General Financial Eligibility

Link to law: http://arcweb.sos.state.or.us/pages/rules/oars_400/oar_461/461_140.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 140
GENERAL FINANCIAL ELIGIBILITY

461-140-0010
Assets; Income and Resources
(1) An available asset, either income or a resource, is categorized as either excluded or countable (defined in OAR 461-001-0000).
(2) The availability of resources is covered in OAR 461-140-0020.
(3) The availability of income is covered in OAR 461-140-0040.
(4) Excluded assets are identified in the rules in this chapter (see divisions 140 and 145 in particular) and are not considered when a client's eligibility and benefit level are determined.
(5) In the GA, GAM, OSIP, OSIPM, and QMB programs, an asset excluded pursuant to a rule in OAR Chapter 461 remains excluded as long as the asset is used in a manner consistent with the rule that provided the exclusion.
(6) An available asset not specifically excluded is countable, and its value is used in determining the eligibility and benefit level of a client.
(7) An asset may not be counted as a resource and as income in the same month.
Stat. Auth: ORS 411.060, 411.070, 411.816, 412.049

Stats. Implemented: ORS 411.060, 411.070, 411.816, 412.049

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06; SSP 17-2008, f. & cert. ef. 7-1-08
461-140-0020
Availability of Resources
(1) Except as provided in sections (2)
to (4) of this rule:
(a) In the SNAP program,
a resource owned jointly by a client and another individual is available in its
entirety to the client.
(b) In all other programs,
jointly-owned resources are available to members of a financial group (see OAR 461-110-0530)
only to the extent they own the resource; except that in the OSIPM and QMB programs,
jointly-owned "liquid resources" (including bank and other financial institution
accounts) are assumed to be available in their entirety to the client. The client
has the right to provide evidence rebutting the ownership assumption. For the purposes
of this rule, "liquid resources" means cash as well as other resources that can
be converted to cash within 20 business days.
(2) A resource is not available
to a client in each of the following situations:
(a) The client has a legal
interest in the resource, but the resource is not in the client's possession and
the client is unable to gain possession of it. In the REF and REFM programs, if
a resource remains in the applicant's country of origin, it is not available.
(b) The resource is jointly
owned with others not in the financial group who are unwilling to sell their interest
in the resource, and the client's interest is not reasonably saleable.
(c) The client verifiably
lacks the competence to gain access to or use the resource and there is no legal
representative available to act on the client's behalf.
(d) The client is a victim
of domestic violence (see OAR 461-001-0000) and:
(A) Attempting to use the
resource would subject the client to risk of domestic violence; or
(B) The client is using the
resource to avoid the abusive situation.
(e) Except as provided in
OAR 461-145-0540, the resource is included in an irrevocable or restricted trust
and may not be used to meet the basic monthly needs of the financial group.
(f) In the OSIP, OSIPM, and
QMB programs, there is a legal bar to the sale of the resource.
(3) A resource is not considered
available during the time the owner does not know he or she owns the resource.
(4) If a resource is subject
to an early withdrawal penalty, the amount of the penalty is not available.
Stat. Auth.: ORS 409.050, 411.060, 411.070,
411.404, 411.706, 411.816, 412.014, 412.049, 413.085, 414.685
Stats. Implemented: ORS 409.010,
409.050, 411.060, 411.070, 411.404, 411.706, 411.816, 412.014, 412.049, 413.085,
414.685, 414.839
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 8-1992, f. & cert. ef. 4-1-92; AFS 17-1992, f. & cert.
ef. 7-1-92; AFS 6-1994, f. & cert. ef. 4-1-94; AFS 10-1995, f. 3-30-95, cert.
ef. 4-1-95; AFS 25-1998, f. 12-28-98, cert. ef. 1-1-99; AFS 10-2000, f. 3-31-00,
cert. ef. 4-1-00; AFS 12-2001, f. 6-29-01, cert. ef. 7-1-01; SSP 14-2006, f. 9-29-06,
cert. ef. 10-1-06; SSP 10-2007, f. & cert. ef. 10-1-07; SSP 37-2013, f. 12-31-13,
cert. ef. 1-1-14; SSP 15-2014, f. & cert. ef. 7-1-14; SSP 25-2015, f. 9-29-15,
cert. ef. 10-1-15
461-140-0040
Determining Availability of Income
(1) This rule describes the date income
is considered available, what amount of income is considered available, and situations
in which income is considered unavailable.
(2) Income is considered
available the date it is received or the date a member of the financial group (see
OAR 461-110-0530) has a legal right to the payment and the legal ability to make
it available, whichever is earlier, except as follows:
(a) Income usually paid monthly
or on some other regular payment schedule is considered available on the regular
payment date if the date of payment is changed because of a holiday or weekend.
(b) Income withheld or diverted
at the request of an individual is considered available on the date the income would
have been paid without the withholding or diversion.
(c) An advance or draw of
earned income is considered available on the date it is received.
(d) Income that is averaged,
annualized, converted, or prorated is considered available throughout the period
for which the calculation applies.
(e) A payment due to a member
of the financial group, but paid to a third party for a household expense, is considered
available when the third party receives the payment.
(f) In prospective budgeting,
income is considered available in the month the income is expected to be received
(see OAR 461-150-0020).
(g) In the OSIP, OSIPM, and
QMB programs, except for self-employment (see OAR 461-145-0915), wages that are
earned in one period of time but paid in another are considered available when they
are received, such as a teacher who works for nine months but is paid over twelve.
(3) The following income
is considered available even if not received:
(a) Deemed income.
(b) In the ERDC, REF, REFM,
