Release 79: Effective October 1, 2015

Generic Program Information -
G.  Standards


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  1. Prorated standards; adjusted number in household
  2. Prorated standards are used only in the no-adult tables and the non-SSI/OSIP table. Prorated standards should not be applied to OSIPM waivered cases. The no-adult tables are used when there are no adults in TANF benefit groups. Prorated standards are based on the number of people in the benefit group, compared to the adjusted number in the household. To determine the adjusted number in the household to apply to the tables, use the total number in the household minus the following:

    Additionally for OSIP and OSIPM, do not count the biological and adoptive children of either spouse or recipients of GA, GAM, OSIP, OSIPM, QMB or TANF.

    Prorated Standards; Adjusted Number in Household Rule
    461-155-0020 — Prorated Standards; Adjusted Number in Household

  3. Income and payment standards
    1. Income and payment standards; REF and TANF

      The Countable Income Limit Standard is the amount set as the maximum countable income limit.

      For need groups containing an adult, use the following table:

      Countable Income Limit for Eligible
      Members in the Need Group
      No. of Eligible Members Amount
      1 $ 345
      2    499
      3    616
      4    795
      5    932
      6 1,060
      7 1,206
      8 1,346
      9 1,450
      10 1,622
      Each additional person    172

      Calculate the No-Adult Countable Income Limit Standard as follows:

      • #1 Refer to the Countable Income Limit Standard for need groups with adults whose needs are included. Use the standard for the number of people in the household.

      • #2 Divide the standard in #1 by the number of people in the household. Round this figure down to the next lower whole number if the figure is not a whole number.

      • #3 Multiply the figure from #2 by the number of people in the benefit group. The result is the standard.

      The Adjusted Income Limit is used as the adjusted income limit for benefit groups with an adult.

      Adjusted Income Limit
      Benefit Group - With Adult
      No. in Need Group Amount
      1 $ 326
      2    416
      3    485
      4    595
      5    695
      6    796
      7    886
      8    976
      9 1,039
      10 1,150
      Each additional person    110

      Calculate the No-Adult Adjusted Income Limit as follows:

      • #1 Refer to the Adjusted Income Standard for need groups containing adults whose needs are included. Use the standard for the number of people in the household.

      • #2 Divide the standard in #1 by the number of people in the household. Round this figure down to the next lower whole number if the figure is not a whole number.

      • #3 Multiply the figure from #2 by the number of people whose needs are included in the need group.

      • #4 Add $12 to the figure calculated in #3.

      Income and Payment Standards; JOBS, REF, TANF Rule
      461-155-0030 — Income and Payment Standards; JOBS, REF, TANF

    2. Payment standard for AFC and RCF; REF, TANF

      For REF and TANF, the payment standard for one person in AFC or RCF is the same as the adjusted income standard for a benefit group with one adult per OAR 461-155-0030. The payment, minus a $30 personal allowance for clothing and personal incidentals, is for room and board.

      Payment Standard for AFC and RCF; TANF Rule
      461-155-0050 — Payment Standard for AFC and RCF; TANF

    3. Income and payment standard; EA

      1. The income limit for EA is:

        • The TANF Adjusted Income/Payment Standard for benefit groups receiving services from CAF SSP.

        Example:

        For TANF clients, the TANF Adjusted Income/Payment Standard is the maximum amount of TANF benefits they can get in the payment month. For example, a client received $175 of TANF benefits in 1/99 based on his earned income in 12/98. The income limit for EA for this client is $175 if he applies for EA in 1/99, because that is the maximum amount of TANF benefits he can get in 1/99.

        • One hundred percent of the federal poverty level for benefit groups receiving services from Community Action Agencies (CAAs).

      2. EA benefits are limited to the following:

        • The minimum amount necessary to meet the emergent need.

        • Except for clients listed in the sections below, the maximum EA benefit amount for the 30-day eligibility period is $100.

        • The maximum EA benefit amount for the 30-day eligibility period is:

          • - $7,200 for services provided by Community Action Agencies to stabilize homeless benefit groups.

