Manual |
Change |
Section/Item |
Rule Change
(available 4-1-2019 unless otherwise indicated) |
OSIP(M) |
New MSC 3010 Authorization for Disclosure, Sharing and Use of Individual Information replaced MSC 2099. |
OSIPM B.7, WG 4, WG 11.11 |
|
|
EPD
- Updated the following:
- Income standards and participant fee categories updated to reflect annual FPL changes.
- Clarified that payment of the EPD participant fee is a condition of eligibility and non-payment results in closure and overpayment referral.
- Process for requesting a refund of fees paid in error.
- Added the following:
- Process for when the participant fee is not paid (including examples).
- HCBS individuals that are on EPD and placed in a Nursing Facility will need their liability zeroed out in MMIS.
- 850E should be sent at approval and when the participant fee increases causing a reduction in benefits.
- Approved Accounts remain excluded during the extended EPD timeframe after loss of employment.
|
OSIPM WG 11 |
461-145-0025 |
|
Language was added to clarify that redeterminations may be completed earlier than 12 months to align with other programs or for other customer service considerations. |
OSIPM F.5 |
|
|
Income standards for EPD and 24-hour mental health residential care were updated to reflect annual FPL changes. |
OSIPM E.2 |
|
|
Language was added (under Medical Costs and in WG-1 Step 6) to clarify that when an insurance premium covers an individual and a spouse and/or dependent, count only the verified amount that the premium would be for the individual alone. If verification is not readily available, count half the current premium as the individual's portion and update the case if verification is received at a later date. |
OSIPM E.6 & WG 1 |
|
|
Updated to remove interview requirement at initial application for OSIPM individuals who are assumed eligible and not requesting services. |
OSIPM B.5 |
461-115-0230 |
|
Updated Special Diet Allowance (H. Special Needs, #11) with the new requirements and process for calculating the allowance. |
OSIPM H.11 |
|
|
Updated the effective date for denial of benefits to the date the decision was made that the individual is not eligible, including if the ineligibility results from failure to provide information or otherwise cooperate. |
OSIPM F.4 |
461-180-0060 |
|
Removed language in Resource Limits (section on Excluded Resources for Payments Received Under a Qualified Partnership Policy) that states the exclusion "is not reduced when the value of excluded resources has decreased due to no action on the individual's part, such as a loss of value due to economic factory. In this circumstance, additional assets may be excluded up the entire Qualified Partnership Policy amount." |
OSIPM E.7 |
461-140-0220, 461-160-0855 |
|
Clarified that form 547 is sent in addition to the 512, not in place of it. |
OSIPM WG.12 |
|
MSP |
New MSC 3010 Authorization for Disclosure, Sharing and Use of Individual Information replaced MSC 2099. |
MSP B.11 |
|
|
Income standards updated to reflect annual FPL changes |
MSP E.2 |
|
|
Updated Medicare Buy-In Unit branch assignments and contact information. |
MSP WG 4, WG 5 |
|
|
Updated the effective date for denial of benefits to the date the decision was made that the individual is not eligible, including if the ineligibility results from failure to provide information or otherwise cooperate. |
MSP F.3 |
461-180-0060 |
Counting Client Assets |
Updated Personal Belongings (section 56) to clarify the definition and specify that items meeting the definition are countable if held or acquired for their value. |
CCA B.56 |
461-145-0390 |
|
Updated the definition of Lump-Sum Income to clarify it can be earned or unearned and is received less frequently than annually. |
CCA A.4 |
461-001-0000 |
|
Removed language on the treatment of Qualified Partnership Policies that states the exclusion "is not reduced when the value of excluded resources has decreased due to no action on the individual's part, such as a loss of value due to economic factory. In this circumstance, additional assets may be excluded up the entire Qualified Partnership Policy amount." |
