Decision Notices

Link to law: http://arcweb.sos.state.or.us/pages/rules/oars_400/oar_461/461_175.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 175
DECISION NOTICES

461-175-0010
What a Decision Notice Must Include
(1) A decision notice (see OAR 461-001-0000):
(a) Specifies the date the notice is mailed, which is the effective date for a basic decision notice (see OAR 461-001-0000).
(b) Except as provided in section (2) of this rule, specifies the action the Department intends to take and the effective date of the action.
(c) Specifies the reasons for the action.
(d) In the SNAP program, except as provided in paragraph (2)(c)(B) of this rule, provides the name and phone number of the Department staff person or identifies the office to contact for additional information.
(e) Informs the client of the extent to which the client has a right to a hearing before an impartial person.
(f) Specifies the method and deadline for requesting a hearing.
(g) Informs the client of the right to representation, including legal counsel, and the right to have witnesses testify on his or her behalf.
(h) Provides information about the availability of free legal help.
(i) Cites the rules that support the action.
(2) If benefits are reduced or closed to reflect cost-of-living adjustments in benefits or any other mass change under a program operated by a federal agency or to reflect a mass change to payments in a program operated by the Department:
(a) The requirements in subsection (1)(b) of this rule are optional. Instead of specifying the action the Department intends to take and the effective date of the action, the decision notice may state all of the following:
(A) The general nature of the change.
(B) Examples of how the change affects a client's benefits.
(C) The month in which the change will take place.
(b) The decision notice must also state the client's right to continue receiving benefits.
(c) In the SNAP program:
(A) The decision notice must also state under what circumstances benefits will be continued pending a hearing.
(B) The requirements in subsection (1)(d) of this rule are optional. A decision notice may indicate instead that a client may contact a local office or worker for additional information.
(3) In the SNAP program, a continuing benefit decision notice (see OAR 461-001-0000) and a decision notice under section (2) of this rule also must state that the client's household will incur a liability for any overissued benefits if:
(a) Benefits are continued pending the hearing; and
(b) The hearing decision is adverse to the client.
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 19-1993, f. & cert. ef. 10-1-93; AFS 6-1994, f. & cert. ef. 4-1-94; AFS 23-1994, f. 9-29-94, cert. ef. 10-1-94; AFS 40-1995, f. 12-26-95, cert. ef. 1-1-96; AFS 17-1998, f. & cert. ef. 10-1-98; AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00; AFS 25-2000, f. 9-29-00, cert. ef. 10-1-00; AFS 23-2002(Temp), f. 12-31-02, cert. ef. 1-1-03 thru 6-30-03; SSP 16-2003, f. & cert. ef. 7-1-03; SSP 22-2004, f. & cert. ef. 10-1-04; SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07; SSP 7-2007, f. 6-29-07, cert. ef. 7-1-07; SSP 28-2009, f. & cert. ef. 10-1-09; SSP 26-2010(Temp), f. & cert. ef. 8-16-10 thru 2-12-11; SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11
461-175-0050
Notice Period
The notice period is used to determine the effective date for taking action when a decision notice (see OAR 461-001-0000) is sent to the filing group:
(1) For a basic decision notice (see OAR 461-001-0000), the notice period is the month in which the notice is mailed.
(2) For a continuing benefit decision notice (see OAR 461-001-0000), the notice period is the budget month from which information is used to initiate the decision notice.
(3) For a timely continuing benefit decision notice (see OAR 461-001-0000), the notice period is the month in which the mailing requirement ends. Except as provided in OAR 461-175-0206, this mailing requirement is 15 calendar days for clients in the Address Confidentiality Program (see OAR 461-001-0000) and 10 calendar days for all other clients.
Stat. Auth.: ORS 411.060, 411.730, 411.816, 418.100

