OAR 411-435-0040: Conditions of Purchase

(1) Ancillary services must meet all of the following requirements: (a) Be of direct benefit to an individual. (b) Authorized in an individual's ISP or Annual Plan consistent with OAR 411-415-0070 and tied to an identified need. (c) Cost-effective. Items must be in new or certified refurbished in like-new condition. (d) Purchased in accordance with the Expenditure Guidelines. (2) Department funds may not be used for: (a) A reimbursement to an individual, or the legal or designated representative or family member of the individual, for expenses related to ancillary services. (b) An advance payment of funds to an individual, or the legal or designated representative or family member of the individual, to obtain ancillary services. (c) Services, supports, materials, or activities that are illegal or in support of illegal conduct, experimental, or determined unsafe by the Department. (d) Services or activities that are carried out in a manner that constitutes abuse as defined in OAR 411-317-0000. (e) The purchase of a vehicle. (f) Health and medical costs that the general public normally must pay including, but not limited to: (A) Medications. (B) Health insurance co-payments. (C) Mental health evaluation and treatment. (D) Dental treatments and appliances. (E) Medical treatments. (F) Dietary supplements. (G) Treatment supplies not related to nutrition, incontinence, or infection control. (g) Ambulance services. (h) Legal fees. (i) Services that do not meet: (A) The description of ancillary services as described in these rules; or (B) The definition of a social benefit in OAR 411-317-0000. (j) Services or items available through third-party payers or that supplant services or items available through third-party payers. (k) Services or activities for which the legislative or executive branch of Oregon government has prohibited use of public funds. (l) Services provided in a nursing facility, correctional institution, or hospital. (m) Services when there is evidence to believe that an individual, a legal or designated representative of an individual (as applicable), or a provider, has engaged in fraud, misrepresentation, failed to use resources as agreed upon in an ISP or Annual Plan, refused to cooperate with documenting use of Department funds, or otherwise knowingly misused public funds associated with ancillary services. (n) Items or services provided to a child that are necessary for a child of the same age without a disability or typical for a parent or guardian to provide. (o) Services available through natural supports. (p) A toy or outdoor play equipment that is not of direct benefit to an individual’s identified support needs and does not meet the criteria in OAR 411-435-0050 for assistive devices or assistive technology. (q) Items or services of general utility and not directly related to an individual’s identified support needs.