CCA B.60 |
461-140-0220, 461-160-0855 |
|
Added language to the Reimbursement section to clarify that a payment turned over to the Department because the cost was already covered by Medicaid benefits is not counted. |
CCA B.68 |
461-145-0440 |
APD Worker Guide |
The Eligibility and Application Processes section (under Intake forms and Redetermination forms) was updated to add the Adult Abuse Awareness flyer (9377A) to the list of required forms for Medicaid. |
APD B.8 |
|
|
New MSC 3010 Authorization for Disclosure, Sharing and Use of Individual Information replaced MSC 2099. |
APD WG B.1 & B.8 |
|
|
Updated the list of large print forms available on the DHS forms server |
APD WG A.2.2 |
|
|
Decision Notice Preparation Tips:
- Updated the following:
- Replaced Word document translations with online versions in Russian, Traditional Chinese, Simple Chinese, Somali, and Vietnamese
- OSIPM income standards updated in applicable decision notice language
- Entire Services Issues section updated
- Added the following:
- Decision notice language for reduction of OSIPM due to increased Participant Fee
|
APD WG G.9 Russian, Traditional Chinese, Simple Chinese, Somali, and Vietnamese |
|
|
Income standards updated to reflect annual FPL changes |
APD WG D.10 & E.5 |
461-155-0290, 461-155-0291, 461-155-0295 |
|
Updated to remove interview requirement at initial application for OSIPM individuals who are assumed eligible and not requesting services |
APD WG B.8 |
461-115-0230 |
|
Updated age requirements for eligibility of individuals in a State Hospital |
APD WG D.7 |
461-135-0950 |
SNAP |
See SS-PT-19-004 and SS-PT-19-005 for more information on changes to SNAP. |
|
|
APD MAGI Manual |
New MSC 3010 Authorization for Disclosure, Sharing and Use of Individual Information replaced MSC 2099. |
MAGI B & G |
|
|
Added section (8) on how to handle misrouted ONE tasks under E. APD Referrals from 5503 |
MAGI E.8 |
|
|
This manual will be updated frequently; check periodically for new information. |
APD MAGI Manual |
|
REF(M) |
See SS-PT-19-004 and SS-PT-19-005 for more information on changes to REF(M). |
|
|
Miscellaneous |
Staff Tools:
- Added the following:
- ABAWD Worker Guide
- APS Manual (under Additional manuals)
- General Assistance Program Manual
|
ABAWD Worker Guide
APS Manual
General Assistance Program Manual |
|
|
Added various documents and videos to the new Asset Verification System page |
AVS |
|
|
Annual income limits updated in Others with Limited Income |
MMA B.1 |
|
MMIS |
No updates this quarter |
|
|
Generic Program Elements |
New MSC 3010 Authorization for Disclosure, Sharing and Use of Individual Information replaced MSC 2099. |
Generic Program Elements A
|
|
|
Added "failing to send a required or appropriate notice when benefits are closed or reduced" to the list of administrative underpayments in the Restoring Benefits section. |
Generic Program Elements C.14 |
461-116-0200 |
Case Management Tools |
Adult Day Services Section:
- Updated the following:
- Adult Day Services – Certification and Registration List
|
Adult Day Services |
Chapter 411, Division 066 |
|
APD Client Pay-In section: No updates this quarter |
APD Client Pay-In |
|
|
APD Program October 2017 Changes section:
No updates this quarter |
APD Program October 2017 Changes |
|
|
APD Training section:
- Updated the following:
- 2019 APD Financial Eligibility Training Calendar
- Case Manager Training Curriculum
- Added the following:
- New Oral Health and Aging Caregiver Materials and Oral Health America (OHA) Webinar
- APD-IM-19-003 – 2019 Case management training
|
APD Training |
|
|
Assessment Tools section: No updates this quarter. |
Assessment Tools |
|
|
Behavior Support Services Page:
- Updated the following:
- Behavior Support Services Contacts
|
Behavior Support Services |
Chapter 411, Division 046 |
|
Client Details, Treatment, Forms & Miscellaneous LTC Info section
- Updated the following:
- APD Long Term Care Services Form Requirements
|
Client Details, Treatment, Forms & Miscellaneous LTC Info |
|
|
Complex Case Consultations section: No updates this quarter |
Complex Case Consultations |
|
|
Diversion/Transition Section:
- Updated the following:
- Older American Behavioral Health Specialists Contact List
|
Diversion/Transition |
|
|
Emergency Response Systems page: No updates this quarter |
Emergency Response Systems |
|
|
Employed Persons with Disabilities (EPD) Section:
- Added the following:
- APD-PT-19-005 – Adjusted Income Standard and Participant Fee for the Employed Persons with Disabilities (EPD) Program Effective March 1, 2019
|
Employed Persons with Disabilities |
|
|
Enhanced Care page: No updates this quarter |
Enhanced Care |
Chapter 309, Division 32-0720 through 32-0830 |
|
Exceptions section:
- Added the following:
- Tier 2 Approval Email/Narration Template
|
Exceptions |
|
|
Extended Waiver Eligibility (EWE) Section:
- Updated the following:
- Added the following:
- APD-PT-19-010 – Extended Waiver Eligibility (EWE) Clarifications
|
Extended Waiver Eligibility (EWE) |
|
|
Facilities section:
- Updated the following:
- FAQs regarding consumers in facilities for CMs and other field staff
- Added the following:
- APD-AR-19-017 – New CBC Facilities and changes in ownership, name changes, new specific needs contracts, new in-home care agencies
- APD-AR-19-013 / APD-AR-19-005 / APD-AR-19-001- New CBC Facilities and changes in ownership, name changes, new specific needs contracts, and Adult day services
|
Facilities |
RCF & ALF Rules - Chapter 411, Division 054
Memory Care Communities - Chapter 411, Division 057
Nursing Facilities Licensing - Chapter 411, Division 085 |
|
General Assistance page: No updates this quarter |
General Assistance |
Chapter 411, Division 031 |
|
Home and Community Based Services page: No updates this quarter |
Home and Community Based Services |
Chapter 411, Division 004 |
|
Home Delivered Meals (HDM) section:
- Updated the following:
- HDM Provider Nutrition Standards
- Added the following:
- CSSU Nutrition Program Website
|
Home Delivered Meals (HDM) |
|
|
Homecare Worker section:
- Updated the following:
- HCW Payroll Calendar for 2019 List Format form DHS 5754 in the following languages:
- English
- Russian
- Spanish
- Vietnamese
- Arabic
- Chinese
- Somali
- HCW Payroll Calendar for 2019 color calendar version form DHS 5755 in the following languages:
- English
- Russian
- Spanish
- Vietnamese
- Arabic
- Chinese
- Somali
- Homecare Worker Handouts (for Orientation)
- DOJ Fraud Referral Form SDS 0727
- Added the following:
- Medicaid Fraud Control Unit – FAQs
- APD-IM-19-011 – Additional check runs due to office closures
- APD-IM-19-005 – Vendor payment for purchase of gloves and masks for homecare workers
|
Homecare Worker |
Chap. 411, Div. 031 |
|
Independent Choices section:
- Updated the following:
- ICP Worker Guide
- ICP Participant Handbook
- Program Overview for Consumers
- Program Outline for Staff
- Forms Processing Chart
- Participant Agreement
- Representative Agreement
- Notice of ICP Payment Ending
- Budget Worksheet
- Six Month Budget Review Checklist
- ICP Checklist
- ICP Screening Tool
- Added the following:
- APD-IM-19-006 – Independent Choices Program 2019 taxes
- Acumen ICP Employer Forms
- Acumen ICP Provider Forms
- Acumen Introduction PowerPoint
- Acumen Introduction Audio Webinar Recording
- Acumen Referral Fact Sheet
- Acumen Trifold Brochure
|
Independent Choices |
411-030-0100 |
|
In-Home Care Agencies section:
- Updated the following:
- In-Home Care Agencies list of providers
- HCW and In-Home Care Agency Comparison Chart
- Added the following:
- APD-AR-19-017 – New CBC facilities and changes of ownership, name changes, new specific needs contracts, new in-home care agencies
- APD-AR-19-001 – New CBC facilities and changes of ownership, name changes, new specific needs contracts, and adult day services
|
In-Home Care Agencies |
Chap. 411, Div. 033 |
|
In-Home Support Services section:
- Added the following:
