Retrospective/prospective Eligibility And Budgeting

Link to law: http://arcweb.sos.state.or.us/pages/rules/oars_400/oar_461/461_150.html
Published: 2015

The Oregon Administrative Rules contain OARs filed through November 15, 2015

 

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DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS









 

DIVISION 150
RETROSPECTIVE/PROSPECTIVE ELIGIBILITY AND BUDGETING

461-150-0020
Prospective Eligibility and Budgeting
For prospective eligibility (see OAR
461-001-0000) and budgeting (see OAR 461-001-0000):
(1) The budget month (see
OAR 461-001-0000) and payment month (see OAR 461-001-0000) are the same.
(2) The client's anticipated
income, household composition, and other relevant factors are used to determine
the client's eligibility and benefit level. The client and Department jointly anticipate
the client's income based on the income already received and the income the client
expects to receive.
(3) Prospective budgeting
is used for annualized income and prorated educational income.
(4) When prospective budgeting
is used and the actual income differs from the amount determined under section (2)
of this rule:
(a) If the anticipated income
exceeds the actual income, a client is not entitled to a benefit supplement.
(b) If the actual income
exceeds the anticipated income, there may be a client-error overpayment under OAR
461-195-0521.
Stat. Auth.: ORS 411.060, 411.404, 411.816,
412.049
Stats. Implemented: ORS 411.060,
411.404, 411.816, 412.049
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 20-1992, f. 7-31-92, cert. ef. 8-1-92; AFS 3-2000, f. 1-31-00,
cert. ef. 2-1-00; AFS 7-2001(Temp), f. & cert. ef. 4-4-01 thru 6-30-01; AFS
12-2001, f. 6-29-01, cert. ef. 7-1-01; SSP 7-2004(Temp), f. & cert. ef. 4-1-04
thru 6-30-04; SSP 17-2004, f. & cert. ef. 7-1-04; SSP 13-2009, f. & cert.
ef. 7-1-09; SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14; SSP 38-2013,
f. 12-31-13, cert. ef. 1-1-14
461-150-0042
Prospective Eligibility and Budgeting; EA
In the EA program, the Department uses prospective eligibility (see OAR 461-001-0000) and budgeting (see OAR 461-001-0000) as follows:
(1) For the month of application, prospective eligibility is used, including for a client who leaves a filing group (see OAR 461-110-0310) because of domestic violence.
(2) For budgeting, OAR 461-160-0140 is used to determine benefit level.
Stat. Auth.: ORS 411.060

Stats. Implemented: ORS 411.060

Hist.: AFS 13-1991, f. & cert. ef. 7-1-91; AFS 19-1993, f. & cert. ef. 10-1-93; SSP 17-2004, f. & cert. ef. 7-1-04; SSP 13-2009, f. & cert. ef. 7-1-09
461-150-0050
Prospective Eligibility and Budgeting; GA, GAM, OSIP, OSIPM, QMB
In the GA, GAM, OSIP, OSIPM, and QMB programs, the Department uses prospective eligibility (see OAR 461-001-0000) and budgeting (see OAR 461-001-0000) as follows:
(1) In the GA, GAM, OSIP (except OSIP-IC), OSIPM (except OSIPM-IC), and QMB programs:
(a) For the initial month (see OAR 461-001-0000), the Department uses prospective eligibility and budgeting. Money received from a nonrecurring source before the date of application is excluded. If any money remains after the date of application, it is counted as a resource.
(b) For each ongoing month (see OAR 461-001-0000) the Department uses prospective eligibility and budgeting.
(2) In the OSIP-IC and OSIPM-IC programs, the budget month (see OAR 461-001-0000) is the initial month of eligibility.
Stat. Auth.: ORS 411.060

