Oregon Administrative Code

461-170-0130 Acting on Reported Changes; OSIPM, QMB (1) When an OSIPM or QMB client, who is required by this division of rules to report a change in circumstances, makes a timely report of a change that could reduce or end medical benefits, prior to reducing or ending medical ben…

461-170-0200 State and Federal Government-Initiated Changes An individual is not required to report any of the following changes: (1) Periodic cost-of-living adjustments to the federal Black Lung Program, Social Security Benefits (SSB), Social Security Disability Insurance (SSDI)…

461-175-0010 What a Decision Notice Must Include (1) A decision notice (see OAR 461-001-0000): (a) Specifies the date the notice is mailed, which is the effective date for a basic decision notice (see OAR 461-001-0000). (b) Except as provided in section (2) of this rule, specifie…

461-175-0050 Notice Period The notice period is used to determine the effective date for taking action when a decision notice (see OAR 461-001-0000) is sent to the filing group (see OAR 461-110-0310): (1) For a basic decision notice (see OAR 461-001-0000), the notice period is th…

461-175-0200 Notice Situations; General Information (1) In the Emergency Assistance (EA) program, a basic decision notice (see OAR 461-001-0000) is sent for all situations. (2) For Medicare Savings Programs (see OAR 461-001-0000) and Oregon Supplemental Income Program Medical (OS…

461-175-0205 Notice Situation; Benefits for Less Than 30 Days To end benefits if a client receives them for less than 30 days, send the following notice: (1) For all programs except SNAP, a basic decision notice. (2) For SNAP: (a) A basic notice if the information on ending benef…

461-175-0210 Notice Situation; Individual Moved or Whereabouts Unknown (1) In all programs except the Supplemental Nutrition Assistance Program (SNAP), to end benefits for an individual who has moved out of Oregon and no longer meets residency requirements under OAR 461-120-0010,…

461-175-0220 Notice Situation; Disqualification (1) If a benefit group (see OAR 461-110-0750) or individual is disqualified for a Supplemental Nutrition Assistance Program (SNAP) voluntary job quit or for failure to apply for or provide a Social Security number (SSN), pursue asse…

461-175-0222 Notice Situations — Expiration of Certification Period; SNAP, TANF In the SNAP and TANF programs: (1) The Department must provide a household certified for one month or certified in the second month of a two-month certification period (see OAR 461-001-0000) a notice …

461-175-0224 Notice Situation; Changes in Housing Arrangements that Cause Decreases; GA In the GA program, no decision notice (see OAR 461-001-0000) is required under the following circumstances: (1) The Department reduces housing assistance payments because a change in housing a…

461-175-0225 Notice Situation; Institution/Income and Resource Allowances If an institutionalized spouse is determined eligible for OSIPM, or upon request by either spouse, or a person acting on behalf of either spouse, send a basic decision notice to each spouse or each person’s…

461-175-0230 Notice Situation; Nonstandard Living Situations (1) In the SNAP program: (a) A timely continuing benefit decision notice (see OAR 461-001-0000) is sent to terminate, suspend, or reduce benefits if the notice occurs as a result of any of the following situations: (A) …

461-175-0240 Notice Situation; Lump-Sum If a financial group (see OAR 461-110-0530) receives lump-sum income that will make the financial group ineligible or cause a reduction in benefits: (1) The Department will deny benefits to an applicant and send a basic decision notice (see…

461-175-0250 Notice Situation; Mass Changes (1) If benefits are reduced or closed to reflect cost-of-living adjustments in benefits or other mass change under a program operated by a federal agency or to reflect a mass change to payments in a program operated by the Department: (…

461-175-0270 Notice Situation; Simplified Reporting System (SRS) or Transitional Benefit Alternative (TBA) (1) When the Department takes action on information reported on the Periodic Report form, the Department sends a continuing benefit decision notice (see OAR 461-001-0000) fo…

461-175-0280 Notice Situation; Failure to Submit Periodic Report; SNAP In the SNAP program: (1) The Department sends a continuing benefit decision notice when a benefit group in Simplified Reporting System (SRS) fails to return a complete (see OAR 461-170-0101) Periodic Report fo…

