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APD Manual Letters

Manual Letter #97

Effective Date: October 1, 2022

Changes to the APD Staff Tools (Case Management Tools, Non-MAGI Financial Eligibility Tools, and APD Staff Tools) are summarized below. Click on the related links to view the changes. Changes to APD Case Management Tools will be indicated with red 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 or for changes to the other tools. Check the above listed references for Self-Sufficiency policy updates.

Program manual updates are covered specifically in the Oregon Programs Eligibility Notebook.

Manual Letter Index

Manual/Worker Guide

Change

Section/Item

Rule Change

(available 10-1-2022 unless otherwise indicated)

Oregon Programs Eligibility Notebook updates for APD

Updates to EPD:

  • Max countable earned income from $5,453 to $5,749
  • Updated participant fee payment portal URL
  • Updated to reflect elimination of in-home liabilities

 

Chapter 2, Section 9: EPD

  • Financial eligibility
  • Participant fee, Making payments
  • EPD and long-term care (LTC) services

 
 

Updated all examples and calculations due to FUA and LUA changes

Chapter 8, Examples:

  • Chapter 2, section 10: Long-term care (LTC) services
    • Financial eligibility, examples 1 & 2
    • Post-eligibility
      • Calculating the liability, example 1
      • Deciding to what extent to allow the CSIA, example 1
  • Chapter 2, section 11: Medical Related Payments (MRP)
    • Accommodation allowance, example 1
461-160-0420
  Updated to reflect that individuals are no longer required to pursue Medicare
  • Chapter 2, Section 6: Non-financial eligibility, Pursuit of assets
  • Chapter 7, Section 7: OSIPM worker guides, Verifying assumed and protected eligibility, Disabled adult child status
461-120-0345
  Added provision that allows income to be excluded and room and board to be paid for up to 3 months when an incapacitated LTC recipient requires it to obtain placement while they find a financial representative.
  • Chapter 2, Section 10: Long-term care services, Financial eligibility, Income, Availability of income
  • Chapter 2, Section 11: Medical Related Payments (MRP), Community-based care
461-140-0040 & 461-155-0630 (changes will not be reflected in rule until Jan 2023)
  Added LTC disquaification divisor of $10,342 for initial month that is on or after October 1, 2022. Chapter 2, Section 10: Long-term care services, Financial eligibility, Calculating the disqualification 461-140-0296
  Added note clarifying that CDDPs, Brokerages, and CIIS are ODHS partner agencies that can report address changes without a release of information.
  • Chapter 2, Section 10: Long-term care services, Coordination
  • Chapter 3, Section 1: Acting on reported changes, Medical reporting requirements
 
See coming transmittal for SSP program updates to OPEN    
APD Staff Tools No updates this quarter    
APD Non-MAGI Financial Eligibility Tools No updates this quarter    
SNAP/REF(M) See SS-PT-22-018 for more information on changes to SNAP.    
Case Management Tools

Adult Day Services page:

  • No updates this quarter
Adult Day Services Chapter 411, Division 066
 

APD Training page:

  • Added the following:
    • Transmittals -
      • APD-IM-22-079: PACE Learing Modules
      • APD-IM-22-063: Summer 2022 Collective Basic Training
APD Training

 

 

Assessment Tools page:

  • No updates this quarter
Assessment Tools

 

 

Behavior Support Services (BSS) page:

  • No updates this quarter
Behavior Support Services Chapter 411, Division 046
 

Client Details, Treatment, Forms & Miscellaneous LTC Info page:

  • Updated the following:
    • SPAN Notice Flow Chart
    • APD Long Term Care Services Form Requirements
    • Comparison of In-Home Service Plan Assistance Roles
  • Added the following:
    • Consumer Health and Safety - Red Flags
Client Details, Treatment, Forms & Miscellaneous LTC Info  
 

Complex Case Consultations page:

  • No updates this quarter
Complex Case Consultations  
 

Crisis Support Program page:

  • No updates this quarter
Crisis Support Program  
 

Diversion/Transition page:

  • No updates this quarter
Diversion/Transition

 

 

Emergency Response Systems (ERS) page:

  • No updates this quarter
Emergency Response Systems

Special Need OAR 461-155-0680

K-State Plan Ancillary Services OAR 411-035-0025

 

Employed Persons with Disabilities (EPD) page:

  • Added the following:
    • Transmittals -
      • APD-IM-22-059: New Online Payment Portal for Employed Persons with Disabilities (EPD)
Employed Persons with Disabilities

OSIP Program Manual - WG.11

 

Enhanced Care page:

  • No updates this quarter
Enhanced Care OAR 309-019-0155
 

Exceptions page:

  • Updated the following:
    • Request for SPPC Exception
Exceptions

Payment Limitations for In-Home and Community-Based Services Rules - Chapter 411, Division 027

In-Home Services Rules - Chapter 411, Division 030

 

Extended Waiver Eligibility (EWE) page:

  • No updates this quarter
Extended Waiver Eligibility (EWE)

OAR 411-015-0030

 

Facilities page:

  • Added the following:
    • Transmittals -
      • APD-IM-22-092: Name Change Residential Care Facility
      • APD-AR-22-044: APS Investigations and Acuity-Based Staffing Tools (ABST) in Assisted Living Facilities (ALF), Residential Care Facilities (RCF), and Endorsed Memory Care Communities (MCC)
      • APD-IM-22-090: ALF Payment Level Calculation
      • APD-AR-22-043: Change in Ownership & Name Change Memory Care Facility, Change in Ownership Specific Needs Facility, New Residential Care Facility, New In-Home Care Agency
      • APD-IM-22-084: CBC Payments Delayed
      • APD-AR-22-037: Facility Draft Report Distribution
      • APD-PT-22-023: APD AFH Public Disclosure File
      • APD-PT-22-022: APD AFH Licensing Visits
      • APD-AR-22-034: Change in Ownership Memory Care Facilities
Facilities

RCF & ALF Rules - Chapter 411, Division 054

Memory Care Communities - Chapter 411, Division 057

Nursing Facilities Licensing - Chapter 411, Division 085

 

General Assistance (GA) page:

  • No updates this quarter
General Assistance Chapter 411, Division 031
 

Healthier Oregon page:

  • Added the following:
    • Transmittals -
      • APD-IM-22-058: Healthier Oregon: Case Management Information
Healthier Oregon  
 

Hearings Information page:

  • No updates this quarter
APD Hearings

Chapter 137, Division 003

Chapter 461, Division 025
 

Home and Community Based Services (HCBS) page:

  • No updates this quarter
Home and Community Based Services Chapter 411, Division 004
 

Home Delivered Meals (HDM) page:

  • Updated the following:
    • SPPC HDMs Invoice
Home Delivered Meals (HDM)

Home Delivered Meals - Chapter 411, Division 040

Payment for Home Delivered Meals - OAR 411-027-0020(7)

 

Homecare Worker (HCW) page:

  • Updated the following:
    • HCW Payroll Calendar for 09/2021 thru 01/03/2024 List Format
    • CEP Specialist Training Manual
  • Added the following:
    • Transmittals -
      • APD-IM-22-095: In-Person Orientation Informational Sessions for Staff in Lane, Linn, and Benton Counties Who Work with Homecare Workers, Personal Support Workers, and Personal Care Attendants
      • APD-IM-22-073: Updated Homecare Worker Credential Renewal Letter
      • APD-AR-22-035: Those that process homecare worker credentials
      • APD-IM-22-065: Informational Sessions for Local Office Staff: 2021-2023 Collective Bargaining Agreement Between SEIU, Local 503 and the Oregon Home CareCommission
      • APD-IM-22-061: In-Person Orientation Informational Sessions for Staff in Clackamas andJackson Counties Who Work With Homecare Workers, Personal Support Workers,and Personal Care Attendants
Homecare Worker

