Definitions for Chapter 461: 461-001-0000

Definitions for Chapter 461: 461-001-0000

1. All participants are employees; and

2. Participants can choose, cafeteria-style, from a menu of two or more cash or qualified benefits. In this context, qualified benefits are benefits other than cash that the Internal Revenue Services does not consider part of an employee’s gross income. Qualified benefits include, but are not limited to:
   • Accident and health plans (including medical plans, vision plans, dental plans, accident and disability insurance);

   • Group term life insurance plans (up to $50,000);

   • Dependent care assistance plans; and

   • Certain stock bonus plans under section 401(k)(2) of the Internal Revenue Code (but no 401(k)(1) plans).

1. In the REF, Pre-TANF, SFPSS, and TANF programs, a dependent child's father, mother, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, uncle, aunt, first cousin, nephew or niece who lives in a residence maintained by one or more of the relatives as the child's or the relative's own home.

   This includes:

   • Half-brother and sisters;
   • Any individual who legally adopts the child and any individual related to the individual adopting the child;
   • Individuals who met the definition of caretaker relative before the child was adopted;
   • Individuals who met the definition of caretaker relative through marriage even if the marriage ends through death or divorce.
2. In all other programs, one of the following relatives of the dependent child:
   • Any blood relative, including those of half-blood, and including first cousins, nephews or nieces, and individuals of preceding generations denoted by the prefixes of grand, great- or great-great-;
   • Stepfather, stepmother, stepbrother and stepsister;
   • Any individual who legally adopts the child and any individual related to the individual adopting the child, either naturally or through adoption.
3. Is or was a spouse of an individual listed above.

4. Met the definition of caretaker relative above before the child was adopted (notwithstanding the child's subsequent adoption).

If any of the preceding relationships are established through marriage, the relationship remains the same even if the marriage is terminated by death or divorce.

Definitions for Chapter 461: 461-001-0000
Requirement to Live With a Caretaker or Caretaker Relative: 461-120-0630

A non-needy caretaker relative is a caretaker relative (other than a parent) for TANF who is not required to apply for benefits with the dependent child, and does not wish to do so.

An individual is categorically eligible for SNAP benefits if the individual:

• Receives benefits or is authorized to receive GA or SSI benefits;

• Receives or is authorized to receive cash, in-kind benefits or services funded either under title IV-A of the Social Security Act or by the state as part of the TANF maintenance of effort;

• Is deemed to be receiving SSI under Section 1619(a) or 1619(b) of the Social Security Act (42 U.S.C. 1382h(a) or (b); or

• Is a member of a financial group with countable income less than 185 percent of the federal poverty level and has received a pamphlet about Information and Referral Services.

No filing group member is considered categorically eligible if a member of the filing group is disqualified from receiving SNAP due to an IPV or the head of household is disqualified for failure to comply with OFSET work requirements.

A SNAP filing group is considered categorically eligible when all its members are considered categorically eligible for SNAP benefits:

Categorical Eligibility for SNAP: 461-135-0505

1. For ERDC, child includes children who have no biological or legal relationship to the caretaker, but must be in the care and custody of the caretaker, must meet the citizenship or alien status requirements of OAR 461-120-0110, and must be:
   • Under age 18; or or
   • Under the age of 19 and in secondary school or vocational training at least half time.

   Definitions for Chapter 461: 461-001-0000
   Citizenship and Alien Status Requirements 461-120-0110

   F	See SNAP C.3.

2. For GA, GAM and OSIP, child means an individual under age 18.

3. For OHP, child means an individual, including a minor parent, who is under age 19.

4. For OSIPM and QMB, child means unmarried people living with their parent(s) and:
   • Under age 18; or

   • Under age 22 and attending full-time secondary, post-secondary or vocational/technical training designed to prepare the individual for employment.

Definitions for Chapter 461: 461-001-0000

1. Adult foster care - Room and board and 24-hour care and services for the elderly or for disabled people age 18 and older. The care is contracted to be provided in a home for five or fewer clients.

