The Oregon Administrative Rules contain OARs filed through January 15, 2010

DEPARTMENT OF HUMAN SERVICES, ADDICTIONS AND MENTAL HEALTH DIVISION: MENTAL HEALTH SERVICES

309-041-0200

Purpose and Statutory Authority

(1) Purpose. These rules prescribe standards for the Mental Health and Developmental Disability Services Division and the Department of Education for the provision of early intervention services to handicapped preschool children with mental retardation or other developmental disabilities, vision impairment, or hearing impairment.

(2) Statutory Authority. These rules are authorized by ORS 430.041 and carry out the provisions of 343.353 to 343.367.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0205

Definitions

As used in these rules:

(1) "Age of Eligibility" is determined based on the child's age on the date established in Oregon law for determining school age for the current year. Children under the age of five are eligible for the program. Children between the ages of five and six are eligible if their resident school district does not provide public education beginning at age five.

(2) "Ancillary Services" means specialized services provided so the child may participate in the appropriate early intervention program. Such services may include but are not limited to physical therapy, occupational therapy, speech therapy, and services by specialists in hearing and vision impairment.

(3) "Classroom Training" means an early intervention program provided in a classroom setting that may include education and training in self-contained programs for the handicapped, parent cooperatives, Head Start programs, or other programs for preschool aged children.

(4) "Community Mental Health Program" means the organization of all services for persons with mental or emotional disturbances, drug abuse problems, mental retardation or other developmental disabilities, and alcoholism and alcohol abuse problems, operated by, or contractually affiliated with, a local mental health authority, operated in a specific geographic area of the state under an interagency agreement or direct contract with the Mental Health and Developmental Disability Services Division.

(5) "Developmental Disability (DD)" means for the purposes of this rule a disability of a person which is attributed to mental retardation, cerebral palsy, epilepsy or other handicapping condition and the disability:

(a) Originates before the person attains the age of 22 years, except that in case of mental retardation the condition must be manifested before the age of 18;

(b) Can be expected to continue indefinitely; and

(c) Constitutes a substantial delay in the child's ability to function in society.

(6) "Division" means the Mental Health and Developmental Disability Services Division of the Department of Human Services.

(7) "Early Intervention" means services of treatment and habilitation designed to address a child's developmental deficits in sensory, motor, communication, self-help, and socialization areas. Such services may include classroom training, parent training and consultation, transportation to classroom programs, and other ancillary services, such as physical therapy, occupational therapy, and speech therapy.

(8) "Handicapped Preschool Child" means children between the time of identification of their handicap and school age who meet the eligibility criteria for early intervention services as established under these rules.

(9) "Hearing Impairment" means:

(a) An average of 25 decibels or greater pure tone loss of hearing across three frequencies in the better ear (other than a temporary loss which can be reversed medically);

(b) For children three years old to school age one or more of the following characteristics:

(A) Speech unintelligible to the listener 25 percent of the time for students through age four and 15 percent of the time for students age five to school age;

(B) Oral language delay as determined by appropriate instruments, of one year, for ages three to six.

(10) "Individual Training" means a specific program based on an assessment of a child's need for skill training.

(11) "Individual Program Plan" means a training plan developed annually for each preschool child which contains measurable goals and objectives for the child's developmental growth, and which is developed after consideration of all appropriate assessment information and with full involvement of the child's parent(s), guardian, or representative and professional with specific knowledge related to the child's disability.

(12) "Local Mental Health Authority" means the county court or board of county commissioners of one or more counties who operate a community mental health program, or in the case of a Native American reservation, the tribal council, or if the county declines to operate or contract for all or part of a community mental health program, the board of directors of a public or private corporation.

(13) "Mental Retardation (MR)" means significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the development period. Persons of borderline intelligence may be considered mentally retarded if there is also serious impairment of adaptive behavior. Definitions and classifications shall be consistent with the "Manual on Terminology and Classification in Mental Retardation" of the American Association on Mental Deficiency, 1977 Revision. Mental retardation is synonymous with mental deficiency.

(14) "Parent" means a natural parent, guardian, or other primary residential care giver including but not limited to foster parents.

(15) "Parent Training Program" means a training program for the parents of children designed to teach the parents or other primary caregivers, the skills necessary to provide the child with the stimulation and skill level necessary to maximize the child's development.

(16) "Regional Program" means programs contracted by the Oregon Department of Education which provide early intervention and ancillary services to handicapped preschool children with vision impairment and hearing impairment.

(17) "State Agency" means the Mental Health and Developmental Disability Services Division in the case of children with mental retardation or other developmental disabilities, and the Department of Education for children with vision impairment or hearing impairment.

(18) "Vision Impairment" means a condition that exists if one or more of the following exist:

(a) Residual visual acuity is 20/200 or less in the better eye with correction; or

(b) Acuity is 20/70 or less in the better eye with correction; or

(c) Visual field is restricted to 20 degrees; or

(d) Presence of an eye condition, either an eye pathology or a progressive eye disease, which is anticipated to reduce either acuity or field of vision as described above and the child has received or is receiving medical treatment for this condition;

(e) Inadequate functional vision exists as described above and the child is unable to be adequately tested temporarily.

[Publications: The publication(s) referred to or incorporated by reference in this rule are available from the agency.]

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0210

General

(1) Each early intervention program shall be operated by or subcontracted by the community mental health program or a Department of Education regional program.

(2) Community mental health early intervention programs serve children found eligible primarily because of mental retardation or developmental disability. Department of Education regional early intervention programs serve children found eligible primarily because of hearing or vision impairment.

(3) Each early intervention program shall enroll children determined eligible for service without regard to race, color, creed, sex, national origin, or duration of Oregon residence.

(4) Each early intervention program shall develop cooperatively with the community mental health program and the Department of Education regional program serving their areas a written comprehensive plan and agreements to assure the delivery of coordinated early intervention services to all children eligible under this rule. This plan shall:

(a) Be developed within 12 months of the adoption of this rule and modified at least annually thereafter;

(b) Be consistent with the early intervention provisions of ORS 343.353 to 343.367 requiring the coordinated delivery of services;

(c) Assure the provision of state-approved early intervention services to all eligible preschool children within the service area; and

(d) Include at least the following elements:

(A) Evidence that a local early intervention advisory group has been formed in the local area representing both providers and parents of handicapped preschool children;

(B) Designation of which agency or agencies will be the primary providers for early intervention services;

(C) Determination of the array of services needed in the area;

(D) Determination of ancillary services needed in the area;

(E) Description of eligible children in the area, categorized by age, sex, and diagnosis;

(F) Description of how services and funding will be mixed and matched in the most efficient manner across all disability categories;

(G) Description of how programs will assure opportunities for handicapped preschool children to interact with their non-handicapped peers;

(H) Description of agreements between the primary providers and other agencies that assure the provision of needed ancillary services; and

(I) Determination of a "fixed point of referral" for the area that assures a timely evaluation and placement of an eligible child in one or more components of the early intervention program.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0215

Eligibility Determination

(1) The fixed point of referral, established under OAR 309-041-0210(4), shall accept the referral, notify the resident district of a possible eligible child, and assure that a complete evaluation occurs through referral and follow-up to an approved evaluation source.

(2) An approved evaluation source, for the purposes of this rule shall include:

(a) The Crippled Children's Division; or

(b) The Diagnosis and Evaluation section of the Mental Health and Developmental Disability Services Division; or

(c) A multi-disciplinary team from the resident school district or education services district, charged with the identification of handicapped children; or

(d) Other agencies as approved by the Mental Health and Developmental Disability Services Division or the Department of Education; or

(e) Any combination of the above listed sources.

