Previous Rules

461-155-0500    Effective 07/01/18
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, a client 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, a client may not be eligible for the item through Medicare, Medicaid, or any other medical coverage.

4. A client 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:
   1. One-time needs for the following:
      1. Community based facility room and board (see OAR 461-155-0630).

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

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

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

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

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

   2. Ongoing needs for the following:
      1. Accommodation allowances (see OAR 461-155-0660).

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

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

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

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

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

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

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

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

461-155-0500    Effective 04/01/12
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, a client 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, a client may not be eligible for the item through Medicare, Medicaid, or any other medical coverage.

4. A client 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:
   1. One-time needs for the following:
      1. Community based facility room and board (see OAR 461-155-0630).

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

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

      4. Home adaptations to accommodate a client's physical condition (see OAR 461-155-0551).

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

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

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

   2. Ongoing needs for the following:
      1. Accommodation allowances (see OAR 461-155-0660).

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

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

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

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

      6. Restaurant meals (see OAR 461-155-0640).

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

      8. Telephone allowances (see OAR 461-155-0680).

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

Stat. Auth.: ORS 411.060, 411.070, 411.404, 411.706
Stats. Implemented: ORS 411.060, 411.070, 411.404, 411.706

461-155-0500    Effective 07/01/10
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, a client 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, a client may not be eligible for the item through Medicare, Medicaid, or any other medical coverage.

4. A client 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:
   1. One-time needs for the following:
      1. Community based facility room and board (see OAR 461-155-0630).

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

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

      4. Home adaptations to accommodate a client's physical condition (see OAR 461-155-0551).

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

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

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

   2. Ongoing needs for the following:
      1. Accommodation allowances (see OAR 461-155-0660).

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

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

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

      5. Restaurant meals (see OAR 461-155-0640).

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

      7. Telephone allowances (see OAR 461-155-0680).

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

      9. Transportation services payment (see OAR 461-155-0693).

Stat. Auth.: ORS 411.060, 411.070
Stats. Implemented: ORS 411.060, 411.070

461-155-0500    Effective 01/01/09
Special Needs; Overview

1. In the GA, GAM, MAA, MAF, OSIP, OSIPM, REF, REFM, and TANF programs, special needs are needs not included in the basic standard. They may be one-time needs or ongoing needs.

2. 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.

3. To be eligible for a special need item, a client must have no other available resources in the community or natural support system to meet the need, excluding resources used in determining eligibility.

4. To be eligible for a special need item, a client must not be eligible for the item through Medicare, Medicaid, or any other medical coverage.

5. A client 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.

6. The Department will authorize payment for one-time and ongoing special needs for the following, in accordance with OAR 461-155-0510 to 461-155-0710:
   1. One-time needs for the following:
      1. Community based facility room and board (see OAR 461-155-0630)

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

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

      4. Home adaptations to accommodate a client's physical condition (see OAR 461-155-0551)

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

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

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

   2. Ongoing needs for the following:
      1. Accommodation allowances (see OAR 461-155-0660)

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

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

      4. Personal Incidentals and Room and Board Allowance (see OAR 461-155-0700)

      5. Restaurant meals (see OAR 461-155-0640)

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

      7. Telephone allowances (see OAR 461-155-0680)

Stat. Auth.: ORS 411.060, 411.070
Stats. Implemented: ORS 411.060, 411.070

461-155-0500    Temporary Effective 10/01/08 through 12/31/08
Special Needs; Overview

1. In the GA, GAM, MAA, MAF, OSIP, OSIPM, REF, REFM, and TANF programs, special needs are needs not included in the basic standard. They may be one-time needs or ongoing needs.

2. 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.

3. To be eligible for a special need item, clients must have no other available resources in the community or in their natural support system to meet the need, excluding resources used in determining eligibility.

4. To be eligible for a special need item, clients must not be eligible for the item through Medicare, Medicaid, or any other medical coverage.

5. Clients 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 through 411-030-0090 and is more cost-effective.

6. The Department will authorize payment for one-time and ongoing special needs for the following, in accordance with OAR 461-155-0510 through 461-155-0700:
   1. One-time needs for the following:
      1. Community based facility room and board (see OAR 461-155-0630)

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

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

      4. Home adaptations to accommodate a client's physical condition (see OAR 461-155-0551).

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

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

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

   2. Ongoing needs for the following:
      1. Accommodation allowances (see OAR 461-155-0660)

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

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

      4. Personal Incidentals and Room and Board Allowance (see OAR 461-155-0700)

      5. Restaurant meals (see OAR 461-155-0640)

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

      7. Telephone allowances (see OAR 461-155-0680)

Stat. Auth.: ORS 411.060, 411.070
Stats. Implemented: ORS 411.060, 411.070

461-155-0500 Temporary Effective 08/01/08 through 09/30/08
Special Needs; Overview

1. In the GA, GAM, MAA, MAF, OSIP, OSIPM, REF, REFM, and TANF programs, special needs are needs not included in the basic standard. They may be one-time needs or ongoing needs.