461-175-0290 Notice Situation; Overpayment Repayment When benefits are reduced for recovery of an overpayment (see OAR 461-195-0551) a timely continuing benefit decision notice (see OAR 461-001-0000) is sent for the first month of the reduction. Statutory/Other Authority: ORS 411…

461-175-0300 Notice Situation; Prior Notice (1) Except as provided in section (5) of this rule, when benefits in any Department program except a medical program and the SNAP program will end or be reduced after a specific period of time, the Department may issue a decision notice…

461-175-0305 Notice Situation; Removing an Individual from a Benefit Group; REF, REFM, SNAP, TANF (1) To remove an individual from a benefit group (see OAR 461-110-0750), the following notices are used: (a) A continuing benefit decision notice (see OAR 461-001-0000) is used when …

461-175-0310 Notice Situation; Asset Transfer Disqualification (1) When the Department proposes to disqualify a filing group (see OAR 461-110-0310) because of a disqualifying transfer of assets (see OAR 461-140-0210), the following notice is sent: (a) For new applicants, a basic …

461-175-0320 Notice Situation; Restoring SNAP Benefits In the SNAP program, after the Department determines whether a person is entitled to restoration of benefits, the person is entitled to a basic decision notice that includes the amount to be restored, any offsetting that was …

461-175-0340 Notice Situation; Voluntary Action (1) Unless the Department (see OAR 461-001-0000) chooses to proceed as described in section (2) of this rule: (a) For all programs except the Supplemental Nutrition Assistance Program (SNAP), if the primary person (see OAR 461-001-0…

461-175-0350 Notice Situation; EBT Benefit Expungement (1) When EBT benefit expungement is required under OAR 461-165-0010, an expungement notice is sent no later than 30 days before expungement is scheduled to begin. (2) The notice shall include the earliest date the benefits ar…

461-180-0006 Effective Dates; Changes for Cases in the Simplified Reporting System (SRS); SNAP In the SNAP program, and only as allowed under OAR 461-170-0103: (1) The effective date of a change based on a complete (see OAR 461-170-0101) Periodic Report form is: (a) The first day…

461-180-0010 Effective Dates; Adding a New Person to an Open Case (1) In the following programs, the effective date for adding an individual (other than an assumed eligible newborn) to the benefit group (see OAR 461-110-0750) is one of the following: (a) In the OSIPM program, the…

461-180-0020 Effective Dates; Changes in Income or Income Deductions That Cause Increases This rule is used to determine the effective date when a change in income or income deductions causes an increase in benefits. The effective date is one of the following: (1) In the GA, REF,…

461-180-0030 Effective Dates; Changes in Income or Income Deductions that Cause Reductions For all cases except those assigned to the SRS or TBA reporting systems, this rule is used to determine the effective date when changes in income or income deductions cause a decrease in be…

461-180-0040 Effective Dates; Special and Service Needs (1) The effective date for a special need is the later of the following: (a) The date of request (see OAR 461-115-0030) for the special need item; or (b) The effective date for OSIPM. (2) The effective date for in-home servi…

461-180-0044 Effective Dates; Income Cap Trust The effective date for an income cap trust that makes a client income-eligible for long term care or home and community-based care (see OAR 461-001-0030) under 461-135-0750 and 461-145-0540(9)(c) is the first day of the month in whic…

461-180-0050 Effective Dates; Suspending or Closing Benefits and JOBS and REP Support Service Payments (1) This rule explains the effective date for closing or suspending benefits for the entire benefit group (see OAR 461-110-0750) and the effective date for ending Job Opportunit…

461-180-0060 Effective Dates; Denial of Benefits The effective date for denying benefits is the date the decision is made that the client is not eligible. Statutory/Other Authority: ORS 411.060, 411.404, 411.816, 412.014, 412.049, 329A.500, 409.050, 413.085 & 414.685 Statutes/Oth…

461-180-0065 Effective Dates; Ending Disqualifications (1) The effective date for ending a JOBS disqualification or a disqualification related to diagnosis, counseling, or treatment for substance abuse or mental health is; (a) The date the client meets the requirements for ending…

461-180-0070 Effective Dates; Initial Month Benefits (1) In the EA program, the effective date for opening the case is the day benefits are issued to the benefit group (see OAR 461-110-0750). For a benefit group whose only eligible child is an unborn, the effective date cannot be…