          • - Child Welfare provides emergency service payments for families that need child welfare intervention. These payments do not affect the client's eligibility for EA.

        • The amount of help needed to return a family to their state of former residence. Allow a reasonable amount for mileage, meals and lodging; however, the actual costs cannot exceed the EA maximum benefit amount. Document the allowance in the case record.

        • Payments for food cannot exceed the maximum SNAP allotment by household group size.

      Income and Payment Standard; EA Rule
      461-155-0070 — Income and Payment Standard; EA

    4. Child care payment rates and ERDC copay standard

      These child care payment rates apply to ERDC, JOBS, JOBS Plus and TANF. The following definitions apply to the child care rates:

      • Infant: A child age:

        • - Newborn to 1 year (12 months) for nonlicensed care; or

        • - Newborn to 2 years (24 months) for licensed care, registered or certified.

      • Toddler: A child age:

        • - 1 year (12 months) to 3 years for nonlicensed care; or

        • - 2 to 3 years for licensed care, registered or certified.

      • Preschool: A child age 3 years to 6 years;

      • School: A child age 6 years or older;

      • Special Needs: A child who meets the age requirement of the program (TANF or ERDC) and who requires a level of care over and above the norm for their age due to a physical, behavioral or mental disability.

      The disability must be verified by one of the following:

      • A physician, nurse practitioner, licensed/certified psychologist or clinical social worker;

      • Eligibility for Early Intervention and Early Childhood Special Education Programs or school-age Special Education Programs, or SSI.

      The need for a higher level of care must be determined by the provider, and verified by using the Special Need Child Care Rate Request (DHS 7486) form. The client must get the DHS 7486) from their worker and attach verification.

      Child care rate charts definitions:

      Standard rates:

      Family: Child care provided in the provider's own home. This rate also applies when care is provided in the home where the child lives.

      Center: Child care provided in a facility that is not located in a residential dwelling. The facility must be exempt per OAR 414-300-0000.

      Enhanced rates:

      Family: The provider has to meet established training requirements. Child care is provided in the provider's own home or the home of the child.

      Center: The child care is provided in a facility that is exempt from regulation with the Office of Child Care and whose staff meet training requirements of the Oregon Registry entry level established by the Oregon Center for Career Development in Childhood Care and Education.

      Licensed rates:

      Registered
      Family:
      The provider has to meet training requirements established by the Office of Child Care.

      Certified
      Family:
      The facility must be certified by the Office of Child Care. Child care is provided in a facility that is not located in a residential dwelling.

      Certified
      Center:
      The facility must be certified by the Office of Child Care. Child care is provided in a residential dwelling. To earn this designation, both the provider and the facility are required to meet certain standards not required of a family provider.

      The monthly limit for child care payments is the lesser of the following:

      1. The DHS monthly rate for the type of care and area per item (4) below; or

      2. The allowed child care hours in the Child Care program chapter G (CC‑G), multiplied by the DHS hourly rate for the type of care and area per item (4) below; or

      3. Additionally for ERDC and TANF:

        • Work hours multiplied by 125 percent multiplied by the hourly rate for the type and area of care; or

        • For clients in employment that does not pay an hourly wage or salary, the limit is one hour of child care for each hourly equivalent of the state minimum wage anticipated to be earned (CC-G).The amount is multiplied by 125 percent.

          The system automatically multiplies the figure in CC Work Hrs by 125 percent to allow for meal and commuting time.

      4. The allowed child care rate is the lesser of the following:

        1. The actual rate charged by the child care provider; OR

        2. The DHS rate for the type of care provided.

        3. In addition, providers are paid at an hourly rate for children usually in care less than 158 hours a month for the standard rate or 62 hours a month for the enhanced and licensed rate.

        Child care rates (see CC-I): The rates are based on the type of provider, the location of the provider (shown by zip code), the age of the child and the type of billing used (i.e., hourly or monthly).

