333-022-2030 HIV Case Management: Enrollment Process (1) To enroll in the HIV Case Management Program an individual must go through an intake process with a local Ryan White Part B case management services agency. A list of the agencies may be obtained on the Authority's website at www.healthoregon.org/hiv. (2) During the intake process an individual must provide information to an agency that enables the agency to verify at least the following: (a) Identity; (b) HIV status; (c) Residency in the HIV case management service area; (d) Income; (e) Household member information; and (f) Health insurance information, if applicable. (3) Identity may be verified for an individual by providing one of the following: (a) Oregon Driver License; (b) Tribal identification (ID); (c) State of Oregon ID card; (d) Military ID; (e) Passport; (f) Student ID; (g) Social Security Card; (h) Citizenship/Naturalization documents; (i) Student visa; (j) Oregon Learner's Permit or Temporary License; (k) Birth certificate; or (l) Other form of verification determined appropriate by an agency. (4) HIV/AIDS status must be verified within 30 days of intake by a physician or lab result. (5) Documents that verify that an individual resides in the HIV case management service area include but are not limited to documents with the client's full legal name and an address, within the service area, that matches the residential address provided during the intake. (6) Determination and verification of income: (a) Family size will be determined by counting the individuals related by birth, marriage, adoption, or legally defined dependent relationships who either live in the same household as the individual seeking to enroll in the HIV Case Management Program and for whom that individual is financially responsible, or whom do not live in the same household as the individual but fall within the categories listed in subsections (b), (c) or (d) of this section, including but not limited to: (A) A legal spouse; or (B) A child 18 years of age or younger who qualifies as a dependent for tax filing purposes; or (C) A child age 19 to 26 years of age who takes 12 or more credit hours in a school term, or its equivalent; or (D) An adult for whom the individual has legal guardianship. (b) Gross monthly income: (A) An individual must submit documentation for all family members and from all sources to determine total monthly gross income for a family. Income after taxes or other withholdings may only be used when: (i) A self-employed individual or the individual’s family member files an Internal Revenue Service, Form 1040, Schedule C in which case the agency will allow a 50 percent deduction from gross receipts or sales; or (ii) An individual or individual’s family member has income from rental real estate and provides a copy of the most recent year’s IRS Form 1040 (Schedule E). In this case the agency may use the total rental real estate income, as reported on the Schedule E. If the Schedule E shows a loss, the applicant or applicant’s family member shall be considered to have no income from this source. (B) The agency must determine an applicant’s income by adding together all sources of family income, and dividing that number by the applicable FPL. The resultant sum is the applicant’s percentage of the FPL. (7) An individual must sign any authorization necessary to permit the agency to exchange information with the individual’s health care providers, and any other individual or entity necessary to coordinate care and services. Statutory/Other Authority: ORS 413.042, 431.250 & 431.830 Statutes/Other Implemented: ORS 431.250 & 431.830 History: PH 29-2014, f. 11-10-14, cert. ef. 12-1-14