and TANF programs, the portion of a payment from an assistance program, such as
public assistance, unemployment compensation, or Social Security, withheld to repay
an overpayment.
(c) In the GA, GAM, OSIPM,
and QMB programs, the portion of a payment from an assistance program (such as public
assistance, unemployment compensation, or Social Security) withheld to repay an
overpayment of the same source:
(A) If withheld prior to
July 1, 2014.
(B) If withheld on or after
July 1, 2014 and:
(i) No member of the financial
group was receiving GA, GAM, OSIP, OSIPM, or QMB during the period the benefit was
overpaid; or
(ii) The withheld amount
is not excluded under paragraph (5)(e)(A) of this rule.
(d) In the SNAP program,
the portion of a payment from the TANF program counted as disqualifying income under
OAR 461-145-0105.
(4) The amount of income
considered available is the gross before deductions, such as garnishments, taxes,
or other payroll deductions including flexible spending accounts.
(5) The following income
is not considered available:
(a) Wages withheld by an
employer in violation of the law.
(b) Income received by another
individual who does not pay the client his or her share.
(c) Income received by a
member of the financial group after the individual has left the household.
(d) Moneys withheld from
or returned to the source of the income to repay an overpayment from that source
unless the repayment is countable (see OAR 461-001-0000):
(A) In the SNAP program,
under OAR 461-145-0105.
(B) In the ERDC, REF, REFM,
and TANF programs, under subsection (3)(b) of this rule.
(e) In the GA, GAM, OSIP,
OSIPM, and QMB programs:
(A) The portion of a payment
from an assistance program, such as public assistance, unemployment compensation,
or Social Security withheld on or after July 1, 2014 to repay an overpayment from
the same source if at least one member of the financial group was receiving GA,
GAM, OSIPM, or QMB during the period the benefit was overpaid. The amount considered
unavailable cannot exceed the amount of the overpaid benefit previously counted
in determining eligibility (see OAR 461-001-0000) for GA, GAM, OSIP, OSIPM, or QMB.
(B) Monies withheld from
or returned to a source of income, when the source is not an assistance program,
to repay an overpayment of the same source.
(f) For an individual who
is not self-employed, income required to be expended on an ongoing, monthly basis
on an expense necessary to produce the income, such as supplies or rental of work
space.
(g) Income received by the
financial group but intended and used for the care of an individual not in the financial
group as follows:
(A) If the income is intended
both for an individual in the financial group and an individual not in the financial
group, the portion of the income intended for the care of the individual not in
the financial group is considered unavailable.
(B) If the portion intended
for the care of the individual not in the financial group cannot readily be identified,
the income is prorated evenly among the individuals for whom the income is intended.
The prorated share intended for the care of the individual not in the financial
group is then considered unavailable.
(h) In the ERDC, REF, REFM,
SNAP, and TANF programs, income controlled by the client's abuser if the client
is a victim of domestic violence (see OAR 461-001-0000), the client's abuser controls
the income and will not make the money available to the filing group (see OAR 461-110-0310),
and the abuser is not in the client's filing group.
(i) In the OSIP, OSIPM, and
QMB programs, unearned income not received because a payment was reduced to cover
expenses incurred by a member of the financial group to secure the payment. For
example, if a retroactive check is received from a benefit program other than SSI,
legal fees connected with the claim are subtracted. Or, if payment is received for
damages received as a result of an accident the amount of legal, medical, or other
expenses incurred by a member of the financial group to secure the payment are subtracted.
(j) In the REFM program,
any income used for medical or medical-related purposes.
(6) The availability of lump-sum
income (see OAR 461-001-0000) is covered in OAR 461-140-0120.
Stat. Auth.: ORS 409.050, 411.060, 411.070,
411.404, 411.816, 412.049, 413.085, 414.685
Stats. Implemented: ORS 409.010,
409.050, 411.060, 411.070, 411.117, 411.404, 411.706, 411.816, 412.049, 413.085,
414.685, 414.839
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 9-1991, f. 3-29-91,
cert. ef. 4-1-91; AFS 13-1991, f. & cert. ef. 7-1-91; AFS 17-1992, f. &
cert. ef. 7-1-92; AFS 19-1993, f. & cert. ef. 10-1-93; AFS 22-1995, f. 9-20-95,
cert. ef. 10-1-95; AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97; AFS 25-1998, f. 12-28-98,
cert. ef. 1-1-99; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 17-2000, f. 6-28-00,
cert. ef. 7-1-00; AFS 13-2002, f. & cert. ef. 10-1-02; SSP 17-2004, f. &
cert. ef. 7-1-04; SSP 1-2005(Temp), f. & cert. ef. 2-1-05 thru 6-30-05; SSP
4-2005, f. & cert. ef. 4-1-05; SSP 5-2005(Temp), f. & cert. ef. 4-1-05 thru
6-30-05; SSP 7-2005, f. & cert. ef. 7-1-05; SSP 10-2006, f. 6-30-06, cert. ef.
7-1-06; SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07; SSP 10-2007, f. & cert. ef.
10-1-07; SSP 8-2008, f. & cert. ef. 4-1-08; SSP 17-2008, f. & cert. ef.
7-1-08; SSP 5-2009, f. & cert. ef. 4-1-09; 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; SSP 15-2014,
f. & cert. ef. 7-1-14; SSP 23-2014(Temp), f. & cert. ef. 9-19-14 thru 3-18-15;
SSP 13-2015, f. & cert. ef. 3-19-15; SSP 25-2015, f. 9-29-15, cert. ef. 10-1-15
461-140-0070
Treatment of Excluded Assets
Unless stated otherwise in another rule in this chapter of rules:
(1) Excluded income remains excluded as long as it is kept in a separate account and not commingled with other funds.
(2) Excluded income that is commingled in an account with funds not excluded remains excluded for six months from the date it is commingled, after which it is counted as a resource.
Stat. Auth.: ORS 411.060, 411.070, 411.816, 418.100