2. 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.

3. To be eligible for a special need item, clients must have no other available resources in the community or in their natural support system to meet the need, excluding resources used in determining eligibility.

4. To be eligible for a special need item, clients must not be eligible for the item through Medicare, Medicaid, or any other medical coverage.

5. Clients 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 through 411-030-0090 and is more cost-effective.

6. The Department will authorize payment for one-time and ongoing special needs for the following, in accordance with OAR 461-155-0510 through 461-155-0700:
   1. One-time needs for the following:
      1. Community based facility room and board (see OAR 461-155-0630)

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

      3. Home adaptations to accommodate a client's physical condition (see OAR 461-155-0551).

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

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

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

   2. Ongoing needs for the following:
      1. Accommodation allowances (see OAR 461-155-0660)

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

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

      4. Personal Incidentals and Room and Board Allowance (see OAR 461-155-0700)

      5. Restaurant meals (see OAR 461-155-0640)

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

      7. Telephone allowances (see OAR 461-155-0680)

Stat. Auth.: ORS 411.060, 411.070
Stats. Implemented: ORS 411.060, 411.070

461-155-0500 Effective 07/01/08
Special Needs; Overview

1. In the GA, GAM, MAA, MAF, OSIP, OSIPM, REF, REFM, and TANF programs, special needs are needs not included in the basic standard. They may be one-time needs or ongoing needs.

2. 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.

3. To be eligible for a special need item, clients must have no other available resources in the community or in their natural support system to meet the need, excluding resources used in determining eligibility.

4. To be eligible for a special need item, clients must not be eligible for the item through Medicare, Medicaid, or any other medical coverage.

5. Clients 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 through 411-030-0090 and is more cost-effective.

6. The Department will authorize payment for one-time and ongoing special needs for the following, in accordance with OAR 461-155-0510 through 461-155-0680:
   1. One-time needs for the following:
      1. Community based facility room and board (see OAR 461-155-0630)

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

      3. Home adaptations to accommodate a client's physical condition (see OAR 461-155-0551).

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

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

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

   2. Ongoing needs for the following:
      1. Accommodation allowances (see OAR 461-155-0660)

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

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

      4. Restaurant meals (see OAR 461-155-0640)

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

      6. Telephone allowances (see OAR 461-155-0680)

Stat. Auth.: ORS 411.060
Stats. Implemented: ORS 411.070

461-155-0500 Effective 07/01/04
Special Needs; Overview

1. In the GA, GAM, MAA, MAF, OSIP, OSIPM, REF, REFM, and TANF programs, special needs are needs not included in the basic standard. They may be one-time needs or ongoing needs.

2. Ongoing special needs are needs that last several months at a consistent cost. Examples are special diets and shelter exceptions. OAR 461-155-0010 is used to determine how special needs are considered for each program.

3. Some special need items replace the standard allowances and do not change the standard payment. No additional payments are made for these items, for instance room and board or adult foster care.

4. To be eligible for a special need item, clients must have no other available resources in the community or in their natural support system to meet the need, excluding resources used in determining eligibility.

5. To be eligible for a special need item, clients must not be eligible for the item through Medicare, Medicaid, or any other medical coverage.

6. The Department will authorize payment for one-time and ongoing special needs for the following, in accordance with the rules that follow:
   1. One-time needs for the following:
      1. Home adaptations to accommodate a client's physical condition

      2. Home repairs

      3. Moving costs

      4. Property taxes

      5. Transportation costs

      6. Community transition services

   2. Ongoing needs for the following:
      1. Adult foster care (AFC)

      2. Food for guide dogs and special assistance animals

      3. Laundry allowances

      4. Residential care facility (RCF) or assisted living facility (ALF)

      5. Restaurant meals

      6. Room and board

      7. Shelter exceptions

      8. Special diet allowances

      9. Telephone allowances

7. In the GA, GAM, OSIP, and OSIPM programs, payment for a one-time special need will be authorized if providing for the need will sustain the client's independence and stability. This includes payments to prevent foreclosure resulting from nonpayment of property taxes and payments for adaptations to the home for reasonable accommodation of physical needs. Ongoing special needs are to be provided to enhance the client's ability to meet an unmet maintenance need such as a telephone allowance in lieu of additional service hours or due to a rural setting. Ongoing special needs are to be considered if the client cannot meet these needs through family support or other service organizations that provide funding for persons who are elderly or disabled.

