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APD Manual Letters

Manual Letter #83

Effective Date: April 1, 2019
Reference: SS-PT-19-004, SS-PT-19-005

Manual changes are summarized below. Click on the related links. Most changes will be indicated with red text or a red line to the right of the text (you may need to scroll to find the related policy change). There is no red indication for the corresponding changes to the Administrative Rules. Check the above listed reference for all policy updates.

SNAP program updates are covered specifically in the Family Services Manual.

Manual Letter Index

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:
    • EWE Planning Form
  • 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


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