1. Program Definition and Services

Home Health Care Services in Oregon provide short-term support to children and adults with intellectual/developmental disabilities and chronic conditions. The program aims to help maintain individuals with disabilities in the community, averting the need for long-term services and supports. Services include:

• In-Home Personal Care: Individual support in the individual/family home or community (Home Health Aide Services like bathing, dressing, and hygiene; Medication Management; Care Coordination; and Nutritional Support)
• Residential Personal Care: Supervision and care in a licensed residential, community-based setting (Skilled Nursing Services like wound care, catheter care, and IV therapy; Physical Therapy [PT]; Occupational Therapy [OT], and Speech Therapy [ST])

2. Regulations

The program is governed by the following regulations:

• Oregon Administrative Rules (OAR) Chapter 333, Division 530 (Home Health Agency Licensing Rules)
• Oregon Administrative Rules (OAR) Chapter 410, Division 127 (Home Health Services Medicaid Reimbursement Rules)
• Oregon Administrative Rules (OAR) Chapter 411, Division 033 (In-Home Care Agencies Providing Medicaid Services)
• Federal 42 CFR Part 484 (Conditions of Participation for Home Health Agencies)

3. Licensing or Certification

Providers must be licensed as a Home Health Agency by the Oregon Health Authority (OHA) Public Health Division and follow all Home and Community-Based Services (HCBS) requirements.

4. Responsible State Agency

The Oregon Health Authority (OHA) Health Care Regulation and Quality Improvement (HCRQI) section and the Oregon Department of Human Services (ODHS) are responsible for reviewing applications and licensing home health care services providers.

5. Application Process

The application process is conducted through the electronic Oregon Health Authority (OHA) Provider Portal. Providers must submit forms online to initiate the application process.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Proof of compliance with state safety and operational rules
• Agency policies and procedures
• Staff qualifications and training records
• Proof of general and professional liability insurance

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity. Providers should contact their regional office for detailed information on current processing timeframes.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their business entity and secure necessary federal identification numbers.

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access details are sent to qualified applicants once preliminary paperwork is reviewed.

10. Additional Notes

• Providers must ensure that intensive care settings meet all state accessibility and environmental safety guidelines
• In-Home Personal Care must be provided directly by the certified agency's employed personnel
• All direct care staff must conduct mandatory background clearances and fingerprinting screenings
• Providers must maintain detailed records of face-to-face services for Medicaid documentation and billing

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Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

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