Stats Implemented: ORS 411.060, 411.730, 411.816, 418.100

Hist.: AFS 20-1992, f. 7-31-92, cert. ef. 8-1-92; SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07; SSP 8-2008, f. & cert. ef. 4-1-08
461-175-0200
Notice Situations; General Information
(1) In the EA program, a basic decision
notice (see OAR 461-001-0000) is sent for all situations.
(2) In the SNAP program,
a basic decision notice is sent for all actions on applications for assistance.
(3) In the JOBS program:
(a) A basic decision notice
is sent whenever a request for a support service payment is denied.
(b) No decision notice is
required if request for a support service is approved.
(4) A basic decision notice
is sent to close JPI benefits when the filing group (see OAR 461-110-0310) reports
a change during the reporting period in which SNAP benefits do not decrease.
(5) In the TANF program,
a notice approving benefits informs the client, within one month following eligibility
determination, of the opportunity to volunteer for JOBS participation and of the
procedure for JOBS program entry.
(6) In the Pre-TANF program,
a basic decision notice is sent when payment for basic living expenses is denied
or when payment for other support services in the JOBS program is denied. No other
notices are required for this program.
(7) In the TA-DVS program,
a basic decision notice (see OAR 461-001-0000) is sent to a safe mailing address
or hand delivered for all situations. This includes when the program is approved,
denied, or closed (prior to the end of the 90 day eligibility period) and when a
payment under the program is denied.
(8) In all programs except
the Pre-TANF program, unless stated differently in this rule or another rule, the
Department mails or otherwise provides the client with (sends) a decision notice
(see OAR 461-001-0000) as follows:
(a) A basic decision notice
is sent whenever an application for assistance, including retroactive medical assistance,
is approved or denied or a request for a support service payment in the JOBS program
is denied.
(b) A timely continuing benefit
decision notice (see OAR 461-001-0000) is sent whenever benefits or support service
payments authorized by 461-190-0211 are reduced or closed, or the method of payment
changes to protective, vendor, or two-party.
(c) A decision notice is
sent whenever the Department adjusts previously underissued cash assistance or SNAP
benefits.
(9) In all programs:
(a) Notwithstanding any rule
in Chapter 461, to the extent permitted by OAR 137-003-0530, the Department may
take any of the following actions:
(A) Amend a decision notice
with another decision notice or a contested case notice.
(B) Amend a contested case
notice.
(C) Delay a reduction or
closure of benefits as a result of a client's request for hearing.
(D) Extend the effective
date on a decision notice or contested case notice.
(b) Except as provided in
subsection (a) of this section or when a delay results from the client's request
for a hearing, a notice to reduce or close benefits becomes void if the reduction
or closure is not initiated on the date stated on the notice. If the notice is void,
a new notice is sent to inform the financial group (see OAR 461-110-0530) of a new
date on which their benefits will be reduced or closed.
(c) No decision notice is
required in each of the following situations:
(A) Benefits are ended because
there is no living person in the benefit group (see OAR 461-110-0750).
(B) A notice was sent, the
client requested a hearing, and either the hearing request is dismissed or a final
order is issued.
(C) The client has signed
a voluntary agreement that qualifies as a final order under ORS 183.417(3)(b) (see
OAR 461-175-0340(2)).
(D) A decision notice that
included the eligibility begin and end dates was given for TA-DVS program benefits
and the 90 day eligibility period ends.
(d) When the Department amends
a decision notice with another decision notice under subsection (a) of this section,
the date of the amended notice restarts the client's deadlines to request a hearing
or continuing benefits, or both.
(e) When a contested case
notice extends an effective date or delays a reduction or closure, the date of the
amended notice restarts a client's timeline to request continuing benefits.
(f) When a client has a pending
hearing request or is receiving continuing benefits, and the Department amends a
notice under this section, the client need not re-file the hearing request or renew
the request for continuing benefits.
Stat. Auth.: ORS 411.060, 411.070, 411.404,
411.706, 411.816, 412.014, 412.049, 414.231
Stats. Implemented: ORS 183.415,
183.417, 411.060, 411.070, 411.117, 411.404, 411.706, 411.816, 412.014, 412.049,
414.231, 414.826
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 23-1990, f. 9-28-90,
cert. ef. 10-1-90; AFS 13-1991, f. & cert. ef. 7-1-91; AFS 28-1992, f. &
cert. ef. 10-1-92; AFS 29-1993, f. 12-30-93, cert. ef. 1-1-94; AFS 23-1994, f. 9-29-94,
cert. ef. 10-1-94; AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95; AFS 23-1995, f. 9-20-95,
cert. ef. 10-1-95; AFS 42-1996, f. 12-31-96, cert. ef. 1-1-97; AFS 9-1997, f. &
cert. ef. 7-1-97; AFS 9-1999, f. & cert. ef. 7-1-99; AFS 25-2000, f. 9-29-00,
cert. ef. 10-1-00; AFS 34-2000, f. 12-22-00, cert. ef. 1-1-01; AFS 27-2001, f. 12-21-01,
cert. ef. 1-1-02; SSP 23-2003, f. & cert. ef. 10-1-03; SSP 33-2003, f. 12-31-03,
cert. ef. 1-4-04; SSP 17-2004, f. & cert. ef. 7-1-04; SSP 21-2004, f. &
cert. ef. 10-1-04; SSP 4-2005, f. & cert. ef. 4-1-05; SSP 7-2007, f. 6-29-07,
cert. ef. 7-1-07; SSP 10-2007, f. & cert. ef. 10-1-07; SSP 16-2007(Temp), f.
12-31-07, cert. ef. 1-1-08 thru 6-27-08; SSP 8-2008, f. & cert. ef. 4-1-08;
SSP 11-2008(Temp), f. & cert. ef. 4-7-08 thru 9-30-08; SSP 17-2008, f. &
cert. ef. 7-1-08; SSP 28-2009, f. & cert. ef. 10-1-09; SSP 3-2010(Temp), f.
& cert. ef. 2-23-10 thru 8-22-10; SSP 18-2010, f. & cert. ef. 7-1-10; SSP
25-2010(Temp), f. & cert. ef. 8-16-10 thru 2-12-11; SSP 41-2010, f. 12-30-10,
cert. ef. 1-1-11; SSP 17-2011, f. & cert. ef. 7-1-11; 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; SSP 27-2015(Temp). f. 9-29-15, cert. ef.
10-1-15 thru 3-28-16
461-175-0205
Notice Situation; Benefits for Less Than 30 Days
To end benefits if a client receives them for less than 30 days, send the following notice:
(1) For all programs except SNAP, a basic decision notice.
(2) For SNAP:
(a) A basic notice if the information on ending benefits is included in the initial approval notice;
(b) In all other situations, a timely continuing benefit decision notice.
Stat. Auth.: ORS 411.060, 411.816

