Previous Rules

461-155-0630    Effective 12/15/21 - Technical Amendment
Special Need; Community-Based Care; OSIPM

In the OSIPM program:

1. An individual is considered living in a community-based care facility (see OAR 461-155-0630) if the individual resides at one of the following care settings licensed by the Department:
   1. Adult Foster Home.

   2. Residential Care Facility.

   3. Assisted Living Facility.

   4. Specialized Living Facility.

   5. Group Care Home.

2. If an individual who meets the applicable income requirements begins living in a community-based care facility:
   1. Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate.

   2. 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:
      1. The absence occurs because the individual is admitted to a hospital or nursing home.

      2. The Department determines the intent of the individual to return to the community-based care facility.

      3. The community-based care facility is willing to accept the room and board payment.

      4. The individual returns within the calendar month following the month in which the absence began.

3. Spouses who each receive 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.

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

461-155-0630    Effective 12/14/21 - Technical Amendment
Special Need; Community Based Care; OSIPM

In the OSIPM program:

1. An individual is considered living in a community-based care facility (see OAR 461-155-0630) if the individual resides at one of the following care settings licensed by the Department:
   1. Adult Foster Home.

   2. Residential Care Facility.

   3. Assisted Living Facility.

   4. Specialized Living Facility.

   5. Group Care Home.

2. If an individual who meets the applicable income requirements begins living in a community-based care facility:
   1. Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate.

   2. 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:
      1. The absence occurs because the individual is admitted to a hospital or nursing home.

      2. The Department determines the intent of the individual to return to the community-based care facility.

      3. The community-based care facility is willing to accept the room and board payment.

      4. The individual returns within the calendar month following the month in which the absence began.

3. Spouses who each receive 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.

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

461-155-0630    Effective 07/01/18
Special Need; Community Based Care; OSIPM

In the OSIPM program:

1. A client is considered living in a community based care facility (see OAR 461-001-0000) if the client resides at one of the following care settings licensed by the Department:
   1. Adult Foster Home.

   2. Residential Care Facility.

   3. Assisted Living Facility.

   4. Specialized Living Facility.

   5. Group Care Home.

2. If a client who meets the applicable income requirements begins living in a community based care facility:
   1. Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate.

   2. Room and board payments may be paid to the community based care facility during the temporary absence of a client if all of the following criteria are met:
      1. The absence occurs because the client is admitted to a hospital or nursing home.

      2. The Department determines the intent of the client to return to the community based care facility.

      3. The community based care facility is willing to accept the room and board payment.

      4. The client returns within the calendar month following the month in which the absence began.

3. Spouses who each receive 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.

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

461-155-0630    Effective 07/01/17
Special Need; Community Based Care; OSIPM

In the OSIPM program:

1. A client is considered living in a community based care facility (see OAR 461-001-0000) if the client resides at one of the following care settings licensed by the Department:
   1. Adult Foster Home.

   2. Residential Facility.

   3. Assisted Living Facility.

   4. Specialized Living Facility.

   5. Group Care Home.

2. In determining eligibility for OSIPM for an individual receiving care 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, the special need (see OAR 461-155-0010) is the amount of the service payment authorized by the Department and is added to the OSIP maintenance standard.

3. If a client who meets the applicable income requirements begins living in a community based care facility:
   1. Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate.

   2. Room and board payments may be paid to the community based care facility during the temporary absence of a client if all of the following criteria are met:
      1. The absence occurs because the client is admitted to a hospital or nursing home.

      2. The Department determines the intent of the client to return to the community based care facility.

      3. The community based care facility is willing to accept the room and board payment.

      4. The client returns within the calendar month following the month in which the absence began.

4. Spouses who each receive 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 and the individual's total countable income. If one spouse has income above the OSIPM standard, the excess income is applied to the other spouse's countable income.

Stat. Auth.: ORS 409.050, 411.060, 411.404, 413.085, 414.685
Stats. Implemented: ORS 409.010, 411.060, 411.404, 413.085, 414.685

461-155-0630    Effective 10/01/13
Special Need; Community Based Care; OSIPM

In the OSIPM program:

1. A client is considered living in a community based care facility (see OAR 461-001-0000) if the client resides at one of the following care settings licensed by the Department:
   1. Adult Foster Care.

   2. Residential Care.

   3. Assisted Living.

   4. Specialized Living.

   5. Group Care Home.

2. In determining eligibility for OSIPM for an individual receiving care 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, the special need (see OAR 461-155-0010) is the amount of the service payment authorized by the Department and is added to the OSIP maintenance standard.

3. If a client who meets the applicable income requirements begins living in a community based care facility:
   1. Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate.

   2. Room and board payments may be paid to the community based care facility during the temporary absence of a client if all of the following criteria are met:
      1. The absence occurs because the client is admitted to a hospital or nursing home.

      2. The Department determines the intent of the client to return to the community based care facility.

      3. The community based care facility is willing to accept the room and board payment.

      4. The client returns one month following the month in which the absence began.

4. Spouses who each receive 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 and the individual's total countable income. If one spouse has income above the OSIPM standard, the excess income is applied to the other spouse's countable income.

