461-160-0540    Effective 10/01/18
Determining Income Eligibility; QMB and OSIPM (except OSIPM-EPD) Living in the Community or Residing in a 24-Hour Mental Health Residential Care Setting

  1. This rule is used to determine income eligibility for the OSIPM (except OSIPM-EPD) and QMB programs for individuals who---

    1. Live in the community or a 24-hour mental health residential care setting;

    2. Do not receive SSI; and

    3. Do not receive home and community-based care (see OAR 461-001-0030).

  2. In the OSIPM program:

    1. Individuals residing in a 24-hour mental health residential care setting -- such as an adult foster home, residential treatment home, residential treatment facility, or a secure treatment facility -- meet the income requirements if their adjusted income (see OAR 461-001-0000) is equal to or less than the income standard specified in OAR 461-155-0250(6).
    2. Except as provided in subsection (a) of this section, individuals meet the income requirements if the adjusted income of the individual’s financial group (see OAR 461-110-0530) is less than the OSIPM program adjusted income standard.
  3. In the QMB-BAS and QMB-DW programs, an individual meets the income requirements if the adjusted income of the individual’s financial group is equal to or less than the QMB program adjusted income standard.

  4. In the QMB-SMB and QMB-SMF programs, an individual meets the income requirements if the adjusted income of the individual’s financial group is less than the adjusted income standard.

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, 42 CFR 435.219, 42 CFR 435.726

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