ORS 417.345 Medically Involved Home-Care Program; services; enrollment; effect of program on funding for certain programs; rules

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.

The department 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 subsection (1) of this section. The criteria shall include, but are not limited to, consideration of:

The medical needs of the child;

The needs of any other family member with a disability or chronic illness in the child’s home;

Family and community support available to the child and family caregivers; and

The assistance necessary for the family to care for the child in the child’s home, disregarding parental or legal guardian income.

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 child transferring to the child’s home from nursing home placement, foster care placement or other out-of-home placement;

A child living at home who is at risk of nursing home placement, foster care placement or other out-of-home placement;

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

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.

The department 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.

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.

As used in this section, “child” means a person under 18 years of age.