reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0210 - Payment Standards and Methods of Issuance; GA

Current through Register Vol. 63, No. 7, July 1, 2024
(1) For purposes of this rule, "eligible
			 spouse" means a
spouse
(see OAR
			 461-001-0000) who is eligible
			 for and receiving OSIPM under OAR
			 461-125-0370(c).
(2) The GA payment standards are:
(a) $615 for one person.
(b) $921 for two persons.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0225 - Income Standard; REFM

Current through Register Vol. 63, No. 7, July 1, 2024
In the REFM program, the adjusted income standard is 200
				percent of the federal poverty level, as listed in OAR
				461-155-0180, based on the size
				of the need group (see OAR
				461-110-0630).
Statutory/Other Authority: ORS
				  409.050,
				  411.060,
				  411.070,
				  411.404 &
				  414.231
Statutes/Other Implemented: ORS
				  409.010,
				  411.060,
				  411.070,
				  411.404 &
				  414.231
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0250 - Income and Payment Standard; OSIPM

Current through Register Vol. 63, No. 7, July 1, 2024
In the OSIPM program:
(1) An individual who is assumed eligible per
			 OAR 461-135-0010 is presumed to meet
			 the income limits for the OSIPM program.
(2) An individual meeting the requirements of
			 OAR 461-135-0745 or OAR
			 461-135-0750, who is not assumed
			 eligible and does not meet the income standards set out in sections (3) or (5)
			 of this rule, must have
countable
(see OAR
			 461-001-0000) income that is
			 equal to or less than 300 percent of the full Supplemental Security Income
			 (SSI) standard for a single individual or have established a qualifying trust
			 as specified in OAR 461-145-0540(9)(c).
(3) An individual, other than one identified
			 in sections (1), (2), (5), or (6) of this rule, must have
adjusted
			 income
(see OAR
			 461-001-0000) below the standard
			 in this section.
OSIPM Adjusted Income Standards
Number in Need Group ......... One ................. Two
AB/AD/OAA ......... 943 ............ 1,415
(4) In the OSIPM (except OSIPM-EPD) program,
			 an individual receiving Medicaid services in a nursing facility or an ICF-ID is
			 allowed the following amounts for clothing and personal incidentals:
(a) For an individual who receives a VA
			 pension based on unreimbursed medical expenses (UME), $90 is allowed.
(b) For all other individuals, $77.14 is
			 allowed.
(c) For an individual
			 identified in subsection (b) of this section with
countable
income (including any SSI) that is less than $77.14, the payment standard is
			 equal to the difference between the individual's
countable
income (including any SSI) and $77.14. For the purposes of this subsection,
countable
income includes income that would otherwise be
countable
for an individual who is assumed eligible under OAR
			 461-135-0010.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0270 - Room and Board Standard; Community-Based Care

Current through Register Vol. 63, No. 7, July 1, 2024
For an individual residing in a
community-based care
				facility
(see OAR
				461-155-0630(1)),
				the room and board standard is $733. An individual residing in a
community-based care facility
must pay room and
				board.
Statutory/Other Authority: ORS
				  411.060,
				  411.070,
				  411.704,
				  411.706, ORS
				  409.050,
				  411.404,
				  413.085 &
				  414.685
Statutes/Other Implemented: ORS
				  411.060,
				  411.070,
				  411.704,
				  411.706, ORS
				  409.010,
				  411.404 & P.L.
				  92-336
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0290 - Income Standard; QMB-BAS

Current through Register Vol. 63, No. 7, July 1, 2024
The adjusted income standard for the Qualified Medicare
				Beneficiaries - Basic (QMB-BAS) program is 100 percent of the 2024 federal
				poverty level.
QMB-BAS Adjusted Income Standard
No. in Need Group
						  ..............................
Amount
1 .
						  ...........................................................
$1,255
2 .
						  ...........................................................
1,704
3 .
						  ...........................................................
2,152
4 .
						  ...........................................................
2,600
5 .
						  ...........................................................
3,049
6 .
						  ...........................................................
3,497
7 .
						  ...........................................................
3,945
8 .
						  ...........................................................
4,394
9 .
						  ...........................................................
4,842
10 .
						  .........................................................
5,290
Each additional person
						  .......................
+ 449
To view attachments referenced in rule text,
click here to view
				  rule
.
Statutory/Other Authority: ORS
				  411.060,
				  411.070,
				  411.404, ORS
				  409.050,
				  413.085 &
				  414.685
Statutes/Other Implemented: ORS
				  411.060,
				  411.070,
				  411.404, ORS
				  409.010,
				  42 CFR
				  400.200 &
				  42 USC
				  1396d(p)
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0291 - Income Standard; QMB-DW

