mandatory Reporter" means any public or private official as defined in OAR 407-045-0260 who, for the purpose of these rules, is a staff or volunteer working with adults 18 years and older who, while acting in an official capacity, comes in contact with and has reasonable cause to believe an adult with developmental disabilities has suffered abuse, or comes in contact with any person whom the official has reasonable cause to believe abused an adult with developmental disabilities. Nothing contained in ORS 40.225 to 40.295 shall affect the duty to report imposed by this section of this rule, OAR 411-328-0560, except that a psychiatrist, psychologist, clergy, or attorney is not required to report if the communication is privileged under ORS 40.225 to 40.295.

(32) "Medicaid Agency Identification Number" means the numeric identifier assigned by the Department to a service provider following the service provider's enrollment as described in OAR chapter 411, division 370.

(33) "Medicaid Performing Provider Number" means the numeric identifier assigned to an entity or person by the Department, following enrollment to deliver Medicaid funded services as described in OAR chapter 411, division 370. The Medicaid Performing Provider Number is used by the rendering service provider for identification and billing purposes associated with service authorizations and payments.

(34) "Medication" means any drug, chemical, compound, suspension, or preparation in suitable form for use as a curative or remedial substance taken either internally or externally by any person.

(35) "Needs Meeting" means a process in which the Individual Support Plan team defines the supports an individual needs to live in his or her own home, and makes a determination as to the feasibility of creating such services. The information generated in this meeting or discussion is used by the service provider to develop the individual's Transition Plan.

(36) "Personal Futures Planning" means an optional planning process for describing a desirable future for an individual with developmental disabilities. The planning process generally occurs around major life transitions (e.g. moving into a new home, graduation from high school, marriage, etc.). Personal futures planning helps determine activities, supports, and resources that best create a desirable future for the individual.

(37) "Person-Centered Planning" means:

(a) A process, either formal or informal, for gathering and organizing information that helps an individual:

(A) Determine and describe choices about personal goals, activities, and lifestyle preferences;

(B) Design strategies and networks of support to achieve goals and a preferred lifestyle using individual strengths, relationships, and resources; and

(b) The methods for gathering information vary, but all are consistent with individual needs and preferences.

(38) "Prescription Medication" means any medication that requires a physician prescription before it may be obtained from a pharmacist.

(39) "Productivity" as defined in ORS 427.005 means:

(a) Engagement in income-producing work by an individual with developmental disabilities that is measured through improvements in income level, employment status, or job advancement; or

(b) Engagement by an individual with developmental disabilities in work contributing to a household or community.

(40) "Protection" and "Protective Services" means necessary actions taken as soon as possible to prevent subsequent abuse or exploitation of the individual, to prevent self-destructive acts, and to safeguard an individual's person, property, and funds.

(41) "Protective Physical Intervention (PPI)" means any manual physical holding of, or contact with, an individual that restricts the individual's freedom of movement. The term "protective physical intervention" is synonymous with "physical restraint".

(42) "Psychotropic Medication" means medication the prescribed intent of which is to affect or alter thought processes, mood, or behavior including but not limited to anti-psychotic, antidepressant, anxiolytic (anti-anxiety), and behavior medications. The classification of a medication depends upon its stated, intended effect when prescribed.

(43) "Self-Administration of Medication" means the individual manages and takes his or her own medication, identifies his or her own medication and the times and methods of administration, places the medication internally in or externally on his or her own body without staff assistance upon written order of a physician, and safely maintains the medication without supervision.

(44) "Service Provider" means a public or private community agency or organization that provides recognized developmental disability services and is certified and endorsed by the Department to provide these services under these rules and the rules in OAR chapter 411, division 323. For the purpose of these rules, "agency", "provider", or "program" is synonymous with "service provider."

(45) "Services Coordinator" means an employee of the community developmental disability program or other agency that contracts with the county or Department, who is selected to plan, procure, coordinate, and monitor Individual Support Plan services, and to act as a proponent for individuals with developmental disabilities.

(46) "Significant Other" means a person selected by the individual to be the individual's friend.

(47) "Staff" means paid employees responsible for providing services to individuals and whose wages are paid in part or in full with funds sub-contracted with the community developmental disability program or contracted directly through the Department.

(48) "Substantiated" means an abuse investigation has been completed by the Department or the Department's designee and the preponderance of the evidence establishes the abuse occurred.

