OAR 411-035-0075: Eligible Transition Services

(1) Approval for services and supports must: (a) Be based on an assessed need determined during the person-centered service planning process. (b) Support the desires and goals of the consumer receiving services and supports. (2) Total expenses for transition services and supports covered under this rule may be approved from the date of authorization up to 30 days after a consumer discharges from a nursing facility or the Oregon State Hospital on a permanent basis and may include more than one item. (3) Total purchases for basic household goods and furnishings are limited to one time per year within the first 30 days a consumer discharges from a nursing facility on a permanent basis. (4) Total purchases for transition services and supports, other than basic household goods and furnishings, are limited to no more than twice annually. To access transition services and supports a second time within a year, the consumer must be transitioning from a nursing facility or the Oregon State Hospital. (5) Funds must not be used to retroactively reimburse a consumer, natural supports, or community-based care providers for transition service expenses. (6) Unless indicated in this rule, allowable moving and move-in costs are limited to an in-home setting and include: (a) Transportation for touring community-based care facilities and in-home service settings. (b) Housing application fees. (c) Payment for background and credit checks related to housing. (d) Cleaning deposits. (e) Security deposits. (f) Initial deposits for heating, lighting, and land line phone service. (g) Payment of previous utility bills that prevent a consumer from receiving utility services. (h) Cleaning before move-in, is limited to consumers returning to a previous in-home setting and the service is needed to mitigate a health or safety risk. (i) Basic household goods. (A) Including, but not limited to: (i) Cookware; (ii) Tableware; (iii) Garbage cans; (iv) Trash bags; (v) Toilet paper; (vi) Bedding; (vii) Linens; or (viii) Basic cleaning supplies. (B) The purchase of basic household goods is not intended to replace useable items already available to the consumer. (C) Purchases are limited to: (i) The amount necessary to adequately meet the needs of the consumer, but may not exceed $500. (ii) The Department may approve additional household goods if the consumer's functional needs assessment indicates the need for additional household goods beyond the standard limit. (j) Basic household furnishings. (A) Including, but not limited to: (i) Beds; (ii) Mattresses; (iii) Dressers; (iv) Couches; (v) Tables; or (vi) Chairs required in an in-home or community-based service setting. (B) The purchase of basic household goods is not intended to replace useable items already available to the consumer. (C) Purchases are limited to: (i) The amount necessary to adequately meet the needs of the consumer and may not exceed $1,000. (ii) The Department may approve additional household furnishings if the consumer's functional needs assessment indicates the need for additional household furnishings beyond the standard limit. (k) Basic food stocking. (A) Including, but not limited to: (i) Pantry staples; (ii) Perishable food items; or (iii) Canned or boxed foods that meet the basic nutritional needs of a consumer. (B) The purchase of food items is not intended to replace non-perishable items already available to the consumer. (i) The purchase of food items must be limited to the amount necessary to adequately meet basic nutritional needs within the transition period and may not exceed $200. (ii) The Department may approve additional food stocking if the consumer's functional needs assessment indicates the need for additional food stocking beyond the standard limit. (C) A consumer's available income and benefits may be used before approving expenses for basic food stocking. (D) Consumers transitioning to a community-based care setting are not eligible to use funds for basic food stocking. (l) Clothing that meets the basic needs of a consumer transitioning to a community-based care or in-home service setting. (A) The purchase of clothing items are not intended to replace useable items already available to the consumer. (B) A consumer's available income may be used before approving expenses. (m) Movers and moving expenses, required to transition a consumer to a community-based care or in-home service setting, are limited to $1,000. (n) Delivery costs associated with moving a consumer's property from an off-site location to a community-based or in-home setting during the transition. (o) Extra locks, for security purposes, in a community-based care or in-home service setting. (p) Duplicate keys in a community-based care or in-home service setting. (7) The following services and expenses must be pre-authorized by the Department's Central Office: (a) Purchases that exceed the monetary limits described in this rule. (b) Approval for expenses that occur greater than 30 days after the transition period. (c) Items required to re-establish a home not identified in this rule. (d) Other necessities not identified in this rule that are required for a consumer to transition from a nursing facility or the Oregon State Hospital. (e) Transportation for community-based service setting tours that require overnight travel. (f) Payment of past rent or utility bills in which a consumer was more than one month behind. (g) Transportation costs for the individual to transition from a nursing facility or the state hospital to a home or community-based care setting. This may include attendant services and transportation out of state.