OAR 461-135-0950
Eligibility for Inmates and Residents of Public Institutions


(1)

This rule sets out additional restrictions on the eligibility of inmates and residents of state hospitals for programs covered by Chapter 461 of the Oregon Administrative Rules.

(2)

Definition of an “inmate”.

(a)

An inmate is an individual living in a public institution (see section (3) of this rule) who is:

(A)

Confined involuntarily in a local, state or federal prison, jail, detention facility, or other penal facility, including an individual being held involuntarily in a detention center awaiting trial or an individual serving a sentence for a criminal offense;

(B)

Residing involuntarily in a facility under a contract between the facility and a public institution where, under the terms of the contract, the facility is a public institution;

(C)

Residing involuntarily in a facility that is under governmental control;

(D)

Receiving care as an outpatient while residing involuntarily in a public institution; or

(E)

In the OSIPM and QMB programs, released from the public institution during a temporary period of hospitalization in a medical institution outside of the correctional facility.

(b)

An individual is not considered an inmate when:

(A)

The individual is released on parole, probation, or post-prison supervision;

(B)

The individual is on home- or work-release, unless the individual is required to report to a public institution for an overnight stay;

(C)

The individual is voluntarily residing in a supervised community residential facility and all of the following are true:
(i) Residents are not precluded from working outside the facility in employment available to individuals who are not under justice system supervision;
(ii)
Residents can use community resources such as libraries, grocery stores, recreation and education at will, notwithstanding any house rules such as a requirement to sign in and out, curfews, or hours during which the residence is closed or locked; and
(iii) Residents can seek health care treatment in the broader community to the same or similar extent as other Medicaid enrollees in the state.

(D)

The individual is staying voluntarily in a detention center, jail, or county penal facility after their case has been adjudicated and while other living arrangements are being made for the individual; or

(E)

The individual is in a public institution pending other arrangements as defined in 42 CFR 435.1010.

(3)

A “public institution” is any of the following:

(a)

A state hospital (see ORS 162.135 (Definitions for ORS 162.135 to 162.205)).

(b)

A local correctional facility (see ORS 169.005 (Definitions for ORS 169.005 to 169.685 and 169.730 to 169.800)): a jail or prison for the reception and confinement of prisoners that is provided, maintained and operated by a county or city and holds individuals for more than 36 hours.

(c)

A Department of Corrections institution (see ORS 421.005 (Definitions)): a facility used for the incarceration of individuals sentenced to the custody of the Department of Corrections, including a satellite, camp, or branch of a facility.

(d)

A youth correction facility (see ORS 162.135 (Definitions for ORS 162.135 to 162.205)):

(A)

A facility used for the confinement of youth offenders and other individuals placed in the legal or physical custody of the youth authority, including a secure regional youth facility, a regional accountability camp, a residential academy and satellite, and camps and branches of those facilities; or

(B)

A facility established under ORS 419A.010 (Appointment of counselors and director) to 419A.020 (County responsibility for expenses of juvenile department) and 419A.050 (Authority to acquire, equip and maintain detention and shelter facilities) to 419A.063 (Requirements for detention facilities) for the detention of children, wards, youth, or youth offenders pursuant to a judicial commitment or order.

(4)

Definition of serious mental illness. An individual has a serious mental illness if the individual has been diagnosed by a psychiatrist, a licensed clinical psychologist or a certified non-medical examiner as having dementia, schizophrenia, bipolar disorder, major depression or other affective disorder or psychotic mental disorder other than a substance abuse disorder and other than a disorder that is caused primarily by substance abuse.

(5)

An individual who resides in a state hospital (see subsection (3)(a) of this rule) meets the definition of a serious mental illness (see section (4) of this rule), and applies for medical assistance between 90 and 120 days prior to the expected date of the person’s release from the state hospital may be found eligible for medical assistance. If the individual is determined to be eligible, the effective date of the individual’s medical assistance is the date the individual is released from the institution.

(6)

In the OSIPM and QMB programs, except as provided for in section (7) of this rule, an individual who is at least 21 years of age and less than 65 years of age who becomes a resident of a state hospital has medical benefits suspended. When an individual with suspended medical benefits is no longer a resident of the state hospital, or when the individual is admitted to a medical institution outside of the state hospital for a period of hospitalization, medical benefits are reinstated effective the first day the individual is no longer a resident, if the individual continues to meet eligibility for the medical program.