Stats. Implemented: ORS 411.060, 411.070, 411.816, 418.100

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 29-1994, f. 12-29-94, cert. ef. 1-1-95; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 5-2002, f. & cert. ef. 4-1-02; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
461-140-0110
Treatment of Periodic Income
(1) For SNAP and TANF clients in a filing
group (see OAR 461-110-0310) that includes at least one member who is working under
a TANF JOBS Plus agreement, periodic income (see OAR 461-001-0000) is excluded.
(2) For REF, REFM, SNAP,
and TANF clients not covered under section (1) of this rule, periodic income is
averaged over the applicable period.
(3) In the ERDC program,
periodic income is averaged over the applicable period.
(4) In the OSIP-EPD and OSIPM-EPD
programs, periodic income received during a certification period (see OAR 461-001-0000)
is averaged among the months in the certification period.
(5) In all programs not covered
under sections (1) to (4) of this rule, periodic income is counted in the month
received.
Stat. Auth.: ORS 409.050, 411.060, 411.070,
411.404, 411.706, 411.816, 412.014, 412.049, 413.085, 414.685
Stats. Implemented: ORS 409.010,
409.050, 409.610, 411.060, 411.070, 411.404, 411.816, 412.014, 412.049, 413.085,
414.685
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 12-1993, f. &
cert. ef. 7-1-93; AFS 23-1994, f. 9-29-94, cert. ef. 10-1-94; AFS 3-1997, f. 3-31-97,
cert. ef. 4-1-97; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 17-2000, f. 6-28-00,
cert. ef. 7-1-00; SSP 17-2004, f. & cert. ef. 7-1-04; SSP 24-2004, f. 12-30-04,
cert. ef. 1-1-05; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06; SSP 10-2011, f. 3-31-11,
cert. ef. 4-1-11; SSP 23-2015, f. 9-28-15, cert. ef. 10-1-15
461-140-0120
Availability and Treatment of Lump-Sum
Income
(1) Lump-sum income (see OAR 461-001-0000)
is treated as follows if it is received by a member of a financial group (see OAR
461-110-0530).
(2) In the EA, REF, REFM,
SNAP, and TANF programs:
(a) Lump-sum income is a
resource.
(b) In the EA, REF, REFM,
and TANF programs:
(A) Lump-sum income is considered
available to the financial group when a member of the group receives the income
and until the income becomes unavailable for a reason beyond the group's control.
(B) Lump-sum income is considered
unavailable for a reason beyond the group's control if the member who received the
lump-sum income:
(i) Leaves the financial
group before spending any of the lump-sum income; or
(ii) Spends the lump-sum
income on an immediate basic need or emergency.
(3) In the ERDC program,
lump-sum income is excluded.
(4) In the GA, GAM, OSIP
(except OSIP-EPD), OSIPM (except OSIPM-EPD), and QMB programs, lump-sum income is
treated as follows:
(a) Lump-sum income not excluded
is unearned income in the month of receipt, and any amount remaining in future months
is a resource, except that in the OSIP and OSIPM programs retroactive SSB and SSI
payments are treated in accordance with OAR 461-145-0490 and 461-145-0510.
(b) The following lump-sum
income is excluded:
(A) The first $20 received
in a month;
(B) The income the client
turns over to the Department as reimbursement for previous assistance; and
(C) The income the client
uses to pay for special need items approved by the Department. Special needs are
explained at OAR 461-155-0500 and following.
(5) In the OSIP-EPD and OSIPM-EPD
programs, lump-sum income is counted as a resource.
Stat. Auth.: ORS 411.060, 411.404, 411.816,
412.014, 412.049
Stats. Implemented: ORS 411.060,
411.404, 411.816, 412.014, 412.049
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 12-1990, f. 3-30-90, cert. ef. 4-1-90; 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 1-1991(Temp),
f. & cert. ef. 1-2-91; AFS 13-1991, f. & cert. ef. 7-1-91; AFS 20-1992,
f. 7-31-92, cert. ef. 8-1-92; AFS 5-1993, f. & cert. ef. 4-1-93; AFS 12-1993,
f. & cert. ef. 7-1-93; AFS 19-1993, f. & cert. ef. 10-1-93; AFS 2-1994,
f. & cert. ef. 2-1-94; AFS 13-1994, f. & cert. ef. 7-1-94; AFS 23-1994,
f. 9-29-94, cert. ef. 10-1-94; AFS 27-1996, f. 6-27-96, cert. ef. 7-1-96; AFS 36-1996,
f. 10-31-96, cert. ef. 11-1-96; AFS 42-1996, f. 12-31-96, cert. ef. 1-1-97; AFS
3-1997, f. 3-31-97, cert. ef. 4-1-97; AFS 7-1999, f. 4-27-99, cert. ef. 5-1-99;
AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; SSP 29-2003(Temp), f. 10-31-03, cert.
ef. 11-1-03 thru 3-31-04; SSP 6-2004, f. & cert. ef. 4-1-04; SSP 17-2004, f.
& cert. ef. 7-1-04; SSP 24-2004, f. 12-30-04, cert. ef. 1-1-05; SSP 4-2005,
f. & cert. ef. 4-1-05; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06; SSP 4-2007,
f. 3-30-07, cert. ef. 4-1-07; 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. 1-1-14
461-140-0210
Asset Transfer; General Information and Timelines
(1) OAR 461-140-0210 to 461-140-0300 regulate the effect of a transfer of an asset on a client.
(2) If an asset is transferred during the periods of time listed in section (4) or (5) of this rule and if the transfer is made in whole or in part for the purpose of establishing or maintaining eligibility for benefits:
(a) In the REFM program, the filing group is disqualified if:
(A) A member of the financial group (see OAR 461-110-0530) transferred the asset; and
(B) The client is an inpatient in a nursing facility, or is an inpatient in a medical institution in which payment for the client is based on a level of care provided in a nursing facility.
(b) In the REF, SNAP, and TANF programs, the filing group is disqualified if:
(A) The asset was a resource; and
(B) A member of the financial group transferred the resource.
(c) In the GA, GAM, OSIP, and OSIPM programs, a client in a nonstandard living arrangement (see OAR 461-001-0000) is disqualified if the client or the spouse of the client transferred the asset.
(3) In all programs except the ERDC program, clients in financial groups whose members transfer an asset covered under section (2) of this rule within the time periods listed in section (4) or (5) of this rule must report the transfer as soon as practicable and must provide information requested by the Department concerning the transfer.
(4) In the REF, REFM, SNAP, and TANF programs, a transfer of an asset may be disqualifying if the transfer occurs:
(a) In the REFM program, during the three years preceding the date of request (see OAR 461-115-0030).
(b) In the SNAP program, during the three months preceding the filing date or during a certification period (see OAR 461-001-0000) if the asset was a resource.
(c) In the REF and TANF programs, during the three years preceding the date of request (see OAR 461-115-0030) if the asset was a resource.
(5) In the GA, GAM, OSIP, and OSIPM programs, for a client in a nonstandard living arrangement, a transfer of an asset may be disqualifying if the transfer occurs:
(a) On or before June 30, 2006 and as described in one of the following paragraphs:
(A) On or after the date that is 60 months prior to the date of request — for assets that are transferred without compensation equal to or greater than fair market value from a revocable trust (see OAR 461-145-0540(7)(c)).
(B) On or after the date that is 60 months prior to the date of request — for assets that are transferred without compensation equal to or greater than fair market value to an irrevocable trust (see OAR 461-145-0540(8)(a)).
(C) On or after the date that is 60 months prior to the date of request — when there is a change in circumstances that makes assets in an irrevocable trust unavailable to the client (see OAR 461-145-0540(8)(d)).
(D) On or after the date that is 36 months prior to the date of request — for assets transferred without compensation equal to or greater than fair market value from an irrevocable trust (see OAR 461-145-0540(8)(b) and (c)).
(E) On or after the date that is 36 months prior to the date of request — for other asset transfers made without compensation equal to or greater than fair market value.
(b) On or after:
(A) July 1, 2006; and
(B) The date that is 60 months prior to the date of request.
(6) The duration of the period of disqualification or ineligibility is set out in OAR 461-140-0260 to 461-140-0300.
Stat. Auth.: ORS 411.060, 411.404, 411.710, 411.816, 412.049

