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OREGON YOUTH AUTHORITY

 

DIVISION 335

BEHAVIOR REHABILITATION SERVICES PROGRAM

416-335-0000

Effective Date and Administration of the BRS Program

(1) OAR 416-335-0000 through 416-335-0100 are effective on January 1, 2014.

(2) BRS Programs provided through contract with OYA must meet the requirements in the BRS Program general rules (OAR 410-170-0000 through 410-170-0120) and the additional requirements contained in these rules (OAR 416-335-0000 — 416-335-0100).

(3) All references to federal and state laws and regulations referenced in these rules are those in place on November 13, 2013, and the Agency-specific BRS Program rules that are effective on January 1, 2014.

Stat. Auth.: ORS 183.355, 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

416-335-0010

Purpose

The purpose of the Behavior Rehabilitation Services (BRS) Program is to remediate the BRS Client’s debilitating psychosocial, emotional and behavioral disorders by providing such Services as behavioral intervention, counseling, and skills-training. These rules supplement the BRS Program general rules with additional requirements for BRS Programs provided through contract with OYA.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

416-335-0020

Definitions

In addition to the definitions provided in OAR 410-170-0020, the following definitions apply to terms used in OAR chapter 416, division 335.

(1) “Absent Day” means a calendar day that:

(a) The BRS Client is enrolled but not physically present in the BRS Provider’s program;

(b) Does not meet the definition of a Billable Care Day;

(c) The Agency’s placement plan is to return the BRS Client to the BRS Provider; and

(d) The BRS Contractor or BRS Provider obtains written authorization from the BRS Client’s JPPO and the Community Resources Manager to bill the calendar day as an Absent Day.

(2) “Aftercare and Transition Plan — Stabilization” (ATP–S) means the Aftercare and Transition Plan developed in a Short-Term Stabilization program, including the Aftercare and Transition Plan as defined in OAR 410-170-0070 and additional requirements provided in 416-335-0070.

(3) “Assessment and Evaluation Report — Stabilization” (AER –S) means the Assessment and Evaluation Report developed in a Short-Term Stabilization program, including the Assessment and Evaluation Report as defined in OAR 410-170-0070 and additional requirements provided in 416-335-0070.

(4) “Juvenile Parole and Probation Officer” (JPPO) means the individual who coordinates Services and Placement Related Activities for the BRS Client with the BRS Contractor and BRS Provider. For purposes of these rules, a JPPO is the Caseworker as defined in OAR 410-170-0020.

(5) “Master Service Plan — Stabilization” (MSP–S) means the Master Service Plan developed in a Short-Term Stabilization program, including the Master Service Plan as defined in OAR 410-170-0070 and additional requirements provided in 416-335-0070.

(6) “Master Service Plan — Transition” (MSP –T) means the Master Service Plan developed in an Independent Living Program, including the Master Service Plan as defined in OAR 410-170-0070 and additional requirements provided in 416-335-0070.

(7) “Transition Facilitator” means a Social Service Staff employed by or contracted with the BRS Provider, and responsible for overseeing and monitoring the BRS Client in the BRS Contractor’s Independent Living Program, either operated by itself or by its BRS Provider, which includes but is not limited to assisting with developing the BRS Client’s Service plans and identifying support resources. Additional requirements are provided in OAR 416-335-0060.

(8) “Transitional Visit” means an overnight visit by the BRS Client to another placement for the purpose of facilitating the BRS Client’s transition.

(9) “Young Person” means a person aged 21 through 24 years of age.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

416-335-0030

Additional Requirements for OYA BRS Contractors and BRS Providers

(1) The BRS Contractor must comply, and ensure its BRS Provider complies, with all applicable provisions in OAR 416-530-0000 through 416-530-0200, and 416-550-0000 through 416-550-0080.

(2) The BRS Contractor and the BRS Provider must ensure that its employees, volunteers, contractors, vendors, Approved Provider Parents, or other persons providing Services or Placement Related Activities to BRS Clients pass a criminal history check based on the Agency’s criminal history records check standards as set forth in OAR 416-800-0000 to 416-800-0095.

(3) The BRS Contractor and the BRS Provider must ensure that its employees, volunteers, contractors, vendors, Approved Provider Parents, or other persons providing Services or Placement Related Activities to BRS Clients, who have not yet successfully completed the requirements in section (2) of this rule are supervised by a person who has successfully met these requirements when having direct contact with BRS Clients.

(4) The BRS Contractor must ensure that its BRS program, either operated by itself or its BRS Provider, has a medication management policy that complies with OAR 416-340-0000 through 416-340-0070.