(3) The community mental health program or the appropriate regional program, after making the evaluation material available to the resident school district to review, shall make the determination of eligibility using:

(a) Documentation, from an approved evaluation source, that the referred child has a vision impairment, hearing impairment, mental retardation, or a developmental disability as defined in this rule; and

(b) Documentation from an approved evaluation source that the child's developmental age is:

(A) 56 to 75 percent of the child's chronological age in three or more of the following skill areas:

(i) Gross motor;

(ii) Fine motor;

(iii) Communication;

(iv) Expressive language;

(v) Receptive language;

(vi) Cognitive;

(vii) Self-help; and

(viii) Capacity to relate appropriately to people, objects, or events.

(B) 40 to 55 percent of the child's chronological age in two of the skill areas in paragraph (A) of this subsection; or

(C) Less than 40 percent of the child's chronological age in one of the skill areas in paragraph (A) of this subsection; or

(D) In the case of children below 18 months of age, there is medical documentation that the child has an identified genetic, neurological, muscular, or medical condition that will result in the child being developmentally disabled.

(4) Upon determination of eligibility, the resident school district of the child shall be notified of the determination, and the child shall be enrolled in the appropriate early intervention program.

(5) In areas where Department of Education regional programs are limited, early intervention program under the Mental Health and Developmental Disability Services Division shall serve children eligible for regional program services for early intervention if:

(a) The Mental Health and Developmental Disability Services Division (MHDDSD) program is deemed by all participants in the development of the individual program plan as the most appropriate early intervention program; and

(b) Provisions have been made for the Department of Education regional program to purchase these services from the MHDDSD program at a rate equal to the rate for any other MHDDSD eligible child.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0220

Enrollment

(1) Eligible children will be enrolled in the appropriate early intervention program, based on the handicapping condition of the child, as defined in these rules.

(2) The following information must be on file with the early intervention program:

(a) Copies of evaluation materials used to determine eligibility;

(b) Statement of eligibility from the community mental health program or the appropriate regional program;

(c) Signed statement from the child's parents, guardians, or representative indicating that the purpose of enrollment has been clearly explained, program services have been described, grievance procedures have been explained, and they agree to the child's enrollment in the program;

(d) Documentation that the resident school district of the child has been notified that the enrollment has taken place;

(e) A written statement by a physician licensed by the State of Oregon, California, Washington or Idaho that the child has been examined. The statement shall specify:

(A) Whether there are any physical factors contributing to the individual's skill deficit;

(B) Whether medical treatment is required prior to initiation of early intervention services;

(C) Whether there are any medical limitations to the child's full participation in the early intervention program; and

(D) Whether any other medical examinations are required before initiation of all or any part of the early intervention program.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0225

Individual Program Plans

(1) Within 30 days of enrollment of an eligible child in the program, an individual program plan shall be developed in writing.

(2) To develop the individual program plan, the early intervention program will assess each child using formal assessments, observations, parent interviews, informal assessment procedures, and, if necessary, placement in the program not to exceed 30 days to determine each child's functional level in the areas of gross-motor, fine motor cognition, communication, self-help, and socialization (capacity to relate appropriately to people, objects, or events).

(3) Participants in the development and review of each individual program plan shall include the child's parent(s) or guardian and the child's instructor/parent trainer. For a child's initial individual program plan, an instructor/parent trainer or some other person who is knowledgeable about the assessment procedures used and is familiar with the results shall be present at the meeting. A representative of the resident school district shall be invited to participate and must be represented during the year prior to the child's attaining school age. Others as appropriate shall be involved.

(4) The individual program plan shall include:

(a) A statement of the child's present level of skill performance;

(b) A statement of annual goals, including short-term training objectives;

(c) A statement describing the specific early intervention services to be provided to the child within the appropriate early intervention program;

(d) The projected dates for beginning each service, anticipated frequency of services, and the expected duration of the services;

(e) A description of the training and habilitation methods to be used and objective criteria, procedures, and schedules for evaluating whether the program goals and objectives are being met. This evaluation of program effectiveness must occur at least annually; and

(f) A listing of all parties participating in the individual program plan development.

(5) Each child's individual program plan shall be reviewed at least annually.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0230

Program Requirements

(1) Statement of Purpose: Each early intervention program shall develop and maintain for public review a written statement of purpose, which shall include:

(a) A statement of the program's goals and objectives;

(b) A general statement of the services provided by the program;

(c) A description of parent involvement in the program;

(d) A statement of the program's enrollment criteria; and

(e) A description of the program's policy and procedures to assure coordination with other providers of early intervention services within the same county.

(2) Reporting: Each early intervention program shall provide the following reports to the state agency responsible for the program:

(a) An individual progress assessment for each child, on forms provided by the state agency;

(b) A monthly report documenting the current status of children enrolled or terminated from service;

(c) An annual statement verifying the resident school district of each enrolled child found eligible for the program;

(d) Other reports as may be reasonably required by the state agency.

(3) Furniture and Equipment: An early intervention program shall secure, and maintain in good repair, furniture and other equipment necessary to meet the training needs of each child enrolled.

(4) Instructional Materials: An early intervention program shall secure and maintain age-appropriate and current instructional materials and supplies required for each child enrolled.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0235

Building Requirements

(1) All early intervention programs shall be free of architectural barriers which might prevent use of the facility by handicapped persons.

(2) All early intervention programs shall comply with all local and state fire, health, and safety regulations.

(3) Classroom programs shall provide:

(a) Adequate classroom space for each child in addition to adequate storage capability and outside playground areas;

(b) A restroom adjacent or readily accessible to the classroom; and

(c) Adequate lighting for classroom activities.

(4) Parent training programs shall provide a private area for parents receiving parent training.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0240

Transportation

(1) The school district of residence shall provide transportation services to handicapped preschool children eligible for services under this rule.

(2) Transportation services are required for children only, and are intended to assure services are not denied to any eligible child because of the inaccessibility of the program.

(3) Transportation services may include:

(a) Mileage reimbursement to parents or volunteers;

(b) Direct transportation using school district transportation services;

(c) Contracts for transportation services with private parties or agencies.

(4) Transportation services shall be provide for each eligible child to the most appropriate program, within the county of residence. Transportation to programs across county borders shall be required only when the parent(s), service provider(s), County Mental Health Program, and the resident school district agree that the local approved program cannot meet the eligible child's needs.

(5) Transportation of parents for the purposes of parent training services, is not required under this rule, but may be provided at the discretion of the resident district.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0245

Staffing Requirements

(1) Each early intervention program shall have an affirmative action policy which prohibits discrimination in employment practices.

(2) Each parent training program shall provide at a minimum:

(a) Staff necessary to assure at least one hour per week, 12 months per year, of direct instruction to the child and the parent(s), guardian, or designated primary care giver for each enrolled child; and

(b) Consultation and assessment services in the ancillary services areas as appropriate to the child's needs.

(3) Each parent trainer shall possess a minimum of a Bachelor of Science degree and have specialized training in the area of early childhood development and/or special education.

