APD Counting Client Assets - OSIP(M) and Medicare Savings Programs
B. Specific Types of Assets
For information on OCCS Medical or self-sufficiency programs, please refer to the Administrative
Rules. OCCS Medical programs are located in the 410-200 Chapter and Division of the OAR's. The remaining SSP programs are located in the 461 Chapter of the OARs. OCCS, REF(M), SNAP, and other SSP programs have been removed from this section. Click here for SNAP.
Information applies to both OSIPM and QMB/SMB/SMF unless specifically labeled.
1. Achieving a Better Life Experience for Everyone (ABLE) Act of 2014
The Achieving a Better Life Experience for Everyone (ABLE) Act of 2014 allows individuals with disabilities who qualify to open special accounts under Section 529 of the Internal Revenue Code. The purpose of these accounts is to allow qualifying people with disabilities to save money for items that enhance their quality of life without losing needed entitlements and public benefits.
Individuals can qualify to open an ABLE Act account (or have one opened for them) if:
- The individual is blind or has a disability that does or would qualify them to receive SSI or Social Security based on blindness or disability; and
- The onset of the blindness or the disability occurred before the age of 26.
Balances in ABLE Act accounts are excluded when considering eligibility for OSIPM and the MSPs.
Withdrawals from ABLE Act accounts for Qualified Disability Expenses, or QDEs, are excluded for OSIPM and the MSPs. QDEs include the following:
- Housing expenses, which include:
- mortgage payments,
- real property taxes,
- heating fuel,
- sewer, or
- garbage removal;
- Employment training or support;
- Assistive technology and related services;
- Prevention and wellness;
- Financial management and administrative services;
- Legal Fees
- Expenses for ABLE account oversight and monitoring;
- Funeral and burial; and
- Basic living expenses.
Disbursements from ABLE Act accounts for purposes other than those listed above count as unearned income in the month of the disbursement. Any money left from that disbursement would be considered a resource in the month after the month of withdrawal.
Staff are not expected to monitor these accounts with regularity, given that all monies held in the accounts are excluded, and the QDEs are written in such a broad fashion that clients have wide latitude with expenditures.
2. Adoption Assistance
Adoption assistance is financial assistance provided to families adopting children
with special needs. Adoption assistance may be state or federally funded. Federal
adoption assistance is authorized by the Adoption Assistance and Child Welfare
Act of 1980 (Public Law 96-272). State adoption assistance is authorized by
ORS 418.330 to 418.335.
Exclude the entire amount of adoption assistance from Oregon (all adoption assistance in Oregon is for the special needs of the child).
Exclude the portion of adoption assistance that is for the special needs
of the child when the adoption assistance is from other states. This includes needs such as special diet, special clothing,
counseling, and medical costs not covered under Title XIX. Count the rest of the adoption assistance as unearned income.
3. Agent Orange Disability Benefits
All payments made under the Agent Orange Act of 1991 or from the Agent Orange settlement fund or any other fund established pursuant to the settlement in the Agent Orange product liability litigation is excluded in all APD medical programs.
4. Alaska Permanent Fund Dividend
The Alaska Permanent Fund Dividend is issued annually to eligible Alaskan residents
who apply for the payment. Out-of-state residents, except military personnel
and students who claim Alaska as their residence, are not eligible unless they
resided in Alaska and filed for the payment before leaving the state.
Count Alaska Permanent Fund Dividend payments as lump-sum income.
If an animal is considered a pet or raised specifically as food for the filing group, it’s excluded. For example, lamb or cattle or chickens that will be slaughtered and eaten by the family would fall under this category, as would chickens that lay eggs eaten by the family or a dairy cow that provides them with milk. Any animal can be considered a pet as long as it doesn’t generate income, including cows, horses, sheep, and chickens. Furthermore, animals can be both pets and a source of food for the family.
The equity value of animals that are raised or kept for eventual sale is countable as a resource. This could include pigs, sheep, or cows that are raised and then auctioned off at fair time or sold to a third party. This could also include puppies bred specifically for sale as pets or show dogs, or horses that are bred or purchased, trained, and re-sold as roping or barrel-racing horses. These animals are countable resources regardless of whether or not they are also considered pets.
