Bill Text: OR SB641 | 2013 | Regular Session | Introduced

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Bill Title: Relating to reimbursement paid to providers of developmental disability services; declaring an emergency.

Sponsorship: Partisan Bill (Democrat 2)

Status: (Failed) 2013-07-08 - In committee upon adjournment. [SB641 Detail]

Download: Oregon-2013-SB641-Introduced.html

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     77th OREGON LEGISLATIVE ASSEMBLY--2013 Regular Session

NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .

LC 2166

                         Senate Bill 641

Sponsored by Senator DEVLIN, Representative BUCKLEY

                             SUMMARY

The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.

  Requires Department of Human Services to calculate amount paid
to all providers of services to adults with developmental
disabilities using uniform tool that reimburses for all services
provided under individualized written service plan.
  Requires department to provide to adult receiving developmental
disabilities services, and to adult's guardian, health care
providers, caregivers and family members, notice containing
detailed accounting of reimbursement paid to service providers.
  Declares emergency, effective on passage.

                        A BILL FOR AN ACT
Relating to reimbursement paid to providers of developmental
  disability services; creating new provisions; amending ORS
  427.400; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
  SECTION 1.  { + Section 2 of this 2013 Act is added to and made
a part of ORS chapter 427. + }
  SECTION 2.  { + (1) As used in this section, 'service provider
' means any person who contracts with the Department of Human
Services to provide one or more of the services identified in the
individualized written service plan of an adult with a
developmental disability regardless of whether the service is
provided in a group home, adult foster home or any other
residential setting, including the adult's own home.
  (2) The department shall reimburse a service provider an amount
that includes payment for the cost of all of the services
identified in the individualized written service plan that are
provided by the service provider.
  (3) The department shall use a uniform tool to calculate the
amount of reimbursement paid to a service provider in accordance
with this section. The tool must clearly indicate to the service
provider the formula, factors and rates used in the calculation.
  (4) The department shall appoint an advisory group consisting
of service providers and advocates for adults receiving
developmental disability services. The department shall involve
the advisory group in developing and updating the uniform tool
described in subsection (3) of this section. + }
   { +  (5) The department shall provide to each adult receiving
developmental disability services and to the adult's guardian,
health care providers, primary caregivers and family members, if
appropriate, a written notice containing a detailed accounting of
the reimbursement paid to the service providers and the rates,
factors and weighting of factors used to determine the amount of
the reimbursement. + }
  SECTION 3. ORS 427.400 is amended to read:
  427.400. As used in this section and ORS 427.402 and 427.410
 { +  and section 2 of this 2013 Act + }:
  (1) 'Adult' means an individual who is 18 years of age or
older.
  (2) 'Community living and inclusion supports' means services
that may or may not be work-related and includes services
designed to develop or maintain the individual's skills in the
following areas:
  (a) Eating, bathing, dressing, personal hygiene, mobility and
other personal needs;
  (b) Self-awareness and self-control, social responsiveness,
social amenities, interpersonal skills, interpersonal
relationships and social connections;
  (c) Community participation, recreation and the ability to use
available community services, facilities or businesses;
  (d) Expressive and receptive skills in verbal and nonverbal
language, the functional application of acquired reading and
writing skills and other communication needs; and
  (e) Planning and preparing meals, budgeting, laundering,
housecleaning and other personal environmental needs.
  (3) 'Comprehensive services' means a package of services, other
than support services for adults, that is provided by or under
the direction of a community developmental disabilities program
and that includes at least one of the following living
arrangements licensed or regulated by the Department of Human
Services:
  (a) Twenty-four-hour residential care, including but not
limited to a group home, a foster home or a supported living
program.
  (b) Assistance provided to maintain an individual in the
individual's own home or the home of the individual's family and
that costs more than an amount specified by the department by
rule.
  (4) 'Employment services' means services provided to develop or
maintain the skills necessary for an individual to obtain and
retain employment, including job assessment, job exploration, job
development, job training, job coaching, work skills, and ongoing
supports.
  (5) 'Environmental accessibility adaptations' means physical
modifications to an individual's home that are necessary to
ensure the health, welfare and safety of the individual in the
home, or that enable the individual to function with greater
independence in the home.
  (6) 'Individualized written service plan' means a plan
described in ORS 430.210 (1)(a), (b) and (c) that identifies the
resources, services and purchases necessary for an individual
with a developmental disability to achieve identified personal
goals and maximize self-determination.
  (7) 'Person-centered planning' means an informal or formal
process for gathering and organizing information that helps an
individual to:
  (a) Enhance self-determination by choosing personal goals and
lifestyle preferences;
  (b) Design strategies and networks of support to achieve
personal goals and a preferred lifestyle using individual
strengths, relationships and resources; and
  (c) Identify, use and strengthen naturally occurring
opportunities for support in the home and in the community.
  (8) 'Self-determination' means empowering individuals to:
  (a) Select and plan, together with freely-chosen family members
and friends, the support services for adults that are necessary

instead of purchasing a predefined program or package of
services;
  (b) Control the expenditure of available financial assistance
in order to purchase support services for adults, with the help
of a social support network if needed;
  (c) Live an autonomous life in the community, rich in community
affiliations, through formal or informal arrangements of
resources and personnel; and
  (d) Have a valued role in the community through competitive
employment, organizational affiliations, personal development and
general caring for others in the community, and to be accountable
for spending public dollars in ways that are life-enhancing for
the individual.
  (9)(a) 'Specialized medical equipment and supplies' means:
  (A) Devices, aids, controls, supplies or appliances that enable
individuals:
  (i) To increase their ability to perform activities of daily
living; or
  (ii) To perceive, control or communicate with the environment
in which they live;
  (B) Items necessary for life support, including ancillary
supplies and equipment necessary to the proper functioning of
these items; and
  (C) Medical equipment not available in the medical assistance
program.
  (b) 'Specialized medical equipment and supplies' does not
include items that have no direct medical or remedial benefit to
the individual.
  (10) 'Specialized supports' means treatment, training,
consultation or other unique services that are not available
through the medical assistance program but are necessary to
achieve the goals identified in the individualized written
service plan, or other support services for adults prescribed by
the department by rule.
  (11) 'Support service brokerage' means an entity that contracts
with the department to provide or to arrange for support services
for adults.
  (12) 'Support services for adults' means the services for
adults with developmental disabilities provided by a support
service brokerage under ORS 427.402 and 427.410.
  SECTION 4.  { + This 2013 Act being necessary for the immediate
preservation of the public peace, health and safety, an emergency
is declared to exist, and this 2013 Act takes effect on its
passage. + }
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