Previous Rules


461-160-0610    Effective 02/18/21 - Technical Amendment
Client Liability; OSIPM (except OSIPM-EPD)

  1. A client in the OSIPM (except OSIPM-EPD) program who receives long-term care (see OAR 461-001-0000) services must, in order to remain eligible, make the payment required by this rule, except as provided in sections (2) to (6) of this rule. The client must apply his or her adjusted income to the cost of the care or service. This amount is the client liability. If the client's adjusted income exceeds the cost of care or service, the client must pay the full cost of care but has no additional liability.

  2. A client who receives SSI, or is deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), is eligible for OSIPM program benefits without having to make a payment.

  3. The ICP service payment of a client in OSIPM-ICP is reduced by the amount of his or her liability.

  4. The following clients, if they receive the services described in section (5) of this rule, are exempt from payments required by this rule:

    1. A disabled adult child under OAR 461-135-0830.

    2. A widow or widower under OAR 461-135-0820.

    3. A Pickle amendment client under OAR 461-135-0780.

  5. A client identified in section (4) of this rule is exempt from payments required by this rule if the client receives home and community-based care (see OAR 461-001-0030).

  6. In the initial month of placement, a client may be exempt from payments required under this rule if the Department determines that the client's income has been exhausted prior to placement. If any income remains, the client must contribute to the cost of care or service.

  7. A client residing in an acute care hospital or mental health residential treatment facility is exempt from payments required by this rule while residing in the acute care hospital or mental health residential treatment facility. If a service benefit was received prior to admission to the acute care hospital, payment must be made for that service. For purposes of this rule, only the following types of treatment centers qualify as a mental health residential treatment facility:

    1. A mental health adult foster home.
    2. A mental health residential treatment home.
    3. A mental health residential treatment facility.
    4. A mental health secure residential treatment facility.

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


461-160-0610    Effective 07/01/18
Client Liability; OSIPM (except OSIPM-EPD)

  1. A client in the OSIPM (except OSIPM-EPD) program who receives long-term care (see OAR 461-001-0000) services must, in order to remain eligible, make the payment required by this rule, except as provided in sections (2) to (6) of this rule. The client must apply his or her adjusted income to the cost of the care or service. This amount is the client liability. If the client's adjusted income exceeds the cost of care or service, the client must pay the full cost of care but has no additional liability.

  2. A client who receives SSI, or is deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), is eligible for OSIPM program benefits without having to make a payment.

  3. The IC service payment of a client in the OSIPM-IC program is reduced by the amount of his or her liability.

  4. The following clients, if they receive the services described in section (5) of this rule, are exempt from payments required by this rule:

    1. A disabled adult child under OAR 461-135-0830.

    2. A widow or widower under OAR 461-135-0820.

    3. A Pickle amendment client under OAR 461-135-0780.

  5. A client identified in section (4) of this rule is exempt from payments required by this rule if the client receives home and community-based care (see OAR 461-001-0030).

  6. In the initial month of placement, a client may be exempt from payments required under this rule if the Department determines that the client's income has been exhausted prior to placement. If any income remains, the client must contribute to the cost of care or service.

  7. A client residing in an acute care hospital or mental health residential treatment facility is exempt from payments required by this rule while residing in the acute care hospital or mental health residential treatment facility. If a service benefit was received prior to admission to the acute care hospital, payment must be made for that service. For purposes of this rule, only the following types of treatment centers qualify as a mental health residential treatment facility:

    1. A mental health adult foster home.
    2. A mental health residential treatment home.
    3. A mental health residential treatment facility.
    4. A mental health secure residential treatment facility.

Stat. Auth.: ORS 409.050, 411.060, 411.070, 411.404, 411.706, 413.085, 414.685
Stats. Implemented: ORS 409.010, 411.060, 411.070, 411.404, 411.706


461-160-0610    Effective 10/01/13
Client Liability OSIPM (except OSIPM-EPD)

  1. A client in the OSIPM (except OSIPM-EPD) program who receives long-term care (see OAR 461-001-0000) services must, in order to remain eligible, make the payment required by this rule, except as provided in sections (2) to (6) of this rule. The client must apply his or her adjusted income to the cost of the care or service. This amount is the client liability. If the client's adjusted income exceeds the cost of care or service, the client must pay the full cost of care but has no additional liability.

  2. A client who receives SSI, or is deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), is eligible for OSIPM program benefits without having to make a payment.

