Oregon Case Management Service (CMS) Policy Manual
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The Oregon Case Management Service (CMS) Policy Manual provides a comprehensive framework for the delivery, coordination, and oversight of case management services for individuals receiving support under Oregon’s Medicaid Home and Community-Based Services (HCBS) programs. This manual aligns with the Oregon Administrative Rules (OAR) Chapter 411, Division 415, the Oregon Health Authority (OHA) and Department of Human Services (DHS) guidelines, and the federal HCBS Settings Rule (42 CFR §441.301) to ensure full regulatory compliance and promote person-centered service delivery.
The manual outlines detailed policies and procedures in areas such as eligibility determination, conflict-free case management, individualized support planning, care coordination, service authorization, cultural and tribal coordination, and documentation standards. It also supports compliance with other applicable regulations, including HIPAA/HITECH, ORS 124.050 (Mandatory Abuse Reporting), and the Olmstead Decision regarding community-based living options.
Special emphasis is placed on quality assurance, data tracking, health and safety monitoring, and the promotion of equity and access through culturally responsive practices and tribal sovereignty protections. The manual guides case managers in developing and implementing Individual Support Plans (ISPs) that reflect the unique needs, preferences, and goals of each participant while fostering independence, inclusion, and self-determination.
The CMS Policy Manual serves as an operational and regulatory resource for agencies, case management entities, and professionals responsible for facilitating service access, coordinating care, and monitoring outcomes for individuals with intellectual and developmental disabilities, seniors, and other Medicaid-eligible populations in Oregon.