Stats. Implemented: ORS 411.060

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00; AFS 17-2000, f. 6-28-00, cert. ef. 7-1-00; AFS 11-2001, f. 6-29-01, cert. ef. 7-1-01; SSP 10-2003(Temp) f. & cert. ef. 5-1-03 thru 9-30-03; SSP 26-2003, f. & cert. ef. 10-1-03; SSP 24-2004, f. 12-30-04, cert. ef. 1-1-05; SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09; SSP 13-2009, f. & cert. ef. 7-1-09; SSP 32-2010, f. & cert. ef. 10-1-10
461-150-0060
Prospective or Retrospective Eligibility
and Budgeting; ERDC, REF, REFM, SNAP, TANF
In the ERDC, REF, REFM, SNAP, and TANF
programs, the Department determines how and when to use prospective or retrospective
eligibility (see OAR 461-001-0000) and budgeting (see OAR 461-001-0000) as follows:
(1) For the initial month
(see OAR 461-001-0000):
(a) In the ERDC program,
income is budgeted so the anticipated amount is the same for each month, including
the initial month.
(b) For a SNAP case in CRS,
the Department uses "actual income" (see subsection (h) of this section) in the
initial month.
(c) For a SNAP program case
in SRS, "actual income" is used in the initial month if that income is not reflective
of ongoing monthly income due to a new or terminated source or a significant change
in ongoing income. All other income is processed under section (3) of this rule.
(d) In the REF and TANF programs,
ongoing income, processed under section (2) of this rule, is used in the initial
month, except when the source of income is a new or terminated source. When there
is a new or terminated source of income, "actual income" is used in the initial
month.
(e) In the REFM program,
the Department uses only the initial month for eligibility and budgeting.
(f) The Department uses prospective
eligibility and budgeting under OAR 461-150-0020 for cases not covered under subsections
(a) to (e) of this section, including for an individual who leaves a filing group
(see OAR 461-110-0310) because of domestic violence (see OAR 461-001-0000) and enters
a domestic violence shelter (see OAR 461-001-0000) or safe home (see OAR 461-001-0000).
(g) No supplement is issued
based on incorrectly anticipated information.
(h) "Actual income" means
income already received in the initial month plus all the income that reasonably
may be expected to be received within the initial month.
(2) Income is budgeted so
that the anticipated amount is the same for each month. The type of income is determined
and calculated as follows:
(a) Income that must be annualized
is calculated under OAR 461-150-0090 to arrive at a monthly figure.
(b) Educational income (see
OAR 461-145-0150) is assigned to the months it is intended to cover, regardless
of when it is received. The income is prorated over these months.
(c) Ongoing stable income
(see OAR 461-001-0000) is anticipated under OAR 461-150-0070.
(d) Ongoing variable income
(see OAR 461-001-0000) is anticipated under OAR 461-150-0080.
(e) Periodic income (see
OAR 461-001-0000) is anticipated under OAR 461-140-0110.
(f) Lump-sum income (see
OAR 461-001-0000) is anticipated under OAR 461-140-0120.
(3) For an ongoing month
(see OAR 461-001-0000):
(a) For a benefit group (see
OAR 461-110-0750), the Department uses prospective eligibility and budgeting. The
type of income is determined and calculated under section (2) of this rule.
(b) If the budgeting method
changes from prospective to retrospective, the Department treats income from a terminated
source that was counted prospectively as follows:
(A) If the actual amount
received was less than or equal to the anticipated amount, the income is excluded.
(B) If the actual amount
received was greater than the anticipated amount, the Department counts the difference
between actual and anticipated amounts.
(4) When an individual is
added to an ongoing filing and benefit group, prospective budgeting is used to determine
eligibility.
(5) In the SNAP program,
income reported on the Interim Change Report form under OAR 461-170-0011 and 461-170-0102
is used to determine eligibility and benefit level. Income for the fifth month of
the SNAP program certification period (see OAR 461-001-0000) is used to determine
the income for the seventh and following months in the certification period if the
individual anticipates the income will remain the same throughout the period. If