(49) "Support" means assistance that individuals require, solely because of the affects of developmental disability, to maintain or increase independence, achieve community presence and participation, and improve productivity. Support is subject to change with time and circumstances.

(50) "Supported Living" means the endorsed service that provides the opportunity for individuals with developmental disabilities to live in a residence of their own choice within the community. Supported living is not grounded in the concept of "readiness" or in a "continuum of services model" but rather provides the opportunity for individuals to live where they want, with whom they want, for as long as they desire, with a recognition that needs and desires may change over time.

(51) "These Rules" mean the rules in OAR chapter 411, division 328.

(52) "Transfer" means movement of an individual from one type of service to another within the same county, administered by the same service provider.

(53) "Transition Plan" means a written plan for the period of time between an individual's entry into a particular service and when the individual's Individual Support Plan (ISP) is developed and approved by the ISP team. The Transition Plan includes a summary of the services necessary to facilitate adjustment to the services offered, the supports necessary to ensure health and safety, and the assessments and consultations necessary for ISP development.

(54) "Unusual Incident" means incidents involving serious illness or accidents, death of an individual, injury or illness of an individual requiring inpatient or emergency hospitalization, suicide attempts, a fire requiring the services of a fire department, or any incident requiring an abuse investigation.

(55) "Variance" means a temporary exception from a regulation or provision of these rules that may be granted by the Department upon written application by the service provider.

(56) "Volunteer" means any person assisting a service provider without pay to support the services provided to an individual.

Stat. Auth.: ORS 409.050 & 410.070
Stats. Implemented: ORS 430.610, 430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92, cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0560 by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 25-2009(Temp), f. 12-31-09, cert. ef. 1-1-10 thru 6-30-10; SPD 5-2010, f. 6-29-10, cert. ef. 7-1-10; SPD 19-2011(Temp), f. & cert. ef. 7-1-11 thru 12-28-11; SPD 1-2012, f. & cert. ef. 1-6-12

411-328-0570

Program Management

(1) CERTIFICATION, ENDORSEMENT, AND ENROLLMENT. To provide supported living services, a service provider must have:

(a) A certificate and an endorsement to provide supported living services as set forth in OAR chapter 411, division 323;

(b) A Medicaid Agency Identification Number assigned by the Department as described in OAR chapter 411, division 370; and

(c) For each specific geographic service area where supported living services shall be delivered, a Medicaid Performing Provider Number assigned by the Department as described in OAR chapter 411, division 370.

(2) INSPECTIONS AND INVESTIGATIONS. The service provider must allow inspections and investigations as described in OAR 411-323-0040.

(3) MANAGEMENT AND PERSONNEL PRACTICES. The service provider must comply with the management and personnel practices as described in OAR 411-323-0050.

(4) PERSONNEL FILES AND QUALIFICATION RECORDS. The service provider must maintain written documentation of six hours of pre-service training prior to supervising individuals that includes mandatory abuse reporting training and training on individual profiles and Transition Plans or ISPs.

(5) CONFIDENTIALITY OF RECORDS. The service provider must ensure all individuals' records are confidential as described in OAR 411-323-0060.

(6) DOCUMENTATION REQUIREMENTS. All entries required by these rules, unless stated otherwise must:

(a) Be prepared at the time, or immediately following the event being recorded;

(b) Be accurate and contain no willful falsifications;

(d) Be maintained for no less than five years.

Stat. Auth.: ORS 409.050 & 410.070
Stats. Implemented: ORS 430.610, 430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92, cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0570 by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 5-2011(Temp), f. & cert. ef. 2-7-11 thru 8-1-11; SPD 13-2011, f. & cert. ef. 7-1-11; SPD 19-2011(Temp), f. & cert. ef. 7-1-11 thru 12-28-11; SPD 1-2012, f. & cert. ef. 1-6-12

411-328-0620

Variances

(1) The Department may grant a variance to these rules based upon a demonstration by the service provider that an alternative method or different approach provides equal or greater program effectiveness and does not adversely impact the welfare, health, safety, or rights of individuals.

(2) The service provider requesting a variance must submit, in writing, an application to the CDDP that contains the following:

(a) The section of the rule from which the variance is sought;

(b) The reason for the proposed variance;

(d) If the variance applies to an individual's services, evidence that the variance is consistent with an individual's currently authorized ISP.

