74th OREGON LEGISLATIVE ASSEMBLY--2007 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 1174
A-Engrossed
House Bill 2406
Ordered by the House February 8
Including House Amendments dated February 8
Sponsored by Representatives GELSER, CAMERON, Senators BATES,
MORRISETTE; Representatives BARNHART, BERGER, BUCKLEY, CANNON,
ESQUIVEL, GREENLICK, HUNT, KOTEK, OLSON, ROBLAN, ROSENBAUM,
SCHAUFLER, SHIELDS, TOMEI, Senators BROWN, KRUSE, MONNES
ANDERSON, MORSE, WINTERS (Presession filed.)
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure.
Creates Medically Involved Home-Care Program in Department of
Human Services. Requires department to adopt criteria for program
by rule. Requires Director of Human Services to seek necessary
federal approval.
Declares emergency, effective on passage.
A BILL FOR AN ACT
Relating to home care for medically involved children; creating
new provisions; amending ORS 414.737, 417.340 and 417.342; and
declaring an emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 417.340 is amended to read:
417.340. As used in ORS 417.340 to 417.348 and 417.349:
{ + (1) 'Child's home' means the home in which a child
resides with the child's biological or adoptive parents or legal
guardian. It does not include foster care, proctor care, group
home placement or other institutional placement. + }
{ - (1) - } { + (2) + } 'Family' means the unit that
consists of:
(a) A member with a disability or chronic illness; and
(b) One or more related persons who reside in the same
household.
{ - (2) - } { + (3) + } 'Family member with a disability or
chronic illness' means a person who has a disability or chronic
illness that:
(a) Is likely to continue indefinitely;
(b) Results in substantial functional limitations in one or
more of the following areas of major life activity:
(A) Self-care;
(B) Receptive and expressive language;
(C) Learning;
(D) Mobility;
(E) Self-direction;
(F) Capacity for independent living; or
(G) Economic self-sufficiency; and
(c) Reflects the person's need for special, interdisciplinary
or generic care, treatment or other services that are of lifelong
duration and must be individually planned and coordinated.
{ + (4) 'Medically involved' means having a physical or
developmental disability that requires assistance with most
activities of daily living and requires health and personal care
throughout the day and night. + }
SECTION 2. ORS 417.342 is amended to read:
417.342. (1) Family support services are based on the belief
that all people, regardless of disability, chronic illness or
special need, have the right to a permanent and stable familial
relationship in the community. { + Children have a developmental
need to grow up in a family home environment. + } However,
nothing in ORS 417.340 to 417.348 or 417.349 is intended { - to
keep a family member with a disability or chronic illness in the
family home or - } to require any person with a disability or
chronic illness to live in the family home.
(2) Family support services can provide the support necessary
to enable the family to meet the needs of caring for a family
member with a disability or chronic illness at home and, subject
to available funds, shall be based on the following principles:
(a) Family support services may use private and volunteer
resources, publicly funded services and other flexible dollars to
provide a family with the services needed to care for the family
member with a disability or chronic illness.
(b) Family support services must be sensitive to the unique
needs, strengths and multicultural values of an individual and
the family rather than fitting the individual and family into
existing services.
(c) Family support services must be built on a relationship of
respect and trust that recognizes that families are better able
to determine their own needs than have their needs determined by
the state or a public agency.
(d) Family support services shall be provided in a manner that
develops comprehensive, responsive and flexible support to
families in their role as primary caregivers for family members
with disabilities or chronic illnesses.
(e) Family support services shall focus on the entire family
and be responsive to the needs of the individual and the family.
(f) Family support services may be needed throughout the
lifespan of the individual family member living at home who has a
disability or chronic illness.
(g) Family support services shall be available to families
before they are in crisis.
(h) Family support services may be a service option offered to
families, but not imposed on them.
(i) Family support services shall encourage maximum use of
existing social networks and natural sources of support and
should encourage community integration.
(j) Family support services shall not be confined to a single
program or set of services but shall be a philosophy that
permeates all programs and services.
SECTION 3. { + Sections 4 to 6 of this 2007 Act are added to
and made a part of ORS 417.340 to 417.348. + }
SECTION 4. { + The Medically Involved Home-Care Program is
created in the Department of Human Services. The department shall
provide all State Plan Medicaid and waivered services available
under state and federal law that are necessary to enable a
medically involved child to be cared for in the child's home. The
waivered services that must be available include but are not
limited to home nursing care, durable medical equipment and
respite care. + }
SECTION 5. { + (1) The Department of Human Services shall
adopt by rule criteria for determining the need for and extent of
assistance to be provided to a medically involved child enrolled
in the Medically Involved Home-Care Program created by section 4
of this 2007 Act. The criteria shall include, but are not limited
to, consideration of:
(a) The medical needs of the child;
(b) The needs of any other family member with a disability or
chronic illness in the child's home;
(c) Family and community support available to the child and
family caregivers; and
(d) The assistance necessary for the family to care for the
child in the child's home, disregarding parental or legal
guardian income.
