461-135-0010
Assumed Eligibility for Medical Programs

(1) This rule sets out when an individual is assumed eligible for certain medical programs because the individual receives or is deemed to receive benefits of another program.

(2) A pregnant individual who is eligible for and receiving benefits the day the pregnancy ends is assumed eligible for the OSIPM program until the last day of the twelfth month following the month in which the last day of the pregnancy falls.

(3) A pregnant individual who was eligible for and receiving medical assistance under the OSIPM program and becomes ineligible while pregnant is assumed eligible for Medicaid and can continue to receive OSIPM benefits until the last day of the twelfth month following the month in which the last day of the pregnancy falls.

(4) A child (see OAR 461-001-0000) born to an individual eligible for and receiving OSIPM benefits is assumed eligible for medical benefits under this section until the end of the month the child turns one year of age.

(5) The individuals described in subsection (a) and (b) of this section are assumed eligible for OSIPM (except OSIPM-EPD) unless subsection (c) or (d) of this section applies:

(a) A recipient of Supplemental Security Income (SSI) benefits who meets all non-financial requirements for the OSIPM program except citizen and noncitizen status.  SSI recipients are presumed to meet all citizen and noncitizen status requirements for the OSIP program .

(b) An individual who meets all non-financial requirements for the OSIPM program except citizen and noncitizen status and is deemed eligible for SSI under Sections 1619(a) or (b) of the Social Security Act (42 U.S.C. 1382h(a) or (b)), which cover individuals with disabilities whose impairments have not changed but who have become gainfully employed and have continuing need for OSIPM. Individuals deemed eligible for SSI under Sections 1619(a) or (b) of the Social Security Act are assumed to meet all citizen and noncitizen status requirements for the OSIPM program.

(c) An individual described in subsection (a) or (b) of this section who is in a nonstandard living arrangement (see OAR 461-001-0000) is not eligible for long-term care (see OAR 461-001-0000) services if the individual would otherwise be ineligible for OSIPM due to a disqualifying transfer of assets (OAR 461-140-0210 to 461-140-0300 regulate the effect of a transfer of assets on a client).

(d) An individual described in subsection (a) or (b) of the section who is in a nonstandard living arrangement is not assumed eligible for long-term care services if countable (see OAR 461-001-0000) resources exceed the limit after performing the calculation under OAR 461-160-0580.

(6) For the purposes of this section the definition of a "child" means an unmarried individual under age 19 and includes natural, step, and adoptive children. A child found eligible for OSIPM is assumed eligible until the end of the twelfth month following the determination of the child's OSIPM eligibility or redetermination of eligibility unless the child:

(a) No longer meets the definition of a child given in this section;

(b) Moves out of state;

(c) Voluntarily ends benefits; or

(d) Is eligible for any other Medicaid program that provides OHP Plus benefits.

(7) An individual who receives both benefits under Part A of Medicare and SSI benefits is assumed eligible for the QMB-BAS program unless the individual does not meet the requirements of OAR 461-120-0345 or the residency requirements (see OAR 461-120-0010).

Statutory/Other Authority: ORS 409.050, ORS 411.060, 411.070, 411.404, 413.085 & 414.685
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070 & 411.404
History:
SSP 34-2022, amend filed 04/28/2022, effective 05/01/2022
SSP 31-2022, temporary amend filed 03/09/2022, effective 04/01/2022 through 09/27/2022
SSP 14-2022, minor correction filed 02/16/2022, effective 02/16/2022
SSP 58-2021, minor correction filed 12/13/2021, effective 12/13/2021
SSP 6-2021, minor correction filed 02/18/2021, effective 02/18/2021
SSP 13-2020, minor correction filed 06/02/2020, effective 06/02/2020
SSP 26-2019, amend filed 12/27/2019, effective 01/01/2020
SSP 22-2018, amend filed 06/05/2018, effective 07/01/2018
SSP 11-2018, amend filed 03/09/2018, effective 04/01/2018
SSP 33-2017, amend filed 12/08/2017, effective 01/01/2018
SSP 34-2016, f. 9-30-16, cert. ef. 10-1-16
SSP 16-2014, f. & cert. ef. 7-1-14
SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14
SSP 24-2013, f. & cert. ef. 10-1-13
SSP 25-2012, f. 6-29-12, cert. ef. 7-1-12
SSP 1-2012(Temp), f. & cert. ef. 1-13-12 thru 7-11-12
SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11
SSP 27-2009, f. & cert. ef. 9-29-09
SSP 10-2009(Temp), f. & cert. ef. 5-6-09 thru 9-28-09
SSP 6-2009(Temp), f. & cert. ef. 4-1-09 thru 9-28-09
SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09
SSP 23-2008, f. & cert. ef. 10-1-08
SSP 17-2008, f. & cert. ef. 7-1-08
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08
SSP 10-2007, f. & cert. ef. 10-1-07
SSP 7-2007, f. 6-29-07, cert. ef. 7-1-07
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07
SSP 12-2006(Temp), f. & cert. ef. 9-1-06 thru 12-31-06
SSP 6-2006, f. 3-31-06, cert. ef. 4-1-06
SSP 14-2005, f. 9-30-05, cert. ef. 10-1-05
SSP 33-2003, f. 12-31-03, cert. ef. 1-4-04
SSP 1-2003, f. 1-31-03, cert. ef. 2-1-03
AFS 10-2002, f. & cert. ef. 7-1-02
AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 12-1999(Temp), f. & cert. ef. 10-1-99 thru 1-31-00
AFS 17-1998, f. & cert. ef. 10-1-98
AFS 9-1997, f. & cert. ef. 7-1-97
AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97
AFS 22-1995, f. 9-20-95, cert. ef. 10-1-95
AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95
AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95
AFS 23-1994, f. 9-29-94, cert. ef. 10-1-94
AFS 13-1994, f. & cert. ef. 7-1-94
AFS 2-1994, f. & cert. ef. 2-1-94
AFS 1-1993, f. & cert. ef. 2-1-93
AFS 28-1992, f. & cert. ef. 10-1-92
AFS 2-1992, f. 1-30-92, cert. ef. 2-1-92
AFS 13-1991, f. & cert. ef. 7-1-91
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0070
Specific Requirements; TANF

(1) To be eligible for TANF program benefits:

(a) An individual must be one of the following:

(A) A dependent child (see OAR 461-001-0000). However, a dependent child for whom foster care payments are made is not eligible while the payments are being made for the dependent child.

(B) A caretaker relative (see OAR 461-001-0000) of an eligible dependent child when the caretaker relative:

(i) Is receiving TANF program benefits for the dependent child, or

(ii) Is applying for TANF program benefits for the dependent child.

(C) A caretaker relative of a dependent child, when the dependent child is ineligible for TANF program benefits because of one of the following reasons:

(i) The child is receiving SSI.

(ii) The child is in foster care, but is expected to return home within 30 days.

(D) A parent (see OAR 461-001-0000) of an unborn, as follows:

(i) For the TANF program, any parent whose only child is an unborn child once the pregnancy has reached the calendar month before the month in which the due date falls.

(ii) For the TANF program, the parent of an unborn child, if there is another dependent child in the filing group.

(b) Unless the individual is exempt from JOBS participation and JOBS disqualification under OAR 461-130-0310, an individual must demonstrate two-consecutive weeks of cooperation in appropriate activities (see OAR 461-001-0025) if:

(A) TANF program benefits had closed within the prior three consecutive calendar months from the filing date (see OAR 461-115-0040) for TANF with an active level 1 through level 4 TANF program disqualification (see OAR 461-130-0330 and 461-135-0085); or

(B) The filing date for TANF program benefits is within the prior three consecutive calendar months after the end of a two consecutive month period of TANF ineligibility according to OAR 461-130-0330(5)(e).

(c) The TANF program monthly benefit amount determined under OAR 461-160-0100 must be $10 or greater.

(2) As used in this rule:

(a) Except as provided otherwise in this section, "good cause" means a reasonable person of normal sensitivity, exercising ordinary common sense under similar circumstances, would have --

(A) Quit work, including in anticipation of discharge;

(B) Participated in behavior leading to the individual's discharge; or

(C) Voluntarily reduced work hours.

(b) For an individual with a physical or mental impairment (as defined at 29 CFR 1630.2(h)), except as provided otherwise in subsection (c) of this section, "good cause" for leaving work means that a reasonable person with the characteristics and qualities of such individual under similar circumstances would have --

(A) Quit work, including in anticipation of discharge;

(B) Participated in behavior leading to the individual's discharge; or

(C) Voluntarily reduced work hours.

(c) There is no "good cause" if the reason for separation from employment is a labor dispute.

(3) Except as provided under section (4) of this rule, a need group (see OAR 461-110-0630) is not eligible for TANF program benefits for 120 days from the date a parent or caretaker relative was separated from or voluntarily reduced work hours at their last employment in which a parent or caretaker relative in the need group was hired to work 100 or more hours per month or worked or was scheduled to work 100 or more hours in the last full calendar month of employment. This applies at initial certification, recertification, and is a condition of ongoing eligibility (see OAR 461-001-0000).

(4) A need group (see OAR 461-110-0630) may not be reduced or denied TANF program benefits based on section (3) of this rule if the parent or caretaker relative is one of the following:

(a) A teen parent (see OAR 461-001-0000) returning to high school or equivalent.

(b) An individual fleeing from or at risk of domestic violence (see OAR 461-001-0000).

(c) An individual who is pregnant and the pregnancy has reached the first of the calendar month prior to the month in which the due date falls.

(d) An individual who is pregnant and experiencing medical complications due to the pregnancy that prohibit participation in activities of the program and are documented by a qualified and appropriate professional.

(e) An individual unable to work due to a disability or medical condition documented by a qualified and appropriate professional, and which is expected to last for 30 days or more from the filing date for TANF program benefits.

(f) An individual who was separated from employment for a reason the Department determines is good cause as defined in section (2) of this rule.

(g) An individual who was separated from employment as a result of a layoff.

(5) Members of The Klamath Tribes may apply for either The Klamath Tribes TANF program or the ODHS TANF program.

(a) A Level 1 or Level 2 Klamath Tribes TANF program benefit disqualification does not establish an ODHS TANF program disqualification.

(b) For families whose Klamath Tribes TANF program benefits have been closed due to failure to comply with program requirements:

(A) The Klamath Tribes TANF program shall decide if the family may receive TANF from the ODHS TANF program (if eligible under Chapter 461).

(B) If the Klamath Tribes TANF program decides the family may receive TANF from ODHS, the ODHS TANF benefits shall be initially approved with no ODHS TANF program disqualification.

(6) For the Confederated Tribes of Siletz Indians of Oregon, a family is ineligible for ODHS TANF program benefits if all of the following subsections apply to the family:

(a) A parent, caretaker relative, or child is a member of The Confederated Tribes of Siletz Indians of Oregon and lives in one of the eleven service area counties: Benton, Clackamas, Lane, Lincoln, Linn, Marion, Multnomah, Polk, Tillamook, Washington, or Yamhill counties.

(b) The family includes members who are living in the same household and at least one of the following paragraphs applies:

(A) A two-parent family with one enrolled Siletz tribal member with a shared dependent.

(B) A single-parent family with one enrolled Siletz tribal member.

(C) A non-needy caretaker relative or essential person with one enrolled Siletz tribal member who is a minor.

(D) A pregnant enrolled Siletz tribal member in their eighth month of pregnancy.

(c) The family is eligible for the Siletz Tribes TANF program or would be eligible for the Siletz Tribes TANF program if not for the failure of the family to cooperate with Siletz TANF program requirements.

(7) If a parent or caretaker relative covered by section (6) of this rule fails to follow through with a Department referral to The Confederated Tribes of Siletz Indians of Oregon TANF program, the entire filing group is ineligible for ODHS TANF program benefits.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.400, 411.404, 412.006, 412.016, 412.049 & 412.124
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.400, 411.404, 412.006, 412.016, 412.049, 412.064 & 412.124
History:
SSP 41-2022, amend filed 06/30/2022, effective 07/01/2022
SSP 30-2022, temporary amend filed 03/01/2022, effective 03/01/2022 through 08/27/2022
SSP 5-2020, amend filed 03/30/2020, effective 04/01/2020
SSP 21-2018, amend filed 06/05/2018, effective 07/01/2018
SSP 22-2017, f. 9-8-17 & cert. ef. 10-1-17
SSP 35-2016, f. 9-30-16, cert. ef. 10-1-16
SSP 15-2016, f. & cert. ef. 4-1-16
SSP 38-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14
SSP 13-2013, f. & cert. ef. 7-1-13
SSP 30-2012, f. 9-28-12, cert. ef. 10-1-12
SSP 17-2012(Temp), f. & cert. ef. 5-1-12 thru 10-28-12
SSP 25-2011, f. 9-30-11, cert. ef. 10-1-11
SSP 18-2011(Temp), f. & cert. ef. 7-1-11 thru 12-28-11
SSP 33-2009, f. & cert. ef. 10-29-09
SSP 19-2009(Temp), f. 7-29-09, cert. ef. 8-1-09 thru 10-28-09
SSP 8-2009(Temp), f. 4-20-09, cert. ef. 5-1-09 thru 10-28-09
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08
SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07
AFS 34-2000, f. 12-22-00, cert. ef. 1-1-01
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 2-1999, f. 3-26-99, cert. ef. 4-1-99
AFS 26-1998(Temp), f. 12-30-98, cert. ef. 1-1-99 thru 3-31-99
AFS 17-1998, f. & cert. ef. 10-1-98
AFS 8-1998, f. 4-28-98, cert. ef. 5-1-98
AFS 25-1997(Temp), f. 12-31-97, cert. ef. 1-1-98 thru 4-30-98
AFS 19-1997, f. & cert. ef. 10-1-97
AFS 9-1997, f. & cert. ef. 7-1-97
AFS 26-1996, f. 6-27-96, cert. ef. 7-1-96
AFS 19-1993, f. & cert. ef. 10-1-93
AFS 13-1991, f. & cert. ef. 7-1-91
AFS 9-1991, f. 3-29-91, cert. ef. 4-1-91
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0071
TANF Time Limit; General Provisions

(1) Except as provided in OAR 461-135-0073 and 461-135-0075, a minor parent (see OAR 461-001-0000) head of household or needy caretaker relative (see OAR 461-001-0000) may not receive a TANF grant in Oregon if the minor parent head of household or needy caretaker relative has received a TANF grant in any state or states in excess of 60 months.

(2) Each minor parent head of household and needy caretaker relative who qualifies for a TANF grant under OAR 461-135-0073 and 461-135-0075 must also meet all other TANF eligibility (see OAR 461-001-0000) requirements and cooperate with the requirements of his or her case plan (see OAR 461-001-0025), unless good cause (see OAR 461-130-0327) exists.

(3) A minor parent head of household or a needy caretaker relative who reaches the 60-month time limit and does not meet any of the extension criteria in OAR 461-135-0073 or exemption criteria in OAR 461-135-0075 is removed from the benefit group (see OAR 461-110-0750). The remaining need group (see OAR 461-110-0630) members may continue to receive TANF benefits.

(4) If a minor parent head of household or needy caretaker relative is removed from the benefit group under section (3) of this rule, any disqualifications or sanctions that are accrued or have been accrued remain in place.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 412.006, 412.049 & 412.079
Statutes/Other Implemented: ORS 409.010, 409.050, 411.060, 411.070, 412.006, 412.049, 412.064 & 412.079
History:
SSP 15-2016, f. & cert. ef. 4-1-16

461-135-0073
TANF Time Limit; Extension Criteria

(1) Effective April 1, 2016, a minor parent (see OAR 461-001-0000) head of household or needy caretaker relative (see OAR 461-001-0000) who has reached the 60-month time limit in OAR 461-135-0071 may receive an extension of benefits if the individual is unable to obtain or maintain employment that provides earnings in excess of income limits established by the Department because the minor parent head of household or needy caretaker relative:

(a) Is a victim of domestic violence (see OAR 461-001-0000);

(b) Has a learning disability;

(c) Has a mental health condition or an alcohol or drug abuse problem;

(d) Has a disability (see OAR 461-001-0000);

(e) Has a child (see OAR 461-001-0000) with a disability;

(f) Is deprived of needed medical care; or

(g) Is subjected to battery or extreme cruelty. For purposes of this rule, an individual is subjected to battery or extreme cruelty if the individual has been subjected to one or more of the following:

(A) Physical acts that resulted in, or threatened to result in, physical injury to the individual.

(B) Sexual abuse.

(C) Sexual activity involving a dependent child (see OAR 461-001-0000).

(D) Being forced as the caretaker relative of a dependent child to engage in nonconsensual sexual acts or activities.

(E) Threats of, or attempts at, physical or sexual abuse.

(F) Mental abuse.

(G) Neglect or deprivation of medical care.

(2) When a minor parent head of household or needy caretaker relative receiving TANF reaches 60 months of receipt of TANF benefits, benefits may be temporarily continued past 60 months if the individual is otherwise eligible and:

(a) Is completing a previously approved JOBS Plus agreement; or

(b) Is experiencing a situation that is expected to last less than 12 months and the Department has determined it is not reasonable for the individual to obtain or maintain employment while the situation is continuing.

(3) Extensions granted based on a condition described in subsections (1)(b) to (1)(e) of this rule require documentation from a licensed or certified professional qualified to make such a determination (see OAR 461-125-0830).

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 412.006, 412.049 & 412.079
Statutes/Other Implemented: ORS 409.010, 409.050, 411.060, 411.070, 411.117, 412.001, 412.006, 412.049, 412.064, 412.079 & 412.084
History:
SSP 15-2016, f. & cert. ef. 4-1-16

461-135-0075
TANF Time Limit; Exemptions

(1) The following months do not count toward the accrual of the time limit in OAR 461-135-0071:

(a) Months prior to July 1, 2003 in which a minor parent (see OAR 461-001-0000) head of household or an adult received a TANF grant in Oregon or another state.

(b) Months between July 1, 2003 and September 30, 2007 in which a minor parent head of household or adult received TANF in Oregon; and

(A) Participated in required JOBS activities or other education, employment, or job training program including teen parent (see OAR 461-001-0000) programs; or

(B) Was not required to participate in JOBS activities or other education, employment, or job training program including teen parent programs.

(c) Months between October 1, 2007 and June 30, 2009 and months between October 1, 2011 and April 30, 2012 in which the filing group (see OAR 461-110-0330) is a two-parent family receiving cash assistance in Oregon for which deprivation is based on unemployment or underemployment.

(d) Months beginning October 1, 2007 in which a minor parent head of household or adult received aid in Oregon and is a participant in the Degree Completion Initiative (DCI) activity (see OAR 461-001-0025) enrolled in an educational institution.

(e) Months beginning October 1, 2008 in which a minor parent head of household or adult received aid in Oregon and is a participant in the Parents as Scholars (PAS) activity (see OAR 461-001-0025) enrolled in an educational institution consistent with OAR 461-190-0199.

(f) Months between October 1, 2007 and March 31, 2016 in which the individual is unable to obtain or maintain employment for a sufficient number of hours in a month to satisfy the federally required participation rates (see OAR 461-001-0025) because the individual:

(A) Was a survivor of domestic violence (see OAR 461-001-0000);

(B) Had a certified learning disability;

(C) Had a verified alcohol and drug or mental health condition;

(D) Had a child (see OAR 461-001-0000) with a disability (see OAR 461-001-0000), which prevented the parent (see OAR 461-001-0000) from obtaining or keeping employment;

(E) Was an individual with a disability;

(F) Was providing care for a family member who lived in the home and was an individual with a disability;

(G) Was deprived of needed medical care; or

(H) Was subjected to battery or extreme cruelty. For purposes of this rule, an individual was subjected to battery or extreme cruelty if the individual was subjected to one or more of the following:

(i) Physical acts that resulted in, or threatened to result in, physical injury to the individual.

(ii) Sexual abuse.

(iii) Sexual activity involving a dependent child.

(iv) Being forced as the caretaker relative (see OAR 461-001-0000) of a dependent child (see OAR 461-001-0000) to engage in nonconsensual sexual acts or activities.

(v) Threats of, or attempts at, physical or sexual abuse.

(vi) Mental abuse.

(vii) Neglect or deprivation of medical care.

(g) Months beginning July 1, 2003 in which the parent or needy caretaker relative resided in Indian Country (as defined in 18 U.S.C. 1151) and 50 percent or more of the adult residents of that area were unemployed. The Department considers an individual to meet the requirements of this subsection if:

(A) The individual resides on an Indian reservation, tribal allotment, or Dependent Indian Community as defined by the Bureau of Indian Affairs; or

(B) The individual is a member of one of the nine federally-recognized tribes in Oregon and resides in a county listed in subparagraph (ii) of this paragraph.

(i) The nine federally-recognized tribes in Oregon are Burns Paiute Tribe; Confederated Tribes of the Coos, Lower Umpqua and Siuslaw Indians; Confederated Tribes of the Grand Ronde Community of Oregon; Confederated Tribes of the Siletz Indians; Confederated Tribes of the Umatilla Reservation; Confederated Tribes of Warm Springs; Coquille Indian Tribe; Cow Creek Band of the Umpqua Tribe of Indians; and Klamath Tribes.

(ii) The following Oregon counties are covered under paragraph (B) of this subsection for October 1, 2017 to September 30, 2018: Coos, Crook, Curry, Douglas, Josephine, and Lincoln.

(h) Months beginning October 1, 2007 in which the minor parent head of household or adult is a participant in the JOBS Plus, Pre-TANF, or SFPSS program.

(i) Months beginning October 1, 2007 in which the individual who is now a parent or pregnant was in that month a minor child and neither the head of a household nor married to the head of a household.

(j) Months beginning October 1, 2011 in which the minor parent head of household or adult is a participant in the JPI program.

(k) Months in which the minor parent head of household or adult is a recipient of Employment Payments (see OAR 461-001-0025 and 461-135-1270) unless a TANF payment was issued in the same month.

(l) Months between July 1, 2008 and April 30, 2012 in which the individual did not qualify for any other TANF time-limit exemption under this rule, and was unable to obtain or maintain employment for a sufficient number of hours in a month to satisfy the federally required participation rates (see OAR 461-001-0025) when Oregon's statewide average unemployment rate as published by the Oregon Employment Department was equal to or greater than seven percent. For purposes of this rule, this determination:

(A) Through December 31, 2011 is calculated based on a six-month period as follows:

(i) The time period during July 1, 2008 through June 30, 2009 was based on Oregon's statewide average unemployment rate as published by the Oregon Employment Department for the period July 1, 2008 through December 31, 2008.

(ii) In each six-month period, starting July 1, 2009 and ending December 31, 2011:

(I) The time period during January 1 through June 30 was based on Oregon's statewide average unemployment rate as published by the Oregon Employment Department for the period April 1 through September 30 of the preceding year.

(II) The time period during July 1 through December 31 was based on Oregon's statewide average unemployment rate as published by the Oregon Employment Department for the period October 1 through December 31 of the preceding year and January 1 through March 31 of the current year.

(B) From January 1, 2012 through April 30, 2012 was based on Oregon's statewide average unemployment rate as published by the Oregon Employment Department for the period April 1 through September 30, 2011.

(2) Months that did not count toward the time limit based on a condition described in paragraphs (1)(f)(B) to (1)(f)(F) of this rule require documentation from a licensed or certified professional qualified to make such a determination.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 412.006, 412.049 & 412.079
Statutes/Other Implemented: ORS 409.010, 409.050, 411.060, 411.070, 411.117, 412.049 & 412.079
History:
SSP 26-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 22-2017, f. 9-8-17 & cert. ef. 10-1-17
SSP 35-2016, f. 9-30-16, cert. ef. 10-1-16
SSP 16-2017(Temp), f. 6-28-17, cert. ef. 7-1-17 thru 9-30-17
SSP 15-2017(Temp), f. 6-19-17, cert. ef. 7-1-17 thru 9-30-17
SSP 15-2016, f. & cert. ef. 4-1-16
SSP 24-2014, f. & cert. ef. 10-1-14
SSP 30-2012, f. 9-28-12, cert. ef. 10-1-12
SSP 17-2012(Temp), f. & cert. ef. 5-1-12 thru 10-28-12
SSP 9-2012, f. 3-29-12, cert. ef. 4-1-12
SSP 30-2011(Temp), f. & cert. ef. 11-1-11 thru 4-29-12
SSP 28-2009, f. & cert. ef. 10-1-09
SSP 15-2009(Temp), f. & cert. ef. 7-1-09 thru 12-28-09
SSP 13-2009, f. & cert. ef. 7-1-09
SSP 12-2009(Temp), f. 6-23-09, cert. ef. 7-1-09 thru 12-28-09
SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09
SSP 22-2008(Temp), f. & cert. ef. 10-1-08 thru 3-30-09
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 9-1997, f. & cert. ef. 7-1-97
AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97
AFS 27-1996, f. 6-27-96, cert. ef. 7-1-96

461-135-0080
TANF Eligibility for Minor Parents

To be eligible for TANF, a minor parent applying for benefits for his or her child must live with the minor's parent, parents or legal guardian unless it is unsafe or impractical for the minor parent to live with those individuals.

Statutory/Other Authority: ORS 411.060 & 412.049
Statutes/Other Implemented: ORS 411.060, 412.049 & 412.084
History:
SSP 38-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 27-1996, f. 6-27-96, cert. ef. 7-1-96

461-135-0085
Requirement to Attend an Assessment or Evaluation, or Seek Medically Appropriate Treatment for Substance Abuse and Mental Health; Disqualification and Penalties; Pre-TANF, REF, TANF

In the Pre-TANF and TANF programs:

(1) For the purposes of this rule:

(a) "Assessment for substance abuse" means an assessment performed by an appropriate licensed professional with the purpose of discovering the presence of substance abuse.

(b) "Controlled substance" means a drug or its immediate precursor classified in Schedules I through V under the Controlled Substances Act, 21 U.S.C. 811 to 812, as modified under ORS 475.035. The use of the term "precursor" in this subsection does not control and is not controlled by the use of the term "precursor" in ORS 475.840 to 475.980. Alcohol is not a controlled substance.

(c) "Self-identified illegal use" means an individual states he or she illegally used a controlled substance within the previous 30 days. Illegal use does not include the use of a controlled substance pursuant to a valid prescription, or other use authorized by the Uniform Controlled Substances Act, ORS 475.005 to 475.285 and 475.840 to 475.980, the federal Controlled Substances Act, or other Federal law.

(2) When directed by the Department, an adult member or parenting teen in the need group (see OAR 461-110-0630), regardless of participation classification (see OAR 461-130-0310), must participate in:

(a) An assessment for substance abuse if:

(A) The individual has self-identified illegal use of a controlled substance; and

(B) The assessment is available and at no cost to the individual.

(b) Medically appropriate treatment for substance abuse if it is available and at no cost to the individual when:

(A) The individual reports a qualified and appropriate professional has diagnosed the individual with a substance abuse disorder within the previous twelve months; or

(B) An assessment resulted in a diagnosis requiring medically appropriate treatment for the individual to be successful in the workplace.

(3) When directed by the Department, an adult member or parenting teen in the need group (see OAR 461-110-0630), regardless of participation classification (see OAR 461-130-0310), must participate in medically appropriate treatment for mental health if it is available and at no cost to the individual when:

(a) The individual reports a qualified and appropriate professional has diagnosed the individual with a mental health disorder within the previous twelve months; or

(b) An evaluation resulted in a mental health diagnosis requiring medically appropriate treatment for the individual to be successful in the workplace.

(4) An individual is responsible for providing information needed by the Department to determine whether the individual had good cause (see OAR 461-130-0327) for failing to meet the requirements of this rule. If a medical condition must be evaluated in regard to the requirements of this rule, the Department will assist the client in obtaining a medical opinion from an appropriate medical professional.

(5) An individual who refuses to participate in a required assessment, evaluation, or the medically appropriate treatment required by this rule is subject to disqualification in accordance with this section and OAR 461-130-0330 only after the individual has had an opportunity to participate in the re-engagement process (see OAR 461-190-0231) including a determination by the Department of whether the individual had good cause for non-participation. The penalties are progressive and, once imposed, continue as long as the individual refuses to participate. If there is a change in the participation classification (see OAR 461-130-0310) of the individual the penalty ends and the individual must have an opportunity to participate in the re-engagement process under OAR 461-190-0231 before applying a disqualification.

Statutory/Other Authority: ORS 411.060, 411.070, 411.816, 412.006, 412.009, 412.049 & 412.089
Statutes/Other Implemented: ORS 411.060, 411.070, 411.816, 412.006, 412.009, 412.049 & 412.089
History:
SSP 10-2017, f. 3-24-17, cert. ef. 4-1-17
SSP 35-2016, f. 9-30-16, cert. ef. 10-1-16
SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08
SSP 17-2004, f. & cert. ef. 7-1-04
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 9-1997, f. & cert. ef. 7-1-97
AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97
AFS 36-1996, f. 10-31-96, cert. ef. 11-1-96
AFS 27-1996, f. 6-27-96, cert. ef. 7-1-96

461-135-0087
Good Cause for Failure to Comply with Substance Abuse or Mental Health Requirements

For the TANF and REF programs, a client has good cause for missing a scheduled appointment or for any other failure to comply with the requirements imposed under OAR 461-135-0085 if the failure to comply was caused in significant part by circumstances beyond the client’s reasonable control.

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 27-1996, f. 6-27-96, cert. ef. 7-1-96

461-135-0089
Demonstrating Compliance with Substance Abuse and Mental Health Requirements; Restoring Cash Benefits; Pre-TANF, TANF

In the Pre-TANF and TANF programs:

(1) In order to end a penalty imposed under OAR 461-135-0085:

(a) At the first, second, third, and fourth level of disqualification (see OAR 461-130-0330), a client must:

(A) Cooperate for a period of two consecutive weeks with each activity (see OAR 461-001-0025) specified in the client's current or revised case plan (see OAR 461-001-0025); and

(B) Demonstrate a willingness to participate in treatment required under OAR 461-135-0085 if treatment is still required.

(b) When the fourth level of disqualification (see OAR 461-130-0330) ends, program benefits are closed for two consecutive months, unless the client:

(A) Contacts a representative of the Department and agrees to each activity in the case plan before the end of the fourth level; and

(B) Demonstrates a willingness to participate in treatment required under OAR 461-135-0085 if treatment is still required.

(2) The penalty imposed under OAR 461-135-0085 ends when:

(a) TANF program benefits are closed for a reason other than described in OAR 461-130-0330(5)(e); or

(b) The individual complies with the requirements of section (1) of this rule.

