Oregon State Archives

Oregon Bulletin

March 1, 2011

Department of Human Services,
Children, Adults and Families Division: Self-Sufficiency Programs
Chapter 461

Rule Caption: Changing OARs affecting public assistance, medical assistance, or Supplemental Nutrition Assistance Program clients.

Adm. Order No.: SSP 1-2011(Temp)

Filed with Sec. of State: 1-20-2011

Certified to be Effective: 1-20-11 thru 7-19-11

Notice Publication Date:

Rules Amended: 461-155-0180

Subject: OAR 461-155-0180 about poverty-related income standards is being amended to reflect the annual increase in the federal poverty guidelines.

Rules Coordinator: Annette Tesch—(503) 945-6067

461-155-0180

Poverty Related Income Standards; Not OSIP, OSIPM, QMB, TANF

(1) A Department program may cite this rule if the program uses a monthly income standard based on the federal poverty level.

(2) A monthly income standard set at 100 percent of the 2011 federal poverty level is set at the following amounts: [Table not included. See ED. NOTE.]

(3) A monthly income standard set at 133 percent of the 2011 federal poverty level is set at the following amounts: [Table not included. See ED. NOTE.]

(4) A monthly income standard set at 150 percent of the 2011 federal poverty level is set at the following amounts: [Table not included. See ED. NOTE.]

(5) A monthly income standard set at 163 percent of the 2011 federal poverty level is set at the following amounts: [Table not included. See ED. NOTE.]

(6) A monthly income standard set at 185 percent of the 2011 federal poverty level is set at the following amounts: [Table not included. See ED. NOTE.]

(7) A monthly income standard set at 200 percent of the 2011 federal poverty level is set at the following amounts: [Table not included. See ED. NOTE.]

(8) A monthly income standard set at 201 percent of the 2011 federal poverty level is set at the following amounts: [Table not included. See ED. NOTE.]

[ED. NOTE: Tables referenced are available from the agency.]

Stat. Auth.: ORS 411.060, 411.070, 411.816, 412.049

Stats. Implemented: ORS 411.060, 411.070, 411.816, 412.049

Hist.: SSP 10-2006, f. 6-30-06, cert. ef. 7-1-06; SSP 1-2007, f. & cert. ef. 1-24-07; SSP 1-2008(Temp), f. & cert. ef. 1-24-08 thru 6-30-08; SSP 17-2008, f. & cert. ef. 7-1-08; SSP 1-2009, f. & cert. ef. 1-27-09; SSP 29-2009(Temp), f. & cert. ef. 10-1-09 thru 3-30-10; SSP 4-2010, f. & cert. ef. 3-31-10; SSP 25-2010(Temp), f. & cert. ef. 8-16-10 thru 2-12-11; SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11; SSP 1-2011(Temp), f. & cert. ef. 1-20-11 thru 7-19-11

Rule Caption: Changing OARs affecting public assistance, medical assistance, or Supplemental Nutrition Assistance Program clients.

Adm. Order No.: SSP 2-2011

Filed with Sec. of State: 1-20-2011

Certified to be Effective: 1-20-11

Notice Publication Date: 11-1-2010

Rules Amended: 461-155-0235

Subject: OAR 461-155-0235 about the premium standards for the Oregon Health Plan Standard (OHP-OPU) is being amended to adjust these standards to reflect the annual federal poverty level adjustments as published by the federal government.

Rules Coordinator: Annette Tesch—(503) 945-6067

461-155-0235

OHP Premium Standards

In the OHP program, the following steps are followed to determine the amount of the monthly premium for the filing group (see OAR 461-110-0400):

(1) The number of persons in the OHP need group is determined in accordance with OAR 461-110-0630.

(2) The countable income of the financial group (see OAR 461-110-0530) is determined in accordance with OAR 461-150-0055 and 461-160-0700.

(3) Based on the number in the need group and the countable income, the monthly premium for each non exempt OHP-OPU client in the benefit group (see OAR 461-110-0750) is determined from the following table: [Table not included. See ED. NOTE.]

[ED. NOTE: Tables referenced are available from the agency.]