Stat. Auth.: ORS 411.060
Stats. Implemented: ORS 411.070

461-155-0500 Effective: 5/01/03
Special Needs; Overview

1. In the GA, GAM, MAA, MAF, OSIP, OSIPM, REF, REFM and TANF programs, special needs are needs not included in the basic standard. They may be one-time needs or ongoing needs.

2. Ongoing special needs are needs that last several months at a consistent cost. Examples are special diets and shelter exceptions. Ongoing special needs are used to determine eligibility and benefit amount for clients who are in a non-waivered living arrangement. For all other clients, ongoing special needs are not used to determine eligibility.

3. Some special need items replace the standard allowances and do not change the standard payment. No additional payments are made for these items, for instance room and board or adult foster care.

4. To be eligible for a special need item, clients must have no other available resources in the community or in their natural support system to meet the need, excluding resources used in determining eligibility.

5. To be eligible for a special need item, clients must not be eligible for the item through Medicare, Medicaid or any other medical coverage.

6. The Department will authorize payment for one-time and ongoing special needs for the following, in accordance with the rules that follow--
   1. One-time needs for the following:
      1. Home adaptations to accommodate a client's physical condition

      2. Home repairs

      3. Moving costs

      4. Property taxes

      5. Transportation costs

      6. Community transition services

   2. Ongoing needs for the following:
      1. Adult foster care (AFC)

      2. Food for guide dogs and special assistance animals

      3. Laundry allowances

      4. Residential care facility (RCF)/(ALF)

      5. Restaurant meals

      6. Room and board

      7. Shelter exceptions

      8. Special diet allowances

      9. Telephone allowances

7. In the GA, GAM, OSIP and OSIPM programs, payment for a one-time special need will be authorized if providing for the need will sustain the client's independence and stability. This includes payments to prevent foreclosure resulting from nonpayment of property taxes and payments for adaptations to the home for reasonable accommodation of physical needs. Ongoing special needs are to be provided to enhance the client's ability to meet an unmet maintenance need such as a telephone allowance in lieu of additional service hours or due to a rural setting. Ongoing special needs are to be considered if the client cannot meet these needs through family support or other service organizations that provide funding for persons who are elderly or disabled.

Stat. Auth.: ORS 411.060
Stats. Implemented: ORS 411.070

461-155-0500 Temporary Effective 11/01/02 through 4/30/03
Special Needs; Overview

1. In the GA, GAM, MAA, MAF, OSIP, OSIPM, REF, REFM and TANF programs, special needs are needs not included in the basic standard. They may be one-time needs or ongoing needs.

2. Ongoing special needs are needs that last several months at a consistent cost. Examples are special diets and shelter exceptions. Ongoing special needs are used to determine eligibility and benefit amount for clients who are in a non-waivered living arrangement. For all other clients, ongoing special needs are not used to determine eligibility or benefit amount.

3. Some special need items replace the standard allowances and do not change the standard payment. No additional payments are made for these items, for instance room and board or adult foster care.

4. To be eligible for a special need item, clients must have no other available resources in the community or in their natural support system to meet the need, excluding resources used in determining eligibility.

5. To be eligible for a special need item, clients must not be eligible for the item through Medicare, Medicaid or any other medical coverage.

6. The Department will authorize payment for one-time and ongoing special needs for the following, in accordance with the rules that follow --
   1. One-time needs for the following:
      1. Home adaptations to accommodate a client's physical condition

      2. Home repairs

      3. Moving costs

      4. Property taxes

      5. Transportation costs

      6. Community transition services

   2. Ongoing needs for the following:
      1. Adult foster care (AFC)

      2. Food for guide dogs and special assistance animals

      3. Laundry allowances

      4. Residential care facility (RCF)/(ALF)

      5. Restaurant meals

      6. Room and board

      7. Shelter exceptions

      8. Special diet allowances

      9. Telephone allowances

7. In the GA, GAM, OSIP and OSIPM programs, payment for a one-time special need will be authorized if providing for the need will sustain the client's independence and stability. This includes payments to prevent foreclosure resulting from nonpayment of property taxes and payments for adaptations to the home for reasonable accommodation of physical needs. Ongoing special needs are to be provided to enhance the client's ability to meet an unmet maintenance need such as a telephone allowance in lieu of additional service hours or due to a rural setting. Ongoing special needs are to be considered if the client cannot meet these needs through family support or other service organizations that provide funding for persons who are elderly or disabled.