2. Assisted living facility - A program approach within a physical structure which provides or coordinates a range of services available on a 24-hour basis, for support of resident independence in a residential setting.

3. In-home services - People living in their home receiving services determined necessary by the department.

4. Residential care facility - A facility that provides residential care in one or more buildings on contiguous property for six or more individuals who have a physical disability or are socially dependent.

5. Specialized living facility - Identifiable services designed to meet the needs of individuals in specific target groups that exist as the result of a problem, condition or dysfunction resulting from a physical disability or a behavioral disorder and require more than basic services of other established programs.

6. Independent choices - In-Home Services Program participants given cash benefits to purchase self-directed personal assistance services or goods and services provdided pursuant to a weritten service plan.

Definitions: 411-030-0020
Definitions for Chapter 461: 461-001-0000

Overview of Costs: 461-160-0030

Definitions for Chapter 461: 461-001-0000

1. An individual who is not a caretaker relative of a child in the household, is unmarried or married but separated, and is under the age of 18, or is 18 and a full-time student in secondary school or the equivalent level of vocational or technical training; or
2. A minor parent whose parents have chosen to apply for benefits for the minor parent. This does not apply to a minor parent who is married and living with his or her spouse.

1. In the REF, SFPSS, TA-DVS and TANF programs, for purposes other than determining eligibility:
   • An individual with a physical or mental impairment that substantially limits the individual's ability to meet the requirements of the program; or
   • An individual with a physical or mental impairment that substantially limits one or more major life activities, a record of such impairment, or who is regarded as having such an impairment as defined by the Americans with Disabilities Act (42 USC 12102; 28 CFR 35.104).

2. In the SNAP program, an individual with a disability means an individual who meets any of the following:
   • Receives SSI benefits under title XVI of the Social Security Act; SSB benefits based on blindness or disability criteria under titles I, II, X, XIV or XVI of the Social Security Act; or OSIP, or other state or federal supplement under section 1616(a) of the Social Security Act.

   • Receives state general assistance benefits based upon disability or blindness criteria under title XVI of the Social Security Act; or is a recipient of disability-related medical assistance under title XIX of the Social Security Act; or receives interim assistance benefits pending the receipt of SSI.

   • Receives a state or federally administered supplemental benefit under section 212(a) of Public Law 93-66.

   • Receives an annuity payment under section 2(a)(l)(iv) of the Railroad Retirement Act of 1974 and is determined to be eligible for Medicare by the Railroad retirement Board; or section 2(a)(1)(iv) of the Railroad Retirement Act of 1974 and meets the disability criteria used under title XVI of the Social Security Act.

   • Receives VA benefits for nonservice or service-connected disability rated or paid as total under title 38 of the United States Code.

   • Receives disability retirement benefits from a governmental agency because of a disability considered permanent under section 221(i) of the Social Security Act.

     Note:

     PERS disability or workers compensation from SAIF or Department of Labor does not meet the requirements for SNAP disability because they are not based on SSA criteria.

   • Is the surviving spouse or surviving child of a veteran and considered by the VA to be entitled to compensation for a service connected death or pension benefits for a nonservice connected death under title 38 of the United State Code and has a disability considered permanent under section 221(i) of the Social Security Act.

   • Is a veteran or the surviving spouse of a veteran, considered by the VA to be in need of Aid and Attendance benefits under title 38 of the United States Code.

   • Is a veteran or the surviving spouse or child of a veteran and is considered permanently incapable of self-support under title 38 of the United States Code.

Definitions; SNAP: 461-001-0015

1. Attempting to cause or intentionally, knowingly or recklessly causing physical injury or emotional, mental or verbal abuse;
2. Intentionally, knowingly or recklessly placing another in fear of imminent serious physical injury;
3. Committing sexual abuse in any degree as defined in ORS 163.415, ORS 163.425 and ORS 163.427;
4. Using coercive or controlling behavior.

Definitions for Chapter 461: 461-001-0000

1. The department's option to rely on a determination, made within a reasonable period, by an ELA finding that a child satisfies the requirements for OHP-CHP or OHP-OPC program eligibility. ELE qualifies a child for medical assistance benefits based on a finding from another public agency, even when the other agency's eligibility methodology differs from that ordinarily used by the department to determine HKC, OHP-CHP and OHP-OPC program eligibility.