  3. The IC service payment of a client in the OSIPM-IC program is reduced by the amount of his or her liability.

  4. The following clients, if they receive the services described in section (5) of this rule, are exempt from payments required by this rule:

    1. A disabled adult child under OAR 461-135-0830.

    2. A widow or widower under OAR 461-135-0820.

    3. A Pickle amendment client under OAR 461-135-0780.

  5. A client identified in section (4) of this rule is exempt from payments required by this rule if the client receives --

    1. Home and community-based care (see OAR 461-001-0030); or

    2. Mental health services and lives in a mental health residential treatment facility. For purposes of this rule, only the following types of treatment centers qualify as a mental health residential treatment facility:

      1. A mental health adult foster home.

      2. A mental health residential treatment home.

      3. A mental health residential treatment facility.

      4. A mental health secure residential treatment facility.

  6. In the initial month of placement, a client may be exempt from payments required under this rule if the Department determines that the client's income has been exhausted prior to placement. If any income remains, the client must contribute to the cost of care or service.

  7. A client residing in an acute care hospital is exempt from payments required by this rule while residing in the acute care hospital. If a service benefit was received prior to admission to the acute care hospital, payment must be made for that service.

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


461-160-0610    Temporary Effective 07/01/13 through 09/30/13
Client Liability OSIPM (except OSIPM-EPD)

  1. A client in the OSIPM (except OSIPM-EPD) program who receives long-term care (see OAR 461-001-0000) services must, in order to remain eligible, make the payment required by this rule, except as provided in sections (2) to (6) of this rule. The client must apply his or her adjusted income to the cost of the care or service. This amount is the client liability. If the client's adjusted income exceeds the cost of care or service, the client must pay the full cost of care but has no additional liability.

  2. A client who receives SSI, or is deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), is eligible for OSIPM program benefits without having to make a payment.

  3. The IC service payment of a client in the OSIPM-IC program is reduced by the amount of his or her liability.

  4. The following clients, if they receive the services described in section (5) of this rule, are exempt from payments required by this rule:

    1. A disabled adult child under OAR 461-135-0830.

    2. A widow or widower under OAR 461-135-0820.

    3. A Pickle amendment client under OAR 461-135-0780.

  5. A client identified in section (4) of this rule is exempt from payments required by this rule if the client receives --

    1. Home and community-based care (see OAR 461-001-0030); or

    2. Mental health services and lives in a mental health residential treatment facility. For purposes of this rule, only the following types of treatment centers qualify as a mental health residential treatment facility:

      1. A mental health adult foster home.

      2. A mental health residential treatment home.

      3. A mental health residential treatment facility.

      4. A mental health secure residential treatment facility.

  6. In the initial month of placement, a client may be exempt from payments required under this rule if the Department determines that the client's income has been exhausted prior to placement. If any income remains, the client must contribute to the cost of care or service.

  7. A client residing in an acute care hospital is exempt from payments required by this rule while residing in the acute care hospital. If a service benefit was received prior to admission to the acute care hospital, payment must be made for that service.

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


461-160-0610    Effective 10/01/10
Client Liability OSIPM (except OSIPM-EPD)

  1. A client in the OSIPM (except OSIPM-EPD) program who receives long-term care (see OAR 461-001-0000) services must, in order to remain eligible, make the payment required by this rule, except as provided in sections (2) to (6) of this rule. The client must apply his or her adjusted income to the cost of the care or service. This amount is the client liability. If the client's adjusted income exceeds the cost of care or service, the client must pay the full cost of care but has no additional liability.

  2. A client who receives SSI, or is deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), is eligible for OSIPM program benefits without having to make a payment.

  3. The IC service payment of a client in the OSIPM-IC program is reduced by the amount of his or her liability.

  4. The following clients, if they receive the services described in section (5) of this rule, are exempt from payments required by this rule:

    1. A disabled adult child under OAR 461-135-0830.

    2. A widow or widower under OAR 461-135-0820.

    3. A Pickle amendment client under OAR 461-135-0780.

    4. An individual who receives services for a developmental disability under a support services waiver under OAR 411-340-0100 and 411-340-0130.

