Current through Register Vol. 63, No. 9, September 1, 2024
(1)
The payment authorized by OAR 414-175-0075(11) is calculated by adding the
applicable high need payment established by section (4) of that rule to the
additional amount determined by this rule.
(2) The additional amount determined by this
rule is allowed in consideration of the additional cost to a child care
provider for the additional care and supervision required because of a child's
physical, mental or behavioral condition. To determine the additional amount, a
factor ranging from 0 to 2, determined by this rule is multiplied by:
(a) $5.00 for a payment calculated on an
hourly basis; or
(b) $840 for a
payment calculated on a monthly basis.
(3) The factor used to make the calculation
described in section (2) of this rule is determined by first establishing a
score for each category listed in section (5) of this rule. The score is
established by multiplying a rating and the weight for each category. The
weight is given in section (5). The rating is determined as follows:
(a) The child's need for care and supervision
is assessed and is compared with the needs of other children of the same age,
and a rating is determined for each category. The rating is a whole number from
zero to ten.
(b) Benchmark scores
are given in section (5) of this rule for each category using several
descriptions of need. The child's level is matched with the benchmark
descriptions, and a rating is assigned based on a comparison of the child's
needs and the benchmark descriptions. If a child's level of need falls between
- or is described in part by - two benchmarks in the rule, an appropriate
intermediate rating is assigned based on the benchmarks scores.
(4) After a score is determined
for each category, the scores are added. The sum of the scores is changed to
100 if it is less than 110 and is reduced to 300 if it exceeds 300. The
adjusted score is decreased by 100, and the remainder is divided by 100. The
result is the factor used in section (2) of this rule.
(5) The categories, their weights, and
standards for their ratings are as follows:
(a) Level of medical care - weight is 7:
(A) Child requires on-site medical attention
by a licensed medical or mental health professional and the child care provider
must have specialized training related to the child's medical or mental health
needs - rating of 10.
(B) The
provider must have specialized training related to the child's medical or
mental health needs and consults frequently with a medical or mental health
professional - rating of 8.
(C)
Child requires medical attention by an individual who has received some
specialized training related to the child's medical or mental health needs -
rating of 4.
(D) Child requires
medical attention or monitoring by an individual who has received special
instructions from the parent or a service provider related to the child's
medical or mental health needs - rating of 1.
(E) Child's needs can be met by staff with
general knowledge - rating of zero.
(b) Self-sufficiency with daily tasks -
weight is 5:
(A) Child requires total
assistance with eating or toileting, such as requiring tube feedings or with
special toileting needs, such as ostomy care - rating of 10.
(B) Child requires considerable assistance in
eating or toileting - rating of 5.
(C) Child requires only minor assistance with
eating or toileting - rating of 1.
(D) Child can take care of daily tasks with
very little assistance - rating of zero.
(c) Mobility - weight is 5:
(A) Child is unable to help with positioning
or movement, needs frequent repositioning, and the child is difficult to move -
rating of 10.
(B) Child can help
with transfers, pivoting and position - rating of 5.
(C) Child is able to move independently with
minor support - rating of 1.
(D)
Child's mobility is similar to other children of the same age - rating of
zero.
(d) Communication
skills - weight is 6:
(A) Child is unable to
communicate needs and wants, and is unable to use alternative communication
methods - rating of 10.
(B) Child
relies entirely upon alternative methods such as sign language, picture boards,
gestures, or facial expressions, to communicate the child's needs or to
understand requests made of the child - rating of 8.
(C) Child has limited verbal skills. The
child may require one-on-one communication to gain the child's attention,
simplify instructions, or to understand the child's speech or gestures. Child
may use alternative methods, mentioned in paragraph (B) of this sub-section, as
a supplement to verbal skills - rating of 4.
(D) Child's communication skills are roughly
similar to other children of the same age - rating of zero.
(e) Need for monitoring and
intervention - weight is 11:
(A) The child
must remain within the child care provider's direct view at all times and needs
frequent intervention to prevent harm to self or other children - rating of
10.
(B) The child must remain
within the provider's direct view at all times but does not need frequent
intervention - rating of 7.
(C)
Child has behaviors that frequently require adult intervention but are not a
threat to the child's or other children's safety - rating of 4.
(D) Child needs assistance to initiate,
respond to, or engage in peer interactions that are safe, positive, and
appropriate - rating of 2.
(E)
Child needs some assistance but generally does well if the assistance is
provided - rating of zero.
(f) Cognition and comprehension - weight is
7:
(A) Child is unable to recognize danger, is
unable to follow instructions without one-on-one assistance, and has difficulty
processing basic sensory information about the environment. This does not
include vision or hearing as the primary difficulty - rating of 10.
(B) Child needs to be given one instruction
at a time and may need reminders of what was asked in order to complete
instruction - rating of 5.
(C)
Child is able to understand and solve problems with some special attention -
rating of zero.
(g)
Other special considerations - weight is 5. There are other considerations
relating to the level of supervision required for the child that are not
included in the above categories. A rating is determined based on how much more
supervision the child needs - because of the other consideration - than other
children of the same age.