OSIPM and QMB/SMB/SMF
There is a distinction between animals that are sold for income (as above) and animals that produce income. For example, if a family has a cow and sells the milk or has chickens and sells the eggs, the animals are considered income-producing property and treated in accordance with the income-producing property rule (see OAR 461-145-0252). On the other hand, if selling the milk or eggs constitutes self-employment (see OAR 461-145-0915), the cow or chicken could be treated as a work-related capital asset and excluded (see OAR 461-145-0600).
Even though all animals are excluded as a resource for QMB/SMB/SMF, any income produced by animals still has to be evaluated under 461-145-0252 or under the self-employment income rules.
Note: If some of the eggs and milk are consumed by the family and the excess is sold, the chickens and cows are still excluded; however, the income from selling the eggs and milk is counted as unearned income.
6. Annuities; QMB/SMB/SMF
For a client, an annuity does not include benefits that are set up and accrued in a regularly funded retirement account while an individual is working, whether maintained in the original account or used to purchase an annuity, if the Internal Revenue Service recognizes the account as dedicated to retirement or pension purposes (461-145-0380).
Annuity payments (principal and interest) are counted as unearned income to the payee.
For OSIPM, see below.
7. Annuities; OSIPM
How we treat an annuity depends on many factors. In order to figure it out, you will need to know all of the following:
- Whether the annuity can be considered a commercial annuity
- When the annuity was purchased or set up
- Was it established prior to January 1, 2006? These may constitute a disqualifying transfer. Since 2006 is before the 5-year look-back period, this would only affect annuities we discover after-the-fact for clients who were on services between 2006 and 2011. In other words, it would be an overpayment and not a future disqualification.
- Was it established between January 1st and June 30th of 2006?
- Was it established after July 1, 2006?
- Whether or not the client is in a non-standard living arrangement or a standard living arrangement
- Whether the annuity is irrevocable and nonassignable
- Whether the annuity is actuarially sound.
- Who owns the annuity
Once you have all that information, you can refer to the Treatment of Annuities section of the APD Worker Guide (APD E.1) to determine how they are treated, including whether the purchase of an annuity is a disqualifying transfer of assets.
8. Approved Accounts; EPD
All monies in an approved account are excluded as income or a resource
during the determination of eligibility; however, the exclusion can only be
made if the account has been designated as an Approved Account and approved
as such by the local branch prior to eligibility determination.
Monies deposited in the approved account that the client wants to be considered
as an Employment and Independence Expense to be used as a deduction from countable
income must be approved by the branch prior to the deposit being made.
If monies from the approved account are used for a purpose not consistent
with the definition of approved account in 461-001-0035,
the client may be prohibited from utilizing an approved account for the next
12 months for the purposes of the determination of eligibility.
9. Bank Account
A bank account includes a money market account and an account in a financial institution, except that accounts in financial institutions for stocks, bonds, and certificates of deposit (CDs) are covered in CCA B.71.
For OSIPM, money in a bank account is counted as a resource (as long as it's considered available, see 461-140-0020), unless it can be excluded using the criteria below.
The following types of bank accounts are excluded as a resource:
- An approved account if excluded under 461-145-0025 (see CCA B.7).
- A burial fund, if excluded under 461-145-0040 (see CCA B.9)
- A designated bank account for an Independent Choices Program (ICP) client is an excluded asset if:
- The account is designated to receive program benefits by direct deposit through electronic funds transfer; and
- The benefit funds are not commingled with other assets of the client.
- Funds from excluded income if excluded as a resource under 461-140-0070.
- An Individual Education Account if excluded under 461-145-0145 (see CCA B.23).
- Money for a plan for self-support if excluded under 461-145-0405 (see CCA B.55).
- Proceeds from the sale of a home if excluded as a resource under 461-145-0460 ( see CCA B.65).
For OSIPM and QMB/SMB/SMF, interest and dividends earned on funds in a bank account are excluded as income.
Note: Be sure to review 461-140-0070
about commingling excluded income with other funds in a bank account.
10. Black Lung Benefits
Black Lung Benefits paid to miners or their survivors under the provisions of the Federal Mine Safety and Health Act are counted as unearned income.
11. Burial Arrangements and Burial Funds - Not QMB/SMB/SMF
The following definitions apply to this policy:
- A burial arrangement is an agreement with an entity --- such as a funeral agreement (which means an arrangement made with a licensed funeral provider), burial insurance, or a burial trust designating a funeral director as the beneficiary --- that makes allowance for burial costs. A burial arrangement does not include a burial space, which is covered in 461-145-0050, or a burial fund.