      Determining the copay

      The copay is calculated by a mathematical formula that gradually increases the copay as family income increases. The income limit for families newly applying for ERDC is 185  percent of the Federal Poverty Level. The income limit for families during their certification and at recertification is higher (see CC-F.2). The ERDC copay calculator can be found at https://apps.state.or.us/cf1/ERDC/ and will supply an estimate of a family’s copay.

      To determine the copay amount, enter the number of persons in the ERDC need group in the Choose Family Size field. Make sure to include all adult members of the need group as well as older children who do not need child care. Enter the monthly gross income and click on Calculate.

      ERDC Initial Certification Income Limit
      # in ERDC Group Gross Income Limit
      (185% of 2015 FPL)
      2    $2,457
      3    $3,099
      4    $3,739
      5    $4,381
      6    $5,023
      7    $5,663
      8 or more    $6,305

      ERDC Ongoing and Recertification Income Limit
      Number in ERDC Group Gross Income
      2    $3,994
      3    $4,362
      4    $5,089
      5    $5,919
      6    $6,785
      7    $7,652
      8 or more    $8,519

      Child Care Eligibility Standard, Payment Rates, and Copayments Rule
      461-155-0150(9) — Child Care Eligibility Standard, Payment Rates, and Copayments

      Poverty Related Income Standards; Not OSIP, OSIPM, QMB Rule
      461-155-0180 — Poverty Related Income Standards; Not OSIP, OSIPM, QMB

      Use of Income to Determine Eligibility and Benefits for ERDC Rule
      461-160-0300 — Use of Income to Determine Eligibility and Benefits for ERDC

    5. Income and payment standards; SNAP

      SNAP Countable and Adjusted Income Limits:

      Eligible Members
      Group Size
      Countable
      Income Limit
      Adjusted
      Income Limit
      1 $1,276 $  981
      2   1,726  1,328
      3   2,177  1,675
      4   2,628  2,021
      5   3,078  2,368
      6   3,529  2,715
      7   3,980  3,061
      8   4,430  3,408
      Each additional person     451     347

      SNAP payment standard (Thrifty Food Plans):

      SNAP Payment Standard (TFP)
      No. in Eligible Members Group Amount
      1 $194
      2  357
      3  511
      4  649
      5  771
      6  925
      7 1,022   
      8 1,169   
      Each additional person  146

      Income and Payment Standards; SNAP Rule
      461-155-0190 — Income and Payment Standards; SNAP

    6. Basic standard; GA, GAM

      There is no countable income standard for GA or GAM.

      The standard includes shelter, food and energy assistance. The Basic Standard is $309 for a one-person benefit group (including clients in room and board) and $618 for a two-person benefit group.

      The basic standard for all GA and GAM clients in Adult Foster Care (AFC), Assisted Living Facilities (ALF), a Residential Care Facility (GCH/RCF), satellite apartments or MHDDSD Substitute Homes is $292 for room and board, plus $40 personal allowance for clothing and personal incidentals.

      For GA and GAM clients in nursing facilities, $30 is allowed for clothing and personal incidentals.

      Payment Standard; GA, GAM Rule
      461-155-0210 — Payment Standard; GA, GAM

    7. Income and payment standard; OSIP, OSIPM

      For OSIP and OSIPM (except OSIP-EPD, OSIPM-EPD) in long-term care and in waivered nonstandard living arrangements, the Countable Income Limit Standard is 300 percent of the SSI standard. Use the one-person SSI standard for an individual who has no income and is living alone in the community to compute the Countable Income Limit. Other OSIP and OSIPM cases do not have a countable income limit.

      The non-SSI OSIP and OSIPM (except OSIP-EPD, OSIPM-EPD) adjusted income standard takes into consideration the need for housing, utilities, food, clothing, personal incidentals and household supplies.

      The payment standard is used as the adjusted income limit and to calculate cash benefits for non-SSI OSIP cases. The OSIP-AB Adjusted Income/Payment Standard includes a transportation allowance.

      The total standard is:

      Non-SSI/OSIP and OSIPM Adjusted Income Standards
        One Person in Need Group Two People in Need Group
      Adjusted No. in Household One Two or More Two Three or More
      AD/OAA 675.70 451.03 1011.00 674.00
      AB 700.70 476.03 1036.00 699.00

      The payment standard for SSI/OSIP cases living in the community is the SIP amount. The SIP (Supplemental Income Payment) is a need amount added to any other special or service needs to determine the actual payment.