Current through Register Vol. 63, No. 7, July 1, 2024
The adjusted income standard for the Qualified Medicare
				Beneficiaries - Disabled Worker (QMB-DW) program is 200 percent of the 2024
				federal poverty level (see OAR
				461-155-0290).
QMB-DW Adjusted Income Standard
No. in Need Group
						  ..............................
Amount
1 .
						  ...........................................................
$2,510
2 .
						  ...........................................................
3,407
3 .
						  ...........................................................
4,304
4 .
						  ...........................................................
5,200
5 .
						  ...........................................................
6,097
6 .
						  ...........................................................
6,994
7 .
						  ...........................................................
7,890
8 .
						  ...........................................................
8,787
9 .
						  ...........................................................
9,684
10 .
						  .........................................................
10,580
Each additional person
						  .......................
+ 897
To view attachments referenced in rule text,
click here to view
				  rule
.
Statutory/Other Authority: ORS
				  411.060,
				  411.070,
				  411.404, ORS
				  409.050,
				  413.085 &
				  414.685
Statutes/Other Implemented: ORS
				  411.060,
				  411.070,
				  411.404, ORS
				  409.010,
				  42 CFR
				  400.200 &
				  42 USC
				  1396d(s)
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0295 - Income Standard; QMB-SMB, QMB-SMF

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Eligibility for Qualified Medicare
			 Beneficiaries - Specified Low Income Medicare Beneficiary (QMB-SMB) requires
			 income greater than 100 percent (see OAR
			 461-155-0290) but less than 120
			 percent of the federal poverty level. The adjusted income standard for QMB-SMB
			 is 120 percent of the 2024 federal poverty level.
QMB-SMB Adjusted Income Standard
(Case Descriptor SMB)
No. in Need Group
						  ..............................
Amount
1 .
						  ...........................................................
$1,506
2 .
						  ...........................................................
2,044
3 .
						  ...........................................................
2,582
4 .
						  ...........................................................
3,120
5 .
						  ...........................................................
3,658
6 .
						  ...........................................................
4,196
7 .
						  ...........................................................
4,734
8 .
						  ...........................................................
5,272
9 .
						  ...........................................................
5,810
10 .
						  .........................................................
6,348
Each additional person
						  .......................
+ 538
(2)
			 Eligibility for Qualified Medicare Beneficiaries - Supplemental Medicare Full
			 (QMB-SMF) requires income equal to or greater than 120 percent (see section (1)
			 of this rule) but less than 135 percent of the federal poverty level. The
			 adjusted income standard for QMB-SMF is 135 percent of the 2024 federal poverty
			 level.
QMB-SMF Adjusted Income Standard
(Case Descriptor SMF)
No. in Need Group
						  ..............................
Amount
1 .
						  ...........................................................
$1,695
2 .
						  ...........................................................
2,300
3 .
						  ...........................................................
2,905
4 .
						  ...........................................................
3,510
5 .
						  ...........................................................
4,116
6 .
						  ..........................................................
4,721
7 .
						  ...........................................................
5,326
8 .
						  ...........................................................
5,931
9 .
						  ...........................................................
6,537
10 .
						  .........................................................
7,142
Each additional person
						  .......................
+ 606
To view attachments referenced in rule text,
click here to view
				  rule
.
Statutory/Other Authority: ORS
				  411.060,
				  411.070, ORS
				  409.050,
				  413.085 &
				  414.685
Statutes/Other Implemented: ORS
				  411.060,
				  411.070, ORS
				  409.010 &
				  42 USC
				  1396a(10)(E)(iii) and (iv)
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0300

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  411.060 &
				  411.070
Stats. Implemented: ORS
				  411.060 &
				  411.070
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0310 - Special Shelter Allowance; REF, TANF

Current through Register Vol. 63, No. 7, July 1, 2024
The Special Shelter Allowance is included in the REF and TANF
				Payment. It is an advance of the ERA refund per ORS
				412.155:
Special Shelter Allowance
No. in Need Group - Amount
1 - $22.35
2 - 22.35
3 - 21.14
4 - 20.34
5 - 19.53
6 - 18.73
7 - 17.92
8 - 17.12
9 - 16.32
10 or more - 14.71
Stat. Auth.: ORS
				  411.060,
				  411.070,
				  411.081,
				  411.085,
				  412.006,
				  412.049 &
				  412.155
Stats. Implemented: ORS
				  411.060,
				  411.070,
				  411.081,
				  411.085,
				  412.006,
				  412.049 &
				  412.155
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0320 - Payment Standard; SFPSS