(5) Therapeutic Foster Care Model (Proctor Parents):

(a) Proctor Parents must meet the applicable requirements in OAR 416-530-0000 through 416-530-0200 and 416-550-0000 through 416-550-0080, including but not limited to minimum training requirements.

(b) The BRS Contractor, the BRS Provider, and Proctor Parent must cooperate with OYA in the Proctor Parent dual-certification process in accordance with applicable provisions in OAR 416-530-0000 through 416-530-0200, 416-550-0000 through 416-550-0080 and 416-800-0000 through 416-800-0095.

(6) The BRS Contractor and BRS Provider must provide separate bedrooms for Children and persons 18 years or older, except in cases where the Child shares a room with a Young Adult or Young Person who is the Child’s parent and caregiver or where there is written approval from the Department of Human Services Office of Licensing and Regulatory Oversight Coordinator and the Agency.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

416-335-0040

Prior Authorization for the BRS Program; Appeal Rights

(1) BRS Program Eligibility:

(a) OYA may provide prior authorization for the BRS Program to a person who:

(A) Meets the requirements in subsections (2)(a)(A) through (D) of OAR 410-170-0040; and

(B) Is in the legal custody and care of OYA.

(b) Notwithstanding section (1)(a) of this rule, OYA may provide prior authorization to a person who:

(A) Is a Child, Young Adult or Young Person;

(B) Meets the requirements in subsections (2)(a)(A) through (C) of OAR 410-170-0040;

(C) Is in the legal custody and care of OYA; and

(D) Is eligible for state-funded medical assistance through OYA but not eligible for Medicaid.

(2) Appeal Rights:

(a) If a person is denied prior authorization for the BRS Program under OAR 416-335-0040(1)(a) then the person is entitled to notice and contested hearing rights under 410-120-1860 and 410-120-1865. The contested case hearing will be held by the Authority.

(b) If a person is denied prior authorization for the BRS Program by OYA under OAR 416-335-0040(1)(b), then the person is entitled to notice and contested hearing rights pursuant to the provisions of ORS 183.341. The contested case hearing will be held by OYA. OYA adopts the Attorney General's Model Rules of Procedure OAR 137-003-0001 to 137-003-0091 and 137-003-0580, effective January 2012, as procedural rules for contested case hearings.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

416-335-0050

Additional BRS Service Planning Requirements — All BRS Types of Care Except ILP

In addition to the requirements in OAR 410-170-0070 the BRS Contractor or BRS Provider must ensure that the Assessment and Evaluation Report (AER) describes the assessment of BRS Client characteristics that may require service delivery modification to ensure successful participation in BRS Services. The BRS Contractor, if not also the BRS Provider, must ensure that its BRS Provider meets this requirement.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

416-335-0060

Additional Requirements for Independent Living Program (BRS Type of Care).

(1) The Independent Living Program is a BRS Type of Care that is designed to transition a BRS Client to independent living outside of a residential placement while receiving medically appropriate Services in a structured BRS Program environment. BRS Clients are placed in a structured, supervised setting prior to transitioning to a supported community placement.

(2) Minimum Staffing Requirements: The BRS Contractor must ensure that its BRS Independent Living Program, either operated by itself or its BRS Provider, has a BRS Program staff member onsite at the program at all times (24 hours a day, 7 days a week), and another BRS Program staff member available to go out into the community on routine or emergency visits to monitor or assist the BRS Client.

(3) Transition Facilitator: Upon each BRS Client’s admission to the Independent Living

Program, the BRS Contractor or BRS Provider must ensure that the Transition Facilitator:

(a) Ensures that the BRS Client completes an independent living skills assessment prior to developing the MSP-T. Assessments must be strength-based, focusing on identifying the strengths and resources of the BRS Client, and his or her family and other supports.

(b) Assists the BRS Client in the development of the MSP-T, including identifying short and long-term goals, developing a plan to achieve those goals, and tracking his or her progress towards those goals;

(c) Identifies and coordinates resources that will assist and support the BRS Client in his or her community placement, including but not limited to family and other natural supports;

(d) Assists the BRS Client in articulating his or her goals and plans;

(e) Assists the BRS Client in developing and updating his or her MSP-T, and overseeing the implementation of the MSP-T; and

(f) Teaches the BRS Client skills including goal setting, planning, resource identification, and engagement that will help the BRS Client lead a productive adult life.

