OAR 410-172-0845: Temporary rule language in effect until 02/15/2027. Agency with Choice Provider Requirements

(1) An Agency with Choice (AWC) is a qualified provider under this rule so long as it meets all applicable standards in OAR chapter 309, division 045 including provider enrollment, service delivery, background checks, critical incident reporting, and co-employer responsibilities. (2) An AWC must enroll with the Authority as a Medicaid provider in accordance with OAR 410-120-1260. (3) To remain a qualified provider of SPPC program services, an AWC must maintain a valid license issued under OAR chapter 309, division 045 and comply with all applicable provider and program integrity requirements in OAR 943-120-0300 through 943-120-0350. (4) An AWC and its direct support workers (DSW) must provide all SPPC program services in accordance with this rule, OARs 410-172-0774 through 410-172-0840, OAR chapter 309, division 045, and all other applicable state and federal laws. (5) AWC services provided under this rule, inclusive of assistance with ADLs and IADLs provided by DSWs, must be authorized within the individual’s person-centered service plan (PCSP) developed by the IQA. (6) In accordance with ORS 443.360, an AWC serves as the employer of record for DSW. The AWC is responsible for paying the DSWs employed by the AwC, complying with all applicable wage and hour laws, paying all payroll and other applicable taxes, and complying with Electronic Visit Verification (EVV) requirements. In addition, an AWC: (a) Serves as employer of record for all DSWs providing services under this rule; (b) Ensures all employees and contractors, including DSWs, meet background check and training requirements prior to service delivery; (c) Provides or ensures and documents completion of Authority-approved orientation and training for all DSWs prior to the delivery of services; (d) Implements and maintains an Authority-approved EVV system to record service delivery consistent with OAR 410-120-1360 and 42 U.S.C. 1396b(l); and. (e) Maintains documentation of all services provided, including EVV records, PCSP authorizations, and payroll records. (7) An AWC must, in accordance with OAR chapter 309, division 045, use Medicaid payments only for authorized service delivery, wages, benefits, and administrative costs directly related to AWC operations. (8) An AWC must report to the Authority any critical incidents, abuse or suspected abuse, or neglect in accordance with OAR 410-172-0630 and OAR 309-045-0390. (9) An AWC shall participate in Authority-led quality assurance activities, including reviews and audits.