the individual anticipates the income will change, the individual and the Department
jointly estimate the income for the remaining months of the certification period.
For an individual who had self-employment income annualized, no change is made unless
there is a substantial change in the revenue of the business.
Stat. Auth.: ORS 409.050, 411.060, 411.070,
411.404, 411.816, 412.049
Stats. Implemented: ORS 409.010,
409.050, 409.610, 411.060, 411.070, 411.404, 411.816, 412.049
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 20-1990, f. 8-17-90, cert. ef. 9-1-90; AFS 30-1990, f. 12-31-90,
cert. ef. 1-1-91; AFS 19-1993, f. & cert. ef. 10-1-93; AFS 6-1994, f. &
cert. ef. 4-1-94; AFS 13-1994, f. & cert. ef. 7-1-94; AFS 10-1995, f. 3-30-95,
cert. ef. 4-1-95; AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97; AFS 9-1997, f. &
cert. ef. 7-1-97; AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00; AFS 6-2001, f. 3-30-01,
cert. ef. 4-1-01; SSP 10-2007, f. & cert. ef. 10-1-07; SSP 13-2009, f. &
cert. ef. 7-1-09; SSP 5-2010, f. & cert. ef. 4-1-10; SSP 13-2013, f. & cert.
ef. 7-1-13; SSP 19-2013(Temp), f. 7-31-13, cert. ef. 8-1-13 thru 1-28-14; SSP 28-2013(Temp),
f. & cert. ef. 10-1-13 thru 1-28-14; SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14;
SSP 23-2015, f. 9-28-15, cert. ef. 10-1-15
461-150-0070
Prospective Budgeting of Stable
Income
(1) Stable income (see OAR 461-001-0000)
in prospective budgeting (see OAR 461-001-0000) and eligibility (see OAR 461-001-0000)
is treated so that the monthly amount is used to anticipate the income of the financial
group (see OAR 461-110-0530). The amount of stable income for each month is determined
as follows:
(a) If paid once per month,
that amount is used.
(b) If paid twice per month
or semi-monthly, that amount is converted to a monthly amount by multiplying it
by two.
(c) If paid once every other
week or biweekly, that amount is converted to a monthly amount by multiplying it
by 2.15.
(d) If paid once per week,
that amount is converted to a monthly amount by multiplying it by 4.3.
(2) In the SNAP program,
stable income the client expects to receive less often than monthly is treated as
periodic income (see OAR 461-001-0000) under OAR 461-140-0110.
Stat. Auth.: ORS 411.060, 411.404, 411.816,
412.049
Stats. Implemented: ORS 411.060,
411.404, 411.816, 412.049
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 12-1990, f. 3-30-89, cert. ef. 4-1-90; AFS 2-1992, f. 1-30-92,
cert. ef. 2-1-92; AFS 20-1992, f. 7-31-92, cert. ef. 8-1-92; AFS 12-1993, f. &
cert. ef. 7-1-93; AFS 12-2001, f. 6-29-01, cert. ef. 7-1-01; SSP 15-2006, f. 12-29-06,
cert. ef. 1-1-07; SSP 13-2009, f. & cert. ef. 7-1-09; SSP 30-2013(Temp), f.
& cert. ef. 10-1-13 thru 3-30-14; SSP 38-2013, f. 12-31-13, cert. ef. 1-1-1
461-150-0080
Prospective Budgeting of Variable
Income; Not OHP; Not MRS
Variable income (see OAR 461-001-0000)
is used as follows in prospective budgeting (see OAR 461-001-0000) and eligibility
(see OAR 461-001-0000) so that the anticipated amount is the same for each month,
except as specified in OAR 461-150-0060 and section (6) of this rule:
(1) For income paid more
than once per month, determine an average amount per pay period in accordance with
sections (2) to (4) of this rule. The average amount is then converted to a monthly
amount as follows, if paid:
(a) Twice per month, multiply
by 2;
(b) Every other week, multiply
by 2.15; or
(c) Once per week, multiply
by 4.3.
(2) For variable earned income
based on an hourly wage when the past is representative, monthly income is determined
by calculating an average number of hours per pay period, then these hours are multiplied
by the hourly wage and converted to a monthly amount under section (1) of this rule.
(3) For variable earned income
involving various rates of pay (overtime, shift differential, tips) when the past
is representative, monthly income is determined by calculating the average income
per pay period, then the average income is converted to a monthly amount under section
(1) of this rule.
(4) For variable earned or
unearned income when the past is representative and income cannot be calculated
under section (2) or (3) of this rule, monthly income is determined by averaging
the income over:
(a) A representative period