  5. A client identified in section (4) of this rule is exempt from payments required by this rule if the client receives --

    1. Waivered services (see OAR 461-001-0030); or

    2. Mental health services and lives in a mental health residential treatment facility. For purposes of this rule, only the following types of treatment centers qualify as a mental health residential treatment facility:

      1. A mental health adult foster home.

      2. A mental health residential treatment home.

      3. A mental health residential treatment facility.

      4. A mental health secure residential treatment facility.

  6. In the initial month of placement, a client may be exempt from payments required under this rule if the Department determines that the client's income has been exhausted prior to placement. If any income remains, the client must contribute to the cost of care or service.

  7. A client residing in an acute care hospital is exempt from payments required by this rule while residing in the acute care hospital. If a service benefit was received prior to admission to the acute care hospital, payment must be made for that service.

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


461-160-0610    Effective 01/01/10
Client Liability OSIPM (except OSIPM-EPD)

  1. A client in the OSIPM (except OSIPM-EPD) program who receives long-term care (see OAR 461-001-0000) services must, in order to remain eligible, make the payment required by this rule, except as provided in sections (2) to (6) of this rule. The client must apply his or her adjusted income to the cost of the care or service. This amount is the client liability. If the client's adjusted income exceeds the cost of care or service, the client must pay the full cost of care but has no additional liability.

  2. A client who receives SSI, or is deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), is eligible for OSIPM program benefits without having to make a payment.

  3. The IC service payment of a client in the OSIPM-IC program is reduced by the amount of his or her liability.

  4. The following clients, if they receive the services described in section (5) of this rule, are exempt from payments required by this rule:

    1. A disabled adult child under OAR 461-135-0830.

    2. A widow or widower under OAR 461-135-0820.

    3. A Pickle amendment client under OAR 461-135-0780.

  5. A client identified in section (4) of this rule is exempt from payments required by this rule if the client receives --

    1. Waivered services (see OAR 461-001-0030); or

    2. Mental health services and lives in a mental health residential treatment facility. For purposes of this rule, only the following types of treatment centers qualify as a mental health residential treatment facility:

      1. A mental health adult foster home.

      2. A mental health residential treatment home.

      3. A mental health residential treatment facility.

      4. A mental health secure residential treatment facility.

  6. In the initial month of placement, a client may be exempt from payments required under this rule if the Department determines that the client's income has been exhausted prior to placement. If any income remains, the client must contribute to the cost of care or service.

  7. A client residing in an acute care hospital is exempt from payments required by this rule while residing in the acute care hospital. If a service benefit was received prior to admission to the acute care hospital, payment must be made for that service.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610    Effective 10/01/08
Client Liability for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

  1. Clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or enter a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule, except as provided in sections (2) to (5) of this rule. These clients must apply their adjusted income to the cost of their care or service. This amount is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

  2. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM without having to make a payment.

  3. The IC service payment of clients in the OSIP-IC and OSIPM-IC programs is reduced by the amount of their liability.

  4. The following clients, if they receive the services described in section (5) of this rule, are exempt from payments required by this rule:

    1. A disabled adult child under OAR 461-135-0830.

    2. A widow or widower under OAR 461-135-0820.

    3. A Pickle amendment client under OAR 461-135-0780.

  5. A client identified in section (4) of this rule is exempt from payments required by this rule if the client receives --

    1. Waivered services (see OAR 461-001-0030); or

    2. Mental health services and lives in a mental health residential treatment facility. For purposes of this rule, only the following types of treatment centers qualify as a mental health residential treatment facility:

      1. A mental health adult foster home.

      2. A mental health residential treatment home.

      3. A mental health residential treatment facility.

      4. A mental health secure residential treatment facility.

  6. A client residing in an acute care hospital is exempt from payments required by this rule while residing in the acute care hospital. If a service benefit was received prior to admission to the acute care hospital, payment must be made for that service.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610    Effective 07/01/07
Client Liability for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

  1. Clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or enter a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule, except as provided in sections (2) to (5) of this rule. These clients must apply their adjusted income to the cost of their care or service. This amount is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

  2. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM without having to make a payment.