      For clients whose unearned income minus any
      SSI or Veterans Nonservice-Connected
      Disability Benefits is less than $20:

      SSI/OSIP and OSIPM Payment Standard
      (Unearned Income Less Than $20)
      No. in Need Group AD/OAA AB
        SIP (need) SIP (need)
      1 1.70 26.70
      2 0.00 25.60

      For clients whose unearned income minus any
      SSI or Veterans Nonservice-Connected
      Disability Benefits is $20 or more:

      SSI/OSIP and OSIPM Payment Standard
      (Unearned Income $20 or More)
      No. in Need Group AD/OAA AB
        SIP (need) SIP (need)
      1 0.00 18.70
      2 0.00 17.60

      The SSI/OSIP-AB standard includes a transportation allowance. The standard for two assumes one individual is blind and the other is not. If both are blind, $20 is added to the SIP amount.

      For SSI couples in AFC, ALF or RCF, an amount is added to each person's SIP entry that equals the difference between the individual's income (including SSI and other income) and the OSIP standard for a one-person need group.

      For SSI couples in AFC, ALF, or RCF, create a separate CMS record for each person.

      In the OSIP and OSIPM programs, individuals in long-term care, a nursing facility, or an ICF-MR are allowed the following amounts for clothing and personal incidentals:

      • For clients who receive a VA pension based on unreimbursed medical expenses (UME), $90 is allowed;

      • For all other clients, $30 is allowed.

      For OSIP-EPD and OSIPM-EPD, the Adjusted Income Limit is 250 percent of the Federal Poverty Level for a family of one. For the current income standards for OSIP-EPD and OSIPM-EPD, see the APD Worker Guide on EPD: http://www.dhs.state.or.us/spd/tools/program/osip/wg11.htm

      Income and Payment Standards; OSIPM Rule
      461-155-0250 — Income and Payment Standards; OSIPM

    8. Payment standard for NSLA; OSIP, OSIPM

      For all OSIP and OSIPM cases in a waivered nonstandard living arrangement (see OAR 461-001-0000), the OSIP/OSIPM Income Standard is allocated as follows:

      1. Room and board allowance is $523.70 amounts listed in OAR 461-155-0270.

      2. Personal needs allowance:

         NON-SSI/SSB Combo Cases SSI/SSB Combo Cases
      Program
      AD/OAA $152.00 $172.00
      AB $177.00 $189.00

      Room and Board Standard; OSIPM Rule
      461-155-0270 — Room and Board Standard; OSIPM

    9. Income standard; QMB-BAS

      The Adjusted Income Standard for QMB-BAS is as follows. It is 100 percent of the 2009 federal poverty level.

      QMB-BAS Adjusted Income Standard
      No. in Need Group Amount
      1 $903
      2  1,215
      3  1,526
      4  1,838
      5  2,150
      6  2,461
      7 2,773
      8 3,085
      9  3,396
      10 3,708
      Each additional person  312

      Income Standard; QMB-BAS Rule
      461-155-0290 — Income Standard; QMB-BAS

    10. Income standard; QMB-DW

      The Adjusted Income Standard for QMB-DW is as follows. It is 200 percent of the 2009 federal poverty level.

      QMB-DW Adjusted Income Standard
      No. in Need Group Amount
      1 $1,805
      2  2,429
      3  3,052
      4  4,299
      5  2,150
      6  4,922
      7 5,545
      8 6,169
      9  6,792
      10 7,415
      Each additional person  624

      Income Standard; QMB-DW Rule
      461-155-0291 — Income Standard; QMB-DW

    11. Income standard; QMB-SMB

      The Adjusted Income Standard for QMB-SMB is as follows. It is 120 percent of the 2009 federal poverty level.