(3) The CDDP must forward the signed variance request form to the Department within 30 days of receipt of the request indicating its position on the proposed variance.

(4) The Department shall approve or deny the request for a variance.

(5) The Department's decision shall be sent to the service provider, the CDDP, and to all relevant Department programs or offices within 30 calendar days of receipt of the variance request.

(6) The service provider may appeal the denial of a variance request within 10 working days of the denial, by sending a written request for review to the Director and a copy of the request to the CDDP. The Director's decision is final.

(7) The Department shall determine the duration of the variance.

(8) The service provider may implement a variance only after written approval from the Department.

411-328-0630

Health: Medical Services

(1) All individuals' medical records must be kept confidential as described in OAR 411-323-0060.

(2) Individuals must receive sufficient oversight and guidance by the service provider to ensure that the individual's health and medical needs are adequately addressed.

(3) Written health and medical supports must be developed as required by the individual's ISP team and integrated into the Transition Plan or ISP. The Plan must be based on a review or identification of the individual's health and medically related support needs and preferences, and updated annually or as significant changes occur.

(4) The service provider must have and implement written policies and procedures that maintain or improve the physical health of individuals. Policies and procedures must address:

(a) Early detection and prevention of infectious disease;

(b) Emergency medical intervention;

(d) Obtaining, administering, storing, and disposing of prescription and non-prescription drugs including self administration.

(5) The service provider must ensure each individual has a primary physician whom the individual has chosen from among qualified providers.

(6) Provisions must be made for a secondary physician or clinic in the event of an emergency.

(7) The service provider must ensure that individuals have a medical evaluation by a physician no less often than every two years or as recommended by a physician. Evidence of the evaluation must be placed in the individual's record and must address:

(a) Current health status;

(b) Changes in health status;

(d) Any remedial and corrective action required and when such actions were taken;

(e) Statement of restrictions on activities due to medical limitations; and

(f) A review of medications, treatments, special diets, and therapies prescribed.

(8) Before entry, the service provider must obtain the most complete medical profile available including:

(a) The results of a physical exam made within 90 days prior to entry;

(b) Results of any dental evaluation;

(d) Status of Hepatitis B screening;

(e) A record of known communicable diseases and allergies; and

(f) A summary of the individual's medical history including chronic health concerns.

(9) The provider must ensure that all medications, treatments, and therapies:

(a) Have a written order or copy of the written order, signed by a physician or physician designee, before any medication, prescription, or non-prescription, is administered to or self-administered by the individual unless otherwise indicated by the ISP team in the written health and medical support section of the ISP or Transition Plan.

(b) Be followed per written orders.

(10) PRN orders are not allowed for psychotropic medication.

(11) The drug regimen of each individual on prescription medication must be reviewed and evaluated by a physician or physician designee, no less often than every 180 days unless otherwise indicated by the ISP team in the written health and medical support section of the ISP or Transition Plan.

(12) All prescribed medications and treatments must be self-administered unless contraindicated by the ISP team. For individuals who require assistance in the administration of their own medications, the following must be required:

(a) The ISP team has recommended that the individual be assisted with taking their medication;

(b) There is a written training program for the self-administration of medication unless contraindicated by the ISP team; and

(13) For individuals who independently self-administer medications, there must be a plan for the periodic monitoring or review of medications on each individual's ISP.

(14) The service provider must assist individuals with the use of prosthetic devices as ordered.

Stat. Auth.: ORS 409.050 & 410.070
Stats. Implemented: ORS 430.610, 430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92, cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0630 by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 19-2011(Temp), f. & cert. ef. 7-1-11 thru 12-28-11; SPD 1-2012, f. & cert. ef. 1-6-12

411-328-0640

Health: Dietary

(1) Identifying amount of support and guidance. The service provider shall be responsible for identifying the amount of support and guidance required to ensure that individuals are provided access to a nutritionally adequate diet.

(2) Written dietary supports. Written dietary supports shall be developed as required by the individual's ISP team and integrated into the transition plan or ISP. The plan shall be based on a review and identification of the individual's dietary service needs and preferences, and updated annually or as significant changes occur.

(3) Dietary policies and procedures. The program shall have and implement policies and procedures related to maintaining adequate food supplies, meal planning, preparation, service, and storage.

411-328-0650

Health: Physical Environment

(1) Maintained. All floors, walls, ceilings, windows, furniture and fixtures shall be maintained.

