№ lp_1_2_16362
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This document serves as an attestation regarding the System of Care policies and procedures required by the CCO under its Medicaid and Non-Medicaid contracts with the Oregon Health Authority for the 2025 contract year.
Year:
2025
Region / City:
Oregon
Subject:
Behavioral Health
Document Type:
Attestation
Authority:
Oregon Health Authority (OHA)
Author:
Coordinated Care Organization (CCO)
Target Audience:
CCO and Subcontractors
Period of Validity:
2025
Approval Date:
Not specified
Amendment Date:
Not specified
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Year:
2026
Region / City:
-
Topic:
Trauma Care, EMS, Hospital Resources
Document Type:
Checklist
Organization / Institution:
-
Author:
-
Target Audience:
Healthcare professionals involved in trauma care
Period of Validity:
-
Approval Date:
-
Date of Changes:
-
Publication Date:
October 2024
PCI DSS Version:
4.0.1
Type:
Self-Assessment Questionnaire (SAQ)
Applicability:
E-commerce merchants using third-party payment processors, not storing cardholder data electronically
Target Audience:
E-commerce merchants
Document Changes:
Detailed revision history from 2014 to October 2024, including updates to align with PCI DSS versions 3.0–4.0.1
Appendices:
A, A1, A2, A3, B, C, D
Publication Date:
January 2025
PCI DSS Version:
4.0.1
SAQ Revision:
1
Document Type:
Self-Assessment Questionnaire and Attestation of Compliance
Standard:
Payment Card Industry Data Security Standard
Issuing Organization:
PCI Security Standards Council
SAQ Type:
SAQ A
Applicable Entities:
Merchants
Payment Channels:
E-commerce; Mail/Telephone-Order
Data Handling Scope:
Fully outsourced account data processing
Applicability Exclusions:
Face-to-face channels; Service providers
Primary Audience:
Card-not-present merchants using PCI DSS compliant third-party service providers
Document Sections:
Assessment Information; Self-Assessment Questionnaire A; Validation and Attestation Details; Appendices
Compliance Confirmation:
Third-party service providers PCI DSS compliance confirmed by merchant
Year:
2023
Region/City:
Wisconsin, USA
Topic:
Provider Certification and Compliance
Document Type:
Form
Organization/Institution:
Community Care, Inc.
Author:
Unknown
Target Audience:
Health service providers, including staff members and operators
Effective Period:
Ongoing
Approval Date:
N/A
Date of Changes:
N/A
Note:
Provider Name
Staff Job Description:
Yes/No
Training Plans:
Yes/No
Staff Competency Validation:
Yes/No
Staff Qualifications Documentation:
Yes/No
Training for Working with Frail Elders/Disabled:
Yes/No
Annual Compliance Training:
Yes/No
Staff Disease Screening:
Yes/No
Criminal and Caregiver Background Checks:
Yes/No
Excluded Individuals and Entities:
Yes/No
Transportation Providers:
Yes/No
Civil Rights/Affirmative Action Compliance:
Yes/No
Year:
2021
Region / City:
Canada
Subject:
Identification Verification, Anti-Money Laundering, Loan Documentation
Document Type:
Form
Organization / Institution:
THINK Financial
Author:
THINK Financial
Target Audience:
Borrowers, Guarantors, Solicitors, Notaries, Signing Agents
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Modifications:
Not specified
Country:
Pakistan
Issuing authority:
Ministry of National Health Services, Regulations & Coordination
City:
Islamabad
Document type:
Application form with specimen affidavit
Subject area:
Attestation of professional documents
Target professions:
Doctors, paramedics, pharmacists, homeopathics, tabibs, physiotherapists
Purpose:
Attestation of documents for overseas employment
Applicant information required:
Personal, educational, professional, and overseas employment details
Required attachments:
Attested copies of degrees, certificates, CNIC, passport, affidavit
Affidavit requirement:
Stamp paper Rs. 20/-
Applicable employment context:
Overseas job placement
Administrative location:
Pak Secretariat, Kohsar Block
Note:
Year
Topic:
Minimum Staffing Requirements for Specialty Out-Of-Home Treatment Services for Youth
Document Type:
Attestation
Organ/Institution:
New Jersey Department of Children and Families
Target Audience:
Providers of Specialty Out-Of-Home Treatment Services for youth
Year:
2014
Region / City:
Global
Topic:
Payment Application Data Security
Document Type:
Attestation
Organization / Institution:
PCI SSC
Author:
Payment Application Qualified Security Assessor (PA-QSA)
Target Audience:
Payment Application Vendors, PA-QSA
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Note:
Year
Topic:
Animal Health, Veterinary Services
Document Type:
Health Attestation
Organization / Institution:
APHA/Defra
Author:
Registered Veterinarian
Target Audience:
Veterinarians, Certifying Officers
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Amendments:
Not specified
Year:
2025
Region / City:
Oregon
Subject:
Medicaid Grievance and Appeal System
Document Type:
Attestation
Organization:
Oregon Health Authority (OHA)
Author:
Medicaid Division, CCO Operations Unit
Target Audience:
Coordinated Care Organizations (CCOs)
Period of Action:
Contract Year 2025
Approval Date:
January 1, 2025
Amendment Date:
N/A
Year:
2025
Coordinated Care Organization:
[Not specified]
Medicaid Contract Number:
[Not specified]
Type of Document:
Attestation
Governing Body:
Oregon Health Authority
Scope:
Wraparound Policies and Procedures
Signatory Authority:
Chief Executive Officer, Chief Financial Officer, or delegated employee