(3) When the Department removes a disqualification due to a client's compliance with the requirements under OAR 461-135-0085, cash benefits are restored effective the date the client completed the two consecutive week cooperation period.

Statutory/Other Authority: ORS 411.060, 411.070, 412.006, 412.009 & 412.049
Statutes/Other Implemented: ORS 411.060, 411.070, 412.006, 412.009, 412.049 & 412.089
History:
SSP 23-2016, f. 6-28-16, cert. ef. 7-1-16
SSP 37-2012, f. 12-28-12, cert. ef. 1-1-13
SSP 35-2011, f. 12-27-11, cert. ef. 1-1-12
SSP 26-2011(Temp), f. 9-30-11, cert. ef. 10-1-11 thru 3-29-12
SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97
AFS 27-1996, f. 6-27-96, cert. ef. 7-1-96

461-135-0200
Multiple Disqualifications; TANF

(1) This rule describes the method for calculating the net TANF benefit when a client's benefits are affected by the penalty provided in division 130 of this chapter of rules for failure to comply with the requirements of a case plan (see OAR 461-001-0025) or the penalty provided by OAR 461-135-0085 and, during the same month, by a concurrent penalty related to child support or a penalty related to recovery from third parties (OAR 461-120-0340 and 461-120-0345 respectively).

(2) If the concurrent penalty relates to child support, during the first three months that the penalties are both applied, the penalty related to the case plan or to OAR 461-135-0085 is applied first, and the concurrent penalty is then applied. During the fourth and successive months, the clients are ineligible for TANF benefits.

(3) If the concurrent penalty relates to recovery from third parties, during the first three months that the penalties are both applied, only the penalty related to third-party recovery is applied. During the fourth and subsequent months, the penalty related to third-party recovery continues and the benefit group (see OAR 461-110-0750) is ineligible for TANF benefits.

Statutory/Other Authority: ORS 411.060, 418.040 & 412.049
Statutes/Other Implemented: ORS 411.060, 418.040 & 412.049
History:
SSP 35-2016, f. 9-30-16, cert. ef. 10-1-16
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08
SSP 17-2004, f. & cert. ef. 7-1-04
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 9-1999, f. & cert. ef. 7-1-99
AFS 8-1998, f. 4-28-98, cert. ef. 5-1-98
AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97
AFS 36-1996, f. 10-31-96, cert. ef. 11-1-96

461-135-0220
REF, REFM, and TANF Programs; COVID-19

The provisions in this rule apply to the REF, REFM, and TANF programs.

(1) The Department amends the resource limit for the REF, REFM, and TANF programs (see OAR 461-160-0015(6) and (8)), as follows:

(a) $2,500 for a need group (see OAR 461-110-0630) with every caretaker relative (see OAR 461-001-0000) serving an intentional program violation (see OAR 461-195-0601).

(b) $10,000 for new applicants and all other need groups.

(2) American Rescue Plan Act of 2021, Pandemic Emergency Assistance funds allotted to the Department shall be distributed in a one-time payment to TANF benefit groups (see OAR 461-110-0750) as follows:

(a) The payment shall be issued in the same method as the TANF benefit.

(b) The payment is limited to groups eligible for TANF for the month of September 2021 whose eligibility (OAR 461-001-0000) was determined and authorized by November 1, 2021.

(c) The payment amount is determined based on the available funds and the total number of eligible benefit groups.

(d) Payments are not subject to overpayment (see OAR 461-195-0501) and shall not be included in any overpayment calculation.

(e) All funds shall be issued in November 2021, on a date determined by the Department, with no remaining funds available.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.083, 412.006, 412.049 & 412.064
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.081, 411.083, 411.087, 412.006, 412.049, 412.064, 45 CFR 206.10, 45 CFR 400.155, 45 CFR 261.11 & 45 CFR 260.31
History:
SSP 7-2022, amend filed 02/03/2022, effective 02/18/2022
SSP 51-2021, temporary amend filed 09/30/2021, effective 10/01/2021 through 03/27/2022
SSP 26-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 41-2020, temporary amend filed 11/30/2020, effective 12/01/2020 through 05/29/2021
SSP 35-2020, adopt filed 09/29/2020, effective 09/30/2020
SSP 28-2020, temporary adopt filed 08/25/2020, effective 09/01/2020 through 09/29/2020
SSP 24-2020, temporary adopt filed 07/27/2020, effective 08/01/2020 through 09/29/2020
SSP 15-2020, temporary adopt filed 06/17/2020, effective 06/17/2020 through 09/29/2020
SSP 7-2020, temporary adopt filed 04/08/2020, effective 04/08/2020 through 09/29/2020
SSP 6-2020, temporary adopt filed 04/03/2020, effective 04/03/2020 through 09/29/2020

461-135-0300
Eligibility for and Needs Covered by EA

Emergency assistance is available for food and shelter needs of financial groups. To be eligible for EA, a financial group must have a shelter or food need that was caused by natural disaster or that resulted from the financial group’s lack of income or cash resources during the month of application and the prior month sufficient to prevent the emergency. The lack of sufficient available money must have resulted from money becoming unavailable due to circumstances beyond the group’s control. Circumstances beyond the group's control include:

(1) Theft that occurs notwithstanding the financial group’s reasonable precautions to prevent theft.

(2) The need to use the money for unexpected and necessary expenditures, such as the payment for car repairs when the car is used for work or for a family emergency.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 17-2004, f. & cert. ef. 7-1-04
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 8-1992, f. & cert. ef. 4-1-92
AFS 13-1991, f. & cert. ef. 7-1-91
AFS 26-1990, f. & cert. ef. 11-29-90
AFS 18-1990(Temp), f. & cert. ef. 7-13-90
AFS 12-1990, f. 3-30-90, cert. ef. 4-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0301
Closure of the Emergency Assistance (EA) Program Effective May 1, 2004

(1) Effective January 1, 2003, the EA program is not funded. Notwithstanding other rules of the Department, the program is closed effective that date.

(2) Effective December 31, 2002, all persons eligible for or receiving benefits of the program become ineligible for the program. The Department will not authorize or provide any benefit for any period after December 31, 2002 except as provided below in this rule.

(3) Effective December 1, 2003, the EA program is funded. The program is open effective that date for any person who meets the eligibility requirements on or after December 1, 2003.

(4) Effective May 1, 2004, the EA program is not funded. Notwithstanding other rules of the Department, the program is closed effective that date.

(5) Effective April 30, 2004, all persons eligible for or receiving benefits of the EA program become ineligible for the program. The Department will not authorize or provide any benefit for any period after April 30, 2004.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 22-2004, f. & cert. ef. 10-1-04
SSP 12-2004(Temp), f. 4-29-04, cert. ef. 5-1-04 thru 9-30-04
SSP 8-2004, f. & cert. ef. 4-1-04
SSP 30-2003(Temp), f. & cert. ef. 12-1-03 thru 4-30-04
SSP 16-2003, f. & cert. ef. 7-1-03
AFS 23-2002(Temp), f. 12-31-02, cert. ef. 1-1-03 thru 6-30-03

461-135-0310
Covered Shelter Needs; EA

The following shelter needs are specifically covered by the Emergency Assistance program:

(1) Rent, mortgage, and utility costs, including basic payments, connection charges, and deposits.

(2) Moving costs.

(3) Property tax up to one year, if necessary to avoid foreclosure.

(4) Transportation to another area or residence.

(5) Repairs to provide safe housing, including one-time house, electrical, and plumbing repairs if essential to the health and safety of the occupants and if less costly than moving to other quarters. Repairs are authorized under this section only for clients who are homeowners or holders of a life estate.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 17-2004, f. & cert. ef. 7-1-04
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 9-1999, f. & cert. ef. 7-1-99
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0320
Time Limits; EA

(1) A financial group determined eligible for EA is eligible for assistance for 30 consecutive days for any needs covered by OAR 461-135-0300 and 461-135-0310.

(2) A benefit group is not eligible for the EA program until the first day of the twelfth month following the start of a previous period of eligibility in Oregon. This limitation applies to the whole group if any member of the group is affected by it.

(3) The limitation in section (2) does not apply if its application would make it more difficult for the client to escape domestic violence or place the client at risk of further domestic violence.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 17-2004, f. & cert. ef. 7-1-04
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 25-1998, f. 12-28-98, cert. ef. 1-1-99
AFS 30-1990, f. 12-31-90, cert. ef. 1-1-91
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0340
Work Requirements; EA

To be eligible for EA, an adult filing group member or a dependent child, if required to participate in the JOBS program, must not have done any of the following without good cause (see OAR 461-130-0327) in the 30 days before receiving emergency assistance benefits:

(1) Quit or refused a job.

(2) Refused a referral to a job or training.

(3) Been discharged for misconduct in accordance with the unemployment insurance compensation laws of Oregon.

(4) Reduced his or her earnings.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 17-2004, f. & cert. ef. 7-1-04
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 17-1998, f. & cert. ef. 10-1-98
AFS 2-1992, f. 1-30-92, cert. ef. 2-1-92
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0350
Eligible People; EA

To be eligible for EA, a client must be a dependent child (defined in OAR 461-135-0070), a caretaker relative (defined in OAR 461-135-0070(1)(a)(B) or (C)), or the mother of an unborn child whose pregnancy has reached the calendar month before the month in which the due date falls.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 17-2004, f. & cert. ef. 7-1-04
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 13-1991, f. & cert. ef. 7-1-91
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0400
Specific Requirements; ERDC

(1) The Department makes payments for child care, including care covered by the ERDC program, subject to the provisions of division 165 of this chapter of rules.

(2) To be eligible for ERDC, a filing group (see OAR 461-110-0310 and 461-110-0350) must meet the requirements of all of the following subsections:

(a) Except as provided in subsection (c) of this section, every caretaker (see OAR 461-001-0000) in the filing group must receive income from employment. This includes self-employment (see OAR 461-145-0910), participation in the Occupational Training and Child Care program (see OAR 461-160-0040), and employment through a work study program.

(b) The filing group must include a child (see OAR 461-001-0000) who needs child care.

(c) The filing group must have an allowable child care need as described in OAR 461 160 0040. If there are two adults required to be in the filing group, and one of the adults is unemployed, the unemployed adult is considered available to provide child care, making the filing group ineligible, except in the following situations:

(A) The unemployed adult is physically or mentally unable to provide adequate child care. This must be verified (see OAR 461-125-0830).

(B) The unemployed adult is unavailable to provide child care while participating in the requirements of a case plan (see OAR 461-001-0025) other than requirements associated with post-secondary education.

(C) Confirmation is received from the Office of Child Welfare Programs that supervised contact is required between the child and an unemployed parent (see OAR 461-001-0000) or spouse (see OAR 461-001-0000) who is living in the home with the child.

(d) The filing group must use a child care provider who meets the requirements in OAR 461-165-0160 and 461-165-0180.

(e) The child needing child care must meet the citizenship or noncitizen status requirements of OAR 461-120-0110.

(f) The filing group must certify that they do not exceed the resource limit in OAR 461-160-0015 and must meet the income limits in OAR 461-160-0300.

(3) A filing group not willing to show verification of immunizations, proof that the immunization series has started, or a copy of the medical or non-medical exemption form for the child is not eligible for a child care payment.

(4) The child care must be necessary to enable the caretaker to remain employed, including self-employed.

(5) A filing group is not eligible for child care when the caretaker or parent in the filing group receives a grant for child care from the Oregon Student Assistance Commission for any month the grant is intended to cover, regardless of when the grant is received.

Statutory/Other Authority: ORS 329A.500, 409.050, 411.060 & 411.070
Statutes/Other Implemented: ORS 329A.500, 409.010, 409.050, 409.610, 411.060, 411.070, 411.122, 411.141 & 418.485
History:
SSP 13-2022, minor correction filed 02/16/2022, effective 02/16/2022
SSP 7-2019, amend filed 03/11/2019, effective 04/01/2019
SSP 30-2018, temporary amend filed 10/19/2018, effective 10/19/2018 through 03/31/2019
SSP 34-2017, amend filed 12/18/2017, effective 01/01/2018
SSP 18-2017(Temp), f. 7-20-17, cert. ef. 8-1-17 thru 1-27-18
SSP 23-2016, f. 6-28-16, cert. ef. 7-1-16
SSP 36-2015, f. 12-23-15, cert. ef. 1-1-16
SSP 23-2015, f. 9-28-15, cert. ef. 10-1-15
SSP 13-2013, f. & cert. ef. 7-1-13
SSP 39-2012(Temp), f. 12-28-12, cert. ef. 1-1-13 thru 6-30-13
SSP 17-2011, f. & cert. ef. 7-1-11
SSP 9-2011(Temp), f. & cert. ef. 3-22-11 thru 8-15-11
SSP 7-2011(Temp), f. & cert. ef. 2-16-11 thru 8-15-11
SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11
SSP 34-2010(Temp), f. & cert. ef. 10-1-10 thru 3-30-11
SSP 18-2010, f. & cert. ef. 7-1-10
SSP 27-2009, f. & cert. ef. 9-29-09
SSP 6-2009(Temp), f. & cert. ef. 4-1-09 thru 9-28-09
SSP 4-2009(Temp), f. 3-11-09, cert. ef. 4-1-09 thru 9-28-09
SSP 23-2008, f. & cert. ef. 10-1-08
SSP 17-2008, f. & cert. ef. 7-1-08
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07
SSP 6-2006, f. 3-31-06, cert. ef. 4-1-06
SSP 7-2005, f. & cert. ef. 7-1-05
SSP 4-2005, f. & cert. ef. 4-1-05
SSP 24-2004, f. 12-30-04, cert. ef. 1-1-05
SSP 8-2004, f. & cert. ef. 4-1-04
SSP 35-2003(Temp), f. 12-31-03 cert. ef. 1-1-04 thru 3-31-04
SSP 7-2003, f. & cert. ef. 4-1-03
AFS 27-2001, f. 12-21-01, cert. ef. 1-1-02
AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 9-1999, f. & cert. ef. 7-1-99
AFS 17-1998, f. & cert. ef. 10-1-98
AFS 19-1997, f. & cert. ef. 10-1-97
AFS 9-1997, f. & cert. ef. 7-1-97
AFS 13-1994, f. & cert. ef. 7-1-94
AFS 12-1993, f. & cert. ef. 7-1-93
AFS 20-1992, f. 7-31-92, cert. ef. 8-1-92
AFS 2-1992, f. 1-30-92, cert. ef. 2-1-92
AFS 12-1990, f. 3-30-90, cert. ef. 4-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0405
Children in the Head Start Program; ERDC

Retroactively effective July 6, 2020:

(1) Initial eligibility (see OAR 461-001-0000) for the ERDC program (see OAR 461-135-0400) must be met prior to receiving child care under a contract between a Head Start agency and the Department.

(2) The following subsections apply when a child (see OAR 461-001-0000) in the ERDC program receives child care under a contract between a Head Start agency and the Department.

(a) The Head Start agency is considered the provider of child care.

(b) If the Head Start agency uses another provider for the child care, that provider must meet the requirements in OAR 461-165-0160 and following.

(c) The payment made by the Department on behalf of the child is made only to the Head Start agency. The child is ineligible for child care payments for care not provided under the contract between the Head Start agency and the Department.

(d) Once the Department makes a child care payment for the child under the contract, the child may not lose child care benefits until the next August 31, unless any of the following paragraphs apply:

(A) The child's caretaker (see OAR 461-001-0000) has been found ineligible for ERDC program benefits under OAR 461 135 0415 for failure to make a copayment.

(B) The caretaker was found ineligible because of inaccurate information provided to the Department or because information was withheld from the Department when eligibility was determined.

(C) The caretaker fails to meet the requirements of the locally-prepared agreement among the client and the Head Start program.

(D) The child is no longer attending a Head Start contracted program.

(E) The caretaker of the child voluntarily quits their job or causes their own dismissal and does not meet the "good cause" criteria set out in OAR 461-135-0070(2).

(F) The caretaker of the child is no longer employed and enrolls in school, unless the caretaker is:

(i) Continuing to actively seek employment during the hours the contracted Head Start program is operating; and

(ii) Available to work during the operating hours of the contracted Head Start program.

(G) The filing group (see OAR 461-110-0310 and 461-110-0350) no longer meets Oregon residency requirements under OAR 461-120-0010.

(e) For any month in which the child is eligible to be served under a contract covered by this rule, the copayment is $0.

(3) The Department will not make a child care payment for a child in a Head Start program if the child's caretaker has been found ineligible for ERDC program under OAR 461-135-0415 for failure to make a copayment.

Statutory/Other Authority: ORS 411.060, 411.116, 412.049 & ORS 409.050
Statutes/Other Implemented: ORS 409.010, 409.050, 409.610, 411.060, 411.116, 411.122 & 412.049
History:
SSP 22-2020, amend filed 07/08/2020, effective 07/08/2020
SSP 36-2015, f. 12-23-15, cert. ef. 1-1-16
SSP 29-2015(Temp), f. & cert. ef. 10-1-15 thru 3-28-16
SSP 16-2015, f. & cert. ef. 4-1-15
SSP 24-2014, f. & cert. ef. 10-1-14
SSP 11-2014(Temp), f. & cert. ef. 4-10-14 thru 10-7-14
SSP 24-2013, f. & cert. ef. 10-1-13
SSP 28-2009, f. & cert. ef. 10-1-09
SSP 9-2009(Temp), f. & cert. ef. 5-1-09 thru 10-28-09
SSP 24-2004, f. 12-30-04, cert. ef. 1-1-05
SSP 22-2004, f. & cert. ef. 10-1-04
SSP 23-2003, f. & cert. ef. 10-1-03
AFS 10-2002, f. & cert. ef. 7-1-02
AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01
AFS 33-2000(Temp), f. 12-22-00, cert. ef. 1-1-01 thru 3-31-01

461-135-0415
Requirement to Make Copay or Satisfactory Arrangements; ERDC

In the ERDC program:

(1) The caretaker is responsible for paying the copayment to the primary provider of child care unless the Child Care Billing form was sent to the provider showing no copayment.

(2) If the client has only one provider during a month, that provider is the primary provider. If the client uses more than one provider, the client must designate one as the primary provider. Notwithstanding any designation by the client, the Department considers a provider having the copayment amount (not to exceed the client's established copayment amount) deducted from its valid billing statement the primary provider for that period.

(3) If the copayment exceeds the amount billed by the primary provider, the Department may treat a different provider as the primary provider or split the copayment among the providers who bill for care.

(4) The copayment amount due from the caretaker to the provider is the lesser of:

(a) The copayment amount determined by the Department based on family size and income.

(b) The total amount allowed by the Department on a provider claim.

(5) A client who fails to pay a copayment to or to make satisfactory arrangements with the primary provider is ineligible for ERDC if the provider notifies the Department of an overdue copayment within 60 days after the Department issues payment for the month at issue. The period of ineligibility ends under any of the following circumstances:

(a) On the first day of the month in which the client makes the copayment or makes satisfactory arrangements with the provider.

(b) On the first day of the month after three years have lapsed from the date the client failed to make the copayment.

(c) On the first day of the month in which the client provides verification that the copayment debt was discharged by a bankruptcy filing.

(6) The Department will make the payment to a provider if a Child Care Billing form is mailed to the provider prior to the notification described in section (5) of this rule.

Statutory/Other Authority: ORS 409.050, 409.610, 411.060, 411.070 & 411.122
Statutes/Other Implemented: ORS 409.050, 409.610, 411.060, 411.070 & 411.122
History:
SSP 23-2015, f. 9-28-15, cert. ef. 10-1-15
SSP 18-2010, f. & cert. ef. 7-1-10
SSP 13-2009, f. & cert. ef. 7-1-09
SSP 7-2003, f. & cert. ef. 4-1-03
AFS 34-2000, f. 12-22-00, cert. ef. 1-1-01
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95
AFS 12-1993, f. & cert. ef. 7-1-93
AFS 20-1992, f. 7-31-92, cert. ef. 8-1-92
AFS 2-1992, f. 1-30-92, cert. ef. 2-1-92
AFS 12-1990, f. 3-30-90, cert. ef. 4-1-90

461-135-0440
Child Care Benefit Eligibility and Payment; COVID-19

(1) The provisions in this rule apply to child care benefits and requirements for child care providers in the ERDC and TANF programs.

(2) The Department shall pay for one-time supplemental payments as follows:

(a) A provider may only receive one of the payments listed in this subsection.

(A) In the amount of $2,312.00 to child care providers who, at the time the Department completed the data pull on November 13, 2020, met the following criteria:

(i) Eligible for payment under OAR 461-165-0180,

(ii) Designation of a license-exempt standard family or enhanced family provider as identified by a Standard Family Rate provider type (see OAR 461-155-0150) or an Enhanced Family Rate provider type (see OAR 461-155-0150), and

(iii) Received a payment from the Department for child care provided during April, May, June, July, August, September, October, or November 2020.

(B) In the amount of $2,842.00 to child care providers who, at the time the Department completed the data pull on November 13, 2020, met the following criteria:

(i) Met all criteria in paragraph (A)(i) through (iii) of this subsection, and

(ii) Have not received an Emergency Child Care grant from the Oregon Department of Education, Early Learning Division for either phase one or phase two.

(b) In the amount of $735.00 to child care providers who, at the time the Department completed the data pull on June 30, 2021, met the following criteria:

(A) Eligible for payment under OAR 461-165-0180,

(B) Designation of a license-exempt standard family or enhanced family provider as identified by a Standard Family Rate provider type (see OAR 461-155-0150) or an Enhanced Family Rate provider type (see OAR 461-155-0150), and

(C) Received a payment from the Department on or after November 13th, 2020, for child care provided during any month from April 2020 through June 2021.

(c) In the amount of $1508; funded by Coronavirus Aid, Relief, and Economic Security Act (2020) funds allotted to the Department in the amount of $1,740,000; to providers who, at the time the Department completed the data pull on August 1, 2022, met the following criteria:

(A) Eligible for payment under OAR 461-165-0180,

(B) Designation of a license-exempt standard family or enhanced family provider as identified by a Standard Family Rate provider type (see OAR 461-155-0150) or an Enhanced Family Rate provider types (see OAR 461-155-0150), and

(C) Did not receive a stabilization grant payment from the Department of Education, Early Learning Division. 

Statutory/Other Authority: ORS 131.715, 329a.500, ORS 84.001, ORS 411.060, 411.070, 412.006, 412.049, 409.050, 84.061, 84.004, 84.007, 84.010, 84.013, 84.014, 84.016, 84.019, 84.022, 84.025, 84.028, 84.031, 84.034, 84.037, 84.040, 84.043, 84.046, 84.049, 84.052, 84.055 & 84.058
Statutes/Other Implemented: ORS 411.122, 411.141, 418.485, ORS 131.715, 329a.500, ORS 84.001, ORS 411.060, 411.070, 412.006, 412.049, 409.610, 84.061, 84.004, 84.007, 84.010, 84.013, 84.014, 84.016, 84.019, 84.022, 84.025, 84.028, 84.031, 84.034, 84.037, 84.040, 84.043, 84.046, 84.049, 84.052, 84.055, 84.058 & 329a.260
History:
SSP 43-2022, temporary amend filed 08/18/2022, effective 08/18/2022 through 02/13/2023
SSP 2-2022, amend filed 01/25/2022, effective 01/26/2022
SSP 81-2021, temporary amend filed 12/28/2021, effective 12/28/2021 through 06/25/2022
SSP 80-2021, temporary amend filed 12/28/2021, effective 12/28/2021 through 06/25/2022
SSP 36-2021, temporary amend filed 07/01/2021, effective 07/01/2021 through 12/27/2021
SSP 26-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 2-2021, temporary amend filed 01/22/2021, effective 01/25/2021 through 03/27/2021
SSP 43-2020, temporary amend filed 12/04/2020, effective 12/04/2020 through 03/27/2021
SSP 42-2020, temporary amend filed 12/01/2020, effective 12/01/2020 through 03/27/2021
SSP 34-2020, temporary amend filed 09/29/2020, effective 09/29/2020 through 03/27/2021
SSP 29-2020, adopt filed 08/31/2020, effective 09/01/2020
SSP 20-2020, temporary adopt filed 06/30/2020, effective 06/30/2020 through 09/11/2020
SSP 16-2020, temporary adopt filed 06/17/2020, effective 06/17/2020 through 09/11/2020
SSP 9-2020, temporary adopt filed 04/17/2020, effective 04/17/2020 through 09/11/2020
SSP 4-2020, temporary adopt filed 03/16/2020, effective 03/16/2020 through 09/11/2020

461-135-0475
Specific Requirements; Pre-TANF Program

(1) This rule explains specific requirements for the Pre-TANF program. The eligibility (see OAR 461-001-0000) criteria of the Pre-TANF program are the same as the TANF program. It is not the intent of the Pre-TANF program to delay the start of TANF program benefits. The purposes of the Pre-TANF program are:

(a) To help individuals find employment or other alternatives.

(b) To assess the employment potential of individuals.

(c) To help individuals determine the service level needed to enhance their employability and their likelihood of becoming self-sufficient.

(d) To determine if a needy caretaker relative (see OAR 461-001-0000) has or may have a barrier (see OAR 461-001-0025) to employment or to family stability (see OAR 461-001-0000).

(e) To develop an individualized case plan (see OAR 461-001-0025), when appropriate, that establishes goals and identifies suitable activities (see OAR 461-001-0025) that promote family stability and financial independence.

(f) To provide basic living expenses, as described in section (5) of this rule, immediately to families in need.

(2) Applicants for the TANF program whose unverified application indicates the individual meets the TANF eligibility requirements participate in the Pre-TANF program. Their applications for the TANF program are also considered applications for the Pre-TANF program. The Pre-TANF program is open for not longer than 30 days following the filing date (see OAR 461-115-0040).

(3) Individuals in the Pre-TANF program are subject to the requirements of the JOBS program, described in divisions 130 and 190 of this chapter of rules, and they are subject to the requirements of OAR 461-135-0085 pertaining to substance abuse and mental health.

(4) During the Pre-TANF program, each caretaker relative authorized to work in the United States in the need group (see OAR 461-110-0630) must complete an employability screening (see OAR 461-135-0485). At least one caretaker relative in the need group must participate in an overview of the JOBS program (see OAR 461-135-0485). If the employability screening indicates there is or may be a barrier, the individual must be offered additional screenings, at no cost to the individual, by a person with relevant expertise or specialized training. When appropriate, per OAR 461-190-0211, the individual and the Department prepare a case plan that lists the activities of the individual and support services (see OAR 461-001-0025) payments if available.

(5) The Department may provide the individual with basic living expenses necessary to stabilize the household so the individual can accomplish the activities in the case plan. Basic living expenses covered by this section are limited to the current need of the individual for personal incidentals that the individual cannot meet with other, immediately available resources. Payments under this section are limited to 100 percent of the payment standard in OAR 461-155-0030 for the benefit group (see OAR 461-110-0750). Payment for "past expenses" is made only when the need of the participant cannot be adequately met by a less expensive alternative.

(6) During the Pre-TANF program, an individual may receive support services payments listed in the case plan pursuant to OAR 461-190-0211.

(7) The Pre-TANF program is closed, at any point during the 30 days following the filing date (see OAR 461-115-0040) for TANF program benefits, in any of the following circumstances:

(a) The individual is unlikely to become employed due to the employability of the individual, the circumstances affecting the family, or other causes.

(b) The individual fails without good cause (see OAR 461-130-0327) to comply with a requirement of an employment program or the case plan.

(c) In any circumstance that would make an individual ineligible for TANF.

(d) Upon starting a JOBS Plus assignment.

(e) Upon employment and enrollment in Employment Payments (see OAR 461-001-0025) under OAR 461-135-1270.

(8) If Pre-TANF benefits are closed pursuant to subsection (7)(a) or (b) of this rule, TANF benefits may be opened if all TANF eligibility requirements are met.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 412.006 & 412.049
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 412.006, 412.049, 412.064 & 412.001
History:
SSP 26-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 10-2018, amend filed 03/07/2018, effective 04/01/2018
SSP 22-2017, f. 9-8-17 & cert. ef. 10-1-17
SSP 35-2016, f. 9-30-16, cert. ef. 10-1-16
SSP 15-2016, f. & cert. ef. 4-1-16
SSP 34-2011, f. 12-27-11, cert. ef. 12-29-11
SSP 27-2011(Temp), f. 9-30-11, cert. ef. 10-1-11 thru 12-28-11
SSP 20-2011(Temp), f. & cert. ef. 7-1-11 thru 12-28-11
Reverted to SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 16-2009(Temp), f. & cert. ef. 7-1-09 thru 9-28-09
SSP 6-2009(Temp), f. & cert. ef. 4-1-09 thru 9-28-09
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07
SSP 14-2005, f. 9-30-05, cert. ef. 10-1-05
AFS 9-1999, f. & cert. ef. 7-1-99
AFS 2-1999, f. 3-26-99, cert. ef. 4-1-99
AFS 8-1998, f. 4-28-98, cert. ef. 5-1-98
AFS 9-1997, f. & cert. ef. 7-1-97

461-135-0485
Requirement to Complete an Employability Screening and Overview of the Job Opportunity and Basic Skills (JOBS) Program; Pre-TANF and TANF

(1) As used in this rule:

(a) "Employability screening" means the form or forms DHS has designated as the employability screening tool for TANF program eligibility.

(b) "Overview of the JOBS program" means a discussion about the requirements and services provided under the JOBS program.

(2) To be eligible for Pre-TANF and TANF benefits, the following must be completed prior to the end of the application processing time frames in OAR 461-115-0190:

(a) Each caretaker relative in the need group, authorized to work in the United States, must complete an employability screening (see section (1) of this rule); and

(b) At least one caretaker relative in the need group, when the need group contains at least one caretaker relative authorized to work in the United States, must participate in an overview of the JOBS program (see section (1) of this rule).

(3) The employability screening and overview of the JOBS program must be offered during the initial eligibility intake for Pre-TANF and TANF program benefits.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 412.006, 412.049 & 412.124
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 412.006, 412.049, 412.064, 412.124, 45 CFR 261.2, 45 CFR 261.10 & 45 CFR 261.11
History:
SSP 21-2018, amend filed 06/05/2018, effective 07/01/2018
SSP 13-2018, temporary amend filed 03/27/2018, effective 04/01/2018 through 06/30/2018
SSP 13-2017, f. 6-5-17, cert. ef. 7-1-17
SSP 15-2016, f. & cert. ef. 4-1-16
SSP 35-2011, f. 12-27-11, cert. ef. 1-1-12
SSP 26-2011(Temp), f. 9-30-11, cert. ef. 10-1-11 thru 3-29-12

461-135-0491
Disaster Supplemental Nutrition Assistance Program (DSNAP)

(1) OAR 461-135-0491 to 461-135-0497 apply only to the Disaster Supplemental Nutrition Assistance Program and only to a disaster benefit period and location authorized by the Food and Nutrition Service.