(2) Subject to limits on enrollment required by state or
federal law, services offered through the Medically Involved
Home-Care Program shall be made available to children meeting the
criteria established by the department by rule. Priority for
enrollment shall be given to:
(a) A child transferring to the child's home from nursing home
placement, foster care placement or other out-of-home placement;
(b) A child living at home who is at risk of nursing home
placement, foster care placement or other out-of-home placement;
(c) A child who does not otherwise qualify for medical
assistance under ORS chapter 414 and for whom the department pays
family support payments pursuant to ORS 430.215 that exceed
$10,000 per year; and
(d) A child who is at risk of losing eligibility for medical
assistance under ORS chapter 414 due to a caregiver's employment
or an increase in a caregiver's earnings.
(3) As used in sections 4 to 6 of this 2007 Act, 'child ' means
a person under 18 years of age. + }
SECTION 6. { + (1) The Department of Human Services shall
enroll no fewer than 125 medically involved children in the
Medically Involved Home-Care Program beginning January 1, 2008.
The department shall enroll an additional 25 medically involved
children each calendar year thereafter, to the maximum number
allowed by federal law or under the terms of the federal
approval.
(2) Moneys appropriated to the department for the Medically
Involved Home-Care Program may not be used to supplant moneys
appropriated to the department for the Children's Intensive
In-Home Services program. + }
SECTION 7. { + Within 30 days after the effective date of this
2007 Act, the Director of Human Services shall seek any form of
federal approval from the Centers for Medicare and Medicaid
Services that is necessary to implement the Medically Involved
Home-Care Program. The director shall notify Legislative Counsel
upon receipt or denial of necessary federal approval. + }
SECTION 8. ORS 414.737 is amended to read:
414.737. (1) Except as provided in subsections (2) and (3) of
this section, a person who is eligible for or receiving physical
health, dental, mental health or chemical dependency services
under ORS 414.705 to 414.750 must be enrolled in the prepaid
managed care health services organizations to receive the health
services for which the person is eligible.
(2) Subsection (1) of this section does not apply to:
(a) A person who is a noncitizen and who is eligible only for
labor and delivery services and emergency treatment services;
(b) A person who is an American Indian and Alaskan Native
beneficiary; and
(c) A person whom the department may by rule exempt from the
mandatory enrollment requirement of subsection (1) of this
section, including but not limited to:
(A) A person who is also eligible for Medicare;
(B) A woman in her third trimester of pregnancy at the time of
enrollment;
(C) A person under 19 years of age who has been placed in
adoptive or foster care out of state;
(D) A person under 18 years of age who is medically fragile and
who has special health care needs;
{ + (E) A person receiving services under the Medically
Involved Home-Care Program created by section 4 of this 2007
Act; + } and
{ - (E) - } { + (F) + } A person with major medical
coverage.
(3) Subsection (1) of this section does not apply to a person
who resides in a designated area in which a prepaid managed care
health services organization providing physical health, dental,
mental health or chemical dependency services is not able to
assign an enrollee to a person or entity that is primarily
responsible for coordinating the physical health, dental, mental
health or chemical dependency services provided to the enrollee.
(4) As used in this section, 'American Indian and Alaskan
Native beneficiary' means:
(a) A member of a federally recognized Indian tribe, band or
group;
(b) An Eskimo or Aleut or other Alaskan Native enrolled by the
United States Secretary of the Interior pursuant to the Alaska
Native Claims Settlement Act, 43 U.S.C. 1601; or
(c) A person who is considered by the United States Secretary
of the Interior to be an Indian for any purpose.
SECTION 9. { + Sections 3 to 6 of this 2007 Act and the
amendments to ORS 414.737, 417.340 and 417.342 by sections 1, 2
and 8 of this 2007 Act become operative upon receipt of the
necessary federal approval described in section 7 of this 2007
Act. + }
SECTION 10. { + This 2007 Act being necessary for the
immediate preservation of the public peace, health and safety, an
emergency is declared to exist, and this 2007 Act takes effect on
its passage. + }
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