Stats. Implemented: ORS 411.060, 411.816

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90
461-175-0206
Notice Situation; Benefit Standard Changes; Not SNAP
(1) If the basis for a decision to reduce,
suspend, or close a grant of public assistance or medical assistance is a change
to a benefit standard, a timely continuing benefit decision notice is sent at least
30 calendar days before the effective date of the action, or if the Department has
fewer than 60 days before the effective date to implement a change to a benefit
standard:
(a) At least 15 working days
before the effective date of the action for clients in the Address Confidentiality
Program (see OAR 461-001-0000).
(b) At least 10 working days
before the effective date of the action for clients not in the Address Confidentiality
Program.
(2) For purposes of this
rule, the term "change to a benefit standard" means a change to the applicable inflation-adjusted
contribution, income, or payment standard. It does not include the annual adjustment
to a standard based on a federal or state inflation rate.
(3) This rule does not apply
in the SNAP program.
Stat. Auth.: ORS 409.050, 411.060, 411.404,
412.014, 412.049
Stats. Implemented: ORS 192.856,
409.010, 411.060, 411.095, 411.404, 412.014, 412.049
Hist.: SSP 6-2006, f. 3-31-06,
cert. ef. 4-1-06; SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07; SSP 37-2013, f. 12-31-13,
cert. ef. 1-1-14
461-175-0207
Notice Situation; Child Care Benefit Calculation
For decisions concerning ERDC or TANF child care benefits, the Department sends a continuing benefit decision notice when benefits are calculated in accordance with OAR 461-155-0150.
Stat. Auth.: ORS 411.060, ORS 411.105, ORS 411.111 & ORS 411.630

Stats. Implemented: ORS 411.060

Hist.: AFS 6-1993(Temp), f. & cert. ef. 4-6-93; AFS 12-1993, f. & cert. ef. 7-1-93; SSP 7-2003, f. & cert. ef. 4-1-03
461-175-0210
Notice Situation; Client
Moved or Whereabouts Unknown
(1) To end benefits for an individual
who has moved out of Oregon, the Department sends the following decision notice
(see OAR 461-001-0000):
(a) In the ERDC, GA, GAM,
OSIP, OSIPM, QMB, REF, REFM, and TANF programs:
(A) The Department sends
a timely continuing benefit decision notice (see OAR 461-001-0000) to the individual
who has moved out of Oregon.
(B) The Department sends
a basic decision notice (see OAR 461-001-0000) if the individual becomes eligible
for benefits in another state.
(b) In the JPI and SNAP programs,
no decision notice is required if the Department determines that the benefit group
(see OAR 461-110-0750) has moved out of Oregon.
(2) If Department mail or
benefits have been returned with no forwarding address, the Department gives the
individual the benefits if the individual's whereabouts become known during the
period covered by the returned benefits. See OAR 461-165-0130 for when SNAP benefits
may be sent out of Oregon. If the individual's whereabouts are unknown, the Department
ends benefits by sending the following decision notice to their last known address:
(a) In all programs except
the JPI and SNAP programs, a basic decision notice.
(b) In the JPI and SNAP programs,
no decision notice is required.
Stat. Auth.: ORS 411.060, 411.095, 411.404,
411.816, 412.049
Stats. Implemented: ORS 411.060,
411.095, 411.404, 411.816, 412.049
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 12-1990, f. 3-30-90, cert. ef. 4-1-90; AFS 23-1990, f. 9-28-90,
cert. ef. 10-1-90; AFS 19-1993, f. & cert. ef. 10-1-93; AFS 2-1994, f. &
cert. ef. 2-1-94; AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97; AFS 13-1997, f. 8-28-97,
cert. ef. 9-1-97; SSP 24-2004, f. 12-30-04, cert. ef. 1-1-05; SSP 32-2010, f. &
cert. ef. 10-1-10; SSP 37-2011(Temp), f. 12-30-11, cert. ef. 1-1-12 thru 6-29-12;
SSP 22-2012, f. 6-29-12, cert. ef. 6-30-12; SSP 30-2013(Temp), f. & cert. ef.
10-1-13 thru 3-30-14; SSP 33-2013(Temp), f. & cert. ef. 10-3-13 thru 3-30-14;
SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14; SSP 30-2014(Temp), f. & cert. ef.
11-14-14 thru 5-12-15; SSP 12-2015, f. 3-16-15, cert. ef. 4-1-15
461-175-0220
Notice Situation; Disqualification
(1) If a benefit group (see OAR 461-110-0750) or individual is disqualified for a SNAP voluntary job quit or for failure to apply for or provide an SSN, pursue assets, cooperate in the JOBS, JOBS Plus, or OFSET program, or assist the state's efforts to collect support, the Department sends the following type of notice:
(a) If benefits are reduced or closed because of the disqualification:
(A) A continuing benefit decision notice (see OAR 461-001-0000) is used when changes are reported on the Interim Change Report form.
(B) A timely continuing benefit decision notice (see OAR 461-001-0000) is used when changes are not reported on the Interim Change Report form.
(b) If benefits are opened without the disqualified individual in the benefit group or if the entire benefit group is denied assistance, a basic decision notice (see OAR 461-001-0000) is used.
(2) For a JOBS, JOBS Plus, or OFSET disqualification, and for a SNAP voluntary job quit by an individual receiving SNAP benefits, the notice includes the following information:
(a) The client action that resulted in disqualification.
(b) The length of the minimum disqualification period.
(c) The reduced benefit amount.
(d) How the client may end the disqualification after the minimum period.
(3) For a voluntary job quit by an individual applying for SNAP benefits, the notice includes the following information:
(a) The action that resulted in the disqualification; and
(b) The length of the disqualification period.
(4) For an IPV disqualification:
(a) A basic decision notice is required if an individual in the benefit group is disqualified for an IPV as the result of a court order or a final order from an administrative hearing.
(b) A continuing benefit decision is required if an individual in the benefit group is disqualified for an IPV based on a signed waiver.
(5) For a disqualification due to being a fleeing felon or in violation of parole, probation, or post-prison supervision (under OAR 461-135-0560):
(a) A basic decision notice is required if benefits are opened without the disqualified individual in the benefit group or if the entire filing group is denied benefits.
(b) A timely continuing benefit decision notice is required if an individual in the benefit group is disqualified.
(6) The notice situation for a disqualification due to a transfer of assets is covered in OAR 461-175-0310.
Stat. Auth.: 411.060, 411.070, 411.404, 411.816, 412.014 & 412.049