- A burial fund is an identifiable fund set aside for a client's burial costs. A burial fund does not include a burial space, which is covered in 461-145-0050, or a burial arrangement.
The amount in an irrevocable burial trust or any other irrevocable arrangement to cover burial costs is excluded.
- Note: The cash surrender value (CSV) of a life insurance policy can be excluded if the ownership of the policy has been irrevocably assigned to a funeral home. If a funeral home is named as the irrevocable beneficiary (instead of an irrevocable transfer of ownership), the policy can only be excluded if the assignment contains specific language that prevents the owner of the policy from accessing the cash surrender value of the policy by loan or policy cancellation.
A burial arrangement is treated as follows:
- A burial arrangement is treated in the manner as the program treats a burial fund (see below).
- Burial insurance that has cash surrender value is considered life insurance and is treated in accordance with 461-145-0320.
A burial fund may be established only from financial means such as cash, burial contracts, bank accounts, stocks, bonds or life insurance policies. Burial funds are treated as follows:
- A burial fund is counted as a resource if it is commingled with assets unrelated to a burial. The amount set aside for burial must be in a separate account to be excluded from resource consideration.
- A burial fund may be established if the countable resources of a client exceed allowable limits. A burial fund is excluded from the resource calculation to the extent allowed below.
- Up to $1,500 of a burial fund may be excluded from resources for each of the following:
- The client
- The client's spouse
- The $1,500 exclusion above is reduced by the total of the following amounts:
- The face value (not CSV) of life insurance policies owned by the insured individual that have already been excluded from resources (i.e. excluded because the face value is $1,500 or less) Example: Miles has a whole life policy with a face value (FV) of $1,000 and CSV of $700 that he wants his son to use for college if he passes away. He also wants to set aside $2,000 in a savings account for a burial fund. We will only exclude $500 of the burial fund because the $1,500 available exclusion is reduced by the $1,000 FV of the whole life policy we have already excluded as a resource. Even though the CSV of the policy is really what we are excluding, the amount that is subtracted from the exclusion of a burial fund (i.e. the amount that reduces the $1,500 exclusion) is the FV. This is because the FV (the amount payable when he dies) is what could potentially be used for burial had he designated it as such.
- The amount in an irrevocable burial trust or any other irrevocable arrangement to cover burial costs (or a reserve or plan funded through an income cap trust)
- If the $1,500 exclusion is applied to the CSV of a whole life insurance policy, and there is a remaining amount that will be considered a countable resource, it is not considered comingling of a burial fund with another countable resource. Example: Joe has a whole life policy with a FV of $10,000 and CSV of $1,700. He intends to use the policy for burial and has no other burial fund. We can exclude $1,500 of the CSV and count the remaining $200 as a resource. This is not considered comingling because the whole life insurance policy is designated for burial. In this case, the FV of the whole life policy is more than $1,500, so the policy is countable; however, the part that is countable is the CSV, so the $1,500 burial fund exclusion is thus applied to the CSV.
- All interest earned on an excluded burial fund or increases in the value of an excluded burial arrangement if left in the fund is excluded from income.
There is no overpayment for the time period during which the burial arrangement or burial fund existed if a client ---
- Cancels an excluded burial arrangement; or
- Uses an excluded burial fund for any purpose other than burial costs.
If an asset originally used as a burial arrangement or burial fund is converted to other uses, the asset is treated under the other applicable rules.
- Note: From September 27, 1987 to November 5,
1989, Oregon state law prohibited establishing irrevocable burial trust funds.
Burial trust funds established on or after November 5, 1989 may be irrevocable.
- Refer to rule 461-145-0320
for policy on life and term insurance.
Beginning July 1, 2016:
All prepaid irrevocable burial arrangements, including those funded by an irrevocable assignment of a life insurance policy, must include a contract for the goods and services that are funded by the prepayment. If the prepayment does not include a contract that it funds there is a potentially disqualifying transfer (see OAR 461-140-0210 to 461-140-030), which could impact Medicaid eligibility. Additionally, if the amount of the prepayment exceeds the value of the contract that it funds, there is a potentially disqualifying transfer.
For life insurance funded burial arrangements where there is an irrevocable assignment the amount of the assignment is considered to be equal to the face value (FV) of the policy assigned. This means, for instance, if the FV of the policy that funds the contract is $10,000, the cost of the goods and services provided for in the contract must be at least equal to $10,000. In determining the amount of the disqualifying transfer, though, the value of the burial contract is compared to the cash surrender value (CSV) of the life insurance policy, not the FV of the policy.