(2) The regular SNAP program continues to operate during a disaster benefit period and continues to process applications and make eligibility determinations in the normal manner.

(3) The following definitions apply to OAR 461-135-0491 to 461-135-0497:

(a) "DSNAP" refers to the Disaster Supplemental Nutrition Assistance Program.

(b) "FNS" refers to the Food and Nutrition Services, United States Department of Agriculture.

(c) “Household” refers to all individuals living and sharing food together at the time of the disaster who choose to apply together.

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816
History:
SSP 13-2017, f. 6-5-17, cert. ef. 7-1-17
SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07

461-135-0492
Application, Interviews, and Verification for DSNAP

(1) A request to replace food which was purchased with SNAP benefits and lost during a disaster does not require an application for DSNAP to be processed. See OAR 461-165-0230 for the processing of replacement requests.

(2) The Department may be approved by the Food and Nutrition Service of the United States Department of Agriculture (USDA) to issue mass supplements, as described at OAR 461-135-0494, to a current SNAP filing group (see OAR 461-110-0370). All others must complete the application process to receive DSNAP benefits.      

(3) To file an application for DSNAP, a household (see OAR 461-135-0491) must submit a completed application (DHS 349).

(a) The household may submit this application through the mail or at a certification site in person or through an authorized representative (as described at OAR 461-115-0090).

(b) The application must be filed before the expiration of the period during which FNS has authorized the Department to process and approve applications for DSNAP.

(c) The application must be signed by a responsible member of the household or by an authorized representative designated by the household.

(4) As part of the process for determining eligibility, the household or its authorized representative must be interviewed and must provide information and limited verification as described in section (5) of this rule.

(a) The Department must advise the household orally and in writing about the disposition of its application, its rights and responsibilities, when its emergency certification period ends, and about the regular SNAP program.

(b) The Department must advise the household of the civil and criminal penalties for violations of the Food Stamp Act, and of the fact that the household may be subject to a post-disaster review.

(c) The Department must inform each DSNAP-eligible household about the proper use of SNAP benefits.

(5) As part of the process for determining eligibility, the household or its authorized representative must provide the following:

(a) Verification of the identity of the applicant;

(b) Verification that at the time of the disaster, the applicant’s residence or workplace was located in the disaster area; and

(c) An estimate of total take-home pay, cash resources, and allowable disaster-related expenses (see OAR 461-135-0493(2)).

(d) Verification of any questionable information when requested by the Department.

Statutory/Other Authority: ORS 409.050 & 411.816
Statutes/Other Implemented: ORS 409.010, 411.816 & 7 CFR 280.1
History:
SSP 20-2019, amend filed 09/19/2019, effective 10/01/2019
SSP 35-2018, amend filed 12/04/2018, effective 01/01/2019
SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07

461-135-0493
Eligibility and Benefit Amount for DSNAP

(1) To be eligible for emergency SNAP assistance during a disaster, a household (see OAR 461-135-0491) must meet all the following criteria:

(a) At the time the disaster struck, the household must have resided or a member of the household must have worked within the geographical area authorized by Food and Nutrition Service (FNS) for disaster procedures. The household may be certified for emergency SNAP assistance, even if at the time of application it is occupying temporary accommodations outside the disaster area. However, the representative of the household must be present at the disaster certification site to be certified for DSNAP assistance.

(b) The household must purchase food during the disaster period authorized by FNS. A household residing in a temporary shelter but not expected to remain in the shelter for the entire benefit period is eligible for DSNAP program benefits.

(c) The household may not receive a food box under the Disaster Household Distribution Program authorized under TEFAP during the DSNAP application period.

(d) The household may not receive benefits under Food Distribution Program on Indian Reservations (FDPIR) during the DSNAP benefit period authorized by FNS.

(e) The household must have experienced at least one of the following adverse effects due to the disaster:

(A) Loss or inaccessibility of income involving a reduction or termination of income or a significant delay in receipt of income. This effect could occur if the disaster has caused a place of employment to close or reduce its work days, if pay checks or other payments are lost or destroyed, or if there is a significant delay in the issuance of pay checks or other payments. This effect could also occur if the work location is inaccessible due to the disaster.

(B) Inaccessibility of liquid resources. The household is unable to reach its cash resources and is not expected to be able to access its liquid resources for most of the disaster benefit period authorized by FNS. This inaccessibility may occur because the financial institutions where the household has its resources are closed due to the disaster and there is no access to ATMs or on-line banking .

(C) Loss of food that is not eligible for a SNAP benefit replacement.

(D) Disaster-related expenses were paid under subsection (2)(b) of this rule.

(2) To be eligible for emergency SNAP assistance during a disaster, the take-home pay of the household for the disaster benefits period authorized by FNS, plus its cash resources (cash on hand and accessible funds in checking and savings accounts), less disaster-related expenses, must be less than or equal to the DSNAP income standard (see OAR 461-155-0180) for the size of the household and the length of the disaster benefit period (see sections (3) and (4) of this rule).

(a) For DSNAP, take-home pay includes all of the following to the extent accessible during the benefit period:

(A) The wages a household actually receives after taxes and other payroll withholdings are taken out.

(B) The assistance payment or other unearned income a household received.

(C) Self-employment income earned after taxes for personal income and social security as well as actual costs of producing the self-employment income are subtracted. Allowable costs of producing the self-employment income are described in OAR 461-145-0920 and 461-145-0930.

(b) For DSNAP, disaster-related expenses include expenses the household has paid or is expected to pay for one of the following expenses during the disaster benefit period authorized by FNS if full reimbursement is not expected during this disaster benefit period. If the household has received or reasonably anticipates receiving a reimbursement for part or all of the expense during the disaster benefit period, only the net expense to the household is deductible. An expense charged to a credit card is not an allowable expense if the credit card bill is paid after the disaster benefit period. No expenses are considered other than the following:

(A) Expenses to repair damages to the home or other property of the household essential to the employment or self-employment of a household member;

(B) Expenses for temporary shelter during evacuation or if the home of the household is not livable or if the household cannot reach its home;

(C) Expenses related to protecting property from disaster damage, including payment for the packing and storage of the items;

(D) Expenses to clean up the home or business following the disaster;

(E) Expenses related to replacing necessary personal and household items, such as clothing, appliances, tools, and educational materials;

(F) Medical expenses for disaster-related injury to a person who was a household member at the time of the disaster (including funeral and burial expenses in the event of death);

(G) Expenses to repair a vehicle damaged in the disaster;

(H) Pet boarding fees when a pet must be placed in boarding due to a disaster; and

(I) Dependent care expenses incurred during the disaster.

(J) Replacing fuel damaged or destroyed by the disaster (including a wood supply used for heat).

(3)  The disaster benefit period, including its beginning and end date, is determined by the Food and Nutrition Service to be a full-month period or half-month period.

(4) If the disaster benefit period is a full-month:

(a) For a household not already receiving SNAP benefits:

(A) Income over the full-month period and all accessible resources are counted;

(B) Disaster-related expenses (described in subsection (2)(b) of this rule) paid, or expected to be paid during the full-month period, are deducted; 

(C) The income limit is the DSNAP income standard (see OAR 461-155-0180); and

(D) The benefit amount is equal to the full month DSNAP payment standard monthly amount (see OAR 461-155-0190).

(b) For a filing group (see OAR 461-110-0370) already receiving SNAP benefits, see OAR 461-135-0494.

(5) If the disaster benefit period is for a half-month:

(a)  For a household not already receiving SNAP benefits:

(A) Income over the half-month period and all accessible resources are counted;

(B) Disaster-related expenses (described in subsection (3)(b) of this rule) paid, or expected to be paid during the half-month period, are deducted;

(C) The income limit is one-half of the DSNAP income standard (see OAR 461-155-0180); and

(D) The benefit amount is equal to one-half of the full month DSNAP payment standard monthly amount (see OAR 461-155-0190).

(b) For a filing group already receiving SNAP benefits, see OAR 461-135-0494.

(6) The full amount of accessible cash resources must be counted, regardless of the length of the disaster benefit period.

(7) No DSNAP program benefits are authorized after the expiration of the period for which the Department is authorized by FNS to process and approve applications for this emergency SNAP assistance.

(8) A household determined eligible must receive benefits no later than three days after the date of application. If the third day falls on a weekend or holiday, benefits must be issued on either:

(a) The second day; or

(b) The first day if the second day is also a weekend or holiday.

Statutory/Other Authority: ORS 409.050 & 411.816
Statutes/Other Implemented: ORS 409.010, 411.816 & 7 CFR 280.1
History:
SSP 26-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 38-2020, temporary amend filed 10/16/2020, effective 10/16/2020 through 04/13/2021
SSP 1-2020, minor correction filed 01/22/2020, effective 01/22/2020
SSP 20-2019, amend filed 09/19/2019, effective 10/01/2019
SSP 35-2018, amend filed 12/04/2018, effective 01/01/2019
SSP 13-2017, f. 6-5-17, cert. ef. 7-1-17
SSP 23-2008, f. & cert. ef. 10-1-08
Reverted to SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07
SSP 13-2007(Temp), f. & cert. ef. 12-17-07 thru 12-31-07
SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07

461-135-0494
DSNAP Treatment of Households Already Certified and Receiving SNAP Benefits

(1) Mass Supplementation emergency SNAP assistance from the DSNAP program may be issued to an eligible filing group (see OAR 461-110-0370) certified for SNAP benefits prior to the disaster.

(a) The DSNAP benefits are calculated using the maximum disaster benefits for the household (see OAR 461-135-0491) minus the regular SNAP allotment of the benefit group (see OAR 461-110-0750) for the benefit period.

(b) A benefit group currently receiving SNAP benefits may receive a supplement by applying for DSNAP according to OAR 461-135-0492.

(c) The Department may issue Mass Supplementation, without requests, to a benefit group currently receiving SNAP in all or a portion of the disaster area if it is determined the area meets the federal criteria for Mass Supplementation and is approved by the Food and Nutrition Service of the United States Department of Agriculture (USDA).

(d) Neither an application nor an interview is required for a benefit group currently receiving SNAP to receive Mass Supplementation emergency SNAP assistance from the DSNAP program.  

(2) Replacement of the value of food purchased with SNAP lost in the disaster is issued to an eligible filing group certified for SNAP benefits prior to the disaster under OAR 461-165-0230.

(a) A SNAP replacement for the value of food lost in a disaster is not a DSNAP benefit.

(b) The value of lost food replaced with a SNAP benefit replacement is not considered a loss of food under OAR 461-135-0493.

Statutory/Other Authority: ORS 409.050 & 411.816
Statutes/Other Implemented: ORS 409.010, 411.816 & 7 CFR 280.1
History:
SSP 26-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 38-2020, temporary amend filed 10/16/2020, effective 10/16/2020 through 04/13/2021
SSP 20-2019, amend filed 09/19/2019, effective 10/01/2019
SSP 35-2018, amend filed 12/04/2018, effective 01/01/2019
SSP 23-2008, f. & cert. ef. 10-1-08
SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07

461-135-0495
Recertifications for DSNAP

(1) A certified household that has already received emergency benefits may apply for recertification and receive additional SNAP benefits for an additional benefit period if:

(a) The household still meets the disaster eligibility criteria; and

(b) FNS extends the authorization period beyond the end of the original disaster benefit period and authorizes the Department to permit certified households who have already received emergency benefits to apply for recertification.

(2) A household applying for recertification must again submit an application (DHS 349) and be interviewed.

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816
History:
SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07

461-135-0496
Hearings for DSNAP

(1) A household denied emergency SNAP benefits is entitled to an expedited hearing as provided under OAR 461-025-0315.

(2) A household requesting a hearing must be offered an immediate supervisory review of its case.

(3) The supervisory review does not replace the expedited hearing. If the situation is resolved by the supervisory review:

(a) The request for a hearing may be withdrawn if the client withdraws the hearing in writing; or

(b) The Department may request a final order that documents the agreed resolution under OAR 137-003-0510(4) and 137-003-0665(5).

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816
History:
SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07

461-135-0497
Household Liability in the DSNAP

(1) Households are held liable for any overissuances or overpayments discovered in the course of post-disaster audit activities.

(2) The Department establishes claims and applies penalties in accordance with OAR 461-195-0501 to 461-195-0621 against any household that received more DSNAP benefits than it was entitled to receive.

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816
History:
SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07

461-135-0505
Categorical Eligibility for SNAP

(1) Individuals and categorical eligibility.

(a) Except as provided under section (c) of this section, an individual is categorically eligible for SNAP benefits:

(A) When they receive or are authorized to receive GA or SSI benefits;

(B) When deemed to be receiving SSI under Section 1619(a) or 1619(b) of the Social Security Act (42 U.S.C. 1382h(a) or (b)); or

(C) When they receive or are authorized to receive cash, in-kind benefits, or services either under Title IV-A of the Social Security Act or by the state as part of the TANF maintenance of effort:

(i) Employment Related Day Care (ERDC);

(ii) Temporary Assistance to Needy Families (TANF) cash assistance; and

(iii) TANF-related programs:

(I) Pre-TANF,

(II) TA-DVS,         

(III) TANF-JOBS Plus,

(IV) Housing Stabilization Program through Housing and Community Services, and

(V) Employment Payments.

(b) For the purposes of categorical eligibility, every individual filing group (see OAR 461-110-0370) member:

(A) Of ERDC and TA-DVS programs are considered receiving the benefits of the program.

(B) Eligible for transition services or the TA-DVS program is considered receiving benefits for the entire period of eligibility even if benefits are not received during each month of that period.

(c) The following individuals shall not be categorically eligible for SNAP benefits:

(A) Those disqualified from receiving SNAP benefits because of an established intentional program violation under OAR 461-195-0611.

(B) The primary person (see OAR 461-001-0015) disqualified from receiving SNAP benefits for failure to comply with a SNAP employment and training requirement under OAR 461-130-0315.

(2) Filing group and categorical eligibility.

(a) Except as provided under subsections (b) and (c) of this section, a filing group is categorically eligible for SNAP benefits when:

(A) All members of the filing group are categorically eligible under section (1) of this rule; or

(B) The filing group meets all of the following:

(i) Has received, or will receive upon approval, the pamphlet about Information and Referral Services. The receipt of the Information and Referral services pamphlet by one member of the filing group is considered received by the entire group.

(ii) The countable income (see OAR 461-140-0010) is less than 185 percent of the federal poverty level (see OAR 461-155-0180).

(iii) The filing group has liquid assets from lottery or gambling winnings less than the resource limit listed in OAR 461-160-0015(7)(a). For the purposes of this rule, liquid assets are assets that are easily accessible and do not need to be sold to access their value.

(b) A filing group shall not be categorically eligible for SNAP benefits when a member of the filing group is not categorically eligible.

(c) A filing group that loses SNAP benefit eligibility (see OAR 461-001-0000) due to lottery or gambling winnings (see OAR 461-140-0263) is not eligible for SNAP benefits, or to have SNAP eligibility determined using categorical eligibility, until they meet financial eligibility under the following SNAP financial eligibility resource and income requirements (see OAR 461-160-0400):  

(A) Resources must be below the resource limit set under OAR 461-160-0015,

(B) Countable income (see OARs 461-001-0000 and 461-140-0010) must be below the countable income limit set at 130 percent of the federal poverty level under OAR 461-155-0180, except for a financial group (see OAR 461-110-0530) that includes an individual who is elderly (see OAR 461-001-0015) or has a disability (see OAR 461-001-0015), and

(C) Adjusted income (see OAR 461-001-0000) must be below the adjusted income limit set at 100 percent of the federal poverty level under OAR 461-155-0180.

(D) This provision applies to all types of categorical eligibility.

(E) After a filing group regains eligibility for SNAP under this subsection, future eligibility may be determined using categorical eligibility.

(3) When a filing group contains both members who are categorically eligible for SNAP benefits and those who are not, a resource owned in whole or in part by a categorically eligible member is excluded.

(4) Presumed eligibility.

(a) If verified in a public assistance or medical assistance program, an individual found categorically eligible for the SNAP program is presumed to meet the following eligibility requirements, unless questionable:

(A) Social security number,

(B) U.S. Citizenship and Immigration Services sponsorship information, and

(C) Oregon residency.

(b) A filing group found categorically eligible for the SNAP program is presumed to meet the following financial eligibility resource and income requirements (see OAR 461-160-0400):  

(A) Resource limit,

(B) Countable income limit, and

(C) Adjusted income limit.

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816 & 7 CFR 273.11
History:
SSP 35-2022, amend filed 04/28/2022, effective 05/01/2022
SSP 3-2022, temporary amend filed 01/26/2022, effective 01/26/2022 through 07/24/2022
SSP 2-2022, amend filed 01/25/2022, effective 01/26/2022
SSP 82-2021, temporary amend filed 12/29/2021, effective 01/01/2022 through 06/25/2022
SSP 80-2021, temporary amend filed 12/28/2021, effective 12/28/2021 through 06/25/2022
SSP 42-2021, temporary amend filed 07/14/2021, effective 07/14/2021 through 12/27/2021
SSP 36-2021, temporary amend filed 07/01/2021, effective 07/01/2021 through 12/27/2021
SSP 5-2020, amend filed 03/30/2020, effective 04/01/2020
SSP 20-2019, amend filed 09/19/2019, effective 10/01/2019
SSP 34-2017, amend filed 12/18/2017, effective 01/01/2018
SSP 25-2017(Temp), f. 9-15-17, cert. ef. 10-1-17 thru 1-31-18
SSP 9-2014, f. & cert. ef. 4-1-14
SSP 39-2013(Temp), f. 12-31-13, cert. ef. 1-1-14 thru 6-30-14
SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08
SSP 10-2006, f. 6-30-06, cert. ef. 7-1-06
SSP 4-2005, f. & cert. ef. 4-1-05
SSP 16-2003, f. & cert. ef. 7-1-03
SSP 2-2003(Temp), f. & cert. ef. 2-7-03 thru 6-30-03
AFS 9-2001, f. & cert. ef. 6-1-01
AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01
AFS 29-2000(Temp), f. & cert. ef. 12-1-00 thru 3-31-01
AFS 11-1999, f. & cert. ef. 10-1-99
AFS 9-1997, f. & cert. ef. 7-1-97
AFS 19-1993, f. & cert. ef. 10-1-93
AFS 13-1991, f. & cert. ef. 7-1-91
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0506
Transitional Benefit Alternative (TBA) in the SNAP Program

(1) This rule establishes the transitional benefit alternative (TBA). A client participating in TBA continues to receive SNAP benefits without reduction during the transition period. The transition period is five months. If the filing group (see OAR 461-110-0310 and 461-110-0370) separates into two groups during the TBA period, only the group containing the head of household continues in the TBA.

(2) In the SNAP program, a client who receives a cash grant from the Department in the SFPSS or TANF programs may participate in TBA when the benefits are stopped, except as provided in section (4) of this rule.

(3) The benefit level for the transition period is based on countable (see OAR 461-001-0000) income for SNAP during the last month before TBA begins, but the Title IV-A grant is not counted as income. Once it is established, the TBA benefit level is changed only when;

(a) The filing group submits a new application in the SNAP program and will receive more SNAP benefits if they are not using the TBA reporting system;

(b) A member of the filing group leaves and applies for SNAP benefits as a member of another household; or

(c) The Department initiates a change identified in OAR 461-170-0200.

(4) A household may not participate in TBA in each of the following situations:

(a) A member of the filing group is receiving benefits of the TANF program.

(b) The TANF benefits are stopped because the household does not reside in Oregon.

(c) The TANF benefits are stopped because of a change that results in ineligibility for TANF and the household failed to complete a timely report or to complete a required action on time.

(d) As of the date the TANF case closed, an individual in the household was serving a penalty imposed in the TANF program.

(e) The TANF benefits are stopped at the request of the household after the household is informed of an impending disqualification in the TANF program.

(f) The head of household becomes ineligible for the SNAP program because he or she lives in an institution or in a facility that provides at least 50 percent of the meals.

(g) A member of the financial group (see OAR 461-110-0530) is subject to a penalty in the SNAP program because of the individual's conduct, for instance, because the individual:

(A) Was excluded from the need group under OAR 461-110-0630;

(B) Was penalized for failure to meet a requirement of an employment program;

(C) Was ineligible for SNAP benefits under OAR 461-105-0410; or

(D) Was ineligible for or disqualified from participation in the SNAP program because of a failure to comply with a requirement of the program to provide complete and accurate information to the Department.

(h) A member of the financial group becomes ineligible for the SNAP program because of the SNAP time limit imposed under OAR 461-135-0520.

(5) Once the TBA benefits have ended, a client's eligibility for the SNAP program is determined on the basis of a new application.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070 & 411.816
Statutes/Other Implemented: ORS 409.050, 411.060, 411.070, 411.816, 411.825 & 411.837
History:
SSP 34-2017, amend filed 12/18/2017, effective 01/01/2018
SSP 15-2016, f. & cert. ef. 4-1-16
SSP 1-2016(Temp), f. & cert. ef. 1-1-16 thru 6-28-16
SSP 23-2008, f. & cert. ef. 10-1-08
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07
SSP 6-2006, f. 3-31-06, cert. ef. 4-1-06
SSP 4-2005, f. & cert. ef. 4-1-05
SSP 13-2003, f. 6-12-03, cert. ef. 6-16-03

461-135-0510
Residents of Institutions; SNAP

Residents of institutions that provide more than 50 percent of three daily meals as a part of the normal services of the institution are ineligible for SNAP benefits, unless they fall into one of the following five exceptions to this rule:

(1) The individual is a resident of federally subsidized housing for the elderly built under either section 202 of the Housing Act of 1959 or section 236 of the National Housing Act.

(2) The individual, and any children also residing with the individual, resides at a facility or treatment center for the purpose of regular participation in a drug and alcohol treatment and rehabilitation program (see OAR 461-001-0015) that meets the following criteria:

(a) The drug and alcohol treatment and rehabilitation program is conducted by a private nonprofit organization or institution, or a publicly operated community mental health center that—

(A) Qualifies under part B of title XIX of the Public Health Service Act to receive funds, even if it does not actually receive funding under part B of title XIX; or

(B) Is authorized as a retailer by the Food and Nutrition Service (FNS).

(b) Residents of a drug and alcohol treatment and rehabilitation program must apply and be certified in accordance with OAR 461-115-0020, through an authorized representative (see OAR 461-115-0090 and OAR 461-115-0145) employed by the facility and designated for that purpose.

(3) The individual is a resident of a group living arrangement (see OAR 461-001-0015) and is blind or disabled (see OAR 461-001-0015).

(4) The individual resides at a public or private nonprofit shelter for homeless persons.

(5) The individual is a temporary resident of domestic violence shelters (see OAR 461-001-0000).

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816 & 7 CFR 273.11
History:
SSP 25-2019, amend filed 12/24/2019, effective 01/01/2020
SSP 34-2017, amend filed 12/18/2017, effective 01/01/2018
SSP 7-2007, f. 6-29-07, cert. ef. 7-1-07
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07
SSP 24-2004, f. 12-30-04, cert. ef. 1-1-05
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 24-1997, f. 12-31-97, cert. ef. 1-1-98
AFS 30-1990, f. 12-31-90, cert. ef. 1-1-91
AFS 12-1990, f. 3-30-90, cert. ef. 4-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0520
Time Limit and Special Requirements for ABAWD; SNAP

This rule establishes the time limit and special requirements for receipt of SNAP benefits for certain adults.

(1) Unless the context indicates otherwise, the following definitions apply to rules in OAR chapter 461:

(a) "Able-bodied adult without dependents (ABAWD)" means an individual 18 years of age or over, but under the age of 50, without dependents. For the purpose of this definition, "without dependents" means there is no child (see OAR 461-001-0000) under the age of 18 years in the filing group (see OAR 461-110-0310 and 461-110-0370).

(b) "SNAP time-limit areas" means areas of Oregon in which the limitation on eligibility (see OAR 461-001-0000) for SNAP benefits for ABAWD in section 6(o)(2) of the Food and Nutrition Act of 2008 (7 U.S.C. 2015(o)(2)) applies. There are no "SNAP time-limit areas" in Oregon during January 1, 2022 to December 31, 2022.

(c) "SNAP time-limit exempt areas" means areas of Oregon in which the limitation on eligibility for SNAP benefits contained in section 6(o)(2) of the Food and Nutrition Act of 2008 (7 U.S.C. 2015(o)(2)) does not apply per a waiver approved by the United States Department of Agriculture. "Exempt areas" are all counties in Oregon during January 1, 2022 to December 31, 2022.

(2) Except as provided otherwise in this rule, an ABAWD who resides in one of the SNAP time-limit areas (see section (1) of this rule) is ineligible to receive food benefits as a member of any household after the individual received food benefits for three countable months (see section (3) of this rule) during January 1, 2022 to December 31, 2024.

(3) "Countable months" means months within the 36-month period of January 1, 2022 to December 31, 2024 in which an individual as a member of any household receives SNAP benefits in Oregon or in any other state, unless at least one of the following applies:

(a) Benefits were prorated for the month.

(b) The individual was exempt from the SNAP time limit for any part of the month for any of the following reasons:

(A) The individual resided for any part of the month in one of the SNAP time-limit exempt areas (see section (1) of this rule).

(B) The individual was pregnant.

(C) A child under the age of 18 years joined the filing group.

(D) The individual met the criteria under OAR 461-130-0310(3)(a) or (b).

(c) The individual participated in one or more of the activities in paragraphs (A) to (D) of this subsection for 20 hours per week averaged over the month. For purposes of this rule, 20 hours per week averaged monthly means 80 hours per month. (Activities may be combined in one month to meet the 20 hours per week averaged monthly requirement.)

(A) Work for pay, in exchange for goods or services, or unpaid work as a volunteer.

(i) Work in exchange for goods and services includes bartering and in-kind work.

(ii) Unpaid or voluntary work hours must be verified by the employer.

(iii) For self-employed individuals, countable income after deducting the costs of producing income (as described in OAR 461-145-0930(5)) must average at least the federal minimum wage times 20 hours per week.

(B) Participate in a program under the Workforce Investment Act of 1998, Pub. L. No. 105‑220, 112 Stat. 936 (1998).

(C) Participate in a program under section 236 of the Trade Act of 1974, Pub. L. 93‑618, 88 Stat. 2023, (1975) (19 U.S.C. 2296).

(D) Comply with the SNAP Employment and Training program requirements described in OAR 461-001-0020, 461-130-0305, and 461-130-0315. Work search activities must be combined with other work-related activities to equal 20 hours per week and may not exceed 9 hours per week.

(d) The individual complied with the Workfare requirements in OAR 461-190-0500.

(4) An ABAWD must submit evidence to the Department within 90 days following the month they received the countable month to show they were exempt or met the 80 hour activity requirement.

(5) An ABAWD who is ineligible under section (2) of this rule but otherwise eligible may regain eligibility if the requirements of subsections (a) or (b) of this section are met.

(a) The individual becomes exempt under subsection (3)(b) of this rule. Eligibility regained under this subsection begins on the date the individual files a new application and continues as long as the individual is exempt and is otherwise eligible. If not eligible on the filing date (see OAR 461-115-0040), eligibility begins the date all other eligibility requirements are met.

(b) The individual, during a consecutive 30-day period during which the individual is not receiving SNAP benefits, meets the requirements of subsection (3)(c) or (3)(d) of this rule.

(A) Eligibility regained under this subsection begins on the date the individual files a new application and continues as long as the individual meets the requirements of subsection (3)(c) or (3)(d) of this rule and is otherwise eligible. If not eligible on the filing date, eligibility begins the date all other eligibility requirements are met.

(B) There is no limit to how many times an individual may regain eligibility under this subsection during January 1, 2022 to December 31, 2024.

(c) See OAR 461-180-0010 to add an individual to an open SNAP case after the individual has regained eligibility under this section.

(6) An individual who regains eligibility under section (5) of this rule and later fails to comply with the participation requirements of subsection (3)(c) or (3)(d) of this rule may receive a second set of food benefits for three consecutive countable months. The countable months are determined as follows:

(a) If the individual stopped participation in a work program, countable months start when the Department notifies the individual they are no longer meeting the work requirement.

(b) If the individual stopped participation in a work program, countable months start when the individual notifies the Department they are no longer meeting the work requirement.

(c) If a change occurred which results in an individual becoming subject to the time limit in section (2) of this rule and the change was required to be reported under rules in OAR chapter 461, division 170, the countable months start when the change occurred.

(d) If a change occurred which results in an individual becoming subject to the time limit and the change was not required to be reported under rules in OAR chapter 461, division 170, countable months start when the Department notifies the individual they must meet the work requirement.

(e) An individual may only receive benefits without meeting the requirements of subsection (3)(c) or (3)(d) of this rule for no more than a total of six countable months during January 1, 2022 to December 31, 2024.

(7) This space is reserved for the use of discretionary exemptions, granted by the Food and Nutrition Service, for ABAWDs residing in certain SNAP time-limit areas who are at risk of having their benefits closed or reduced.  Beginning April 1, 2020 to December 31, 2022, the Department is not granting discretionary exemptions.

