Defined terms are often italicized throughout this chapter of
rules. If a defined term is accompanied by a cross-reference to a rule defining
the term, subsequent usages of that term in the same rule refer to the same
definition cross-referenced earlier in the rule. In this chapter of rules,
unless the context indicates otherwise:
(1) A reference to Division, Adult and Family
Services Division (or AFS), Senior and Disabled Services Division (or SDSD),
Department of Human Services (DHS), or any other agency formerly part of the
Oregon Department of Human Services means the Oregon Department of Human
Services (ODHS), except:
(a) The rule in which
reference occurs only regulates programs covered by OAR chapter 461.
(b) Eligibility rules for HSD medical
programs (see section (34) of this rule) are in OAR chapter 410, division
200.
(2) "Address
Confidentiality Program" (ACP) means a program of the Oregon Department of
Justice, which provides a substitute mailing address and mail forwarding
service for ACP participants who are survivors of domestic
violence (see section (25) of this rule), sexual assault, or
stalking.
(3) "Adjusted income"
means the amount determined by subtracting income deductions from
countable (see section (19) of this rule) income (see OAR
461-140-0010). Specific rules on
the deductions are in OAR chapter 461, division 160.
(4) "Adoption assistance" means financial
assistance provided to families adopting children with special needs. "Adoption
assistance" may be state or federally funded. Federal adoption assistance is
authorized by the Adoption Assistance and Child Welfare Act of 1980 (Pub. L.
No. 96-272, 94 Stat.
500 (1980)). State adoption assistance is authorized by
ORS
418.330 to
418.335.
(5) "Assets" mean income and
resources.
(6) "Basic decision
notice" means a decision notice (see section (21) of this
rule) mailed no later than the date of action given in the notice.
(7) "Blind Work Expenses" has the meaning
given in OAR
461-001-0035.
(8) "Branch office" means any Department or
AAA (Area Agency on Aging) office serving a program covered by this chapter of
rules.
(9) "Budgeting" means the
process of calculating the benefit level.
(10) "Budget month" means the calendar month
from which nonfinancial and financial information is used to determine
eligibility (see section (28) of this rule) and benefit level
for the payment month (see section (49) of this
rule).
(11) "Cafeteria plan" means
a written benefit plan offered by an employer in which:
(a) All participants are employees;
and
(b) Participants may choose,
cafeteria-style, from a menu of two or more cash or qualified benefits. In this
context, qualified benefits are benefits other than cash that the Internal
Revenue Service does not consider part of an employee's gross income. Qualified
benefits include, but are not limited to:
(A)
Accident and health plans (including medical plans, vision plans, dental plans,
accident and disability insurance);
(B) Group term life insurance plans (up to
$50,000);
(C) Dependent care
assistance plans; and
(D) Certain
stock bonus plans under section
401(k)(2) of the Internal
Revenue Code (but not 401(k)(1) plans).
(12) "Capital asset" means property that
contributes toward earning self-employment income, either directly or
indirectly. A "capital asset" generally has a useful life of over one year and
a value, alone or in combination, of $100 or more.
(13) "Caretaker" means an individual who is
responsible for the care, control, and supervision of a child
(see section (16) of this rule). The status of "caretaker" ends once the
individual no longer exercises care, control, and supervision of the
child for 30 days.
(14) "Caretaker relative" means an individual
with whom the
dependent child (see section (23) of this rule)
is living, who assumes primary responsibility for the care of the
dependent child, and:
(a) Is
a biological, step, or adoptive relative of the dependent
child; or
(b) Is the
spouse of an individual described in subsection (a), even after the marriage is
terminated by death or divorce.
(15) "Certification period" means the period
for which an individual is certified eligible for a program.
(16) "Child" includes natural, step, and
adoptive children. The term "child" does not include an unborn.
(a) In the General Assistance (GA) program
and the Oregon Supplemental Income Program (OSIP), a "child" is an individual
under the age of 18.
(b) In the
Oregon Supplemental Income Program Medical (OSIPM) and Qualified Medicare
Beneficiaries (QMB) program, "child" means an unmarried individual who:
(A) Is not considered a decision-maker in the
household;
(B) Is under the age of
18; and
(C) Has at least one
natural or adoptive parent in the same household.
