OAR 418-040-0020: Participant Eligibility

(1) In order to enroll as a participant in the Homecare Choice Program, an individual, or the individual's representative, must: (a) Complete a self-assessment developed by the Oregon Home Care Commission. (b) Enter into a written service plan with a Homecare Choice provider before the commencement of services. (c) Pay the Commission in advance for services. (d) Be able to comply with state and federal wage and tax laws and recordkeeping requirements by completing, submitting, and retaining necessary documents provided by the fiscal intermediary contracted by the Commission. (e) Complete a Homecare Choice Program enrollment agreement. (f) Provide information, when requested, for workers' compensation claims related to the individual's provider. (g) Be able and willing to effectively manage and direct homecare services by performing the functions of an employer, including: (A) Locating, screening, and hiring a qualified provider. (B) Evaluating whether the provider has the skills and abilities to meet the individual's specific service needs. (C) Assigning and directing the provider's work. (D) Supervising and training the provider. (E) Scheduling the providers' work, leave, and coverage. (F) Tracking the hours worked and validating the authorized hours were completed by the provider. (G) Recognizing, discussing, and attempting to correct any performance deficiencies with the provider. (H) Discharging an unsatisfactory provider. (2) An individual becomes ineligible to participate in the Homecare Choice Program when: (a) The individual, or individual's representative, fails to pay for services in advance. (b) The individual, or the individual's representative, fails to maintain an account balance equal to one service period. (c) The individual, or the individual's representative, is unable or unwilling to effectively manage and direct homecare services by failing to meet the requirements outlined in OAR 418-040-0020(1)(g)(A)–(H). (d) The individual, or the individual's representative, is unable or unwilling to comply with state and federal wage and tax laws or recordkeeping requirements by failing to complete, submit, and retain necessary documents provided by a fiscal intermediary contracted with the Oregon Home Care Commission. (e) Dangerous conditions in the individual's service setting jeopardize the health or safety of the individual or provider, and the individual, or the individual's representative, is unable or unwilling to implement necessary safeguards to minimize the dangers. (f) Services are not able to be provided safely or adequately by the provider based on: (A) The extent of the participant's service needs; or (B) The choices or preferences of the participant or the participant's representative. (3) Participants determined to be ineligible for continued participation in the Homecare Choice Program will be sent written notice 10 days in advance of the proposed action.