Current through Register Vol. 63, No. 7, July 1, 2024
In the SFPSS program the following payment standards
				apply:
(1) When one
adult
(see section (5) of this rule) in the
filing
			 group
(see OAR
			 461-110-0330) is applying for
			 SSI: [see attached table]
(2) When
			 there are two individuals in the
filing group
who are either a
parent
(see OAR
			 461-001-0000) or a
caretaker relative
(see OAR
			 461-001-0000), and one of them
			 is an
adult
and applying for SSI: [see attached
			 table]
(3) When two adults (see
			 section (5) of this rule) in the
filing group
are applying for
			 SSI: [see attached table]
(4) The
			 standard for eleven individuals or more in the
need group
(see
			 OAR 461-110-0530) is the sum of the
			 Adults Amount for ten individuals in the
need group
, plus $110
			 for each additional individual in the
need group
. (The
			 additional
adult
portion in sections (1), (2), and (3) would
			 be $110.)
(5) For purposes of this
			 rule, "adult" means an individual who is age 18 years or older, and either a
parent
or
caretaker relative
.
To view tables referenced in rule text,
click here to view
				  rule
.
Statutory/Other Authority: ORS
				  409.050,
				  411.060,
				  411.070,
				  412.006,
				  412.014 &
				  412.049
Statutes/Other Implemented: ORS
				  409.050,
				  411.060,
				  411.070,
				  412.006,
				  412.014 &
				  412.049
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0350 - Minimum Contribution Standard

Current through Register Vol. 63, No. 7, July 1, 2024
The Minimum Contribution Standard is used to determine which
				portion of a lodger's income is excluded for REF, REFM, and TANF. [Table not
				included. See ED. NOTE.]
Tables referenced are not included in rule text.
Click here for PDF copy of
				  table(s)
Stat. Auth.: ORS
				  411.060,
				  411.070,
				  411.081,
				  411.083,
				  411.085,
				  411.404,
				  412.006,
				  412.049
Stats. Implemented: ORS
				  411.070,
				  411.081,
				  411.083,
				  411.085,
				  411.404,
				  412.006,
				  412.049
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0360 - Pursuit of Cost-Effective Employer Sponsored Health Insurance

Current through Register Vol. 63, No. 7, July 1, 2024
(1) This rule
			 applies to the OSIPM program and is for the purpose of applying OAR
			 461-120-0345.
(2) The Health Insurance Group (HIG)
			 determines if employer sponsored health insurance meets the criteria as cost
			 effective for the purpose of OAR
			 410-120-1960.
(3) If the insurance is determined to be cost
			 effective and the client or eligible applicant pursues the insurance, HIG will
			 authorize reimbursement of the client or eligible applicant's portion of the
			 premium per OAR 410-120-1960.
(4) If the insurance is determined to be cost
			 effective and the client or eligible applicant fails to pursue cost effective
			 employer sponsored insurance, the Department will apply a penalty per OAR
			 461-120-0345.
Stat. Auth.: ORS
				  411.060,
				  411.404
Stats. Implemented: ORS
				  411.060,
				  411.404
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0500 - Special Needs; Overview

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Ongoing special needs are needs that last several months at a consistent cost.
			 Examples are special diets and accommodation allowances. OAR
			 461-155-0010 is used to
			 determine how special needs are considered for each program.
(2) To be eligible for a special need item,
			 an individual may not have any other available resources in the community or
			 natural support system to meet the need, excluding resources used in
			 determining eligibility.
(3) To be
			 eligible for a special need item, an individual may not be eligible for the
			 item through Medicare, Medicaid, or any other medical coverage.
(4) An individual may be eligible for an
			 ongoing special need item if providing the ongoing special need item is
			 authorized in lieu of additional provider service hours pursuant to OAR
			 411-030-0002 to
			 411-030-0090 and is more
			 cost-effective.
(5) The Department
			 may authorize payment for one-time and ongoing special needs for the following,
			 in accordance with OAR
			 461-155-0510 to
			 461-155-0710:
(a) One-time needs for the following:
(A)
Community-based care
			 facility
(see OAR
			 461-155-0630) room and
			 board.
(B) Community transition
			 services (see OAR 461-155-0526).
(C) Diversion and transition services (see
			 OAR 461-155-0710).
(D) Home repairs (see OAR
			 461-155-0600).
(E) Moving costs (see OAR
			 461-155-0610).
(F) Property taxes (see OAR
			 461-155-0620).
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0510 - Special Need in Combined OSIP/REF/TANF Cases

Current through Register Vol. 63, No. 7, July 1, 2024
(1) For OSIP and OSIPM families who receive
			 other cash program benefits, any special need that can be met through the other
			 benefit payment will not be met in the OSIP benefit.
(2) When a special need item is for an
			 individual, rather than a benefit group, include the special need item in the
			 program from which the individual is receiving benefits.
Stat. Auth.: ORS
				  411.060,
				  411.070,
				  411.081,
				  411.083,
				  411.085,
				  411.404,
				  411.706,
				  411.816,
				  412.006,
				  412.014 &
				  412.049
Stats. Implemented: ORS
				  411.060,
				  411.070,
				  411.081,
				  411.083,
				  411.085,
				  411.404,
				  411.706,
				  411.816,
				  412.006,
				  412.014 &
				  412.049
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0526 - Special Need; Community Transition Services; OSIP and OSIPM