(c) In the Refugee Assistance
(REF) and Refugee Assistance Medical (REFM) programs, a "child" is an
individual who is not an emancipated minor and is under the age of
18.
(17)
"Community-based care" is any of the following:
(a) Adult foster care - Room and board and
24-hour care and services for the elderly or for people with disabilities 18
years of age or older. The care is contracted to be provided in a home for five
or fewer individuals.
(b) Assisted
living facility - A program approach, within a physical structure, which
provides or coordinates a range of services, available on a 24-hour basis, for
support of resident independence in a residential setting.
(c) In-home Services - Individuals living in
their home receiving services determined necessary by the Department.
(d) Residential care facility - A facility
that provides residential care in one or more buildings on contiguous property
for six or more individuals who have physical disabilities or are socially
dependent.
(e) Specialized living
facility - Identifiable services designed to meet the needs of individuals in
specific target groups which exist as the result of a problem, condition, or
dysfunction resulting from a physical disability or a behavioral disorder and
require more than basic services of other established programs.
(f) Independent choices - In-Home Services
program wherein the participant is given cash benefits to purchase
self-directed personal assistance services or goods and services provided
pursuant to a written service plan (see OAR
411-030-0020).
(18) "Continuing benefit decision
notice" means a decision notice that informs the individual of
the right to continued benefits and is mailed in time to be received by the
date benefits are, or would be, received.
(19) "Countable" means that an available
asset (either income or a resource) is not excluded and may be considered by
some programs to determine eligibility.
(20) "Custodial parents" mean parents who
have physical custody of a child. "Custodial parents" may be
receiving benefits as dependent children or as caretaker relatives for their
own children.
(21) "Decision
notice" means a written notice of a decision by the Department regarding an
individual's eligibility for benefits in a program.
(22) "Department" means the Oregon Department
of Human Services (ODHS).
(23)
"Dependent child" in the Temporary Assistance for Needy Families (TANF) program
means an individual who has not been legally emancipated and who is one of the
following:
(a) An individual who is not a
caretaker relative (see section (14) of this rule) of a
child in the household, is unmarried or married but separated,
and is under the age of 18, or 18 years of age and a full time student in
secondary school or the equivalent level of vocational or technical training;
or
(b) A minor
parent (see section (45) of this rule) whose parents have chosen to
apply for benefits for the minor parent. This does not apply
to a minor parent who is married and living with their
spouse.
(24) "Disability" means:
(a) In the Supplemental Nutrition Assistance
Program (SNAP), see OAR
461-001-0015.
(b) In the REF, State Family Pre-SSI/SSDI
(SFPSS), Temporary Assistance for Domestic Violence Survivors (TA-DVS), and
TANF programs, for purposes other than determining
eligibility:
(A) An
individual with a physical or mental impairment that substantially limits the
individual's ability to meet the requirements of the program; or
(B) An individual with a physical or mental
impairment that substantially limits one or more major life activities, a
record of such impairment, or who is regarded as having such an impairment as
defined by the Americans with Disabilities Act (42 USC
12102;
28 CFR
35.104).
(25) "Domestic violence" means the occurrence
of one or more of the acts described in subsections (a) to (d) of this section
between family members, intimate partners, or household members:
(a) Attempting to cause or intentionally,
knowingly, or recklessly causing physical injury or emotional, mental, or
verbal abuse.
(b) Intentionally,
knowingly, or recklessly placing another in fear of imminent serious physical
injury.
(c) Committing sexual abuse
in any degree as defined in ORS
163.415,
163.425 and
163.427.
(d) Using coercive or controlling
behavior.
(e) As used in this
section, "family members" and "household members" mean any of the following:
(A)
Spouse;
(B) Former spouse;
(C) Individuals related biologically, by
marriage (see section (44) of this rule), or
adoption;
(D) Individuals who are
cohabitating or have cohabited with each other;
(E) Individuals who have been involved in a
sexually intimate or dating relationship; or
(F) Unmarried parents of a
child.