Stats. Implemented: 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 23-1990, f. 9-28-90, cert. ef. 10-1-90; AFS 13-1991, f. & cert. ef. 7-1-91; AFS 19-1993, f. & cert. ef. 10-1-93; AFS 2-1994, f. & cert. ef. 2-1-94; AFS 23-1994, f. 9-29-94, cert. ef. 10-1-94; AFS 21-1995, f. 9-20-95, cert. ef. 10-1-95; AFS 36-1996, f. 10-31-96, cert. ef. 11-1-96; AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97; SSP 20-2003, f. & cert. ef. 8-15-03; 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 26-2008, f. 12-31-08, cert. ef. 1-1-09; SSP 5-2010, f. & cert. ef. 4-1-10
461-175-0222
Notice Situations — Expiration
of Certification Period; ERDC, SNAP, TANF
In the ERDC, SNAP, and TANF programs:
(1) Except in the ERDC program,
the Department must provide a household certified for one month or certified in
the second month of a two-month certification period (see OAR 461-001-0000) a notice
of expiration at the time of certification.
(2) In the ERDC program,
each household must receive a notice of expiration prior to the last month of the
certification period.
(3) In the ERDC program,
the notice of expiration must contain:
(a) The date the certification
period expires.
(b) A statement that to receive
benefits, the client must reapply and be found eligible for a new benefit amount.
(c) The household's right
to request a contested case hearing if the reapplication is denied or if the household
objects to the benefit amount.
(4) In the SNAP program,
each household other than those covered under section (1) of this rule must receive
a notice of expiration before the first day of the last month of the certification
period (established per OAR 461-115-0450), but not before the first day of the next-to-the-last
month.
(5) In the SNAP program,
notice of expiration under this rule is provided to the filing group (see OAR 461-110-0370)
and must contain all of the following:
(a) The date the certification
period expires.
(b) The date by which a household
must submit an application for recertification to receive uninterrupted benefits.
(c) The consequences of failure
to apply for recertification in a timely manner.
(d) The right to receive
an application form upon request and to have it accepted as long as it contains
a signature and a legible name and address.
(e) Information on alternative
submission methods available to households that are not able to come into the certification
office or do not have an authorized representative and how to exercise these options.
(f) The address of the office
where the application must be filed.
(g) The household's right
to request a contested case hearing if the recertification is denied or if the household
objects to the benefit amount.
(h) A statement that any
household consisting only of Supplemental Security Income (SSI) applicants or recipients
is entitled to apply for SNAP program benefits recertification at an office of the
Social Security Administration.
(i) A statement that failure
to attend an interview may result in delay or denial of benefits.
(j) A statement that the
household is responsible for rescheduling a missed interview and for providing required
verification information.
(k) A statement that the
client has no rights to continuation of benefits after the SNAP program certification
period expires; and that to receive benefits, the client must reapply and be found
eligible for a new benefit amount after the end of the certification period, including
a client who is receiving continuation of benefits when his or her SNAP program
certification period ends.
(6) In the TANF program,
each household other than those covered under section (1) of this rule must be sent:
(a) Before the first day
of the last month of the certification period (see OAR 461-001-0000 and 461-115-0430),
but not before the first day of the next-to-the-last month, a recertification packet
that contains application forms, deadlines, and information about the consequences
of not reapplying on time; and
(b) A basic decision notice
(see OAR 461-001-0000) about the expiration of the certification period (see OAR
461-001-0000 and 461-115-0430).
Stat. Auth.: ORS 409.050, 411.060, 411.070,
411.816, 412.049
Stats. Implemented: ORS 409.010,
411.060, 411.070, 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 1-2000, f. 1-13-00, cert. ef. 2-1-00; Renumbered from 461-115-0510,
SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07; SSP 15-2010, f. & cert. ef. 5-27-10;
SSP 13-2013, f. & cert. ef. 7-1-13; SSP 29-2015(Temp), f. & cert. ef. 10-1-15
thru 3-28-16
461-175-0225
Notice Situation; Institution/Income and Resource Allowances
If an institutionalized spouse is determined eligible for OSIPM, or upon request by either spouse, or a person acting on behalf of either spouse, send a basic decision notice to each spouse or each person's authorized representative, containing all the following:
(1) The amount of the community spouse's income allowance.
(2) The amount of income allowances for family members.
(3) The method for computing the income allowances for the community spouse and family members.
(4) The amount of the community spouse's resource allowance.
(5) The method for computing the community spouse's resource allowance.
(6) Either spouse's right to a hearing regarding ownership or availability of income or resources, and the determination of the community spouse's income or resource allowance.
Stat. Auth.: ORS 411.060, 411.070 & 411.404

