Or. Admin. Code § 410-133-0120

Current through Register Vol. 63, No. 12, December 1, 2024

Section 410-133-0120 - Medically Qualified Individuals

(1) School-Based Health Services (SBHS) must be provided and documented by medically-qualified individuals that meet the respective federal requirements of 42 CFR 440.1 through 440.185 and that provide services within their scope of practice and in compliance with their respective board rules and requirements.

(2) The school medical provider shall:

(a) Furnish covered health services through medically-qualified individuals.

(b) Employ or contract with medically-qualified individuals that are eligible to provide Medicaid services in accordance with OARs 410-120-1260, 410-120-1396, and 410-120-1510.

(c) Maintain and retain credentials and qualifications records for each medically-qualified individual, staff or contractor, providing SBHS in the district in compliance with OAR 410-120-1260. Credentials and qualifications documentation must:

(A) Comply with the provider enrollment agreement (OHP 3120); and

(B) State the process by which the school medical provider checked, and periodically re-checked, the Medicaid provider exclusion list to confirm that each medically-qualified individual is eligible to provide health services to Medicaid-enrolled children and young adults.

(3) Medically-qualified individuals providing services in education settings must document each service in compliance with their respective board rules and OAR 410-120-1360.

(4) Medically-qualified individuals with the following qualifications are recognized by the Authority to provide Medicaid-covered SBHS in education settings:

(a) A licensed audiologist providing and documenting services within their scope of practice and in compliance with Oregon Board of Examiners for Speech-Language Pathology and Audiology's OARs Chapter 335;

(b) A licensed psychiatrist providing and documenting services within their scope of practice and in compliance with Oregon's Medical Practice Act and the Oregon Medical Board's OARs Chapter 847.

(c) A licensed psychologist providing and documenting services within their scope of practice and in compliance with Board of Psychology's OARs Chapter 858.

(d) A psychologist associate, practicing under the supervision of a licensed psychologist or with authority to function without immediate supervision, and providing and documenting services within their scope of practice and in compliance with Board of Psychology's OARs Chapter 858.

(e) A psychology technician, performing allowable services under the supervision of a psychologist, and providing and documenting services within their scope of practice and in compliance with Board of Psychology's OARs Chapter 858.

(f) A Licensed Professional Counselor (LPC) providing and documenting services within their scope of practice and in compliance with Board of Licensed Professional Counselors and Therapists' OARs Chapter 833.

(g) A Licensed Marriage and Family Therapist (LMFT) providing and documenting services within their scope of practice and in compliance with Board of Licensed Professional Counselors and Therapists' OARs Chapter 833.

(h) A Licensed Clinical Social Worker (LCSW) providing and documenting services within their scope of practice and in compliance with Board of Licensed Social Workers' OARs Chapter 877.

(i) A Clinical Social Work Associate (CSWA), holding an unrestricted certificate and practicing under an approved plan of practice and supervision with a LCSW, and providing and documenting services within their scope of practice and in compliance with Board of Licensed Social Workers' OARs Chapter 877.

(j) A licensed dentist providing and documenting services within their scope of practice and in compliance with Oregon Board of Dentistry's OARs Chapter 818, Oregon Dental Practice Act.

(k) An expanded practice dental hygienist, practicing under the general supervision of a licensed dentist, and providing and documenting services within their scope of practice and in compliance with Oregon Board of Dentistry's OARs Chapter 818, Oregon Dental Practice Act.

(l) A licensed dental therapist, practicing dental therapy under the supervision of a dentist and pursuant to a collaborative agreement with the dentist, and providing and documenting services within their scope of practice and in compliance with Oregon Board of Dentistry's OARs Chapter 818, Oregon Dental Practice Act.

(m) A Nurse Practitioner (NP) providing and documenting services within their scope of practice and in compliance with Oregon State Board of Nursing's OARs Chapter 851, Oregon Nurse Practice Act.

(n) A Registered Nurse (RN) providing and documenting services within their scope of practice and in compliance with Oregon State Board of Nursing's OARs Chapter 851, Oregon Nurse Practice Act.

(o) A Licensed Practical Nurse (LPN), practicing under the clinical direction of a RN, NP, or physician who meets the standards of licensing or certification for the health service provided, and providing and documenting services within their scope of practice and in compliance with Oregon State Board of Nursing's OARs Chapter 851, Oregon Nurse Practice Act.

(p) An Unregulated Assistive Person (UAP) performing a specific nursing task that has been delegated to the UAP by a RN or NP. The delegating nurse retains accountability for the nursing procedure and must document services within their scope of practice and in compliance with Oregon State Board of Nursing's OARs Chapter 851, Oregon Nurse Practice Act.