Stat. Auth.: ORS 411.060, 411.598, 411.600

Stats. Implemented: ORS 411.060, 411.070, 411.598, 411.600

Hist.: AFS 35-1995, f. 11-28-95, cert. ef. 12-1-95; AFS 22-1996, f. 5-30-96, cert. ef. 6-1-96; AFS 5-1997, f. 4-30-97, cert. ef. 5-1-97; AFS 6-1998(Temp), f. 3-30-98, cert. ef. 4-1-98 thru 5-31-98; AFS 8-1998, f. 4-28-98, cert. ef. 5-1-98; AFS 3-1999, f. 3-31-99, cert. ef. 4-1-99; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01; AFS 5-2002, f. & cert. ef. 4-1-02; SSP 1-2003, f. 1-31-03, cert. ef. 2-1-03; SSP 6-2003(Temp), f. 2-26-03, cert. ef. 3-1-03 thru 6-30-03; SSP 7-2003, f. & cert. ef. 4-1-03; SSP 5-2004(Temp), f. & cert. ef. 3-1-04 thru 3-31-04; SSP 8-2004, f. & cert. ef. 4-1-04; SSP 2-2005, f. & cert. ef. 2-18-05; SSP 1-2006, f. & cert. ef. 1-24-06; SSP 8-2006, f. & cert. ef. 6-1-06; SSP 1-2007, f. & cert. ef. 1-24-07; SSP 1-2008(Temp), f. & cert. ef. 1-24-08 thru 6-30-08; SSP 17-2008, f. & cert. ef. 7-1-08; SSP 1-2009, f. & cert. ef. 1-27-09; SSP 2-2011, f. & cert. ef. 1-20-11

Rule Caption: Changing OARs affecting public assistance,
medical assistance, or Supplemental Nutrition Assistance Program clients.

Adm. Order No.: SSP 3-2011(Temp)

Filed with Sec. of State: 2-1-2011

Certified to be Effective: 2-1-11 thru 7-31-11

Notice Publication Date:

Rules Amended: 461-155-0528, 461-155-0693

Subject: OAR 461-155-0528 about emergency assistance payments in the Oregon Supplemental Income Program Medical (OSIPM) is being amended to restate which OSIPM program clients receiving Supplemental Security Income (SSI) payments are eligible for emergency assistance payments. This rule also is being amended to restate the amount of the authorized maximum emergency assistance payment.

      OAR 461-155-0693 about transportation services payments in the Oregon Supplemental Income Program Medical (OSIPM) is being amended to restate the amount of the authorized maximum monthly payment.

Rules Coordinator: Annette Tesch—(503) 945-6067

461-155-0528

Special Need; Emergency Assistance; OSIPM

In the OSIPM program:

(1) The Department provides an emergency assistance payment for a client if the client meets the requirements of all of the following subsections:

(a) The client must:

(A) Receive SSI; or

(B) Have an adjusted income (see OAR 461-001-0000) less than the SSI standard, and the Department has determined the client meets the eligibility requirements under OAR 461-125-0370(1)(c).

(b) The client does not reside in a community-based care facility (see OAR 461-155-0630(1)) or nursing facility;

(c) The client experiences an unexpected cost or loss of income or resources (not including garnishments or other withholdings authorized by Section 207 of the Social Security Act) resulting from circumstances beyond the client’s control; and

(d) The client lacks sufficient income for basic needs such as food, housing, and shelter.

(2) The Department makes emergency assistance payments in accordance with the following subsections:

(a) The Department may authorize an emergency assistance payment for a client only once in any 12-month period;

(b) An emergency assistance payment is limited to the lesser of the following amounts:

(A) The unexpected cost or loss of income or resources; or

(B) $250.

(c) The Department must pay the total emergency assistance payment to the client over a two-month period.

Stat. Auth.: ORS 411.060, 411.070, 411.404, 411.706

Stats. Implemented: ORS 411.060, 411.070, 411.404, 411.704, 411.706

Hist.: SSP 36-2010(Temp), f. & cert. ef. 10-13-10 thru 4-11-11; SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11; SSP 3-2011(Temp), f. & cert. ef. 2-1-11 thru 7-31-11

461-155-0693

Special Need; Transportation Services Payment; OSIPM

In the OSIPM program:

(1) The following individuals may be eligible for a transportation services payment:

(a) A client who receives SSI; or

(b) A client who the Department determines meets the requirements of OAR 461-125-0370(1)(c) and has adjusted income less than the SSI standard.