(2) Water and sewage. The water supply and sewage disposal shall meet the requirements of the current rules of the Oregon Public Health Division governing domestic water supply.

(3) Kitchen and bathroom. Each residence shall have:

(a) A kitchen area for the preparation of hot meals; and

(b) A bathroom containing a properly operating toilet, handwashing sink and bathtub or shower.

(4) Adequately heated and ventilated. Each residence shall be adequately heated and ventilated.

Stat. Auth.: ORS 409.050 & 410.070
Stats. Implemented: ORS 430.610, 430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92, cert. ef. 8-24-92; Renumbered from 309-041-0650 by SPD 17-2009, f. & cert. ef. 12-9-09

411-328-0660

Safety: General

(1) Employing means for protecting health and safety. The service provider shall employ means for protecting individuals health and safety which:

(a) Are not unduly restrictive;

(b) May include risks, but do not inordinately affect an individual's health, safety and welfare; and

(2) Written safety supports. Written safety supports shall be developed as required by the individual's ISP team and integrated into the transition plan or ISP. The plan shall:

(a) Be based on a review and identification of the person's safety needs and preferences;

(b) Be updated annually or as significant changes occur; and

(c) Identify how the individual will evacuate his/her residence, specifying at a minimum, routes to be used and the level of assistance needed.

(3) Policies and procedures related to safety, emergencies and disasters. The program shall have and implement policies and procedures that provide for the safety of individuals and for responses to emergencies and disasters.

(4) Smoke detectors. An operable smoke detector shall be available in each bedroom and in a central location on each floor.

(5) Fire extinguisher. An operable class 2A10BC fire extinguisher shall be easily accessible in each residence.

(6) First aid supplies. First aid supplies should be available in each residence.

(7) Emergency fire procedures. The need for emergency evacuation procedures and documentation thereof shall be assessed and determined by the individual's ISP team.

(8) Flashlight. An operable flashlight shall be available in each residence.

(9) Adaptations required for sensory or physically impaired. The service provider shall provide necessary adaptations to ensure fire safety for sensory and physically impaired individuals.

(10) Square footage requirement for bedrooms. Bedrooms shall meet minimum space requirements (single 60 square feet, double 120 square feet with beds located three feet apart).

(11) Window openings. Sleeping rooms shall have at least one window readily openable from the inside without special tools that provides a clear opening through which the individual can exit.

(12) Availability of emergency information. Emergency telephone numbers shall be available at each individual's residence as follows:

(a) The telephone numbers of the local fire, police department and ambulance service, if not served by a 911 emergency service; and

(b) The telephone number of the Director or designee, emergency physician and other persons to be contacted in case of an emergency.

411-328-0680

Safety: Staffing Requirements

(1) On-call staff. The program shall provide responsible persons or agency, on-call and available to individuals by telephone at all times.

(2) General staffing requirements. The program shall provide staff appropriate to the number and needs of individuals served as specified in each individual's support plan.

(3) Contract requirements for support staff ratios. Each program shall meet all requirements for staff ratios as specified by contract requirements.

Stat. Auth.: ORS 409.050 & 410.070
Stats. Implemented: ORS 430.610, 430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92, cert. ef. 8-24-92; Renumbered from 309-041-0680 by SPD 17-2009, f. & cert. ef. 12-9-09

411-328-0690

Safety: Individual Summary Sheets

Current record. A current record shall be maintained by the program for each individual receiving services. The record shall include:

(1) The individual's name, current address, home phone number, date of entry into the program, date of birth, sex, marital status, social security number, social security beneficiary account number, religious preference, preferred hospital, where applicable the number of the Disability Services Office (DSO) or the Multi-Service Office (MSO) of the Division, guardianship status; and

(2) The name, address and telephone number of:

(a) The individual's legal representative, family, advocate, or other designated contact person;

(b) The individual's preferred physician, secondary physician and/or clinic;

(d) The individual's day program, or employer, if any;

(e) The individual's case manager; and

(f) Other agency representatives providing services to the individual.

411-328-0700

Safety: Incident Reports and Emergency Notifications

(1) Incident reports. A written report that describes any injury, accident, act of physical aggression or unusual incident involving an individual shall be placed in the individual's record. Such description shall include:

(a) Conditions prior to or leading to the incident;

(b) A description of the incident;

(d) Administrative review and follow-up to be taken to prevent a recurrence of the injury, accident, physical aggression or unusual incident.