of months by totaling the income for those months and dividing by the number of
months used; or
(b) A representative number
of pay periods and converting to a monthly amount under section (1) of this rule.
(5) For variable earned and
unearned income when the past is not representative of the income the financial
group (see OAR 461-110-0530) will receive during the eligibility period, the client
and the Department jointly determine the anticipated income.
(6) In the SNAP program,
a financial group meeting the definition of "destitute household" in OAR 461-135-0575
is not eligible to use the income averaging option for the initial month (see OAR
461-001-0000) of eligibility or the first month of a new certification period. For
a destitute financial group, income for the initial month of eligibility and the
first month of a certification period is determined under OAR 461-150-0100, thereafter,
the financial group is subject to sections (2) to (5) of this rule.
Stat. Auth.: ORS 411.060, 411.070, 411.404,
411.816, 412.014, 412.049
Stats. Implemented: ORS 411.060,
411.070, 411.404, 411.816, 412.014, 412.049
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 2-1992, f. 1-30-92, cert. ef. 2-1-92; AFS 13-1992, f. &
cert. ef. 5-1-92; AFS 20-1992, f. 7-31-92, cert. ef. 8-1-92; AFS 28-1992, f. &
cert. ef. 10-1-92; AFS 12-1993, f. & cert. ef. 7-1-93; AFS 2-1994, f. &
cert. ef. 2-1-94; AFS 23-1995, f. 9-20-95, cert. ef. 10-1-95; AFS 9-1997, f. &
cert. ef. 7-1-97; AFS 8-1998, f. 4-28-98, cert. ef. 5-1-98; AFS 9-1999, f. &
cert. ef. 7-1-99; AFS 9-1999, f. & cert. ef. 7-1-99; AFS 34-2000, f. 12-22-00,
cert. ef. 1-1-01; AFS 12-2001, f. 6-29-01, cert. ef. 7-1-01; SSP 15-2006, f. 12-29-06,
cert. ef. 1-1-07; SSP 13-2009, f. & cert. ef. 7-1-09; SSP 25-2012, f. 6-29-12,
cert. ef. 7-1-12; SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14; SSP
38-2013, f. 12-31-13, cert. ef. 1-1-1
461-150-0090
Prospective Budgeting: Annualizing
and Prorating Contracted or Self-employment Income
In all programs except the REFM program:
(1) Income from self-employment,
including contract income while self-employed, is treated in accordance with OAR
461-145-0910 unless the income meets the provisions of section (2) of this rule.
(2) If past contract income
is not representative of future income or when a substantial increase or decrease
is expected in countable (see OAR 461-001-0000) self-employment income (see OAR
461-145-0910) in the next year, costs as allowed under OAR 461-145-0930 and anticipated
income are used to determine the countable income.
(3) In the ERDC, REF, SNAP,
and TANF programs, contract income that does not meet the criteria of self-employment
income (see OAR 461-145-0910) is treated as follows:
(a) Income received during
a less than 12-month period but intended as a full year's income is annualized.
(b) Income received on an
hourly or piecework basis or monthly over the term of the contract period is not
annualized. It is treated as stable income (see OAR 461-001-0000) under OAR 461-150-0070
or variable income (see OAR 461-001-0000) under OAR 461-150-0080.
(4) Contract income that
is not the annual income of the financial group (see OAR 461-110-0530) and not paid
on an hourly or piecework basis is prorated over the period the income is intended
to cover.
Stat. Auth.: ORS 409.050, 411.060, 411.070,
411.816, 412.014, 412.049
Stats. Implemented: ORS 409.010,
409.050, 411.060, 411.070, 411.816, 412.014, 412.049
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 13-1992, f. & cert. ef. 5-1-92; AFS 20-1992, f. 7-31-92,
cert. ef. 8-1-92; AFS 12-1993, f. & cert. ef. 7-1-93; AFS 2-1994, f. & cert.
ef. 2-1-94; SSP 4-2005, f. & cert. ef. 4-1-05; SSP 7-2005, f. & cert. ef.
7-1-05; SSP 13-2009, f. & cert. ef. 7-1-09; SSP 37-2009(Temp), f. & cert.
ef. 12-1-09 thru 5-30-10; SSP 5-2010, f. & cert. ef. 4-1-10; SSP 30-2013(Temp),
f. & cert. ef. 10-1-13 thru 3-30-14; ; SSP 38-2013, f. 12-31-13, cert. ef. 1-1-14;
SSP 25-2015, f. 9-29-15, cert. ef. 10-1-15
461-150-0095
Prospective Budgeting: Averaging
and Estimating Self-employment Income; OSIP, OSIPM, QMB
(1) Net earnings from self-employment
are counted on a taxable year basis by dividing the total earnings by twelve to
arrive at a monthly amount.
(2) Only net losses from