Chap. 411, Div. 031

 

Housing Navigators (For Housing Navigators) page:

  • No updates this quarter
Housing Navigators  
 

Housing Support Services (For Case Managers) page:

  • No updates this quarter
Housing Support Services  
 

Independent Choices Program (ICP) page:

  • Updated the following:
    • ICP Forms Processing Chart
Independent Choices 411-030-0100
 

In-Home Care Agencies (IHCA) page:

  • Updated the following:
    • In-Home Care Agencies
  • Added the following:
    • Transmittals -
      • APD-AR-22-043: Change in Ownership & Name Change Memory Care Facility, Change in Ownership Specific Needs Facility, New Residential Care Facility, New In-Home Care Agency
      • APD-IM-22-074: New In-Home Care Agency
In-Home Care Agencies

Chap. 411, Div. 033

 

In-Home Support Services page:

  • Updated the following:
    • Comparison of In-Home Service Plan Assistance Roles
  • Added the following:
    • Transmittals -
      • APD-AR-22-039: Air Conditioner Distribution and Installation
In-Home Support Services

Chap. 411, Div. 030

 

K-State Plan Ancillary Services page:

  • Updated the following:
    • K-Plan Ancillary Services Provider List
K-State Plan Ancillary Services Chap. 411, Div. 035
 

Long Term Care Community Nursing (LTCCN) page:

  • No updates this quarter
Long Term Care Community Nursing Chapter 411, Division 048
 

Long Term Care Rates page:

  • No updates this quarter
Long Term Care Rates

Chap. 411: Div 027, Div. 030, Div. 031

 

Mandatory Case Manager In-Service Webinars page:

  • No updates this quarter
Mandatory Case Manager In-Service Webinars  
 

Mental or Emotional Disorders Review (MED) page:

  • Updated the following:
    • MED Process Flow Chart
Mental or Emotional Disorder Review Team (MED) Chap. 411, Div. 015
 

MMIS Desk Manuals page:

  • Updated the following:
    • MMIS Plan of Care Reference Guide and Tips
    • Issuing a Temporary Medical ID
APD MMIS Resources  
 

Money Management Services (MMS) page:

  • No updates this quarter
   
 

Nursing Facilities & PAS page:

  • Added the following:
    • Transmittals -
      • APD-IM-22-081: Nursing Facility Change of Ownership and Name Change
      • APD-IM-22-067: Nursing Facility Change of Ownership and Name Changes
Nursing Facilities & PAS  
 

Older Americans Act (OAA) page:

  • No updates this quarter
Older Americans Act

Older Americans Act of 1965

CFR for OAA

ORS 410

Chap. 411, Div. 002

Chap. 411, Div. 011

 

ONE System Information & Resources section on the CM Tools page:

  • Updated the following:
    • Medical Denials and Terminations with LTSS QRG
CM Tools Home Page  
 

Oregon ACCESS & CA/PS Information page:

  • Updated the following:
    • SPAN Notice Flow Chart
  • Added the following:
    • Transmitals -
      • APD-IM-22-090: ALF Payment Level Calculation
Oregon ACCESS & CA/PS Information  
 

Oregon Project Independence (OPI) page:

  • Updated the following:
  • Added the following:
    • Transmitals -
      • APD-IM-22-072: Oregon Project Independence to Oregon Project Independence-Medicaid: Transition Reviews
Oregon Project Independence Chap. 411, Div. 032
 

Oregon Project Independence-Medicaid (OPI-M) and Family Caregiver Assistance Program (FCAP) page:

  • Added the following:
    • 1115 Medicaid Demonstration Waiver Application
    • 1115 Questions and Answers
    • OPI/OPI-M/Medicaid Comparison Chart
    • OPI-M and FCAP Business Flowchart
Oregon Project Independence-Medicaid (OPI-M) and Family Caregiver Assistance Program (FCAP)  
 