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

461-155-0630    Temporary Effective 07/01/13 through 09/30/13
Special Need; Community Based Care; OSIPM

In the OSIPM program:

1. A client is considered living in a community based care facility (see OAR 461-001-0000) if the client resides at one of the following care settings licensed by the Department:
   1. Adult Foster Care.

   2. Residential Care.

   3. Assisted Living.

   4. Specialized Living.

   5. Group Care Home.

2. In determining eligibility for OSIPM for an individual receiving care 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, the special need (see OAR 461-155-0010) is the amount of the service payment authorized by the Department and is added to the OSIP maintenance standard.

3. If a client who meets the applicable income requirements begins living in a community based care facility:
   1. Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate.

   2. Room and board payments may be paid to the community based care facility during the temporary absence of a client if all of the following criteria are met:
      1. The absence occurs because the client is admitted to a hospital or nursing home.

      2. The Department determines the intent of the client to return to the community based care facility.

      3. The community based care facility is willing to accept the room and board payment.

      4. The client returns one month following the month in which the absence began.

4. Spouses who each receive 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 and the individual's total countable income. If one spouse has income above the OSIPM standard, the excess income is applied to the other spouse's countable income.

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

461-155-0630    Effective 01/01/10
Special Need; Community Based Care; OSIPM

In the OSIPM program:

1. A client is considered living in a community based care facility (see OAR 461-001-0000) if the client resides at one of the following care settings licensed by the Department:
   1. Adult Foster Care.

   2. Residential Care.

   3. Assisted Living.

   4. Specialized Living.

   5. Group Care Home.

2. In determining eligibility for OSIPM for an individual not covered by a home and community based care waiver, the special need (see OAR 461-155-0010) is the amount of the service payment authorized by the Department and is added to the OSIP maintenance standard.

3. If a client who meets the applicable income requirements begins living in a community based care facility:
   1. Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate.

   2. Room and board payments may be paid to the community based care facility during the temporary absence of a client if all of the following criteria are met:
      1. The absence occurs because the client is admitted to a hospital or nursing home.

      2. The Department determines the intent of the client to return to the community based care facility.

      3. The community based care facility is willing to accept the room and board payment.

      4. The client returns one month following the month in which the absence began.

4. Spouses who each receive 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 and the individual's total countable income. If one spouse has income above the OSIPM standard, the excess income is applied to the other spouse's countable income.

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

461-155-0630    Effective 10/01/07
Special Need; Community Based Care; OSIPM

In the OSIPM program:

1. A client is considered living in a community based facility if the client resides at one of the following care settings licensed by the Department:
   1. Adult Foster Care.

   2. Residential Care.

   3. Assisted Living.

   4. Specialized Living.

   5. Group Care Home.

2. In determining eligibility for OSIPM for an individual not covered by a home and community based care waiver, the special need (see OAR 461-155-0010) is the amount of the service payment authorized by the Department and is added to the OSIP maintenance standard.

3. If a client who meets the applicable income requirements begins living in a community based facility:
   1. Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate.

   2. Room and board payments may be paid to the community based facility during the temporary absence of a client if all of the following criteria are met:
      1. The absence occurs because the client is admitted to a hospital or nursing home.

      2. The Department determines the intent of the client to return to the community based facility.

      3. The community based facility is willing to accept the room and board payment.

      4. The client returns one month following the month in which the absence began.

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

461-155-0630    Effective 01/01/06
Special Need; Community-Based Care

In the OSIPM program:

1. A client is considered living in community based facility if the client resides at one of the following care settings licensed by the Department:
   1. Adult Foster Care

   2. Residential Care

   3. Assisted Living

   4. Specialized Living

   5. Group Care Homes

2. In determining eligibility for OSIPM for an individual not covered by a home and community based care waiver, the special need (see OAR 461-155-0010) is the amount of the service payment authorized by the Department and is added to the OSIP maintenance standard.

3. If a client who meets the applicable income requirements begins living in community based facility:
   1. Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate.

   2. Room and board payments may be paid to the community based facility during the temporary absence of a client if all of the following criteria are met:
      1. The absence occurs because the client is admitted to a hospital or nursing home.

      2. The Department determines the intent of the client to return to the community based facility.

      3. The community based facility is willing to accept the room and board payment.

      4. The client returns within two full months following the month in which the absence began.

   3. Service payments will not be paid for any time during the period of absence of the client from a community based facility.

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

461-155-0630 Effective 10/01/04
Special Need; Community-Based Care

A client living in a residential care facility, a specialized living facility, an adult foster care facility, or an assisted living facility may receive a room-and-board payment limited to the month of admission, but only if the facility is licensed by the Department.

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

461-155-0630
Special Need; Residential Care Facilities (RCF) /Assisted Living

1. Residential care facilities (RCF) /Assisted Living are community-based living situations for clients.

2. Special need allowances for RCF/Assisted Living are limited to clients in facilities licensed by MHDDSD.