(2) Services eligible for payment under this rule are for transportation to non-medical and non-waivered activities and resources approved by the Department. Examples of such transportation services include, but are not limited to: reimbursement for non-commercial transportation not available through natural supports (limited to mileage only at the full United States General Services Administration mileage reimbursement rate); transportation provided by common carriers, taxicab, or bus; and assistance with purchase of a pass for public transportation.

(3) The following items are not eligible for payment under this rule: purchase of a vehicle; vehicle maintenance or repair; compensation for non-commercial transportation providers (payment to non-commercial transportation providers is limited to mileage only); and transportation services that may be obtained through other means, such as the State Medicaid Plan, waiver, or other public or private resources available to the individual, including natural supports.

(4) Payment for services authorized by this rule may not exceed $50 per month.

(5) Service costs must be verified annually or when questionable.

Stat. Auth.: ORS 411.060, 411.070, 411.083, 411.404, 411.706

Stats. Implemented: ORS 411.060, 411.070, 411.083, 411.404, 411.704, 411.706

Hist.: SSP 38-2009, f. 12-31-09, cert. ef. 1-1-10; SSP 18-2010, f. & cert. ef. 7-1-10; SSP 22-2010(Temp), f. & cert. ef. 7-1-10 thru 12-28-10; SSP 32-2010, f. & cert. ef. 10-1-10; SSP 33-2010(Temp), f. & cert. ef. 10-1-10 thru 3-30-11; SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11; SSP 3-2011(Temp), f. & cert. ef. 2-1-11 thru 7-31-11

Rule Caption: Changing OARs affecting public assistance,
medical assistance, or Supplemental Nutrition Assistance Program clients.

Adm. Order No.: SSP 4-2011(Temp)

Filed with Sec. of State: 2-4-2011

Certified to be Effective: 2-4-11 thru 8-3-11

Notice Publication Date:

Rules Amended: 461-145-0530

Subject: OAR 461-145-0530 about how the Department treats tax refunds when determining a client’s assets (income and resources) is being amended to revise how the Department treats federal income tax refunds to comply with recent federal legislation (Tax Relief, Unemployment Insurance Reauthorization, and Job Creation Act of 2010 (Pub. Law 111-312)).

Rules Coordinator: Annette Tesch—(503) 945-6067

461-145-0530

Tax Refund

The following types of tax refunds are counted as a resource:

(1) Income tax refunds as follows:

(a) Effective December 17, 2010, a federal income tax refund received after December 31, 2009 and before January 1, 2013 is excluded from a client’s resources for the 12 calendar months following receipt of the refund.

(b) Any other income tax refund is counted as a resource.

(2) Property tax refunds, including Elderly Rental Assistance (ERA).

Stat. Auth.: ORS 411.060, 411.070, 411.816, 414.042, 412.049

Stats. Implemented: ORS 411.060, 411.070, 411.816, 414.042, 412.049

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 8-1992, f. & cert. ef. 4-1-92; SSP 29-2003(Temp), f. 10-31-03, cert. ef. 11-1-03 thru 3-31-04; SSP 6-2004, f. & cert. ef. 4-1-04; SSP 8-2008, f. & cert. ef. 4-1-08; SSP 9-2008(Temp), f. & cert. ef. 4-1-08 thru 9-26-08; Administrative correction 10-21-08; SSP 4-2011(Temp), f. & cert. ef. 2-4-11 thru 8-3-11

Rule Caption: Changing OARs affecting public assistance, medical assistance, or Supplemental Nutrition Assistance Program clients.

