Current through Register Vol. 63, No. 3, March 1, 2024
(1) The ONA:
(a) Determines if an individual who is
eligible for services under OAR 411-320-0080 meets the ICF/IID Level of Care.
(A) An individual meets ICF/IID Level of Care
when the individual demonstrates significant impairment in at least one area of
major life activity as identified in OAR 411-317-0000 by requiring some level
of assessed support in response to at least 50 percent of the questions
associated with one or more areas of major life activity.
(B) A completed ONA shall provide a Level of
Care summary that includes:
(i) The areas of
major life activity an individual demonstrates significant impairment by
requiring some level of assessed support in response to at least 50 percent of
the associated questions and the specific questions that lead to the result;
and
(ii) The areas of major life
activity an individual does not demonstrate significant impairment because at
least 50 percent of the associated questions in that area did not require some
level of support and the specific questions that lead to the result. An
individual who does not require some level of support is independent, meaning
that the individual needs support with the activity fewer than 50 percent of
the times the activity was performed in the previous 30 calendar days prior to
the initiation of the first component of the ONA as described in subsection (c)
of this section.
(C)
When an individual does not meet ICF/IID Level of Care, the individual must
receive a Notification of Planned Action in accordance with OAR
411-318-0020.
(b) Is a
functional needs assessment that:
(A)
Identifies an individual's ability to perform ADL and IADL. An individual is
considered to be independent in an ADL or IADL when the individual needs
support with the activity fewer than 50 percent of the times the activity was
performed in the previous 30 calendar days prior to the initiation of the first
component of the ONA as described in subsection (c) of this section.
(B) Determines an individual's ability to
address health and safety concerns.
(C) Includes an individual's preferences to
meet service needs.
(c)
Is comprised of three components that may or may not occur simultaneously:
(A) A face to face observation of an
individual's ability to independently meet their ADL and IADL support needs in
their home or service setting unless the individual requests an alternative
location.
(B) An interview with any
people chosen by an individual, or as applicable the individual's legal
representative, to contribute to the understanding of the individual's ability
to independently meet their ADL and IADL support needs.
(C) A review of an individual's record for
documented evidence of the individual's ability to independently meet their ADL
and IADL support needs.
(d) Is considered to be complete when the
components of subsection (c) of this section have occurred and the ONA is
submitted to the Department's electronic payment and reporting system. The
submission requirement may be waived when the components of subsection (c) of
this section have occurred and the Department has determined the ONA to be
complete.
(e) Is current for twelve
months from the submission date.
(2) STANDARDS FOR ASSESSMENT.
(a) An ONA must be conducted in accordance
with the standards of practice established by the Department and these
rules.
(b) An ONA must be conducted
based on an assessment of an individual's abilities in the absence of
alternative resources, supports provided in a service setting or by community
providers, and regardless of environmental modifications, environmental safety
modifications, assistive devices, or assistive technology.
(c) Evaluation of an individual's need for
assistance in ADLs and IADLs is based on:
(A)
The individual's ability to complete activities, components, and tasks rather
than the services provided; and
(B)
Evidence of the actual or predicted need for support within the assessment time
frame of 30 calendar days. The need for support must not be based on possible
or preventative needs.
(d) An individual may request the presence of
natural supports or any other person the individual believes may contribute
information or support at an assessment.
(e) An individual, or as applicable the
individual's legal representative, must participate in, and provide information
necessary to, complete an assessment and re-assessment within the time frame
requested by the Department.
(A) When given
adequate notice as described in OAR 411-415-0060, failure to participate in or
provide requested assessment or re-assessment information when required by the
Department, results in a termination of service eligibility.
(B) The Department may allow additional time
if no more than 12 months pass between ONAs and circumstances beyond the
control of the individual, or as applicable the individual's legal
representative, prevent timely participation or submission of
information.
(3) At the discretion of the Department, the
Department may conduct or assign an alternate assessor to conduct an ONA in
lieu of a CME assessor, supervisor, or case manager.
(4) The submission date of the ONA may be no
later than 30 calendar days from the date the first component identified in
section (1)(c) of this rule was conducted.
(5) When an ONA is completed, the ONA is the
functional needs assessment for an individual and replaces any previous
functional needs assessments.
(6)
If a note contained in a note field in the ONA conflicts with a scored item,
the scored item is used for determining ICF/IID Level of Care and the
identification of ADL, IADL, and other support needs as part of the functional
needs assessment.
Statutory/Other Authority: ORS
409.050,
427.104,
427.105,
427.115 & 430.662
Statutes/Other Implemented: ORS
409.010,
427.007,
427.104,
427.105,
427.115,
430.215,
430.610 &
430.662