Example 1: Mr. Jones completes an irrevocable assignment of a life insurance policy (FV = $15,000, CSV = $8,500) to fund a burial arrangement for goods and services that total $6,000. Since the cost of the arrangement is less than the FV of the life insurance policy the transfer of the policy is a potentially disqualifying transfer. To determine the amount of the disqualifying transfer subtract the cost of the contract from the CSV of the life insurance policy. In this example the disqualifying transfer amount is $8,500 (CSV of the life insurance policy) - $6,000 (the cost of the goods and services provided for in the contract) = $2,500.
Example 2: Mr. Smith pays $7,000 for an irrevocable burial arrangement, but the contracted goods and services only total $4,000. The difference between the prepayment and the contract that it funds ($3,000) is potentially disqualifying. Note: When an individual purchases a burial arrangement the individual must be the owner of the policy, not a family member or other individual.
12. Burial Space and Merchandise - Not QMB/SMB/SMF
Burial spaces include conventional grave sites, crypts, mausoleums, urns, and
other repositories that are traditionally used for the remains of deceased persons.
Burial spaces also include headstones and the opening and closing of the grave.
- The equity value of a burial space is excluded as a resource if owned by the client and designated for the client, the spouse of the client, minor and adult children, siblings, parents, and the spouse of any of these people.
Burial merchandise includes, but is not limited to, caskets, liners, burial
vaults, markers, and foundations.
- The equity value of burial merchandise is excluded as a resource if owned by the client and designated for the client, the spouse of the client, minor and adult children, siblings, parents, and the spouse of any of these people.
13. Cash - NOT QMB/SMB/SMF
In the month of receipt, cash is counted as income unless the cash qualifies as excluded income under another rule.
After the month of receipt, cash (including cash on hand, cash in a safety deposit box, and cash held by others) is counted as a resource, unless the cash qualifies as an excluded resource under another rule.
Foreign currency that can be converted to U.S. currency is treated in the same manner as cash under this rule. The value of foreign currency is its value in U.S. currency, determined by the current exchange rate.
The treatment of a check is based on the source of the funds.
14. Child Support and Cash Medical Support
Child support and cash medical support paid by a non-custodial parent for a dependent child or minor parent in the financial group are considered income of the dependent child or minor parent, whether the support is paid voluntarily or in accordance with an order to pay child support.
“Pass-through” means child support, up to $50 per dependent child or minor parent per financial group per month and not to exceed $200 per financial group per month, that is sent to the client before any remaining amount of current child support is withheld by the State. Pass-through includes current child support only.
“Disregard” means child support, up to $50 per dependent child or minor parent per financial group per month and not to exceed $200 per financial group per month, that is not counted as income of the client. Disregard includes current child support only.
All child support and cash medical support paid to the financial group are considered countable unearned income. Child support and cash medical support paid by the financial group are not deductible from income.
Example: Single mother of two applies for OSIPM and services. She receives SSD and child support from her ex-husband. Per 461-110-0410(1)(a), her children are not in the financial group and therefore, the child support would not be considered income for the mother.
Contributions are monies not considered gifts or winnings given voluntarily to a member of the financial group
by someone who is not in the group.
Contributions are counted as unearned income.
For non-cash contributions, see CCA B.41 below for the treatment of unearned in-kind income.
16. Corporations and Business Entities
This section will help you determine:
- What to do when an individual owns a business;
- Whether or not they are considered self-employed, employees, or passive/silent business owners; and
- How to count income and resources of the business
Corporation: A closely-held corporation is usually incorporated by one or a small number of owners. For example, a farmer or a farming family who incorporate their farming business. Note: The owner of a closely-held corporation will have legal documents showing the date the business was incorporated.
A Subchapter S corporation is incorporated under Chapter S of the Internal Revenue Code. Each shareholder is responsible to file his or her own taxes on the profits the corporation distributes. For example, a law firm or other partnership may incorporate their business under Chapter S.
Other corporations include companies that sell stock to investors including the general public. For example, Proctor & Gamble, AT&T, Starbucks, etc.
Ownership interest in a corporation is usually held in the form of stocks.
Other Business Entities: This includes all other business arrangements that are not considered corporations - sole proprietorships, partnerships, and unincorporated limited liability companies (LLC).