(2) Sent to case manager. Copies of all unusual incident (as defined by OAR 411-328-0560) reports shall be sent to the case manager within five working days of the incident.

(3) Immediate notification of allegations of abuse and abuse investigations. The program shall notify the CMHP immediately of an incident or allegation of abuse falling within the scope of OAR 411-328-0560(1)(a) through (d). When an abuse investigation has been initiated, the CMHP shall ensure that either the case manager or the program shall also immediately notify the individual's legal guardian or conservator. The parent, next of kin or other significant person may also be notified unless the individual requests the parent, next of kin or other significant person not be notified about the abuse investigation or protective services, or notification has been specifically prohibited by law.

(4) Immediate notification. In the case of a serious illness, injury or death of an individual, the program shall immediately notify:

(a) The individual's legal guardian or conservator, parent, next of kin, designated contact person and/or other significant person;

(b) The Community Mental Health Program; and

(5) Missing person notification. In the case of an individual who is missing beyond the timeframes established by the ISP team, the program shall immediately notify:

(a) The individual's designated contact person;

(b) The individual's guardian, if any, or nearest responsible relative;

(d) The Community Mental Health Program.

411-328-0710

Safety: Vehicles and Drivers

(1) Vehicles operated to transport individuals. Service providers that own or operate vehicles that transport individuals shall:

(a) Maintain the vehicles in safe operating condition;

(b) Comply with Driver and Motor Vehicle Services Division laws;

(d) Carry in vehicles a fire extinguisher and first aid kit.

(2) Drivers. Drivers operating vehicles to transport individuals must meet applicable Driver and Motor Vehicle Services Division requirements.

411-328-0715

Rights: Financial

(1) Written individual financial supports. Written individual financial supports shall be developed as required by the individual's ISP team and integrated into the transition plan or ISP. The plan shall be based on a review and identification of the individual's financial support needs and preferences, and be updated annually or as significant changes occur.

(2) Financial policies and procedures. The program shall have and implement written policies and procedures related to the oversight of the individual's financial resources.

(3) Reimbursement to individual. The program shall reimburse to the individual any funds that are missing due to theft and/or mismanagement on the part of any staff of the program, and/or of any funds within the custody of the program that are missing. Such reimbursement shall be made within 10 working days of the verification that funds are missing.

Stat. Auth.: ORS 409.050 & 410.070
Stats. Implemented: ORS 430.610, 430.630 & 430.670
Hist.: MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0715 by SPD 17-2009, f. & cert. ef. 12-9-09

411-328-0720

Rights: General

(1) Abuse prohibited. Any adult or any individual as defined at OAR 411-328-0560 shall not be abused nor shall abuse be condoned by an employee, staff or volunteer of the program.

(2) Policies and procedures. The program shall have and implement written policies and procedures which protect individual's rights and encourage and assist individuals to understand and exercise these rights. These policies and procedures shall at a minimum provide for:

(a) Assurance that each individual has the same civil and human rights accorded to other citizens;

(b) Adequate food, housing, clothing, medical and health care, supportive services and training;

(d) Private communication, including personal mail and telephone;

(e) Personal property and fostering of personal control and freedom regarding that property;

(f) Privacy;

(g) Protection from abuse and neglect, including freedom from unauthorized training, treatment and chemical/mechanical restraints;

(h) Freedom from unauthorized personal restraints;

(i) Freedom to choose whether or not to participate in religious activity;

(j) The opportunity to vote and training in the voting process if desired;

(k) Expression of sexuality, to marry and to have children;

(l) Access to community resources, including recreation, agency services, employment and alternatives to employment programs, educational opportunities and health care resources;

(m) Transfer of individuals within a program;

(n) Individual choice that allows control and ownership of their personal affairs;

(o) Appropriate services which promote independence, dignity and self-esteem and are also appropriate to the age and preferences of the individual;

(p) Individual choice to consent to or refuse treatment; and

(q) Individual choice to participate in community activities.

(3) Notification of policies and procedures. The program shall inform each individual and parent/guardian/advocate orally and in writing of its rights policy and procedures and a description of how to exercise them at entry to the program and, in a timely manner, as changes occur.

411-328-0740

Rights: Grievances

(1) The service provider must implement written policies and procedures for individuals' grievances as required by OAR 411-323-0060.

(2) The service provider must send copies of the documentation on all grievances to the services coordinator within 15 working days of initial receipt of the grievance.