Current through Register Vol. 63, No. 7, July 1, 2024
In the OSIP and OSIPM programs:
(1) When an individual who has been admitted
			 as an inpatient is leaving a psychiatric hospital or is being transitioned out
			 of a nursing facility:
(a) The Department may
			 authorize one-time payments for allowable expenses necessary to set up housing
			 in Oregon in the individual's own home or apartment, or a community-based care
			 facility.
(b) Payments made to a
			 community-based care facility under subsection (a) of this section may only be
			 made if the facility is not required to provide the item covered by the payment
			 by contract or by the administrative rules governing assisted living facilities
			 (OAR 411-054-0000 to
			 411-054-0300). Payments are
			 allowed only for an individual leaving a psychiatric hospital or nursing
			 facility and returning to the community if the individual meets the criteria
			 for one of the service priority levels served by the Department according to
			 OAR 411-015-0015(1).
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0530 - Special Need; Food for Guide Dogs and Special Assistance Animals

Current through Register Vol. 63, No. 7, July 1, 2024
(1) For an OSIP or
			 OSIPM program client receiving SSI, having an adjusted income less than the
			 OSIPM program standard under OAR
			 461-155-0250, or receiving home
			 and community-based care (see OAR
			 461-001-0030), a food allowance
			 is allowed for guide dogs and special assistance animals that are individually
			 trained to:
(a) Meet the client's specific
			 medical needs by performing tasks, such as alerting and protecting a client who
			 is having a seizure; or
(b)
			 Perform specific physical tasks that the client is unable to do, such as
			 picking up items that are dropped, turning on light switches, and pulling a
			 wheelchair.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0551

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  411.060
Stats. Implemented: ORS
				  411.060
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0575 - Special Need; In-home Supplement; OSIPM

Current through Register Vol. 63, No. 7, July 1, 2024
In the OSIPM program:
(1) The Department may provide a monthly
			 supplementary payment for an individual who meets the requirements of all of
			 the following subsections:
(a) The individual
			 must receive SSI as his or her only source of countable (see OAR
			 461-001-0000) income.
(b) The individual must receive home and
			 community-based care (see OAR
			 461-001-0030) in-home services
			 or State Plan Personal Care Services authorized under OAR chapter 411, division
			 034.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0580 - Special Need; Laundry Allowances

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OSIP and OSIPM clients who are receiving
			 SSI or home and community-based care (see OAR
			 461-001-0030) or have adjusted
			 income less than the OSIPM program income standard under OAR
			 461-155-0250 are eligible for a
			 laundry allowance if they have proven, excessive, coin-operated laundry
			 facility costs and do not:
(a) Have their own
			 laundry facilities; or
(b) Reside
			 in an adult foster home, assisted living facility, nursing facility,
			 residential care facility, or specialized living facility, unless the
			 specialized living facility is apartment based.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0600 - Special Need; Home Repairs; OSIP and OSIPM

Current through Register Vol. 63, No. 7, July 1, 2024
In the OSIP and OSIPM programs, the Department will authorize a
				special need payment for home repairs for homeowners or buyers as a onetime
				special need within the following limits:
(1) The repairs must be needed to remove a
			 physical hazard to the health and safety of the client.
(2) Payment for repairs authorized by this
			 rule:
(a) Is limited to the least expensive
			 means possible;
(b) May not exceed
			 $1,000 in any 24-month period; and
(c) When the home is jointly owned, is
			 limited to a percentage of the cost of the repairs equal to the percentage of
			 client ownership.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0610 - Special Need; Moving Costs; OSIP and OSIPM

Current through Register Vol. 63, No. 7, July 1, 2024
For clients who are 18 years of age or older in the OSIP and
				OSIPM programs:
(1) The Department
			 will authorize payment for the cost of moving a client's household effects as a
			 one-time special need if the requirements of at least one of the following
			 subsections are met:
(a) Moving is essential
			 to provide nonhazardous housing. "Hazardous" housing means a building so
			 deteriorated and unsafe that it is uninhabitable or subject to condemnation. If
			 no official certification to that effect can be obtained, the condition of the
			 dwelling must have been seen by a Department employee and documented in the
			 case record.
(b) The client has
			 been evicted for reasons other than his or her own neglect or failure to make
			 rent or house payments.
(c) The
			 move is necessary to protect the safety of the client and is a result of the
			 client being the victim of domestic violence (see OAR
			 461-001-0000) or abuse (see OAR
			 411-020-0002).
(d) For a client in a nonstandard living
			 arrangement (see OAR 461-001-0000), a move is
			 necessary because the level of services of the client increases or
			 decreases.
(e) The needs of the
			 client would be better met out of state.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0620 - Special Need; Property Taxes