Definitions; SNAP: 461-001-0015

Definitions for Chapter 461: 461-001-0000

• A supervised shelter that provides temporary accommodations;

• A halfway house or residence for people who may become institutionalized;

• A temporary accommodation in another person's or family's residence for 90 days or less;

• A place not designed to be, or ordinarily used as a regular sleeping place for individuals to sleep, such as a hallway, bus station or similar place.

Definitions; SNAP: 461-001-0015

1. Adjusted income is countable income minus income deductions.

   Definitions for Chapter 461: 461-001-0000

2. Countable income is the amount of available income remaining after allowing exclusions.

   Definitions for Chapter 461: 461-001-0000
   Determining Availability of Income: 461-140-0040
   

3. Income deductions are specified amounts subtracted from countable income.

   Income Deductions; SNAP 461-160-0430

4. Deemed assets are the portion of the income and resources of an individual not in the financial group used to determine eligibility and benefit level for a financial group member.

   Deemed Assets; Overview: 461-145-0810

5. Earned income is income received in exchange for a person's physical or mental labor.

   Earned Income; Defined: 461-145-0120

6. In-kind income is compensation in a form other than money (such as food, clothing, cars, furniture and payments made to a third party).

7. Periodic income is income received on a regular basis less often than monthly.

8. Lump-sum income means income received too infrequently or irregularly to be reasonably anticipated, or received as a one-time payment. Lump-sum income includes:
   • Retroactive benefits covering more than one month, whether received in a single payment or several payments;

   • Income from inheritance, gifts, winnings and personal injury settlements.

Definitions for Chapter 461: 461-001-0000

1. Livestock, poultry and other animals;

2. Farmland, rental homes (including a room or other space in the home or on the property of a member of the financial group), vacation homes, condominiums.

• In all programs, the first month a benefit group (see OAR 461-110-0750) is eligible for a program benefit in Oregon after a period during which the group is not eligible;

• In all programs except the SNAP program, the first month a benefit group is eligible for a program benefit after there has been a break in the program benefit of at least one full calendar month. If benefits are suspended for one month, that is not considered a break;

• In the SNAP Program:
  • - The first month for which the benefit group is certified following any period during which they were not certified to participate, except for migrant and seasonal farmworkers (see OAR 461-001-0015);

  • - For migrant and seasonal farmworkers, the first month for which the benefit group is certified following any period of one month or more during which they were not certified to participate.

• In the OHP program, the first month of a redetermination or recertification period.

• For a new applicant to the GA, GAM, OSIP or OSIPM programs living in a nonstandard living arrangement, for the purposes of calculating the correct divisor in OAR 461-140-0296, the month in which the client would have been eligible had it not been for the disqualifying transfer of assets.

Definitions for Chapter 461: 461-001-0000

Definitions; SNAP: 461-001-0015

1. The statutes of the state where the marriage occurred;

2. The common law of the state in which the man and woman previously resided while meeting the requirements for common law marriage in that state; or

3. The laws of a country in which the man and woman previously resided while meeting the requirements for legal or cultural marriage in that country.

Definitions for Chapter 461: 461-001-0000

1. Is not a member of the filing group; and

2. Pays the filing group for room and board.

Definitions for Chapter 461: 461-001-0000

Definitions for Chapter 461: 461-001-0000

Definition; SNAP: 461-001-0015

Definitions for Chapter 461: 461-001-0000

1. Need is the amount at the Department of Human Services (DHS) payment standards that represents the client's need for items covered by the benefit.

2. Special needs are costs in addition to standard allowances. If required, they must be used to determine:
   • Initial eligibility and

   • Ongoing eligibility for nonwaivered GA clients and nonwaivered OSIP and OSIPM clients in SPD/AAA facilities and clients in mental health facilities.