Adm. Order No.: SSP 5-2011(Temp)

Filed with Sec. of State: 2-4-2011

Certified to be Effective: 2-4-11 thru 4-30-11

Notice Publication Date:

Rules Amended: 461-150-0055

Rules Suspended: 461-150-0055(T)

Subject: OAR 461-150-0055 which concerns eligibility and budgeting in the Healthy KidsConnect (HKC) and Oregon Health Plan (OHP) programs and was amended by temporary rule on January 1, 2011, is being amended further to state which month the Department uses as the budget month (the calendar month from which nonfinancial and financial information is used to determine eligibility and benefit level for the payment month) during an HKC program recertification. This rule also is being amended to restate how the Department determines the budget month when the Department initiates a redetermination of eligibility for an HKC or OHP program client.

Rules Coordinator: Annette Tesch—(503) 945-6067

461-150-0055

Eligibility and Budgeting; HKC, OHP

In the HKC and OHP programs:

(1) The budget month (see OAR 461-001-0000) is:

(a) For a new applicant, the month of application.

(b) For a client reapplying at the end of an OHP certification period (see OAR 461-001-0000), no longer eligible for his or her current OHP program, or moving from the BCCM, EXT, GAM, MAA, MAF, OSIPM, REFM, or SAC programs to the OHP program: the last month of the current eligibility (see OAR 461-001-0000) period.

(c) For a client reapplying at the end of an HKC certification period, the tenth month of the HKC certification period.

(d) When the Department initiates a redetermination of eligibility:

(A) The last month of the current OHP program eligibility period if the Department initiates the redetermination by sending a DHS 945 form.

(B) For OHP program cases not covered by paragraph (A) of this subsection, the month the Department initiates a date of request (see OAR 461-115-0030).

(e) For an individual joining a filing group (see OAR 461-110-0400), the month in which the individual requests medical benefits.

(f) For a late reapplication, the month the Department receives the new application.

(g) For a new applicant or current recipient who is not eligible using the budget month described in subsections (1)(a) to (1)(d) of this rule, any month falling within 45 days after the date of request.

(2) Countable (see OAR 461-001-0000) income is determined as follows:

(a) Income is considered available during a month under OAR 461 140 0040.

(b) Income is not annualized, converted, or prorated.

(c) For a self-employed client, countable self-employment income is determined under OAR 461-145-0920 and 461-145-0930.

(3) Except as provided in section (5) of this rule, the Department calculates the countable income of the financial group (see OAR 461-110-0530) by adding together the income the financial group has already received in the budget month and the income that reasonably may be expected to be received in the budget month.

(4) A change in income or resources during a certification period (see OAR 461-001-0000) does not affect the eligibility of the benefit group (see OAR 461-110-0750) for that certification period.

(5) In the HKC, OHP-CHP, and OHP-OPC programs, when the Department uses a finding made during an ELE determination and the child meets all other HKC, OHP-CHP, or OHP-OPC program nonfinancial eligibility requirements, the standard for the number of eligibility group members determined by the ELA is used to determine eligibility regardless of the need group (see OAR 461-110-0630) size. The countable income of the financial group is the same as the income amount determined by the ELA.

(a) A child is deemed eligible for the HKC, OHP-CHP, or OHP-OPC program as follows:

(A) If the income of the need group is below 163 percent of the federal poverty level (FPL) as listed in OAR 461-155-0180, the Department deems the child eligible for OHP-OPC.

(B) If the income of the need group is at or above 163 percent of the FPL but under 201 percent of the FPL, the Department deems the child eligible for OHP-CHP.

(C) If the income of the need group is at or above 201 percent of the FPL, the Department deems the child eligible for HKC.

(b) If the income of the need group is above 301 percent of the FPL, the Department determines eligibility using the standard medical assistance eligibility determination processes.

