Or. Admin. R. 410-138-0420

Current through Register Vol. 63, No. 8, August 1, 2024

Section 410-138-0420 - Targeted Case Management Asthma/Healthy Home - Risk Criteria

(1) This administrative rule will be implemented contingent on CMS approval for the TCM Asthma/Healthy Home Program. This rule is to be used in conjunction with the Division's General Rules (chapter 410, division 120) and other Targeted Case Management Program rules OAR 410-138-0000 through 410-138-0009.

(2) The target group is Medicaid eligible children with poorly controlled asthma or a history of environmentally induced respiratory distress, which can result in a life threatening asthma exacerbation or exacerbation of respiratory distress.

(3) Risk factors for the target group could include, but are not limited to:

(a) Unscheduled visits for emergency or urgent care;

(b) One or more in-patient stays;

(c) History of intubation or Intensive Care Unit care;

(d) A medication ratio of control medications to rescue medications of less than or equal to .33 indicating less than desirable control of asthma;

(e) Environmental or psychosocial concerns raised by medical home;

(f) School day loss greater than two school days per year;

(g) Inability to participate in sports or other activities due to asthma;

(h) Homelessness;

(i) Inadequate housing, heating, or sanitation.

Or. Admin. R. 410-138-0420

DMAP 22-2010, f. 6-30-10, cert. ef. 7-1-10; DMAP 41-2010, f. 12-28-10, cert. ef. 1-1-11; DMAP 76-2016, f. 12-29-16, cert. ef. 1/1/2017; DMAP 2-2017(Temp), f. & cert. ef. 1-13-17 thru 7-11-17; DMAP 9-2017, f. 3-31-17, cert. ef. 4/1/2017

Stat. Auth.: ORS 413.042 & 414.065

Stats. Implemented: ORS 414.065