(4) Additional BRS Service Planning Requirements: In addition to the requirements in OAR 410-170-0070, the BRS Contractor or BRS Provider must meet the following service planning requirements for BRS Clients in the Independent Living Program:

(a) Master Service Plan — Transition (MSP-T)

(A) The BRS Contractor or BRS Provider must:

(i) Ensure that a Transition Facilitator, in collaboration with the BRS Client, completes a written MSP-T within 2 business days of the BRS Client’s admission to the program and provides copies to the individuals listed in OAR 410-170-0070 section (1)(a)(B);

(ii) Provide the Services identified in the MSP-T during the first 30 days in the program.

(B) The BRS Contractor or BRS Provider must ensure that the MSP-T is individualized, includes goals that are measurable and attainable within the first 30 days, is based on a thorough assessment of the BRS Client’s referral information and assessment of independent living skills, and addresses at minimum the following domains where need is indicated:

(i) Independent living skills, to include use of technology;

(ii) Social support, recreation, and community connection or membership (including planning for supportive relationships);

(iii) Finances and consumer awareness;

(iv) Transportation planning and responsibility;

(v) Free-time supervision and structure, including requirements for moving toward reduced supervision and greater autonomy; and

(vi) Relapse, safety and crisis planning.

(b) Master Service Plan — Transition 30-day Updates. The BRS Contractor or BRS Provider must:

(A) Ensure that the Transition Facilitator, in collaboration with the BRS Client, reviews and updates in writing the BRS Client’s MSP-T no later than 30 days from the date the MSP-T was first finalized or the last time it was updated, and every 30 days thereafter; and

(B) Provide the services identified in the most recent MSP-T Update.

(5) Placement Related Activities:

(a) The BRS Contractor or BRS Provider is responsible for providing the Placement Related Activities described in OAR 416-335-0080 except as provided in section (5)(b) of this rule.

(b) Transportation: BRS Clients are responsible for taking public transportation to and from employment and other daily activities. The BRS Contractor or BRS Provider must assist the BRS Client as necessary with transportation for attendance at: school, to the extent not provided by the school district; medical, dental, and therapeutic appointments; recreational and community activities; places of employment; and shopping for incidental items.

(6) The BRS Contractor, if not also the BRS Provider, must ensure that its BRS Provider meets the requirements described in this rule.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

416-335-0070

Additional Requirements for BRS Enhanced Short-Term Stabilization (BRS Type of Care)

(1) The Short-Term Stabilization program is a BRS Type of Care designed to provide short-term intervention to BRS Clients in need of behavioral stabilization.

(2) Additional Program Referrals and Admission Requirements: In addition to the requirements in OAR 410-170-0050, the BRS Contractor or BRS Provider must notify the BRS Client’s JPPO of its admission decision within five business days of receiving the BRS Client’s referral packet.

(3) Additional BRS Service Planning Requirements: In addition to the requirements in OAR 410-170-0070 the BRS Contractor or BRS Provider must meet the following service planning requirements for BRS Clients in the Short Term Stabilization Program:

(a) Master Service Plan — Stabilization (MSP-S)

(A) The BRS Contractor or BRS Provider must:

(i) Ensure that a Social Service Staff completes a written MSP-S within 2 business days of the BRS Client’s admission to the program and provides copies to the individuals listed in OAR 410-170-0070 section (1)(a)(B); and

(ii) Provide the Services identified in the MSP-S during the first 30 days in the program.

(B) The BRS Contractor or BRS Provider must ensure that the MSP-S is individualized and based on the BRS Client’s available referral information and current behaviors needing remediation, and include at minimum the following:

(i) Objectives for placement as described by JPPO;

(ii) Identified reasons for behavioral instability; and

(iii) Goals that are measurable and attainable within the BRS Client’s first 30 days in the program.

(b) Assessment and Evaluation Report — Stabilization (AER-S)

(A) The BRS Contractor or BRS Provider must:

(i) Ensure that a Social Service Staff conducts a comprehensive assessment and completes a written AER-S for each BRS Client who is anticipated to remain in the program for over 30 days; and

(ii) If the BRS Client is anticipated to be in the program for 30 days or less, no AER-S is required.

(B) The BRS Contractor or BRS Provider must ensure that the AER-S describes the following:

(i) Assessment of BRS Client characteristics that may require service delivery modification to ensure successful participation in BRS Services; and

(ii) Summary of BRS Client’s readiness for return to previous placement or recommended placement.

(c) Master Service Plan-Stabilization 30 Day Updates. The BRS Contractor or BRS Provider must:

(A) Ensure that the Social Service staff reviews and updates in writing the BRS Client’s MSP-S no later than 30 days from the date the MSP-S was first finalized or the last time it was updated, and every 30 days thereafter. The first update of the MSP-S must be based upon findings from the AER-S; and

(B) Provide the services identified in the most recent MSP-T Update.

