Or. Admin. R. 461-155-0500 - Special Needs; Overview

(1) Ongoing special needs are needs that last several months at a consistent cost. Examples are special diets and accommodation allowances. OAR 461-155-0010 is used to determine how special needs are considered for each program.

(2) To be eligible for a special need item, an individual may not have any other available resources in the community or natural support system to meet the need, excluding resources used in determining eligibility.

(3) To be eligible for a special need item, an individual may not be eligible for the item through Medicare, Medicaid, or any other medical coverage.

(4) An individual may be eligible for an ongoing special need item if providing the ongoing special need item is authorized in lieu of additional provider service hours pursuant to OAR 411-030-0002 to 411-030-0090 and is more cost-effective.

(5) The Department may authorize payment for one-time and ongoing special needs for the following, in accordance with OAR 461-155-0510 to 461-155-0710:

(a) One-time needs for the following:

(A) Community-based care facility (see OAR 461-155-0630) room and board.

(B) Community transition services (see OAR 461-155-0526).

(C) Diversion and transition services (see OAR 461-155-0710).

(D) Home repairs (see OAR 461-155-0600).

(E) Moving costs (see OAR 461-155-0610).

(F) Property taxes (see OAR 461-155-0620).

(b) Ongoing needs for the following:

(A) Accommodation allowances (see OAR 461-155-0660).

(B) Food for guide dogs and special assistance animals (see OAR 461-155-0530).

(C) In-home supplement (see OAR 461-155-0575).

(D) Laundry allowances (see OAR 461-155-0580).

(E) Personal incidentals and room and board allowance (see OAR 461-155-0700).

(F) Special diet allowances (see OAR 461-155-0670).

(G) Supplemental Communication Allowance (see OAR 461-155-0680).

(H) Prescription drug co-pay coverage (see OAR 461-155-0688).

Notes

Or. Admin. R. 461-155-0500

AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90; AFS 13-1991, f. & cert. ef. 7-1-91; AFS 2-1992, f. 1-30-92, cert. ef. 2-1-92; AFS 12-1993, f. & cert. ef. 7-1-93; AFS 23-1994, f. 9-29-94, cert. ef. 10-1-94; AFS 23-1995, f. 9-20-95, cert. ef. 10-1-95; AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97; AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00; AFS 16-2002(Temp), f. & cert. ef. 11-1-02 thru 4-30-03; SSP 11-2003, f. & cert. ef. 5-1-03; SSP 17-2004, f. & cert. ef. 7-1-04; SSP 17-2008, f. & cert. ef. 7-1-08; SSP 18-2008(Temp), f. & cert. ef. 8-1-08 thru 1-28-09; SSP 21-2008(Temp), f. & cert. ef. 10-1-08 thru 1-28-09; SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09; SSP 18-2010, f. & cert. ef. 7-1-10; SSP 9-2012, f. 3-29-12, cert. ef. 4-1-12; SSP 22-2018, amend filed 06/05/2018, effective 7/1/2018; SSP 65-2021, minor correction filed 12/14/2021, effective 12/14/2021

Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.404, 411.706, 413.085 & 414.685

Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.404 & 411.706