OAR 411-425-0055: Oregon Needs Assessment (ONA)

(1) The ONA: (a) Determines if an individual who is eligible for services under OAR 411-320-0080 meets the ICF/IID Level of Care. (A) An individual meets ICF/IID Level of Care when the individual demonstrates significant impairment in at least one area of major life activity as identified in OAR 411-317-0000 by requiring some level of assessed support in response to at least 50 percent of the questions associated with one or more areas of major life activity. (B) A completed ONA shall provide a Level of Care summary that includes: (i) The areas of major life activity an individual demonstrates significant impairment by requiring some level of assessed support in response to at least 50 percent of the associated questions and the specific questions that lead to the result; and (ii) The areas of major life activity an individual does not demonstrate significant impairment because at least 50 percent of the associated questions in that area did not require some level of support and the specific questions that lead to the result. An individual who does not require some level of support is independent, meaning that the individual needs support with the activity fewer than 50 percent of the times the activity was performed in the previous 30 calendar days prior to the initiation of the first component of the ONA as described in subsection (c) of this section. (C) When an individual does not meet ICF/IID Level of Care, the individual must receive a Notification of Planned Action in accordance with OAR 411-318-0020. (b) Is a functional needs assessment that: (A) Identifies an individual's ability to perform ADL and IADL. An individual is considered to be independent in an ADL or IADL when the individual needs support with the activity fewer than 50 percent of the times the activity was performed in the previous 30 calendar days prior to the initiation of the first component of the ONA as described in subsection (c) of this section. (B) Determines an individual's ability to address health and safety concerns. (C) Includes an individual's preferences to meet service needs. (c) Is comprised of three components that may or may not occur simultaneously: (A) A face to face observation of an individual’s ability to independently meet their ADL and IADL support needs in their home or service setting unless the individual requests an alternative location. (B) An interview with any people chosen by an individual, or as applicable the individual's legal representative, to contribute to the understanding of the individual’s ability to independently meet their ADL and IADL support needs. (C) A review of an individual’s record for documented evidence of the individual’s ability to independently meet their ADL and IADL support needs. (d) Is considered to be complete when the components of subsection (c) of this section have occurred and the ONA is submitted to the Department’s electronic payment and reporting system. The submission requirement may be waived when the components of subsection (c) of this section have occurred and the Department has determined the ONA to be complete. (e) Is current for twelve months from the submission date. (2) STANDARDS FOR ASSESSMENT. (a) An ONA must be conducted in accordance with the standards of practice established by the Department and these rules. (b) An ONA must be conducted based on an assessment of an individual's abilities in the absence of alternative resources, supports provided in a service setting or by community providers, and regardless of environmental modifications, environmental safety modifications, assistive devices, or assistive technology. (c) Evaluation of an individual's need for assistance in ADLs and IADLs is based on: (A) The individual's ability to complete activities, components, and tasks rather than the services provided; and (B) Evidence of the actual or predicted need for support within the assessment time frame of 30 calendar days. The need for support must not be based on possible or preventative needs. (d) An individual may request the presence of natural supports or any other person the individual believes may contribute information or support at an assessment. (e) An individual, or as applicable the individual's legal representative, must participate in, and provide information necessary to, complete an assessment and re-assessment within the time frame requested by the Department. (A) When given adequate notice as described in OAR 411-415-0060, failure to participate in or provide requested assessment or re-assessment information when required by the Department, results in a termination of service eligibility. (B) The Department may allow additional time if no more than 12 months pass between ONAs and circumstances beyond the control of the individual, or as applicable the individual's legal representative, prevent timely participation or submission of information. (3) At the discretion of the Department, the Department may conduct or assign an alternate assessor to conduct an ONA in lieu of a CME assessor, supervisor, or case manager. (4) The submission date of the ONA may be no later than 30 calendar days from the date the first component identified in section (1)(c) of this rule was conducted. (5) When an ONA is completed, the ONA is the functional needs assessment for an individual and replaces any previous functional needs assessments. (6) If a note contained in a note field in the ONA conflicts with a scored item, the scored item is used for determining ICF/IID Level of Care and the identification of ADL, IADL, and other support needs as part of the functional needs assessment.