461-155-0630 Effective 01/01/23
Special Need; Community-Based Care; OSIPM
In the OSIPM program:
- An individual is considered living in a community-based care (see OAR 461-001-0000) facility if the individual resides at one of the following care settings licensed by the Department:
- Adult Foster Home.
- Residential Care Facility.
- Assisted Living Facility.
- Specialized Living Facility.
- Group Care Home.
- If an individual who meets the applicable income requirements begins living in a community-based care facility:
- Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate.
- Room and board payments may be paid to the community-based care facility during the temporary absence of the individual if all of the following criteria are met:
- The absence occurs because the individual is admitted to a hospital or nursing home.
- The Department determines the intent of the individual to return to the community-based care facility.
- The community-based care facility is willing to accept the room and board payment.
- The individual returns within the calendar month following the month in which the absence began.
- Spouses who each receive Supplemental Security Income (SSI) and receive services in a community-based care facility are eligible for a payment in the amount that equals the difference between the OSIPM standard for a one-person need group (see OAR 461-110-0630) and the individual's total countable (see OAR 461-001-0000) income. If one spouse (see OAR 461-001-0000) has income above the OSIPM standard, the excess income is applied to the countable income of the other spouse.
- The Department may authorize payment for room and board for up to three months for an incapacitated individual when the individual is determined eligible for community-based care, the individual has no legal or financial representative, and payment for room and board is necessary to secure placement. The payments are allowed while a legal or financial representative is being established and may be extended past the three month period if the Department determines additional time is needed to establish a legal or financial representative.
Statutory/Other Authority: ORS 409.050, 411.060, 411.404, 413.085, 414.685
Statutes/Other Implemented: ORS 409.010, 411.060, 411.404, 413.085, 414.685