(q) A licensed dietician providing and documenting services within their scope of practice and in compliance with Oregon Board of Licensed Dieticians' OARs Chapter 834.

(r) A licensed Occupational Therapist (OT) providing and documenting services within their scope of practice and in compliance with Oregon Occupational Therapy Licensing Board OARs Chapter 339, Occupational Therapy Practice Act.

(s) A Certified Occupational Therapist Assistant (COTA), providing occupational therapy treatment under the supervision of a licensed occupational therapist, and providing and documenting services within their scope of practice and in compliance with Oregon Occupational Therapy Licensing Board OARs Chapter 339, Occupational Therapy Practice Act.

(t) A licensed Physical Therapist (PT) providing and documenting services within their scope of practice and in compliance with Oregon Board of Physical Therapy OARs Chapter 848.

(u) A licensed Physical Therapist Assistant (PTA), providing physical therapy treatment under the supervision of a licensed physical therapist, and providing and documenting services within their scope of practice and in compliance with Oregon Board of Physical Therapy OARs Chapter 848.

(v) A Medical Doctor (MD) providing and documenting services within their scope of practice and in compliance with Oregon's Medical Practice Act and the Oregon Medical Board's OARs Chapter 847.

(w) A Doctor of Osteopathic Medicine (DO) providing and documenting services within their scope of practice and in compliance with Oregon's Medical Practice Act and the Oregon Medical Board's OARs Chapter 847.

(x) A Doctor of Podiatric Medicine (DPM) providing and documenting services within their scope of practice and in compliance with Oregon's Medical Practice Act and the Oregon Medical Board's OARs Chapter 847.

(y) A Physician Assistant (PA), practicing under a written collaboration agreement signed by a physician, and providing and documenting services within their scope of practice and in compliance with Oregon's Medical Practice Act and the Oregon Medical Board's OARs Chapter 847.

(z) A licensed respiratory therapist, practicing under the direction of a licensed physician, and providing and documenting services within their scope of practice and in compliance with Oregon's Respiratory Therapist and Polysomnographic Technologist Licensing Board's OARs Chapter 331, Divisions 705-740.

(aa) A licensed Speech-Language Pathologist (SLP) providing and documenting services within their scope of practice and in compliance with Oregon Board of Examiners for Speech-Language Pathology and Audiology's OARs Chapter 335.

(bb) An educator licensed and endorsed, prior to July 1, 2016, by the Teacher Standards and Practice Commission (TSPC) with a Communication Disorder endorsement (speech language pathology), exempted in ORS 681.230(4) pursuant to SB287, who meets the following requirements:

(i) Holds a Certificate of Clinical Competency (CCC) from the American Speech and Hearing Association (ASHA); or

(ii) Has completed the equivalent educational requirements and work experience necessary for the certificate; or

(iii) Has completed the academic program and is acquiring supervised work experience to qualify for the certificate; or

(iv) Is authorized to administer speech therapy to an individual when the individual is a child or young adult eligible for special education, as defined by state or federal law, receiving speech therapy services pursuant to an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP).

(cc) A speech-language pathologist in their Clinical Fellowship Year (CFY), practicing under the supervision of a licensed speech-language pathologist, and providing and documenting services within their scope of practice and in compliance with Oregon Board of Examiners for Speech-Language Pathology and Audiology's OARs Chapter 335.

(dd) A licensed Speech-Language Pathology Assistant (SLPA), practicing under the supervision of a licensed speech-language pathologist, and providing and documenting services within their scope of practice and in compliance with Oregon Board of Examiners for Speech-Language Pathology and Audiology's OARs Chapter 335.

Or. Admin. Code § 410-133-0120

HR 39-1991, f. & cert. ef. 9-16-91; HR 49-1991(Temp), f. & cert. ef. 10-24-91; HR 3-1992, f. & cert. ef. 1-2-92; HR 29-1993, f. & cert. ef. 10-1-93; HR 19-1994, f. & cert. ef. 4-1-94; HR 21-1995, f. & cert. ef. 12-1-95; OMAP 38-1999, f. & cert. ef. 10-1-99; OMAP 31-2003, f. & cert ef. 4-1-03; OMAP 53-2003, f. 8-13-03 cert. ef. 9-1-03; OMAP 24-2005(Temp), f. & cert. ef. 4-5-05 thru 10-1-05; OMAP 53-2005, f. 9-30-05, cert. ef. 10-1-05; DMAP 19-2009, f. 6-12-09, cert. ef. 7-1-09; DMAP 15-2011, f. 6-29-11, cert. ef. 7-1-11; DMAP 33-2016, f. 6-29-16, cert. ef. 7/1/2016; DMAP 121-2024, amend filed 09/06/2024, effective 9/6/2024

Statutory/Other Authority: ORS 413.042

Statutes/Other Implemented: 414.065