Stat. Auth.: ORS 409.050, 411.060, 411.070, 411.404, 414.231

Stats. Implemented: ORS 409.010, 411.060, 411.070, 411.404, 414.231

Hist.: AFS 2-1994, f. & cert. ef. 2-1-94; AFS 22-1995, f. 9-20-95, cert. ef. 10-1-95; AFS 10-1998, f. 6-29-98, cert. ef. 7-1-98; AFS 24-1998(Temp), f. 11-30-98, cert. ef. 12-1-98 thru 3-31-99; AFS 2-1999, f. 3-26-99, cert. ef. 4-1-99; AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00; AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00; SSP 1-2003, f. 1-31-03, cert. ef. 2-1-03; SSP 4-2005, f. & cert. ef. 4-1-05; SSP 7-2005, f. & cert. ef. 7-1-05; SSP 6-2006, f. 3-31-06, cert. ef. 4-1-06; SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07; SSP 13-2009, f. & cert. ef. 7-1-09; SSP 29-2009(Temp), f. & cert. ef. 10-1-09 thru 3-30-10; SSP 38-2009, f. 12-31-09, cert. ef. 1-1-10; SSP 25-2010(Temp), f. & cert. ef. 8-16-10 thru 2-12-11; SSP 38-2010(Temp), f. & cert. ef. 11-1-10 thru 2-12-11; SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11; SSP 43-2010(Temp), f. 12-30-10, cert. ef. 1-1-11 thru 4-30-11; SSP 5-2011(Temp), f. & cert. ef. 2-4-11 thru 4-30-11

Rule Caption: Changing OARs affecting public assistance, medical assistance, or Supplemental Nutrition Assistance Program clients.

Adm. Order No.: SSP 6-2011(Temp)

Filed with Sec. of State: 2-14-2011

Certified to be Effective: 2-14-11 thru 8-13-11

Notice Publication Date:

Rules Amended: 461-190-0416

Subject: OAR 461-190-0416 about how the Department determines eligibility for and calculates the amount of a Temporary Assistance for Needy Families (TANF) or Supplemental Nutrition Assistance Program (SNAP) program supplemental payment made to a client when the client’s Job Opportunity and Basic Skills (JOBS) Plus income reduces the client’s TANF or SNAP program benefits is being amended to restate how the Department determines a client’s full benefit equivalency income and minimum benefit equivalency income (the income amounts used to determine eligibility for and the amount of the supplemental payment under this rule). This rule also is being amended in response to recently enacted federal legislation (The Education Jobs and Medicaid Assistance Act of 2010 (Pub. Law 111-226)) to state how, effective January 1, 2011, the Department determines eligibility for and calculates the amount of a supplemental payment under this rule.

Rules Coordinator: Annette Tesch—(503) 945-6067

461-190-0416

Supplemental Payments; JOBS

In the JOBS Plus program (see OAR 461-001-0025):

(1) If the net monthly full-time wage paid to a participant is less than the amount of the TANF program and the SNAP program benefits the participant would otherwise receive, the Department will determine and pay to the participant a supplemental payment as provided in section (3) or (6) of this rule.

(2) Income Calculations prior to January 1, 2011:

(a) JOBS Plus income for sections (2) and (3) of this rule is calculated retrospectively as follows:

(A) For the full benefit equivalency income test, the applicable hourly wage is multiplied by the hours that were available for work, specifically the hours for which the participant was paid, including sick leave used and hours the participant was engaged in job search (see OAR 461-001-0025), and hours the participant missed work without being excused by the employer. From that product, a $90 standard deduction and the amount of garnishments withheld are subtracted. To the remainder is added any child support received by the participant and $102 to account for the participant’s potential earned income credit. If the participant missed work referred to in this paragraph due to good cause (see OAR 461-130-0327), the hours are excluded from the calculation.

(B) For the minimum benefit equivalency income test, the applicable hourly wage is multiplied by the hours for which the participant was paid. From that product, a $90 standard deduction and the amount of garnishments withheld are subtracted. To the remainder is added any child support received by the participant and $102 to account for the participant’s potential earned income credit.

(b) Full benefit equivalency income is the total of the TANF program and SNAP program benefits as determined for the need group (see OAR 461-110-0630).

(c) Minimum benefit equivalency income is determined by deducting from the full benefit equivalency income the difference between the TANF program payment standard under OAR 461-155-0030 for the need group with the participant included and the TANF program payment standard for the need group without the participant included.