461-180-0080 Effective Dates; Initial Month SNAP Benefits In the SNAP program: (1) Except as provided in section (2) of this rule, for a filing group making an initial application or applying after the end of its certification period, the effective date for starting benefits is t…

461-180-0081 Effective Dates; Cases Receiving Transitional Benefit Alternative (TBA) (1) The effective date for starting TBA benefits is the first day of the month after the TBA notice is mailed. The effective date cannot precede the date the Department has determined the client …

461-180-0083 Effective Dates; Other Changes That Cause Increases; OSIPM and QMB (1) In the OSIP, OSIPM, and QMB programs, this rule is used to determine the effective date when reported changes, other than changes in income or income deductions, cause an increase in benefits. See…

461-180-0085 Effective Dates; Redeterminations of OSIPM and QMB In the OSIPM and QMB programs, when the Department initiates a redetermination of eligibility (see OAR 461-001-0000): (1) Prior to reducing or ending medical benefits: (a) The Department must review each individual i…

461-180-0090 Effective Dates; Initial Month Medical Benefits The effective date for starting medical benefits for an eligible client is as follows: (1) In the OSIPM and QMB-DW programs: (a) Except as provided for in subsections (b) to (h) of this section: (A) If the client meets …

461-180-0100 Effective Dates; Eligibility Following Closure The new effective date of eligibility following closure of benefits or following the end of a certification period is determined as follows: (1) In the SNAP program, see OAR 461 115 0450. (2) In the REF and TANF programs…

461-180-0105 Effective Dates; Reductions Delayed Pending a Hearing Decision (1) If a proposed reduction or closure of benefits or a proposed disqualification arising out of an employment program is delayed because the client requested a hearing, the proposed action takes effect i…

461-180-0110 Effective Dates; Reimbursement of Employer-Sponsored Health Insurance Premiums The effective date for starting reimbursement of cost-effective employer-sponsored health insurance premiums per OAR 461-135-0990 is one of the following: (1) For new cases, the later of t…

461-180-0120 Effective Dates; Removing an Individual The effective date for removing an individual from a benefit group (see OAR 461-110-0750) is one of the following: (1) If the individual has left the benefit group in the current budget month because they are ineligible, disqua…

461-180-0130 Effective Dates; Restored Benefits (1) The effective date for restoring benefits that were underpaid (including erroneous collections of overpayments) or denied or closed in error is set as follows: (a) Except as provided in subsections (b) and (c) of this section, i…

461-180-0135 Effective Dates; Restoring SNAP Benefits for ABAWD Following Counting Month (Not Regaining) (1) In the SNAP program, benefits may be restored effective the first of the month when SNAP benefits for an ABAWD (see OAR 461-135-0520) end following the third countable mon…

461-180-0140 Effective Dates; Retroactive Medical Benefits (1) In the OSIPM program: (a) If an applicant requests and is eligible for retroactive medical benefits, the earliest date the applicant may be eligible is the first day of the third month before the month that includes t…

461-185-0010 T & A Overview, When to Use (1) T&A is a system for handling client funds when the Department is responsible for receiving and disbursing these funds. These accounts are set up when the Department is the client’s representative payee for SSB, SSI, Veterans, or other …

461-185-0020 Authorization of T&A (1) The client, or their guardian or conservator, authorizes establishment of a T&A account on a form prescribed by the Department. (2) Spouses must each sign the authorization form to have their funds administered in trust. (3) Clients not able …

461-185-0030 Interest Paid on T&A Accounts Interest earned from investment of T&A account monies will be put into the T&A accounts on a quarterly basis. Interest will be reported in accordance with IRS regulations on a Department form. Statutory/Other Authority: ORS 409.050, 411.…

461-185-0050 Patient Liability Pay-In System (1) The Department ends all provisions in this rule on December 31, 2021. (2) Except as provided in sections (3) and (4) of this rule, an individual who receives home and community-based care (see OAR 461-001-0030) in-home services and…

461-190-0151 Case Planning; JOBS, Pre-TANF, REP, SFPSS, TA-DVS (1) In the Job Opportunity and Basic Skills (JOBS), Pre-Temporary Assistance for Needy Families (Pre-TANF), Refugee Employment Program (REP), State Family Pre-SSI/SSDI (SFPSS), and Temporary Assistance to Domestic Vio…