RFP 6124 Att A - Definitions.pdf

ATTACHMENT A

DEFINITIONS

OregonBuys Bid Number S-10000-00013757/ODHS & OHA RFP 6124

1. Terminology specific to the OregonBuys system may be found at:

https://www.oregon.gov/das/ORBuys/Documents/Phase1TerminologyCrosswalk.pdf

2. Capitalized terms not specifically defined in this document are defined in

OAR-125-246-0110.

3. For the purposes of this RFP, project-specific capitalized terms in this RFP are as defined below:

3.1 Common Terms for ODHS/OHA

a. “Administrator” means the person designated by the licensee through an employment agreement to be responsible for the daily operations and maintenance of the Agency with Choice.

b. “Representative” for the purpose of these rules means a person designated by an Individual or the Individual’s Legal Representative to act on behalf of the Individual in making decisions on matters pertaining to the planning and implementation of an in-home service plan.

(1) Chosen and appointed by the Individual or their Legal Representative, if applicable; and

(2) Not a paid provider of Home and Community Based Services (HCBS) and supports.

c. “Contract” means the Contract awarded as a result of this RFP.

d. “Contractor” means the Proposer selected through this RFP to enter into a Contract with ODHS/OHA to perform the Work.

e. “Electronic Visit Verification (EVV)” means a system under which visits conducted as part of the person-centered service plan are electronically verified at the time of service, and meets the requirements specified the 21st Century Cures Act. (f) The Individual providing the service.

f. “Key Person” or “Key Personnel” means the person or persons on Proposer’s staff to be assigned to perform the Work under the Contract who are essential for the work to be performed.

g. “Legal Representative (Representative)” means a person who has been legally designated by court order to make financial or health care decisions on behalf of another Individual. The Legal Representative only has authority to act within the https://www.oregon.gov/das/ORBuys/Documents/Phase1TerminologyCrosswalk.pdf scope and limits of their authority as designated by the court or other agreement.

For the purpose of these rules, representatives and Legal Representatives are synonymous. “Oregon Administrative Rules (OAR)” means any agency directive, standard, regulation, or statement of general applicability that implements, interprets, or prescribes law or policy, or describes the procedure or practice requirements of any agency.

h. “Proposal” means a written response submitted to OC&P in response to this RFP.

i. “Proposer” means the person or entity that submits a Proposal.

3.2 ODHS-Specific Terms

a. “Agency with Choice” means an organization that provides agency with choice services licensed by the Department that providers self-directed Agency with Choice services for compensation to Individuals primarily at the Individual’s home and their community.

b. "Activities of Daily Living (ADL)" means those personal, functional activities as defined in OAR 411-015-0006. "Aging and People with Disabilities (APD)” means the program area of Aging and People with Disabilities, within the Oregon Department of Human Services.

c. “Back Up Plan” - A plan developed by the Individual or authorized or Legal Representative in coordination with the Agency with Choice Contractor to ensure uninterrupted services and supports in the event of planned or unplanned absences of the Direct Support Worker or in case of an emergency.

d. “Direct Support Worker (DSW)” means a person employed by an Agency with Choice Contractor, to assist Individuals with activities of daily living, instrumental activities of daily living and health related tasks as defined in the Individual’s Individualized service plan. Direct support worker does not mean a homecare worker or a personal support worker as defined in ORS 410.600

e. “Individual” means an adult receiving Agency with Choice services and supports who is approved for home and community based services by the Department as defined in OAR 411-015-0020. "Instrumental Activities of Daily Living (IADL)" means those activities defined in OAR 411-015-0007.

f. “Person-Centered Service Plan (Service Plan)" means the details of the supports, desired outcomes, activities, and resources required for an Individual to achieve and maintain personal goals, health, and safety, as described in OAR 411-004- 0030. The case manager completes the person-centered service plan directed and agreed by the Individual, authorized representative, or Legal Representative.

g. "Provider Enrollment Agreement" refers to the agreements between the, Aging and People with Disabilities (APD), under the Oregon Department of Human Services, and a qualified Medicaid provider to receive a provider number and deliver services for compensation.

h. “Services and Supports” means services and supports that are tailored to each Individual to ensure they align with the Individual’s “ADL” and “IADL” needs as assessed under OAR 411-015-0006 and 411-015-0007.

3.3 OHA-Specific Terms

a. "Activities of Daily Living (ADL)" means those functional activities required by an Individual for continued well-being that are essential for health and safety. ADLs including eating, dressing/grooming, bathing/personal hygiene, mobility (ambulation and transferring), and elimination/toileting bowel, and maintaining continence as defined in OAR 410-173-0005.

b. “Individual” means an Individual, who receives Agency with Choice services and supports who has a behavioral health condition.

c. “Person-Centered Service Plan (PCSP)” as it applies to an Individual with “behavioral health needs” means the written document prepared by the IQA or the person-centered service plan coordinator that details the supports, desired outcomes, activities, and resources required for an Individual to achieve and maintain personal goals, health, and safety as described in OAR 410-173-0025. The PCSP must be completed and signed prior to the Individual receiving HCBS. The PCSP is not satisfied by a document primarily prepared by a provider.

d. “Self-directed Service Delivery Model” means a model in which an Individual is supported by an Agency with Choice Contractor that functions as the common law employer of direct support workers recruited by the Individual and provides financial management services and tasks in place of the Individual or the Agency with Choice. The Individual directs the direct support workers and is considered a co-employer with the Agency with Choice.

e. “Independent Qualified Agent (IQA)” means an entity meeting the qualification requirements identified in 42 CFR §441.730 and under contract with the Authority.

f. “Services and Supports” means services defined as habilitation services and psychosocial rehabilitation services under OAR chapter 410, division 173 or personal care services under OAR 410-172-0776.