(4) Each classroom program shall provide at a minimum:

(a) Instructional staff including teaching assistants and aides, necessary to assure a one adult to four children ratio and to provide at least 15 hours per week of individualized instruction in a classroom setting;

(b) Operation for a minimum of 175 days per year;

(c) Consultation and training to parents, guardians, or designated primary care givers of enrolled children, as appropriate; and

(d) Consultation and assessment services in the ancillary services areas as appropriate to the child's needs.

(5) Each preschool classroom teacher shall possess at least a Bachelor of Science degree in early childhood development or special education.

(6) Each early intervention program may provide direct therapy services, in the areas defined as ancillary services in this rule, as appropriate to the individual program plan of a child, and within the limit of funds available to the program.

(7) Each classroom assistant shall receive at least 12 hours of pre-service training.

(8) Each person employed to provide ancillary services shall possess the appropriate license or certification necessary to practice in Oregon, or documentation of the completion of recognized specialized training in the area in which they are employed to work.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0250

Grievance Procedures

In cases where parents, guardians, surrogate parents, advocates, program staff, or concerned others have disagreements regarding eligibility, the provision of services required under these rules or other child-centered issues, the following process to resolve these disagreements shall be followed:

(1) All issues should be resolved through the use of internal/local informal procedures when possible to include:

(a) Parent-staff meetings;

(b) Meetings with program administrative staff; and

(c) Local interagency meetings.

(2) When informal procedures cannot resolve the issue, the party(ies) filing the grievance shall request a formal mediation of the disagreement from the community mental from the health program or regional program, as appropriate, using procedures developed by each program.

(3) Local mediation recommendations can be appealed, in cases of disagreements, using the following formal procedure:

(a) The party requesting resolution shall submit in writing a request for formal appeal to the Program Office for Mental Retardation and Developmental Disabilities of the Mental Health and Developmental Disability Services Division or the Division of Special Education of the Department of Education as appropriate;

(b) The agency receiving the request shall:

(A) Schedule a formal appeal meeting to occur within 30 days of the receipt of the request;

(B) Notify in writing each party involved in the disagreement of the date, time, and location of the meeting, allowing at least 15 days from the receipt of meeting notification until the scheduled meeting time;

(C) Appoint an appeal officer to conduct the meeting, using procedures established by the state agency; and

(D) Guarantee that the meeting will be conducted using procedures established by the state agency for such meetings, assure parent and child rights, and afford clear protection for due process procedures.

(c) Within 15 days after the conclusion of the meeting, the appeal officer will provide his recommendations in writing to the appropriate state agency official for implementation;

(d) The appropriate official of the state agency will notify in writing all participants in the appeal meeting of the recommendations and implementation process within 15 days of receipt of the recommendations.

(4) If any party does not agree with the recommendations or implementation process they may appeal to the Administrator of the Mental Health and Developmental Disability Services Division or the Superintendent of Instruction, as appropriate, for review and reconsideration. The decision of the appropriate state agency administrator is final except as it may be appealed through normal judicial procedures:

(a) The appeal must be made in writing within 15 days of the receipt of the recommendations and implementation process; and

(b) The appropriate state agency administrator shall review all relevant testimony, seek clarification as needed, and issue the decision on the appeal to all parties within 30 days of receipt of the appeal.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0255

Variances

A variance from these rules may be granted to an early intervention program in the following manner:

(1) An agency requesting a variance shall submit, in writing, through the community mental health program or regional program, to the Mental Health and Developmental Disability Services Division or the Department of Education:

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

(b) The reason for the proposed variance;

(c) The alternative practice proposed;

(d) A plan and timetable for compliance with the section of the rule from which the variance is sought; and

(e) Signed documentation from the local mental health authority or regional services agency and the local early intervention advisory group indicating its support of the proposed variance.

(2) The appropriate state agency shall approve or deny the request for variance.

(3) The state agency shall notify the community mental health program or regional program of the decision. The appropriate community agency will forward the decision and reasons therefor to the program requesting the variance. This notice shall be given the program within 30 days of receipt of the request by the state agency.

(4) Appeal of the denial of a variance request shall be to the Administrator of the appropriate state agency, whose decision shall be final.

(5) A variance granted by the state agency shall be attached to, and become a part of, the contract for that year.

Stat. Auth.: ORS 343 & ORS 430
Stats. Implemented:
Hist.: MHD 6-1985, f. & ef. 4-5-85

309-041-0550 [Renumbered to 411-328-0550]

309-041-0560 [Renumbered to 411-328-0560]

309-041-0570 [Renumbered to 411-328-0570]

309-041-0580 [Renumbered to 411-328-0580]

309-041-0590 [Renumbered to 411-328-0590]

309-041-0600 [Renumbered to 411-328-0600]

309-041-0610 [Renumbered to 411-328-0610]

309-041-0620 [Renumbered to 411-328-0620]

309-041-0630 [Renumbered to 411-328-0630]

309-041-0640 [Renumbered to 411-328-0640]

309-041-0650 [Renumbered to 411-328-0650]

309-041-0660 [Renumbered to 411-328-0660]

309-041-0670 [Renumbered to 411-328-0670]

309-041-0680 [Renumbered to 411-328-0680]

309-041-0690 [Renumbered to 411-328-0690]

309-041-0700 [Renumbered to 411-328-0700]

309-041-0710 [Renumbered to 411-328-0710]

309-041-0715 [Renumbered to 411-328-0715]

309-041-0720 [Renumbered to 411-328-0720]

309-041-0730 [Renumbered to 411-328-0730]

309-041-0740 [Renumbered to 411-328-0740]

309-041-0750 [Renumbered to 411-328-0750]

309-041-0760 [Renumbered to 411-328-0760]

309-041-0770 [Renumbered to 411-328-0770]

309-041-0780 [Renumbered to 411-328-0780]

309-041-0790 [Renumbered to 411-328-0790]

309-041-0800 [Renumbered to 411-328-0800]

309-041-0805 [Renumbered to 411-328-0805]

309-041-0810 [Renumbered to 411-328-0810]

309-041-0820 [Renumbered to 411-328-0820]

309-041-0830 [Renumbered to 411-328-0830]

309-041-1190

Statement of Purpose and Statutory Authority

(1) Purpose. These rules prescribe standards and procedures for the maintenance of service wait lists for persons with developmental disabilities.

(2) Statutory Authority. These rules are authorized by ORS 430.041 and carry out the provisions of 427.007 and 430.640.

Stat. Auth.: ORS 427 & ORS 430
Stats. Implemented:
Hist.: MHD 8-1992, f. & cert. ef. 11-16-92

309-041-1200

Definitions

As used in these rules the following definitions apply:

(1) "Case Manager" means an employee of the community mental health program or other agency which contracts with the County or Division, who is selected to plan, procure, coordinate, and monitor individual support plan services and who acts as a proponent for persons with developmental disabilities.

(2) "Community Mental Health Program" or "CMHP" means the organization of all services for individuals with mental or emotional disturbances, developmental disabilities or chemical dependency, operated by, or contractually affiliated with, a local mental health authority, operated in a specific geographic area of the state under an intergovernmental agreement or direct contract with the Mental Health and Developmental Disability Services Division.

(3) "Comprehensive Services" means 24-hour residential care, including care provided in a group home, supported living, or foster care. Comprehensive services also include intensive in-home supports that exceed $20,000 per year. Intensive supports may include in-home shift care, respite care, employment and other day program supports, community inclusion activities, environmental adaptations, or other services needed to support an individual with complex needs.

