OAR 411-046-0150: Authorizations

(1) Behavior Support Services must be prior-authorized by the eligible individual’s case manager using the referral process noted in OAR 411-046-0140(4)(a). The Case manager is responsible for ensuring the individual is eligible for an initial referral and ongoing Behavior Support Services. (2) Service hours for person-centered evaluation and development of the Behavior Support Plan are authorized by the individual’s case manager effective on the date the behavior consultant accepts and signs the Department approved referral form. (3) Case managers can authorize up to 40 hours for the initial assessment, service planning, and follow up. An additional 40 hours may be approved by the local office management for ongoing service delivery. The Department may approve additional hours as defined in OAR 411-046-0220 if the individual’s functional needs assessment indicates the need for additional hours. (4) For services noted in OAR 411-046-0140(4)(a) to (4)(f), the provider should make every effort to complete them within 120 days from the service activation date. However, prior authorizations are effective for a full 12 month period from the initial service activation date. After 12 months, a new authorization must be requested and approved. (5) Authorizations for service hours must be completed by the local office within 5 business days of receiving notification of referral acceptance. (6) Prior authorizations are in effect for a 12 month period from the initial service activation date. After 12 months, a new authorization must be requested and approved. (7) Requests for more than 80 hours of service must be reviewed and approved by the Department.