justicedao/ipfs_state_laws huggingface dataset:
461-135-0725 Specific Requirements; OSIPM-EPD (1) To be eligible for the Oregon Supplemental Income Program Medical - Employed Persons with Disabilities (OSIPM-EPD) program, an individual must meet all of the following: (a) Have a disability , as defined in OAR 461-125-0370. (b) Have adjusted income (see OAR 461-001-0000) below the limit provided in OAR 461-155-0250(5). (c) Have employment as defined in OAR 461-001-0035. Once found eligible, an individual remains eligible under this subsection for the OSIPM-EPD program while not working if the employer treats the individual as an employee, such as when the individual is absent from the job under the provisions of the Family Medical Leave Act. (d) Not be assumed eligible for OSIPM, as defined in OAR 461-135-0010(2). (e) Except for those in a nonstandard living arrangement (see OAR 461-001-0000), not meet one of the following: (A) The income requirements for OSIPM under section (3) of OAR 461-155-0250. (B) The resource limits for OSIPM under section (2)(a) of OAR 461-160-0015. (2) If an OSIPM-EPD participant becomes unemployed and meets all financial and non-financial eligibility requirements for OSIPM except for resources, the individual may retain eligibility for OSIPM-EPD for up to 12 months in order to spend down to the OSIPM resource limit. The individual must continue to meet all financial and nonfinancial eligibility factors for OSIPM-EPD except employment . The 12-month period begins the first of the month following the loss of employment. Statutory/Other Authority: ORS 409.050, 411.060, 411.404, 413.085 & 414.685 Statutes/Other Implemented: ORS 409.010, 411.060 & 411.404 History: SSP 6-2025, minor correction filed 04/08/2025, effective 04/08/2025 SSP 48-2023, minor correction filed 11/14/2023, effective 11/14/2023 SSP 50-2022, amend filed 09/30/2022, effective 10/01/2022 SSP 6-2019, minor correction filed 03/11/2019, effective 03/11/2019 SSP 28-2018, amend filed 09/06/2018, effective 10/01/2018 SSP 14-2007, f. 12-31-07, cert. ef. 1-1-08 SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07 SSP 14-2005, f. 9-30-05, cert. ef. 10-1-05 SSP 17-2003, f. & cert. ef. 7-1-03 SSP 10-2003(Temp), f. & cert. ef. 5-1-03 thru 9-30-03 AFS 17-2000, f. 6-28-00, cert. ef. 7-1-00 AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99 AFS 7-1999, f. 4-27-99, cert. ef. 5-1-99 AFS 1-1999(Temp), f. & cert. ef. 2-1-99 thru 7-31-99
461-135-0726 Specific Requirements; OSIPM-ICP To be eligible for OSIPM-ICP (Independent Choices Program), a person must meet criteria for In-Home Services and the Independent Choices Program contained in OAR Chapter 411, Division 030. Statutory/Other Authority: ORS 411.060 Statutes/Other Implemented: ORS 411.060 History: SSP 7-2021, minor correction filed 02/18/2021, effective 02/18/2021 SSP 26-2013, f. & cert. ef. 10-1-13 SSP 17-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13 AFS 11-2001, f. 6-29-01, cert. ef. 7-1-01
461-135-0745 Eligibility for Individuals in Acute Care Settings; OSIPM An individual in an acute care hospital or nursing facility is evaluated for Oregon Supplemental Income Program Medical (OSIPM) as follows: (1) The individual must meet all non-financial eligibility requirements for OSIPM. (2) Individuals are considered in their own household group (see OAR 461-110-0210) and filing group (see OAR 461-110-0410). (3) The financial group (see OAR 461-110-0530) consists only of the individual applying for benefits, except that the spouse (see OAR 461-001-0000) is included in the financial group to determine initial eligibility as follows: (a) At initial eligibility, the resources of the spouse are considered and the provisions of OAR 461-160-0580 apply. (b) The income of the spouse is not considered in determining initial eligibility, and the spouse is not included in any other eligibility group. (4) The individual must have countable (see OAR 461-001-0000) income at or below 300 percent of the full Supplemental Security Income (SSI) standard or have established a qualifying trust as specified in OAR 461-145-0540(9)(c). (5) The individual is subject to the home equity limits as described in section (2) of OAR 461-145-0220. (6) The individual must require a continuous period of care (see OAR 461-001-0030). Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.404, 413.085 & 414.685 Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.404, 413.085 & 414.685 History: SSP 41-2024, amend filed 06/20/2024, effective 07/01/2024 SSP 35-2023, minor correction filed 07/18/2023, effective 07/18/2023 SSP 23-2017, f. 9-11-17, cert. ef. 10-1-17 SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09 SSP 10-2007, f. & cert. ef. 10-1-07