(8) An ABAWD involved in the activities specified in subsection (3)(c) or (3)(d) of this rule or an activity listed in the individual's case plan (see OAR 461-001-0020) is eligible for support service payments necessary for transportation and other costs related to completing the activity as allowed by OAR 461-190-0360.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.121 & 411.816
Statutes/Other Implemented: 7 USC 2015, 7 USC 2029, 7 CFR 273.7, 7 CFR 273.24, ORS 409.010, 409.050, 411.060, 411.070, 411.121, 411.816, 411.825 & 411.837
History:
SSP 43-2022, temporary amend filed 08/18/2022, effective 08/18/2022 through 02/13/2023
SSP 7-2022, amend filed 02/03/2022, effective 02/18/2022
SSP 76-2021, temporary amend filed 12/20/2021, effective 01/01/2022 through 03/27/2022
SSP 51-2021, temporary amend filed 09/30/2021, effective 10/01/2021 through 03/27/2022
SSP 26-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 1-2021, temporary amend filed 01/22/2021, effective 01/25/2021 through 07/23/2021
SSP 25-2019, amend filed 12/24/2019, effective 01/01/2020
SSP 21-2019, temporary amend filed 09/30/2019, effective 10/01/2019 through 12/31/2019
SSP 11-2019, temporary amend filed 04/01/2019, effective 04/01/2019 through 09/26/2019
SSP 7-2019, amend filed 03/11/2019, effective 04/01/2019
SSP 37-2018, temporary amend filed 12/07/2018, effective 01/01/2019 through 03/31/2019
SSP 24-2018, temporary amend filed 06/28/2018, effective 07/01/2018 through 09/30/2018
SSP 14-2018, temporary amend filed 03/28/2018, effective 04/01/2018 through 04/30/2018
SSP 6-2018, temporary amend filed 01/30/2018, effective 02/01/2018 through 02/28/2018
SSP 34-2017, amend filed 12/18/2017, effective 01/01/2018
SSP 25-2017(Temp), f. 9-15-17, cert. ef. 10-1-17 thru 1-31-18
SSP 45-2016, f. 12-20-16, cert. ef. 1-1-17
SSP 38-2016(Temp), f. & cert. ef. 10-19-16 thru 4-16-17
SSP 35-2016, f. 9-30-16, cert. ef. 10-1-16
Reverted to SSP 15-2016, f. & cert. ef. 4-1-16
SSP 18-2016(Temp), f. 4-29-16, cert. ef. 5-1-16 thru 6-30-16
SSP 16-2016(Temp), f. & cert. ef. 4-5-16 thru 4-30-16
SSP 15-2016, f. & cert. ef. 4-1-16
SSP 10-2016(Temp), f. & cert. ef. 3-2-16 thru 8-2-16
SSP 6-2016(Temp), f. & cert. ef. 2-5-16 thru 8-2-16
SSP 37-2015, f. 12-23-15, cert. ef. 1-1-16
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07
AFS 13-2002, f. & cert. ef. 10-1-02
AFS 8-2002, f. & cert. ef. 5-1-02
AFS 8-2001, f. & cert. ef. 5-1-01
AFS 34-2000, f. 12-22-00, cert. ef. 1-1-01
AFS 25-2000, f. 9-29-00, cert. ef. 10-1-00
AFS 12-2000(Temp), f. 5-1-00, cert. ef. 5-1-00 thru 9-30-00
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 22-1998, f. 10-30-98, cert. ef. 11-1-98
AFS 17-1998, f. & cert. ef. 10-1-98
AFS 15-1998(Temp), f. 9-15-98, cert. ef. 10-1-98 thru 10-31-98
AFS 8-1998, f. 4-28-98, cert. ef. 5-1-98
AFS 6-1998(Temp), f. 3-30-98, cert. ef. 4-1-98 thru 5-31-98
AFS 24-1997, f. 12-31-97, cert. ef. 1-1-98
AFS 19-1997, f. & cert. ef. 10-1-97
AFS 5-1997, f. 4-30-97, cert. ef. 5-1-97
AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97
AFS 42-1996, f. 12-31-96, cert. ef. 1-1-97
AFS 39-1996(Temp), f. 11-27-96, cert. ef. 12-1-96

461-135-0521
Job Quit by Applicants; SNAP

(1) An applicant who is required to meet the SNAP employment and training requirements in OAR 461-130-0305 and 461-130-0315, who voluntarily and without good cause (see OAR 461-130-0327) quits a job or reduces the weekly number of hours of work to below 30, is ineligible for SNAP benefits.

(2) For purposes of this rule, an individual quits a job upon quitting a job of at least 30 hours a week or the equivalent of 30 hours a week multiplied by the federal minimum wage.

(3) The period of ineligibility is determined as follows. If the filing date falls within the 30-day period following a job quit or work reduction described in sections (1) and (2) of this rule, the person who quit the job or reduced work hours will be ineligible during the month in which the filing date falls and for the appropriate disqualification of one, three or six calendar months (see OAR 461-130-0330).

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816
History:
SSP 23-2016, f. 6-28-16, cert. ef. 7-1-16
SSP 14-2016(Temp), f. 3-24-16, cert. ef. 4-1-16 thru 9-27-16
AFS 13-2002, f. & cert. ef. 10-1-02
AFS 19-2001, f. 8-31-01, cert. ef. 9-1-01
AFS 10-2001(Temp), f. 6-29-01, cert. ef. 7-1-01 thru 10-1-01

461-135-0530
People in Adult Foster Care (AFC) and Boarding Houses; SNAP

(1) Residents of commercial boarding houses are not eligible for SNAP benefits. A person operating the boarding house and his or her filing group may receive benefits separate from the residents. Commercial boarding house is defined in 7 CFR 273.1 as a commercial establishment that offers meals and lodging for compensation with the intent of making a profit. The definition does not include federally subsidized housing for the elderly, alcohol or drug treatment centers, group homes, battered persons shelters, or homeless shelters.

(2) Residents of AFC facilities not licensed by the State are not eligible for SNAP benefits. Residents of AFC facilities licensed by the state must apply with their caregiver to be eligible for SNAP benefits, as required by OAR 461-110-0370.

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816
History:
SSP 7-2003, f. & cert. ef. 4-1-03
AFS 9-2001, f. & cert. ef. 6-1-01
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 23-1995, f. 9-20-95, cert. ef. 10-1-95
AFS 30-1990, f. 12-31-90, cert. ef. 1-1-91
AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0560
Fleeing Felon and Violators of Parole, Probation, and Post-Prison Supervision; REF, REFM, SNAP, and TANF

Retroactively effective July 6, 2020:

(1) An individual is ineligible for the REF, REFM, SNAP, and TANF programs if the individual is a fleeing felon or in violation of parole, probation, or post-prison supervision.

(2) An individual is considered a fleeing felon when a law enforcement officer acting in their official capacity presents a warrant conforming to one of the following National Crime Information Uniform Offense Classification (NCIC) Codes:

(a) Escape (4901),

(b) Flight to Avoid (prosecution, confinement, etc.) (4902), or

(c) Flight-Escape (4999).

(3) An individual is considered in violation of parole, probation, or post-prison supervision if the Department receives a report of this violation from a local, state, or federal corrections agency or court responsible for supervision of the individual and the law enforcement agency is actively seeking the individual.

(4) For purposes of this rule, “actively seeking” is defined as one of the following:

(a) A Federal, State, or local law enforcement agency presents a felony arrest warrant conforming to one of the NCIC codes in section 2 of this rule; or 

(b) A court, Federal, State, or local law enforcement agency intends to arrest an individual for a parole or probation violation within:

(A) 20 days from the date the Department was notified of the parole or probation violation, or

(B) 30 days from the date the Department requests information from the law enforcement agency verifying that they intend to arrest the individual.

Statutory/Other Authority: ORS 409.050, 411.060, 411.816 & 412.049
Statutes/Other Implemented: ORS 409.010, 411.060, 411.816, 412.049, 7 CFR 272.1 & 7 CFR 273.11
History:
SSP 22-2020, amend filed 07/08/2020, effective 07/08/2020
SSP 35-2018, amend filed 12/04/2018, effective 01/01/2019
SSP 10-2017, f. 3-24-17, cert. ef. 4-1-17
SSP 31-2016, f. & cert. ef. 9-1-16
SSP 25-2016(Temp), f. 6-30-16, cert. ef. 7-1-16 thru 12-27-16
SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06

461-135-0570
Eligible and Ineligible Students; SNAP

(1) For the purposes of this rule and OAR 461-001-0015, "higher education" refers to the following:

(a) Public and private universities and colleges and community colleges that offer degree programs regardless of whether a high school diploma is required for the program. However, GED, ABE, ESL and high school equivalency programs at those institutions are not considered higher education.

(b) Vocational, technical, business, and trade schools that normally require a high school diploma or equivalency certificate for enrollment in the curriculum or in a particular program at the institution. However, programs at those institutions that do not require the diploma or certificate are not considered higher education.

(2) Except to the extent provided otherwise in section (4) of this rule, an individual is considered a "student of higher education" if all of the following subsections apply:

(a) The individual is attending higher education (see section (1) of this rule) at least half time or more as determined by the school.

(b) The individual is 18 years of age or older, but under 50 years of age.

(3) To be eligible for SNAP benefits, a student of higher education (see section (2) of this rule) must meet the requirements of one of the following subsections:

(a) Subject to section (6) of this rule, the student of higher education is:

(A) A paid employee (see OAR 461-001-0015) working an average of 20 hours or more per week except as excluded by section (6) of this rule; or

(B) Self-employed for a minimum of 20 hours per week and receives weekly earnings at least equal to the federal minimum wage multiplied by 20 hours.

(b) The student of higher education is participating in a state or federally funded work study program during the regular school year.  To qualify under this subsection:

(A) The student of higher education must be approved for state or federally funded work study at the time of application for SNAP.

(B) The work study must be approved for the school term.

(C) The student of higher education must anticipate working in a work study job during the school term.

(D) The period of eligibility for a student of higher education eligible under this subsection:

(i) Begins with the month in which the school term begins or with the month that work study is approved, whichever is later.

(ii) Continues until the end of the month in which the school term ends, or it becomes known that the student of higher education has refused an assignment.

(iii) Continues through breaks of less than a month. For breaks of a month or longer, eligibility continues only if the student of higher education participates in a work study job during the break.

(c) The student of higher education is responsible for the care of a child in the filing group (see OAR 461-110-0370), and one of the following conditions is met:

(A) The child is--

(i) Under six years of age; or

(ii) Six years of age or older, but under the age of 12 years, and adequate child care is not available to enable the student to both attend class and meet the requirements of section (3)(a) or (3)(b) of this rule.

(B) The student of higher education is enrolled full time in higher education and is a single parent (meaning there is only one parent in the filing group) or a single adult who has parental control, with the responsibility of caring for a child under 12 years of age.

(d) The student of higher education is in a TANF benefit group (see OAR 461-110-0750).

(e) The student of higher education is physically or mentally unfit for employment.

(f) The student of higher education is receiving Unemployment Compensation (UC).

(g) The student of higher education is enrolled in higher education to receive training and skills for employment as defined below:

(A) Job training classes under the Workforce Innovation & Opportunity Act of 2014 (Pub. L. 113-128).

(B) Participation in the higher education component of the JOBS program.

(C) Employer-sponsored on-the-job training.

(D) Enrolled in an employment and training program or course of study that leads to employment. To qualify under this paragraph, the employment and training program or course of study must be of undergraduate or lower level and designed to be completed in not more than four years.

(E) Participating in at least one of the following training programs:

(i) The Trade Readjustment Allowance (TRA) program serving displaced workers under the Trade Act.

(ii) The Training Unemployment Insurance (TUI) program.

(iii) The Self-Employment Assistance (SEA) program.

(iv) The Apprenticeship Program (APT).

(4) An individual's status as a student of higher education continues during school vacation and breaks. An individual is no longer considered a student of higher education when the individual:

(a) Graduates.

(b) Drops out.

(c) Withdraws from classes.

(d) Reduces credit hours to less than half time.

(e) Is suspended or expelled.

(f) Does not intend to register for the next school term (excluding summer term).

(5) A student of higher education residing in a dormitory or other living situation with a meal plan that provides more than 50 percent of the student's meals is ineligible for SNAP program benefits.

(6) The following situations do not earn the student of higher education hours toward the 20 hours per week requirement in section (3) of this rule:

(a) Income that is considered educational income under OAR 461-145-0150, including income from work in the following:

(A) An externship (see OAR 461-001-0015);

(B) A graduate assistantship (see OAR 461-001-0015);

(C) A graduate fellowship (see OAR 461-001-0015); or

(D) An internship (see OAR 461-001-0015).

(b) Receiving in-kind payments in lieu of actual wages.

Statutory/Other Authority: ORS 409.050 & 411.816
Statutes/Other Implemented: ORS 409.010, 411.816, 411.825, 7 USC 2015 & 7 CFR 273.5
History:
SSP 20-2019, amend filed 09/19/2019, effective 10/01/2019
SSP 19-2019, temporary amend filed 07/30/2019, effective 07/30/2019 through 09/30/2019
SSP 32-2018, amend filed 11/26/2018, effective 12/01/2018
SSP 23-2018, temporary amend filed 06/26/2018, effective 07/01/2018 through 12/27/2018
SSP 34-2017, amend filed 12/18/2017, effective 01/01/2018
SSP 24-2013, f. & cert. ef. 10-1-13
SSP 10-2013(Temp), f. & cert. ef. 5-1-13 thru 10-28-13
SSP 25-2011, f. 9-30-11, cert. ef. 10-1-11
SSP 18-2010, f. & cert. ef. 7-1-10
SSP 6-2010(Temp), f. & cert. ef. 4-1-10 thru 8-4-10
SSP 5-2010, f. & cert. ef. 4-1-10
SSP 2-2010(Temp), f. & cert. ef. 2-5-10 thru 8-4-10
SSP 17-2008, f. & cert. ef. 7-1-08
SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
SSP 6-2006, f. 3-31-06, cert. ef. 4-1-06
SSP 7-2005, f. & cert. ef. 7-1-05
SSP 4-2005, f. & cert. ef. 4-1-05
SSP 23-2003, f. & cert. ef. 10-1-03
AFS 10-2002, f. & cert. ef. 7-1-02
AFS 3-2002(Temp), f. 2-26-02, cert. ef. 3-1-02 thru 6-30-02
AFS 9-2001, f. & cert. ef. 6-1-01
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 41-1995, f. 12-26-95, cert. ef. 1-1-96
AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95
AFS 1-1993, f. & cert. ef. 2-1-93
AFS 8-1992, f. & cert. ef. 4-1-92
AFS 13-1991, f. & cert. ef. 7-1-91
AFS 30-1990, f. 12-31-90, cert. ef. 1-1-91
AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0575
SNAP Expedited Services

In the SNAP program:

(1) For purposes of this rule, "liquid resources" includes cash on hand, a checking or savings account, a savings certificate, and a lump sum payment.

(2) An applicant is screened for expedited services except when a filing group (see OAR 461-110-0370) applies for SNAP benefits before the end of their current certification. If a filing group meets the expedited services criteria and the Department determines the filing group is eligible for SNAP benefits, the filing group qualifies to receive benefits within seven days following the filing date.

(3) The filing group meets expedited services criteria if the filing group:

(a) Has countable income less than $150 a month and liquid resources that do not exceed $100;

(b) Has gross income and liquid resources that total less than the total monthly rent, or mortgage, and utilities of the household; or

(c) Is a "destitute household." To be a destitute household, the filing group must include a migrant or seasonal farmworker and meet one of the following:

(A) The only income received during the month in which the filing date falls was received prior to the filing date and was from a terminated source. Income is considered from a “terminated source” when:

(i) Received on a monthly or more frequent basis and will not be received again from the same source during the month of the filing date or in the following month; or

(ii) Received as periodic income (see OAR 461-001-0000), and the income is not anticipated to be received during the month in which the next payment would normally be received.

(B) The only income received during the month in which the filing date falls will be received from a new source and income of more than $25 from that source is not anticipated to be received by the 10th day following the filing date. Income is considered from a “new source” when $25 or less has been received from that source during the 30 days prior to the filing date.

(C) The only income of the filing group is from a terminated source received prior to the filing date, a new source received after the filing date, and income from the new source of more than $25 is not anticipated to be received by the 10th day following the filing date.

(4) There is no limit to the number of times a benefit group (see OAR 461-110-0750) may receive expedited services. However, all eligibility factors from the last expedited issuance must be verified or the benefit group must have been certified under normal processing standards since the last expedited certification before the client is eligible to receive expedited services again.

(5) An eligibility process interview for an expedited services client is conducted in accordance with OAR 461-115-0690.

(6) The application processing timeframe for an expedited services client is determined under OAR 461-115-0210.

(7) Application information for an expedited services client is verified as required under OAR 461-115-0690.

Statutory/Other Authority: ORS 411.060 & 411.816
Statutes/Other Implemented: ORS 411.060, 411.816 & 7 CFR 273.10
History:
SSP 5-2020, amend filed 03/30/2020, effective 04/01/2020
SSP 5-2010, f. & cert. ef. 4-1-10
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 8-1998, f. 4-28-98, cert. ef. 5-1-98
AFS 6-1998(Temp), f. 3-30-98, cert. ef. 4-1-98 thru 5-31-98
AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97
AFS 42-1996, f. 12-31-96, cert. ef. 1-1-97
AFS 32-1996(Temp), f. & cert. ef. 9-23-96
AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95
AFS 13-1991, f. & cert. ef. 7-1-91
AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0580
Prepared Meals; SNAP

The following SNAP recipients and their spouses may use SNAP benefits to purchase meals prepared for them and delivered to them by a nonprofit meal-delivery service authorized by the United States Department of Agriculture:

(1) People age 60 or over.

(2) Housebound people.

(3) People who have physical or other disabilities which prevent them from adequately preparing their meals.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 13-1997, f. 8-28-97, cert. ef. 9-1-97
AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0590
Communal Dining; SNAP

For SNAP, recipients age 60 or over and their spouses, and those receiving SSI and their spouses, may use SNAP benefits issued to them to purchase meals prepared especially for them at communal dining facilities authorized by the United States Department of Agriculture for that purpose.

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 13-1997, f. 8-28-97, cert. ef. 9-1-97
AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0610
Meal Providers for Homeless Individuals; SNAP

Homeless SNAP recipients may use their SNAP benefits to purchase prepared meals from meal providers who are certified by the state and authorized by the United States Department of Agriculture to accept SNAP benefits from homeless individuals.

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 13-1997, f. 8-28-97, cert. ef. 9-1-97
AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95
AFS 30-1990, f. 12-31-90, cert. ef. 1-1-91
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0660
SNAP; COVID-19

The provisions in this rule apply to the SNAP program.

(1) The Department suspends sections (2) and (6) of OAR 461-135-0520.

(2) The Department amends OAR 461-135-0570 (3) as provided in section (6) of this rule.

(3) Per the Families First Coronavirus Act, Title 3, Section 2301:

(a) SNAP time limit work requirements for ABAWDs (see OAR 461-135-0520) are temporarily waived.

(b) ABAWDs will not be subject to earning countable months (see OAR 461-135-0520).

(4) An individual who the Department has determined is mandatory (see OAR 461-130-0305) will be granted “good cause” (see OAR 461-130-0327) if the reason for not accepting employment or for leaving a job was due to the individual’s concerns regarding their health due to the COVID-19 pandemic.  

(5) Emergency allotments (supplements) are permitted through USDA waiver under Families First Coronavirus Response Act of 2020. The Department may issue an emergency allotment of SNAP benefits for any months approved for an emergency allotment by the Food and Nutrition Service, with the following limitations:

(a) The emergency allotment does not change the benefit level, calculated under OAR 461-160-0400, for the benefit group (see OAR 461-110-0750).

(b) The emergency allotment shall be issued on a date determined by the Department, not subject to OAR 461-165-0100.

(c) Beginning April 2020, and except as provided in paragraphs (A) and (B) of this subsection, the amount of the emergency allotment shall be the difference between the benefit level calculated under OAR 461-160-0400 and the maximum Payment Standard for the number of individuals in the benefit group. If there is no difference, no emergency allotment shall be issued.

(A) Beginning April 2021, if the difference calculated equals an amount less than $95, the amount emergency allotment shall be $95.

(B) Beginning May 2021, if the benefit level calculated under OAR 461-160-0400 of a benefit group is $0, no emergency allotment shall be issued.

(d) When the Food and Nutrition Service makes a change that ends, reduces, or suspends the emergency allotment:

(A) No decision notice (see OAR 461-001-0000) is required. The Department is not required to mail a notice of intended action.

(B) The Department shall publicize the change using one or more of the following methods:

(i) Informing the public through the news media.

(ii) Placing posters in the offices that serve affected individuals, in the locations where SNAP is issued, and at other sites frequented by individuals receiving SNAP.

(iii) Mailing a general notice to the households of affected recipients.

(e) Excepting an overpayment (see OAR 461-195-0501), there is no right to hearing to dispute emergency allotment and no right to continuing benefits.

(6) Retroactively effective January 16, 2021: In addition to the provisions under section (3) of OAR 461-135-0570, to be eligible for SNAP benefits, a student of higher education (see OAR 461-135-0570) may also meet the requirements of one of the following subsections:

(a) The student of higher education is eligible to participate in state or federally funded work study program during the regular school year.

(b) The student of higher education has an Expected Family Contribution (EFC) of $0 in the current academic year, as determined through the Free Application for Federal Student Aid (FAFSA).

(7) The provisions--

(a) Listed in sections (1), (3), and (4) of this rule end on the last day of the month in which the public health emergency declaration made by the Secretary of Health and Human Services under section 319 of the Public Health Service Act based on an outbreak of coronavirus disease 2019 (COVID–19) is lifted.

(b) Listed in section (6) of this rule end 30 days after the day upon which the public health emergency declaration made by the Secretary of Health and Human Services under section 319 of the Public Health Service Act based on an outbreak of coronavirus disease 2019 (COVID–19) is lifted.

Statutory/Other Authority: ORS 411.060, 411.070, 411.121, 411.816 & ORS 409.050
Statutes/Other Implemented: ORS 409.010, ORS 411.060, 411.070, 411.121, 411.816, 411.825, 411.837, 7 USC 2015, 7 USC 2029, 7 CFR 273.7, 7 CFR 273.24, Pub. L. 116-127, ORS 409.050, 7 CFR 273.10 & 7 CFR 273.14
History:
SSP 44-2022, temporary amend filed 08/25/2022, effective 08/25/2022 through 09/27/2022
SSP 33-2022, temporary amend filed 03/31/2022, effective 04/01/2022 through 09/27/2022
SSP 7-2022, amend filed 02/03/2022, effective 02/18/2022
SSP 75-2021, temporary amend filed 12/16/2021, effective 12/16/2021 through 06/13/2022
SSP 48-2021, amend filed 09/23/2021, effective 09/28/2021
SSP 31-2021, temporary amend filed 05/14/2021, effective 05/14/2021 through 09/28/2021
SSP 30-2021, temporary amend filed 04/02/2021, effective 04/02/2021 through 09/28/2021
SSP 26-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 39-2020, temporary amend filed 10/22/2020, effective 10/22/2020 through 04/19/2021
SSP 36-2020, adopt filed 10/01/2020, effective 10/01/2020
SSP 25-2020, temporary adopt filed 07/28/2020, effective 07/28/2020 through 10/11/2020
SSP 17-2020, temporary adopt filed 06/17/2020, effective 06/17/2020 through 10/11/2020
SSP 10-2020, temporary adopt filed 04/17/2020, effective 04/17/2020 through 10/11/2020

461-135-0700
Specific Requirements; General Assistance (GA)

(1) For purposes of this rule, referring to an individual’s housing circumstances as "homeless" means any of the following:

(a) The individual does not have a fixed or regular nighttime residence.

(b) The individual provides the Department with verification, under OAR 461-115-0700, that they are required to leave their place of residence within the upcoming 90 days. If the individual is not able to provide documentary verification, the Department will accept, on a case-by-case basis, self-attestation under the following circumstances:

(A) Documentation does not exist at application; or

(B) Documentation is not reasonably available at application, such as in the case of homelessness, domestic violence, or natural disaster.

(c) The individual’s primary residence is one of the following:

(A) A supervised shelter that provides temporary accommodations.

(B) A halfway house or residence for individuals who may become institutionalized.

(C) A temporary accommodation in another individual’s or family’s residence for 90 days or less.

(D) A place not designed to be or ordinarily used as a place for individuals to sleep, such as a hallway, bus station, or similar place.

(E) A place lacking consistent and operational access to essential utilities.

(F) A temporary accommodation rented or leased by another person or entity, on behalf of the individual, for 90 or fewer days.

(2) To be eligible for General Assistance (GA), an individual must meet all of the following requirements:

(a) The individual must be 18 years of age or older.

(b) The individual must be an individual whose housing circumstances qualify as homeless (see section (1) of this rule).

(c) The individual may not be in the same OSIPM household group (see OAR 461-110-0210) with their child (see OAR 461-001-0000).

(d) The individual may not be receiving TANF benefits.

(e) The individual must be eligible for and receiving OSIPM with a basis of need established under OAR 461-125-0370(1)(c).

(f) The individual may not be in a nonstandard living arrangement (see OAR 461-001-0000) other than at home receiving in-home services (see OAR 411-030-0020).

(g) The individual must file a Supplemental Security Income (SSI) claim for benefits. The Department considers an SSI claim for benefits “filed” when all of the following criteria are met:

(A) An application form designated by the Social Security Administration (SSA) to pursue an SSI claim for benefits is filled out.

(B) The application is submitted to the SSA or to another Federal office, State office, or person authorized to receive applications on behalf of the SSA.

(C) The Department receives verification the individual’s application for SSI claim for benefits has been received by the SSA.

(h) The individual must actively pursue the SSI claim for benefits, including:

(A) Cooperate with the Department in applying to the SSA for SSI;

(B) Appeal all denials of SSI made prior to a decision or recommended decision issued by an administrative law judge at the hearing level; and

(C) Attend all appointments designated by the Department relating to obtaining SSI.

(i) The individual must meet the non-financial, non-disability requirements for SSI.

(j) The individual must complete and sign an interim assistance agreement authorizing the Department to recover interim GA benefits paid to the client (or paid to providers on the client's behalf) from the initial SSI payment or initial post-eligibility payment. The SSA must also receive the interim assistance agreement. The following provisions are considered part of the interim assistance agreement:

(A) Interim GA benefits include only those GA cash benefits paid during the period of time that the SSI benefit covers.

(B) For any month in which SSI is prorated, the Department may recover only a prorated amount of the interim GA cash benefit.

(C) If the Department is unable to stop delivery of a GA benefit issued after the SSI payment is made, the GA payment will be included in the interim assistance to be reimbursed to the Department.

(3) Financial Eligibility.

(a) The OSIPM income and resource methodology are used to determine financial eligibility for the GA program, with the following asset limitations: 

(A) Individuals must have an adjusted income (see OAR 461-001-0000) below the amount listed under section (3) of OAR 461-155-0250.

(B) Individuals must meet the countable (see OAR 461-001-0000) resource limit under subsection (3)(a) of OAR 461-160-0015.

(b) The GA benefit amount is determined according to OAR 461-155-0210 and 461-160-0500.

(4) If the Department determines that the individual no longer has an impairment that meets the criteria in OAR 461-125-0370, the individual is ineligible for GA.

(5) An individual found by the SSA not to meet disability criteria at the initial or reconsideration level may continue receiving GA benefits until a decision or a recommended decision is issued by an SSA administrative law judge at the hearing level, pursuant to 20 CFR §416.1453.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.710, OL 2016 ch 93, 20 CFR 416.310 & 20 CFR 416.1453
History:
SSP 42-2022, temporary amend filed 07/18/2022, effective 07/18/2022 through 01/13/2023
SSP 40-2022, amend filed 06/29/2022, effective 07/01/2022
SSP 45-2020, amend filed 12/22/2020, effective 01/01/2021
SSP 33-2016, f. 9-30-16, cert. ef. 10-1-16
SSP 31-2016, f. & cert. ef. 9-1-16
SSP 25-2016(Temp), f. 6-30-16, cert. ef. 7-1-16 thru 12-27-16
SSP 17-2004, f. & cert. ef. 7-1-04
SSP 11-2004(Temp), f. & cert. ef. 4-15-04 thru 6-30-04
SSP 6-2004, f. & cert. ef. 4-1-04
SSP 36-2003(Temp), f. 12-31-03 cert. ef. 1-1-04 thru 3-31-04
SSP 29-2003(Temp), f. 10-31-03, cert. ef. 11-1-03 thru 3-31-04
AFS 13-2002, f. & cert. ef. 10-1-02
AFS 10-2002, f. & cert. ef. 7-1-02
AFS 5-2000, f. 2-29-00, cert. ef. 3-1-00
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 19-1997, f. & cert. ef. 10-1-97
AFS 9-1997, f. & cert. ef. 7-1-97
AFS 4-1997(Temp), f. 4-30-97, cert. ef. 5-1-97
AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95
AFS 6-1994, f. & cert. ef. 4-1-94
AFS 19-1993, f. & cert. ef. 10-1-93
AFS 20-1991, f. & cert. ef. 10-1-91
AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0701
Terminate GA and GAM Programs October 1, 2005; Reinstate GA July 1, 2016

(1) Effective October 1, 2005, funding for the General Assistance (GA) and General Assistance Medical (GAM) programs was discontinued. These programs closed, effective October 1, 2005.

(2) Effective September 30, 2005, all persons eligible for or receiving benefits of the GA or GAM programs became ineligible for these programs. Except as provided in sections (4) and (5) of this rule, the Department did not authorize or provide any benefit under the GA or GAM programs after September 30, 2005.

(3) Effective October 1, 2005, all GA recipients who received medical assistance through the OSIPM program continued to receive OHP Plus benefits through the OSIPM program until they became otherwise ineligible.

(4) Effective October 1, 2005, all recipients of medical assistance through the GAM program who became ineligible for GAM on September 30, 2005 because of the closure of the GAM program received OHP benefits as follows:

(a) Clients who had been determined to meet the eligibility (see OAR 461-001-0000) requirements of the OSIPM program (see OAR 461-125-0370 and the OSIPM eligibility requirements in OAR 461 Division 135) received the OHP Plus benefits package (see OAR 410-120-1210(2)(a)).

(b) Clients may have also received the OHP Plus benefits package for the period that;

(A) The Department had not previously made a determination about whether the client met the disability requirements for OSIPM under OAR 461-125-0370 and the OSIPM eligibility requirements in OAR 461 Division 135; and

(B) A determination was still pending about whether the client met the disability requirements for OSIPM under OAR 461-125-0370 and the OSIPM eligibility requirements in OAR 461 Division 135.

(c) Clients who did not qualify for the OHP Plus benefits may have been eligible for the OHP-OPU program under the eligibility requirements set out in OAR 461 Division 135, and if eligible, received the OHP Standard benefits package (see OAR 410-120-1210(2)(b)).

(5) Effective July 1, 2016, the GA program was restarted as provided in Oregon Laws 2016, chapter 93 and current eligibility rules.

(6) The GA program reinstated on July 1, 2016 is limited to 200 individuals per month.

(a) When the GA program reaches the limit of 200 individuals per month receiving benefits, the Department will place any individual referred for GA on a reservation list.

(b) When a slot becomes available, the Department will determine eligibility for the individual with the earliest date of request (see OAR 461-115-0030) and, if eligible, that individual will begin receiving benefits. When more than one individual has the same date of request, the Department will select from those individuals based on the time the referral was received by the Collaborative Disability Determination Unit (CDDU).