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 OSIP and OSIPM clients who are homeowners or buyers are allowed a special need
			 of one year in an amount equal to the cost of delinquent real property taxes,
			 penalties and interest, if needed to prevent imminent foreclosure (see section
			 (4) of this rule).
(2) Clients
			 whose property taxes have not been paid and who are eligible for the Oregon
			 Property Tax Deferral Program must opt to defer property taxes. If necessary,
			 the state may provide payment for back property taxes, to bring the tax
			 current, to allow clients to defer their ongoing property taxes.
(3) Clients who have not chosen to defer
			 their property taxes and whose property taxes have not been paid will not
			 receive a property tax special need payment unless an exception is authorized
			 by the Department's Estate Administration Unit. The exception will be based on
			 the value of the property, the potential of foreclosure, and the potential of
			 an Estate Administration Unit recovery of such property.
(4) Imminent foreclosure is indicated by a
			 formal notice of foreclosure.
Stat. Auth.: ORS
				  409.050,
				  411.060,
				  411.070,
				  411.404,
				  411.706,
				  411.710,
				  413.085,
				  414.685
Stats. Implemented: ORS
				  409.010,
				  411.060,
				  411.070,
				  411.404,
				  411.706,
				  411.710,
				  413.085,
				  414.685
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0630 - Special Need; Community-Based Care; OSIPM

Current through Register Vol. 63, No. 7, July 1, 2024
In the OSIPM program:
(1) An individual is considered living in a
community-based care
(see OAR
			 461-001-0000) facility if the
			 individual resides at one of the following care settings licensed by the
			 Department:
(a) Adult Foster Home.
(b) Residential Care Facility.
(c) Assisted Living Facility.
(d) Specialized Living Facility.
(e) Group Care Home.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0640

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  411.060
Stats. Implemented: ORS
				  411.060,
				  411.706
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0660 - Special Need; Accommodation Allowance

Current through Register Vol. 63, No. 7, July 1, 2024
Retroactively effective July 6, 2020, an OSIPM recipient may
				receive an accommodation allowance as follows:
(1) Temporary absence of individual from
			 home.
(a) A temporary accommodation allowance
			 may be authorized if an individual meets all the following requirements:
(A) The individual owns, rents or leases a
			 primary residence.
(B) The
			 individual leaves his or her home or rental property and temporarily receives
			 services in a hospital, nursing facility, residential care facility, assisted
			 living facility, adult foster home, specialized living facility or state
			 psychiatric institution.
(C) Except
			 for a temporary absence from the primary residence, the individual must be
			 eligible to receive in-home services under OAR chapter 411 division
			 030.
(D) The individual cannot
			 afford to keep the home or rental property without the allowance.
(E) The individual will be able to return
			 home or rental property within six months of leaving, according to a written
			 statement from a primary practitioner, RN, or PAS (pre-admission screening)
			 RN.
(F) The home or rental property
			 will accommodate the service plan of the individual when the individual
			 returns.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0670 - Special Need; Special Diet Allowance

Current through Register Vol. 63, No. 7, July 1, 2024
(1) In the OSIPM program, an individual
			 receiving any of the following is ineligible for a special diet allowance:
(a) Room and board.
(b) Residential care facility services or
			 assisted living facility services.
(c) Nursing facility services.
(d) Adult foster care services.
(e) An allowance for restaurant
			 meals.
(f) A commercial food
			 preparation diet.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0680 - Special Need - Supplemental Communication Allowance; OSIPM

Current through Register Vol. 63, No. 7, July 1, 2024
In the OSIPM program:
(1) The Department provides a communication
			 allowance to clients meeting the requirements of at least one of the following
			 subsections if the client is 18 years of age or older and unable to leave the
			 residence of the client due to a documented medical condition without the
			 assistance of another person:
(a) Clients
			 receiving SSI.
(b) Clients whose
			 adjusted income is less than the OSIPM program standard under OAR
			 461-155-0250.
(c) Clients receiving in-home services under
			 OAR chapter 411 division 030.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0688 - Prescription Drug Co-pay Coverage