Stats. Implemented: ORS 411.060, 411.404, 411.710, 411.816, 412.049

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 13-1991, f. & cert. ef. 7-1-91; AFS 20-1992, f. 7-31-92, cert. ef. 8-1-92; AFS 12-1993, f. & cert. ef. 7-1-93; AFS 18-1993(Temp), f. & cert. ef. 10-1-93; AFS 29-1993, f. 12-30-93, cert. ef. 1-1-94; AFS 2-1994, f. & cert. ef. 2-1-94; AFS 6-1994, f. & cert. ef. 4-1-94; AFS 13-1994, f. & cert. ef. 7-1-94; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01; AFS 5-2002, f. & cert. ef. 4-1-02; SSP 22-2004, f. & cert. ef. 10-1-04; SSP 10-2006, f. 6-30-06, cert. ef. 7-1-06; SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07; SSP 27-2013, f. & cert. ef. 10-1-13; 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
461-140-0220
Determining if a Transfer of an Asset is Disqualifying
A transfer of an asset is not disqualifying if the requirements of OAR 461-140-0242 or one of the following sections are met:
(1) The asset was personal belongings as described in OAR 461-145-0390.
(2) The asset was sold or traded:
(a) In all programs except the SNAP program, for compensation equal to or greater than fair market value.
(b) In the SNAP program, for compensation near, equal to or greater than fair market value.
(3) The asset was transferred between members of the same financial group, including members who are ineligible aliens or disqualified people.
(4) The transfer settled a legally enforceable claim against the asset or client.
(5) The amount of the resource was equal to or less than the amount that was excluded at the initial month (see OAR 461-001-0000) of eligibility under OAR 461-160-0855 due to payments received under a qualified partnership policy (see OAR 461-001-0000).
(6) In all programs except the OSIP and OSIPM programs, a court ordered the transfer.
(7) In the OSIP and OSIPM programs, a court ordered the transfer and:
(a) The transfer occurs more than 36 months or 60 months before the date of request (see OAR 461-115-0030), whichever is applicable under OAR 461-140-0210(5); or
(b) There is an institutionalized spouse, and — after performing the calculations required in OAR 461-160-0580(2) — the amount of resources allocated to a community spouse does not exceed the largest of the four amounts set forth in OAR 461-160-0580(2)(f).
(8) The client was a victim of fraud, misrepresentation, or coercion, and legal steps have been taken to recover the asset.
(9) In the OSIP and OSIPM programs, for a client in a nonstandard living arrangement (see OAR 461-001-0000), the asset is an annuity purchased on or before December 31, 2005, the client or the spouse of the client is the annuitant, and the entire amount of principal and earned interest is paid in equal installments during the actuarial life expectancy of the annuitant. For purposes of this section, the actuarial life expectancy is established by the Period Life Table of the Office of the Chief Actuary of the Social Security Administration.
(10) In the OSIP and OSIPM programs, the client is in a standard living arrangement (see OAR 461-001-0000).
(11) In the OSIP and OSIPM programs, for a client in a nonstandard living arrangement (see OAR 461-001-0000):
(a) The asset is an annuity purchased from January 1, 2006 through June 30, 2006, and the client or the spouse of the client is the annuitant.
(b) The asset is an annuity purchased on or after July 1, 2006, and the annuity meets the requirements of OAR 461-145-0022(10).
Stat. Auth: ORS 410.070, 411.060, 411.070, 411.816, 412.049, 414.042