Stat. Auth.: ORS 411.060
Stats. Implemented: ORS 411.070

461-155-0500 Effective 2/01/00
Special Needs; Overview

1. For GA, GAM, MAA, MAF, OSIP, OSIPM, REF, REFM and TANF, special needs are items that are not included in the basic standard for each program. They may be one-time needs or ongoing needs.

2. Ongoing special needs are needs that last several months at a fixed cost. (Examples are special diets and shelter exceptions.) Use ongoing special needs to determine eligibility and benefit amount for clients who are in an MHDDSD facility or non-waivered GA clients in an SDSD/AAA facility. For all other clients, use ongoing special needs only in the post-eligibility treatment of income process.

3. Some special need items replace the standard allowances and do not change the standard payment. No additional payments are made for these items (e.g., room and board or adult foster care).

4. To be eligible for a special need item, clients must have no other available resources to meet the need (excluding resources used in determining eligibility).

5. Authorize special needs for:
   1. One-time needs for the following:
      1. Household equipment and furniture.

      2. Minor home repairs.

      3. Moving costs.

      4. Property taxes.

      5. Transportation costs.

   2. Ongoing needs for the following:
      1. Adult foster care (AFC).

      2. Cooperation incentive supplement.

      3. Food for guide dogs and special assistance animals.

      4. Laundry allowances.

      5. Residential care facility (RCF)/(ALF).

      6. Restaurant meals.

      7. Room and board.

      8. Shelter exceptions.

      9. Special diet allowances.

      10. Telephone allowances.

6. For GA, GAM, OSIP and OSIPM, the allowance of a one-time special need will be authorized if the client's independence and stability will be sustained by this special need payment. This includes foreclosure through nonpayment of property taxes or adaptions to the home for reasonable accommodation of physical needs. Ongoing special needs are to be provided to enhance the client's ability to meet an unmet maintenance need such as a telephone allowance in lieu of additional service hours or due to a rural setting. This would also include payments for MHDDSD case managed clients. Ongoing special needs are to be considered if the client cannot meet these needs through family support or other service organizations that provide funding for persons who are elderly or disabled.

Stat. Auth.: ORS 411.060
Stats. Implemented: ORS 411.070

Special Needs; Overview
Rule: 461-155-0500

1. For ADC-BAS, ADCM (except ADCM-EA) , GA, GAM, OSIP, OSIPM, REF and REFM, special needs are items that are not included in the basic standard for each program. They may be one-time needs or ongoing needs.

2. Ongoing special needs are needs that last several months at a fixed cost. (Examples are special diets and shelter exceptions.) Use ongoing special needs to determine eligibility and benefit amount for clients who are in an MHDDSD facility or non-waivered GA clients in an SDSD/AAA facility. For all other clients, use ongoing special needs only in the post-eligibility treatment of income process.

3. Some special need items replace the standard allowances and do not change the standard payment. No additional payments are made for these items (e.g., room and board or adult foster care) .

4. To be eligible for a special need item, clients must have no other available resources to meet the need (excluding resources used in determining eligibility) .

5. Authorize special needs for:
   1. One-time needs for the following:
      1. Household equipment and furniture.

      2. Minor home repairs.

      3. Moving costs.

      4. Property taxes.

      5. Transportation costs.

   2. Ongoing needs for the following:
      1. Adult foster care (AFC) .

      2. Cooperation incentive supplement.

      3. Food for guide dogs and special assistance animals.

      4. Laundry allowances.

      5. Residential care facility (RCF) /(ALF)

      6. Restaurant meals.

      7. Room and board.

      8. Shelter exceptions.

      9. Special diet allowances.

      10. Telephone allowances.

6. For GA, GAM, OSIP and OSIPM, allowance of a special need must be associated with the relocation of a client from a nursing facility or the diversion of a client from the need for nursing facility care. The provision of the special need may, if not associated with direct relocation or diversion activities, be allowed if the special need allowance will keep the individual from requiring more costly services or will remove the need for the client to access paid services.

7. Clients must pursue all natural and organized support resources, such as family, friends, neighbors, the Salvation Army, and other United Way services for example, before payment is made for a special need item.