Current through Register Vol. 63, No. 7, July 1, 2024
In the OSIPM program for a client who is receiving SSI:
(1) The Department will provide a payment for
			 all Medicare Part D or Veteran's Administration Health Care prescription
			 co-pays if a client's co-pays exceed $10 per month.
(2) Payment for Medicare Part D co-pays is
			 limited to the current Low-Income Subsidy (LIS) program amounts for a fully
			 dual eligible individual under 100 percent of the Federal Poverty Limit.
(3) If the payment exceeds $30 per
			 month, it must be approved by Aging and People with Disabilities central office
			 staff.
Stat. Auth.: ORS
				  409.050,
				  411.060,
				  411.404,
				  411.706,
				  413.085,
				  414.685
Stats. Implemented: ORS
				  409.010,
				  411.060,
				  411.083,
				  411.404,
				  411.704,
				  411.706,
				  413.085,
				  414.685
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0700 - Special Need; Personal Incidentals and Room and Board Allowances; OSIPM

Current through Register Vol. 63, No. 7, July 1, 2024
In the OSIPM program:
(1) In the following circumstances, personal
			 incidentals and room and board allowances may be paid for an individual to
			 reside in a
community-based care facilit
y (see OAR
			 461-155-0630(1))
			 to avoid placement in a nursing facility or leave a nursing facility or an
			 acute care hospital, when an individual meets the requirements of one of the
			 following subsections:
(a) Is determined to be
			 eligible based on a disability determination made by the Department (see OAR
			 461-125-0370).
(A) To receive this payment, the individual
			 must pursue Supplemental Security Income (SSI) by making application with the
			 Social Security Administration (SSA) and appealing denials until SSA makes a
			 final administrative decision. If SSI is denied at the final SSA administrative
			 level, the individual is no longer eligible for this payment.
(B) The payment is the difference between the
			 countable (see OAR 461-001-0000) income of the
			 individual and the OSIPM program adjusted income standard (see OAR
			 461-155-0250).
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 155 - INCOME AND PAYMENT STANDARDS, AND SPECIAL NEEDS › Section 461-155-0710 - Special Need; Diversion Services; OSIP and OSIPM

Current through Register Vol. 63, No. 7, July 1, 2024
In the OSIP and OSIPM programs:
(1) The Department may authorize one-time
			 payments for expenses that the Department has determined are necessary to
			 divert individuals who might otherwise be served in nursing facilities to
community based care
(see OAR
			 461-001-0000). Payments are
			 allowed for individuals who meet the criteria established in OAR
			 411-015-0015(1)(a).
(2) Payments will be authorized at the lowest
			 possible cost.
(3) To be eligible
			 for payment, individuals may not be eligible for the item through Medicare,
			 Medicaid, or any other medical coverage.
(4) Payment for a household item is not
			 allowed if the
community-based care
facility (see OAR
			 461-155-0630) is required to
			 provide the item by contract or administrative rule.
(5) Payment is not allowed if the item or
			 service may be provided under any other special need rule in this division (OAR
			 461-155-0510 to
			 461-155-0700).
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
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0010 - Use of Resources in Determining Financial Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
Countable
(see OAR
				461-001-0000) resources are used
				to determine
eligibility
(see OAR
				461-001-0000) as follows:
(1) In the EA program, the
countable
resources of a
financial group
(see
			 OAR 461-110-0530) are used to reduce
			 benefits.
(2) In the QMB-DW, REF,
			 REFM, and TANF programs, a
need group
(see OAR
			 461-110-0630) is not eligible
			 for benefits if the
financial group
has
countable
resources above the resource limit (see OAR
			 461-160-0015).
(3) In the SNAP program, unless
categorically eligible
(see OAR
			 461-135-0505), a
need
			 group
is not eligible for benefits if the
financial
			 group
has
countable
resources above the resource
			 limit (see OAR 461-160-0015).
(4) In the OSIP (except OSIP-EPD) and OSIPM
			 (except OSIPM-EPD) programs:
(a) An individual
			 is not eligible for benefits if the
financial group
has
countable
resources above the resource limit (see OAR
			 461-160-0015).
(b) The following provisions apply when a
child
(see OAR
			 461-001-0000) who is not
assumed eligible
(see OAR
			 461-135-0010) is applying:
(A) As used in the subsection, "ineligible
			 parent" means a
parent
(see OAR
			 461-001-0000) who is not
			 receiving Supplemental Security Income (SSI) or TANF.
(B) As used in this section, "parental
			 resources" means the
countable
resources of:
(i) Each
ineligible parent
(see paragraph (A) of this subsection) in the
financial group
of the
child
; and
(ii) Each
spouse
(see OAR
			 461-001-0000) of an
ineligible
parent
in the
financial
			 group
of the
child
.
(C) The
parental resources
(see paragraph (B) of this subsection) are deemed available to the
child
. The amount deemed available to the
child
is the amount the
parental resources
exceed the resource limit (see OAR
			 461-160-0015) of:
(i) A one-person
need group
,
			 if one
parent
(see OAR
			 461-001-0000) lives in the
			 household of the
child
; or
(ii) A two-person
need
			 group
, if two parents (or one
parent
and the
spouse
(see OAR
			 461-001-0000) of that parent)
			 live in the household of the
child
.
(D) If more than one
child
is applying, the value of the deemed resources is divided evenly between the
			 applying children. If an applying
child
is determined to be
			 ineligible for OSIPM for any reason including excess resources resulting from
			 deeming, no resources are deemed to that
child
. Any resources
			 deemed to an applying
child
determined to be ineligible for
			 OSIPM are deemed equally to other applying children.
(E) The
parental resources
are not deemed available to a non-applying
child
.
(F) The value of the
parental
			 resources
is subject to deeming whether or not those resources are
			 available to the
child
.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0015 - Resource Limits

