Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 110 - ELIGIBILITY GROUPS › Section 461-110-0530 - Financial Group

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Except as provided in section (4) of this
			 rule, the "financial group" consists of the filing group (see OAR
			 461-110-0310) members whose
			 income and resources the Department considers in determining
eligibility
(see OAR
			 461-001-0000) and
			 benefits.
(2) In the Oregon
			 Supplemental Income Program Medical-Employed Persons with
			 Disabilities(OSIPM-EPD), Qualified Medicare Beneficiaries (QMB), and
			 Supplemental Nutrition Assistance Program (SNAP), the "financial group"
			 consists of each individual in the filing group.
(3) In the Refugee Assistance (REF) and
			 Refugee Assistance Medical (REFM) programs, the "financial group" consists of
			 each individual in the filing group, except an individual who is eligible for
			 and receives a Supplemental Security Income(SSI) cash payment.
(4) In the Oregon Supplemental Income Program
			 Medical (OSIPM) (except OSIPM-EPD):
(a) For
			 the purposes of this section of this rule, "ineligible" means an individual not
			 eligible to receive either SSIor Temporary Assistance for Needy Families (TANF)
			 program benefits.
(b) When an
			 individual lives in a
standard living arrangement
(see OAR
			 461-001-0000):
(A) Except as provided in paragraph (B) of
			 this subsection, each member of the filing group is in the "financial
			 group".
(B) When an individual is
			 married, not
assumed eligible
(see OAR
			 461-135-0010) for OSIPM, and the
			 individual's
spouse
(see OAR
			 461-001-0000) is considered
			 "ineligible" (see subsection (a) of this section):
(i) If the individual's
adjusted
			 income
(see OAR
			 461-001-0000) using the
			 deductions allowed under OAR
			 461-160-0550(4),
			 or after being evaluated under certain protected groups (see OAR
			 461-135-0771 to OAR
			 461-135-0830), is greater than
			 the OSIPM program
adjusted income
standard for a
need
			 group
of one under OAR
			 461-155-0250, the individual is
			 in theirown "financial group" and not eligible for OSIPM.
(ii) When there are children in the home, if
			 the
ineligible
spouse's remaining
countable
(see OAR 461-001-0000) income after
			 allocation (see OAR 461-160-0551) to each
ineligible
child is equal to or less than the difference
			 between the couple and the individual SSI standards: the
spouse
is not included in the "financial group" when
			 determining income
eligibility
; however, the
spouse
is included in the "financial group" when determining
			 resource
eligibility
.
(iii) When there are no children in the home,
			 if the
ineligible
spouse's
countable
income
			 is less than the difference between the couple and the individual SSI
			 standards: the
spouse
is not included in the "financial group"
			 when determining income
eligibility
; however, the
spouse
is included in the "financial group" when determining
			 resource
eligibility
.
(c) When an individual is in a
nonstandard living arrangement
(see OAR
			 461-001-0000), or the individual
			 is beingevaluated underOAR
			 461-135-0745, and the
community spouse
is not in the
household
			 group
; the
community spouse
is included in the
			 "financial group" to determine initial
eligibility
as follows:
(A) At initial
eligibility
,
			 the resources of the
community spouse
are considered in order
			 to calculate the
community spouse
resource allowance and the
			 provisions of OAR 461-160-0580 apply.
(B) The income of the
community
			 spouse
is not considered in determining initial
eligibility
except when calculating the
community
			 spouse
resource allowance as specified in OAR
			 461-160-0580, and the
community spouse
is not included in any other
eligibility
group.