(4) "Developmental Disability" means a disability attributable to mental retardation, autism, cerebral palsy, epilepsy or other neurological handicapping condition which requires training or support similar to that required by individuals with mental retardation and the disability:

(a) Originates before the individual attains the age of 22 years, except that in the case of mental retardation the condition must be manifested before the age of 18; and

(b) Has continued, or can be expected to continue, indefinitely; and

(c) Constitutes a substantial handicap to the ability of the person to function in society; or

(d) Results in significant subaverage general intellectual functioning with concurrent deficits in adaptive behavior which are manifested during the developmental period. Individuals of borderline intelligence may be considered to have mental retardation if there is also serious impairment of adaptive behavior. Definitions and classifications shall be consistent with the Manual of Terminology and Classification in Mental Retardation by the American Association on Mental Deficiency, 1983 Revision. Mental retardation is synonymous with mental deficiency.

(5) "Division" means the Mental Health and Developmental Disability Services Division.

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

(7) "Individual Support Plan Team" or "ISP Team" means a team composed of the individual, the case manager, the individual's legal guardian, representatives of all current service providers, advocate or other determined appropriate by the individual receiving services. If the individual is unable or does not express a preference, other appropriate team membership shall be determined by the ISP team.

(8) "Office of Development Disability Services" or "ODDS" means the Office of Developmental Disability Services of the Mental Health and Developmental Disability Services Division.

(9) "Private Pay Status" means those individuals who are buying vocational/residential service(s) while waiting for a state funded service.

(10) "Support" means those ancillary services other than direct training which may include, but are not limited to, assisting an individual to maintain skill competencies, achieve community access and social integration, enhance productivity, increase independent functioning and enjoy a satisfying lifestyle.

[Publications: Publications referenced are available from the agency.]

Stat. Auth.: ORS 427 & ORS 430
Stats. Implemented: ORS 427.007 & ORS 430.640
Hist.: MHD 8-1992, f. & cert. ef. 11-16-92; MHD 8-2001(Temp) f. 8-30-01, cert. ef. 9-1-01 thru 2-27-02; MHD 3-2002, f. 2-26-02, cert. ef. 2-27-02

309-041-1210

Maintenance of a Centralized Wait List(s) for Individuals Waiting for Services

(1) Eligibility. Individuals must be age 15 or older and must be formally determined eligible for developmental disability case management services to be placed on the county wait list. Individuals in private pay status are eligible for the wait list if they meet these criteria.

(2) Assessment. A written needs and wants assessment will be completed for each individual prior to the placement of the individual's name on the wait list. Such needs assessment will be updated annually thereafter until the individual's name has been removed from the wait list.

(3) Required Data. At a minimum the following information shall be maintained for each individual placed on the wait list:

(a) Name of the individual, current address, and phone number;

(b) Date of birth;

(c) Type of support; i.e., residential, vocational, and/or other support;

(d) Urgency of support need; i.e., how soon will the support be needed;

(e) Level of support; i.e., the degree of support needed; and

(f) Date placed on the wait list. (Private pay status does not affect this date.)

(4) Reporting. The CMHP Developmental Disability Case Management Service will report to the Division individual wait list information at the time the individual is accepted to the county wait list. The Division will provide a format to the CMHP for reporting the required information. Such information will be reviewed annually by the CMHP and any changes in status will be reported to the Division. Terminations from the wait list will be reported when the termination occurs.

Stat. Auth.: ORS 427 & ORS 430
Stats. Implemented:
Hist.: MHD 8-1992, f. & cert. ef. 11-16-92

309-041-1220

Criteria for Selection from Wait List

(1) Selection Factors. When a vacancy in an existing service occurs or a new service is developed, the following factors will be considered in assigning an individual to a vacancy:

(a) Date of entry on the wait list;

(b) Appropriateness of available service to individual need;

(c) Urgency of need; and

(d) The individual's preferences.

(2) Order of Selection. Generally, the individual who has been on the wait list the longest will be assigned to the first service vacancy which arises that is appropriate to that individual's needs. This selection order is subject to the following exceptions:

(a) An individual in crisis having no vocational service and needing such service to resolve the crisis may be given first consideration for an appropriate vocational vacancy regardless of date of entry on the wait list;

(b) An individual in crisis having no residential service and needing such service to resolve the crisis may be given first consideration for an appropriate residential vacancy regardless of date of entry on the wait list; and

(c) No fewer than 300 adult individuals will be selected for entry into non-crisis comprehensive services pursuant to the Staley v Kitzhaber (USDC CV00-0078-ST) settlement agreement during the period July 1, 2001, through June 30, 2009.

(A) The number of individuals receiving non-crisis comprehensive services must be no fewer than the following: 20 individuals by June 30, 2003; 40 individuals by June 30, 2005; 170 individuals by June 30, 2007; 300 individuals by June 30, 2009.

(B) Individuals receiving non-crisis comprehensive services must be adults, 18 years of age or older; must be enrolled in case management; must be eligible for Oregon's Medicaid Waiver for Comprehensive Services; must not at the time of selection be authorized to receive Crisis services as defined in OAR 411-320-0160(7); and individuals and their legal representatives must be ready to accept and move into the developed services within the time frames established and published by the Department.

(C) Priority consideration must be given to individuals previously identified for non-crisis comprehensive services but whose plans were developed during the previous biennium but not completed.

(D) Local Criteria. When Community Developmental Disability Program resources are insufficient to serve all otherwise eligible individuals in the area of service, additional considerations for determining individual selection may be established by Community Developmental Disability Programs under these conditions:

(i) Increasing local capacity must be a local criteria consideration; and

(ii) Local criteria for selection must reflect local needs and resources including the identified needs of the individuals in the service area, the development budget available, the resource opportunities available and the number of individuals requesting services; and

(iii) Established local criteria must be applied consistently across all otherwise qualified individuals in the service area.

(iv) When individuals under consideration for non-crisis comprehensive services meet the criteria established in paragraphs (2)(c)(B) and (C) and have comparable needs and are equally appropriate for those services, priority will be given to the individual currently living in the family home.

Stat. Auth.: ORS 409.050 & ORS 410.070
Stats. Implemented: ORS 427.007 & 430.640
Hist.: MHD 8-1992, f. & cert. ef. 11-16-92; MHD 8-2001(Temp) f. 8-30-01, cert. ef. 9-1-01 thru 2-27-02; MHD 3-2002, f. 2-26-02, cert. ef. 2-27-02; MHD 2-2006, f. 6-28-06, cert. ef. 7-1-06

309-041-1230

Wait List Referrals from Other Counties

(1) Referral Process. Services for an individual may be requested of other counties by the Developmental Disability case manager initially by phone. If the referral appears to be feasible the case manager will submit a complete written referral packet including the latest needs assessment to the other county.

(2) Wait List Entry. The wait list status of an individual may be reported to the state only by the county of residence of the individual. A wait list referral to another county will not be entered on the state wait list report for that county but rather will be maintained by the county of residence. The county receiving the referral may add the individual's name to the county's internal wait list.

Stat. Auth.: ORS 427 & ORS 430
Stats. Implemented:
Hist.: MHD 8-1992, f. & cert. ef. 11-16-92

309-041-1240

Grievance Procedures

Mediation of grievances. Individuals, legal representatives, family members or advocates may mediate eligibility for, or appropriateness of, services in individual cases per the "Case Management Services for Individuals with Developmental Disabilities and Their Families" rule. (OAR 309-041-0465).