Current through Register Vol. 63, No. 7, July 1, 2024
(1) In the EA
			 program, all
countable
(see OAR
			 461-001-0000) resources must be
			 used to meet the emergent need.
(2)
			 In the OSIP and OSIPM programs, the resource limit is as follows:
(a) $2,000 for a one-person
need
			 group
(see OAR
			 461-110-0630) and $3,000 for a
			 two-person
need group
.
(b) $5,000 for the OSIP-EPD and OSIPM-EPD
			 programs (see OAR 461-001-0035 and
			 461-145-0025 for funds that may
			 be excluded as approved accounts).
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0030 - Overview of Costs

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Costs
			 incurred by the filing group that the filing group has a legal responsibility
			 to pay are deductible from income in accordance with the rules in this division
			 of rules.
(2) The following costs
			 are not deductible:
(a) A cost paid by
			 someone outside the filing group through a reimbursement, vendor payment, or
			 in-kind benefit.
(b) A cost that is
			 paid by a person or company outside the filing group or that is written off by
			 a medical facility. These are referred to as third-party payments.
(c) The cost for a service provided by
			 someone in the filing group, such as child care provided by the father while
			 the mother works.
(d) A cost used
			 as an income deduction in one budget month or averaged over several months
			 cannot be used again.
(e) In the
			 OSIPM program, a cost that the client incurred while the client was serving a
			 disqualification from Medicaid under OAR
			 461-140-0210 to
			 461-140-0300 for a transfer of
			 assets for less than fair market value.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0040 - Dependent Care Costs Deduction; SNAP

Current through Register Vol. 63, No. 7, July 1, 2024
In the SNAP Program:
(1) Dependent care is deductible (see OAR
			 461-160-0430) when all of the
			 following are true:
(a) The dependent is a
			 member of the
filing group
(see OAR
			 461-110-0310 and OAR
			 461-110-0370) and is in the
			 care, control, and custody of an individual in the group.
(b) The dependent care provider:
(A) Is not in the
filing
			 group
; and
(B) Is not the
parent
(see OAR
			 461-001-0000) of the
			 dependent.
(c) The
			 dependent care is necessary because the
caretaker
(see OAR
			 461-001-0000) is working,
			 commuting, on a meal break, in training, participating in pre-employment
			 education, or participating in a SNAP Employment and Training
case
			 plan
(see OAR
			 461-001-0020).
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0055 - Medical Costs That Are Deductible; OSIP, OSIPM, and SNAP

Current through Register Vol. 63, No. 7, July 1, 2024
(1) This rule
			 applies to SNAP filing group (see OAR
			 461-110-0370) members who are
			 elderly (see OAR 461-001-0015) or who have a
			 disability (see OAR 461-001-0015), and to clients in
			 the OSIP and OSIPM programs.
(2)
			 Medical costs are deductible to the extent a deduction is authorized in OAR
			 461-160-0415 and
			 461-160-0430 and in this
			 rule.
(3) Health and
			 hospitalization insurance premiums and coinsurance are deductible. In the OSIPM
			 and SNAP programs, health insurance premiums paid less frequently than monthly
			 may be prorated over the period covered by the premium.
(4) In the OSIPM and SNAP programs:
(a) Long-term care insurance premiums are
			 deductible if the insurance pays for services while an individual is;
(A) Receiving home and community-based care
			 (see OAR 461-001-0030);
(B) Receiving nursing facility services;
			 or
(C) In an intermediate care
			 facility for individuals with intellectual disabilities (ICF/IID).
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0060 - Use of Rounding in Calculating Benefit Amount

Current through Register Vol. 63, No. 7, July 1, 2024
(1) In the REF and TANF programs, a benefit
			 amount not a whole number of dollars is rounded down to the next lower whole
			 dollar.
(2) In the GA, OSIP, OSIPM,
			 and QMB programs, rounding is not used.
(3) In the SNAP program:
(a) Except as provided in subsection (b) of
			 this section, when income and deductions are calculated, a figure ending with
			 less than 50 cents is rounded to the next lower dollar and a figure ending with
			 50 cents or more is rounded to the next higher dollar.
(b) After multiplying the adjusted income by
			 30 percent, any amount from 1 to 99 cents is rounded up to the next higher
			 dollar.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0070 - Benefits for Less Than a Full Month