(26) "Domestic violence shelters" are public
or private nonprofit residential facilities providing services to survivors of
domestic violence. If the facility serves other people, a
portion must be used solely for survivors of domestic
violence.
(27) "Electronic
application" is an application electronically signed and submitted through the
Internet.
(28) "Eligibility" means
the decision as to whether an individual qualifies, under financial and
nonfinancial requirements, to receive program benefits.
(29) "Equity value" means fair market
value (see section (30) of this rule) minus encumbrances.
(30) "Fair market value" means the amount an
item is worth on the open market.
(31) "Family stability" in the Job
Opportunity and Basic Skills (JOBS), Pre-TANF, SFPSS, TA-DVS, and TANF programs
means the characteristics of a family that support healthy child development,
including parental mental health, drug and alcohol free environment, stable
relationships, and a supportive, flexible, and nurturing home
environment.
(32) "Family stability
activity" in the JOBS, Pre-TANF, SFPSS, TA-DVS, and TANF programs means an
action or set of actions taken by an individual, as specified in a case plan,
intended to promote the ability of one or both parents to achieve or maintain
family stability (see section (31) of this rule).
(33) "Financial institution" means a bank,
credit union, savings and loan association, investment trust, or other
organization held out to the public as a place receiving funds for deposit,
savings, checking, or investment.
(34) "HSD medical programs" means all
programs administered by the Health Systems Division (HSD). These medical
programs are described in OAR
410-200-0015 and governed under
chapter 410 division 200.
(35)
"Impairment-Related Work Expenses" have the meaning found in OAR
461-001-0035.
(36) "Income producing property" means:
(a) In all programs except OSIP, OSIPM, and
QMB, real or personal property that generates income for the
financial
group (see OAR
461-110-0530). Examples of
"income producing property" are:
(A)
Livestock, poultry, and other animals.
(B) Farmland, rental homes (including a room
or other space in the home or on the property of a member of the
financial group), vacation homes, and condominiums.
(b) In the OSIP, OSIPM, and QMB
programs, "income-producing property" means any real or personal property not
used in self-employment (see OAR
461-145-0600 and
461-145-0915) that produces
income for the
financial group. "Income-producing property"
includes:
(A) Livestock, poultry, or other
animals that produce marketable products sold by the financial
group.
(B) Farmland not
excluded under OAR
461-145-0220 that is farmed or
rented out by the
financial group.
(C) Real property other than the home
(including vacation homes and condominiums), that is rented out.
(c) In the OSIP, OSIPM, and QMB
programs, "income-producing property" does not include:
(A) Rooms or other space for rent in the home
(see OAR
461-145-0220).
(B) Livestock, poultry, or other animals kept
for resale (see OAR
461-145-0010).
(37) "Initial month" of
eligibility means any of the following:
(a) In all programs, the first month a
benefit group (see OAR
461-110-0750) is eligible for a
program benefit in Oregon after a period during which the group is not
eligible.
(b) In all programs
except the SNAP program, the first month a benefit group is
eligible for a program benefit after there has been a break in the program
benefit of at least one full calendar month. If benefits are suspended for one
month, that is not considered a break.
(c) In the SNAP program:
(A) The first month for which the
benefit group is certified following any period during which
they were not certified to participate, except for
migrant and
seasonal farm workers (see OAR
461-001-0015).
(B) For migrant and
seasonal farmworkers, the first month for which the
benefit group is certified following any period of one month
or more during which they were not certified to participate.
(d) For a new applicant for
Department-paid nursing facility services or
home and community-based
care (see OAR
461-001-0030), for the purposes
of calculating the correct divisor in OAR
461-140-0296, the month in which
the individual would have been eligible had it not been for the disqualifying
transfer of
assets (see section (5) of this rule).
(e) For a current recipient of
Department-paid nursing facility services or
home and community-based
care, for the purpose of calculating the correct divisor in OAR
461-140-0296, the month the
disqualifying transfer occurred.
(38) "In-kind income" means income in a form
other than money (such as food, clothing, cars, furniture, and payments made to
a third party).
