Oregon Administrative Rules
Chapter 413 - DEPARTMENT OF HUMAN SERVICES, CHILD WELFARE PROGRAMS
Division 95 - BEHAVIOR REHABILITATION SERVICES PROGRAM (BRS)
Section 413-095-0040 - Prior Authorization for the BRS Program; Appeal Rights
Universal Citation: OR Admin Rules 413-095-0040
Current through Register Vol. 63, No. 12, December 1, 2024
(1) BRS program eligibility.
(a) The Department may provide
prior authorization for the BRS program for a child who:
(A) Meets the requirements in OAR
410-170-0040(2)(a)(A) to (C); and
(B) Is in the care or custody of the
Department or one of the federally recognized Oregon tribes.
(b) Notwithstanding subsection
(1)(a) of this rule, the Department may provide prior authorization for the BRS
program for a child who:
(A) Meets the
requirements in OAR 410-170-0040(2)(a)(B) through (E);
(B) Is eligible for state-funded medical
assistance under Title XIX and General Assistance Medical Eligibility, OAR
413-100-0400 through 413-100-0530; and
(C) Is in the care or custody of the
Department or one of the federally recognized Oregon tribes.
(2) Appeal rights.
(a) When a child is in the care or custody of
the Department or a federally recognized Oregon tribe and is denied prior
authorization for the BRS program under subsection (1)(a) of this rule, the
child is entitled to notice and contested case hearing rights under OAR
410-120-1860 to 410-120-1865. The contested case hearing will be provided by
the Authority (see OAR 410-120-1860(1)) and conducted by the Office of
Administrative Hearings (see ORS
183.635).
(b) When a child in the care or custody of
the Department and enrolled in the Oregon Health Plan is denied prior
authorization for the BRS program under subsection (1)(b) of this rule, the
child is entitled to notice and contested case hearing rights under OAR
413-010-0500 to 413-010-0535. The contested case hearing will be provided by
the Department and conducted by the Office of Administrative Hearings (see ORS
183.635).
(3) Qualified Residential Treatment Program eligibility.
(a) A BRS
client or child must have a QRTP assessment, conducted in compliance with OAR
413-070-1090, recommending placement in a QRTP. The assessment must be
completed prior to or within 30 days of the child's or BRS client's placement
in a QRTP
(b) When a BRS client or
child does not receive a recommendation by the Qualified
Individual for a QRTP placement, the BRS client or child must
transition out of the BRS contractor's program within 30 days if placed prior
to the completion of the QRTP Assessment.
Statutory/Other Authority: ORS 411.060, ORS 411.070, ORS 411.116, ORS 418.005 & ORS 409.050
Statutes/Other Implemented: ORS 411.060, ORS 411.070, ORS 411.116, ORS 418.005, ORS 409.010, ORS 411.095, ORS 411.141, ORS 418.015, ORS 418.027, ORS 418.285, ORS 418.312, ORS 418.315, ORS 418.490, ORS 418.495 & ORS 409.010
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