Stat. Auth.: ORS 427 & ORS 430
Stats. Implemented:
Hist.: MHD 8-1992, f. & cert. ef. 11-16-92

309-041-1250

Variances

(1) Criteria for a variance. Variances may be granted to a CMHP if there is a lack of resources to implement the standards required in this rule or if implementation of the proposed alternative services, methods, concepts, or procedures would result in services or systems that meet or exceed the standards in this rule.

(2) Variance Application. The CMHP requesting a variance shall submit, in writing, an application to the Division which contains the following:

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

(b) The reason for the proposed variance;

(c) The alternative practice, service, concept, method, or procedure proposed;

(d) A plan and timetable for compliance with the section of the rule from which a variance is sought; and

(e) Signed documentation from the CMHP reflecting the justification for the proposed variance.

(3) Office of Developmental Disability Services Review. The assistant Administrator or designee of the Office of Developmental Disability Services shall approve or deny the request for a variance.

(4) Notification. The ODDS shall notify the CMHP within 30 days of the receipt of the request by the DD Office with a copy to other relevant sections of the Division.

(5) Appeal Application. Appeal of the denial of a variance request shall be made in writing to the Administrator of the Division, whose decision shall be final.

(6) Written Approval. The CMHP may implement a variance only after written approval from the Division. The Intergovernmental Agreement shall be amended to the extent that the variance changes terms in that agreement.

Stat. Auth.: ORS 427 & ORS 430
Stats. Implemented:
Hist.: MHD 8-1992, f. & cert. ef. 11-16-92

309-041-1300

Statement of Purpose, Mission Statement and Statutory Authority

(1) Purpose. These rules prescribe standards for the development and implementation of an Individual Support Plan for individuals with developmental disabilities.

(2) Mission statement. The overall mission of the State of Oregon Mental Health and Developmental Disability Services Division, Office of Developmental Disability Services, is to provide support services that will enhance the quality of life of persons with developmental disabilities.

(a) While the service system reflects the value of family member(s) participation in the ISP process, the Division also recognizes the rights of adults to make informed choices about the level of participation by family members. It is the intent of this rule to fully support the provision of education about personal control and decision-making to individuals who are receiving services.

(b) The ISP process is critical in determining the individual's and the family's preferences for services and supports. The preferences of the individual and family shall serve to guide the team. The individual's active participation and input shall be facilitated throughout the planning process.

(c) The ISP process is designed to identify the types of services and supports necessary to achieve the individual's and family's preferences, identify the barriers to providing those preferred services and develop strategies for reducing the barriers.

(d) The ISP process should also identify strategies to assist the individual in the exercise of his or her rights. This may create tensions between the freedom of choice and interventions necessary to protect the individual from harm. The ISP team must carefully nurture the individual's exercise of rights while being equally sensitive to protecting the individual's health and safety.

(e) The ISP team assigns responsibility for obtaining or providing services to meet those needs.

(3) Statutory authority. These rules are authorized by ORS 430.041 and carry out the provisions of 430.610 to 430.670 and 427.005 to 427.007.

Stat. Auth.: ORS 430.041
Stats. Implemented: ORS 430.610 - ORS 430.670 & ORS 427.005 - ORS 427.007
Hist.: MHD 9-1997, f. & cert. ef. 10-9-97

309-041-1310

Definitions

As used in these rules:

(1) "Abuse investigation and protective services" means an investigation as required by OAR 309-040-0240 and any subsequent services or supports necessary to prevent further abuse.

(2) "Abuse of an Adult" means:

(a) Any death caused by other than accidental or natural means, or occurring in unusual circumstances;

(b) Any physical injury caused by other than accidental means, or that appears to be at variance with the explanation given of the injury;

(c) Willful infliction of physical pain or injury;

(d) Sexual harassment or exploitation including, but not limited to, any sexual contact between an employee of a community facility or community program, or service provider or other staff and the adult. Sexual exploitation also includes failure of staff to discourage sexual advances towards staff by adults served. For situations other than those involving an employee, service provider, or other staff and an adult, sexual harassment or exploitation means unwelcome verbal or physical sexual contact including requests for sexual favors and other verbal or physical behavior directed toward the adult;

(e) Failure to act/neglect that leads to or is in imminent danger of causing physical injury, through negligent omission, treatment, or maltreatment of an adult, including but not limited to the failure of a service provider or staff to provide an adult with adequate food, clothing, shelter, medical care, supervision, or through condoning or permitting abuse of an adult by any other person. However, no person shall be deemed neglected or abused for the sole reason that he or she voluntarily relies on treatment through prayer alone in lieu of medical treatment;

(f) Verbal mistreatment by subjecting an adult to the use of derogatory names, phrases, profanity, ridicule, harassment, coercion or intimidation and threatening injury or withholding of services or supports. However, it is not considered verbal mistreatment in situations where the consequences of non-compliance may result in termination of services if agreed upon by the ISP team, including implied or direct threat of termination of services;

(g) Placing restrictions on an individual's freedom of movement by seclusion in a locked room under any condition, restriction to an area of the residence or from access to ordinarily accessible areas of the residence, unless arranged for and agreed to on the Individual's Support Plan;

(h) Using restraints without written physician's order, or unless an individual's actions present an imminent danger to himself/herself or others and in such circumstances only until other appropriate action is taken by medical, emergency or police personnel or unless arranged for and agreed to on the ISP;

(i) Financial exploitation which may include, but is not limited to, unauthorized rate increases, staff borrowing from or loaning money to individuals, witnessing wills in which the program is beneficiary, adding program's name to individual's bank accounts or other personal property without approval of the individual, his/her legal guardian, and the ISP team; and

(j) Inappropriately expending the individual's personal funds, theft of an individual's personal funds, using an individual's personal funds for staff's own benefit, commingling the individual's funds with program and/or other individuals' funds, or the program becoming guardian or conservator.

(3) "Adult" means an individual 18 years or older with developmental disabilities for whom services are planned and provided.

(4) "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.

(5) "Annual ISP Meeting" means an annual meeting which is attended by the individual served, agency representatives who provide service to the individual, case manager, the guardian, if any, relatives of the individual and/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 Individual Support Plan.

(6) "Case Management" means an organized service to assist individuals to select, obtain and utilize resources and services.

(7) "Case Manager" means an employee of the community mental health program or other agency which contracts with the County or Division, who is selected to plan, procure, coordinate, and monitor individual support plan services and to act as a proponent for persons with developmental disabilities.

(8) "Choice" means the individual's expression of preferences of activities and services through verbal, sign language or other communication method.

(9) "Community Mental Health Program" or "CMHP" means the organization of all services for individuals with mental or emotional disturbances, developmental disabilities, or chemical dependency, operated by, or contractually affiliated with, a local mental health authority, operated in a specific geographic area of the state under an intergovernmental agreement or direct contract with the Mental Health and Developmental Disability Services Division.

(10) "Crisis Services" means case management services provided in response to any event that substantially threatens the individual's health, safety or the stability of his/her support system.

(11) "Developmental Disability (DD)" means a disability attributable to mental retardation, autism, cerebral palsy, epilepsy, or other neurological handicapping condition which requires training or support similar to that required by individuals with mental retardation, and the disability:

(a) Originates before the individual attains the age of 22 years, except that in the case of mental retardation the condition must be manifested before the age of 18; and

(b) Has continued, or can be expected to continue, indefinitely; and

(c) Constitutes a substantial handicap to the ability of the person to function in society; or

(d) Results in significant sub-average general intellectual functioning with concurrent deficits in adaptive behavior which are manifested during the developmental period. Individuals of borderline intelligence may be considered to have mental retardation if there is also serious impairment of adaptive behavior. Definitions and classifications shall be consistent with the "Manual of Terminology and Classification in Mental Retardation" by the American Association on Mental Deficiency, 1977 Revision. Mental retardation is synonymous with mental deficiency.

