461-155-0630 Effective 01/01/10
Special Need; Community Based Care; OSIPMIn the OSIPM program:
- 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:
- Adult Foster Care.
- Residential Care.
- Assisted Living.
- Specialized Living.
- Group Care Home.
- 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.
- If a client 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 a client if all of the following criteria are met:
- The absence occurs because the client is admitted to a hospital or nursing home.
- The Department determines the intent of the client to return to the community based care facility.
- The community based care facility is willing to accept the room and board payment.
- The client returns one month following the month in which the absence began.
- 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.