Series Title (Agency Series #): Description, Retention (Legal Citation)

Agency Provider Invoices (ADS3-002): Documents requests by private agencies for payment for services provided to clients under their care. Invoice (SDS 599A) shows provider's name and address, client name and identifying information, service dates, service type, hours billed and authorized, amount due, and authorizing signatures.
Retention: Retain 6 years. (45 CFR 164.530(j))

Branch Correspondence (ADS3-001): Documents the administration and implementation of established policies in ADS branch offices. Documents includes correspondence, organizational charts, employee listings, copies of contracts and interagency agreements, special project records, directives and informational letters from the state Seniors and People with Disabilities Division, newsletters, email messages and related materials. Program correspondence records document the implementation of existing policies, and are significant enough to warrant retention for future reference.
Retention: Correspondence duplicated or summarized in case files: retain until entered; all other records: retain 6 years. (MOAR 166-150-0005(8))

Cash Payment Authorizations (ADS3-003): Documents the authorization of cash payments to providers for non-medical services, and equipment and other expenditures paid for from the state general fund. Used to enter information in MMIS and generate a payment check from the SPD office. A copy is maintained in the client's case record. Authorization (AFS 437) shows client name and number, payee name and address, amount authorized, description of payment, reason payment authorized, and authorized signature.
Retention: Retain 4 years. (2014-0005/006)

Check Disposal Authorizations (ADS3-004): Documents authorization of caseworker to dispose of checks or medical service cards. Authorization (AFS 459) shows client name, description of check/card, caseworker name, and date disposed.
Retention: Retain 4 years. (2008-0012/005)

Client Case Records (ADS3-005): Documents all service provided to ADS clients. Financial services are provided through the following programs: Oregon Supplemental Income Program, General Assistance Program (ended  10/01/2005), Oregon Health Plan, and Food Stamp Program. Clients also receive a variety of case management services through the Aging Services, Disability Services and Nursing programs. Includes correspondence,  pre-admission screening assessments of clients' physical and psycho-social needs, client assessment planning tools used to assess level of care, client financial records used to determine eligibility, client medical records indicating  clients' medical conditions and needs, service applications, award authorization forms, case manager narratives, client choice service option forms, medical resource reports, financial status verification records, financial status change forms, and related records.
Retention: (a) Individual Service Plans: 10 years (b) All other records if death date is known: 7 years after date of death (c) All other records if case is closed, inactive, or death date is unknown: 70 years. (OAR 166-150-0055(3))

Dammasch State Hospital Case Records (ADS3-007): Medical records for clients who received services at Dammasch State Hospital during 1993. This function is no longer performed.
Retention: Retain 6 years after last service, or until 21st birthday, whichever is longer. (MOAR 166-150-0060(2))

Facility Disclosure Records (ADS3-008): Documents all information relating to nursing facilities that is not exempt from disclosure under the public records law. Used to provide easy public access to information about specific nursing facilities. Records include letters of determination from state Seniors and People with Disabilities Division related to complaints against the nursing facility, CCMU reports, administrative hearing findings, and related correspondence.
Retention: Retain 10 years. (2008-0012/006)

Food Stamp Accounting Records (ADS3-009): Documents the issuance of food stamp benefits and Oregon Trail cards to clients. Records may include cash-out register, monthly transaction reports, cancelled check/card ledger, and related records.
Retention: Retain 6 years. (2014-0005/011)

General Assistance Hearing Records (ADS3-010): Records document administrative hearings held by the County Aging and Disability Services Division to determine client eligibility for continued general assistance disability payments. Records include record of hearing, final order, supporting documentation (the bulk of this is medical records), correspondence, and related records. (GA ended 10/01/2005).
Retention: Retain 6 years after hearing determination. (45 CFR 64.530(j))

Home Care Worker (CEP) Invoices/ Vouchers (ADS3-006): Documents requests for and payment of authorized provider Medicaid services to clients. Used for individual providers hired by the client. Input into the MMIS system and used to generate provider checks and the next payment period's blank voucher. Invoices (SDS 598B) show client's name and  personal information, provider's name and personal information, description of services provided, amount authorized for payment, date, and client (or personal representative) signature. May also include supporting documentation like mileage or hours worked detail.
Retention: Retain 6 years. (45 CFR 164.530(j))

Interim Assistance Agreements (ADS3-011): Documents agreement (AFS 418) of client to repay general assistance once they begin receiving social security payments. Agreement shows date, client's name, and amount to be repaid and related information. One copy of this form is filed in the client's case record. (GA ended 10/01/2005).
Retention: Retain 3 years. (2008-0012/008)

Lost Check Affidavits (ADS3-012): Used to notify DHS that a provider's check has been lost and that a new one should be issued as detailed in ORS 293.475. Affidavit shows provider's name, original check information (number, date, amount, and payee), new check information, and notarization.
Retention: Retain 4 years. (2014-0005/012)

Medical Service Authorization Requests (ADS3-013): Documents authorization by county medical workers that a requested medical service is needed and should be paid for. Used to enter information into MMIS and is duplicated in the client case record. Request (AFS 405B) shows client name and address, case number, itemized services and provider price quotes, justification for service, and medical worker approval.
Retention: Retain 7 years. (OAR 166-150-0065(20))

Pre-Admission Screening (PAS) Records (ADS3-014): Documents pre-admission screening team assessments of clients' physical and psycho-social needs, as performed at the request of the case manager or a private provider.  Includes pre-admission screening and annual resident review forms indicating client mental and medical health status and exemptions, intake registration initial contact sheets (SPDD Form 539B) indicating screeners' assessments and client information, adult services assessment forms (SDS Form 0460) assessing reason for referral, outcomes of previous plans, client social histories, medical needs, diagnosis, treatments, vital signs, activities, and related information, client medical records, and related materials.
Retention: Retain 6 years. (45 CFR 164.530(j))

Provider License Records (ADS3-015): Documents application and licensing of foster home care to care for clients in the provider's home and the enrollment of home care workers. Annual licensing for FHC and enrollment is required every two years. Records include application, contract, license, references, copies of identification, I-9's, criminal background checks, and supporting documentation. The Relative Adult Foster Home program closed on 07/01/2013. 
Retention: a) Home care worker enrollments: retain 3 years; b) licensing records: retain 7 years. (2014-0005/013)

Social Security Hearing Records (ADS3-016): Records document continuing disability review hearings. These are administrative hearings held by the Social Security Administration to determine client eligibility for continued social security disability payments. Records include record of hearing, final order, supporting documentation (the bulk of this is medical records), correspondence, and related records. A large part of this file is also maintained by the Social Security Administration, but is costly to obtain if needed for future research. Since 10/1/2005, ADS no longer represents clients at SSA hearings.
Retention: Retain 6 years. (45 CFR 164.530(j))

Social Security Liaison Client Case Records (ADS3-017): Documents clients who are requesting SSI eligibility determinations in order to receive benefits. Records include medical records, case narrative, legal records, face sheet, liaison's notes, hearings records, background information, appeals, and related correspondence. Since 10/1/2005, ADS no longer has Social Security Liaisons, and do not currently provide the services they performed.
Retention: Retain 6 years after last action. (45 CFR 164.530(j))