Stats. Implemented: ORS 410.070, 411.060, 411.070, 411.708, 411.816, 412.049, 414.025, 414.042

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 13-1991, f. & cert. ef. 7-1-91; AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95; AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01; AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01; AFS 2-2002(Temp), f. & cert. ef. 2-26-02 thru 6-30-02; AFS 10-2002, f. & cert. ef. 7-1-02; SSP 19-2005, f. 12-30-05, cert. ef. 1-1-06; SSP 10-2006, f. 6-30-06, cert. ef. 7-1-06; SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07; SSP 14-2007, f. 12-31-07, cert. ef. 1-1-08; SSP 17-2008, f. & cert. ef. 7-1-08
461-140-0242
Disqualifying Transfer of Assets Including Home; GA, GAM, OSIP, OSIPM
For a client in a nonstandard living arrangement (see OAR 461-001-0000) in the GA, GAM, OSIP, and OSIPM programs:
(1) For the purposes of this rule:
(a) The definition of "child" in OAR 461-001-0000 does not apply.
(b) "Child" means a natural or adoptive son or daughter who is:
(A) Under age 21; or
(B) Any age and has been determined to meet the blindness criteria of OAR 461-125-0330 or the disability criteria of OAR 461-125-0370.
(2) A transfer of an asset (including a home) by a client or the spouse of the client is a disqualifying transfer unless the requirements of at least one of the following subsections are met:
(a) The transfer was made exclusively for purposes other than establishing eligibility or maintaining benefits.
(b) The title to the asset was transferred to the person's spouse, the person's child who is blind or has a disability under the criteria of the Social Security Administration, or another for the sole benefit of the spouse or a child who is blind or has a disability under the criteria of the Social Security Administration, provided that the transfer is arranged in such a way that no individual or entity except this spouse or child can benefit from the asset transferred in any way, whether at the time of transfer or any time in the future. A direct transfer, transfer instrument, or trust that provides for funds or property to pass to a beneficiary who is not the spouse or child who is blind or has a disability under the criteria of the Social Security Administration is not considered to be established for the benefit of one of those individuals. In order for a transfer or a trust to be considered for the sole benefit of one of these individuals, the instrument or document must provide for the spending of the funds involved for the benefit of the individual based on the life expectancy of the individual.
(c) The transfer was made to a trust described in OAR 461-145-0540(9), except that a transfer to a trust under OAR 461-145-0540(9)(a) is disqualifying if the client is age 65 or older.
(d) The transfer was made to a trust described in OAR 461-145-0540(10) established solely for the benefit of an individual under 65 years of age who has a disability that meets the criteria of the Social Security Administration. This subsection applies to all transfers made on or after July 1, 2006.
(e) The transfer is a transfer described in OAR 461-160-0580(2).
(f) The resource is transferred by the community spouse after the Department has determined the community spouse's resource allowance in accordance with OAR 461-160-0580 and the resource has not been attributed to the institutionalized spouse. Notwithstanding this subsection, a transfer of a resource by a community spouse who is receiving or applying for benefits remains subject to all rules regarding the transfer of an asset by a client.
(3) A transfer of a home by a client or the spouse of the client is a disqualifying transfer unless the title was transferred to the client's:
(a) Child;
(b) Sibling who has equity interest in the home and was residing in the home for at least one year immediately before the client's admission to long-term care (see OAR 461-001-0000); or
(c) Natural or adoptive son or daughter who meets the requirements of each of the following paragraphs:
(A) The son or daughter resided with the client in the client's home continuously for at least two years immediately prior to the client's admission to long-term care other than an absence from the home that is not intended to, and does not, exceed 30 days.
(B) The son or daughter provides convincing evidence that he or she provided services that permitted the client to reside at home for at least two years rather than in an institution or long-term care facility.
(C) Without receiving payment from the Department, the son or daughter must have directly provided the services required by paragraph (B) of this subsection as described in both of the following subparagraphs for a total of at least 20 hours per week.
(i) On a daily basis, one or a combination of any of the following activities of daily living, as each sub-subparagraph is further defined at OAR 411-015-0006:
(I) Eating.
(II) Dressing/Grooming.
(III) Bathing/Personal Hygiene.
(IV) Mobility.
(V) Elimination.
(VI) Cognition/Behavior.
(ii) One or a combination of any of the following instrumental activities of daily living, as each sub-subparagraph is further defined at OAR 411-015-0007:
(I) Housekeeping.
(II) Laundry.
(III) Meal Preparation.
(IV) Medication Management.
(V) Shopping.
(VI) Transportation.
(4) Except for a transfer permitted under section (3) of this rule, each of the following subsections applies in determining whether an asset is considered transferred for fair market value:
(a) The compensation received for the asset must be in a tangible form with intrinsic value.
(b) The Department presumes that services provided for free at the time were intended to be provided without compensation, and that a transfer to an individual for services provided for free in the past is a disqualifying transfer of assets. This presumption is rebuttable with convincing evidence. This evidence must also show that there was an express agreement to provide services for compensation at the time the services were provided.
(c) Compensation for services is valued at the average market rate at the time the services were provided, unless the express agreement provides a lower rate.
(5) If a transfer is made for less than fair market value and is not exempt from disqualification under this rule, there is a rebuttable presumption that the asset was transferred for the purpose of establishing or maintaining eligibility and is not exempt under subsection (2)(a) of this rule.
(6) To rebut the presumption in section (5) of this rule, the client must present evidence other than his or her own statement and must provide to the Department the information it requests for the purpose of evaluating the purpose of the transfer. To meet the burden, it is sufficient for the client to show one of the following:
(a) The decision to make the transfer was not within the client's control;
(b) At the time of transfer, the client could not reasonably have anticipated applying for medical assistance;
(c) Unexpected loss of resources or income occurred between the time of transfer and the application for medical assistance;
(d) Because of other, similarly convincing, circumstances, it appears more likely than not that the transfer was not made, in whole or in part, for the purpose of establishing or maintaining eligibility for benefits.
(7) The fact that a recipient was already eligible for benefits is not sufficient to rebut the presumption in section (5) of this rule because the asset may not always be excluded and if the client had received full compensation for the asset, the compensation received would have been used to determine future eligibility.
Stat. Auth.: ORS 411.060 & 411.710