(7)

An individual residing in a state hospital may be eligible for OSIPM and QMB program benefits if the individual meets the requirements of one of the following subsections:

(a)

The individual is 65 years of age or older.

(b)

The individual receives a Certificate of Need for Services from the State-authorized agency, and meets one of the following:

(A)

The individual is under 21 years of age.

(B)

The individual is 21 years of age, received a Certificate of Need for Services from the State-authorized agency, and received those services immediately before reaching age 21. Except as provided for in subsection (a) of this section, eligibility ends at age 22.

(8)

For all programs covered under chapter 461 of the Oregon Administrative Rules:

(a)

Except as provided otherwise in this rule, an inmate (see section (2) of this rule) of a public institution is not eligible for benefits.

(b)

If a pregnant woman receiving medical assistance through the OSIPM program becomes an inmate of a public institution, her medical benefits are suspended. When the Department is informed the woman is no longer an inmate, her medical benefits are reinstated – effective on the first day she is no longer an inmate – if she is still in her protected period of eligibility under OAR 461-135-0010 (Assumed Eligibility for Medical Programs).

(c)

If an individual receiving medical assistance through the OSIPM or QMB programs becomes an inmate of a correctional facility, medical benefits are suspended during the incarceration period.

(d)

In the OSIPM and QMB programs, when the Department is notified that an individual with suspended benefits has been released or has been admitted to a hospital outside of the public institution for a period of hospitalization, medical benefits are reinstated effective the first day the client is no longer an inmate if both of the following are true:

(A)

The client continues to meet eligibility for the medical program; and

(B)

The notification takes place within ten calendar days of the release, or the notification takes place more than ten calendar days from the release date and there is good cause for the late reporting.

(9)

In the GA and SNAP programs, in addition to the other provisions of this rule, an inmate released from a public institution on home arrest and required to wear an electronic device to monitor their activity, is ineligible for benefits if the correctional agency provides room and board to the individual.

(10)

In the GA program, when an individual becomes an inmate of a public institution:

(a)

Benefits may continue for the two calendar months following the month the Department is notified of the incarceration, if the individual will be released before the end of the second calendar month and the housing arrangement is still available.

(b)

If the individual will be released after the end of the second calendar month following the month of notification, or if the release date is not known, benefits will be closed effective the end of the notice period (see OAR 461-175-0050 (Notice Period)) for a timely continuing benefit decision notice (see OAR 461-001-0000 (Definitions for Chapter 461)).

Source: Rule 461-135-0950 — Eligibility for Inmates and Residents of Public Institutions, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=461-135-0950.