Statutory/Other Authority: ORS 409.050 & 411.060
Statutes/Other Implemented: ORS 411.010, 411.060, 411.710, 411.730 & 411.740, OL 2016 & ch 93
History:
SSP 31-2016, f. & cert. ef. 9-1-16
SSP 25-2016(Temp), f. 6-30-16, cert. ef. 7-1-16 thru 12-27-16
SSP 18-2005, f. 12-30-05, cert. ef. 1-1-06
SSP 12-2005(Temp), f. & cert. ef. 9-20-05 thru 2-25-06
SSP 10-2005(Temp), f. & cert. ef. 8-29-05 thru 2-25-06
SSP 6-2004, f. & cert. ef. 4-1-04
SSP 29-2003(Temp), f. 10-31-03, cert. ef. 11-1-03 thru 3-31-04
SSP 12-2003, f. 5-29-03, cert. ef. 6-1-03
AFS 21-2002(Temp), f. & cert. ef. 12-30-02 thru 6-27-03

461-135-0708
Criteria for Developing a Plan for Self-support; OSIP, OSIPM, and QMB

(1) A client and the Department may develop a plan for self-support in the OSIP, OSIPM, and QMB programs for a client who:

(a) Meets the applicable disability or impairment criteria; and

(b) Is not eligible for SSI.

(2) A plan for self-support allows a client to retain a portion of his or her nonexcluded assets for a specific period of time to meet a specific occupational goal. The plan may provide for specialized or advanced education or training for clients with a severe disability.

(3) To be approved, a plan for self-support must meet all of the following criteria:

(a) The plan must be in writing and approved by the Department.

(b) The plan must identify a realistic occupational goal, considering the client's physical limitations and capabilities.

(c) The goal of the plan must be to provide the client with income necessary to meet his or her needs, not just for improving potential earning capability or increasing self-sufficiency within the home.

(d) Resources designated to support the plan must be kept in a separate bank account with a specific savings or planned disbursement goal for using the resources. Previously commingled funds must be put in a separate bank account in order for them to be considered designated for the plan.

(e) The duration of the plan must be limited to the time necessary to complete the plan but cannot exceed thirty-six months plus an additional 12 months if necessary for completion of education or training.

(4) A client must do all of the following to comply with a plan for self-support:

(a) Report any changes in circumstances that require a change to the current plan.

(b) Follow through with the plan without any break in excess of the longer of:

(A) Normal vacations from school or training.

(B) Three months, unless the reasons are beyond his or her control.

(5) If a client fails to comply with the requirements of section (4) of this rule, program eligibility is redetermined without the resource exclusions allowed by OAR 461-145-0405.

(6) The client and the Department may revise a plan for self-support or may agree to a new plan. To be new, the plan must not have any relationship to the old plan. When a plan is revised or a new plan established:

(a) Resources designated to support the old plan may become a part of the revised or new plan.

(b) If changes are made in the amount of resources to support the plan, eligibility and the payment amount for program benefits are redetermined.

(c) If the duration of the revised plan in addition to the months the old plan was in effect exceeds the time limits in subsection (3)(e) of this rule, approval is limited to the remainder of the maximum period only.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 31-2016, f. & cert. ef. 9-1-16
SSP 25-2016(Temp), f. 6-30-16, cert. ef. 7-1-16 thru 12-27-16
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07
Renumbered from 461-140-0440, SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
AFS 10-2002, f. & cert. ef. 7-1-02
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90
Repealed by SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
AFS 10-2002, f. & cert. ef. 7-1-02
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0725
Specific Requirements; OSIPM-EPD

(1) To be eligible for the OSIPM-EPD program, an individual must--

(a) Have a disability, as defined in OAR 461-125-0370;

(b) Have adjusted income below the limit provided in OAR 461-155-0250(5);

(c) Have employment as defined in OAR 461-001-0035. Once found eligible, a client remains eligible under this subsection for the OSIPM-EPD program while not working if the employer treats the client as an employee, such as when the client is absent from the job under the provisions of the Family Medical Leave Act; and

(d) Not be assumed eligible for OSIPM, as defined in OAR 461-135-0010(6), and 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 (3)(a) of OAR 461-160-0015.

(2) If an OSIPM-EPD client becomes unemployed and meets all financial and non-financial eligibility requirements for OSIPM except for resources, the client 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 6-2019, 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

461-135-0730
Specific Requirements; QMB, SMB, SMF

(1) The following requirements apply to QMB-BAS:

(a) To qualify for QMB-BAS, an individual must be receiving Medicare hospital insurance under Part A. This includes an individual who must pay a monthly premium to receive coverage.

(b) A client who qualifies for QMB-BAS is not eligible to receive the full range of the Department's medical services. QMB-BAS benefits are limited to payments toward Medicare cost-sharing expenses. These expenses are:

(A) Medicare Part A and Part B premiums; and

(B) Medicare Part A and Part B deductibles and coinsurance up to the Department's fee schedule.

(2) The following requirements apply to QMB DW:

(a) To qualify for the QMB-DW program, an individual must be eligible for Part A of Medicare as a qualified worker with a disability under Section 1818A of the Social Security Act (42 USC 1395i-2a). This is an individual under age 65 who has lost eligibility for Social Security disability benefits because the individual has become substantially gainfully employed, but can continue to receive Part A of Medicare by paying a premium.

(b) A QMB-DW client is eligible only for payment of premiums for Part A of Medicare. If the client is eligible for any other medical assistance program the client is not eligible for QMB-DW.

(3) The following requirements apply to QMB SMB:

(a) To qualify for QMB SMB, an individual must be receiving Medicare hospital insurance under Part A. This includes an individual who must pay a monthly premium to receive coverage.

(b) A client who qualifies for QMB SMB is not eligible to receive the full range of the Department's medical services. QMB SMB benefits are limited to payment of Medicare Part B premiums.

(4) The following requirements apply to QMB-SMF:

(a) To qualify for QMB-SMF, an individual must be receiving Medicare hospital insurance under Part A. This includes an individual who must pay a monthly premium to receive coverage.

(b) A client who is otherwise eligible for another Medicaid program offered by the Department or the Oregon Health Authority is not eligible for QMB-SMF.

(c) A client who qualifies for QMB-SMF is not eligible to receive the full range of the Department's medical services. QMB-SMF benefits are limited to payment for Medicare Part B premiums.

(d) The QMB-SMF program is subject to an enrollment cap based on the federal allocation. If the enrollment in this program exceeds the federal allocation, the program may be closed.

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
SSP 5-2010, f. & cert. ef. 4-1-10
SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09
Reverted to SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07
SSP 19-2008(Temp), f. & cert. ef. 8-8-08 thru 12-28-08
SSP 15-2008(Temp), f. & cert. ef. 7-1-08 thru 12-28-08
SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07
SSP 10-2006, f. 6-30-06, cert. ef. 7-1-06
SSP 3-2006(Temp), f. & cert. ef. 2-6-06 thru 6-30-06
SSP 17-2004, f. & cert. ef. 7-1-04
SSP 9-2004(Temp), f. & cert. ef. 4-1-04 thru 6-30-04
SSP 8-2004, f. & cert. ef. 4-1-04
SSP 33-2003, f. 12-31-03, cert. ef. 1-4-04
AFS 22-2002, f. 12-31-02, cert. ef. 1-1-03
AFS 19-2002(Temp), f. 12-10-02, cert. ef. 1-1-03 thru 5-31-03
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 24-1997, f. 12-31-97, cert. ef. 1-1-98
AFS 35-1992, f. 12-31-92, cert. ef. 1-1-93
AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0745
Eligibility for Individuals in Acute Care Settings; OSIPM

An individual in an acute care hospital or nursing facility is evaluated for the OSIPM program 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 SSI standard or have established a qualifying trust as specified in OAR 461-145-0540(10)(c); and

(5) 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 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

461-135-0780
Pickle Amendment Clients; OSIPM

In the OSIPM program:

(1) The countable (see OAR 461-001-0000) SSB income of an individual is determined according to sections (2) to (4) of this rule if the individual meets all of the following requirements:

(a) Is receiving Social Security Benefits (SSB);

(b) Was eligible for and receiving SSI or state supplements but became ineligible for those payments after April 1977; and

(c) Would be eligible for SSI or state supplement if the SSB COLA increases paid under section 215(i) of the Social Security Act, after the last month the individual was both eligible for and received SSI or a supplement and was entitled to SSB, were deducted from current SSB.

(2) The SSB amount received by the individual when the individual became ineligible for SSI or OSIP is used as the individual's countable SSB income, for the purposes of the Pickle Amendment. If the spouse (see OAR 461-001-0000) of the individual also had Social Security benefits at the time the individual lost SSI benefits, SSB amount at that time of the spouse is considered the countable income of the spouse. If the amount cannot be determined using the information provided by the SSA, it is calculated in accordance with section (3) of this rule.

(3) The Department determines the month in which the individual was entitled to SSB and received SSI in the same month. The Department uses the table in section (4) of this rule to find the percentage that applies to that month. The Department multiplies the present amount of the SSB of the individual by the applicable percentage. If the spouse of the individual also had SSB at the time the individual lost SSI benefits, the Department adjusts the SSB of the spouse using the same multiplier that was used for the individual’s calculation under this section. This amount, rounded down to the next lower whole dollar, is the individual's countable SSB income.

(4) The following guide contains the calculations used to determine the SSB for prior years (the Department uses this table only if the prior year's amount using information provided by SSA):

If SSI was Last Received During  ........................................    Multiply Current SSB by

 

January 2021 – December 2021........................................................   .944

January 2020 – December 2020......................................................   .932

January 2019 – December 2019.......................................................   .917

January 2018 – December 2018.......................................................   .893

January 2017 – December 2017.......................................................    .875

January 2015 - December 2016........................................................   .872

January 2014 - December 2014........................................................   .858

January 2013 - December 2013........................................................   .845

January 2012 - December 2012........................................................   .831

January 2009 - December 2011........................................................   .802

January 2008 - December 2008........................................................  .758

January 2007 - December 2007........................................................  .741

January 2006 - December 2006........................................................  .717

January 2005 - December 2005........................................................  .689

January 2004 - December 2004........................................................  .671

January 2003 - December 2003........................................................  .657

January 2002 - December 2002........................................................  .648

January 2001 - December 2001.........................................................  .632

January 2000 - December 2000.......................................................  .610

January 1999 - December 1999........................................................  .596

January 1998 - December 1998........................................................  .588

January 1997 - December 1997........................................................  .576

January 1996 - December 1996........................................................  .560

January 1995 - December 1995........................................................  .546

January 1994 - December 1994........................................................  .531

January 1993 - December 1993........................................................  .517

January 1992 - December 1992........................................................  .502

January 1991 - December 1991........................................................  .484

January 1990 - December 1990........................................................  .460

January 1989 - December 1989........................................................  .439

January 1988 - December 1988........................................................  .422

January 1987 - December 1987........................................................  .405

January 1986 - December 1986........................................................  .400

January 1985 - December 1985........................................................  .388

January 1984 - December 1984........................................................  .375

July 1982 - December 1983.............................................................   .362

July 1981 - June 1982......................................................................   .337

July 1980 - June 1981......................................................................   .303

July 1979 - June 1980......................................................................   .265

July 1978 - June 1979......................................................................   .241

July 1977 - June 1978......................................................................   .227

May or June 1977.............................................................................  .214

Statutory/Other Authority: 411.060, 411.070, 411.083, 411.404, ORS 409.050, 413.085 & 414.685
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.083, 411.404, 411.704, 413.085, 414.685, 42 CFR 435.135 & P.L. 92-336
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 45-2020, amend filed 12/22/2020, effective 01/01/2021
SSP 26-2019, amend filed 12/27/2019, effective 01/01/2020
SSP 18-2019, temporary amend filed 07/23/2019, effective 07/23/2019 through 12/31/2019
SSP 34-2018, amend filed 12/04/2018, effective 01/01/2019
SSP 11-2018, amend filed 03/09/2018, effective 04/01/2018
SSP 4-2018, temporary amend filed 01/04/2018, effective 01/04/2018 through 03/31/2018
SSP 33-2017, amend filed 12/08/2017, effective 01/01/2018
SSP 23-2017, f. 9-11-17, cert. ef. 10-1-17
SSP 44-2016, f. 12-7-16, cert. ef. 1-1-17
SSP 5-2016, f. & cert. ef. 2-3-16
SSP 4-2015, f. & cert. ef. 1-1-15
SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 8-2013, f. & cert. ef. 4-1-13
SSP 39-2012(Temp), f. 12-28-12, cert. ef. 1-1-13 thru 6-30-13
SSP 35-2011, f. 12-27-11, cert. ef. 1-1-12
SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11
SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09
SSP 17-2008, f. & cert. ef. 7-1-08
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 19-2005, f. 12-30-05, cert. ef. 1-1-06
SSP 4-2005, f. & cert. ef. 4-1-05
SSP 24-2004, f. 12-30-04, cert. ef. 1-1-05
SSP 17-2004, f. & cert. ef. 7-1-04
SSP 33-2003, f. 12-31-03, cert. ef. 1-4-04
SSP 23-2003, f. & cert. ef. 10-1-03
SSP 14-2003(Temp), f. & cert. ef. 6-18-03 thru 9-30-03
AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01
AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00
AFS 24-1997, f. 12-31-97, cert. ef. 1-1-98
AFS 42-1996, f. 12-31-96, cert. ef. 1-1-97
AFS 41-1995, f. 12-26-95, cert. ef. 1-1-96
AFS 29-1994, f. 12-29-94, cert. ef. 1-1-95
AFS 29-1993, f. 12-30-93, cert. ef. 1-1-94
AFS 35-1992, f. 12-31-92, cert. ef. 1-1-93
AFS 25-1991, f. 12-30-91, cert. ef. 1-1-92
AFS 30, f. 12-31-90, cert. ef. 1-1-91
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

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

461-135-0832
Estate Administration; Definitions

Effective July 18, 1995, for purposes of these rules (OAR 461-135-0832 to 461-135-0847) and ORS 93.268, 410.075, 411.620, 411.630, 411.694, 411.708, 411.795, 416.310, 416.340, and 416.350 the terms listed below have the meanings ascribed to them herein; provided, however, as used in these rules, any term has the same meaning as when used in a comparable context in the laws of the United States in effect on June 1, 1996, relating to the recovery of medical assistance paid by a state pursuant to 42 USC 1396 et. seq. relating to Grants to States for Medical Assistance Programs, unless a different meaning is clearly required or the term is specifically defined herein. The Department applies the definitions and procedures set forth in these rules to recoveries and claims made pursuant to ORS 411.708, 411.795, 416.310, 416.340, and 416.350.

(1) "Assets" means all income and resources of an individual, including any income or resources that an individual is entitled to at the time of death, including any income or resources to which the individual is entitled, but does not receive, because of action: by the individual; the individual's spouse (see OAR 461-001-0000); by a person, including a court or administrative body with legal authority to act in place of or on behalf of the individual; or by any person, including any court or administrative body, acting at the direction or upon the request of the individual.

(2) "Assign" means a person who acquires an interest in real or personal property or an asset pursuant to a written or oral assignment of such real or personal property or asset from a person with the legal right to assign it.

(3) "Assistance" means general assistance and public assistance as defined in ORS 411.010 and medical assistance as defined in ORS 414.025.

(4) "Bona fide purchaser for value" means any person who provides consideration, including money or property, to a seller or transferor of real property or personal property equal to the fair market value of the real or personal property sold or transferred.

(5) "Child under age 21" means the deceased recipient's natural or adopted son or daughter who is under 21 years of age throughout the time the Department seeks to enforce its claim.

(6) "Child with a disability" means the deceased recipient's natural or adopted son or daughter of any age, who meets SSI disability criteria throughout the time the Department seeks to enforce its claim, and who presents evidence to the Department substantiating the disability within two years after the Department initially asserts its claim.

(7) "Child with a visual impairment" means the deceased recipient's natural or adopted son or daughter, of any age, who, within two years after the Department initially asserts its claim, substantiates blindness throughout the time the Department seeks to enforce its claim by presenting evidence of:

(a) Vision of 20/200 or less in the better eye with a corrective lens;

(b) A limitation in vision field to an angle of 20 degrees or less; or

(c) Meeting any other SSI criteria for blindness.

(8) "Consideration furnished test" means the method by which the ownership of real or personal property is traced to its economic origin. The fractional share of the property considered owned by a co-owner shall be that fractional share to have originally belonged to or to be attributable to the monetary consideration furnished by the co-owner. The fractional share is based on the proportion the original ownership share or monetary consideration bore to the acquisition cost and, if applicable, capital additions for the property. The fractional share is not based on the dollar amount of contribution compared to the current market value of the property. For example, if one co-owner contributed $2,500 and the other $7,500 to the purchase price of a $10,000 property in 1960; in 1995, the property is appraised at $50,000. The co-owner who contributed $2,500 is considered to own 25% of the property in 1995.

(9) "Convincing evidence" includes, but is not limited to:

(a) Recorded documents of title.

(b) Unrecorded documents of title executed contemporaneously with the transaction or transfer at issue.

(c) Tax statements or returns.

(d) Records of banking, financial or other similar institutions.

(e) Written receipts, bills of sale or other writings or documents executed contemporaneously with the transaction or transfer at issue.

(f) Such other reliable, probative evidence, including oral, of a similar nature and authenticity that accurately reflects the true facts of the transaction or transfer at issue.

(10) "Date of request" means the date an individual or someone authorized on behalf of the individual contacts the Department or uses another appropriate method to request benefits (see OAR 461-115-0150). The request may be oral or in writing. It starts the application process.

(11) "Department" means the Department of Human Services, the Oregon Health Authority, or both.

(12) "Estate" means with respect to the collection of payments made for medical assistance provided on or after July 18, 1995 all real property, personal property, or other assets, wherever located, in which a recipient had any legal title or ownership or beneficial interest at the time of death, including real property, personal property, or other assets conveyed by the recipient to, subsequently acquired by, or traceable to, a person, including the recipient's spouse and any successor-in-interest to the recipient's spouse, through:

(a) Tenancy by the entirety;

(b) Joint tenancy;

(c) Tenancy in common;

(d) Not as tenants in common, but with the right of survivorship;

(e) Life estate;

(f) Transfer on death deed;

(g) Living trust;

(h) Annuity purchased on or after April 1, 2001; or

(i) Other similar arrangement.

(13) “General Assistance” means “general assistance” as defined in ORS 411.010.

(14) "Heir" means any individual, including the surviving spouse, who is entitled under intestate succession to the real property, personal property, and assets of a decedent who died wholly or partially intestate.

(15) "Interest" means any form of legal, beneficial, equitable or ownership interest.

(16) "Interspousal transfer" means any transfer, or chain of transfers, that effectively transfers title or control of an asset, or an interest in an asset, from one spouse to another, including: direct transfers between spouses, transfers from one or both spouses to a trust, and transfers from one trust to another trust.

(17) "Intestate" means one who dies without leaving a valid will, or the circumstance of dying without leaving a valid will, effectively disposing of all of a decedent's estate.

(18) "Intestate succession" means succession to real property, personal property or assets of a decedent who dies intestate or partially intestate.

(19) "Joint tenancy" means ownership of property held under circumstances that entitle one or more owners to the whole of the property on the death of the other owner(s), including, but not limited to, joint tenants with right of survivorship and tenants by the entirety.

(20) "Legal title" means legal ownership by a person.

(21) "Life estate" means an interest in real or personal property that terminates upon the death of a measuring life.

(22) "Living trust" means a revocable or irrevocable inter vivos trust funded with assets to which the recipient is legally entitled.

(23) "Medical Assistance" (MA) is defined in ORS 414.025 and incorporated by this reference.

(24) "Medical institution" means a facility that provides care and services equivalent to those received in a nursing facility. "Medical institution" does not apply to home and community-based care (see OAR 461-001-0030), in-home services, adult foster home (AFH) care, residential care facility (RCF) services, or assisted living facility (ALF) care.

(25) "Medicare cost sharing" means medical assistance funds used to pay Medicare premiums, coinsurance, copayments and deductibles.

(26) "Ownership documents" mean any applicable documents, certificates or written evidence of title or ownership such as, but not limited to, recorded deeds, stock certificates, certificates of title, bills of sale, or other similar documents evidencing ownership or legal title held by a person.

(27) "Permanently institutionalized" means an individual, regardless of age, who, at the time of his or her death, had resided in a nursing facility, intermediate care facility for individuals with intellectual disabilities, or other medical institution, for 180 days or more.

(28) "Person" means any individual, corporation, association, firm, partnership, trust, estate or other form of entity.

(29) "Personal property" means all tangible and intangible personal property wherever located, including, but not limited to, chattels and movables, boats, vehicles, furniture, personal effects, livestock, tools, farming implements, cash, currency, negotiable papers, securities, contracts, and contract rights.

(30) "Probate estate" means all real property, personal property, or other assets included in a decedent's estate as it is defined by applicable state probate law.

(31) "Real property" means all land wherever situated, including improvements and fixtures thereon, and every estate, Interest, and right, whether legal or equitable, therein including, but not limited to, fee simple, terms for years, life estates, leasehold interests, condominiums or time share properties. "Real property" includes property conveyed by the individual to, subsequently acquired by, or traceable to, a person, including the individual's surviving spouse and any successor-in-interest to the individual's surviving spouse, if the "real property" may be included in the individual's, or the individual's surviving spouse's, estate, as defined in this rule.

(32) "Recipient of property" means:

(a) Any survivor, heir, assign, devisee under a will, beneficiary of a trust, transferee or other person to whom real property, personal property or other assets pass upon the death of the decedent either by law, intestate succession, contract, will, trust instrument or otherwise; and

(b) Any subsequent transferee of such real property, personal property, or asset, or proceeds from the sale thereof, through any form of conveyance, that is not a bona fide purchaser for value.

(33) "Registered Domestic Partner" means an individual joined in a domestic partnership as defined in ORS 106.310.

(34) "Survivor" means any person who, as a co-tenant, is automatically entitled to an expanded share of real or personal property upon the death of a fellow co-tenant.

(35) "Survivorship" means an interest in real or personal property that expires upon the death of an individual whereby the Interest of the individual's co-owners automatically expands to the same extent without necessity for any act of transfer or distribution.

(36) "Tenancy in common" means ownership of real or personal property by an individual together with one or more other persons which ownership interest shall not pass by survivorship upon the death of the individual.

(37) "Time of death" means the instant of death, the time and date of which shall be established in the place of the decedent's residence; in no case shall time of death be construed to mean a time after which an interest in real or personal property or other assets may:

(a) Pass by survivorship or other operation of law due to the death of the decedent; or

(b) Terminate by reason of the decedent's death.

(38) "Transfer on death deed" has the meaning set out in ORS 93.949.

(39) "Value" means the fair market value. Fair market value is the price at which real or personal property would change hands between a willing buyer and a willing seller. In the event the real or personal property was not reported to the Department by the deceased Medicaid recipient, the "value" would be established based on its fair market value at the time of discovery.

Statutory/Other Authority: ORS 410.075, 411.060, 411.070, 413.042, 416.340, 416.350 & 2013 OL 14 Sec. 10
Statutes/Other Implemented: ORS 93.969, 410.070, 410.075, 411.010, 411.060, 411.708, 411.795, 416.310, 416.340, 416.350 & 2013 OL 14 Sec. 10
History:
SSP 21-2021, minor correction filed 02/24/2021, effective 02/24/2021
SSP 45-2020, amend filed 12/22/2020, effective 01/01/2021
SSP 14-2017, f. 6-5-17, cert. ef. 7-1-17
SSP 2-2017(Temp), f. & cert. ef. 2-13-17 thru 8-11-17
SSP 15-2014, f. & cert. ef. 7-1-14
SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 26-2013, f. & cert. ef. 10-1-13
SSP 17-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13
SSP 35-2011, f. 12-27-11, cert. ef. 1-1-12
SSP 5-2010, f. & cert. ef. 4-1-10
SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09
SSP 16-2008, f. 7-1-08, cert. ef. 10-1-08
SSP 6-2006, f. 3-31-06, cert. ef. 4-1-06
SSP 24-2004, f. 12-30-04, cert. ef. 1-1-05
SSP 33-2003, f. 12-31-03, cert. ef. 1-4-04
SSP 16-2003, f. & cert. ef. 7-1-03
AFS 10-2002, f. & cert. ef. 7-1-02
AFS 5-2002, f. & cert. ef. 4-1-02
AFS 22-2001, f. & cert. ef. 10-1-01
AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01
AFS 30-2000, f. & cert. ef. 12-1-00
AFS 29-1996, f. & cert. ef. 8-28-96

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 $3,500. 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 April 1, 2008, 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 $3,500 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:
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 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, Department of Human Services at the address in section (4) of this rule.

(2) 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 (4) 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.

(3) A trustee of a trust established under 42 USC § 1396p(d)(4) shall mail notice of any termination of the trust or account in a master trust to the address in section (4) of this rule.

(4) The mailing address for the Estate Administration Unit is: Estate Administration Unit, PO Box 14021, Salem OR 97309-5024.

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
History:
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

461-135-0835
Limits on Estate Claims

(1) The Estate Administration Unit is designated and authorized to administer the estate recovery program for the Oregon Health Authority and the Department of Human Services, and to present and file claims for payment. The Manager and Assistant Manager of the Estate Administration Unit, Estate Administrators, Assistant Estate Administrators, and Accounts Receivable Specialist are authorized to present, file, and resolve claims for the Estate Administration Unit. The Manager or Assistant Manager may designate other individuals to present, file, or resolve claims. This rule sets out some of these claims.

(2) For the OSIP program (see OAR 461-101-0010):

(a) The amount of any payments or benefits, including an overpayment (see OAR 461-195-0501), are a claim against the probate estate (see OAR 461-135-0832) of any deceased recipient.

(b) The claim for correctly paid payments or benefits under OSIP are deferred until the death of the spouse (see OAR 461-001-0000) or registered domestic partner (see OAR 461-135-0832), if any, of the deceased recipient.

(c) If the deceased recipient has no probate estate, the enforcement of the claim has been deferred, or there are insufficient resources in the probate estate to pay the claim in full, the probate estate of the spouse or registered domestic partner of the deceased recipient, if any, is charged for any payments or benefits paid under OSIP to the deceased recipient, the spouse, or registered domestic partner.

(d) The claim for correctly paid payments or benefits under OSIP may not be enforced if the deceased recipient is survived by a child under age 21 (see OAR 461-135-0832), a child with a disability (see OAR 461-135-0832), or a child with a visual impairment (see OAR 461-135-0832); and the child survives to the closing of the probate estate.

(e) Transfers of real or personal property without adequate consideration, by recipients of payments or benefits under OSIP, are voidable and may be set aside under ORS 411.620.

(f) Except when there is a surviving spouse or registered domestic partner, or a surviving child under age 21, a child with a disability, or a child with a visual impairment, the amount of any payments or benefits provided is a claim against the estate (see OAR 461-135-0832) in any conservatorship proceedings and may be paid pursuant to ORS 125.495.

(3) For General Assistance (see OAR 461-135-0832):

(a) The amounts of any payments or benefits, including overpayments, are a claim against the probate estate of any deceased recipient. The amount includes the state’s monthly contribution, paid prior to January 1, 2014, to the federal government for the recipient’s Medicare Part D prescription drug coverage. Effective July 1, 2016, any correctly paid benefits under Oregon Laws 2016, chapter 93, section 1 are excluded, except than an overpayment of benefits under Oregon Laws 2016, chapter 93, section 1 is included in a claim against the probate estate.

(b) The claim for correctly paid payments or benefits under the General Assistance program is deferred until the death of the spouse or registered domestic partner, if any, of the deceased recipient.

(c) If the deceased recipient has no probate estate, the enforcement of the claim has been deferred, or there are insufficient resources in the probate estate to pay the claim in full, then the probate estate of the spouse or registered domestic partner of the deceased recipient, if any, is charged for any payments or benefits to the deceased recipient, the spouse, or registered domestic partner.

(d) The claim for correctly paid payments or benefits under the General Assistance program may not be enforced if the deceased recipient is survived by a child under age 21, a child with a disability, or a child with a visual impairment; and the child survives to the closing of the probate estate.

(e) Except when there is a surviving spouse or registered domestic partner, or a surviving child under age 21, a child with a disability, or child with a visual impairment, the amount of any assistance paid is a claim against the estate in any conservatorship proceedings and may be paid pursuant to ORS 125.495.

(4) For Medical Assistance (MA, as defined in OAR 461-135-0832):

(a) In determining the extent of the estate resources subject to the claim of the Department for correctly paid benefits, except as provided in subsection (b) of this section, the Department must disregard resources in an amount equal to the value (see OAR 461-135-0832) of resources excluded in the most recent eligibility determination under OAR 461-160-0855, based on payments received under a qualified partnership policy (see OAR 461-001-0000). The disregard of resources specific to the estate recovery claim applies to MA benefits received after the effective date of the MA eligibility determination in which a qualified partnership policy was considered and approved. The amount of any MA incurred in a prior MA eligibility period where qualified partnership policy benefits were not considered is not subject to the estate resource disregard.

(b) There is no disregard of resources under subsection (a) of this section if the recipient, or the spouse of the recipient, at any time transferred the value of the qualified partnership policy excluded resource amount to another individual for less than fair market value prior to the death of the recipient or the recipient's spouse, or exhausted the disregarded resource amount by purchasing things of value to the recipient or the recipient's spouse while either was living.

(c) The amount of any incorrectly paid payments or benefits, excluding an administrative error overpayment, are a claim, against the probate estate of any deceased recipient.

(d) The claim for correctly paid payments or benefits under MA is deferred until the death of the surviving spouse, if any, of the deceased recipient. After the death of a surviving spouse, the deferred claim of the deceased recipient is a claim against the following assets (see OAR 461-135-0832) or their proceeds in the estate of the spouse. The Department has a claim against the estate of the spouse for medical assistance (see OAR 461-135-0832) paid to the recipient, but only to the extent that the spouse received property or other assets from the recipient through any of the following:

(A) Probate.

(B) Operation of law.

 (e) The claim for correctly paid payments or benefits under MA may not be enforced if the deceased recipient is survived by a child under age 21, a child with a disability, or a child with a visual impairment.

(f) An MA claim in an estate includes:

(A) The amount of any payments or benefits paid prior to October 1, 1993 to or on behalf of a recipient 65 years of age or older are a claim against the probate estate of any deceased recipient.