(3) At entry to service and as changes occur, the service provider must inform each individual and parent, guardian, or advocate orally and in writing of the service provider's grievance policy and procedures and a description of how to utilize them.

Stat. Auth.: ORS 409.050 & 410.070
Stats. Implemented: ORS 430.610, 430.630 & 430.670
Hist.: MHD 5-1992, f. 8-21-92, cert. ef. 8-24-92; MHD 3-1997, f. & cert. ef. 2-7-97; Renumbered from 309-041-0740 by SPD 17-2009, f. & cert. ef. 12-9-09; SPD 19-2011(Temp), f. & cert. ef. 7-1-11 thru 12-28-11; SPD 1-2012, f. & cert. ef. 1-6-12

411-328-0750

Rights: Personalized Plans

(1) Team process. The decision to support an individual so that he/she can live in and maintain his/her own home requires significant involvement from the individual and his/her ISP team. In supported living, this process is characterized by a series of team meetings or discussions to determine what personalized supports the individual will need to live in his/her home, a determination as to the feasibility of creating such supports, and the development of a written plan which describes services the individual will receive upon entry into supported living.

(2) Needs meeting. Prior to moving into his/her own home, the ISP team shall meet to discuss the individual's projected service needs in a needs meeting. This meeting shall:

(a) Review information related to the individual's health and medical, safety, dietary, financial, social, leisure, staff, mental health and behavioral support needs and preferences;

(b) Include any potential providers, the individual and other ISP team members;

(d) Discuss the selection of potential providers based on list of support and services needed.

(3) Transition plan. The provider will be required to spend time getting to know the individual personally before working on the development of the transition plan. The individual, provider, and other ISP team members shall participate in an entry meeting prior to the initiation of services. The outcome of this meeting shall be a written transition plan which shall take effect upon entry and shall:

(a) Address the individual's health and medical, safety, dietary, financial, staffing, mental health and behavioral support needs and preferences as required by the ISP team;

(b) Indicate who is responsible for providing the supports described in the plan;

(c) Be based on the list of supports identified in the needs meeting and other assessments and/or consultation required by the ISP team; and

(d) Be in effect and available at the site until the ISP is developed and approved by the ISP team.

(4) Individual support team membership. The team shall include the individual, the case manager, the individual's legal guardian, representatives of all current service providers, the provider who will provide supported living services, and advocate or others determined appropriate by the individual receiving services.

(5) Individual support plan. A copy of each individual's Individual Support Plan shall be developed and approved by the ISP team within 90 days of entry and shall be available at the individual's home within 30 days of development and approval. The plan shall:

(a) Be based on a review and identification of the individual's service needs and preferences;

(b) Include a summary of the services related to the individual's health and medical, safety, dietary, financial and mental health and behavioral needs and preferences as determined by the ISP team;

(d) Be updated as significant changes occur and/or at least annually.

(6) Distribution of ISP document. The case manager shall ensure distribution of a copy of the ISP to all team members within 30 calendar days of the ISP team meeting.

(7) Individual Profile. The program shall develop a written profile which describes the individual. This information shall be used in training new staff. The profile shall be completed within 90 days of entry. The profile shall include information related to the individual's history or personal highlights, lifestyle and activity choices and preferences, social network/significant relationships, and other information that helps describe the individual.

(8) Profile composition. The profile shall be composed of written information generated by the program. It may include reports of assessments or consultations; historical or current materials developed by the CMHP, training centers, and/or nursing homes; material/pictures from the family and/or advocates; newspaper articles; and other relevant information.

(9) Profile maintained. The profile shall be maintained at the service site and updated as significant changes occur.

411-328-0760

Rights: Behavior Intervention

(1) Written policy. The service provider shall have and implement a written policy concerning behavior intervention procedures. The service provider shall inform the individual and his/her legal guardian of the behavior intervention policy and procedures at the time of entry and as changes occur.

(2) Implementation of a program to alter an individual's behavior. A decision to implement a program to alter an individual's behavior shall be made by the ISP team and the program shall be described fully in the individual's ISP. The program shall:

(a) Emphasize the development of the functional alternative behavior and positive approaches and positive behavior intervention;

(b) Use the least intervention possible;

(d) Be evaluated by the service provider through timely review of specific data on the progress and effectiveness of the procedure.