(3) Wage supplements prior to January 1, 2011: A participant is entitled to a wage supplement payment for any month in which JOBS Plus income is exceeded by either the full benefit equivalency income or the minimum benefit equivalency income. The supplement payment amount is determined by subtracting the JOBS Plus income calculated in accordance with paragraph (2)(a)(A) of this rule from the full benefit equivalency income and by subtracting the JOBS Plus income calculated in accordance with paragraph (2)(a)(B) of this rule from the minimum benefit equivalency income. The larger remainder, if greater than zero, is the wage supplement payment amount.

(4) SNAP program supplemental payment prior to January 1, 2011:

(a) To ensure that a SNAP program client does not incur a net loss of income because of her or his participation in the JOBS Plus program, the Department provides a supplemental payment equal to the amount by which the participant’s JOBS Plus income is less than the Thrifty Food Stamp Plan benefit standard for the participant’s need group.

(b) The JOBS Plus income for this section is calculated prospectively by subtracting $90 from the sum of the gross JOBS Plus wages the participant already has received for the month and any that the participant reasonably can expect to receive during the month, and adding the remainder to any EIC payment the participant received or anticipates receiving during the month and any other prospective income, and then subtracting the amount scheduled to be garnished during the month.

(5) Effective January 1, 2011:

(a) JOBS Plus income for this section and section (6) of this rule is calculated retrospectively as follows:

(A) For the full benefit equivalency income test, the applicable hourly wage is multiplied by the hours that were available for work, specifically the hours for which the participant was paid, including hours of sick leave used, hours the participant was engaged in job search (see OAR 461-001-0025), and hours the participant missed work without being excused by the employer. From that product, a $90 standard deduction and the amount of any garnishments withheld are subtracted. To the remainder is added any child support received by the participant. If the participant missed work referred to in this paragraph due to good cause (see OAR 461-130-0327), the hours are excluded from the calculation.

(B) For the minimum benefit equivalency income test, the applicable hourly wage is multiplied by the hours for which the participant was paid. From that product, a $90 standard deduction and the amount of garnishments withheld are subtracted. To the remainder is added any child support received by the participant.

(b) Full benefit equivalency income is the total of the TANF program benefits and SNAP program benefits as determined for the participant’s need group (see OAR 461-110-0630).

(c) Minimum benefit equivalency income is determined by deducting from the full benefit equivalency income the difference between the TANF payment standard under OAR 461-155-0030 for the need group with the participant included and the TANF payment standard for the need group without the participant included.

(6) Wage supplements effective January 1, 2011: A participant is entitled to a wage supplement payment for any month in which JOBS Plus income is exceeded by either the full benefit equivalency income or the minimum benefit equivalency income. The wage supplement payment amount is determined by subtracting the JOBS Plus income calculated in accordance with paragraph (5)(a)(A) of this rule from the full benefit equivalency income and by subtracting the JOBS Plus income calculated in accordance with paragraph (5)(a)(B) of this rule from the minimum benefit equivalency income. The larger remainder, if greater than zero, is the wage supplement payment amount.

(7) SNAP program supplemental payment effective January 1, 2011:

(a) To ensure that a SNAP program client does not incur a net loss of income because of their participation in the JOBS Plus program, the Department provides a supplemental payment equal to the amount by which the JOBS Plus income of the participant is less than the Thrifty Food Stamp Plan benefit standard for the need group of the participant.

(b) The JOBS Plus income for this section is calculated prospectively by subtracting $90 from the sum of the gross JOBS Plus wages the participant has already received for the month and any the participant can reasonably expect to receive during the month plus any other prospective income, and then subtracting the amount scheduled to be garnished during the month.

Stat. Auth.: ORS 409.050, 411.060, 411.070, 411.404, 411.408, 411.816, 411.877, 411.892, 412.006, 412.009, 412.014, 412.049, 412.124

Stats. Implemented: ORS 409.010, 409.050, 411.060, 411.070, 411.400, 411.404, 411.408, 411.816, 411.877, 411.892, 412.006, 412.009, 412.014, 412.049, 412.124

Hist.: AFS 18-1998, f. & cert. ef. 10-2-98; SSP 6-2011(Temp), f. & cert. ef. 2-14-11 thru 8-13-11

Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2010.

2.) Copyright 2011 Oregon Secretary of State: Terms and Conditions of Use