  3. The IC service payment of clients in the OSIP-IC and OSIPM-IC programs is reduced by the amount of their liability.

  4. The following clients, if they receive the services described in section (5) of this rule, are exempt from payments required by this rule:

    1. A disabled adult child under OAR 461-135-0830.

    2. A disabled widow or widower under OAR 461-135-0811.

    3. A widow or widower under OAR 461-135-0820.

    4. A Pickle amendment client under OAR 461-135-0780.

  5. A client identified in section (4) of this rule is exempt from payments required by this rule if the client receives --

    1. Waivered services (see OAR 461-001-0030); or

    2. Mental health services and lives in a mental health residential treatment facility. For purposes of this rule, only the following types of treatment centers qualify as a mental health residential treatment facility:

      1. A mental health adult foster home.

      2. A mental health residential treatment home.

      3. A mental health residential treatment facility.

      4. A mental health secure residential treatment facility.

  6. A client residing in an acute care hospital is exempt from payments required by this rule while residing in the acute care hospital. If a service benefit was received prior to admission to the acute care hospital, payment must be made for that service.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Effective 04/01/07
Client Liability for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

  1. Clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or enter a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule, except as provided in sections (2) to (5) of this rule. These clients must apply their adjusted income to the cost of their care or service. This amount is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

  2. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM without having to make a payment.

  3. The IC service payment of clients in the OSIP-IC and OSIPM-IC programs is reduced by the amount of their liability.

  4. The following clients are exempt from payments required by this rule if they receive waivered services (see OAR 461-001-0030):

    1. A disabled adult child under OAR 461-135-0830.

    2. A disabled widow or widower under OAR 461-135-0811.

    3. A widow or widower under OAR 461-135-0820.

    4. A Pickle amendment client under OAR 461-135-0780.

  5. A client residing in an acute care hospital is exempt from payments required by this rule while residing in the acute care hospital. If a service benefit was received prior to admission to the acute care hospital, payment must be made for that service.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Effective 01/01/07
Client Liability for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

  1. The IC service payment of clients in the OSIP-IC and OSIPM-IC programs is reduced by the amount of their liability. Other clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or enter a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule as follows:

    1. Clients who do not receive SSI, but who meet the income requirements, may be eligible for OSIP and OSIPM. These clients must apply their adjusted income to the cost of their care or service. This amount is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

    2. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM without having to make a payment.

  2. The following clients are exempt from payments required by this rule if they receive waivered services (see OAR 461-001-0030):

    1. A disabled adult child under OAR 461-135-0830.

    2. A disabled widow or widower under OAR 461-135-0811.

    3. A widow or widower under OAR 461-135-0820.

    4. A Pickle amendment client under OAR 461-135-0780

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Effective: 10/01/06
Client Liability for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

  1. The IC service payment of clients in the OSIP-IC and OSIPM-IC programs is reduced by the amount of their liability. Other clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or enter a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule as follows:

    1. Clients who do not receive SSI, but who meet the income requirements, may be eligible for OSIP and OSIPM. These clients must apply their adjusted income to the cost of their care or service. This amount is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

    2. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM without having to make a payment.

  2. The following clients are exempt from payments required by this rule if they receive waivered services (as defined in OAR 461-145-0560):

    1. A disabled adult child under OAR 461-135-0830.

    2. A disabled widow or widower under OAR 461-135-0811.

    3. A widow or widower under OAR 461-135-0820.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Effective: 01/01/06
Client Liability for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

Clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or enter a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule as follows:

  1. Clients who do not receive SSI, but who meet the income requirements, may be eligible for OSIP and OSIPM. These clients must apply their adjusted income to the cost of their care or service. This is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

  2. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM without having to make a payment.

  3. A client identified in section (4) of this rule is subject to or exempt from payments as follows:

    1. If this client is living in a nursing facility, a state institution, an Intermediate Care Facility for the Mentally Retarded, or a non-waivered mental health facility, the client makes the payments required by this rule.

    2. If this client lives in a waivered living arrangement, the client is exempt from payments required by this rule.

  4. Section (3) of this rule applies to each client who meets the eligibility requirements for one of the following categories:

    1. A disabled adult child under OAR 461-135-0830.

    2. A disabled widow or widower under OAR 461-135-0811.

    3. A widow or widower under OAR 461-135-0820.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Effective: 10/01/05
Client Liability for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

Clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or enter a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule as follows:

  1. Clients who do not receive SSI, but who meet the income requirements, may be eligible for OSIP and OSIPM. These clients must apply their adjusted income to the cost of their care or service. This is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

  2. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM without having to make a payment.

  3. An adult disabled child as described at OAR 461-135-0830 is eligible for OSIP and OSIPM. An adult disabled child is subject to or exempt from payments as follows:

    1. An adult disabled child living in a nursing facility, state institution, an Intermediate Care Facility for the Mentally Retarded, or a non-waivered mental health facility makes the payments required by this rule.

