461-135-0750    Effective 07/01/19
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:

    1. 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).

    2. The level-of-need criteria for an ICF-ID.
    3. 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:

    1. A Medicaid-certified nursing facility.
    2. An intermediate care facility for individuals with intellectual disabilities (ICF-ID).
    3. 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

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