(d) Aftercare and Transition Plan — Stabilization (ATP-S). The BRS Contractor or BRS Provider must:

(A) Ensure that a Social Service Staff member completes an initial ATP-S upon admission for each BRS Client that is anticipated to remain in the Short-Term Stabilization BRS Provider’s program for more than 30 days and transition to foster care or home upon discharge from BRS Short Term Stabilization Program.

(B) Develop a final written ATP-S prior to the BRS Client’s planned discharge.

(4) The BRS Contractor, if not also the BRS Provider, must ensure that its BRS Provider meets the requirements described in this rule.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

416-335-0080

Placement Related Activities for OYA’s BRS Contractors and BRS Providers

(1) In cases where OYA is the Agency, the BRS Contractor or BRS Provider must provide the following Placement Related Activities, and all facilities, personnel, materials, equipment, supplies and services, and transportation necessary to provide those activities:

(a) Clothing: The BRS Contractor or BRS Provider must ensure that each BRS Client has an adequate wardrobe as prescribed by a “Youth Sub-Care Clothing List and Authorization" form, incorporated by reference in this rule, and available at http://www.oregon.gov/oya/forms/ya3070.pdf, or a printed copy may be obtained from OYA. The BRS Contractor or BRS Provider must make an initial assessment of the BRS Client’s clothing and document the results. If there is a determined need for clothing based on the Youth Sub-Care Clothing List and Authorization form, the BRS Contractor or BRS Provider must notify the BRS Client’s JPPO that a clothing authorization is needed.

(b) Transportation: The BRS Contractor or BRS Provider is responsible for the transportation of the BRS Client to attend school, to the extent not provided by the school district; medical, dental, and therapeutic appointments; recreational and community activities; places of employment; and shopping for incidental items.

(c) Educational and vocational activities: The BRS Contractor or BRS Provider must have a system in place to meet the educational and vocational needs of the BRS Client in its program either on-site or at an off-site location or a combination of the two.

(d) Recreational, social, and cultural activities:

(A) The BRS Contractor or BRS Provider must provide recreation time for the BRS Client on a daily basis, and offer activities that are varied in type to allow BRS Clients to obtain new experiences. The BRS Contractor or BRS Provider must document recreation as having been provided, by recording the type of activity the BRS Client participated in, and the date it occurred.

(B) The BRS Contractor or BRS Provider must provide each BRS Client a minimum of one opportunity per week to participate in recreational activities in the community, unless the BRS Client is clearly unable to participate in offsite activities due to safety issues. If a BRS Client is restricted from participation in community recreation, the BRS Provider must document the reason in the BRS Client’s case file, and the reason must be reviewed regularly to ensure that the BRS Client is not unnecessarily restricted from offsite activities. The BRS Contractor or BRS Provider must offer any BRS Client who is restricted from community activities alternative opportunities for recreation on site.

(C) The BRS Contractor or BRS Provider must provide access to or make available social and cultural activities for the BRS Clients as part of the therapeutic milieu of the program. These activities are to promote the BRS Client’s normal development and help broaden the BRS Client’s understanding and appreciation of the community, arts, environment and other cultural groups.

(D) The BRS Contractor or BRS Provider must not permit BRS Clients to participate in recreational activities that present a higher level of risk to BRS Clients without pre-approval by the Community Resources Unit and JPPO. This applies to activities that require a moderate to high level of technical expertise to perform safely, present environmental hazards, or where special certification or training is recommended or required such as: whitewater rafting, rock climbing, ropes courses, activities on or in any body of water where a certified lifeguard is not present and on duty, camping, backpacking, mountain climbing, using motorized yard equipment, and horseback riding.

(e) Academic Assistance: If needed, the BRS Contractor or BRS Provider must provide adequate opportunities for the BRS Clients to complete homework assignments with assistance from staff, or an Approved Provider Parent, if applicable.

(2) Non BRS-Related Medical Care:

(a) If there is no record that the BRS Client has received a physical examination within the six months immediately prior to the BRS Client’s placement with its program, the BRS Contractor or BRS Provider must ensure or make every effort to ensure that the BRS Client receives a general medical check, consistent with health insurance allowances, within 30 days of placement. The BRS Contractor or BRS Provider must keep documentation of this procedure in the BRS Client’s file, and send a copy to the BRS Client’s JPPO.