    2. An adult disabled child in a waivered living arrangement is exempt from payments under this rule.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Temporary Effective: 07/06/05 through 09/30/05
Client Liability for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

Clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or entering a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule.

  1. Clients who do not receive SSI, but whose countable income is under the countable income limit, may be eligible for OSIP and OSIPM. These clients must apply their adjusted income to the cost of their care or service. This is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

  2. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM without having to make a payment.

  3. An adult disabled child as described at OAR 461-135-0830 is eligible for OSIP and OSIPM. An adult disabled child is subject to or exempt from payments as follows:

    1. An adult disabled child living in a nursing facility, state institution, or an Intermediate Care Facility for the Mentally Retarded makes the payments required by this rule.

    2. An adult disabled child in a waivered living arrangement is exempt from payments under this rule.

  4. This temporary rule has a retroactive effective date of July 1, 2005.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Temporary Effective: 07/01/05 through 07/05/05
Client Liability for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

Clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or entering a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule.

  1. Clients who do not receive SSI, but whose countable income is under the countable income limit, may be eligible for OSIP and OSIPM. These clients must apply their adjusted income to the cost of their care or service. This is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

  2. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM without having to make a payment.

  3. Adult disabled children as described at OAR 461-135-0830 are eligible for OSIP and OSIPM without having to make a payment.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Effective: 10/01/04
Client Liability for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

Clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or entering a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule.

  1. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM without having to make a payment.

  2. Clients who do not receive SSI, but whose countable income is under the countable income limit, may be eligible for OSIP and OSIPM. These clients must apply their adjusted income to the cost of their care or service. This is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Effective: 7/01/03
Client Liability and Spend-Down for Clients in Long-term Care or Receiving Waivered Services; OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

Clients in the OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or entering a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule.

  1. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM (except OSIPM-MN) without having to make a payment.

  2. Clients who do not receive SSI, but whose countable income is under the countable income limit, may be eligible for OSIP and OSIPM (except OSIPM-MN). These clients must apply their adjusted income to the cost of their care or service. This is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

  3. Clients whose countable income exceeds the countable income limit are not eligible for OSIPM-MN unless they meet OSIPM-MN spend-down requirements in this section. The spend-down is the difference between adjusted income and the OSIPM-MN income standard. A client meets the spend-down requirement as follows:

    1. If the anticipated cost of care equals or exceeds the spend-down, the client is deemed to have met the spend-down requirement.

    2. If the anticipated cost of care is less than the spend-down, the cost of care is subtracted from the spend-down. The client must pay the full amount of care and incur additional medical expenses to meet the remainder of the spend-down requirement.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Effective: 7/01/02
Client Liability and Spend-Down for Clients in Long-term Care or Receiving Waivered Services; OHP, OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD)

Clients in the OHP, OSIP (except OSIP-EPD) and OSIPM (except OSIPM-EPD) programs who live in or entering a long-term care setting or who receive Title XIX waivered services must, in order to remain eligible, make the payment required by this rule.

  1. Clients who receive OHP must make the payment determined by OAR 461-160-0620(9).

  2. Clients who receive SSI, or are deemed to receive SSI under section 1619(b) of the Social Security Act (42 U.S.C. § 1382h(b)), are eligible for OSIP and OSIPM (except OSIPM-MN) without having to make a payment.

  3. Clients who do not receive SSI, but whose countable income is under the countable income limit, may be eligible for OSIP and OSIPM (except OSIPM-MN). These clients must apply their adjusted income to the cost of their care or service. This is their client liability. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care but have no additional liability.

  4. Clients whose countable income exceeds the countable income limit are not eligible for OSIPM-MN unless they meet OSIPM-MN spend-down requirements in this section. The spend-down is the difference between adjusted income and the OSIPM-MN income standard. A client meets the spend-down requirement as follows:

    1. If the anticipated cost of care equals or exceeds the spend-down, the client is deemed to have met the spend-down requirement.