(B) The amount of any payments or benefits, paid on or after October 1, 1993 and prior to July 18, 1995, to or on behalf of a recipient 55 years of age or older are a claim against the probate estate of any deceased recipient.

(C) The amount of any payments or benefits, paid on or after July 18, 1995 and prior to October 1, 2013, to or on behalf of a recipient 55 years of age or older are a claim against the estate of any deceased recipient. All correctly made payments on or after January 1, 2010 for Medicare cost sharing (see OAR 461-135-0832) are excluded from a claim.

(D) The amount of any payments or benefits, paid October 1, 2013 or later, to or on behalf of a recipient 55 years of age or older, during the time the Department was paying any of the cost of care of the individual in a nursing facility, home and community-based care (see OAR 461-001-0030), or in home services through the State Plan Personal Care Services (see OAR 411-034-0010), are a claim against the estate of any deceased recipient. All correctly made payments on or after January 1, 2010 for Medicare cost sharing are excluded from a claim.

(5) The amount paid, for a recipient age 55 or older, after December 31, 2013, to the federal government for the recipient’s Medicare Part D prescription drug coverage is a claim against the estate of the deceased recipient.

(6) For trusts under OAR 461-145-0540(10), upon termination of the trust or upon the death of the original beneficiary the trust pays to the State or States from such remaining amounts in the trust an amount equal to the total amount of medical assistance paid on behalf of the original beneficiary. The State or States must be listed as the first payee or payees and first remainder beneficiary or beneficiaries, and have priority over payment of other debts and administrative expenses, and other beneficiaries, except as allowed in subsection (a) of this section. Subsections (4)(d) and(4)(e) of this rule do not apply to this section.

(a) Allowable administrative expenses payable before any State include:

(A) Taxes due from the trust, excluding taxes due from the beneficiary, to the State or States or federal government because of the death of the beneficiary; and

(B) Reasonable fees for administration of the trust estate such as an accounting of the trust to a court, completion and filing of documents, or other required actions associated with termination and wrapping up of the trust. Trustee fees or conservator fees, not both, are limited to the month of the original beneficiary’s death and the prior month.

(i) For a person that is a trustee, but not a conservator, trustee fees after the month of death, if claimed, must be reasonable and approved by the by the Department prior to payment.

(ii) For a person that is a conservator and trustee, conservator fees after the month of death, if claimed, must be approved by the court, after the Department is given notice and opportunity to object.

(b) Upon the death of the original beneficiary, the following expenses and payments are examples of some of the types not permitted prior to reimbursement of the State or States for medical assistance:

(A) Taxes due from the estate of the beneficiary other than those arising from inclusion of the trust in the estate;

(B) Payment of debts owed to third parties;

(C) Trustee or conservator fees, except as allowed by subsection (a) of this section;

(D) Funeral expenses; and

(E) Payments to residual beneficiaries.

Statutory/Other Authority: ORS 411.060, 411.070, 411.404, 413.042, 413.085, 416.340, ORS 409.050, 416.350 & 414.685
Statutes/Other Implemented: ORS 93.969, 125.495, 411.404, 411.620, 411.630, 411.708, 411.795, 413.085, 416.310 & 416.350
History:
SSP 59-2021, minor correction filed 12/13/2021, effective 12/13/2021
SSP 45-2020, amend filed 12/22/2020, effective 01/01/2021
SSP 22-2018, amend filed 06/05/2018, effective 07/01/2018
SSP 14-2017, f. 6-5-17, cert. ef. 7-1-17
SSP 2-2017(Temp), f. & cert. ef. 2-13-17 thru 8-11-17
SSP 34-2016, f. 9-30-16, cert. ef. 10-1-16
SSP 24-2016, f. 6-29-16, cert. ef. 7-1-16
SSP 15-2014, f. & cert. ef. 7-1-14
SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 26-2013, f. & cert. ef. 10-1-13
SSP 17-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13
SSP 32-2010, f. & cert. ef. 10-1-10
SSP 16-2010(Temp), f. & cert. ef. 5-27-10 thru 11-23-10
SSP 5-2010, f. & cert. ef. 4-1-10
SSP 38-2009, f. 12-31-09, cert. ef. 1-1-10
SSP 16-2008, f. 7-1-08, cert. ef. 10-1-08
SSP 14-2007, f. 12-31-07, cert. ef. 1-1-08
SSP 6-2006, f. 3-31-06, cert. ef. 4-1-06
SSP 16-2003, f. & cert. ef. 7-1-03
AFS 13-2002, f. & cert. ef. 10-1-02
AFS 10-2002, f. & cert. ef. 7-1-02
AFS 5-2002, f. & cert. ef. 4-1-02
AFS 24-1997, f. 12-31-97, cert. ef. 1-1-98
AFS 41-1995, f. 12-26-95, cert. ef. 1-1-96
AFS 13-1991, f. & cert. ef. 7-1-91

461-135-0837
Administering Medicaid Estate Claims When the Recipient of Assistance was a Native American Indian or Alaskan Native Village Tribal Member

(1) When the Department has a claim against the Estate of a deceased Native American Indian or Alaskan Native Village tribal member, certain exemptions from recovery apply. The following income, resources and property are exempt from Medicaid estate recovery:

(a) Income and resources that are specifically exempt by law from Medicaid estate recovery, such as:

(A) Interests in and income derived from tribal land and other resources currently held in trust status; and

(B) Judgment funds from the Indian Claims Commission and the United States Court of Federal Claims.

(b) Ownership interest in trust or non-trust property, including real property and improvements:

(A) Located on a reservation (any federally recognized Indian Tribe’s reservation, pueblo, or colony, including former reservations in Oklahoma, Alaska Native regions established by the Alaska Native Claims Settlement Act and Indian allotments);

(B) Located near a reservation as designated and approved by the Bureau of Indian Affairs of the U.S. Department of the Interior; or

(C) For any federally recognized tribe not described in paragraphs (A) and (B) of this subsection, located within the most recent boundaries of a prior federal reservation.

(c) Income left as a remainder in an Estate, derived from property described in sections (1)(a) and (b) of this rule, that was collected by an Indian, by a tribe, or by a tribal organization and distributed to one or more Indians, as long as the personal representative of the Estate can clearly trace and document that the income came from the protected property.

(d) As long as the personal representative of the Estate can clearly trace and document that it came from the protected sources:

(A) An ownership interest left as a remainder in an Estate in rents, leases, royalties, or usage rights related to natural resources (including extraction of natural resources or harvesting of timber, other plants and plant products, animals, fish, and shellfish) resulting from the exercise of federally protected rights; and

(B) Income derived from these sources that is collected by an Indian, a tribe, or a tribal organization and distributed to one or more Indians.

(e) Ownership interest in and usage rights to items not covered by subsections (a) through (d) of this section that have unique religious, spiritual, traditional or cultural significance.

(f) Rights that support subsistence or a traditional life style according to applicable tribal law or custom.

(2) Protection of non-trust property described in sections (1)(a) and (b) of this rule is limited to circumstances when it passes from an Indian (as defined in section 4 of the Indian Health Care Improvement Act, Pub. L. No. 94-437) to:

(a) One or more relatives (by blood, adoption or marriage), including Indians not enrolled as a member of a tribe and non-Indians, such as spouses and step-children, who would be protected as family members by the tribe;

(b) A tribe or tribal organization; or

(c) One or more Indians.

(3) The following are subject to Medicaid estate recovery:

(a) Native American Indian and Alaskan Native tribal member ownership interest in assets and property, both real and personal, that are not described in sections (1) and (2) of this rule.

(b) Any income or assets left as a remainder in the Estate that do not derive from protected property or sources described in sections (1) and (2) of this rule.

[Publication.: Publications referenced are available from the agency.]

Statutory/Other Authority: ORS 409.050, 410.070 & 414.105
Statutes/Other Implemented: ORS 414.106 & 416.340
History:
AFS 13-2002, f. & cert. ef. 10-1-02

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

461-135-0844
Procedures for Applying for Undue Hardship Waiver

In connection with a request for an undue hardship waiver under OAR 461-135-0841:

(1) The Department will provide written notice of the hardship waiver rules to:

(a) The personal representative or other person handling the deceased client's estate, if that person is known to the Department at the time the Department files its claim with the probate court. If the person handling the deceased client's estate is not known to the Department, the Department will file the written notice with the claim that it files with the probate court; or

(b) Any beneficiary, heir or family member of the deceased client who contacts the Department asserting a right superior to that of the Department to receive property or other assets of the deceased client unless the Department agrees that the beneficiary, heir or family member's claim is superior; or

(c) Any beneficiary, heir or family member of the deceased client who held an asset jointly with the deceased client at the time of death, if that person is known to the Department unless the Department determines that it has no right to the jointly held asset.

(2) Any beneficiary, heir, or family member claiming entitlement to receive the assets of the deceased client may apply for a hardship waiver under this rule by submitting a written request for a waiver to the Department within 45 days of the date the notice was sent to the person or to the probate court. The Department may, in its discretion, consider waiver applications filed after the 45-day period if the waiver applicant demonstrates that there was good cause for the delay.

(3) The written request shall include all the following information:

(a) The relationship of the waiver applicant to the decedent.

(b) The nature of the applicant's right to receive the property of the decedent if the waiver is granted.

(c) The applicant's financial situation or other facts that support the applicant's claim that an undue hardship exists.

(d) A statement of the type of waiver that is being requested.

(e) Documentation establishing or demonstrating any of the information submitted.

(f) Any other information or documentation that the applicant believes should be considered by the Department in determining whether an undue hardship exists.

(4) The Department may request additional information or documentation from the applicant. If the additional information or documentation is not provided within 30 days of the Department's request for additional information or documentation, the hardship waiver application will be considered by the Department on the basis of the information and documentation provided.

(5) Within 90 days of receipt of the hardship waiver application, the Department will issue a written decision granting or denying, in whole or in part, the applicant's request for an undue hardship waiver.

(6) If the decision is adverse to the hardship waiver applicant, the Department's written decision shall include information regarding the applicant's right to a contested case hearing before the Office of Administrative Hearings.

(7) The rules and procedures adopted by the Department in chapters 137 and 461 of the Oregon Administrative Rules shall apply to hearings challenging the denial of a hardship waiver application.

(8) The issue for the hearing will be whether the Department's decision was correct based on the information available to the Department at the time the written decision was issued, unless the applicant can show good cause for failing to submit relevant information or documentation to the Department prior to the date the written decision was issued.

(9) Receipt of a timely request for waiver or request for hearing shall not prevent or delay the Department's pursuit of its estate recovery claim pending issuance of a final order at the conclusion of the hearing. The Department shall return any funds it collected if it is ultimately decided that the waiver should have been granted.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.795
History:
SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
AFS 41-1995, f. 12-26-95, cert. ef. 1-1-96

461-135-0845
Valuation of Life Estate, Reversionary Interest, and Property

(1) In this rule, “spouse” or “spouses”:

(a) For federally-funded programs, has the meaning defined in OAR 461-001-0000,

(b) For programs not federally-funded, has the meaning defined in OAR 461-001-0000 but also includes a registered domestic partner (see OAR 461-135-0832).

(2) Effective July 18, 1995, the value (see OAR 461-135-0832) of a life estate (see OAR 461-135-0832) or other interest (see OAR 461-135-0832) in real property (see OAR 461-135-0832), personal property (see OAR 461-135-0832),or other assets (see OAR 461-135-0832) measured by or valued with respect to a life span, including that of the relevant recipient of assistance (see OAR 461-135-0832), is established by reference to the life estate valuation tables in this section and is valued as of the time of death (see OAR 461-135-0832) of the recipient of assistance irrespective of the actual life span of the measuring life. [Table not included. See ED. NOTE.]

(3) Excluding accounts under section (4) of this rule or property under section (6) of this rule, for assistance recovery purposes, the interest of a person (see OAR 461-135-0832) in real property, personal property, or other assets held in joint tenancy (see OAR 461-135-0832) (including transfers with right of survivorship covered by ORS 93.180), tenancy in common (see OAR 461-135-0832), or other form of concurrent ownership with one or more other persons with right of survivorship (see OAR 461-135-0832), other than a spouse, is presumed to be the fractional share held by the person. The fractional share of a person is presumed to be the share reflected in the ownership documents (see OAR 461-135-0832). Such presumption may be rebutted under the consideration furnished test (see OAR 461-135-0832) using convincing evidence (see OAR 461-135-0832) of the actual consideration contributed by another co-owner of the property or assets. In the absence of any stated fractional share on the ownership documents, each co-owner is presumed to have an equal fractional share of ownership of the whole, unless rebutted by the consideration furnished test using convincing evidence.

(4) For medical assistance (see OAR 461-135-0832) recovery purposes, the interest of a recipient in multi-party accounts with an insured institution or credit union is presumed to be one-hundred percent, and the account’s value shall be determined at time of death. The presumption may be rebutted by the consideration furnished test using convincing evidence.

(5) With respect to real property, personal property, or assets held jointly by spouses, as tenants in common, tenants by the entirety, or other concurrent ownership, the interest of a person in such property or assets is conclusively deemed to be one-half; provided, however, that in the event the ownership documents expressly set forth a different fractional share of ownership, and such fractional share is lawful in the appropriate jurisdiction, then the interest of a person is presumed to be the fractional share set forth in such ownership documents. Such presumption may be rebutted using convincing evidence. The consideration furnished test does not apply to this section of the rule.

(6) With respect to real property, personal property, or other assets conveyed by a transfer on death deed or other similar arrangement, including, but not limited to, payable on death accounts with financial institutions; the interest of the transferor is presumed to be one-hundred percent, except that if there is more than one transferor their respective interests are determined in accordance with sections (3), (4), and (5) of this rule.

(7) The value of real property is determined by establishing the value of the property to the satisfaction of the department (see OAR 461-135-0832). The burden of proof for establishing the value of the real property to the satisfaction of the department lies with the person or, after the time of death of the person, with the person's representative, and may be established by any methodology, including an appraisal performed by an appraiser certified or licensed in the applicable jurisdiction, that the department determines most accurately reflects the value of the real property. The sum of liens or other encumbrances, if any, attached to the real property established using convincing evidence, is subtracted from the value of the real property to determine a net value of the real property.

(8) The value of personal property consisting of shares of stock or other securities traded on an exchange is evidenced by the average of the bid and ask prices. If such bid and ask prices are unavailable for certain stocks or securities, the value may be established by a written estimate from the corporation or other entity issuing such shares or securities of the value, or if such estimate is unobtainable, an estimate from a broker, trader or other person with knowledge in the field. The sum of liens or other encumbrances established using convincing evidence, is subtracted from the value of such stock or securities to determine a net value of the personal property consisting of stock or other securities.

(9) Subject to section (8) of this rule, the value of tangible personal property, including, but not limited to, livestock, furniture, vehicles and other tangible items may be established:

(a) By a written estimate from a person knowledgeable in the field of appraising such items of personal property; or

(b) From published sources such as catalogs of antiques or collectibles, blue books or other convincing evidence that accurately establishes the value of the property.

(10) The sum of liens or other encumbrances, if any, attached to such property in section (9), established using convincing evidence, is subtracted from the value of the tangible personal property to determine a net value of the tangible personal property. 

(11) The value of intangible personal property not otherwise provided for in this rule, is established by a written estimate from a person knowledgeable in the field of appraising such items of intangible personal property. The sum of liens or other encumbrances, if any, attached to such property, established using convincing evidence, is subtracted from the value of the intangible personal property to determine a net value of the intangible personal property. 

(12) Notwithstanding anything to the contrary in this rule, any real property, personal property, or other assets in a probate estate is valued in accordance with the probate code of the jurisdiction of the probate proceeding.

(13) Notwithstanding anything to the contrary in this rule, if a claim under OAR 461-135-0835 is deferred until a recipient’s spouse dies; the value of any real property, personal property or other assets, subject to the deferred claim, is established as follows:

(a) For real property, personal property, or other assets in the probate estate of the deceased spouse; the value is the current value at the time of probate; or

(b) For real property, personal property, or other assets not in the probate estate of the deceased spouse; the value is determined on the later of the date of the claim or the sale of the real property, personal property, or other assets.

(14) The amount of a claim of the department that is recoverable from a person other than the recipient of assistance is calculated through the following steps:

(a) Step One: Determine the value of the real property, personal property, or other assets received by the person from the recipient of assistance.

(b) Step Two: Deduct from the value the amount of any liens or encumbrances.

(c) Step Three: Multiply the result by the fraction or percentage that constitutes the interest received from the recipient of assistance.

[ED. NOTE: To view attachments referenced in rule text, click here to view rule.]

Statutory/Other Authority: ORS 411.060, 416.350, 413.085, 414.685, ORS 409.050 & 413.042
Statutes/Other Implemented: ORS 416.340, 416.350, 411.708, 411.795, 416.310, 413.085, 414.685, 106.300 to 106.340 & ORS 93.969
History:
SSP 45-2020, amend filed 12/22/2020, effective 01/01/2021
SSP 23-2019, amend filed 10/21/2019, effective 10/22/2019
SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 35-2011, f. 12-27-11, cert. ef. 1-1-12
SSP 17-2004, f. & cert. ef. 7-1-04
SSP 1-2004(Temp), f. & cert. ef. 2-5-04 thru 6-30-04
AFS 13-2002, f. & cert. ef. 10-1-02
AFS 5-2002, f. & cert. ef. 4-1-02
AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00
AFS 29-1996, f. & cert. ef. 8-28-96

461-135-0847
Forms; Request for Notice of Transfer or Encumbrance; Termination of Request for Notice of Transfer or Encumbrance; Notice of Transfer or Encumbrance

(1) The forms set forth in this rule are adopted in accordance with ORS 93.268, 205.246, and 411.692.

(2) Request for Notice of Transfer or Encumbrance Form; [Form not included. See ED. NOTE.]

(3) Termination of Request for Notice of Transfer or Encumbrance Form; [Form not included. See ED. NOTE.]

(4) Model Form — Notice of Transfer or Encumbrance Form; [Form not included. See ED. NOTE.]

(5) These forms are available at http://dhsforms.hr.state.or.us/
forms/databases/findforms.htm. At the Find a form window in the Form Number field, type in the four-digit form number and click on search.

[ED. NOTE: Form referenced are available from the agency.]

Statutory/Other Authority: ORS 93.268, 205.246 & 411.692
Statutes/Other Implemented: ORS 93.268, 205.246 & 411.692
History:
SSP 22-2004, f. & cert. ef. 10-1-04
SSP 33-2003, f. 12-31-03, cert. ef. 1-4-04

461-135-0850
Specific Requirements; Repatriate Program

(1) For purposes of this rule, "repatriate" means a US citizen who has returned, or been brought back to the US because of destitution, illness (including mental illness), war, threat of war, invasion, or a similar crisis.

(2) To be eligible for the Department’s repatriation services, an individual must be identified by the Department of State’s International Social Services office as a repatriate needing assistance.

(3) A repatriate may receive monthly loan assistance equal to the monthly TANF standard for the equivalent case size (see OAR 461-155-0030) for a duration of time determined by the federal agency. A Repayment Agreement must be signed prior to the first payment.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 35-2016, f. 9-30-16, cert. ef. 10-1-16
SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0875
Specific Requirements; Retroactive Eligibility

(1) Individuals are evaluated for retroactive eligibility as follows:

(a) In the OSIPM program, when individuals received Medicaid-covered medical services prior to the date of request (see OAR 461-115-0030). This includes deceased individuals who would have been eligible for Medicaid covered services had they, or someone acting on their behalf, applied.

(b) In the QMB-DW program, when individuals paid or incurred Medicaid-covered Medicare Part A premiums, or were eligible for but not enrolled in Medicare Part A prior to the date of request and received Medicare Part A-covered services. This includes deceased individuals who would have been eligible for Medicaid-covered premiums had they, or someone acting on their behalf, applied.

(c) In the QMB-SMB and QMB-SMF programs, when individuals paid or incurred Medicaid-covered Medicare Part B premiums, or were eligible for but not enrolled in Medicare Part B prior to the date of request and received Medicare Part B-covered services. This includes deceased individuals who would have been eligible for Medicaid-covered premiums had they, or someone acting on their behalf, applied.

(d) Individuals applying for medical assistance through the REFM program are evaluated for retroactive eligibility.

(e) Individuals found ineligible for the OSIPM program solely because they do not meet the citizenship requirements of OAR 461-120-0125. Individuals eligible under this subsection are eligible only for CWM program benefits (see OAR 461-135-1070).

(2) If eligible for medical assistance retroactively, the eligibility of the individual may not start earlier than the date indicated by OAR 461-180-0140.

(3) In the QMB-BAS program, there are no retroactive medical benefits.

Statutory/Other Authority: ORS 409.050, 411.060, 411.404, 413.085 & 414.685
Statutes/Other Implemented: ORS 409.010, 411.060, 411.404, 413.085 & 414.685
History:
SSP 22-2022, minor correction filed 02/16/2022, effective 02/16/2022
SSP 23-2017, f. 9-11-17, cert. ef. 10-1-17
SSP 16-2014, f. & cert. ef. 7-1-14
SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14
SSP 17-2008, f. & cert. ef. 7-1-08
SSP 6-2006, f. 3-31-06, cert. ef. 4-1-06
SSP 22-2004, f. & cert. ef. 10-1-04
AFS 5-2002, f. & cert. ef. 4-1-02
AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01
AFS 5-2000, f. 2-29-00, cert. ef. 3-1-00
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95
AFS 2-1994, f. & cert. ef. 2-1-94
AFS 19-1993, f. & cert. ef. 10-1-93
AFS 12-1993, f. & cert. ef. 7-1-93
AFS 8-1993(Temp), f. & cert. ef. 4-26-93
AFS 28-1992, f. & cert. ef. 10-1-92
AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0880
OSIPM and QMB Programs; COVID-19

The provisions in this rule apply to the OSIPM and QMB programs.

(1) The Department amends the following rules or rule sections regarding the OSIPM and QMB programs.

(a) OAR 461-115-0700,

(b) OAR 461-175-0704,

(c) OAR 461-180-0030, and

(d) OAR 461-180-0120(1), (2), and (3)(b).

(2) Notwithstanding OAR 461-180-0030 and OAR 461-180-0120(1), (2), and (3)(b), the Department shall suspend the effective date for all actions that reduce or close OSIPM or QMB program benefits, except for:

(a) Program closures when an individual:

(A) Passes away,

(B) Is confirmed to have moved out of state,

(C) Requests a voluntary closure,

(D) In the QMB programs, is no longer eligible for Medicare,

(E) Is approved for a one-time cash payment, such as a special needs payment for home repairs,

(F) Is no longer eligible for an ongoing special needs payment,

(G) Is approved for benefits due to an administrative error (see OAR 461-195-0501), or

(H) When a court determines the individual made a false or misleading statement, or misrepresented, concealed, or withheld a fact for the purpose of establishing or maintaining eligibility.

(b) Benefit reductions when an individual

(A) Requests a voluntary reduction.

(B) Is no longer eligible for the same level or amount of a special needs payment.

(c) Increases to patient liability when restoring previous liability.

(d) Benefit suspension when an individual becomes a resident of a correctional facility under OAR 461-135-0950.

(3) Notwithstanding OAR 461-115-0700, the Department will accept self-attestation (see OAR 461-115-0700(2)(b)) to verify all eligibility criteria, except US citizenship, US national, and non-US citizen status.

(4) Notwithstanding OAR 461-115-0704(10), if the Department cannot promptly verify US citizenship, US national, or qualified non-US citizen status; the Department extends the reasonable opportunity period to 180 days from the date the notice is received.

(5) The provisions of this rule shall end on the last day of the month in which the public health emergency declaration by the Secretary of Health and Human Services under section 319 of the Public Health Service Act based on an outbreak of coronavirus disease 2019 (COVID–19) is lifted.

Statutory/Other Authority: ORS 409.050, ORS 411.060, 411.070, 411.083, 412.006, ORS 84.001 to 84.061, 412.009, 412.024, 412.049, 412.064 & 412.089
Statutes/Other Implemented: ORS 411.060, 411.070, 411.083, 412.006, ORS 84.001 to 84.061, 412.009, 412.024, 412.049, 412.064, 412.089, 409.010, 411.081, 411.087, 45 CFR 206.10, 45 CFR 263.2, 45 CFR 400.155, Pub. L. 116-127, 42 CFR 435.907, 42 CFR 435.914 & 42 CFR 433.400
History:
SSP 60-2021, minor correction filed 12/13/2021, effective 12/13/2021
SSP 34-2021, amend filed 06/23/2021, effective 07/01/2021
SSP 28-2021, temporary amend filed 03/25/2021, effective 03/25/2021 through 09/20/2021
SSP 33-2020, adopt filed 09/21/2020, effective 10/01/2020
SSP 30-2020, temporary adopt filed 09/02/2020, effective 09/02/2020 through 12/12/2020
SSP 14-2020, temporary adopt filed 06/16/2020, effective 06/16/2020 through 12/12/2020

461-135-0900
Specific Requirements; REF, REFM

(1) In addition to the eligibility (see OAR 461-001-0000) requirements in other rules in OAR chapter 461, an individual must meet all of the requirements in this rule to be eligible for the REF and REFM programs.

(2) An individual must meet the noncitizen status requirements of OAR 461-120-0125, except a child (see OAR 461-001-0000) born in the United States to an individual in the REF or REFM program meets the noncitizen status requirements for the REF and REFM programs as long as each parent (see OAR 461-001-0000) in the household group (see OAR 461-110-0210) meets the noncitizen status requirements of OAR 461-120-0125.

(3) An individual is not eligible to receive REF and REFM program benefits if the individual is a full-time student of "higher education", unless such education is part of a cash assistance case plan. Any education or training allowable under an approved case plan must be less than one year in length. For the purposes of this rule, "higher education" means education that meets the requirements of one of the following subsections:

(a) Public and private universities and colleges and community colleges that offer degree programs regardless of whether a high school diploma is required for the program. However, GED, ABE, ESL, and high school equivalency programs at these institutions are not considered "higher education".

(b) Vocational, technical, business, and trade schools that normally require a high school diploma or equivalency certificate for enrollment in the curriculum or in a particular program at the institution. However, programs at those institutions that do not require the diploma or certificate are not considered "higher education".

(4) Eligibility for REF and REFM program benefits –

(a) For individuals whose date of eligibility is before October 1, 2021, is limited to the first eight months from the date the immigration status was granted. Months in the United States are counted as whole months. There is no prorating of months.

(b) For individuals whose date of eligibility is on or after October 1, 2021, is limited to the first twelve months from the date the immigration status was granted, except for individuals that meet the criteria of paragraph (B) of this subsection.

(A) Months in the United States are counted as whole months. There is no prorating of months.

(B) The twelve-month period begins May 21, 2022, for an individual who is a citizen or national of Ukraine, or an individual who last habitually resided in Ukraine, who was paroled into the United States between February 24, 2022, and May 21, 2022.

(5) In the REF and REFM programs, if an individual was originally resettled in Oregon through the federal refugee resettlement process, then the individual must provide the name of the local resettlement agency that resettled them.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.116, 411.121, 411.404 & 414.685
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.116, 411.121, 411.404, 411.878, 412.049, 414.685, 45 CFR 400 & H.R. 7691, 117th Cong. (2021-2022)
History:
SSP 39-2022, temporary amend filed 06/27/2022, effective 06/27/2022 through 12/11/2022
SSP 38-2022, temporary amend filed 06/15/2022, effective 06/15/2022 through 12/11/2022
SSP 12-2022, minor correction filed 02/16/2022, effective 02/16/2022
SSP 27-2018, amend filed 09/04/2018, effective 10/01/2018
SSP 21-2018, amend filed 06/05/2018, effective 07/01/2018
SSP 5-2018, temporary amend filed 01/25/2018, effective 02/01/2018 through 06/30/2018
SSP 10-2017, f. 3-24-17, cert. ef. 4-1-17
SSP 24-2015, f. 9-29-15, cert. ef. 10-1-15
SSP 38-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14
SSP 13-2013, f. & cert. ef. 7-1-13
SSP 32-2010, f. & cert. ef. 10-1-10
SSP 13-2010(Temp), f. & cert. ef. 5-17-10 thru 11-13-10
SSP 28-2009, f. & cert. ef. 10-1-09
SSP 9-2009(Temp), f. & cert. ef. 5-1-09 thru 10-28-09
SSP 17-2008, f. & cert. ef. 7-1-08
SSP 4-2008(Temp), f. & cert. ef. 2-22-08 thru 7-28-08
SSP 3-2008(Temp), f. & cert. ef. 1-30-08 thru 7-28-08
SSP 10-2007, f. & cert. ef. 10-1-07
AFS 22-2002, f. 12-31-02, cert. ef. 1-1-03
AFS 25-2000, f. 9-29-00, cert. ef. 10-1-00
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 17-1998, f. & cert. ef. 10-1-98
AFS 19-1997, f. & cert. ef. 10-1-97
AFS 42-1996, f. 12-31-96, cert. ef. 1-1-97
AFS 33-1996(Temp), f. 9-26-96, cert. ef. 10-1-96
AFS 40-1995, f. 12-26-95, cert. ef. 1-1-96
AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95
AFS 1-1993, f. & cert. ef. 2-1-93
AFS 4-1992, f. 2-28-92, cert. ef. 3-1-92
AFS 19-1991(Temp), f. & cert. ef. 10-1-91
AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90
AFS 12-1990, f. 3-30-90, cert. ef. 4-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0910
Unaccompanied Minor Program; REF, REFM

Refugees who entered the United States under the Unaccompanied Minor Program administered by the federal Office of Refugee Resettlement are wards of the court and are in the custody of a public agency. They are not eligible for REF or REFM.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 8-2008, f. & cert. ef. 4-1-08
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 19-1997, f. & cert. ef. 10-1-97
AFS 20-1990, f. 8-17-90, cert. ef. 10-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0915
Specific Requirements; REF

In the REF program:

(1) To be eligible, an individual must be determined ineligible for TANF.

(2) As used in this rule:

(a) Except as provided otherwise in this section, "good cause" means a reasonable person of normal sensitivity, exercising ordinary common sense under similar circumstances, would have:

(A) Quit work, including in anticipation of discharge;

(B) Participated in behavior leading to the individual's discharge; or

(C) Voluntarily reduced work hours.

(b) For an individual with a physical or mental impairment (as defined at 29 CFR 1630.2(h)), except as provided otherwise in subsection (c) of this section, "good cause" for leaving work means that a reasonable person with the characteristics and qualities of such individual under similar circumstances would have:

(A) Quit work, including in anticipation of discharge;

(B) Participated in behavior leading to the individual's discharge; or

(C) Voluntarily reduced work hours.