Stats. Implemented: ORS 411.060, 411.710, 414.042

Hist.: AFS 18-1993(Temp), f. & cert. ef. 10-1-93; AFS 29-1993, f. 12-30-93, cert. ef. 1-1-94; 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 13-1995, f. 6-29-95, cert. ef. 7-1-95; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01; SSP 17-2004, f. & cert. ef. 7-1-04; SSP 4-2005, f. & cert. ef. 4-1-05; SSP 10-2006, f. 6-30-06, cert. ef. 7-1-06; SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07; SSP 16-2006(Temp), f. 12-29-06, cert. ef. 1-1-07 thru 3-31-07; SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07; SSP 7-2007, f. 6-29-07, cert. ef. 7-1-07; SSP 17-2008, f. & cert. ef. 7-1-08
461-140-0250
Determining The Uncompensated Value of a Transferred Asset
(1) The uncompensated value of a disqualifying transfer of an asset is used in OAR 461-140-0260 to 461-140-0300 to calculate the ineligibility period of the financial group.
(2) To determine uncompensated value:
(a) In the GA, GAM, OSIP, OSIPM, and QMB programs:
(A) The value of the compensation received for the asset is subtracted from the fair market value of the asset. This result is the uncompensated value, unless the financial group had countable resources of less than the resource limit at the time of the first transfer. If the financial group had countable resources of less than the resource limit at the time of the first transfer, the remainder is then added to other countable resources, and the amount by which the sum exceeds the resource limit in OAR 461-160-0015 is the uncompensated value.
(B) For an annuity, unless the client verifies a lesser amount, the fair market value is equal to the amount of money used to establish the annuity, plus any additional payments used to fund the annuity, plus any earnings, minus any regular monthly payments already received, minus early withdrawals, and minus any surrender fees.
(b) In all other programs, the value of the compensation received for the resource is subtracted from the fair market value of the resource. The remainder is added to the other countable resources at the time of the transfer. The amount by which the sum exceeds the resource limit is the uncompensated value.
(c) The compensation received for a transferred asset includes:
(A) Encumbrances assumed by the buyer; and
(B) Goods or services provided to the client, limited to their true value, if there was a prior agreement to exchange the asset for the goods or services.
Stat. Auth: ORS 411.060, 411.816, 418.100
Stats. Implemented: ORS 411.060, 411.632, 411.816, 418.100
Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 5-2002, f. & cert. ef. 4-1-02; SSP 11-2006(Temp), f. 6-30-06, cert. ef. 7-1-06 thru 9-30-06; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
461-140-0260
Disqualification Due to a Resource Transfer; SNAP
In the SNAP Program:
(1) A financial group disqualified due to the transfer of a resource (described in OAR 461-140-0210 or 461-140-0220) is disqualified from receiving benefits starting on the date of the denial of benefits or on the effective date of the closure. The disqualification applies to each individual in the financial group during the month that the disqualifying transfer of resources occurred.
(2) The duration of the disqualification is based on the amount of uncompensated value (see OAR 461-140-0250) as provided in the following chart: [Table not included. See ED. NOTE.]
[ED. NOTE: Tables referenced are available from the agency.]
Stat. Auth.: ORS 411.816