- An LLC is a form of business organization with the liability-shield of a corporation and the flexibility and tax advantages of a partnership.
From a business standpoint, the corporation is the employer; therefore, an individual with an ownership interest in a corporation (including a principal) does not work
for himself but works for the corporation. In other words, they are considered an employee of the corporation and are not self-employed.
For an individual with an ownership interest in, and actively working for a corporation:
- They are paid a wage by the corporation and their income is counted as earned income (not self-employment income).
- Any dividends or profits they receive from the corporation are treated as unearned income.
- Any income the corporation generates and retains (versus paying out as wages or dividends) is excluded.
- If maintaining the ownership in the corporation is required to continue working for the corporation (this is usually the case with a closely-held corporation), the equity value of the stock is excluded; otherwise, the stock is treated in accordance with OAR 461-145-0520 (does not apply to QMB/SMB/SMF).
For an individual with part or full ownership of a corporation who does not work:
- The equity value of their interest (again, ownership interest is stock) is a countable resource (subject to the availability of resources rule, OAR 461-140-0020). This does not apply to QMB/SMB/SMF.
- Any income they receive is unearned income (subject to the availability of income rule, OAR 461-140-0040)
- Except when the shelter-in-kind rule applies (OAR 461-145-0470), if the corporation pays a non-business expense, such as a personal car or mortgage payment, the payments are treated as unearned income.
- If the corporation gifts or gives away an item to an individual, such as a car or furniture, it is considered unearned in-kind income. Each item provided is then evaluated under the rule which governs that item (per OAR 461-145-0280 In-Kind Income). Note: The use of something is generally not considered in-kind income, except the use of shelter and utilities, which is considered shelter-in-kind.
- Example 1
Bill and Ted started a landscaping business together and decided to incorporate. On the articles of incorporation, both are listed as officers and they are the only two stockholders. The business prospered, and eventually they were able to hire a site supervisor, a staff of 10, and an accountant. The business continued to grow and inevitably Bill and Ted asked themselves why they were breaking their backs when they could play golf and collect the profits. Because they no longer work for the corporation, their stock in the business (i.e. their ownership interest) is a countable resource under OAR 461-145-0520. The profits they receive are countable as unearned income.
- Example 2
Bernie owns stock in Wal-Mart, Apple, and Starbucks; he has an ownership interest in these corporations (albeit small), but he doesn’t work for any of them. His stock is a countable resource and any dividends or profits he receives are countable as unearned income.
- Example 3
Bill, the retired landscaper from example 1, is given one of the corporation-owned vehicles when his truck breaks down. The truck is considered unearned in-kind income (OAR 461-145-0280), but again, that rule specifies that items such as cars are evaluated according to the asset's specific rule. If we evaluate the truck under the motor vehicle rule (OAR 461-145-0360), it is counted as a resource.
Note: For information on a specific corporation, refer to the Employment Business Locator screen by entering EBLU on a clear DHS
mainframe screen. When you locate the business, the bottom of the screen will display navigation tips. Pay attention to 3) owners (or F3) as it will give you the SSN and phone number of all the owners (which is something the Secretary of State's website below will not do). Also see the Secretary of State’s Corporate Division web site.
Other Business Entities
If an individual is part or full owner of any type of a business entity other than a corporation, can be considered a principal, and is working for the business, the individual is considered self-employed and income and resources should be evaluated under the self-employment rules (OAR 461-145-0920 and 461-145-0930 for income and 461-145-0600 for resources).
If the individual has an ownership interest in any type of business entity other than a corporation, does not meet the definition of a principal (e.g. he or she is not responsible for its success or failure or has no authority in its daily operation), but works for the business:
- The income is treated as earned income, except:
- Any dividends or profits are treated as unearned income.
- If the individual has to maintain ownership of the business in order for him or her to work there, the value of the ownership interest is excluded; otherwise, the equity value of the ownership interest is treated as a resource.
- If the business makes a personal car payment, pays the country club dues, or pays the mortgage for the individual, the payments are treated as earned income.
If the individual has an ownership interest in any type of business entity other than a corporation (regardless of principal status), but does not work for the business:
- The equity value of the ownership interest is a countable resource (subject to the availability of resources rule, OAR 461-140-0020)
- Any income from the business is considered unearned income (subject to the availability of income rule, OAR 461-140-0040)
- Any third party payments made by the business on behalf of the individual (such as the car or country club or house payments) are also counted as unearned income.