    2. If the anticipated cost of care is less than the spend-down, the cost of care is subtracted from the spend-down. The client must pay the full amount of care and incur additional medical expenses to meet the remainder of the spend-down requirement.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 Effective 5/01/99
Use of Income; OHP, OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD) Long-Term Care or Waivered

Determine financial eligibility for OHP, OSIP (except OSIP-EPD), and OSIPM (except OSIPM-EPD)clients who are in or entering long-term care, or who receive Title XIX waivered services, as follows:

  1. Clients who receive OHP must apply their adjusted income (per rule 461-160-0620) to reduce the cost of their care or services.

  2. Clients who receive SSI, or are deemed to receive SSI under Section 1619(b) of the Social Security Act, are eligible for OSIP and OSIPM (except OSIPM-MN) and do not have a patient liability.

  3. Clients who do not receive SSI, but whose countable income is under the Countable Income Limit, are eligible for OSIP and OSIPM (except OSIPM-MN).

    1. These clients must apply their adjusted income to reduce the cost of their care or service. This is their patient liability.

    2. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care, but have no additional patient liability.

  4. Clients whose countable income exceeds the Countable Income Limit are not eligible unless they meet OSIPM-MN spend-down. Subtract the OSIPM-MN standard from the adjusted income; the remainder is the client's spend-down.

    1. If the anticipated cost of care equals or exceeds the spend-down, the client has met the spend-down.

    2. If the anticipated cost of care is less than the spend-down, subtract the cost of care from the spend-down. The client must pay the full amount of care and incur additional medical expenses to meet the remainder of the spend-down.

Stat. Auth.: ORS 411.060, 411.070, 414.042
Stats. Implemented: ORS 411.060, 411.070, 414.042


461-160-0610 (Temporary rule 2/1/99 through 7/31/99)
Use of Income; OHP, OSIP (except OSIP-EPD), OSIPM (except OSIPM-EPD) Long-Term Care or Waivered

Determine financial eligibility for OHP, OSIP (except OSIP-EPD), and OSIPM (except OSIPM-EPD)clients who are in or entering long-term care, or who receive Title XIX waivered services, as follows:

  1. Clients who receive OHP must apply their adjusted income (per rule 461-160-0620) to reduce the cost of their care or services.

  2. Clients who receive SSI, or are deemed to receive SSI under Section 1619(b) of the Social Security Act, are eligible for OSIP and OSIPM (except OSIPM-MN) and do not have a patient liability.

  3. Clients who do not receive SSI, but whose countable income is under the Countable Income Limit, are eligible for OSIP and OSIPM (except OSIPM-MN).

    1. These clients must apply their adjusted income to reduce the cost of their care or service. This is their patient liability.

    2. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care, but have no additional patient liability.

  4. Clients whose countable income exceeds the Countable Income Limit are not eligible unless they meet OSIPM-MN spend-down. Subtract the OSIPM-MN standard from the adjusted income; the remainder is the client's spend-down.

    1. If the anticipated cost of care equals or exceeds the spend-down, the client has met the spend-down.

    2. If the anticipated cost of care is less than the spend-down, subtract the cost of care from the spend-down. The client must pay the full amount of care and incur additional medical expenses to meet the remainder of the spend-down.

Use of Income; OHP, OSIP, OSIPM Long-Term Care or Waivered
Rule: 461-160-0610

Determine financial eligibility for OHP, OSIP and OSIPM clients who are in or entering long-term care, or who receive Title XIX waivered services, as follows:

  1. Clients who receive OHP must apply their adjusted income (per rule 461-160-0620) to reduce the cost of their care or services.

  2. Clients who receive SSI, or are deemed to receive SSI under Section 1619(b) of the Social Security Act, are eligible for OSIP and OSIPM (except OSIPM-MN) and do not have a patient liability.

  3. Clients who do not receive SSI, but whose countable income is under the Countable Income Limit, are eligible for OSIP and OSIPM (except OSIPM-MN).

    1. These clients must apply their adjusted income to reduce the cost of their care or service. This is their patient liability.

    2. If their adjusted income exceeds their cost of care or service, they must pay the full cost of care, but have no additional patient liability.

  4. Clients whose countable income exceeds the Countable Income Limit are not eligible unless they meet OSIPM-MN spend-down. Subtract the OSIPM-MN standard from the adjusted income; the remainder is the client's spend-down.

    1. If the anticipated cost of care equals or exceeds the spend-down, the client has met the spend-down.

    2. If the anticipated cost of care is less than the spend-down, subtract the cost of care from the spend-down. The client must pay the full amount of care and incur additional medical expenses to meet the remainder of the spend-down.