- Representative Choice Form SDS 0737 in the following languages –
- Russian
- Spanish
- Vietnamese
- Arabic
- Chinese Traditional
- Korean
- Romanian
- Somali
- APD-IM-19-009 – New publication for individuals receiving Medicaid or OPI funded In-Home services from homecare workers: “What you Need to Know as an Employer of a Homecare Worker”
- APD-IM-19-005 – Vendor payment for purchase of gloves and masks for homecare workers
|
In-Home Support Services |
Chap. 411, Div. 030 |
|
K-Plan Services page:
- Updated the following:
- K-Plan Ancillary Services Provider List
- Consumer Confirmation of Job Completed to Their Satisfaction
- Added the following:
- Lift Chair Acceptance of Delivery
|
K-Plan Services |
Chap. 411, Div. 035 |
|
Long Term Care Community Nursing page: No updates this quarter |
Long Term Care Community Nursing |
Chapter 411, Division 048 |
|
Long Term Care Rates section: No updates this quarter |
Long Term Care Rates |
Chap. 411: Div 027, Div. 030, Div. 031 |
|
Mandatory Case Manager In-Service Webinars page:
- Added the following:
- EWE and Risk Assessment Changes (3/6/19)
- APD-IM-19-012 – Mandatory Webinar for case managers and managers that supervise case managers Wednesday 3/6/19
- APD-AR-19-006 – Mandatory Webinars 2019 schedule
|
Mandatory Case Manager In-Service Webinars |
|
|
Mental or Emotional Disorder Review Team (MED) page:
- Added the following:
- 3010 Authorization for Disclosure, Sharing and Use of Individual Information form: Pre-filled with Maximus Address for MED Referral
|
Mental or Emotional Disorder Review Team (MED) |
Chap. 411, Div. 015 |
|
Nursing Facilities & PAS section: No updates this quarter |
Nursing Facilities & PAS |
|
|
Older Americans Act page: No updates this quarter |
Older Americans Act |
|
|
Oregon ACCESS & CA/PS Information section:
- Added the following:
- APD-PT-19-009 – Authorized Representative and Alternate Payee Alignment for All Programs
|
Oregon ACCESS & CA/PS Information |
|
|
Oregon Project Independence:
- Added the following:
- APD-IM-19-009 - New Publication for Individuals Receiving Medicaid or OPI Funded In-Home Services from Homecare Workers: "What You Need to Know as an Employer of a Homecare Worker"
|
Oregon Project Independence |
Chap. 411, Div. 032 |
|
Program of All-Inclusive Care for the Elderly (PACE) section:
- Updated the following:
- PACE Training for Enrollment and Coding
- Added the following:
- PACE Fact Sheet
- APD-AR-19-002 – 2019 Updates for PACE cases
|
PACE |
Chap. 411, Div. 045 |
|
Provider Time Capture (PTC) Information page:
- Updated the following:
- HCW Payroll Calendar for 2019 List Format form DHS 5754 in the following languages –
- English
- Russian
- Spanish
- Vietnamese
- Arabic
- Chinese
- Somali
- HCW Payroll Calendar for 2019 color calendar version form DHS 5755 in the following languages –
- English
- Russian
- Spanish
- Vietnamese
- Arabic
- Chinese
- Somali
|
Provider Time Capture (PTC) Information |
|
|
Resources section on the CM Tools page:
- Added the following:
- Adult Oral Health Free Publication
|
|
|
|
Service Planning page: No updates this quarter |
Service Planning |
|
|
Service Priority Level Information page: No updates this quarter |
Service Priority Level Information |
Chapter 411, Division 015 |
|
Specialized Services/Specific Needs Contracts page:
- Updated the following:
- Specialized Service Vacancy Report
- Adding the following:
- APD-AR-19-017 – New CBC facilities and changes in ownership, name changes, new specific needs contracts, new in-home care agencies
|
Specialized Services/Specific Needs Contracts |
|
|
Spousal Pay page: No updates this quarter |
Spousal Pay |
411-030-0080 |
|
State Plan Personal Care page: No updates this quarter |
State Plan Personal Care |
Chap. 411, Div. 034 |
|
Tribal Navigator page:
- Added the following:
- This page is new…. Stay tuned for more information
|
Tribal Navigator |
|
|
Waivered Case Management section:
- Updated the following:
- Monthly/Yearly WCM Statistics by Branch
|
Waivered Case Management |
Chapter 411, Division 028 |