Program of All-Inclusive Care for the Elderly (PACE) page:

  • Added the following:
    • Transmitals -
      • APD-IM-22-079: PACE Learning Modules
PACE Chap. 411, Div. 045
 

Provider Guides for Oregon ACCESS page:

  • No updates this quarter
Provider Guides for Oregon ACCESS  
 

Provider Payment Adjustments and Troubleshooting page:

  • Updated the following:
    • CEP Specialist Training Manual
Provider Payment Adjustments and Troubleshooting  
 

Provider Time Capture (PTC) Information page:

  • Updated the following:
  • Added the following:
    • OR PTC DCI Help Tool *BETA VERSION*
    • PTC Quarterly Recap -
      • Q2 2002
      • Q1 2022
    • Transmitals -
      • APD-IM-22-087: Provider Time Capture (PTC) - Attestation Changes to OR PTC DCI
      • APD-IM-22-086: Provider Time Capture (PTC) - OR PTC DCI System Update - 16 hour limit
      • APD-IM-22-076: Provider Time Capture (PTC) - Entries Claimed After 365 Days
      • APD-IM-22-075: Provider Time Capture (PTC) - When a Consumer Changes Programs
      • APD-IM-22-062: Provider Time Capture (PTC) - Do's and Don'ts in OR PTC DCI
Provider Time Capture (PTC) Information  
 

Resources section on the CM Tools page:

  • Added the following:
    • Language Guidance When Serving LGBTQ+ Populations
    • Senior Health Insurance Benefits Assistance (SHIBA)
CM Tools Home Page  
 

Respite Stay page:

  • No updates this quarter
Respite Stay

411-066 Adult Day Services

411-086-0050 NF

411-050 AFH ADS
 

Risk Assessment page:

  • No updates this quarter
Risk Assessment  
 

Service Planning page:

  • No updates this quarter
Service Planning  
 

Service Priority Level (SPL) Information page:

  • Updated the following:
    • SPL Chart: Levels 1-18
  • Added the following:
    • Transmitals -
      • APD-PT-22-021: Definition of Service Priority Level (SPL) 18

Service Priority Level Information

Chapter 411, Division 015
 

Specific Needs Contracts page:

  • Updated the following:
    • Contact List for Specific Needs Contracts
  • Added the following:
    • Adult Foster Home Contracts for multiple providers
    • Assisted Living Facility Contracts for multiple providers
    • Residential Care Facility Contracts for multiple providers

Specialized Services/Specific Needs Contracts


 

Specialized Living Program page:

  • Updated the following:
    • Statement of Work for Brain Rehab Network Oregon, Inc. (Formerly Kampfe Management Services)
  • Added the following:
    • BRN Referral form for Brain Rehab Network Oregon, Inc. (Formerly Kampfe Management Services)
    • Transmittals -
      • APD-IM-22-082: Changes to the Brain Rehab Network Specialized Living Program Contract
Specialized Living Program

Specialized Living Contracts OAR Chap. 411, Div. 065

In-Home Services OAR Chap. 411, Div. 030

 

Spousal Pay (SP) page:

  • No updates this quarter
Spousal Pay 411-030-0080
 

State Plan and Waivers page:

  • No updates this quarter
State Plan and Waivers Medicaid and CHIP State Plans
 

State Plan Personal Care (SPPC) page:

  • Updated the following:
    • SPPC HDMs Invoice
    • Request for SPPC Exception
    • SPPC Changes Fact Sheet
  • Added the following:
    • Transmittals -
      • APD-PT-22-020: State Plan Personal Care (SPPC) Policy Updates
State Plan Personal Care Chap. 411, Div. 034
 

Tribal Navigator page:

  • Added the following:
    • Title VI Grantees in Oregon
Tribal Navigator  
 

Waivered Case Management (WCM) page:

  • Updated the following:
    • Ongoing Monthly/Yearly WCM Statistics by Branch
Waivered Case Management Chapter 411, Division 028


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