Stats. Implemented: ORS 411.816

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 12-1993, f. & cert. ef. 7-1-93; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
461-140-0270
Disqualification Due to An Asset
Transfer; REF, REFM, TANF
In the REF, REFM, and TANF programs:
(1) A financial group (see
OAR 461-110-0530) in which a member is disqualified due to the transfer of an asset
is disqualified for the number of months equal to the uncompensated value (see OAR
461-140-0250) divided by the TANF payment standard (see OAR 461-155-0030).
(2) The disqualification
period starts the date the Department imposes the disqualification by terminating
benefits for the period calculated above or, in the case of an applicant, by denying
benefits for the same period of time measured from the date of application.
Stat. Auth: ORS 409.050, 411.060, 411.404,
412.049
Stats. Implemented: ORS 409.010,
411.060, 411.404, 411.632, 412.049
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; SSP 14-2006, f. 9-29-06,
cert. ef. 10-1-06; SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07; 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
461-140-0295
Length of Disqualification Due to a Resource Transfer; October 1, 1993, through September 30, 1998
(1) A GA, GAM, OSIP, OSIPM or QMB financial group containing a member disqualified due to the transfer of a resource is disqualified from receiving benefits if the group filed an application for benefits between October 1, 1993, and September 30, 1998.
(2) The disqualification period:
(a) Begins the first day of the month the resource was transferred.
(b) Is the number of months equal to the uncompensated value (see OAR 461-140-0250) divided by $2,595, rounded down to the next whole number. This calculation applies to the cumulative value of all disqualifying resource transfers made by the client or the client's spouse within the look back period.
(3) If a resource is owned by more than one person, by joint tenancy, tenancy in common or similar arrangement, the share of resource owned by the client is considered transferred when any action is taken either by the client or any other person that reduces or eliminates the client's control or ownership in the client's share of the resource.
(4) If an annuity is purchased that pays benefits beyond the life expectancy of the client, as determined by the annuity, a disqualification period will be assessed for the value of the annuity beyond the life expectancy of the annuitant.
Stat. Auth.: ORS 411.060

