Or. Admin. Code § 411-346-0240

Current through Register Vol. 63, No. 11, November 1, 2024

Section 411-346-0240 - Standards for Entry, Transfer, Exit, and Closure

(1) NON-DISCRIMINATION. A child may not be denied services in a child foster home or otherwise discriminated against on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin, marital status, age, disability, source of income, duration of Oregon residence, or other protected classes under federal and Oregon Civil Rights laws.

(2) ELIGIBILITY. A child who enters a child foster home is subject to eligibility as described in this section. To be eligible for services in a child foster home, a child must meet the following requirements:

(a) Be an Oregon resident who meets the residency requirements in OAR 461-120-0010.

(b) Be receiving:

(A) A Medicaid Title XIX benefit package through OSIPM or HSD medical programs; or

(B) A benefit package through the Healthier Oregon medical program.

(c) Be determined eligible for:

(A) Developmental disabilities services by the CDDP of the county of origin as described in OAR 411-320-0080; or

(B) Services for Aging and People with Disabilities as described in OAR chapter 411, division 015.

(d) Meet the level of care as defined in OAR 411-317-0000.

(e) Not receive other Department-funded in-home, community living support, or other services in another residential setting.

(3) ENTRY.

(a) A foster provider considering a child for entry into the child foster home must:

(A) Provide notification to the local CDDP of the intended entry prior to the child moving into the home.

(B) Be prior authorized to provide Medicaid-funded services to the child if the child is not private pay.

(C) Receive written permission from the Department prior to:

(i) A child under age 18 moving into a child foster home with individuals age 18 or older; or

(ii) An individual who turns 18 and continues to reside in a child foster home with children under the age of 18.

(D) Gather sufficient information to make an informed decision about the foster provider's ability to safely and adequately support the child.

(b) A foster provider must participate in an entry meeting with a child's case manager prior to delivering services to the child for services to be funded in the home.

(c) Prior to or upon an entry, a foster provider must demonstrate diligent efforts to acquire the following information about the child from the referring case management entity:

(A) A copy of the eligibility determination document.

(B) A statement indicating the safety skills, including the ability of the child to evacuate from a building when warned by a signal device and adjust water temperature for bathing and washing.

(C) A brief written history of any behavioral challenges, including supervision and support needs.

(D) A medical history and information on health care supports that includes (when available):

(i) The results of the most recent physical exam;

(ii) The results of any dental evaluation;

(iii) A record of immunizations;

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

(v) A record of major illnesses and hospitalizations.

(E) A written record of any current or recommended medications, treatments, diets, and aids to physical functioning.

(F) A copy of the most recent functional needs assessment and previous functional needs assessment if the needs of the child have changed over time.

(G) Copies of protocols, the risk tracking record, and any support documentation (if available).

(H) Copies of documents relating to the guardianship, conservatorship, health care representation, power of attorney, court orders, probation and parole information, or any other legal restrictions on the rights of the child (if applicable).

(I) Copies of medical decision-making documents, if applicable.

(J) Written documentation that the child is participating in out of residence activities, including public school enrollment for children or individuals under 21 years of age.

(K) Written documentation to explain why preferences of the child or the child's guardian may not be implemented.

(L) A copy of the most recent Functional Behavior Assessment, Positive Behavior Support Plan, ISP or Service Agreement, Nursing Service Plan, and Individualized Education Plan (if available).

(d) If a child is being admitted from the child's family home and the information required in subsection (c) of this section is not available, the foster provider must assess the child upon entry for issues of immediate health or safety and document a plan to secure the remaining information no later than 30 calendar days after entry. The plan must include a written justification as to why the information is not available.

(e) A foster provider retains the right to deny entry of any child if the foster provider determines the support needs of the child may not be met by the foster provider or for any other reason not specifically prohibited by these rules.

(4) VOLUNTARY TRANSFERS AND EXITS.

(a) A foster provider must promptly notify a child's case manager if the child's guardian gives notice of the intent to exit or abruptly exits services. A child's guardian is not required to give notice to a foster provider if the child's guardian chooses to exit the child from the child foster home.

(b) A foster provider must notify a child's case manager prior to moving a child from one child foster home operated by the foster provider to a new residence operated by the same foster provider.

(c) Notification and authorization of the voluntary transfer or exit of the child must be documented in the record for the child.

(d) A foster provider is responsible for the provision of services until a child exits the child foster home when the exit is a voluntary exit from the child foster home.