(12) "Developmental Disability Program Manager" means an employee of the community mental health program, or other agency which contracts with the county or Division, who is responsible for DD programs within the county.

(13) "Division" means the Mental Health and Developmental Disability Services Division.

(14) "Entry" means admission to a Division-funded service.

(15) "Exit" means either termination or transfer from one Division-funded program to another. Exit from a program does not include transfer within a service provider's program.

(16) "Generic Services" means community resources that are provided to the citizenry at large.

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

(18) "Independence" is defined as the extent to which persons with mental retardation or developmental disabilities, with or without staff assistance, exert control and choice over their own lives.

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

(20) "Individual Support Plan" or "ISP" means a written plan of support and training services for an individual covering a 12-month period which addresses an individual's support needs and each service provider's program plan.

(21) "Individual Support Plan Team" or "ISP Team" means a team composed of the individual, representatives of all current service providers, case manager, the individual's legal guardian if any, advocate, and others determined appropriate by the individual receiving services. If the individual is unable or does not express a preference, other appropriate team membership shall be determined by the ISP team members.

(22) "Integration" means the use by persons with mental retardation or other developmental disabilities of the same community resources that are used by and available to other persons in the community and participation in the same community activities in which persons without a disability participate, together with regular contact with persons without a disability.

(23) "Legal Representative" means the parent if the individual is under age 18, unless the court appoints another individual 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 adult, or a person who is authorized by a court to make decisions about services for the individual.

(24) "Local Mental Health Authority" or "LMHA" means the county court or board of county commissioners of one or more counties who chose to operate a CMHP; or, if the county declines to operate or contract for all or part of a CMHP, the board of directors of a public or private corporation which contracts with MHDDSD to operate a CMHP for that county.

(25) "Monitoring" means the periodic review of the implementation of services identified in the ISP and the quality of services delivered by other organizations.

(26) "Office of Developmental Disability Services" or "DD Office" means the Office of Developmental Disability Services of the Mental Health and Developmental Disability Services Division.

(27) "Priority Population" means individuals possessing one or more of the following characteristics:

(a) The individual has a medical condition that is serious and could be life threatening. Examples include but are not limited to:

(A) Brittle diabetes or diabetes not controlled through medical or physical interventions;

(B) Aspiration or significant risk of choking;

(C) Physical, intellectual, or mental limitations that render the individual totally dependent on others for access to food or fluids;

(D) Mental health or alcohol or drug problems that are not responsive to treatment interventions;

(E) A terminal illness requiring hospice care; and

(F) Condition(s) permitting appointment of a health care representative authorized under OAR 309-041-1500 through 309-041-1610, Health Care Representative.

(b) The individual exhibits behavior that poses a significant danger to the individual. Examples include but are not limited to:

(A) Acts or history of acts which have caused injury to self or others requiring medical attention;

(B) Use of fire or items to threaten injury to persons or damage to property;

(C) Acts that cause significant damage to homes, vehicles, or other property;

(D) Actively searching for opportunities to act out thoughts that involve harm to others.

(c) The ISP team determines that implementation of the Individual's Support Plan developed to address conditions such as those described in (a) or (b) above shall be monitored monthly by the case manager to assure protection of the individual's health and safety. If monthly monitoring by the case manager is not necessary, an individual is not considered part of the priority population.

(28) "Productivity" means engagement in income-producing work by a person with mental retardation or other developmental disabilities which is measured through improvements in income level, employment status or job advancement or engagement by a person with mental retardation or other developmental disabilities in work contributing to a household or community.

(29) "Service Provider" means a public or private community agency or organization that provides a recognized mental health or developmental disability services services and is approved by the Division or other appropriate agency to provide the service.

(30) "Support" means those services that assist an individual in maintaining or increasing his or her functional independence, achieving community presence and participation, enhancing productivity, and enjoying a satisfying lifestyle. Support services can include training, i.e. the systematic, planned maintenance, development and enhancement of self-care, social or independent living skills; or the planned sequence of systematic interactions, activities, structured learning situations, or educational experiences designed to meet each individual's specified needs in the areas of integration and independence.

(31) "Transfer" means movement of an individual from one site to another site administered by the same service provider.

(32) "Transition Plan" means a written plan for the period of time between an individual's entry into a particular service and the time when the individual's ISP is developed and approved by the ISP team. The plan shall include 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/or consultations necessary for the ISP development.

(33) "Unusual Incident" means those 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.

Stat. Auth.: ORS 430.041
Stats. Implemented: ORS 430.610 - ORS 430.670 & ORS 427.005 - ORS 427.007
Hist.: MHD 9-1997, f. & cert. ef. 10-9-97

309-041-1320

Community Mental Health Program Responsibilities for Individual Support Plan, Entry/Exit/Transfer Plans

(1) Individuals in Division-funded residential and/or employment services. The CMHP shall assure that all individuals in Division-funded residential and/or employment services have an annual Individual Support Plan (ISP). An Individual Support Plan shall be developed and reviewed in accordance with OAR 309-041-1330 and 309-041-1360. The case manager shall participate in the development of an Individual Support Plan for individuals who fall within the priority population. The case manager shall, to the extent resources are available and within the priorities established in 309-041-0400 through 309-041-0500, Case Management Services for Individuals with Developmental Disabilities and Their Families, participate in the development of Individual Support Plans for other individuals.

(2) Individuals not in Division-funded residential or employment services. Individuals not in Division-funded residential or employment services are not required to have an ISP. These individuals shall have an Annual Contact and Summary of Support Needs developed and reviewed in accordance with OAR 309-041-0410, Case Management Services for Individuals with Developmental Disabilities and Their Families.

(3) Entry/exit/transfer plans for individuals in Division-funded residential or employment services.

(a) Entry to program services shall be authorized in accordance with OAR 309-041-0445, Case Management Services for Individuals with Developmental Disabilities and Their Families.

(b) Exit from program services shall be in accordance with OAR 309-041-0445, Case Management Services for Individuals with Developmental Disabilities and Their Families.

(c) Transfer between program services shall be in accordance with OAR 309-041-0445, Case Management Services for Individuals with Developmental Disabilities and Their Families.

(4) Crisis services for all individuals. Crisis services shall be assessed, identified, planned, monitored and evaluated by the case manager in accordance with OAR 309-041-0300, Diversion/Crisis Services.

(5) Monitoring of individual support plans.

(a) Services identified in the ISP shall be monitored for individuals receiving Division-funded residential and/or employment services in accordance with OAR 309-041-0445, Case Management Services for Individuals with Developmental Disabilities and Their Families.

(b) The case manager shall monitor the ISP for individuals who fall within the priority population. The case manager shall, to the extent resources are available and within the priorities established in the Case Management Rule, monitor the ISP for other individuals.

Stat. Auth.: ORS 430.041
Stats. Implemented: ORS 430.610 - ORS 430.670 & ORS 427.005 - ORS 427.007
Hist.: MHD 9-1997, f. & cert. ef. 10-9-97

309-041-1330

Standards for the Development of the Individual Support Plan (ISP)

(1) Priority population determination. The ISP team shall make an initial determination whether or not an individual falls within the priority population using the definition in OAR 309-041-0130 and notify the case manager. The case manager shall confirm that the individual falls within the priority population.