      QMB-SMB Adjusted Income Standard
      (Case Descriptor SMB)
      Income greater than 100% but not less than 120% of the Federal Poverty Level
      No. in Need Group Amount
      1 $1,083
      2  1,457
      3  1,831
      4  2,205
      5  2,579
      6  2,953
      7 3,327
      8 3,701
      9  4,075
      10 4,449
      Each additional person  374

      QMB-SMB Adjusted Income Standard
      (Case Descriptor SMF)
      Income greater than 120% but less than 135% of the Federal Poverty Level
      No. in Need Group Amount
      1 $1,219
      2  1,640
      3  2,060
      4  2,481
      5  2,902
      6  3,323
      7 3,743
      8 4,164
      9  4,585
      10 5,006
      Each additional person  421

      Income Standard; QMB-SMB, QMB-SMF Rule
      461-155-0295 — Income Standard; QMB-SMB, QMB-SMF

    12. Shelter-in-Kind Standard

      For OSIP, OSIPM, and QMB, the Shelter-in-Kind Standard is:

      For a single person:

      • Living alone, $415 for total shelter or $250 for housing costs only;

      • Living with others, $193 for total shelter or $115 for housing costs only;

      For a couple:

      • Living alone, $513 for total shelter or $308 for housing costs only;

      • Living with others, $190 for total shelter or $114 for housing costs only.

      Shelter-in-Kind Standard Rule
      461-155-0300 — Shelter-in-Kind Standard

    13. Special Shelter Allowance; REF, TANF

      The Special Shelter Allowance is included in the REF and TANF Payment. It is an advance of the ERA refund per ORS 412.155.

      Special Shelter Allowance
      No. in Eligible Members Group Amount
      1 $22.35
      2  22.35
      3  21.14
      4  20.34
      5  19.53
      6  18.73
      7 17.92
      8 17.12
      9  16.32
      10 or more 14.71

      Special Shelter Allowance; REF, TANF Rule
      461-155-0310 — Special Shelter Allowance; REF, TANF

    14. Minimum Contribution Standard

      The Minimum Contribution Standard is used to determine which portion of a lodger's income is excluded for REF and TANF.

      Minimum Contributions
      (Amount each nonrecipient pays)
      No. in Benefit Group One
      Nonrecipient
      Each of two
      Nonrecipients
      1 $214 $152
      2  164  146
      3  146  130
      4  130  124
      5  124  121
      6  121  118
      7  118  109
      8  109  105
      9  105  102
      10+  105  102
      *Use $98 for each nonrecipient over two.

      Minimum Contribution Standard Rule
      461-155-0350 — Minimum Contribution Standard

    15. Cost-effective health insurance premiums

      For GAM, OSIPM and REFM, use the following to determine if an employer-sponsored health plan is cost-effective:

      • Determine the premium amount for employer-sponsored health insurance paid by a member of the household;

      • Based on the number in the benefit group, determine the maximum cost-effective premium amount for members of the benefit group from the following tables:

      GAM/REFM
      # in Benefit Group covered
      by insurance
      Cost-effective premium amount
      (Employee cost)
      1 $ 82
      2 $164
      3 $246
      4 $328
      5 $410
      6 $492
      7 $574
      8 $656
      9+ $738

      OSIPM-AB
      # in Benefit Group covered
      by insurance
      Cost-effective premium amount
      (Employee cost)
      1 $145
      2 $289

      OSIPM-AD
      # in Benefit Group covered
      by insurance
      Cost-effective premium amount
      (Employee cost)
      1 $167
      2 $334

      OSIPM-OAA
      # in Benefit Group covered
      by insurance
      Cost-effective premium amount
      (Employee cost)
      1 $147
      2 $294

      • The insurance is cost effective if the employee's share of the premium is equal to or less than the amount in second subparagraph of this rule;

      • If the health-insurance premium is cost effective, the department will reimburse the actual amount of the premium, not to exceed the cost-effective amount for the number of persons in the benefit group who are covered by the insurance.

Pursuit of Cost-Effective Employer Sponsored Health Insurance Rule
461-155-0360 — Pursuit of Cost-Effective Employer Sponsored Health Insurance


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