(39) "Legally
married" means a
marriage uniting two individuals according
to:
(a) The statutes of the state where the
marriage occurred;
(b) Except in the SNAP program, the common
law of the state in which the two individuals previously resided while meeting
the requirements for common law marriage in that state; or
(c) The laws of a country in which the two
individuals previously resided while meeting the requirements for legal or
cultural marriage in that country.
(40) "Life estate" means the right to
property limited to the lifetime of the individual holding it or the lifetime
of some other individual. In general, a "life estate" enables the owner of the
"life estate" to possess, use, and obtain profits from property during the
lifetime of a designated individual while actual ownership of the property is
held by another individual. A "life estate" is created when an individual owns
property and then transfers ownership to another individual while retaining,
for the rest of the individual's life, certain rights to that property. In
addition, a "life estate" is established when a member of the financial
group purchases a "life estate" interest in the home of another
individual.
(41) "Lodger" means
someone who---
(a) Is living with an
individual receiving Department benefits;
(b) Is not a member of the individual's
filing group (see OAR
461-110-0310); and
(c) Pays the
filing group:
(A) In all programs except the OSIP, OSIPM,
and QMB programs, for room and board.
(B) In the OSIP, OSIPM, and QMB programs, for
room with or without board.
(42) "Long term care" means the system
through which the Department provides a broad range of social and health
services for extended periods of time to eligible adults who are aged, blind,
or have disabilities. This includes nursing facilities and the Oregon State
Hospital.
(43) "Lump-sum income"
means earned or unearned income received too infrequently or irregularly to be
reasonably anticipated, or received as a one-time payment. "Lump-sum income"
includes but is not limited to:
(a)
Retroactive benefits covering more than one month, whether received in a single
payment or several payments.
(b)
Income from inheritance, gifts, winnings, and personal injury claims.
(c) Income received less frequently than
annually.
(44)
"Marriage" means the union of two individuals who are legally
married (see section (39) of this rule).
(45) "Minor parent" in the TANF program means
a parent under the age of 18.
(46)
"Nonstandard living arrangement" is defined as follows:
(a) In the GA, OSIP, OSIPM, and QMB programs,
an individual is considered to be in a "nonstandard living arrangement" when
the individual is applying for or receiving services in any of the following
locations:
(A) A nursing facility in which the
individual receives long-term care services paid with Medicaid funding, except
this subsection does not apply to a Medicare recipient in a skilled-stay
nursing facility.
(B) An
intermediate care facility for individuals with intellectual disabilities
(ICF/ID).
(C) A psychiatric
institution, if the individual is not yet 21 years of age or has reached the
age of 65.
(D) A
community-based care (see section (17) of this rule) setting,
except a State Plan Personal Care (SPPC) setting is not considered a
"nonstandard living arrangement".
(b) In all programs except GA, OSIP, OSIPM,
and QMB, "nonstandard living arrangement" means each of the following
locations:
(A) Foster care.
(B) Residential Care facility.
(C) Drug or alcohol residential treatment
facility.
(D) Shelter for
individuals experiencing homelessness or domestic violence shelter.
(E) Lodging house if paying for room and
board.
(F) Correctional
facility.
(G) Medical
institution.
(47) "Ongoing month" means one of the
following:
(a) For all programs except the
SNAP program, any month following the initial month (see
section (37) of this rule) of eligibility, if there is no
break in the program benefit of one or more calendar months.
(b) For the SNAP program, any month in the
certification period (see section (15) of this rule) following
the initial month of eligibility.
(48) "Parent" for all programs
except Job Participation Incentive (JPI) (see OAR
461-135-1260) and the SNAP
program means the biological or legal parent of an individual or unborn. For
JPI and the SNAP program, "parent" means the biological or legal parent of an
individual.
(a) If the person who gave birth
(parent 1) to the child lives with an individual (parent 2) and either parent 1
or parent 2 claims that parent 2 is the other biological parent of the
child or unborn, and no one else claims to be the other
biological parent, parent 2 is treated as a parent even if parentage has not
been legally established.
(b) A
stepparent relationship exists if:
(A) The
individual is legally married to the child's biological or
adoptive parent; and
(B) The
marriage has not been terminated by legal separation, divorce,
or death.