(b) The BRS Contractor or BRS Provider must ensure that each BRS Client’s mental health, physical health, (including alcohol and drug treatment services), dental and vision needs are arranged for. This does not include paying the cost of services or medications which are covered by the Oregon Health Plan (OHP) or by the BRS Client’s third party private insurance coverage. The BRS Contractor or BRS Provider must notify and work with the JPPO to secure payment for services or medications not covered by OHP or third party private insurance.

(c) The BRS Contractor or BRS Provider must administer and monitor medications consistent with all applicable licensing rules, OAR 416-340-0070, and the BRS Provider’s own medication management policy.

(d) The BRS Contractor or BRS Provider must facilitate the BRS Client’s access to other providers whenever identified needs cannot be met within the scope of Services offered by the BRS Contractor or BRS Provider. If health care services are needed but the BRS Contractor or BRS Provider is unable to access the needed services for the BRS Client, the BRS Contractor or BRS Provider must immediately notify the JPPO in writing and these unsuccessful efforts made to access healthcare must be documented by the BRS Contractor or BRS Provider as part of the BRS Client’s case file.

(3) The BRS Contractor, if not also the BRS Provider, must ensure that its BRS Provider provides the Placement Related Activities to the BRS Client as described in this rule.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

416-335-0090

Billing and Payment for Services and Placement Related Activities

(1) Billable Care Days:

(a) The BRS Contractor is compensated for a Billable Care Day (Service and Placement Related Activities rates) on a fee-for-service basis in accordance with OAR 410-170-0110 and this rule.

(b) The BRS Contractor may include overnight Transitional Visits by the BRS Client to another placement in its Billable Care Days. The BRS Contractor must:

(A) Receive prior approval for the Transitional Visit from OYA;

(B) Ensure that the Transitional Visit is in support of the MSP, MSP-T, or MSP-S goals related to transition;

(C) Pay the hosting placement at the established Absent Rate for the sending BRS Provider; and

(D) Ensure that the hosting placement will not seek any reimbursement from OYA for the care of the visiting BRS Client.

(2) Absent Days:

(a) The BRS Contractor is compensated for an Absent Day at the Absent Day rate in order to hold a BRS Program placement for a BRS Client with the prior approval of the BRS Client’s JPPO and the Community Resources Manager.

(b) Notwithstanding OAR 410-170-0110(4), the BRS Contractor may request prior approval from OYA to be reimbursed for more than eight calendar days of home visits in a month for a BRS Client. However, any additional days of home visits approved under this rule will be paid at the Absent Day rate.

(3) The BRS Contractor may be reimbursed only for the BRS Type of Care authorized in the contract with OYA.

(4) Invoice Form:

(a) The BRS Contractor must submit a monthly billing form to OYA in a format acceptable to the Agency, on or after the first day of the month following the month in which it provided Services and Placement Related Activities to the BRS Client. The billing form must specify the number of Billable Care Days and Absent Days for each BRS Client in that month.

(b) The BRS Contractor must provide upon request, in a format that meets OYA’s approval, written documentation of each BRS Client’s location for each day claimed as a Billable Care Day and an Absent Day.

(c) The BRS Contractor may only submit a claim for a Billable Care Day and an Absent Day consistent with the Agency’s prior authorization or approval.

(5) Billable Care Day and Absent Day rates are provided in the “BRS Rates Table”, dated January 1, 2014, which is adopted as Exhibit 1 and incorporated by reference into this rule. A printed copy may be obtained from OYA.

[ED. NOTE: Tables referenced are not included in rule text. Click here for PDF copy of table(s).]

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

416-335-0100

Compliance Reviews and Remedies

(1) The BRS Contractor must cooperate, and ensure its BRS Providers cooperate, with program compliance reviews or audits conducted by any federal or state or local governmental agency or entity related to the BRS Program, including but not limited to the OYA audit guidelines described in OAR 416-250-0000 through 416-250-0090.

(2) OYA or its designee will conduct compliance reviews periodically, including but not limited to review of documentation and onsite inspections.

(3) OYA may pursue any combination of: contract remedies including but not limited to recovery of overpayments; licensing actions; and other remedies authorized under the contract, at law or in equity against a BRS Contractor, a BRS Provider, or both, for non-compliance with applicable laws, regulations or contract provisions, or any or all of the above, including but not limited to the actions described in OAR chapter 416 (such as OAR 416-530-0090). In addition to or in lieu of any of the above, OYA may proceed under the applicable provisions of OAR 410-170-0120.

Stat. Auth.: ORS 420A.025
Stats. Implemented: ORS 420A.010, 420A.014
Hist.: OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14

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