- Example 1
Bob and Tom are brothers and trained mechanics. Bob wants to go into business for himself and open an auto shop but he doesn’t have enough money, so he asks Tom if he wants to be his partner. Tom is an excellent mechanic, but he has no business sense whatsoever. He agrees to invest in the business but wants nothing to do with the daily operations and he makes no business decisions; he just works there as the shop’s lead diesel mechanic. Tom doesn’t have to be Bob’s partner in order to work there, Bob would always have a place for his brother in his shop. They agree that Tom will be paid a salary of $25 per hour and also have a 50% share of the profits. The $25 per hour is counted as earned income and the profits are unearned income. Tom’s interest in the business is a countable resource because Bob could buy him out and he could still work there. Note: Bob is considered self-employed, so his income and resources have to be evaluated under the rules governing self-employment.
- Example 2
Let’s say that Tom decides he wants to be bought out, but Bob can’t quite raise the money to do it (he has expensive tastes and his debt-to-income ratio is a bit too high). Bob hits up his younger brother, Stuart, who is an aspiring golf pro. Stuart can get a loan and help Bob buy out Tom, but rather than giving him the money outright, he wants to be Bob’s new business partner because he knows how profitable it is (plus the bank needs collateral). Stuart is trying to work his way into the pro tour and has neither the time nor the desire to be involved in the business; therefore, they decide that he will be a silent partner. The equity value of Stuart’s ownership interest in the business would be a countable resource, and any profits he receives from the business would be countable as unearned income. The business also pays Stuart’s golf match entry fees, so those are counted as unearned income as well.
17. Deeming the Assets of a Noncitizen sponsor to a Noncitizen Corrected
An individual or organization may sponsor the admission of a noncitizen under section 204 of the Immigration and Nationality Act (8 U.S.C. 1154).
An affidavit of support (USCIS Form I-864) is the agreement between the sponsor and the United States Citizenship and Immigration Services in which the sponsor agrees to provide financial support for the noncitizen so that the noncitizen will not become a public charge.
Deeming Income and Resources - General
Deemed assets are the portion of the income and resources of an individual not in the financial group (see OAR 461-110-0530) used to determine eligibility and benefit level for a sponsored noncitizen who is a member of the financial group.
To be eligible for benefits, a sponsored noncitizen must provide necessary information about each individual whose assets are deemed to the sponsored noncitizen who is a member of the financial group.
When deeming applies, the countable assets of an individual sponsor and the spouse of the sponsor are considered countable assets of the noncitizen. The sponsor's assets are considered available to the noncitizen whether or not the sponsor lives in the same household as the noncitizen. The assets of the sponsor's spouse are considered available only when the spouse lives in the sponsor's household.
OSIPM - We would only look at deeming in the first three years after an individual arrives in the United States (discussed in more detail below). This means that deeming can apply to regular OSIPM in certain circumstances, because not everyone has to be here five years to meet the alien status requirements (under 461-120-0125 section (2) or section (4)(b)(A) or (B) or section (5)). For example, an 18-yr-old qualified non-citizen who has been here less than three years and has a sponsor, or an Afghan refugee with a sponsor who just arrived.
Deeming does not apply to OSIPM-CAWEM, because the indiviudal does not meet the alien status requirements for OSIPM.
QMB/SMB/SMF - Look at deeming anytime a non-citizen is sponsored, regardless of how long the individual has been living in the United States; the the three-year time period does not apply to Medicare Savings Programs. This means that an individual who meets the alien status requirements because he/she has been here five years may still be subject to sponsor deeming.
Below are some exceptions to considering assets of a sponsor and sponsor's spouse available to the noncitizen:
- The sponsor has not signed a legally binding affidavit of support, for instance USCIS Form I-864 or I-864A;
- The sponsor receives SNAP, SSI, or TANF benefits;
- The sponsor is deceased. The estate of a deceased sponsor is not responsible for the noncitizen;
- The sponsored noncitizen establishes indigence. A sponsored noncitizen establishes indigence if the total income of the household including in-kind income plus any cash, food, housing, or other assistance provided by other individuals including the sponsor is not enough for the noncitizen to obtain food and shelter without program benefits.
- If the noncitizen is living with the sponsor, the indigence exception may not apply and deeming does apply.