461-135-0750 Individuals Applying for or Receiving Long-Term Care or Home and Community-Based Care In the OSIPM program, an individual who does not meet the income requirements for OSIPM under sections (3) or (5) of OAR 461-155-0250 and who meets the following requirements is subject to the OSIPM income limit specified in OAR 461-155-0250(2): (1) The individual meets at least one of the following eligibility standards: (a) The criteria in OAR 411-015-0100 (except subsection (1)(b)) regarding eligibility for nursing facility care or home and community-based care (see OAR 461-001-0030). (b) The level-of-need criteria for an ICF-ID. (c) The service eligibility standards for the CIIS (Children's Intensive In-Home Services) programs in OAR 411-300-0100 to 411-300-0220. (2) The individual resides in or will reside in one of the following locations for a continuous period of care (see OAR 461-001-0030) and is applying for or receiving long-term care services authorized by the Department: (a) A Medicaid-certified nursing facility. (b) An intermediate care facility for individuals with intellectual disabilities (ICF-ID). (c) A home and community-based care setting. (3) For an individual who resides or will reside in a home and community-based care setting, the individual receives Title 1915(c) waivered services. Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.404, 413.085 & 414.685 Statutes/Other Implemented: ORS 409.010, 411.060, 411.070 & 411.404 History: SSP 15-2019, amend filed 06/11/2019, effective 07/01/2019 SSP 23-2017, f. 9-11-17, cert. ef. 10-1-17 SSP 13-2016, f. 3-21-16, cert. ef. 4-1-16 SSP 32-2015(Temp), f. & cert. ef. 12-15-15 thru 6-11-16 SSP 9-2014, f. & cert. ef. 4-1-14 SSP 26-2013, f. & cert. ef. 10-1-13 SSP 17-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13 SSP 17-2008, f. & cert. ef. 7-1-08 SSP 10-2008(Temp), f. & cert. ef. 4-7-08 thru 9-30-08 SSP 10-2007, f. & cert. ef. 10-1-07 SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07 SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07 SSP 19-2005, f. 12-30-05, cert. ef. 1-1-06 SSP 17-2004, f. & cert. ef. 7-1-04 AFS 11-2001, f. 6-29-01, cert. ef. 7-1-01 AFS 7-1999, f. 4-27-99, cert. ef. 5-1-99 AFS 1-1999(Temp), f. & cert. ef. 2-1-99 thru 7-31-99 AFS 13-1991, f. & cert. ef. 7-1-91 AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90
461-135-0755 Individuals Eligible for 1915(i) State Plan Home and Community-Based Services; OSIPM In the OSIPM program, an individual who meets all of the requirements below is subject to the OSIPM income limit specified in OAR 461-155-0250(6): (1) The individual has been assessed by an Independent and Qualified Agent (IQA) and determined eligible to receive 1915(i) Home and Community-Based Services (HCBS) as specified in OAR 410-173-0010. (2) The individual meets one of the following: (a) Resides or will reside in a 24-hour behavioral health residential care setting. For purposes of this rule, only the following types of treatment centers qualify as a 24-hour behavioral health residential care setting: (A) A behavioral health adult foster home. (B) A behavioral health residential treatment home. (C) A behavioral health residential treatment facility. (b) The individual will receive 1915(i) HCBS services in their own home. (3) The individual is not assumed eligible for OSIPM under OAR 461-135-0010, and does not meet the income requirements for OSIPM for those in a standard living arrangement (see OAR 461-001-0000) under section (3) of OAR 461-155-0250. (4) The individual is age 21 or older. Statutory/Other Authority: ORS 409.050, 411.060, 411.404, 413.085 & 414.685 Statutes/Other Implemented: ORS 409.010, 411.060 & 411.404 History: SSP 5-2022, amend filed 02/02/2022, effective 02/02/2022 SSP 77-2021, temporary amend filed 12/20/2021, effective 01/01/2022 through 06/29/2022 SSP 28-2018, amend filed 09/06/2018, effective 10/01/2018 SSP 22-2018, adopt filed 06/05/2018, effective 07/01/2018
461-135-0771 Eligibility for OSIPM Under December 1973 Supplemental Security Income Eligibility (1) An individual is eligible for OSIPM if the individual was eligible for Supplemental Security Income (SSI) in December 1973. (2) An individual is eligible for OSIPM if the individual is the essential spouse of someone eligible for OSIPM under section (1) of this rule. An essential spouse is one who lives in the same household and provides a service that otherwise would have to be provided by some other means. (3) An individual eligible for OSIPM under this rule is considered eligible continuously since December 1973. Statutory/Other Authority: ORS 411.060 Statutes/Other Implemented: ORS 411.060 History: SSP 29-2022, amend filed 02/24/2022, effective 03/01/2022 SSP 79-2021, temporary amend filed 12/22/2021, effective 01/01/2022 through 06/29/2022 AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01