(c) There is no "good cause" if the reason for separation from employment is a labor dispute.

(3) Except as provided otherwise under section (5) of this rule, a member of the need group (see OAR 461-110-0630) has a “violation” if that individual voluntarily quit employment or refused to accept an offer of employment in which that member was hired to work 100 or more hours per month or worked or was scheduled to work 100 or more hours:

(a) Within 30 days prior of the filing date (see OAR 461-115-0040) for REF benefits; or

(b) While receiving REF program benefits.

(4) A member of the need group is not eligible for REF program benefits:

(a) For the first violation (see section (3) of this rule), three payments months from the date that member of the need group was separated from their employment, voluntarily quit their employment, or refused to accept an offer of employment.

(b) For the second violation, six payments months from the date that member of the need group was separated from their employment, voluntarily quit their employment, or refused to accept an offer of employment.

(5) A need group does not have a violation based on section (3) of this rule if at least one of the following subsections applies:

(a) The member was unable to work due to a disability or medical condition documented by a qualified and appropriate professional, and which is expected to last for 30 days or more from the filing date for REF program benefits.

(b) The member was separated from employment for a reason the Department determines is good cause as defined in section (2) of this rule.

(c) The member was separated from employment as a result of a layoff.

(d) The member was pregnant and experiencing medical complications due to the pregnancy that prohibit participation in activities of the program and are documented by a qualified and appropriate professional.

(e) The member was fleeing from or at risk of domestic violence (see OAR 461-001-0000).

Statutory/Other Authority: ORS 409.050, 411.060 & 411.404
Statutes/Other Implemented: ORS 409.010, 411.060 & 411.404
History:
SSP 22-2017, f. 9-8-17 & cert. ef. 10-1-17
SSP 10-2017, f. 3-24-17, cert. ef. 4-1-17

461-135-0920
Refugees Applying for Supplemental Security Income (SSI)

(1) REF applicants who are age 65 or older or who are blind or have a disability (see OAR 461-001-0000) are referred to Social Security to apply for SSI. REF applicants who are found eligible for the REF program receive REF program benefits until SSI benefits begin or until passage of the twelve-month time limit for the REF program, whichever occurs first.

(2) Refugees eligible for SSI are eligible for the OSIPM program.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070 & 411.706
Statutes/Other Implemented: ORS 409.050, 411.060, 411.070, 411.706 & 45 CFR 400
History:
SSP 38-2022, temporary amend filed 06/15/2022, effective 06/15/2022 through 12/11/2022
SSP 24-2013, f. & cert. ef. 10-1-13
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 4-1992, f. 2-28-92, cert. ef. 3-1-92
AFS 19-1991(Temp), f. & cert. ef. 10-1-91
AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0930
Medical Coverage for Refugees; REFM

(1) Benefits in the REFM program are the same medical coverage as any Medicaid or CHIP program, except the QMB and CWM programs.

(2) An individual is not required to meet the financial eligibility criteria for the REFM program if the individual meets all the non-financial eligibility criteria for the REFM program and the requirements of at least one of the following subsections:

(a) The individual loses eligibility for any Medicaid or CHIP program, except the QMB and CWM programs, due to income from employment.

(b) The individual loses eligibility for any Medicaid or CHIP program, except the QMB and CWM programs, and is currently receiving benefits in the REF program.

(c) The individual had medical assistance established in another state based on refugee status granted by the United States Citizenship and Immigration Services, and:

(A) Moved to Oregon and is still within the individual’s first twelve months in the United States; and

(B) Was found not eligible for any Medicaid or CHIP program other than the CWM and QMB programs.

(3) An individual who is determined eligible for the REFM program will maintain eligibility for the REFM program for the remainder of their first twelve months in the United States even if the individual loses eligibility for the REF program due to having income equal to or over the countable (see OAR 461-001-0000) income and adjusted income (see OAR 461-001-0000) limits (see OAR 461-155-0030).

(4) An individual applying for the REFM program is not required to apply for or receive benefits in the REF program.

(5) Except for the CWM and QMB programs, eligibility for all Medicaid and CHIP programs must be determined prior to determining eligibility for the REFM program.

(6) When a newborn is born to a member of a REFM program benefit group (see OAR 461-110-0750):

(a) Members of the benefit group, may continue to receive REFM program benefits for the remainder of the twelve months, as stated in OAR 461-135-0900(4), if the member is determined ineligible for all Medicaid and CHIP programs.

(b) The newborn may receive REFM program benefits for the remainder of the twelve months of the benefit group, if the newborn is determined ineligible for all Medicaid and CHIP programs.

(7) To be eligible for the REFM program, an individual may not be enrolled in Medicare.

Statutory/Other Authority: ORS 409.050, 411.060, 411.404, 413.085 & 414.685
Statutes/Other Implemented: ORS 409.010, 411.060, 411.404 & 45 CFR 400
History:
SSP 38-2022, temporary amend filed 06/15/2022, effective 06/15/2022 through 12/11/2022
SSP 21-2022, minor correction filed 02/16/2022, effective 02/16/2022
SSP 33-2021, amend filed 06/22/2021, effective 07/01/2021
SSP 29-2021, temporary amend filed 03/29/2021, effective 03/29/2021 through 09/24/2021
SSP 22-2017, f. 9-8-17 & cert. ef. 10-1-17
SSP 10-2017, f. 3-24-17, cert. ef. 4-1-17
SSP 38-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14
SSP 24-2013, f. & cert. ef. 10-1-13
SSP 23-2008, f. & cert. ef. 10-1-08
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95
AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95
AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0950
Eligibility for Residents of Public Institutions

(1) This rule sets out additional restrictions on the eligibility of residents of public institutions for programs covered by Chapter 461 of the Oregon Administrative Rules.

(2) Definition of a "resident of a public institution".

(a) An individual living in a public institution (see section (3) of this rule) who is:

(A) Confined involuntarily in a local, state or federal prison, jail, detention facility, or other penal facility, including an individual being held involuntarily in a detention center awaiting trial or an individual serving a sentence for a criminal offense;

(B) Residing involuntarily in a facility under a contract between the facility and a public institution where, under the terms of the contract, the facility is a public institution;

(C) Residing involuntarily in a facility that is under governmental control;

(D) Receiving care as an outpatient while residing involuntarily in a public institution; or

(E) In the OSIPM and QMB programs, released from the public institution during a temporary period of hospitalization in a medical institution outside of the correctional facility.

(b) An individual is not considered a resident of a public institution when:

(A) The individual is released on parole, probation, or post-prison supervision;

(B) The individual is on home- or work-release, unless the individual is required to report to a public institution for an overnight stay;

(C) The individual is voluntarily residing in a supervised community residential facility and all of the following are true:

(i) Residents are not precluded from working outside the facility in employment available to individuals who are not under justice system supervision;

(ii) Residents can use community resources such as libraries, grocery stores, recreation and education at will, notwithstanding any house rules such as a requirement to sign in and out, curfews, or hours during which the residence is closed or locked; and

(iii) Residents can seek health care treatment in the broader community to the same or similar extent as other Medicaid enrollees in the state.

(D) The individual is staying voluntarily in a detention center, jail, or county penal facility after their case has been adjudicated and while other living arrangements are being made for the individual; or

(E) The individual is in a public institution pending other arrangements as defined in 42 CFR 435.1010.

(3) A "public institution" is any of the following:

(a) A “state hospital” (see ORS 162.135).

(b) A local correctional facility (see ORS 169.005): a jail or prison for the reception and confinement of individuals that is provided, maintained and operated by a county or city and holds individuals for more than 36 hours.

(c) A Department of Corrections institution (see ORS 421.005): a facility used for the incarceration of individuals sentenced to the custody of the Department of Corrections, including a satellite, camp, or branch of a facility.

(d) A youth correction facility (see ORS 162.135):

(A) A facility used for the confinement of individuals placed in the legal or physical custody of the youth authority, including a secure regional youth facility, a regional accountability camp, a residential academy and satellite, and camps and branches of those facilities; or

(B) A facility established under ORS 419A.010 to 419A.020 and 419A.050 to 419A.063 for the detention of individuals pursuant to a judicial commitment or order.

(4) Definition of serious mental illness. An individual has a serious mental illness if the individual has been diagnosed by a psychiatrist, a licensed clinical psychologist or a certified non-medical examiner as having dementia, schizophrenia, bipolar disorder, major depression or other affective disorder or psychotic mental disorder other than a substance abuse disorder and other than a disorder that is caused primarily by substance abuse.

(5) An individual who resides in a state hospital (see subsection (3)(a) of this rule), meets the definition of having a serious mental illness (see section (4) of this rule), and applies for medical assistance between 90 and 120 days prior to the expected date of the person's release from the state hospital may be found eligible for medical assistance. If the individual is determined to be eligible, the effective date of the individual's medical assistance is the date the individual is released from the institution.

(6) In the OSIPM and QMB programs, except as provided for in section (7) of this rule, an individual who is at least 21 years of age and less than 65 years of age who becomes a resident of a state hospital has medical benefits suspended. When an individual with suspended medical benefits is no longer a resident of the state hospital, or when the individual is admitted to a medical institution outside of the state hospital for a period of hospitalization, medical benefits are reinstated effective the first day the individual is no longer a resident, if the individual continues to meet eligibility for the medical program.

(7) An individual residing in a state hospital may be eligible for OSIPM and QMB program benefits if the individual meets the requirements of one of the following subsections:

(a) The individual is 65 years of age or older.

(b) The individual receives a Certificate of Need for Services from the State-authorized agency, and meets one of the following:

(A) The individual is under 21 years of age.

(B) The individual is 21 years of age, received a Certificate of Need for Services from the State-authorized agency, and received those services immediately before reaching age 21. Except as provided for in subsection (a) of this section, eligibility ends at age 22.

(8) For all programs covered under chapter 461 of the Oregon Administrative Rules:

(a) Except as provided otherwise in this rule, a resident of a public institution (see section (2) of this rule) is not eligible for benefits.

(b) Except as provided otherwise in this rule, if a pregnant individual receiving medical assistance through the OSIPM program becomes a resident of a public institution, their medical benefits are suspended. When the Department is informed the individual is no longer a resident of a public institution, their medical benefits are reinstated – effective on the first day they are no longer a resident of a public institution – if they are still in their protected period of eligibility under OAR 461-135-0010.

(c) If an individual receiving medical assistance through the OSIPM or QMB programs becomes a resident of a public institution at a correctional facility (see subsections (3)(b) through (3)(d) of this rule), medical benefits are suspended during the incarceration period.

(d) In the OSIPM and QMB programs, when the Department is notified that an individual with suspended benefits has been released or has been admitted to a hospital outside of the public institution for a period of hospitalization, medical benefits are reinstated effective the first day the individual is no longer a resident of a public institution if both of the following are true:

(A) The individual continues to meet eligibility for the medical program; and

(B) The notification takes place within ten calendar days of the release, or the notification takes place more than ten calendar days from the release date and there is good cause for the late reporting.

(9) In the GA and SNAP programs, in addition to the other provisions of this rule, a resident of a public institution released from a public institution on home arrest and required to wear an electronic device to monitor their activity, is ineligible for benefits if the correctional agency provides room and board to the individual.

(10) In the GA program, when an individual becomes a resident of a public institution:

(a) Housing assistance payments may continue for one calendar month following the month of incarceration if the following are true:

(A) The Department can determine that the individual will be released before the end of the calendar month following the month of incarceration, and

(B) The individual’s housing arrangement is still available.

(b) If the individual will be released after the end of the calendar month following the month of incarceration, or if the release date is not known, housing assistance payments will be closed effective the end of the notice period (see OAR 461-175-0050) for a timely continuing benefit decision notice (see OAR 461-001-0000).

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.404, 411.816, 412.049, 413.085, 414.685 & 412.014
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.404, 411.447, 411.816, 412.014, 412.049, 414.426 & 42 CFR 435.1009
History:
SSP 34-2021, amend filed 06/23/2021, effective 07/01/2021
SSP 27-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 8-2019, amend filed 03/13/2019, effective 04/01/2019
SSP 28-2018, amend filed 09/06/2018, effective 10/01/2018
SSP 25-2018, temporary amend filed 07/11/2018, effective 07/11/2018 through 09/30/2018
SSP 11-2018, amend filed 03/09/2018, effective 04/01/2018
SSP 33-2017, amend filed 12/08/2017, effective 01/01/2018
SSP 23-2017, f. 9-11-17, cert. ef. 10-1-17
SSP 17-2017(Temp), f. 6-28-17, cert. ef. 7-1-17 thru 12-27-17
SSP 31-2016, f. & cert. ef. 9-1-16
SSP 25-2016(Temp), f. 6-30-16, cert. ef. 7-1-16 thru 12-27-16
SSP 9-2014, f. & cert. ef. 4-1-14
SSP 38-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14
SSP 35-2011, f. 12-27-11, cert. ef. 1-1-12
SSP 26-2011(Temp), f. 9-30-11, cert. ef. 10-1-11 thru 3-29-12
SSP 10-2011, f. 3-31-11, cert. ef. 4-1-11
SSP 7-2007, f. 6-29-07, cert. ef. 7-1-07
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07
SSP 6-2006, f. 3-31-06, cert. ef. 4-1-06
SSP 17-2005(Temp), f. 12-30-05, cert. ef. 1-1-06 thru 6-30-06
AFS 27-2001, f. 12-21-01, cert. ef. 1-1-02
AFS 21-2001(Temp), f. & cert. ef. 10-1-01 thru 12-31-01
AFS 17-2000, f. 6-28-00, cert. ef. 7-1-00
AFS 5-2000, f. 2-29-00, cert. ef. 3-1-00
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 4-1998, f. 2-25-98, cert. ef. 3-1-98
AFS 30-1990, f. 12-31-90, cert. ef. 1-1-91
AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90

461-135-0990
Specific Requirements; Reimbursement of Cost-Effective, Employer-Sponsored Health Insurance Premiums

(1) Clients or an eligible applicant (see section (2) of this rule) for a client in the OSIPM program may be reimbursed for their share of the premiums for private or employer-sponsored group health insurance if:

(a) The insurance covers a member of the benefit group (see OAR 461-110-0750);

(b) The insurance coverage is a comprehensive major medical plan that includes inpatient and outpatient hospital, physician, lab, x-ray and full prescription coverage; and

(c) The premium is cost-effective (see OAR 461-155-0360 and OAR 410-120-1960).

(2) An "eligible applicant" may be a non-Medicaid individual living in or outside of the household. The Department may pay a portion of or the entire premium if payment of the premium for the non-Medicaid individual is necessary in order to enroll the Department client in the group health plan (see OAR 410-120-1960).

Statutory/Other Authority: ORS 411.060, 411.070 & 414.042
Statutes/Other Implemented: ORS 411.060, 411.070 & 414.042
History:
SSP 31-2016, f. & cert. ef. 9-1-16
SSP 25-2016(Temp), f. 6-30-16, cert. ef. 7-1-16 thru 12-27-16
SSP 16-2014, f. & cert. ef. 7-1-14
SSP 35-2011, f. 12-27-11, cert. ef. 1-1-12
SSP 38-2009, f. 12-31-09, cert. ef. 1-1-10
SSP 29-2009(Temp), f. & cert. ef. 10-1-09 thru 3-30-10
SSP 23-2008, f. & cert. ef. 10-1-08
SSP 10-2007, f. & cert. ef. 10-1-07
SSP 22-2004, f. & cert. ef. 10-1-04
SSP 1-2003, f. 1-31-03, cert. ef. 2-1-03
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 10-1998, f. 6-29-98, cert. ef. 7-1-98
AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97
AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95
AFS 2-1994, f. & cert. ef. 2-1-94
AFS 28-1992, f. & cert. ef. 10-1-92
AFS 2-1992, f. 1-30-92, cert. ef. 2-1-92

461-135-1070
Specific Requirements; Citizenship Waived Medical (CWM)

To be eligible for the Citizenship Waived Medical (CWM) program, an individual must be ineligible for OSIPM solely because they do not meet citizenship or noncitizen status requirements. Benefits of the CWM program are limited to the services described in the administrative rules of the Oregon Health Authority in chapter 410 of the Oregon Administrative Rules.

Statutory/Other Authority: ORS 409.050 & 411.404
Statutes/Other Implemented: ORS 411.060 & 411.404
History:
SSP 20-2022, minor correction filed 02/16/2022, effective 02/16/2022
SSP 38-2013, f. 12-31-13, cert. ef. 1-1-14
SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14
SSP 22-2004, f. & cert. ef. 10-1-04
SSP 16-2004(Temp), f. & cert. ef. 7-1-04 thru 9-30-04
SSP 1-2003, f. 1-31-03, cert. ef. 2-1-03
AFS 5-2002, f. & cert. ef. 4-1-02
AFS 5-2000, f. 2-29-00, cert. ef. 3-1-00
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 10-1998, f. 6-29-98, cert. ef. 7-1-98
AFS 2-1994, f. & cert. ef. 2-1-94
AFS 17-1992, f. & cert. ef. 7-1-92

461-135-1080
Specific Requirements; Healthier Oregon Medical Program

(1) To be eligible for benefits under the Healthier Oregon medical program an individual must meet both of the following:

(a) Meet all financial and non-financial eligibility (see OAR 461-001-0000) requirements for OSIPM except citizen and noncitizen status requirements (see OAR 461-120-0110).

(b) Be age 19 through 25 or be age 55 and older.

(2) Healthier Oregon recipients who no longer meet the age requirement of subsection (1)(b) of this rule:

(a) Shall maintain eligibility so long as they continue to meet all other financial and non-financial eligibility criteria; or

(b) May regain eligibility if they respond within the 90-day reconsideration period (see OAR 410-200-0110) after closure due to failure to respond at renewal and meet all financial and non-financial eligibility criteria.

(3) Benefits of Healthier Oregon are described in Chapter 410, Division 134 of the Oregon Health Authority.

Statutory/Other Authority: ORS 409.050, 411.404 & 414.231
Statutes/Other Implemented: ORS 411.060, 411.404, 414.231 & HB 3352 Oregon 2021 Reg. Sess.
History:
SSP 40-2022, adopt filed 06/29/2022, effective 07/01/2022

461-135-1175
Senior Farm Direct Nutrition Program

(1) The Senior Farm Direct Nutrition Program (SFDNP) provides farm direct checks to low income individuals.

(2) An individual is eligible for SFDNP if the individual meets all of the following eligibility criteria on April 1 of the calendar year in which benefits are sought:

(a) Has countable income (see OAR 461-001-0000) less than 135 percent of the Federal Poverty Level as listed in OAR 461-155-0295.

(b) Receives Medicaid or SNAP benefits.

(c) Is homeless or resides in their own home or rental property.

(d) Is age 60 or older.

(3) SFDNP is funded by a grant from the United States Department of Agriculture (USDA). The Department determines the allotment amount and number of eligible individuals on an annual basis, based on the grant allocation received from the USDA.

(4) The Department may not issue more than one SFDNP allotment per participant, per year.

(5) SFDNP begins June 1 each year and ends on October 31 each year. In order to qualify for the program, the Department must receive the applicant's letter of interest by September 15 of the year in question.

(6) The Department processes applicants' letters of interest in the order in which the letters are received at the Department's central office.

(7) When the grant allocation received from the USDA is expended in its entirety, the Department closes SFDNP for the year in question.

(8) The Department determines the treatment of SFDNP benefits during the eligibility process for other programs in accordance with OAR 461-145-0190.

Statutory/Other Authority: ORS 409.050, 410.070, 411.060 & 411.070
Statutes/Other Implemented: ORS 409.050, 410.070, 411.060 & 411.070
History:
Reverted to SSP 18-2010, f. & cert. ef. 7-1-10
Suspended by SSP 21-2012(Temp), f. & cert. ef. 6-8-12 thru 12-5-12
SSP 18-2010, f. & cert. ef. 7-1-10
SSP 8-2010(Temp), f. & cert. ef. 4-1-10 thru 9-28-10
SSP 28-2009, f. & cert. ef. 10-1-09
SSP 11-2009(Temp), f. & cert. ef. 6-1-09 thru 11-27-09
SSP 5-2009, f. & cert. ef. 4-1-09
SSP 17-2008, f. & cert. ef. 7-1-08
SSP 8-2008, f. & cert. ef. 4-1-08
SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
SSP 8-2006, f. & cert. ef. 6-1-06

461-135-1185
Low-Income Subsidy Program (LIS)

The Low-Income Subsidy (LIS) program is a federal assistance program for Medicare clients who need extra help meeting their Medicare Part D prescription drug costs. The LIS program helps Medicare clients pay their monthly premium, deductible, and co-insurance costs under Part D. The LIS program is a means-tested program. All clients must qualify on the basis of household income, resources, and size as defined by the Social Security Administration.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 38-2009, f. 12-31-09, cert. ef. 1-1-10
SSP 14-2005, f. 9-30-05, cert. ef. 10-1-05
SSP 8-2005(Temp), f. & cert. ef. 7-1-05 thru 10-1-05

461-135-1186
LIS Applications

An LIS application is complete if all of the following requirements are satisfied:

(1) The applicant satisfies the provisions of OAR 461-115-0050 and completes the Department’s forms.

(2) The applicant must submit:

(a) A certification by the applicant or personal representative, under penalty of perjury or sanction for false statement, as to the accuracy of information provided on the application form (see 42 CFR 423.904(d)(2));

(b) All required statements from financial institutions (see 42 CFR 423.904(d)(3)); and

(c) All information for verification (see 42 CFR 423.904(d)(3)) required under OAR 461-115-0610.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 14-2005, f. 9-30-05, cert. ef. 10-1-05
SSP 8-2005(Temp), f. & cert. ef. 7-1-05 thru 10-1-05

461-135-1187
Eligibility Determinations and Due Process for LIS

(1) The regulations set out at 42 CFR 423.771 to 423.774 are expressly adopted and incorporated by reference for LIS. These regulations apply to the application process, eligibility determinations, and redeterminations.

(2) The Department will send to LIS applicants a decision notice consistent with the provisions of OAR 461-175-0200 not later than the 45th day after the date of request.

(3) An applicant may appeal an adverse decision notice under the provisions of division 461-025 of the Oregon Administrative Rules.

Statutory/Other Authority: ORS 411.060
Statutes/Other Implemented: ORS 411.060
History:
SSP 14-2005, f. 9-30-05, cert. ef. 10-1-05
SSP 8-2005(Temp), f. & cert. ef. 7-1-05 thru 10-1-05

461-135-1195
Specific Requirements; SFPSS Eligibility

In the SFPSS program:

(1) To be eligible, a client must meet the following requirements:

(a) Be an adult;

(b) Meet all TANF program eligibility requirements (except as provided otherwise in this rule);

(c) Be receiving TANF benefits;

(d) Have an impairment that meets the requirements in OAR 461-125-0260;

(e) File an application for Supplemental Security Income (SSI) disability benefits under the Social Security Act; and

(f) Sign an Interim Assistance Authorization authorizing the Department to recover interim SFPSS program benefits paid to the client (or paid to providers on the client's behalf) from the initial SSI payment or the initial payment after the decision on SSI eligibility. The following provisions are considered part of the Interim Assistance Authorization:

(A) Interim SFPSS program benefits include only those SFPSS program cash benefits paid to the adult, who is applying for SSI, during the period of time that the SSI benefit covers.

(B) For any month in which SSI is prorated, the Department may recover only a prorated amount of the interim SFPSS program cash benefit.

(C) If the Department does not stop delivery of an SFPSS program benefit issued after the SSI payment is made, the SFPSS program payment is included in the interim assistance reimbursement to the Department.

(2) Counting earned and unearned income.

(a) The TANF standards in OAR 461-155-0030 are used to determine eligibility for the SFPSS program.

(b) The SFPSS payment standard (see OAR 461-155-0320) is used to determine the benefit amount for the SFPSS program.

(3) A client whose impairment no longer meets the criteria in OAR 461-125-0260 is ineligible for SFPSS benefits.

(4) An SFPSS client found by the Social Security Administration (SSA) not to meet disability criteria may continue receiving SFPSS benefits until all SSA administrative appeals are exhausted.

(5) Once a client is approved for SFPSS, the client is no longer subject to OAR 461-120-0340. The client remains exempt from 461-120-0340 as long as the client is eligible for and receiving SFPSS.

(6) Each client is required to participate in the appropriate activities the Department determines necessary, including activities that promote family stability (see OAR 461-001-0000). The Department must consider the needs of an individual with a disability (see 461-001-0000), and a client's need for accommodation or modification.

(7) A client must provide the information necessary for the Department to administer the program.

(a) The necessary information includes that needed to determine appropriate activities for the client and to assess whether a client had good cause (see OAR 461-130-0327) for any failure to meet a requirement of the program.

(b) If a medical condition is in question, the Department will assist and may require the client to provide a medical opinion from a qualified and appropriate medical professional.

(8) The Department offers each client the opportunity to participate in any suitable JOBS program activity (see OAR 461-001-0025).

Statutory/Other Authority: ORS 411.060, 411.070, 412.006, 412.009, 412.014 & 412.049
Statutes/Other Implemented: ORS 411.060, 411.070, 412.006, 412.009, 412.014, 412.049 & 412.084
History:
SSP 35-2011, f. 12-27-11, cert. ef. 1-1-12
SSP 26-2011(Temp), f. 9-30-11, cert. ef. 10-1-11 thru 3-29-12
SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11
SSP 5-2010, f. & cert. ef. 4-1-10
SSP 34-2009(Temp), f. & cert. ef. 11-16-09 thru 5-14-10
SSP 28-2009, f. & cert. ef. 10-1-09
SSP 12-2009(Temp), f. 6-23-09, cert. ef. 7-1-09 thru 12-28-09
SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08

461-135-1197
Good Cause; SFPSS

In the SFPSS program:

(1) The Department does not require a client to provide verification of good cause if providing the verification would expose the client to increased risk of domestic violence (see OAR 461-001-0000).

(2) If in making a determination under this rule, a client's physical or mental impairment is in question, the Department may require the client to provide documentation from a qualified and appropriate medical professional.

(3) A client is excused for good cause from a failure to comply with a requirement of the SFPSS program, including an activity (see OAR 461-001-0025) in a case plan (see 461-001-0025) in the following circumstances:

(a) Participation in a required activity in a case plan would have an adverse effect on or risk to the client's physical or mental health or would expose the client to increased risk of domestic violence (see OAR 461-001-0000).

(b) Participation is likely to cause undue hardship for the dependent child (see OAR 461-001-0000) or the client.

(c) When the failure to comply is caused by the failure of the Department to timely provide or authorize a support service payment.

(d) Appropriate child care, or day care for an individual in the household who has a disability (see OAR 461-001-0000) that substantially reduces or eliminates the individual's ability to care for himself or herself, cannot be obtained. "Appropriate child care" means that:

(A) Both the provider and the place where care is provided meet health, safety, and provider requirements as required in OAR 461-165-0180;

(B) The care accommodates the parent's work schedule; and

(C) The care meets the specific needs of the dependent child, such as age and special-needs requirements.

(e) The work attachment position or employment offered is vacant due to a strike, lockout, or other labor dispute.

(f) The work attachment position or employment requires the client to join a union, and the client has religious objections to unions.

(g) The client's participation in a required activity in a case plan would prevent or interfere with the client's participation in an activity of the Grande Ronde Tribe's NEW program.

(h) The client's failure to participate is due to a circumstance beyond his or her reasonable control.

(i) When the failure to comply is caused by an aspect of the client's disability, including the Department's failure to provide a reasonable accommodation.

(j) The client quits a job to accept another job with a monthly income at least equal to the monthly income of the first job.

(k) An individual separated from his or her most recent employment for circumstances the Department determines are reasonable.

Statutory/Other Authority: ORS 411.060, 412.006, 412.009, 412.014 & 412.049
Statutes/Other Implemented: ORS 411.060, 411.070, 412.006, 412.009, 412.014 & 412.049
History:
SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11

461-135-1200
Specific Requirements; TA-DVS

(1) The TA-DVS program addresses temporary needs of individuals --

(a) Who are currently victims of domestic violence (see OAR 461-001-0000), have been victims of domestic violence, or are at risk of victimization by domestic violence;

(b) Whose safety is at risk because of domestic violence or the current threat of domestic violence; and

(c) Who meet the financial and non-financial requirements of this rule.

(2) An individual must complete the application process as defined in OAR 461-115-0020. The Department is to follow the application time frames outlined under OAR 461-115-0190.

(3) An applicant may complete the application process as follows:

(a) In addition to the methods listed under OAR 461-115-0040, the "filing date" may be established telephonically by the Department making record of:

(A) The name of the applicant,

(B) The applicant’s address,

(C) The applicant’s request for TA-DVS benefits,

(D) The applicant stating their full name as their signature, and

(E) The date the above occur.

(b) Any individual may apply for TA-DVS benefits using the Department approved “telephonic application” (see section (c) of this rule) and “narrated telephonic signature” (see section (d) of this rule) processes. An individual submitting a telephonic application must submit the application with a narrated telephonic signature.

(c) A telephonic application is accepted when the following requirements are met:

(A) All questions on the application are answered.

(B) All information necessary to determine eligibility (see OAR 461-001-0000) and benefit amount is provided for each individual in the filing group (see OAR 461-110-0310).

(C) The applicant provides a narrated telephonic signature as defined under this rule.

(d) A narrated telephonic signature is accepted for an application for TA-DVS benefits when the Department makes record that the following requirements are met:

(A) The “Your Rights and Responsibilities” form is reviewed and provided to the applicant.

(B) The following sections at the end of the application form are reviewed and provided to the applicant:

(i) “Information about all programs,” and

(ii) “Information about your rights and responsibilities.”

(C) The applicant affirms that they:

(i) Have heard and understand their rights and responsibilities;

(ii) Agree to their rights and responsibilities;

(iii) Have given true, correct, and complete information to the Department; and

(iv) States their full name as their signature.

(D) The Department makes record of the narrated telephonic signature.

(4) The Department is authorized by ORS 411.117 to waive or modify requirements of the TANF program that make it more difficult for applicants to escape domestic violence or put them at risk of further or future domestic violence.

(5) The Department waives the TANF requirement in OAR 461‑135‑0070(1)(a) for a pregnant woman to have reached late pregnancy if an applicant is at risk of further or future domestic violence.