Stats. Implemented: ORS 183.415, 411.060, 411.070 & 411.404

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90
461-175-0230
Notice Situation; Nonstandard Living Situations
(1) In the SNAP program:
(a) A timely continuing benefit
decision notice (see OAR 461-001-0000) is sent to terminate, suspend, or reduce
benefits if the notice occurs as a result of any of the following situations:
(A) A client has been admitted
or committed to an institution.
(B) A client has been placed
in foster care, skilled nursing care, intermediate care, or long term hospitalization.
(C) A client is placed in
official custody or a correctional facility.
(D) A client enters a drug
or alcohol residential treatment facility.
(E) A client leaves a drug
or alcohol residential treatment facility without reapplying for SNAP benefits.
(b) No decision notice (see
OAR 461-001-0000) is required if the Department determines that a resident of a
group living (see OAR 461-001-0015) facility or a drug or alcohol treatment center
is ineligible as a result of one of the following actions taken against the center
or facility:
(A) Disqualification by Food
and Nutrition Services (FNS) as an authorized representative.
(B) Loss of certification
with the Department.
(c) A resident of a facility
that is disqualified or loses its certification as described in subsection (b) of
this section may still qualify for SNAP benefits through a separate application.
(2) Except as provided in
section (3) of this rule, for all programs except the SNAP program, a basic decision
notice (see OAR 461-001-0000) is sent to terminate, suspend, or reduce benefits
in each of the following situations:
(a) The client has been admitted
or committed to an institution, or the client loses Medicaid eligibility while in
the institution.
(b) The client has been placed
in skilled nursing care, intermediate care, or long-term hospitalization.
(c) The client is placed
in official custody or a correctional facility.
(3) In the OSIPM program,
a client receiving home and community-based care (see OAR 461-001-0030) or long
term care services is sent:
(a) A timely continuing benefit
decision notice in each of the following situations:
(A) A reduction or closure
of services occurs as the result of a process of reevaluating both the functional
impairment levels of a client and the requirements of a client for assistance in
performing activities of daily living.
(B) Services are closing
because the client has not paid the client liability.
(C) The client receives benefits
in the OSIP-IC or OSIPM-IC program, and benefits will end under OAR 411-030-0100.
(D) There is a change in
special needs as described in OAR 461-180-0040.
(b) A continuing benefit
decision notice (see OAR 461-001-0000) when there is an increase in the client liability.
(c) A basic decision notice
when there is a decrease in the client liability.
Stat. Auth.: ORS 411.060, 411.101, 411.816,
412.049
Stats. Implemented: ORS 411.060,
411.095, 411.099, 411.101, 411.111, 411.816, 412.049
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 19-1993, f. & cert. ef. 10-1-93; AFS 6-1994, f. &
cert. ef. 4-1-94; AFS 13-1995, f. 6-29-95, cert. ef. 7-1-95; AFS 11-2001, f. 6-29-01,
cert. ef. 7-1-01; SSP 10-2006, f. 6-30-06, cert. ef. 7-1-06; SSP 7-2007, f. 6-29-07,
cert. ef. 7-1-07; SSP 17-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13; SSP
26-2013, f. & cert. ef. 10-1-13; SSP 9-2014, f. & cert. ef. 4-1-14
461-175-0240
Notice Situation; Lump-Sum
(1) If a financial group (see OAR 461-110-0530) receives lump-sum income that will make the financial group ineligible or cause a reduction in benefits:
(a) The Department will deny benefits to an applicant and send a basic decision notice (see OAR 461-001-0000).
(b) If a benefit group (see OAR 461-110-0750) is receiving benefits, the Department will stop or reduce them and:
(A) If the action is based on changes reported on the Interim Change Report form, send a continuing benefit decision notice (see OAR 461-001-0000).
(B) If the action is not based on changes reported on the Interim Change Report form, send a timely continuing benefit decision notice (see OAR 461-001-0000).
(2) In the GA program, the decision notice described in section (1) of this rule includes:
(a) The amount of the countable lump-sum income.
(b) The calculation of this income on a monthly basis.
(c) The length of time that the benefit group is ineligible because of receipt of lump-sum income and the amount that will be included as countable income in the first month of eligibility.
Stat. Auth.: ORS 411.060, 411.095, 411.816