Current through Register Vol. 63, No. 7, July 1, 2024
In the GA, OSIP, REF, SNAP, and TANF programs, if in a month a
				benefit group is eligible for less than a full month's benefits (such as the
				initial and closing months), benefits for that month are determined as
				follows:
(1) The benefit amount for a
			 full month is determined.
(2) The
			 full benefit amount is divided by the number of days in the payment month to
			 determine the daily benefit.
(3)
			 The daily benefit is multiplied by the number of days in the month the group is
			 eligible. The result is the benefit amount for the partial month (prorated
			 benefit), except as adjusted by section (4) of this rule.
(4) Rounding is used in the calculation of
			 the prorated benefit as follows:
(a) In the
			 REF, SNAP, and TANF programs, if the prorated benefit is not a whole dollar
			 amount, the prorated benefit is rounded to the next lower whole
			 dollar.
(b) In the GA and OSIP
			 programs, the prorated benefit is not rounded.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0090 - Employment and Independence Expenses; OSIP-EPD and OSIPM-EPD

Current through Register Vol. 63, No. 7, July 1, 2024
In the OSIP-EPD and OSIPM-EPD programs, an employment and
				independence expense (see OAR
				461-001-0035) must be approved
				by the branch office prior to its use as a deduction from countable income (see
				OAR 461-140-0010).
Stat. Auth.: ORS
				  411.060,
				  411.070,
				  414.042
Stats. Implemented: ORS
				  411.060,
				  411.070,
				  414.042
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0100 - How Income Affects Eligibility and Benefits; REF, SFPSS, TANF

Current through Register Vol. 63, No. 7, July 1, 2024
(1) In the REF and
			 TANF programs, countable (see OAR
			 461-001-0000) income and
			 adjusted income (see OAR
			 461-001-0000 and
			 461-160-0160) are compared to
			 the standards in OAR 461-155-0030 to determine
			 eligibility (see OAR 461-001-0000) and benefit
			 amount.
(2) This section applies to
			 filing groups that do not include an ineligible noncitizen with income. For
			 filing groups that include an ineligible noncitizen with income, see section
			 (3) of this rule.
(a) For individuals not
			 eligible for the Exit Limit Increase (ELI) Standards in OAR
			 461-155-0030(3),
			 compare the countable income of the financial group (see OAR
			 461-110-0530) to the applicable
			 Countable Income Limit Standard for the need group (see OAR
			 461-110-0630) in OAR
			 461-155-0030(2).
(A) If countable income equals or exceeds the
			 applicable standard, the need group is not eligible.
(B) If countable income is less than the
			 applicable standard, compare the adjusted income of the financial group to the
			 Adjusted Income Limit Standard for the need group in OAR
			 461-155-0030(4):
(i) If the adjusted income equals or exceeds
			 the applicable standard, the filing group is not eligible.
(ii) If the adjusted income is less than the
			 applicable standard, determine the benefit amount as provided in subsection (c)
			 of this section.
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0140 - How Income and Resources are Used to Determine Eligibility and Benefit for EA

Current through Register Vol. 63, No. 7, July 1, 2024
The Department considers a client's income and resources in
				determining eligibility and benefit level for EA as follows:
(1) The financial group's countable income is
			 compared to the TANF adjusted income payment standard for the benefit group. If
			 countable income equals or exceeds the standard, the benefit group is not
			 eligible.
(2) If countable income
			 is less than the standard and the financial group meets all other EA
			 eligibility requirements, the client is required to use all income and
			 resources that are immediately available to meet the emergent need. The EA
			 benefit is calculated by subtracting all income and resources that are
			 immediately available to the client from the amount needed to meet the emergent
			 need. The remainder is the benefit, not to exceed the limit in OAR
			 461-155-0070.
Statutory/Other Authority: ORS
				  411.060 &
				  412.049
Statutes/Other Implemented: ORS
				  411.060,
				  412.049 &
				  412.072
Oregon Administrative Rules › Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS › Division 160 - DETERMINING FINANCIAL ELIGIBILITY AND CALCULATING BENEFIT LEVEL › Section 461-160-0160 - Earned Income Deduction; REF, REFM, and TANF

Current through Register Vol. 63, No. 7, July 1, 2024
In the REF, REFM, and TANF programs, the earned income
				deduction authorized in this division of rules is allowed for each person in
				the financial group who has earned income. The earned income deduction is 50
				percent of the individual's gross earned income including self-employment
				income.
Statutory/Other Authority: ORS
				  409.050,
				  411.060 &
				  412.049
Statutes/Other Implemented: ORS
				  409.010,
				  411.060 &
				  412.049