461-135-0790 Eligibility for People in an Institution Since 1973; OSIPM A client living in an institution is eligible for OSIPM even if his or her income exceeds 300 percent of the full SSI payment standard for a person living alone if: (1) The client has continuously met the SSI eligibility criteria used in December 1973 for a person living in an institution; and (2) The client needs institutional care. Statutory/Other Authority: ORS 411.060 Statutes/Other Implemented: ORS 411.060 History: AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99 AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90
461-135-0800 Eligibility for 1972 COLA Clients; OSIPM A client is eligible for OSIPM if he or she meets all eligibility requirements except that his or her income exceeds the income limit because of an SSB cost-of-living increase in July 1972, and if: (1) The client was entitled to receive SSB in August 1972 and received benefits under OSIPM or a state program for the aged, blind or disabled, or were eligible for such a program; or (2) The client would have been eligible for SSB if he or she had not resided in a medical facility. Statutory/Other Authority: ORS 411.060 Statutes/Other Implemented: ORS 411.060 History: AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99 AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90
461-135-0820 Eligibility for Widows and Widowers; OSIPM A widow or widower receiving Title II benefits from the Social Security Administration claim of a deceased spouse or deceased former spouse is eligible for OSIPM if the individual meets all of the following requirements: (1) Is not entitled to premium-free Medicare Part A. (2) Received SSI the month before their Title II payments began. (3) Would continue to be eligible for SSI benefits in the absence of their Title II benefits. Statutory/Other Authority: ORS 411.060 Statutes/Other Implemented: ORS 411.060 History: SSP 44-2016, f. 12-7-16, cert. ef. 1-1-17 AFS 12-2001, f. 6-29-01, cert. ef. 7-1-01 AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99 AFS 6-1994, f. & cert. ef. 4-1-94 AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90
461-135-0830 Eligibility for Disabled Adult Children; OSIPM An individual is evaluated for OSIPM as a Disabled Adult Child if the individual meets all of the following requirements: (1) The individual is age 18 or older. (2) The Social Security Administration has determined that the individual became blind or a person with a disability (as defined by SSA) before reaching the age of 22. (3) The individual lost SSI benefits on or after July 1, 1987 because the individual became eligible for Social Security benefits from a parent’s Social Security benefit as a result of a parent’s retirement, death, or disability, or because of an increase in such benefits. (4) The individual would continue to be eligible for SSI in the absence of the Social Security Disabled Adult Child benefit or increases to that benefit. The amount of the individual’s countable (see OAR 461-001-0000) income is determined as follows: (a) For an individual who loses SSI as a result of receiving an initial award of Title II Disabled Adult Child benefits, the original Title II Disabled Adult Child benefit amount, including any subsequent COLAs, that creates ineligibility for SSI is excluded. (b) For an individual who received both SSI and Title II Disabled Adult Child benefits and who lost SSI as a result of receiving an increase in Title II Disabled Adult Child benefits, the disregard is determined as follows: (A) For individuals who received a non-COLA-related increase to Title II Disabled Adult Child benefits that created ineligibility for SSI, the amount of the increase, and any subsequent COLAs, are excluded and the amount received prior to the increase is used as the countable income amount. (B) For an individual who lost SSI due to an annual Title II COLA, all COLAs received since the last month that the individual was eligible for and received both Title II Disabled Adult Child and SSI benefits are excluded. (c) All other income of the individual is treated according to the administrative rule for that type of asset. (5) An individual receiving Title II Disabled Adult Child benefits must meet the OSIPM resource limit and all other non-financial eligibility requirements. Statutory/Other Authority: ORS 409.050, 411.060, 411.404, 413.085 & 414.685 Statutes/Other Implemented: ORS 409.010, 411.060, 411.404 & 42 USC 1383c History: SSP 11-2018, amend filed 03/09/2018, effective 04/01/2018 SSP 10-2006, f. 6-30-06, cert. ef. 7-1-06 SSP 19-2005, f. 12-30-05, cert. ef. 1-1-06 SSP 33-2003, f. 12-31-03, cert. ef. 1-4-04 AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99 AFS 15-1996, f. 4-29-96, cert. ef. 5-1-96 AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90