(2) ISP team membership. The ISP shall be developed through a team approach and the membership of the team may vary, depending on the unique needs of the individual and the services being provided. Each member shall have equal participation in discussion and decision making. No one member shall have the authority to make decisions for the team. Representatives from service provider(s), families, the CMHP, or advocacy agencies shall be considered as one member for the purpose of reaching majority agreement.

(a) The ISP team shall at a minimum, include the individual, individual's legal guardian, and service provider representatives. The case manager shall be part of the ISP team for individuals who fall within the priority population. The case manager may participate in the ISP meeting for other individuals to the extent case management resources are available and within the priorities set forth for case management services in OAR 309-041-0410, Case Management Services for Individuals with Developmental Disabilities and Their Families.

(b) The individual may suggest additional participants. Typically, family members, advocates or other professionals involved in providing service to the individual are appropriate ISP team members.

(c) The individual may raise objection to participation by a particular person. When an individual raises objections to participation by a particular individual, the team shall attempt to accommodate the individual's objection while allowing participation by team members.

(3) Initial and annual ISP timelines.

(a) An ISP shall be completed within 60 calendar days following entry into Division-funded residential or employment services and at least annually thereafter. All ISPs shall be sent to the CMHP for placement in the individual's file. If the individual has not been identified as a member of the priority population and a case manager believes otherwise, the case manager may reconvene the ISP team. If the case manager does not believe the ISP meets the requirements specified in these rules, the case manager may reconvene the ISP team.

(b) When a service provider's individual planning process (including the outcome system) requires more than annual team meetings, a copy of the plan shall be sent to the CMHP within 30 days of completion for placement in the individual's file. The case manager shall review the plan and provide any comments to the ISP team.

(4) Changes in the ISP. If significant needs or changes or crisis situations arise between scheduled ISP meetings, such as the necessity to develop a new behavior intervention program, reports indicating changes in the health status or functioning level, new evaluations containing substantial recommendations or changes, the report of an unusual incident or any other significant situation which may require prompt action, the case manager or ISP team leader shall be contacted to facilitate a discussion between the ISP team members regarding the ISP changes proposed and assess the need to reconvene as a team. Any ISP team member may contact the case manager regarding changes in the ISP. The case manager or facilitator shall document the team discussion and any subsequent recommendations and distribute to these team members.

Stat. Auth.: ORS 430.041
Stats. Implemented: ORS 430.610 - ORS 430.670 & ORS 427.005 - ORS 427.007
Hist.: MHD 9-1997, f. & cert. ef. 10-9-97

309-041-1340

ISP Meeting Process

(1) ISP Meetings. The case manager shall initiate the ISP meeting for individuals who fall within the priority population. For other individuals, when the case manager is not present, the ISP team shall select a team leader for the meeting. The team leader shall be responsible for assuring that the ISP meeting is scheduled and participants notified.

(2) Case manager or team leader role in the development of the ISP. At the ISP meeting, the case manager or designated team leader shall:

(a) Initiate the discussion of the individual, individual's legal representative's, family's, or other team member's preferences;

(b) Initiate a discussion that the individual and/or legal representative have the right to request that information not be shared across service providers unless the preference is likely to create the situation detrimental to the individual's health and safety as determined by the ISP team.

(c) Initiate discussion of and document the need for evaluations in the areas of medical, dental, vision, hearing; and any other evaluations based on the specialized needs of the individual (such as, but not limited to, neurological evaluations for individuals with seizure disorders, augmentative communication evaluations for individuals with limited speech, physical therapy and equipment evaluations for individuals in wheelchairs, psychiatric or psychological evaluations for individuals who are dually-diagnosed or nutritional evaluations for individuals with metabolic disorders);

(d) Initiate and document discussion of specialized health care needs and health maintenance services (such as, but not limited to, required periodic lab work), including what services are needed and the individual or provider who is responsible for assuring that they are provided;

(e) Determine with the ISP team whether home visits, vacations and other community or family-based activities are considered to be community-based experiences preferred by the individual. If so, then these activities must be considered part of the individual's overall ISP and shall be documented as such through the ISP process;

(f) Initiate the review of and discussion regarding outcome of any previous plan;

(g) Initiate discussion of proposed service provider plans and assist the team to make any needed modifications emphasizing health, safety, and rights;

(h) Determine the extent to which the ISP reflects the individual's choice and preferences in his/her daily activities which are defined in the ISP;

(i) Make efforts to build consensus among the members regarding services and supports included in the ISP, giving the most weight to the preference of the individual receiving services, unless the individual's preference is likely to create a situation detrimental to his/her health and safety as determined by the ISP team;

(j) ISP team decisions shall be made by majority agreement.

(3) ISP document. The ISP document shall include:

(a) Each service provider's program plan, with team modifications;

(b) Documentation of the need for additional evaluations or other services to be obtained and the person or provider responsible for assuring that these evaluations or services are obtained;

(c) Documentation of the specialized health care needs, health maintenance services and the person or provider responsible for assuring that these services are provided;

(d) Documentation of the individual's safety skills including the level of support necessary for the individual to evacuate a building (when warned by a signal device), the individual's ability to adjust water temperature, and the amount of time an individual can be without supervision before the missing notification protocol is implemented;

(e) Documentation of the reason(s) any preferences of the individual, legal representative and/or family members cannot be honored; and

(f) Documentation of the role and responsibilities of each participant in implementing the ISP plan, with specific ISP team member concerns, if any, noted.

(4) Distribution of the ISP document. The case manager or the team leader shall assure the distribution of a copy of the Individual Support Plan to all ISP team members within 30 calendar days of the ISP team meeting.

Stat. Auth.: ORS 430.041
Stats. Implemented: ORS 430.610 - ORS 430.670 & ORS 427.005 - ORS 427.007
Hist.: MHD 9-1997, f. & cert. ef. 10-9-97

309-041-1350

ISP Team Responsibilities for Entry/Exit/Transfer

(1) Entry staffing. Prior to an individual's date of entry into a Division-funded program, the ISP team shall meet to review referral material in order to determine appropriateness of placement. For purposes for entry staffings, a case manager must attend the staffing and authorize the placement. The team shall determine date of entry and develop a transition plan. The transition plan shall include:

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

(b) The date of the meeting;

(c) Documentation of the participants included in the meeting;

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

(e) Documentation of the alternatives considered instead of entry;

(f) Documentation of the reason(s) any preferences of the individual, the individual's legal representative, family or other team member cannot be honored;

(g) Documentation of majority agreement of the participants in the meeting with the decision;

(h) The written plan for services to the individual;

(i) Documentation of decisions regarding the proposed placement; and

(j) Findings of the ISP team and the signatures of all participants.

(2) Crisis services. For a period not to exceed 30 days, subsection (3)(b) of OAR 309-041-0445 does not apply if an individual is temporarily admitted to a program for crisis services.

(3) Exit from Division-funded programs. All exits from Division-funded programs shall be authorized by the CMHP. Prior to an individual's exit date, the ISP team shall meet to review the appropriateness of the move and to coordinate any services necessary during or following the transition. For purposes for exit staffings, a case manager must attend the staffing and authorize the exit.