- If the noncitizen is living apart from the sponsor, the indigence exception applies if the noncitizen meets all of the following requirements:
- The total income (of all kinds and from all sources, even excluded income) the noncitizen receives is less than the OSIPM standard for a one-person need group;
- The noncitizen does not receive free room and board; and
- The resources (even excluded resources) available to the noncitizen are under the applicable resource limit.
- Each indigence determination under this subsection is effective for 12 months and may be renewed for additional 12-month periods.
- The sponsored noncitizen is a battered immigrant spouse, battered immigrant child, immigrant parent of a battered child or an immigrant child of a battered parent, as long as the battered noncitizen does not live in the same household as the person responsible for the battery;
- The sponsored noncitizen does not meet the alien status requirement for the program for which he or she applies;
- The sponsored noncitizen becomes a naturalized citizen;
- The sponsored noncitizen can be credited with 40 qualifying quarters of work; or
- The sponsored noncitizen is under 18 years of age.
For OSIPM, the deeming period is three years after the date of admission, which is the date the U.S. Bureau of Citizenship and Immigration Services establishes as the date the noncitizen was admitted for permanent residence. Deeming ends on the last day of the month that is three years after the date of admission
An amount equal to the OSIPM (not OSIPM-EPD) program income standard is deducted from the total amount of income deemed to the noncitizen (see OAR 461-160-0015). If the sponsor lives with a spouse, the two-person standard is deducted. The result is the amount of income considered available (or deemed) to the noncitizen.
The sponsor's or sponsor's spouse's income is not counted if any of the following is true:
- The individual is a refugee admitted to the United States under section 207 of the Immigration and Nationality Act (INA) (8 USC 1157);
- The individual has been granted asylum under section 208 of the INA (8 USC 1158); or
- The individual has become blind or disabled after admission to the United States.
Resources - OSIPM only
An amount equal to the OSIPM (not OSIPM-EPD) program resource standard is deducted from the total amount of resources deemed to the noncitizen (see OAR 461-160-0015). If the sponsor lives with a spouse, the two-person standard is deducted. The result is the amount of resources considered available (or deemed) to the noncitizen.
18. Disability Benefit
This section covers public and private disability benefits, except the following:
For each disability payment covered under this rule:
- If received monthly or more frequently:
- Income from employer-paid disability insurance is counted as earned income if received within six full calendar months after stopping work.
- All other payments are counted as unearned income.
- Payments received less frequently than monthly are counted as periodic or lump-sum income.
19. Disaster Relief
A major disaster is any natural catastrophe such as a hurricane or drought, or, regardless of cause, any fire, flood or explosion, which the President determines causes damage of sufficient severity and magnitude.
An emergency is any occasion or instance for which the President determines that Federal assistance is needed to supplant State and local efforts and capabilities to save lives and to protect property and public health and safety, or to lessen or avert the threat of a catastrophe.
Disaster Unemployment Assistance is emergency assistance authorized under P.L. 100-107 and received by individuals who are unemployed as a result of a major disaster. Individuals receiving Disaster Unemployment Assistance are not eligible for other unemployment compensation and cannot receive both at the same time. Payments are limited to 26 weeks.
The following payments are excluded as income and resources if they result from an emergency or major disaster:
- Payments received under the Disaster Relief Act of 1974 (P.L. 93-288, section 312(d)) as amended by the Disaster Relief and Emergency Assistance Amendments of 1988 (P.L. 100-707, Section 105(i)).
- Disaster assistance comparable to subsection (a) of this section provided by States, local governments, and disaster assistance organizations.
- Payments from the Federal Emergency Management Agency (FEMA).
- Individual and Family Grant Assistance program (IFG).
- Grants or loans by the Small Business Administration (SBA).
- Voluntary disaster assistance organizations, such as the Red Cross.
- Private insurance payments for losses due to a major disaster such as flood, wind, land movement.
- Each payment made to farmers under the Disaster Assistance Act of 1988 (P.L. 100-387) for crop losses or failure in a disaster.
- Income received from public and private organizations by individuals working in disaster relief efforts and funded under a National Emergency Grant by WIA title 1 (P.L. 105-220).
- An individual is eligible under this funding source if he or she is a dislocated worker, a long-term unemployed individual, or is temporarily or permanently laid off as a consequence of the disaster.
- Eligibility under this funding source is limited to a period of up to six months per disaster.