Stats. Implemented: ORS 411.060, 411.095, 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 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 24-2001, f. & cert. ef. 11-1-01; SSP 20-2003, f. & cert. ef. 8-15-03; SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09; SSP 32-2010, f. & cert. ef. 10-1-10
461-175-0250
Notice Situation; Mass Changes
(1) If benefits are reduced or closed to reflect cost-of-living adjustments in benefits or other mass change under a program operated by a federal agency or to reflect a mass change to payments in a program operated by the Department:
(a) Except as provided in subsection (b) of this section, the type of decision notice (see OAR 461-001-0000) used is the same as otherwise applies to the reduction or closure of benefits under the rules of this division.
(b) In the SNAP program, a continuing benefits decision notice (see OAR 461-001-0000) may be used if the rules in this division of rules would otherwise require a timely continuing benefits decision notice (see OAR 461-001-0000).
(c) OAR 461-175-0010(2) and (3) modify the content requirements for the decision notice that apply to other decision notices under OAR 461-175-0010(1).
(2) In the SNAP program, no decision notice is required when the Department makes the following mass changes:
(a) An annual adjustment to income limits, the shelter deduction, or the standard deduction.
(b) An annual adjustment to a standard utility allowance.
Stat. Auth.: ORS 409.050, 411.060, 411.816, 412.014, 412.049

Stats. Implemented: ORS 409.010, 411.060, 411.816, 412.014, 412.049

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 13-1994, f. & cert. ef. 7-1-94; AFS 4-1998, f. 2-25-98, cert. ef. 3-1-98; AFS 5-1998(Temp), f. & cert. ef. 3-11-98 thru 5-31-98; AFS 8-1998, f. 4-28-98, cert. ef. 5-1-98; SSP 22-2004, f. & cert. ef. 10-1-04; SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07; SSP 20-2003, f. & cert. ef. 8-15-03; SSP 7-2007, f. 6-29-07, cert. ef. 7-1-07; SSP 26-2010(Temp), f. & cert. ef. 8-16-10 thru 2-12-11; SSP 41-2010, f. 12-30-10, cert. ef. 1-1-11
461-175-0270
Notice Situation; SRS or TBA
(1) When the Department takes action
on information reported on the Interim Change Report form, the Department sends
a continuing benefit decision notice (see OAR 461-001-0000) for clients in the ERDC,
OSIP, OSIPM, QMB, REF, REFM, SNAP, and TANF programs. The notice includes the amount
of income used to determine the benefits or ineligibility.
(2) For all changes not reported
on the Interim Change Report form, which result in a closure or reduction in benefits,
the Department sends a timely continuing benefit decision notice.
(3) When the Department changes
the reporting system from one reporting system to another reporting system, the
Department provides a continuing benefit decision notice if the change occurs at
a time other than at the start of a certification period (see OAR 461-001-0000).
Stat. Auth.: ORS 411.060, 411.070, 411.095,
411.111, 411.404, 411.816, 412.049
Stats. Implemented: ORS 411.060,
411.070, 411.095, 411.111, 411.404, 411.816, 412.049
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 12-1990, f. 3-30-90, cert. ef. 4-1-90; AFS 20-1992, f. 7-31-92,
cert. ef. 8-1-92; 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 23-1994, f. 9-29-94,
cert. ef. 10-1-94; AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00; SSP 13-2003, f. 6-12-03,
cert. ef. 6-16-03; SSP 20-2003, f. & cert. ef. 8-15-03; SSP 4-2007, f. 3-30-07,
cert. ef. 4-1-07; SSP 14-2007, f. 12-31-07, cert. ef. 1-1-08; SSP 26-2008, f. 12-31-08,
cert. ef. 1-1-09; SSP 28-2009, f. & cert. ef. 10-1-09; SSP 38-2009, f. 12-31-09,
cert. ef. 1-1-10; SSP 5-2010, f. & cert. ef. 4-1-10; SSP 32-2010, f. & cert.
ef. 10-1-10; 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
461-175-0280
Notice Situation; Failure to Submit Report for SRS or ERDC Reapplication
(1) In the ERDC program, the Department
sends a continuing benefit decision notice (see OAR 461-001-0000) to close benefits
when the benefit group (see OAR 461-110-0750) fails to return the reapplication
form. The case is closed on the last day of the last month of the certification
period (see OAR 461-001-0000).
(2) In the SNAP program,
the Department sends a continuing benefit decision notice when a benefit group in
Simplified Reporting System (SRS) fails to return the Interim Change Report by the
10th day of the sixth month of the certification period. The notice informs the
benefit group that:
(a) The report was not received
by the Department by the 10th day of the sixth month in the certification period.
(b) The benefit group has
until the end of the sixth month of the certification period to provide the report
to receive benefits for the seventh month of the certification period.
(c) If the report is not
received by the Department by the last day of the sixth month of the certification
period, SNAP program benefits will be suspended effective the last day of the sixth
month.
(d) The SNAP program case
remains in suspended status for a month and then is closed.
Stat. Auth.: ORS 409.050, 411.060, 411.070,
411.095, 411.816
Stats. Implemented: ORS 409.010,
409.050, 409.610, 411.060, 411.070, 411.087, 411.095, 411.816, 411.825, 411.837
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 20-1992, 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; AFS 3-2000, f. 1-31-00, cert. ef. 2-1-00; AFS 10-2002, f. & cert.
ef. 7-1-02; SSP 20-2003, f. & cert. ef. 8-15-03; SSP 26-2008, f. 12-31-08, cert.
ef. 1-1-09; SSP 5-2009, f. & cert. ef. 4-1-09; SSP 28-2009, f. & cert. ef.
10-1-09; SSP 32-2010, f. & cert. ef. 10-1-10; SSP 23-2015, f. 9-28-15, cert.
ef. 10-1-15
461-175-0290
Notice Situation; Overpayment Repayment
When benefits are reduced for
recovery of an overpayment (see OAR 461-195-0551) a timely continuing benefit decision notice (see OAR 461-001-0000) is sent for the first month
of the reduction.
Stat. Auth.: ORS 411.060, 411.070, 411.816,
412.014, 412.049