self-employment that are documented are divided over the taxable year in the same
way as net earnings and excluded only from other earned income of the financial
group (see OAR 461-110-0530 and 461-145-0130).
(3) When a self-employed
individual is engaged in a business or trade which is neither seasonal nor has income
peaks at certain parts of the year, estimate net earnings from self-employment for
the current taxable year in the following sequence:
(a) When the individual has
been conducting the same trade or business for two or more years, has had fairly
constant net earnings from self-employment from year-to-year, and anticipates no
change or gives no convincing explanation why current net earnings would be substantially
different from past net earnings, use the net earnings from the prior year as an
estimate for the current taxable year.
(b) When an individual has
been engaged in the same business for only the preceding taxable year, anticipates
no change or gives no convincing explanation why current net earnings would be substantially
different from the previous taxable year:
(A) Calculate the ratio between
net profit or loss and gross receipts from the last year;
(B) Calculate the actual
gross receipts from the individual’s current records and project them for
the remainder of the year; and
(C) Apply the gross-to-net
ratio calculated in paragraph (A) of this subsection to the current year’s
projected gross calculated in paragraph (B) of this subsection to arrive at the
estimated net earnings.
(c) When an individual is
engaged in a new business, project the income received to date for the remainder
of the year as follows:
(A) Calculate the net earnings
from the individual’s profit and loss statement or other business records
for the taxable year to date; and
(B) Average the monthly net
earnings by dividing the net income received to date by the number of months that
have elapsed.
(d) Accept the individual’s
estimate for the net earnings when an individual is engaged in one of the following:
(A) A new business for which
there are insufficient net earnings to date.
(B) At initial application
only, an existing business for which records were not kept.
(C) An existing business
with anticipated income that varies from past years and a convincing explanation
is given for the variation.
(4) When a self-employed
individual is engaged in a trade or business that is seasonal or has income peaks
at certain parts of the year, estimate net earnings from self-employment for the
current taxable year in the following sequence:
(a) When the individual has
been conducting the same trade or business for at least one full taxable year, anticipates
no change or gives no convincing explanation why current net earnings would be substantially
different from past net earnings, use the net earnings from the prior year as an
estimate for the current taxable year.
(b) Accept the individual’s
estimate for the net earnings when an individual is engaged in one of the following:
(A) A new business.
(B) At initial application
only, an existing business for which records were not kept.
(C) An existing business
with anticipated income that varies from past years and a convincing explanation
is given for the variation.
Stat. Auth.: ORS 409.050, 411.060, 411.070,
411.404, 411.706, 413.085, 414.685
Stats. Implemented: ORS 409.010,
409.050, 411.060, 411.070, 411.404, 411.706, 413.085, 414.685, 414.839
Hist.: SSP 25-2015, f. 9-29-15,
cert. ef. 10-1-15
461-150-0100
Initial Month Prospective Budgeting for Destitute Filing Groups; SNAP
For a destitute (see OAR 461-135-0575) filing group, only the following income is used to determine eligibility (see OAR 461-001-0000) and benefit level in the initial month (see OAR 461-001-0000) or the first month of the certification period (see OAR 461-001-0000):
(1) Income received from the first of the month through the filing date (see OAR 461-115-0040); and
(2) Income received after the filing date that is regular and ongoing. Income from a new source anticipated to be received after the filing date is not used.
Stat. Auth.: ORS 411.816

Stats. Implemented: ORS 411.816

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 13-1992, f. & cert. ef. 5-1-92; SSP 13-2009, f. & cert. ef. 7-1-09


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