(3) Documentation requirements. Documentation regarding the behavior program shall include:

(a) Documentation that the individual, the guardian, and ISP team are fully aware of and consent to the program in accordance with the ISP process as defined in the Case Management Services Rule OAR 411-320-0120;

(b) Documentation of all prior programs used to develop an alternative behavior; and

(c) A functional analysis of the behavior which has been completed prior to developing the behavior program by a trained staff member and/or consultant. This written record shall include:

(A) A clear, measurable description of the behavior to include frequency, duration, intensity and severity of the behavior;

(B) A clear description of the need to alter the behavior;

(i) An effort to communicate;

(ii) The result of medical conditions;

(iii) The result of environmental causes; or

(iv) The result of other factors;

(d) A description of the conditions which precede the behavior in question;

(e) A description of what appears to reinforce and maintain the behavior; and

(f) A clear and measurable procedure which will be used to alter the behavior and develop the functional alternative behavior.

411-328-0770

Rights: Physical Restraints

(1) Circumstances when physical restraint allowed. The service provider shall only employ physical restraint:

(a) As part of an Individual Support Plan that meets OAR 411-328-0760 of this rule;

(b) As an emergency measure, but only if absolutely necessary to protect the individual or others from immediate injury; or

(c) As a health-related protection prescribed by a physician, but only if necessary for individual protection during the time that a medical condition exists.

(2) Staff training. Staff members who need to apply restraint as part of an individual's ongoing training program shall be trained by a Division approved trainer. Documentation verifying such training shall be maintained in his/her personnel file.

(3) Physical restraints in emergency situations. Physical restraints in emergency situations shall:

(a) Be only used until the individual is no longer a threat to self or others;

(b) Be authorized by the program's director or designee, or physician;

(d) Result in the immediate notification of the individual's case manager or CMHP designee; and

(e) Prompt an ISP meeting, initiated by the service provider, if used more than three times in a six month period.

(4) Avoid physical injury. Physical restraint shall be designed to avoid physical injury to the individual or others, and to minimize physical and psychological discomfort.

(5) Incident report. All use of physical restraint shall be documented in an incident report. The report shall include:

(a) The name of the individual to whom the restraint is applied;

(b) The date, type and length of time, of restraint application;

(d) The name of the staff member(s) applying the restraint; and

(e) Description of the incident.

(6) Copy to CMHP. A copy of the incident report shall be forwarded within five working days of the incident to the Community Mental Health Program.

411-328-0780

Rights: Psychotropic Medications and Medications for Behavior

(1) Requirements. Psychotropic medications and medications for behavior shall be:

(a) Prescribed by physician through a written order; and

(b) Included on the individual's ISP.

(2) Balancing test. The use of psychotropic medications and medications for behavior shall be based on a physician's decision that the harmful effects without the medication clearly outweigh the potentially harmful effects of the medication. Service providers must present the physician with a full and clear written description of the behavior and symptoms to be addressed, as well as any side effects observed, to enable the physician to make this decision.

(3) Monitoring and review. Psychotropic medications and medications for behavior shall be:

(a) Monitored by the prescribing physician, ISP team and program for desired responses and adverse consequences; and

(b) Reviewed to determine the continued need and/or lowest effective dosage in a carefully monitored program.

411-328-0790

Entry, Exit and Transfer: General

(1) Qualifications for Division funding. All individuals considered for Division-funded services shall:

(a) Be referred by the Community Mental Health Program;

(b) Be determined to have a developmental disability by the Division or its designee; and

(c) Not be discriminated against because of race, color, creed, age, disability, national origin, gender, religion, duration of Oregon residence, method of payment or other forms of discrimination under applicable state or Federal law.

(2) Information required for entry meeting. The program shall acquire the following information prior to an entry ISP meeting:

(a) Written documentation that the individual has been determined to have a developmental disability;

(b) A statement indicating the individual's safety skills including ability to evacuate from a building when warned by a signal device and adjusting water temperature;

(d) Information related to the individual's lifestyle, activities, and other choices and preferences;

(e) Documentation of the individual's financial resources;

(f) Documentation from a physician of the individual's current physical condition, including a written record of any current or recommended medications, treatments, diet and aids to physical functioning;

(g) Documentation of any guardian or conservator, or any other legal restriction on the rights of the individual, if applicable; and

(h) A copy of the most recent ISP, if applicable.

