Oregon Administrative Rules
Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES
Division 15 - LONG-TERM CARE SERVICE PRIORITIES FOR INDIVIDUALS SERVED
Section 411-015-0030 - Extended Waiver Eligibility (EWE)
Current through Register Vol. 63, No. 3, March 1, 2024
(1) An individual determined to no longer meet the criteria in 411-015-0100 and assessed as Service Priority Level (SPL) 14 - 18 through the assessment process outlined in 411-015-0008 may be eligible to continue receiving Long-Term Support Services (LTSS) when one of the following circumstances causes unmet needs or health and safety risks, which would result in the individual being institutionalized or hospitalized within 30 days:
(2) An individual who is approved for EWE may receive the approved services and supports as defined in OAR 411-027-0020 for six calendar months from the effective date.
(3) An individual meeting the criteria for EWE must have a re-assessment, as described in OAR 411-015-0008, completed no less frequently than every 12 calendar months, or when the individual's needs or circumstances change.
(4) EWE may be renewed for an additional six calendar months if the individual or their representative demonstrates:
(5) Case managers may deny initial EWE if the individual does not meet the criteria in (1) of this rule.
(6) Case managers may deny renewals of EWE if the individual does not meet the criteria in (1) of this rule, or if the individual or representative does not meet the criteria in section (4) of this rule.
(7) If the case manager does not deny EWE, they must submit initial and renewal requests for approval of EWE to the Central Office no later than two weeks prior to the service plan being closed.
(8) Initial and ongoing eligibility for EWE shall be determined by APD central office on a case-by-case basis.
(9) An individual receiving Medicaid OHP Plus under OAR chapter 410, division 200 is not eligible for EWE.
(10) An individual receiving home and community-based services as a recipient of Healthier Oregon may be eligible for EWE.
Statutory/Other Authority: ORS 410.070
Statutes/Other Implemented: ORS 410.070