(c) A legal
adoption erases all prior legal and biological relationships and establishes
the adoptive parent as the legal parent. However, the biological parent is also
considered a "parent" if both of the following are true:
(A) The child lives with the
biological parent; and
(B) The
legal parent has given up care, control, and supervision of the
child.
(49) "Payment month" means, for all programs
except Emergency Assistance (EA), the calendar month for which benefits are
issued.
(50) "Payment period"
means, for EA, the 30-day period starting with the date the first payment is
issued and ending on the 30th day after the date the payment is
issued.
(51) "Periodic income"
means income received on a regular basis less often than monthly.
(52) "Primary person" for all programs except
the SNAP program, means the
filing group member who is
responsible for providing information necessary to determine
eligibility and calculate benefits. The "primary person" for
individual programs is as follows:
(a) In the
TANF program, the parent or caretaker
relative.
(c) In the GA, OSIP, OSIPM, QMB, REF, and
REFM programs, the individual or individual's
spouse.
(53) "Qualified Partnership Policy" means a
long-term care insurance policy meeting the requirements of OAR
836-052-0531 that was either:
(a) Issued while the individual was a
resident in Oregon on January 1, 2008 or later; or
(b) Issued in another state while the
individual was a resident of that state on or after the effective date of that
state's federally approved State Plan Amendment to issue qualified partnership
policies.
(54) "Real
property" means land, buildings, and whatever is erected on or affixed to the
land and taxed as "real property".
(55) "Reimbursement" means money or in-kind
compensation provided specifically for an identified expense.
(56) "Safe homes" mean private homes that
provide a few nights lodging to survivors of domestic
violence. The homes must be recognized as such by the local domestic
violence agency, such as crisis hot lines and shelters.
(57) "Shelter costs" mean, in all programs
except the SNAP program, housing costs (rent or mortgage payments, property
taxes) and utility costs, not including cable TV or non-basic telephone
charges. In the SNAP program, see OAR
461-160-0420.
(58) "Shelter-in-kind" means an agency or
individual outside the financial group provides the shelter of
the financial group, or makes a payment to a third party for
some or all of the shelter costs (see section (57) of this
rule) of the financial group. "Shelter-in-kind" does not
include temporary shelter provided by a domestic violence shelter, shelter for
individuals experiencing homelessness, or residential alcohol and drug
treatment facilities or situations where no shelter is being provided, such as
sleeping in a doorway, park, or bus station.
(59) "Sibling" means the brother or sister of
an individual. "Biologically-related" means they share at least one biological
or adoptive parent. "Step" means they are not related biologically, but are
related by the marriage of their parents.
(60) "Spousal support" means income paid
(voluntarily, per court order, or per administrative order) by a separated or
divorced spouse to a member of the financial group.
(61) "Spouse" means an individual who is
legally married to another individual.
(62) "Stable income" means income that is the
same amount each time it is received.
(63) "Standard living arrangement" means a
location that does not qualify as a nonstandard living
arrangement.
(64) "Teen
parent" means, in the JOBS, REF, REFM, and TANF programs, a
parent who is the age of 18 or 19.
(65) "Timely continuing benefit decision
notice" means a
decision notice that informs the individual of
the right to continued benefits and is mailed no later than the time
requirements in OAR
461-175-0050.
(66) "Trust funds" mean money, securities, or
similar property held by an individual or institution for the benefit of
another individual.
(67) "USDA meal
reimbursements" mean cash reimbursements made by the Oregon Department of
Education for family day-care providers who serve snacks and meals to children
in their care.
(68) "Variable
income" means earned or unearned income that is not always received in the same
amount each month.
Notes
Or. Admin. Code
§
461-001-0000
AFS 28-1978, f.
& ef. 7-13-78; AFS 54-1984, f. 12-28-84, ef. 1-1-85; AFS 21-1995, f.
9-20-95, cert. ef. 10-1-95; AFS 25-2000, f. 9-29-00, cert. ef. 10-1-00; AFS
27-2001, f. 12-21-01, cert. ef. 1-1-02; SSP 14-2005, f. 9-30-05, cert. ef.