(3) Entry meeting. An entry ISP team meeting shall be conducted prior to the initiation of services to the individual. The findings of the entry meeting shall be recorded in the individual's file and include at a minimum:

(a) The name of the individual proposed for service;

(b) The date of the meeting;

(d) Documentation of the participants at the meeting;

(e) Documentation of the pre-entry information required by section (2)(a)-(h) of this rule;

(f) Documentation of the decision to serve or not serve the individual requesting service, with reasons; and

(g) Documentation of the proposed transition plan as defined in the Case Management Services Rule OAR 411-320-0020 for services to be provided if the decision was made to serve.

(4) Exit meeting. Each individual considered for exit shall have a meeting by the ISP team before any decision to exit is made. Findings of such a meeting shall be recorded in the individual's file and include at a minimum:

(a) The name of the individual considered for exit;

(b) The date of the meeting;

(d) Documentation of the circumstances leading to the proposed exit;

(e) Documentation of the discussion of the strategies to prevent an exit from services (unless the individual is requesting exit);

(f) Documentation of the decision regarding exit including verification of a majority agreement of the meeting participants regarding the decision; and

(g) Documentation of the proposed plan for services for the individual after the exit.

(5) Requirements for waiver of exit meeting. Requirements for an exit meeting may be waived if an individual is immediately removed from the program under the following conditions:

(a) The individual and his/her guardian requests an immediate removal from the program; or

(b) The individual is removed by a legal authority acting pursuant to civil or criminal proceedings.

(6) Transfer meeting. A decision to transfer an individual within a service provider shall be made by the ISP team. Findings of the ISP team shall be recorded in the individual's file and include at a minimum:

(a) The name of the individual considered for transfer;

(b) The date of the meeting or telephone call(s);

(d) Documentation of the circumstances leading to the proposed transfer;

(e) Documentation of the alternative considered, including transfer;

(f) Documentation of the reasons why any preferences of the individual, legal representative and/or family members cannot be honored;

(g) Documentation of a majority agreement of the participants regarding the decision; and

(h) The written plan for services to the individual after transfer.

411-328-0800

Rights: Entry, Exit and Transfer: Appeal Process

(1) Procedures. In cases where the individual and parent/guardian/advocate object to or the ISP team cannot reach majority agreement regarding an admission refusal, a request to exit the program, or a transfer within a program, an appeal may be filed by any member of the ISP team.

(a) In the case of a refusal to admit, the slot shall be held vacant but the payment for the slot shall continue.

(b) In the case of request to exit or transfer, the individual shall continue to receive the same services received prior to the appeal until the appeal is resolved.

(2) Appeal to the County. All appeals must be made in writing to the Community Mental Health Program Director or his/her designee for decision using the county's appeal process. The Community Mental Health Program Director or designee shall make a decision within 30 working days of receipt of the appeal and notify the appellant of the decision in writing.

(3) Appeal to Division. The decision of the Community Mental Health Director may be appealed by the individual, his/her parent, guardian, advocate or the provider by notifying the Office of Developmental Disability Services in writing within ten working days of receipt of the county's decision.

(a) A committee shall be appointed by the Administrator or the Administrator's designee in the Office of Developmental Disability Services every two years and shall be composed of a Division representative, a residential service representative and a DD case management representative;

(b) In case of a conflict of interest, as determined by the Administrator or designee, alternative representatives will be temporarily appointed by the Administrator or designee to the committee;

(c) The committee will review the appealed decision and make a written recommendation to the Administrator or designee within 45 working days of receipt of the notice of appeal;

(d) The Administrator or designee shall make a decision on the appeal within ten working days after receipt of the recommendation from the committee; and

(e) If the decision is for admission or continued placement and the provider refuses admission or continued placement, the funding for the slot may be withdrawn by the contractor.

The official copy of an Oregon Administrative Rule is contained in the Administrative Order filed at the Archives Division, 800 Summer St. NE, Salem, Oregon 97310. Any discrepancies with the published version are satisfied in favor of the Administrative Order. The Oregon Administrative Rules and the Oregon Bulletin are copyrighted by the Oregon Secretary of State. Terms and Conditions of Use

Oregon State Archives

DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES

DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES

DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES

DEPARTMENT OF HUMAN SERVICES,
AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES

DEPARTMENT OF HUMAN SERVICES,
AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES

DEPARTMENT OF HUMAN SERVICES,
AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES