Page 553

553 (07/2026) Chapter 2:Eligibility • Section 10: Long-Term Care (LTC) services • Intensive Behavior program form SDS 4539 • Medically Involved program form SDS 4538 • Medically Fragile program referral form The CIIS Service Coordinator will: • Establish service eligibility, and • Send a Title XIX Level of Care Waiver Form to the TAU for enrollment and to create/update the Non-CAPS Service Eligibility (SELG) record (these programs have a time-limited enrollment up to the last day of the child’s 17th year). The ODHS|OHA eligibility worker will determine Medicaid eligibility. Note: A child receiving CHIP Title XXI benefits is not eligible to receive supports and services through CIIS. CIIS staff will make a presumptive decision based on CIIS eligibility for those who do not have a Social Security Administration determination of disability. Intensive Behavior Program The Intensive Behavior Program serves children who demonstrate challenging behaviors, such as aggression, self- injury, elopement and sleep disturbances, which require constant adjustments to their environment and routines to maintain safety in their home. Children referred to the Intensive Behavior Program must first be eligible for their county’s developmental disability (DD) program. Medically Involved Program The Medically Involved Program serves children who require moderate to full support with all of their routines and daily activities such as grooming, bathing, dressing, elimination and mobility supports. This can include children requiring specialized medical intervention such as respiratory treatment, tube feeding or seizures. To receive this service, the child must already be on Medicaid and receive SSI or SSDI. Medically Fragile Program The Medically Fragile Program serves children who have extremely intense medical and nursing needs, are generally dependent on specialized medical technology to survive and require a hospital level of care. Their providers are usually registered nurses (RN) or overseen by RN’s to ensure safety. Note: CIIS may be received as Non-Waivered/Basic State Plan Services under this program as well. Children may receive both Children’s Foster Care service under DDC and Medically Fragile Children non-waivered services. Oregon Administrative Rule(s) 411-300-0120 — Eligibility for CIIS