Stats. Implemented: ORS 411.060,
411.070, 411.816, 412.014, 412.049

Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 30-1990, f. 12-31-90, cert. ef. 1-1-91; AFS 28-1992, f. &
cert. ef. 10-1-92; SSP 35-2011, f. 12-27-11, cert. ef. 1-1-12
461-175-0300
Notice Situation; Prior Notice
(1) Except as provided in section (5)
of this rule, when benefits in any Department program except a medical program and
the SNAP program will end or be reduced after a specific period of time, the Department
may issue a decision notice (see OAR 461-001-0000) informing the benefit group (see
OAR 461-110-0750) of the date benefits will end or be reduced, and no further decision
notice is required.
(2) Except as provided in
section (5) of this rule, in any Department program except a medical program and
the SNAP program, if the benefit group was informed in writing when the benefits
began that the benefit group would receive benefits only for a specific period of
time a basic decision notice (see OAR 461-001-0000) may be used to:
(a) Deny an application to
start or continue benefits after the completion of a certification period (see OAR
461-001-0000) or to approve benefits at a level lower than the prior certification
period.
(b) Indicate that benefits
have been ended or reduced when no timely application is submitted.
(3) A basic decision notice
is used when a special need allowance granted for a specific period of time is removed
at the end of the specified period and the benefit group was informed of this in
writing when the allowance began. A timely continuing benefit decision notice (see
OAR 461-001-0000) is required if stopping the special need allowance results in
benefit closure.
(4) In the JOBS Plus program,
a basic decision notice is used if:
(a) An employer submits a
wage reimbursement billing and the Department calculates a supplement (see OAR 461-190-0416
about supplements);
(b) The benefit group received
a timely continuing benefit decision notice that the method of payment would be
changed from cash to employer-paid wages; and
(c) The notice specified
the period of time that benefits would be diverted.
(5) No additional decision
notice is required when:
(a) Notwithstanding OAR 461-115-0010(6),
when a benefit group submits an application for a program from which they currently
are receiving benefits.
(b) In the ERDC program when
a filing group (see OAR 461-110-0350) is receiving priority processing (see OAR
461-170-0150(2)) but does not return postponed verification to the Department by
the last day of the month in which the application period ends (see OAR 461-115-0190).
(c) In the OSIPM program:
(A) A client's liability
returns to the previous higher level after the Department sent the client a continuing
benefit decision notice for a decrease in the client liability due to an allowable
deduction and that notice also specified when the deduction no longer would apply
causing the client liability to return to the previous higher level; or
(B) A client's benefits are
being closed or reduced and the Department sent the client a basic decision notice
of eligibility and a simultaneous continuing benefit decision notice because the
client's circumstances changed between the date of the client's application and
the date of the Department's eligibility decision and the change caused the client's
benefits to be reduced or closed.
(6) In the SNAP program:
(a) A basic decision notice
is used to close benefits if the benefit group was informed in writing, when their
benefits began, that they would receive benefits only for a specific period of time.
(b) No decision notice is
required if the client is provided a decision notice at the time of application
or redetermination that:
(A) The allotment of the
benefit group would vary from month to month and listed the anticipated changes;
(B) In the case the client
applied at the same time for both cash assistance and SNAP benefits, the SNAP benefits
would be reduced or closed upon approval of the cash assistance; or
(C) In the case of a benefit
group receiving benefits under expedited services with postponed verification:
(i) The expedited services
benefits would close if the Department did not receive the postponed verification
within the timeframe established under OAR 461-115-0690.
(ii) The expedited services
benefits may be adjusted beyond the timeframe established under OAR 461-115-0690
based on the verified information provided to the Department without further notice.
Stat. Auth.: ORS 183.417, 411.060, 411.070,
411.117, 411.404, 411.706, 411.816, 412.006, 412.014, 412.049, 414.231, 414.826
Stats. Implemented: ORS 183.417,
411.060, 411.070, 411.117, 411.404, 411.706, 411.816, 412.006, 412.014, 412.049,
414.231, 414.826
Hist.: AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 23-1994, f. 9-29-94, cert. ef. 10-1-94; AFS 25-1994, f. &
cert. ef. 11-1-94; AFS 10-2002, f. & cert. ef. 7-1-02; SSP 17-2004, f. &
cert. ef. 7-1-04; SSP 3-2005(Temp), f. & cert. ef. 3-2-05 thru 6-30-05; SSP
7-2005, f. & cert. ef. 7-1-05; SSP 18-2010, f. & cert. ef. 7-1-10; SSP 29-2015(Temp),
f. & cert. ef. 10-1-15 thru 3-28-16
461-175-0305
Notice Situation; Removing an Individual
From a Benefit Group (REF, REFM, SNAP, TANF) or Need Group (ERDC)
(1) To remove an individual from a benefit
group (see OAR 461-110-0750), the following notices are used:
(a) A continuing benefit
decision notice (see OAR 461-001-0000) is used when the removal is based on information
reported on the Interim Change Report form.
(b) A timely continuing benefit
decision notice (see OAR 461-001-0000) is used when the removal is not based on
the Interim Change Report form.
(2) In the ERDC program,
the Department sends a timely continuing benefit decision notice to remove an individual
from the need group (see OAR 461-110-0630).
(3) In the REF, REFM, and
TANF programs, if a child is removed from the benefit group as a result of a court
order or a voluntary placement in foster care by the child's caretaker relative
(see OAR 461-001-0000), a basic decision notice (see OAR 461-001-0000) is used.
Stat. Auth.: ORS 411.060, 411.095, 411.404,
411.816, 412.049
Stats. Implemented: ORS 411.060,
411.095, 411.404, 411.816, 412.049
Hist.: AFS 30-1990, f. 12-31-90,
cert. ef. 1-1-91; 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; AFS 10-1995, f. 3-30-95,
cert. ef. 4-1-95; AFS 10-2002, f. & cert. ef. 7-1-02; SSP 20-2003, f. &
cert. ef. 8-15-03; SSP 23-2003, f. & cert. ef. 10-1-03; SSP 10-2007, f. &
cert. ef. 10-1-07; SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09; SSP 32-2010, f. &
cert. ef. 10-1-10; 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
461-175-0310
Notice Situation; Resource Transfer Disqualification
(1) When the Department proposes to disqualify a filing group because of a disqualifying transfer of assets (see OAR 461-140-0210), the following notice is sent:
(a) For new applicants, a basic decision notice.
(b) For ongoing clients, a timely continuing benefit decision notice.
(2) A notice required by this rule includes the amount of uncompensated value used in the eligibility determination and the period of ineligibility caused by the transfer.
(3) In the GA, GAM, OSIP, OSIPM and QMB programs, the notice must also include:
(a) The action that resulted in the disqualification, and
(b) Information that the client, or the facility in which the client resides (on behalf of the client), may apply for a waiver of the disqualification on the basis of undue hardship.
Stat. Auth.: ORS 411.060, 411.816, 418.100