461-135-0833 Burial Expenses (1) The Department of Human Services has determined that a plain and decent funeral and disposition of the remains of a decedent can be arranged for an average cost of $6,000. This cost includes all professional services and merchandise. Preparation of the remains will be done in accord with applicable laws and regulations. (2) For individuals dying on or after January 1, 2025, where the Department of Human Services is a claimant in their estate and where there would be insufficient assets remaining after any funeral costs to satisfy the Department's claim in full, not more than $6,000 in estate assets, less any prearranged funeral trust, funds set aside for burial, life insurance policies specifically identified to pay for funeral expenses, or burial insurance, may be expended for funeral expenses and disposition of the remains of the decedent. (3) In instances where a pre-paid funeral plan is sought to be changed for a Medicaid client after their death, and pre-paid funeral funds are refunded, it is the responsibility of the funeral home and the recipient(s) of the funds to inform, in writing, the Department of Human Services, Estate Administration Unit, PO Box 14021, Salem, OR 97309-5024, of any refund within 30 days of such action. Any monies refunded after the client has died are an estate asset and subject to the claims of creditors. (4) The following items are not considered professional services or merchandise and will not be allowable in meeting the plain and decent funeral standard: Transportation of the remains beyond the state of Oregon; and donations to charities in the decedent's name. The aforementioned costs are not all-inclusive and other similar charges may be denied. Statutory/Other Authority: ORS 410.070, 411.060, 411.070 & 414.106 Statutes/Other Implemented: ORS 411.620, 411.630, 411.708, 411.795, 414.105, 416.310 & 416.340 History: SSP 61-2024, amend filed 12/30/2024, effective 01/01/2025 Renumbered from 461-006-0452, SSP 8-2008, f. & cert. ef. 4-1-08 AFS 22-2002, f. 12-31-02, cert. ef. 1-1-03 AFS 9-1999, f. & cert. ef. 7-1-99 AFS 25-1994, f. & cert. ef. 11-1-94 AFS 78-1985, f & cert. ef. 12-9-85 AFS 43-1983(Temp), f. & cert. ef. 7-1-85
461-135-0834 Delivery of Required Notices to the Estate Administration Unit (1) A person required by ORS 93.268, 113.038, 113.145, 114.525, 115.003, 116.093, or 130.370 to send notice to the Oregon Department of Human Services or Oregon Health Authority must send or deliver the notice to the Estate Administration Unit, Office of Payment Accuracy and Recovery, Oregon Department of Human Services using one of the methods in section (5) of this rule. (2) A person required by ORS 114.456 to send information to Oregon Department of Human Services or Oregon Health Authority must send or deliver the notice to the Estate Administration Unit, Office of Payment Accuracy and Recovery, Oregon Department of Human Services using one of the methods in section (5) of this rule. Notices under this section (2) must also include a copy of the decedent’s long form death record, with cause of death. (3) If a claim submitted by the Estate Administration Unit is disallowed, the notice of the disallowance, required by ORS 114.540, 115.135, or 130.400, shall be mailed to the Estate Administration Unit at the address in section (5)(a) of this rule , unless the claim directs that the notice of disallowance be mailed to a person or entity other than the Estate Administration Unit. (4) A trustee of a trust established under 42 USC § 1396p(d)(4) shall send or deliver notice of any termination of the trust or account in a master trust by one of the methods in section (5) of this rule. (5) Notices under this rule may be sent to the to the Estate Administration Unit, Office of Payment Accuracy and Recovery, Oregon Department of Human Services, as follows: (a) The mailing address for the Estate Administration Unit is: Estate Administration Unit, PO Box 14021, Salem OR 97309-5024. (b) The facsimile number for the Estate Administration Unit is: (503)-378-3137. (c) The email address for the Estate Administration Unit is: EAU.notices@odhsoha.oregon.gov Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 413.085 & 414.685 Statutes/Other Implemented: ORS 93.268, 113.145, 114.525, 115.003, 115.135, 116.093, 130.370, 130.400, 409.010, 411.708, 411.795, 416.350, 42 USC 1396p, 113.038 & 114.456 History: SSP 21-2023, amend filed 06/22/2023, effective 07/01/2023 SSP 8-2019, amend filed 03/13/2019, effective 04/01/2019 SSP 28-2016, f. & cert. ef. 8-1-16 SSP 15-2015, f. 3-30-15, cert. ef. 4-1-15 SSP 22-2004, f. & cert. ef. 10-1-04 AFS 5-2002, f. & cert. ef. 4-1-02
