An Oregon Medicaid Agency Supporting Individuals with Intellectual and Developmental Disabilities

Section 5A

Individual Customer Records

The Company will maintain a current record for each customer who receives services. Each customer file will include the following as required by OAR 411-340-0170(2)(c):

  • The Service Agreement as provided by the CDDP in collaboration with the customer or customer’s legal representative. The agreement will be consistent with the Individual Support Plan (ISP) that was drawn up by the brokerage agency.
  • Any specific health, safety or emergency procedures that may be needed during services, including the actions to be taken if the customer cannot provide for their own safety or becomes missing during a community activity while under the care of the Company.
  • The customer’s name, current home address, and home phone number;
  • Contact information for the support services brokerage agency that is assisting the customer in obtaining services.
  • The customer’s current written Service Agreement, signed and dated by the customer or customer’s legal representative.
  • Contact information for the customer’s legal representative and any other people designated as contacts in the case of incident or emergency.
  • Records regarding the services provided, including the types of services and dates, hours, and personnel involved.
  • In addition to those items required by OAR 411-340-0170(2)(c), customer files will also include:
    • Any signed forms consenting to release of information.
    • Signed copy of the customer’s Rights and Responsibilities.
    • Appropriate notes and forms relating to the customer’s progress.
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