Use of Payment Standards to Establish Need: 461-155-0010

1. In the GA, GAM, OSIP, OSIPM and QMB programs, a client is considered to be in a nonstandard living arrangement when the client is applying for or receiving services in any of the following locations:
   • A nursing facility in which the client receives long-term care services paid with Medicaid funding, except this subsection does not apply to a Medicare client in a skilled-stay nursing facility;

   • An intermediate-care facility for the mentally retarded (ICF/MR);

   • A psychiatric institution, if the individual is not yet 21 years of age or has reached the age of 65;

   • A community-based care setting, except a State Plan Personal care (SPPC) setting is not considered a nonstandard living arrangement.

2. In all programs except GA, GAM, OSIP, OSIPM and QMB, a nonstandard living arrangement means each of the following locations:
   • Foster care;

   • Residential care facilities;

   • Drug or alcohol residential treatment facilities;

   • Homeless or domestic violence shelters;

   • Lodging house if paying for room and board;

   • Correctional facilities;

   • Medical institutions.

Definitions for Chapter 461: 461-001-0000

1. Basic decision notice means a decision notice mailed no later than the date of action given in the notice.

2. Continuing decision notice means a decision notice that informs the client of the right to continued benefits and is mailed in time to be received by the date benefits are, or would be, received.

3. Timely continuing benefit decision notice means a decision notice that informs the client of the right to continued benefits. It is mailed no later than the time requirements in OAR 461-175-0050.

• For all programs except OHP and SNAP, any month following the initial month of eligibility, if there is no break in the program benefit of one or more calendar months.

• For OHP and SNAP, any month in the certification period following the initial month of eligibility.

Definitions for Chapter 461: 461-001-0000

1. If the mother lives with a male, and either she or the male claims that he is the father of the child/unborn and no one else claims to be the father, he is treated as the father even if paternity has not been legally established.

2. A stepparent relationship exists if:
   • The person is legally married to the child's biological or adoptive parent; and

   • The marriage has not been terminated by legal separation, divorce or death.

3. A legal adoption erases all prior legal and blood relationships and establishes the adoptive parent as the legal parent. However, the biological parent is also considered a parent if both of the following are true:
   • The child lives with the biological parent; and

   • The legal parent (the adoptive parent) has given up care, control and supervision of the child.

Definitions for Chapter 461: 461-001-0000

Definitions for Chapter 461: 461-001-0000

• For EXT, MAA, MAF and TANF the parent or caretaker relative.

• For ERDC, the caretaker.

• For GA, GAM, OSIP, OSIPM and QMB, the client or their spouse.

• For OHP, REF and REFM, the applicant, caretaker, caretaker relative or parent.

Definitions for Chapter 461: 461-001-0000

1. An adult in the filing group who is designated by the group to serve as the primary person. The household designates the primary person by identifying them as the applicant on the filing page of the application. This is most likely the person coded "head of household" in the FSMIS system. Where there is no adult, the group can designate another responsible person in the filing group.

2. Once the primary person has been designated, the filing group cannot choose a different person to be the primary person during the same certification period or during an OFSET/job quit disqualification period, unless there is a change in the composition of the household group.

Definitions; SNAP: 461-001-0015

1. Issued while the client was a resident in Oregon on January 1, 2008, or later; or

2. Issued in another state while the client was a resident of that state on or after the effective date of that state’s federally approved State Plan Amendment to issue qualified partnership policies.

• Other reported information;

• Other information provided on the application;

• Other information received by the branch office;

• Information reported on previous applications.

Verification; General: 461-115-0610 p>

Definitions for Chapter 461: 461-001-0000

• Employed on a farm or ranch performing field work related to planting, cultivation or harvesting operations; or

• Employed in a canning, packing, ginning, seed conditioning or related research or processing operation, and transported to or from the place of employment by means of a day-haul operation.

Definitions; SNAP: 461-001-0015

Definitions for Chapter 461: 461-001-0000

• Representing themselves as husband and wife to relatives, friends, neighbors or tradespeople, and

• Sharing living expenses or household duties.

Definitions for Chapter 461: 461-001-0000

Definitions for Chapter 461: 461-001-0000

Definitions for Chapter 461: 461-001-0000