(6) The filing group requirements in the TA-DVS program are the same as for the TANF program (see OAR 461-110-0330), except the abuser is not considered in the filing group.

(7) The financial eligibility requirements in the TA-DVS program are the same as for the TANF program except that:

(a) A TANF grant does not count as income.

(b) Income received during the budget month is not counted if the applicant does not have reasonable access to the money or cannot access the money independently of the abuser.

(c) Income received during the budget month is not counted if the applicant needs the money for expenses made necessary to flee from abuse.

(d) There is no resource limit.

(e) The income limit is the applicable TANF Countable Income Limit Standard (OAR 461-155-0030), but the TA-DVS program uses net income, minus living deductions on the DHS Form 1542, against the amounts set out under the TANF Countable Income Limit.

(f) SSI income is countable (see OAR 461-001-0000), if available in time to meet the emergent need (the immediate safety need) of the applicant.

(8) The non-financial requirements in the TA-DVS program are the same as for the TANF program except that:

(a) Citizenship and noncitizen status requirements (OAR 461-120-0110) are waived.

(b) There are no requirements to assign support rights.

(c) There are no requirements to pursue assets (see OAR 461-120-0330).

(d) There is no requirement of regular school attendance (OAR 461-120-0510), except that if the only dependent child (see OAR 461-001-0000) is at least the age of 18, the dependent child must meet requirements of OAR 461-120-0510.

(e) The recipient is not required to participate in an employment program. 

(f) The TANF program requirement for a caretaker relative (see OAR 461-001-0000) in the need group (see OAR 461-110-0630) to not have been separated from their most recent employment (see OAR 461-135-0070) is waived when there is risk of further or future domestic violence.

(9) Verification in the TA-DVS program is required as in the TANF program. Verification of financial or non-financial eligibility factors is postponed if the delay in finding the applicant eligible would prevent the applicant from meeting an emergent need.

(10) No verification is required that the applicant is a victim of domestic violence or needs to flee from abuse unless:

(a) The individual has been arrested for or convicted of an act of domestic violence in the past and it is uncertain whether the individual is a victim of domestic violence. In this situation, the Department verifies that the individual is not or was not a perpetrator of domestic violence.

(b) It is unclear who the abuser is because multiple individuals list each other as the perpetrator during overlapping applications or eligibility periods.

(11) Verification as needed in situations described in subsections (10)(a) and (10)(b) of this rule includes, but is not limited to, a statement from a law enforcement officer, a district attorney, the court, a batterer intervention program, a victim's advocate, a Child Welfare staff person, a mental health provider, a health care or other medical provider, a member of the clergy, or other professional from whom the individual has requested assistance to address the alleged domestic violence indicating that the individual is not a perpetrator of domestic violence or is a self-defending victim. This statement is adequate verification. If no verification is available, the Department's central office TA-DVS Policy Analyst may assist the field in determining what other verification is acceptable.

(12) The following TANF requirements remain in effect as described even if an individual is a victim of domestic violence or at risk of victimization by domestic violence:

(a) The TANF requirements in OAR 461-135-0070 to be a dependent child, a caretaker relative, or a parent (see OAR 461-001-0000).

(b) The TANF requirement in OAR 461-120-0630 that a dependent child live with a caretaker relative, except the latter requirement may be waived while the caretaker relative escapes from further or future domestic violence if the dependent child is expected to return within the 90-day eligibility period.

(c) The TANF requirement of residency (see OAR 461-120-0010) except when an individual does not intend to stay in Oregon if the reason for leaving is due to their current domestic violence situation.

(d) Income or resource limits except as specifically provided in OAR 461-140-0020 and OAR 461-140-0040.

Statutory/Other Authority: ORS 409.050, 411.060, 411.117 & 412.049
Statutes/Other Implemented: ORS 409.010, 411.060, 411.117 & 412.049
History:
SSP 44-2020, amend filed 12/22/2020, effective 01/01/2021
SSP 31-2020, temporary amend filed 09/04/2020, effective 09/04/2020 through 03/02/2021
SSP 21-2018, amend filed 06/05/2018, effective 07/01/2018
SSP 19-2005, f. 12-30-05, cert. ef. 1-1-06
SSP 34-2017, amend filed 12/18/2017, effective 01/01/2018
SSP 14-2005, f. 9-30-05, cert. ef. 10-1-05
AFS 13-2002, f. & cert. ef. 10-1-02
AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99
AFS 25-1998, f. 12-28-98, cert. ef. 1-1-99
AFS 17-1998, f. & cert. ef. 10-1-98
AFS 19-1997, f. & cert. ef. 10-1-97

461-135-1230
Benefits; TA-DVS

In the TA-DVS program:

(1) A client may receive TA-DVS program benefits of the program for up to 90 days from the date the client was found eligible.

(a) Two 90-day eligibility periods may not overlap.

(b) Once a 90-day eligibility period has expired, the client may reapply for TA-DVS program under OAR 461-135-1200(2).

(2) A recipient may receive benefits simultaneously from the TA-DVS and TANF programs.

(3) A client may receive benefits under the TA-DVS program not to exceed $1,200 during the 90-day eligibility period.

(4) The Department does not make payments –

(a) After the 90-day eligibility period unless all of the needed payment verification was received by the Department by day 90 and payment was not able to be issued due to Department error.

(b) Notwithstanding subsection (a) of this section, more than 10 days after the last day of the eligibility period.

(5) TA-DVS benefits address a specific crisis situation or episode of need related to the applicant’s domestic violence (see OAR 461-001-0000) situation (such as securing new or temporary housing, payment of security deposit, first month's rent, moving expenses, furniture, and clothing replacement). TA-DVS benefits are not utilized to meet current ongoing or recurrent needs expected to continue beyond 90 days and are not used for the following items even if the recipient believes the item would contribute to the recipient’s safety:

(a) Payment for attorney or other legal fees;

(b) Payment of a fine or other penalty;

(c) Payment of outstanding or past due costs such as rent or utilities when the individual does not intend to stay in the residence or the need for the payment was not related to the current domestic violence situation;

(d) Payment of a pet fee (unless the pet is a service animal, and only when the service status has been verified by a qualified and appropriate medical professional);

(e) Payment for relocation of household or personal belongings from another state;

(f) Purchase of a car (including making car payments) or recreational vehicle, including a travel trailer;

(g) Purchase of a firearm or other weapon;

(h) Purchase of new furniture unless --

(A) The new furniture is not available through a community resource;

(B) A less costly alternative for acquiring the new furniture is not available;

(C) The old furniture was left behind when the individual fled domestic violence; and

(D) The new furniture is essential to setting up a household (such as beds, dressers, a dining room table and chairs, a couch).

(i) Purchase of a non-essential item such as a television or computer, or service such as cable, satellite, internet, even if such an item or service was left behind when the individual fled the domestic violence situation; or

(j) Purchase of a pet or guard animal.

(k) Payment of a request about which inaccurate information was provided.

(l) Payment without verification to the extent required under OAR 461-115-0610.

(6) The recipient and the Department prepare a case plan that identifies activities necessary to enhance the safety of the family. The case plan specifies the payments the Department makes to meet the needs for shelter and food and for relocation or other services that will enhance safety.

(7) A recipient’s available liquid resources may be considered when developing the case plan.

(8) A payment issued for an item in the case plan is issued as a dual-payee or vendor-pay check unless the use of a dual-payee or vendor-pay check is likely to put the recipient at risk of harm.

(9) Reimbursements are not an allowable payment unless payment was pre-authorized by the Department and the reason for purchase was related to the current episode of need related to the domestic violence situation.

Statutory/Other Authority: 411.060, ORS 409.050, 411.070 & 412.049
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.117 & 412.049
History:
SSP 34-2017, amend filed 12/18/2017, effective 01/01/2018
SSP 38-2009, f. 12-31-09, cert. ef. 1-1-10
SSP 5-2009, f. & cert. ef. 4-1-09
SSP 10-2007, f. & cert. ef. 10-1-07
SSP 8-2004, f. & cert. ef. 4-1-04
AFS 25-2000, f. 9-29-00, cert. ef. 10-1-00
AFS 9-1999, f. & cert. ef. 7-1-99

461-135-1235
TA-DVS; Right to Hearing

A client whose application is denied or who does not receive a decision on an application by the close of the second business day following the date the application is complete is entitled to an expedited hearing (see OAR 461-025-0315). A dispute over the amount of any payment provided to or for the client is resolved in an expedited hearing; other disputes about the contents of a case plan are resolved through re-engagement.

Statutory/Other Authority: ORS 411.060 & 412.049
Statutes/Other Implemented: ORS 411.060, 411.117 & 412.049
History:
SSP 23-2008, f. & cert. ef. 10-1-08
SSP 8-2004, f. & cert. ef. 4-1-04
AFS 9-1999, f. & cert. ef. 7-1-99

461-135-1240
TA-DVS Program; Pandemic

This rule applies to the TA-DVS program and is reserved for use in case of a pandemic.

Statutory/Other Authority: ORS 84.001 to 84.061, 409.050, 411.060, 411.117 & 412.049
Statutes/Other Implemented: ORS 84.001 to 84.061, 411.060, 411.117, 412.049, 409.010 & 45 CFR 260.50
History:
SSP 36-2020, adopt filed 10/01/2020, effective 10/01/2020
SSP 32-2020, temporary adopt filed 09/04/2020, effective 09/04/2020 through 10/06/2020
SSP 26-2020, temporary adopt filed 08/03/2020, effective 08/03/2020 through 10/06/2020
SSP 8-2020, temporary adopt filed 04/10/2020, effective 04/10/2020 through 10/06/2020

461-135-1250
Closure of Post-TANF Program

Notwithstanding any other administrative rule in Chapter 461, effective April 30, 2012 the Post-TANF program funding ends. Continuation of Post-TANF benefits is not authorized after April 30, 2012, regardless of whether a hearing request on Post-TANF is submitted or pending.

Statutory/Other Authority: ORS 411.060, 411.070, 412.006, 412.009, 412.049 & 412.124
Statutes/Other Implemented: ORS 411.060, 411.070, 412.006, 412.009, 412.049 & 412.124
History:
SSP 26-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 15-2016, f. & cert. ef. 4-1-16
SSP 30-2012, f. 9-28-12, cert. ef. 10-1-12
SSP 15-2012(Temp), f. & cert. ef. 4-13-12 thru 10-9-12
SSP 14-2012(Temp), f. & cert. ef. 4-12-12 thru 10-9-12
[SSP 13-2011(Temp), f. & cert. ef. 6-15-11 thru 12-12-11; Suspended by SSP 14 2011(Temp), f. & cert. ef. 6-29-11 thru 12-12-11]
SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11
SSP 29-2010(Temp), f. & cert. ef. 8-16-10 thru 2-12-11
SSP 5-2009, f. & cert. ef. 4-1-09
SSP 25-2008(Temp), f. 12-31-08, cert. ef. 1-1-09 thru 6-30-09
SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08
SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08

461-135-1260
Specific Requirements: Job Participation Incentive

(1) This rule explains specific requirements of the Job Participation Incentive (JPI). The JPI food benefit provides $10 per month for qualifying SNAP households with a dependent child (see OAR 461-001-0000) under age 18.

(2) An individual eligible for JPI may receive a $10 monthly food benefit.

(a) The individual receives the $10 incentive payment starting the month the Department receives documentation that all enrollment criteria in section (3) of this rule have been met.

(b) There are no partial months of JPI benefits.

(c) The individual may only be issued retroactive JPI benefits as allowed under OAR 461-180-0130.

(3) As used in this rule, a “two-parent household” refers to a SNAP household group (see OAR 461-110-0210) that contains a dependent child under age 18 and the dependent child's two parents.

(4) To receive JPI, an individual must be in a SNAP filing group (see OAR 461-110-0370) and meet the requirements of all of the following subsections:

(a) Be working at an unsubsidized paid employment that meets the federally required participation rates (see OAR 461-001-0025). For self-employment or piece rate work, the hours of work must be equivalent to the required average weekly hours at Oregon State minimum wage. An individual must meet the requirements of at least one of the following paragraphs:

(A) Be a single parent (see OAR 461-001-0000) of a dependent child under six years of age and working at an unsubsidized paid employment for an average of at least 20 weekly hours.

(B) Be a single parent of a dependent child at least six years of age and under 18 years of age, and working at an unsubsidized paid employment for an average of at least 30 weekly hours.

(C) Be a parent in a two-parent household (see section (3) of this rule) that does not receive federally-funded child care assistance, and the parents are working at unsubsidized paid employment for a combined average of at least 35 hours per week.

(D) Be a parent in a two-parent household that receives federally-funded child care assistance and the parents are working at unsubsidized paid employment for a combined average of 55 hours per week.

(b) Provide the Department with employer-produced documents of paid, unsubsidized work hours covering a consecutive two-week period that has occurred within the last 60 days.

(c) Anticipate weekly employment hours will remain the same or increase for the reporting period.

(d) Provide employer-produced documents of paid, unsubsidized work hours each time requested by the Department and no later than the last day of the sixth month following the date the individual provides the verification of work hours in accordance with subsections (a) and (b) of this section.

(e) Be an eligible adult in a SNAP benefit group (see OAR 461-110-0750) and the parent of an eligible dependent child under age 18 in the same SNAP benefit group.

(f) Not be receiving any SFPSS or TANF program benefits in the same month.

(5) To remain eligible for JPI, an individual must meet all requirements in section (4) of this rule and all SNAP eligibility and reporting requirements (see OAR 461-170-0011).

(6) Household income in JPI is calculated in accordance with all SNAP financial rules.

(7) An individual is no longer eligible for JPI when it has been determined that the individual does not meet federally required participation rates and requirements due to any of the following:

(a) Loss of employment.

(b) A reduction in work hours.

(c) The individual no longer has a dependent child under age 18 in their SNAP benefit group.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070 & 412.049
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070 & 412.049
History:
SSP 33-2022, temporary amend filed 03/31/2022, effective 04/01/2022 through 09/27/2022
SSP 26-2021, amend filed 03/24/2021, effective 04/01/2021
SSP 24-2014, f. & cert. ef. 10-1-14
SSP 14-2014(Temp), f. & cert. ef. 6-26-14 thru 12-23-14
SSP 30-2012, f. 9-28-12, cert. ef. 10-1-12
SSP 19-2012(Temp), f. 5-23-12, cert. ef. 5-24-12 thru 10-28-12
SSP 17-2012(Temp), f. & cert. ef. 5-1-12 thru 10-28-12
SSP 10-2012, f. 3-29-12, cert. ef. 3-30-12
SSP 26-2011(Temp), f. 9-30-11, cert. ef. 10-1-11 thru 3-29-12

461-135-1270
Specific Requirements; Employment Payments

(1) Effective April 1, 2016, a benefit group (see OAR 461-110-0630) that includes an individual who meets the requirements in section (2) of this rule is eligible to receive $225 in Employment Payments (see OAR 461-001-0025) paid over three months as provided in section (3) of this rule.

(2) To be eligible for three months of Employment Payments, an individual in the benefit group (see OAR 461-110-0750) or an individual not in the benefit group due to the time limit in OAR 461-135-0071 must meet all of the following requirements:

(a) Have obtained unsubsidized paid employment and reported it timely.

(b) Have been a JOBS eligible or JOBS volunteer (see OAR 461-130-0310) individual who closed TANF for one of the following reasons:

(A) Became ineligible for the Pre-TANF, SFPSS or TANF programs due to income above the applicable income standard in OAR 461-155-0030.

(B) Became ineligible for the Pre-TANF, SFPSS or TANF programs due to TANF benefit amount being less than $10.00 in accordance with OAR 461-135-0070.

(C) Voluntarily closed TANF to avoid accruing time toward the time limit in OAR 461-135-0071.

(D) Voluntarily closed TANF to be eligible for TBA (see OAR 461-135-0506).

(c) Meet the TANF residency requirements in OAR 461-120-0010.

(d) Remain at or below 350 percent FPL in OAR 461-155-0180.

(3) Employment Payments begin the month following the month in which Pre-TANF, SFPSS, or TANF benefits close. Payments are limited to one payment per month per benefit group. Payments may not be prorated and are paid in the following amounts and order:

(a) $100 the first month after benefits close.

(b) $75 the second month after benefits close.

(c) $50 the third month after benefits close.

(4) An individual receiving Employment Payments is not eligible for JOBS Plus or JPI (see OAR 461-135-1260).

(5) Employment Payments end when an individual:

(a) Is approved for REF, Pre-TANF, SFPSS, or TANF program benefits;

(b) Is a member of a filing group (see OAR 461-110-0330) approved for REF, Pre-TANF, SFPSS, or TANF program benefits; or

(c) Loses unsubsidized paid employment and the loss is verified by the Department.

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 412.049 & 412.124
Statutes/Other Implemented: ORS 409.050, 411.060, 411.070, 412.049 & 412.124
History:
SSP 41-2022, amend filed 06/30/2022, effective 07/01/2022
SSP 30-2022, temporary amend filed 03/01/2022, effective 03/01/2022 through 08/27/2022
SSP 49-2021, amend filed 09/23/2021, effective 10/01/2021
SSP 32-2021, temporary amend filed 06/03/2021, effective 06/03/2021 through 11/29/2021
SSP 5-2020, amend filed 03/30/2020, effective 04/01/2020
SSP 22-2017, f. 9-8-17 & cert. ef. 10-1-17
SSP 15-2016, f. & cert. ef. 4-1-16

461-135-1511
Pandemic Electronic Benefits Transfer (P-EBT)

(1) OARs 461-135-1511 through 461-135-1515 apply to Pandemic Electronic Benefits Transfer (P-EBT). Except as provided for in OARs 461-135-1511 through 461-135-1515, P-EBT is not subject to Chapter 461 rules.

(2) P-EBT is a food benefit intended to reimburse eligible individuals for the value of the free or reduced-priced meals and snacks usually provided at school or child care centers. Any person using an Electronic Benefits Transfer (EBT) card issued on behalf of a P-EBT eligible individual shall spend the P-EBT benefits to provide meals and snacks to the P-EBT eligible individual.

(3) Although P-EBT benefits are issued to an EBT account linked to an EBT card, P-EBT is separate and apart from the SNAP program.

(4) P-EBT is administered in partnership between ODHS and the Oregon Department of Education Child Nutrition Program.

(5) The following definitions apply to OAR 461-135-1511 to 461-135-1515:

(a) "FNS" refers to the Food and Nutrition Service, United States Department of Agriculture.

(b) “NSLP” refers to the National School Lunch Program.

(c) “NSLP school” refers to an Oregon public school, nonprofit private school, or residential child care institution that is a sponsor of the National School Lunch Program (NSLP).

(d) “NSLP students” refers to individuals enrolled in Oregon public schools, nonprofit private schools, or residential child care institutions that provide meal service as a sponsored National School Lunch Program (NSLP) school.

(e) “ODE” refers to the Oregon Department of Education.

(f) "P-EBT" refers to Pandemic Electronic Benefits Transfer.

(g) “SNAP participants” refers to individuals who are a member of a SNAP benefit group (see OAR 461-110-0750) that received more than $0 in SNAP benefits.

Statutory/Other Authority: ORS 411.806 - 411.845
Statutes/Other Implemented: ORS 411.806 - 411.845
History:
SSP 28-2022, renumbered from 461-135-1501, filed 02/23/2022, effective 02/23/2022
SSP 27-2022, amend filed 02/16/2022, effective 02/17/2022
SSP 44-2021, temporary amend filed 07/22/2021, effective 07/22/2021 through 01/17/2022
SSP 43-2021, renumbered from 461-135-0498, filed 07/22/2021, effective 07/22/2021
SSP 5-2010, f. & cert. ef. 4-1-10

461-135-1512
Application and Eligibility; P-EBT

(1) Apart from applying for free or reduced meals through ODE or an NSLP school, there is no application for P-EBT program period October 2020 through May 2021.

(2) P-EBT eligibility is based upon and evaluated under two separate criteria, NSLP students and SNAP participants.

(a) Individuals who were homeschooled or enrolled in a school that does not participate in the NSLP are not eligible for P-EBT.

(b) NSLP students who were determined eligible for free or reduced meals under Oregon’s Extended Income Limits, and were not SNAP participants for at least one month between October 2020 and May 2021, are not eligible for P-EBT.

(c) NSLP student-based P-EBT: P-EBT eligibility for NSLP students is determined by the NSLP school and is based on the individual meeting one of the following criteria, or receiving services from one of the following programs, for any months beginning October 2020 through the 2020-21 school year:

(A) Determined income eligible based on NSLP eligibility criteria as determined by ODE, the local education agency, or a state agency that ODE has designated to determine student eligibility for P-EBT;

(B) SNAP participant or a member of a TANF program benefit group (see OAR 461-110-0750);

(C) Placement in foster care;

(D) Food Distribution Program on “Indian” Reservations (FDPIR);

(E) Migrant Education Program (MEP); or

(F) McKinney-Vento Act's Education of Homeless Children and Youth Program.

(d) SNAP Participant-based P-EBT: P-EBT eligibility for children ages six years old and younger is determined by ODHS and evaluated in two separate age groups, children ages five and younger and children age six years old. P-EBT eligibility begins the month the child became a SNAP participant.

(A) Children ages five years and younger are eligible for P-EBT if they were a SNAP participant for at least one month between October 2020 and May 2021.

(B) Children age six years old are eligible for P-EBT by meeting the following for at least one month between October 2020 and May 2021:

(i) SNAP participant,

(ii) Not enrolled in school (except for an NSLP school, and in such case, eligibility is determined under subsection (c) of this rule), and

(iii) Enrolled in a child care center that reduced hours or attendance due to a designated public health emergency. A caretaker of the child shall provide verification of the enrollment and child care center’s reduced hours or attendance. A verbal statement is acceptable verification.

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816, PL 116-127, PL 116-159, PL116-260 & PL 117-2
History:
SSP 27-2022, adopt filed 02/16/2022, effective 02/17/2022

461-135-1513
Benefit Amount and Issuance of Benefit; P-EBT

(1) P-EBT Benefit Standard and Determination

(a) The full P-EBT benefit standard is $136 monthly.

(b) The partial P-EBT benefit standard is $75 monthly.

(c) The P-EBT benefit amount is evaluated on a month-by-month basis and may vary from month to month. The September 2020 P-EBT benefit amount is evaluated under subsection (2)(d) of this rule.

(d) NSLP students - Each NSLP school determines a P-EBT benefit amount for each month. This amount applies to all NSLP students of the school who are P-EBT eligible (see OAR 461-135-1512) during that month.

(e) SNAP participants - Children ages six and younger shall receive, for each month they are P-EBT eligible (see OAR 461-135-1512), the greater of the P-EBT benefit amount determined by any NSLP school in the county in which the child:

(A) Resided, or

(B) Attended child care, unless a statewide order is present which closed or reduced attendance statewide at child care centers.

(2) P-EBT Benefit Amount; Program Period October 2020 through May 2021 and September 2020 Supplement -

(a) Full P-EBT benefit of $136 - An NSLP school shall determine a full P-EBT benefit amount for a month in which the majority of NSLP students attended comprehensive distance learning, or breakfast and lunch meal service was not provided on-site.

(b) Partial P-EBT benefit of $75 - An NSLP school shall determine a partial P-EBT benefit amount for a month in which 75 percent or greater of NSLP students attended both onsite and virtual through a hybrid learning model and breakfast and lunch meal service was provided on-site.

(c) No P-EBT benefit - An NSLP school shall determine a zero P-EBT benefit amount when NSLP students attended school on-site and breakfast and lunch meal service was provided.

(d) The P-EBT benefit supplement for September 2020 is evaluated by subtracting the P-EBT benefit amount issued during September 2020 from $136. The difference is the supplement. If the difference is zero, or less than zero, no P-EBT benefit supplement is issued.

(3) P-EBT benefits for program period October 2020 through May 2021, and the September 2020 supplement, shall be issued as follows on a date determined by ODHS:

(a) P-EBT benefits for the months of October, November, and December 2020 shall be issued in July 2021.

(b) P-EBT benefits for the months of January, February, and March 2021 shall be issued in August 2021.

(c) P-EBT for the months of April and May 2021, and the supplement for September 2020, shall be issued in September 2021.

(d) P-EBT benefits, once issued, shall not be transferred to another EBT account.

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816, PL 116-127, PL 116-159, PL116-260 & PL 117-2
History:
SSP 27-2022, adopt filed 02/16/2022, effective 02/17/2022

461-135-1514
Benefit Access and Use; P-EBT

(1) P-EBT benefit eligibility is based solely on the individual circumstances of the student or child, therefore, P-EBT benefits issued to an EBT account are to be used to provide meals and snacks for the P-EBT eligible individual, except for,

(a) When the P-EBT eligible individual has passed away, or

(b) When the P-EBT eligible individual is a SNAP participant at the time of P-EBT issuance, but not residing with the benefit group (see OAR 461-110-0750).

(2) P-EBT benefits, once issued, shall not be transferred to a new EBT account.

(3) P-EBT benefit EBT accounts that are not also the EBT account of a SNAP case, shall have only one active EBT card at a time. When a new EBT card is issued, the previous EBT card shall be cancelled.

(4) When an individual age six and younger is found eligible for “SNAP participant-based P-EBT” under subsection (2)(d) of OAR 461-135-1512, EBT accounts and EBT cards are handled as follows:

(a) P-EBT benefits are issued to the existing EBT account of the SNAP benefit group, and

(b) No additional EBT card is issued, unless

(c) A primary person (see OAR 461-001-0015) in the SNAP benefit group requests P-EBT benefits be issued separately. When this occurs:

(A) An EBT account is established in the name of the P-EBT eligible child, and

(B) An EBT card linked to the EBT account is sent to the address of the primary person.

(5) When an individual is found eligible for “NSLP student-based P-EBT” under subsection (2)(c) of OAR 461-135-1512, EBT accounts and EBT cards are handled as follows:

(a) NSLP students who are also SNAP participants-

(A) P-EBT benefits are issued to the existing EBT account of the SNAP benefit group, and

(B) No additional EBT card is issued, unless

(i) The Department determines an EBT card shall be issued to a different caretaker of the NSLP student under section (6) of this rule, or

(ii) A primary person (see OAR 461-001-0015) in the SNAP benefit group requests P-EBT benefits be issued separately.

(C) When paragraph (B) of this subsection occurs,

(i) An EBT account is established in the name of the P-EBT eligible child, and

(ii) An EBT card linked to the EBT account is sent to the caretaker or primary person, as determined appropriate by ODHS.

(b) All other NSLP students-

(A) An EBT account is established in the name of the NSLP student,

(B) An EBT card linked to the EBT account is sent to the address (reported to ODHS by ODE) of the NSLP student,

(C) Caretakers of the NSLP student will ensure the EBT card follows the P-EBT eligible individual, and

(D) No additional EBT card is issued, unless the Department determines an EBT card shall be issued to a different caretaker of the NSLP student under section (6) of this rule.

(6) The Department may issue a new EBT card when a caretaker reports to ODHS they are the primary caretaker and meal provider of an NSLP student and requests access to the individual’s P-EBT benefits, as follows:

(a) The Department shall only make this evaluation and new EBT card issuance for individuals with NSLP student-based P-EBT (see OAR 461-135-1512(2)(c)).

(b) NSLP students whose P-EBT benefits are issued to the EBT account of a SNAP benefit group:

(A) Access to remaining P-EBT benefits issued to the EBT account of a SNAP benefit group is not permitted.

(B) Access to future P-EBT benefit issuances shall begin when the Department establishes an EBT account in the name of the NSLP student, issues a new EBT card to the primary caretaker, and completes all required changes in the system.

(C) A request for P-EBT benefit access made by the 10th of a month may result in access to the P-EBT benefits issued in the following month.

(c) NSLP students whose P-EBT benefits are issued to an EBT account in the student’s name:

(A) Access to remaining P-EBT benefits begins on the date the Department issues the new EBT card. When a new EBT card is issued to a caretaker under this section, the previous EBT card is cancelled and access to any remaining P-EBT benefits through the cancelled card ends immediately.

(B) Access to future P-EBT benefit issuances shall begin on the date the Department issues the new EBT card.

(d) Evaluating a caretaker request for access to NSLP student-based P-EBT-

(A) There is a rebuttable presumption that the below individuals are the primary caretaker and meal provider:

(i) A caretaker granted sole legal custody,

(ii) An individual who has adopted the child,

(iii) The parent or guardian of a student temporarily away at school (e.g. attending boarding school) or a child attending but not residing at a Residential Child Care Institution, or

(iv) An emancipated child or a child independently responsible for their basic needs.

(B) When a request to access P-EBT comes from parents granted joint custody or an individual not listed in subsection (e) of this section, the Department shall request reasonable verification to assist in determining who is the primary caretaker and meal provider of the NSLP student. This may include, but is not limited to, parenting time schedules, statement from a healthcare or other professional, or a written affidavit from the caretaker.

(e) No notice is sent when access to the P-EBT benefits of an NSLP student is changed.

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816, PL 116-127, PL 116-159, PL116-260 & PL 117-2
History:
SSP 27-2022, adopt filed 02/16/2022, effective 02/17/2022

461-135-1515
Hearings, Claims, and Liability; P-EBT

(1) Excepting an overpayment (see OAR 461-195-0501) or an intentional program violation (see OAR 461-195-0601), there is no right to a contested case hearing to dispute P-EBT and no right to continuing benefits. The Department adopts the general hearings rule provisions (see division 025 of Chapter 461) for allowed contested case hearings.

(2) The Department adopts the SNAP program intentional program violation rule provisions (see OARs 461-195-0601 through 461-195-0621) for P-EBT when an individual:

(a) Accesses or uses P-EBT benefits outside of intended access or use under OARs 461-135-1511(2) or 461-135-1514(1),

(b) Makes a false or misleading statement; misrepresents, conceals or withholds a fact relating to use, presentation, transfer, acquisition, receipt, or possession; or traffics P-EBT (as defined under “trafficking” (see OAR 461-195-0601(2)) for the SNAP program), or

(c) Commits any act that constitutes a violation of P-EBT FNS regulations, or any state statute relating to the use, presentation, transfer, acquisition, receipt, possession, or trafficking of benefits.

(3) The Department adopts the SNAP program overpayment rule provisions in OARs 461-195-0501 through 461-195-0621 for P-EBT when an intentional program violation is established.

Statutory/Other Authority: ORS 411.816
Statutes/Other Implemented: ORS 411.816, PL 116-127, PL 116-159, PL116-260 & PL 117-2
History:
SSP 27-2022, adopt filed 02/16/2022, effective 02/17/2022