(4) Exit staffing. Findings of the exit meeting shall be distributed to all ISP team members. The exit plan shall include:

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

(b) The date of the meeting;

(c) Documentation of the participants included in the meeting;

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

(e) Documentation of the alternatives considered instead of exit;

(f) Documentation of the reason(s) any preferences of the individual, the individual's legal representative, family or other team member cannot be honored;

(g) Documentation of majority agreement of the participants in the meeting with the decision; and

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

(5) Transfer meeting. All transfers must be authorized by the CMHP. Transfer of an individual shall be preceded by a meeting of the ISP team before any decision to transfer is made. This meeting may occur by phone with all ISP team participants to expedite the transfer if so warranted. 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 transfer;

(b) The date of the meeting;

(c) Documentation of the participants included in the meeting;

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

(e) Documentation of the alternatives considered instead of transfer;

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

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

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

Stat. Auth.: ORS 430.041
Stats. Implemented: ORS 430.610 - ORS 430.670 & ORS 427.005 - ORS 427.007
Hist.: MHD 9-1997, f. & cert. ef. 10-9-97

309-041-1360

Standards for Monitoring Individual Support Plans for Individuals

(1) Case manager responsibility for monitoring services for individuals. The case manager shall determine whether services are being provided in accordance with the ISP; that personal, civil, and legal rights of the individual are protected in accordance with this rule; that the satisfaction and desires of the individual, the individual's legal representative or family are addressed; that the services provided continue to meet the needs of the individual; and that the services result in the individual's achievement of goals and objectives identified in the ISP. The case manager shall monitor the ISP for individuals who fall within the priority population. The case manager shall, to the extent resources are available, monitor the ISP of other individuals.

(2) Frequency of monitoring. The frequency of the monitoring will be determined by the needs of the individual. However, the case manager shall meet at least monthly, in addition to the annual ISP meeting, with an individual who falls within the priority population. Arrangements shall be made to meet with the individual in a mutually acceptable location. Communication for the purpose of monitoring may also be done with provider(s) and family members. Should an individual refuse, after being duly informed as to the purpose and nature of the visit, to have the case manager visit, then such a refusal shall be documented in the individual's case record.

(3) Purpose of monitoring. The purpose of the visit is to assure that supports are being provided as defined in the ISP. Monitoring shall include:

(a) Review and documentation of the individual's outcome data, if applicable.

(b) Review of any incident and unusual incident reports.

(c) Review of the process by which an individual accesses and utilizes funds according to standards specified in OAR 309-049-0175.

(d) Review of the ISP document to determine if the goals and objectives or actions to be taken by the case manager or others have been implemented:

(A) Address the individual's participation in activities that will increase integration, independence, and/or productivity;

(B) Address the anticipated outcomes which reflect the preferences and needs of the individual to the extent possible, while at the same time reflect similar interests and activities of persons without disabilities of a similar age; and

(C) Define the behavior, conditions and criterion for achieving the objectives and are consistent with the residential or employment outcome system as set forth in the Interagency Agreement between the Division and the CMHP.

(4) Monitoring follow-up. If the case manager determines that services are not being delivered as agreed, or that an individual's service needs have changed since the last review, the CMHP shall determine the need for technical assistance and/or referral to the DD program manager for consultation or corrective action.

Stat. Auth.: ORS 430.041
Stats. Implemented: ORS 430.610 - ORS 430.670 & ORS 427.005 - ORS 427.007
Hist.: MHD 9-1997, f. & cert. ef. 10-9-97

309-041-1370

Grievance Procedures

(1) Grievances.

(a) Mediation of grievances. Individuals, their legal representatives, family members or advocates may file a grievance concerning a determination regarding the appropriateness of services proposed or provided as set forth in these rules.

(b) Grievances shall be submitted in writing to the CMHP. The CMHP upon request shall assist individuals requiring assistance in preparing a written grievance.

(c) Informal procedures. Grievances concerning the appropriateness of services should, if possible, be resolved through the use of informal procedures. However, the grievant may elect not to utilize informal procedures, and to proceed directly to the county formal mediation committee.

(A) Informal procedures may include one or more of the following:

(i) Meeting with the individual, legal representative, family member(s) and/or advocates;

(ii) Meeting with the CMPH administrative staff;

(iii) Meeting with the ISP team;

(iv) Meeting with program administrative staff; and

(v) Meeting with local agency(ies); and

(vi) Voluntary mediation with a neutral mediator mutually agreed upon by the parties.

(B) Informal procedures shall result in a decision on the grievance no later than 30 days from the date the grievance is filed.

(C) The 30 day period for informal resolution of grievances may be extended by mutual agreement of the grievant and the CMHP to extend the informal process. Such agreement shall be in writing and must extend the process for a specified duration. A copy of the agreement to extend the time for informal resolution shall be sent to the CMHP and the Division within five working days of its signing by the parties involved.

(D) The grievant shall receive written notice of the grievance decision or outcome. The CMHP shall send a copy of this notice to the Division within five working days of issuance of notice to the grievant.

(d) CMHP formal mediation. When informal procedures cannot resolve the dispute, the interested party(ies) may submit to the CMHP a written request for a formal mediation of the disagreement using the CMHP's mediation procedures. The CMHP Director or designee shall make a decision within 30 working days of receipt of the request and notify the appellant of the decision in writing.

(e) Division review process. If the CMHP formal mediation decision is not acceptable to all the parties, decisions can be reviewed using the following formal procedure:

(A) The party requesting review shall submit in writing a request for a formal review to the Mental Health and Developmental Disability Services Division within five working days of receipt of the CMHP's decision:

(i) A grievance review committee shall be appointed by the Administrator of the Division or designee, in the Office of Developmental Disability Services of the Division, every two years, and shall be composed of Division representative, a local service provider program representative, a case management representative, and a representative of the Division's Office of Client Rights;

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

(B) Upon receipt of the request for formal review, the Division shall:

(i) Schedule a grievance committee review meeting within 30 days of written request by the requesting party for a formal review of the decision; and

(ii) Notify in writing, each party involved in the disagreement of the date, time, and location of the committee review meeting, allowing at least 15 days from the meeting notification to the scheduled meeting time; and

(iii) Record the review committee meeting.

(C) Individual rights. The grievance review committee shall afford individuals the following rights:

(i) The opportunity to review documents and other evidence relied upon in reaching the decision being appealed; and

(ii) The opportunity to be heard in person and to be represented; and

(iii) The opportunity to present witnesses or documents to support their position and to question witnesses presented by other parties.

(D) Within 15 days after the conclusion of the meeting, the grievance review committee shall provide written recommendations to the Administrator or designee. The Administrator or designee shall make a decision and send written notification of the recommendations and implementation process to all grievance review committee meeting participants within 15 days of receipt of the recommendations.

(E) The decision of the Administrator or designee shall be final.

(2) Appeals.

(a) Appeals of entry, exit or transfer decisions within residential services may only be initiated according to the "24-Hour Residential Services" (OAR 309-049-0030), and the "Supported Living Services" (309-041-0550) and "Semi-Independent Living Services" (309-041-0015) rules;

(b) Appeals of entry, exit or transfer decisions within employment services may only be initiated according to the "Employment and Alternatives to Employment Services" (OAR 309-047-0000) rule.

Stat. Auth.: ORS 430.041
Stats. Implemented: ORS 430.610 - ORS 430.670 & ORS 427.005 - ORS 427.007
Hist.: MHD 9-1997, f. & cert. ef. 10-9-97

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