461-135-0838 Administering Estate Claims (1) When the Department has a claim against the estate of a deceased person, EAU will be responsible for recovering the claim from the estate. (2) EAU may take necessary action to identify or otherwise preserve assets so they will be available for claims against the estate. (3) EAU will determine the most cost-effective way to dispose of real and personal property. EAU may dispose of the property by conducting sales through licensed real estate brokers, public auctions, competitive bidding, or other methods found most cost-effective. (4) When property has been disposed of, EAU will credit the proceeds to the Department’s claim. Any amounts exceeding the claim will be available to all other claims against the estate. If no other claims exist, any excess amounts will be paid to the heirs or devisees, if any. Any remaining amounts revert to the Division of State Lands. Statutory/Other Authority: ORS 113.145, 130.370, 410.070, 411.060 & 411.070 Statutes/Other Implemented: ORS 411.060, 411.070, 411.404 & 411.710 History: AFS 13-1991, f. & cert. ef. 7-1-91
461-135-0839 Title to Real and Personal Property (1) The Seniors and People with Disabilities Division may take title to real and personal property in performing its duties under ORS 411.630, 411.795, 412.600, 413.200, 414.105, and 416.310. Title shall be taken in the name of the Department. The Department may convey the property by deed or other appropriate conveyance under procedures adopted by rule of the Department: (a) The Department is authorized to convey, as Grantor, property to the Grantee through issuance of the Bargain and Sale Deed or other appropriate conveyances; (b) The Bargain and Sale Deed will be signed by the Assistant Director of the Seniors and People with Disabilities Division or his/her designee. (2) Recording responsibilities of the Deed will be the responsibility of the Grantee unless otherwise agreed upon by the Department. Statutory/Other Authority: ORS 411.060 Statutes/Other Implemented: ORS 411.795 History: AFS 29-1993, f. 12-30-93, cert. ef. 1-1-94 AFS 28-1993(Temp), f. & cert. ef. 11-3-93
461-135-0841 Undue Hardship Waiver Criteria (1) The Department may waive enforcement of any estate recovery claim if it finds that enforcing the claim would result in an undue hardship to the beneficiaries, heirs, or family members of the deceased client claiming entitlement to receive the assets of the deceased client. (2) In determining whether an undue hardship exists, the Department may consider the following criteria: (a) Whether enforcement of the claim would cause the waiver applicant to become eligible for assistance; and (b) Whether enforcement of the claim would cause the waiver applicant, who would otherwise be eligible for assistance, to become homeless. (3) Waiver of an estate recovery claim may include, but is not limited to, the following: (a) Forgiveness of all or part of the claim, or any other relief the Department deems fit; or (b) Taking a mortgage or trust deed in lieu of enforcement of the claim. (4) No waiver will be granted if the Department finds that the undue hardship was created by resort to estate planning methods by which the waiver applicant or deceased client divested, transferred or otherwise encumbered assets, in whole or in part, to avoid estate recovery. (5) No waiver will be granted if the Department finds that the undue hardship will not be remedied by the grant of the waiver. Statutory/Other Authority: ORS 410.070, 411.060 & 414.106 Statutes/Other Implemented: ORS 414.106 & 416.340 History: SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14 AFS 13-2002, f. & cert. ef. 10-1-02 AFS 8-1999, f. 5-27-99, cert. ef. 6-1-99 AFS 41-1995, f. 12-26-95, cert. ef. 1-1-96
461-135-0843 Establishing Legal Title, Interest or Form of Ownership (1) Effective July 18, 1995, The Legal Title to or other Interest of a Person in Real or Personal Property or other Assets shall be presumed to be that set forth in any Ownership Documents. The presumption raised by such Ownership Documents may be rebutted by Convincing Evidence that accurately reflects a Person’s Legal Title to, ownership of or Interest in the Real or Personal Property or other Asset. However, the department shall not consider property or assets in which the decedent held only bare legal title in the capacity as a trustee with no beneficial, equitable, reversionary or other ownership Interest in the property or assets, as property or assets in which the decedent had an Interest or held Legal Title. (2) The form of Interest created by the Ownership Documents shall be governed by the law in effect at the Time of Death of the jurisdiction in which the Real or Personal Property or other Assets are located. Statutory/Other Authority: ORS 411.060 Statutes/Other Implemented: ORS 414.105 History: AFS 29-1996, f. & cert. ef. 8-28-96