10-1-05; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06; SSP 15-2006, f. 12-29-06,
cert. ef. 1-1-07; SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07; SSP 11-2007(Temp),
f. & cert. ef. 10-1-07 thru 3-29-08; SSP 10-2007, f. & cert. ef.
10-1-07; SSP 15-2007(Temp), f. 12-31-07, cert. ef. 1-1-08 thru 3-29-08; SSP
14-2007, f. 12-31-07, cert. ef. 1-1-08; SSP 5-2008, f. 2-29-08, cert. ef.
3-1-08; SSP 8-2008, f. & cert. ef. 4-1-08; SSP 17-2008, f. & cert. ef.
7-1-08; SSP 23-2008, f. & cert. ef. 10-1-08; SSP 26-2008, f. 12-31-08,
cert. ef. 1-1-09; SSP 5-2009, f. & cert. ef. 4-1-09; SSP 13-2009, f. &
cert. ef. 7-1-09; SSP 29-2009(Temp), f. & cert. ef. 10-1-09 thru 3-30-10;
Reverted to SSP 13-2009, f. & cert. ef. 7-1-09; Administrative correction
4-21-10; SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11; SSP 25-2011, f. 9-30-11,
cert. ef. 10-1-11; SSP 17-2012(Temp), f. & cert. ef. 5-1-12 thru 10-28-12;
SSP 30-2012, f. 9-28-12, cert. ef. 10-1-12; SSP 22-2013(Temp), f. & cert.
ef. 8-23-13 thru 2-19-14; SSP 24-2013, f. & cert. ef. 10-1-13; SSP
29-2013(Temp), f. & cert. ef. 10-1-13 thru 2-19-14; SSP 37-2013, f.
12-31-13, cert. ef. 1-1-14; SSP 39-2013(Temp), f. 12-31-13, cert. ef. 1-1-14
thru 6-30-14; SSP 9-2014, f. & cert. ef. 4-1-14; SSP 14-2014(Temp), f.
& cert. ef. 6-26-14 thru 12-23-14; SSP 15-2014, f. & cert. ef. 7-1-14;
SSP 18-2014(Temp), f. & cert. ef. 7-1-14 thru 12-23-14; SSP 24-2014, f.
& cert. ef. 10-1-14;
SSP
11-2015, f. 3-13-15, cert. ef.
4/1/2015;
SSP
25-2015, f. 9-29-15, cert. ef.
10/1/2015; SSP 29-2015(Temp), f. & cert.
ef. 10-1-15 thru 3-28-16;
SSP
36-2015, f. 12-23-15, cert. ef.
1/1/2016;
SSP
15-2016, f. & cert. ef.
4/1/2016; SSP 25-2016(Temp), f. 6-30-16, cert. ef.
7-1-16 thru 12-27-16;
SSP
31-2016, f. & cert. ef.
9/1/2016;
SSP
35-2016, f. 9-30-16, cert. ef.
10/1/2016;
SSP
40-2016, f. & cert. ef.
11/1/2016;
SSP
23-2017, f. 9-11-17, cert. ef.
10/1/2017;
SSP
33-2017, amend filed 12/8/2017, effective
1/1/2018;
SSP
8-2019, amend filed 03/13/2019, effective
4/1/2019;
SSP
21-2020, amend filed 07/08/2020, effective
7/8/2020;
SSP
45-2020, amend filed 12/22/2020, effective
1/1/2021;
SSP
53-2021, minor correction filed 12/13/2021, effective
12/13/2021;
SSP
21-2023, amend filed 06/22/2023, effective
7/1/2023;
SSP
30-2024, amend filed 03/26/2024, effective
4/1/2024;
SSP
41-2024, amend filed 06/20/2024, effective
7/1/2024
Statutory/Other Authority: ORS
409.050,
411.060,
411.070,
411.404,
411.706,
411.816,
412.006,
412.014,
412.049,
413.085 &
414.619
Statutes/Other Implemented: ORS
409.010,
409.050,
411.060,
411.070,
411.404,
411.816,
411.837,
412.001,
412.006,
412.014,
412.049,
413.085 &
414.619