(5) INVOLUNTARY REDUCTIONS, TRANSFERS, AND EXITS.

(a) A foster provider must only reduce services, transfer, or exit a child involuntarily for one or more of the following reasons:

(A) The behavior of the child poses an imminent risk of danger to self or others.

(B) The child experiences a medical emergency that results in the child requiring substantially increased ongoing support that the foster provider is unable to meet.

(C) The service needs of the child exceed the ability of the foster provider.

(D) Payment is not available from Medicaid or other third-party reimbursement.

(E) The foster provider's certificate for the home is suspended, revoked, not renewed, or voluntarily surrendered.

(F) The foster provider's Medicaid provider enrollment agreement or contract has been terminated.

(b) NOTICE OF INVOLUNTARY REDUCTION, TRANSFER, OR EXIT. A foster provider must not reduce services, transfer, or exit a child involuntarily without giving advance written notice 30 calendar days prior to the reduction, transfer, or exit. The notice of involuntary reduction, transfer, or exit must be provided to the child's guardian and case manager, except in the case of a medical emergency or when a child is engaging in behavior that poses an imminent danger to self or others in the child foster home as described in subsection (c) of this section.

(A) The written notice must be provided on the applicable Department form and include:

(i) The reason for the reduction, transfer, or exit; and

(ii) The right of the child or the child's guardian on behalf of the child to a hearing as described in section (6) of this rule.

(B) A notice is not required when a child's guardian requests the reduction, transfer, or exit.

(c) A foster provider may give advance written notice less than 30 calendar days prior to an exit or transfer only in a medical emergency or when a child is engaging in behavior that poses an imminent danger to self or others in the child foster home and undue delay in moving the child increases the risk of harm. The notice must be provided to the child's guardian and case manager immediately upon the foster provider's determination of the need for a reduction, transfer, or exit.

(d) A foster provider must demonstrate through documentation, attempts to resolve the reason for the involuntary reduction, transfer, or exit, including consideration of alternatives to the reduction, transfer, or exit and engagement of the case manager in this process.

(e) A foster provider is responsible for the provision of services until the date of reduction, transfer, or exit identified in the notice, or when a child's guardian requests a hearing, until the hearing is resolved.

(6) HEARING RIGHTS.

(a) A child, or child's guardian on behalf of the child, must be given the opportunity for a hearing under ORS chapter 183 and OAR 411-318-0030 to dispute an involuntary reduction, transfer, or exit, except when a foster provider's certificate is revoked, not renewed, voluntarily surrendered, or the foster provider's Medicaid contract is terminated.

(b) If a child's guardian requests a hearing within 15 calendar days after the date of the notice and requests continuation of services, the child must receive the same services until the hearing is resolved.

(c) When a child has been given written notice less than 30 calendar days in advance of a transfer or exit as described in section (5)(c) of this rule and the child's guardian has requested a hearing, the foster provider must reserve the room of the child and deliver services according to the child's needs until receipt of the Final Order.

(d) A child's guardian may request an expedited hearing as described in OAR 411-318-0030.

(7) EXIT MEETING. A foster provider must participate in an exit meeting before any decision to exit a child is made, unless the exit meeting is waived in accordance with OAR 411-415-0080.

(8) CLOSURE. A foster provider must notify the Department and case management entity in writing prior to announcing a voluntary closure of a child foster home to the children and the children's guardians.

(a) The foster provider must give each child's guardian and the case management entity written notice 30 calendar days in advance of the planned closure, except in circumstances where undue delay might jeopardize the health, safety, or welfare of the children, the foster provider, or alternate caregivers.

(b) If the foster provider is moving the child foster home to a new residence, a child may not be moved without providing each child's guardian and the case management entity written notice 30 calendar days in advance of the planned moved, unless prior approval is given and agreement obtained from the child's guardian and the case management entity.

(c) A foster provider must return the certificate for a child foster home to the Department if the child foster home closes prior to the expiration of the certificate.

Or. Admin. Code § 411-346-0240

APD 40-2019, adopt filed 10/29/2019, effective 11/1/2019; APD 34-2022, temporary amend filed 07/01/2022, effective 7/1/2022 through 12/27/2022; APD 53-2022, amend filed 12/14/2022, effective 12/15/2022

Statutory/Other Authority: ORS 409.050, 427.104, 430.662 & 443.835

Statutes/Other Implemented: ORS 409.010, 427.007, 427.104, 430.215, 430.610, 430.662, 443.830 & 443.835