461‑135‑0010
Assumed Eligibility for Medical Programs
461‑135‑0070
Specific Requirements
461‑135‑0071
TANF Time Limit
461‑135‑0073
TANF Time Limit
461‑135‑0075
TANF Time Limit
461‑135‑0080
TANF Eligibility for Minor Parents
461‑135‑0085
Requirement to Attend an Assessment or Evaluation, or Seek Medically Appropriate Treatment for Substance Abuse and Mental Health
461‑135‑0087
Good Cause for Failure to Comply with Substance Abuse or Mental Health Requirements
461‑135‑0089
Demonstrating Compliance with Substance Abuse and Mental Health Requirements
461‑135‑0200
Multiple Disqualifications
461‑135‑0220
REF, REFM, and TANF Programs
461‑135‑0300
Eligibility for and Needs Covered by EA
461‑135‑0301
Closure of the Emergency Assistance (EA) Program Effective May 1, 2004
461‑135‑0310
Covered Shelter Needs
461‑135‑0320
Time Limits
461‑135‑0340
Work Requirements
461‑135‑0350
Eligible People
461‑135‑0400
Specific Requirements
461‑135‑0405
Children in the Head Start Program
461‑135‑0415
Requirement to Make Copay or Satisfactory Arrangements
461‑135‑0440
Child Care Benefit Eligibility and Payment
461‑135‑0475
Specific Requirements
461‑135‑0485
Requirement to Complete an Employability Screening and Overview of the Job Opportunity and Basic Skills (JOBS) Program
461‑135‑0491
Disaster Supplemental Nutrition Assistance Program (DSNAP)
461‑135‑0492
Application, Interviews, and Verification for DSNAP
461‑135‑0493
Eligibility and Benefit Amount for DSNAP
461‑135‑0494
DSNAP Treatment of Households Already Certified and Receiving SNAP Benefits
461‑135‑0495
Recertifications for DSNAP
461‑135‑0496
Hearings for DSNAP
461‑135‑0497
Household Liability in the DSNAP
461‑135‑0498
Pandemic-related Supplemental Nutrition Assistance Program
461‑135‑0505
Categorical Eligibility for SNAP
461‑135‑0506
Transitional Benefit Alternative (TBA) in the SNAP Program
461‑135‑0510
Residents of Institutions
461‑135‑0520
Time Limit and Special Requirements for ABAWD
461‑135‑0521
Job Quit by Applicants
461‑135‑0530
People in Adult Foster Care (AFC) and Boarding Houses
461‑135‑0560
Fleeing Felon and Violators of Parole, Probation, and Post-Prison Supervision
461‑135‑0570
Eligible and Ineligible Students
461‑135‑0575
SNAP Expedited Services
461‑135‑0580
Prepared Meals
461‑135‑0590
Communal Dining
461‑135‑0610
Meal Providers for Homeless Individuals
461‑135‑0660
SNAP
461‑135‑0700
Specific Requirements
461‑135‑0701
Terminate GA and GAM Programs October 1, 2005
461‑135‑0708
Criteria for Developing a Plan for Self-support
461‑135‑0725
Specific Requirements
461‑135‑0726
Specific Requirements
461‑135‑0730
Specific Requirements
461‑135‑0745
Eligibility for Individuals in Acute Care Settings
461‑135‑0750
Individuals Applying for or Receiving Long-Term Care or Home and Community-Based Care
461‑135‑0755
Individual Residing in a 24-Hour Mental Health Residential Care Setting
461‑135‑0771
Eligibility for OSIPM Under “Grandfathering” Provision
461‑135‑0780
Pickle Amendment Clients
461‑135‑0790
Eligibility for People in an Institution Since 1973
461‑135‑0800
Eligibility for 1972 COLA Clients
461‑135‑0820
Eligibility for Widows and Widowers
461‑135‑0830
Eligibility for Disabled Adult Children
461‑135‑0832
Estate Administration
461‑135‑0833
Burial Expenses
461‑135‑0834
Delivery of Required Notices to the Estate Administration Unit
461‑135‑0835
Limits on Estate Claims
461‑135‑0837
Administering Medicaid Estate Claims When the Recipient of Assistance was a Native American Indian or Alaskan Native Village Tribal Member
461‑135‑0838
Administering Estate Claims
461‑135‑0839
Title to Real and Personal Property
461‑135‑0841
Undue Hardship Waiver Criteria
461‑135‑0843
Establishing Legal Title, Interest or Form of Ownership
461‑135‑0844
Procedures for Applying for Undue Hardship Waiver
461‑135‑0845
Valuation of Life Estate, Reversionary Interest, and Property
461‑135‑0847
Forms
461‑135‑0850
Specific Requirements
461‑135‑0875
Specific Requirements
461‑135‑0880
OSIPM and QMB Programs
461‑135‑0900
Specific Requirements
461‑135‑0910
Unaccompanied Minor Program
461‑135‑0915
Specific Requirements
461‑135‑0920
Refugees Applying for SSI
461‑135‑0930
Medical Coverage for Refugees
461‑135‑0950
Eligibility for Inmates and Residents of Public Institutions
461‑135‑0990
Specific Requirements
461‑135‑1070
Specific Requirements
461‑135‑1175
Senior Farm Direct Nutrition Program
461‑135‑1185
Low-Income Subsidy Program (LIS)
461‑135‑1186
LIS Applications
461‑135‑1187
Eligibility Determinations and Due Process for LIS
461‑135‑1195
Specific Requirements
461‑135‑1197
Good Cause
461‑135‑1200
Specific Requirements
461‑135‑1230
Benefits
461‑135‑1235
TA-DVS
461‑135‑1240
TA-DVS Program
461‑135‑1250
Closure of Post-TANF Program
461‑135‑1260
Specific Requirements: Job Participation Incentive
461‑135‑1270
Specific Requirements
Last Updated

Jun. 8, 2021

Rule 461-135-0950’s source at or​.us