In the OSIP and OSIPM programs:

1. (1) The Department may authorize one-time payments for expenses that the Department has determined are necessary to divert individuals who might otherwise be served in nursing facilities to community based care (see OAR 461-001-0000). Payments are allowed for individuals who meet the criteria established in OAR 411-015-0015(1)(a).
2. (2) Payments will be authorized at the lowest possible cost.
3. (3) To be eligible for payment, individuals may not be eligible for the item through Medicare, Medicaid, or any other medical coverage.
4. (4) Payment for a household item is not allowed if the community-based care facility (see OAR 461-155-0630) is required to provide the item by contract or administrative rule.
5. (5) Payment is not allowed if the item or service may be provided under any other special need rule in this division (OAR 461-155-0510 to 461-155-0700).

Statutory/Other Authority

ORS 409.050, 411.060, 411.070, 411.404, 413.085 & 414.685

Statutes/Other Implemented

ORS 409.010, 411.060, 411.070 & 411.404

History

SSP 66-2021, minor correction filed 12/14/2021, effective 12/14/2021
SSP 28-2018, amend filed 09/06/2018, effective 10/01/2018
SSP 13-2013, f. & cert. ef. 7-1-13
SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09
SSP 22-2008(Temp), f. & cert. ef. 10-1-08 thru 3-30-09