Contract Reference:
Medicaid Contract, Non-Medicaid Contract, OHP Bridge-Basic Health Program Contract
Year:
2025
Region / City:
Oregon
Subject:
Medicaid, Grievance and Appeal Systems
Document Type:
Policy
Organ / Institution:
Oregon Health Authority (OHA)
Author:
Medicaid Division CCO Operations Unit
Target Audience:
Coordinated Care Organizations (CCOs)
Effective Period:
Contract Year 2025
Approval Date:
March 27, 2025
Date of Changes:
None
Note:
Contract Year
Note:
Year
Theme:
Rental Screening
Document Type:
Policy
Organization / Institution:
SG Property Management
Target Audience:
Applicants
Year:
2023
Region / City:
Indianapolis
Topic:
Academic Faculty Policies
Document Type:
Faculty Guide
Institution:
Indiana University School of Medicine
Author:
Indiana University
Target Audience:
Faculty members at Indiana University School of Medicine
Period of Validity:
Ongoing
Approval Date:
2023
Date of Changes:
N/A
Year:
2024
Region / City:
Springfield, VA
Subject:
Medical Laboratory Technology, Education
Document Type:
Handbook
Institution:
Northern Virginia Community College (NOVA)
Author:
Amy McCarty, Danielle Muench, Harrietta Cush, Songvuth Intavong, Patrick Hooe
Target Audience:
Students in the Medical Laboratory Technology Program
Period of Validity:
2024-2025
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2025
Region / City:
Seattle
Topic:
Prosthodontics Education, Graduate Program
Document Type:
Program Syllabus
Institution:
University of Washington, School of Dentistry
Author:
Van Ramos, Jr. D.D.S., FACP
Target Audience:
Graduate students in prosthodontics
Period of Effectiveness:
Ongoing, updated January 13, 2026
Approval Date:
January 13, 2026
Date of Revisions:
January 13, 2026
Note:
Study Summary 1.1 Please provide a brief summary of the study in the table below. A complete description of the study with detailed information should be provided in the body of the protocol. For sections not applicable to the study, mark them as N/A. Study Title Study Design Primary Objective/Purpose Secondary Objective(s)/Purposes Research Intervention(s) ClinicalTrials.gov NCT # Study Population Sample Size Study Duration for individual subjects Study Specific Abbreviations/ Definitions
Background 3.1 Provide the scientific or scholarly background for, rationale for, and significance of the research based on the existing literature and how will it add to existing knowledge. :
this section should be limited to only information directly related to the research questions and objectives. Do not include your full dissertation proposal. 3.2 Describe any relevant preliminary data (e.g. pilot data).
Procedures Involved 5.1 Describe and explain the study design. 5.2 Please select the methods that will be employed in this study (select all that apply):
☐ Audio/Video Recording ☐ Psychophysiological Recording ☐ Behavioral Interventions ☐ Record Review - Educational ☐ Behavioral Observations and Experimentations ☐ Record Review - Employee ☐ Deception ☐ Record Review- Medical ☐ Focus Groups ☐ Record Review - Other ☐ Interviews ☐ Specimen Collection or Analysis ☐ Investigational Medical Device – (e.g. Medical Mobile Applications) ☐ Surveys and/or Questionnaires ☐Psychometric Testing ☐ Other Social-Behavioral Procedures Provide a description of all research procedures being performed and when they are performed. (Upload any surveys, questionnaires, interview scripts, focus group scripts, debriefing scripts, psychometric tests, stimulus materials, intervention manuals, and data collection forms on the Local Site Documents page in the IRB application.) 5.3 Describe the procedures or interventions that are going to be conducted as part of the research project, but that would have been conducted anyway, even if the research was not occurring (i.e. standard of care procedures, activities that would occur in a classroom). 5.4 Describe the procedures performed to lessen the probability or magnitude of risks of items selected in 5.2.5. 5 If accessing or collecting existing data, describe: The data that will be collected during the study (e.g. demographics, medical history, etc.). Attach the data capture sheet(s) on the Local Site Documents page in the IRB application. How the data will be obtained, including how you have the authority to access the data. The source or location of the data (e.g. USF Epic, TGH Epic, Hillsborough County School records, CANVAS records, publicly available databases, etc.). 5.6 If collecting and/or analyzing biological specimens, describe: How the biological specimens will be or have been collected. How the biological specimens will be stored. How long the biological specimens will be stored. How the biological specimens will be used. The laboratories that will be used. Whether the collected biological specimens will undergo genetic testing. If so, indicate if this study is part of a Genome Wide Association Study (GWAS) and whether the data will be forwarded to the NIH dbGaP. 5.7 If there are plans for long-term follow-up (once all research related procedures are complete), what data will be collected during this period.
Data and Specimen Storage for Future Research 6.1 If data or specimens will be banked for future research studies, describe where the data or specimens will be stored, how long it/they will b:
the process to request a release, approvals required for release, who can obtain data or specimens, and the data to be provided with specimens.