Stats. Implemented: ORS 411.060, 411.816, 418.100

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 27-2001, f. 12-21-01, cert. ef. 1-1-02; SSP 4-2005, f. & cert. ef. 4-1-05; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06
461-175-0320
Notice Situation; Restoring SNAP Benefits
In the SNAP program, after the Department determines whether a person is entitled to restoration of benefits, the person is entitled to a basic decision notice that includes the amount to be restored, any offsetting that was done, and the manner in which the benefits will be restored. Once the Department sends the notice, no additional notice is required when the restoration payments stop.
Stat. Auth.: ORS 411.060, 411.816

Stats. Implemented: ORS 411.060, 411.816

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 10-2002, f. & cert. ef. 7-1-02
461-175-0340
Notice Situation; Voluntary Action
(1) Unless the Department chooses to proceed as described in section (2) of this rule:
(a) For all programs except the SNAP program, if the primary person (see OAR 461-001-0000), another adult member of the filing group, or the authorized representative:
(A) Makes an oral request to end or reduce benefits, a timely continuing benefit decision notice (see OAR 461-001-0000) is sent.
(B) Makes a signed, written request to withdraw, end, or reduce benefits, a basic decision notice (see OAR 461-001-0000) is sent.
(C) Makes an oral request to withdraw an application for benefits, a basic decision notice is sent.
(b) In the SNAP program, when the filing group (see OAR 461-110-0370) states it wishes to withdraw its benefits request, or states it wishes to reduce or no longer receive benefits:
(A) If the request is made by phone to end or reduce benefits, a timely continuing benefit decision notice is sent.
(B) If the request is made in person to reduce benefits, a basic decision notice is sent.
(C) If the request to reduce benefits is signed by the primary person (see OAR 461-001-0000), another adult member of the filing group, or the authorized representative, a basic decision notice is sent.
(D) If the request to end benefits is signed by the primary person, another adult member of the filing group, or the authorized representative in the presence of a worker, no notice is required. If it is not signed in the presence of a worker, a basic decision notice is sent.
(E) If the client withdraws a signed request for benefits, a basic decision notice is sent.
(2) The Department may reduce or terminate benefits to an individual when the individual completes a voluntary agreement on a Department form used for this purpose. The Department provides the individual with a copy of the completed agreement and no other notice is required. The individual may request a hearing to set aside this agreement on the grounds of fraud, duress, or reliance on misinformation provided by the Department, subject to the time limits for hearing requests in OAR 461-025-0310.
(3) In the SNAP program, a timely continuing benefit decision notice is sent if the filing group returns a signed Change Report form with information that requires a reduction or closure of benefits.
Stat. Auth.: ORS 411.060, 411.816, 412.014, 412.049, 414.042

Stats. Implemented: ORS 183.417, 411.060, 411.816, 412.014, 412.049, 414.042

Hist.: AFS 80-1989, f. 12-21-89, cert. ef. 2-1-90; AFS 13-1991, f. & cert. ef. 7-1-91; SSP 23-2003, f. & cert. ef. 10-1-03; SSP 24-2004, f. 12-30-04, cert. ef. 1-1-05; SSP 16-2007(Temp), f. 12-31-07, cert. ef. 1-1-08 thru 6-27-08; SSP 8-2008, f. & cert. ef. 4-1-08; SSP 23-2008, f. & cert. ef. 10-1-08


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