Stats. Implemented: ORS 411.060 & ORS 411.632

Hist.: AFS 18-1993(Temp), f. & cert. ef. 10-1-93; AFS 29-1993, f. 12-30-93, cert. ef. 1-1-94; AFS 6-1994, f. & cert. ef. 4-1-94; AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95; AFS 17-1998, f. & cert. ef. 10-1-98; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00
461-140-0296
Length of Disqualification Due to An Asset Transfer; GA, GAM, OSIP, OSIPM
(1) This rule applies to clients in
the GA, GAM, OSIP, and OSIPM programs who live in a nonstandard living arrangement
(see OAR 461-001-0000).
(2) A financial group containing
a member disqualified due to the transfer of an asset is disqualified from receiving
benefits. The length of a disqualification period resulting from the transfer is
the number of months equal to the uncompensated value (see OAR 461-140-0250) for
the transfer divided by the following dollar amount:
(a) If the initial month
(see OAR 461-001-0000) is prior to October 1, 1998 — $2,595.
(b) If the initial month
is on or after October 1, 1998 and prior to October 1, 2000 — $3,320.
(c) If the initial month
is on or after October 1, 2000 and prior to October 1, 2002 — $3,750.
(d) If the initial month
is on or after October 1, 2002 and prior to October 1, 2004 — $4,300.
(e) If the initial month
is on or after October 1, 2004 and prior to October 1, 2006 — $4,700.
(f) If the initial month
is on or after October 1, 2006 and prior to October 1, 2008 — $5,360.
(g) If the initial month
is on or after October 1, 2008 and prior to October 1, 2010 — $6,494.
(h) If the initial month
is on or after October 1, 2010 — $7,663.
(3) For transfers by a client
and the spouse of a client that occurred before July 1, 2006:
(a) Add together the uncompensated
value of all transfers made in one calendar month, and treat this total as one transfer.
(b) If the uncompensated
value of the transfer is less than the applicable dollar amount identified in subsections
(2)(a) to (2)(h) of this rule, there is no disqualification.
(c) If there are multiple
transfers in amounts equal to or greater than the applicable dollar amount identified
in subsections (2)(a) to (2)(h) of this rule, each disqualification period is calculated
separately.
(d) The number of months
resulting from the calculation in section (2) of this rule is rounded down to the
next whole number.
(e) Except as provided in
subsection (3)(f) of this rule, the first month of the disqualification is the month
the asset was transferred.
(f) If disqualification periods
calculated in accordance with this rule overlap, the periods are applied sequentially
so that no two penalty periods overlap.
(g) If both spouses of a
couple are in a nonstandard living arrangement and made the disqualifying transfer,
part of the disqualification is apportioned to each of them, based on their percentage
of ownership in the transferred asset. If one spouse is unable to serve the resulting
disqualification period for any reason, the remaining disqualification applicable
to both spouses must be served by the remaining spouse.
(4) For transfers by a client
and the spouse of a client that occurred on or after July 1, 2006 and for income
cap trusts under OAR 461-145-0540(9)(c) that accumulate funds in excess of the applicable
dollar amount identified in subsections (2)(a) to (2)(h) of this rule:
(a) If there are multiple
transfers by the client and the spouse of the client, including any transfer less
than the applicable dollar amount identified in subsections (2)(a) to (2)(h) of
this rule, the value of all transfers are added together before dividing by the
applicable dollar amount identified in subsections (2)(a) to (2)(h) of this rule.
For an income cap trust, the calculation in section (2) of this rule is performed
as soon as, but not before, funds have accumulated to at least the applicable dollar
amount identified in subsections (2)(a) to (2)(h) of this rule.
(b) The quotient resulting
from the calculation in section (2) of this rule is not rounded. The whole number
of the quotient is the number of full months the financial group is disqualified.
The remaining decimal or fraction of the quotient is used to calculate an additional
partial month disqualification. This remaining decimal or fraction is converted
to an additional number of days by multiplying the decimal or fraction by the number
of days in the month following the last full month of the disqualification period.
If this calculation results in a fraction of a day, the fraction of a day is rounded
down.
(c) Notwithstanding when
the Department learns of a disqualifying transfer, the first month of the disqualification
is:
(A) For a client who transfers
an asset while he or she is already receiving Department-paid long-term care (see
OAR 461-001-0000) or home and community-based care (see OAR 461-001-0030) in a nonstandard
living arrangement, the month following the month the asset was transferred, except
that if disqualification periods calculated in accordance with this rule overlap,
the periods are applied sequentially so that no two penalty periods overlap.
(B) For an applicant who
transfers an asset prior to submitting an application and being determined eligible
and for a client who transfers an asset while he or she is already receiving benefits
in a standard living arrangement (see OAR 461-001-0000), the date of request (see
OAR 461-115-0030) for long-term care or home and community-based care as long as
the applicant or client would otherwise be eligible but for this disqualification
period. If the applicant or client is not otherwise eligible on the date of request,
the disqualification begins the first date following the date of request that the
applicant or client would be otherwise eligible but for the disqualification period.
(d) If both spouses of a
couple are in a nonstandard living arrangement and made the disqualifying transfer,
part of the disqualification is apportioned to each of them, based on their percentage
of ownership in the transferred asset. If one spouse is unable to serve the resulting
disqualification period, the remaining disqualification applicable to both spouses
must be served by the remaining spouse.
(5) If an asset is owned
by more than one person, by joint tenancy, tenancy in common, or similar arrangement,
the share of the asset owned by the client is considered transferred when any action
is taken either by the client or any other person that reduces or eliminates the
client's control or ownership in the client's share of the asset.
(6) For an annuity that is
a disqualifying transfer under section (11) of OAR 461-145-0022, the disqualification
period is calculated based on the uncompensated value as calculated under OAR 461-140-0250,
unless the only requirement that is not met is that the annuity pays beyond the
actuarial life expectancy of the annuitant. If the annuity pays beyond the actuarial
life expectancy of the annuitant, the disqualification is calculated according to
section (7) of this rule.
(7) If a client or the spouse
of a client purchases an annuity on or before December 31, 2005 and the annuity
pays benefits beyond the actuarial life expectancy of the annuitant, as determined
by the Period Life Table of the Office of the Chief Actuary of the Social Security
Administration, a disqualification period is assessed for the value of the annuity
beyond the actuarial life expectancy of the annuitant.
(8) A single transfer of
an asset may cause a disqualification for both a medical assistance program under
this rule and the SSI cash grant. The period of the disqualification is likely to
be longer for SSI than for the medical assistance program, so a person may be eligible
again for the medical assistance program while still disqualified from receiving
SSI. The provisions of this rule are applied without regard to the related disqualification
for SSI.
Stat. Auth.: ORS 411.060, 411.704, 411.706
Stats. Implemented: ORS 411.060,
411.704, 411.706
Hist.: AFS 17-1998, f. &
cert. ef. 10-1-98; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 26-2000, f. &
cert. ef 10-4-00; AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01; AFS 13-2002, f. &
cert. ef. 10-1-02; SSP 23-2003, f. & cert. ef. 10-1-03; SSP 22-2004, f. &
cert. ef. 10-1-04; SSP 19-2005, f. 12-30-05, cert. ef. 1-1-06; SSP 10-2006, f. 6-30-06,
cert. ef. 7-1-06; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06; SSP 15-2006, f. 12-29-06,
cert. ef. 1-1-07; SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07; SSP 7-2007, f. 6-29-07,
cert. ef. 7-1-07; SSP 23-2008, f. & cert. ef. 10-1-08; SSP 32-2010, f. &
cert. ef. 10-1-10; SSP 17-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13; SSP
26-2013, f. & cert. ef. 10-1-13
461-140-0300
Adjustments to the Disqualification for Asset Transfer
(1) The disqualification imposed under
OAR 461-140-0260 is not adjusted once applied in the SNAP program.
(2) In all other programs,
the disqualification ends if the transfer that caused the disqualification is rescinded.
The duration of the disqualification is recalculated if the terms of the transfer
are modified.
(3) In the GA, GAM, OSIP,
OSIPM, and REFM programs, the Department may waive the disqualification if the disqualification
would create an undue hardship on the client. For purposes of this section, the
disqualification would create an undue hardship if the requirements of subsections
(a) and (b) of this section are met:
(a) The client has no other
means for meeting his or her needs. The client has the burden of proving that no
other means exist by:
(A) Exploring and pursuing
all reasonable means to recover the assets to the satisfaction of the Department,
including legal remedies and consultation with an attorney; and
(B) Cooperating with the
Department to take action to recover the assets.
(b) The disqualification
would deprive the client of:
(A) Medical care such that
the client's health or life would be endangered; or
(B) Food, clothing, shelter,
or other necessities of life without which the health or life of the client would
be endangered.
(4) As authorized by ORS
411.620, the Department retains the authority to bring a civil suit or action to
set aside a transfer of assets for less than fair market value and may seek recovery
of all costs associated with such an action.
(5) Notwithstanding the granting
of an undue hardship waiver under section (3) of this rule, the Department is not
precluded from recovering public assistance or medical assistance from any assets
in which the client held an interest, or in which the client previously held an
interest, at the time the undue hardship waiver was granted.
Stat. Auth: ORS 409.050, 411.060, 411.404,
411.816, 412.014, 412.049
Stats. Implemented: ORS 409.010,
411.060, 411.404, 411.632, 411.816, 412.014, 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 12-1993, f. &
cert. ef. 7-1-93; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 26-2000, f. &
cert. ef. 10-4-00; SSP 10-2006, f. 6-30-06, cert. ef. 7-1-06; SSP 15-2006, f. 12-29-06,
cert. ef. 1-1-07; SSP 27-2013, f. & cert. ef. 10-1-13; SSP 37-2013, f. 12-31-13,
cert. ef. 1-1-14
461-140-0410 [Renumbered to 461-135-0708]
461-140-0420 [Renumbered to 461-145-0405]


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