- Disaster Unemployment Assistance
- Payments for flood mitigation received by a homeowner under the National Flood Insurance Act of 1968 as amended by P.L. 109-64
Exception to exclusions:
- Government payments designated for the restoration of a home damaged in a disaster are excluded as income or resources in the month of receipt and as a resource in subsequent months, if the household is subject to a legal sanction if the funds are not used as intended.
20. Dividends, Interest, Royalties
Dividends and interest income is treated as unearned income except as follows:
- Interest income and dividends earned on funds in a bank account are excluded as income (see bank accounts policy above).
- Interest income and dividends from a trust described in 461-145-0540(9) are excluded.
Royalties are counted as unearned income, except that royalties are counted as earned income if the client is actively engaged in the activity from which the royalties are accrued.
21. Domestic Volunteer Services Act (VISTA, RSVP, SCORE,
Under Title I of Public Law 93-113, Domestic Volunteers Service Act of 1973,
payments to volunteers under VISTA, University Year of Action and Urban Crime
Prevention are treated as follows:
The payments are excluded if the client is receiving program benefits
when they join the Title I program. The exclusion of payments
continues until the client has a break in receiving benefits of more
than one month.
The payments are counted as earned income for clients who joined the
Title I program before applying for program benefits.
Payments are excluded under Title II of Domestic Volunteer Service Act (Public
Law 93-113, National Older Americans Volunteer Programs), which include:
- Retired Senior Volunteer Program (RSVP) Title II, Section 201.
- Foster Grandparent Program Title II, Section 211.
- Older American Community programs.
- Senior Companion Program.
Payments are excluded under Title III payments (National Volunteer Programs to
Assist Small Businesses and Promote Volunteer Service by Persons with Business
Experience), which include:
- Service Corps of Retired Executives (SCORE) Title III, Section 302.
- Active Corps of Executives (ACE) Title III, Section 302.
22. Earned Income; Defined
Earned income is income received through employment, received in exchange for an individual's physical or mental labor or any other compensation for services performed. Earned income includes all of the following:
- Wages, salaries, commissions, military pay and allowance (such as BAS, BAH, FSSA and meal allowances) tips, sick leave, vacation pay, draws, or the sale of one's blood or plasma.
- Note: For a military basic pay exclusion, see CCA B.48.
- Income from on-the-job-training, paid job experience, JOBS Plus work experience, WIA work experience, or Welfare-to-Work experience.
- In-kind income, when the client is an employee of the person providing the in-kind income and the income is in exchange for work performed by the client.
- Note: Earned in-kind income may include rent or utilities credit (see OAR 461-145-0470 for more information on earned shelter-in-kind income) that a client receives in exchange for work performed. To determine the amount, subtract the amount the client pays for rent from the amount the dwelling usually rents for. For example, the rent is $550, but the client pays only $100 because of work done for the landlord. The earned in-kind income is $450 ($550 - $100).
- For self-employment, gross receipts and sales, including mileage reimbursements, before costs.
- Cafeteria plan benefits that an employee takes as cash as well as funds placed in a flexible spending account.
- Income from work-study.
- Income from profit sharing that the client receives monthly or periodically.
- The fee for acting as an individual's representative payee, as long as that individual is not included in the filing group.
- Payments made to third parties by a client’s business, corporation, or other employer for things such as car payments, rent, or mortgage (except as provided for in OAR 461-145-0280 In-Kind Income). In order to qualify as earned income, the client must work for the business or corporation.
23. Earned Income; Treatment
Earned income is counted as income for OSIPM and QMB/SMB/SMF and is subject to the earned income deductions (see OAR 461-160-0550 and 461-160-0551 for OSIPM, OAR 461-160-0780 for EPD, and 461-150-0552 for QMB/SMB/SMF). Countable self-employment income (gross minus allowable costs) is also subject to the earned income deductions.
If an individual is the principal of a corporation and works for the corporation, the money he/she earns is counted as wages rather than self-employment income, so there is no exclusions for costs.
Losses from self-employment are excluded from the gross earned income from a separate source (including other self-employment income). Remember exclusions apply to gross income before costs (the result is countable income) and deductions apply to countable income (the result is adjusted income).
24. Earned Income Tax Credit (EITC) and Making Work Pay (MWP) Tax Credit
EITC is a federal and state tax program for low-income families. EITC may be
received in one of two ways:
- On a monthly basis as an advance in the employee's paycheck.
- As one annual payment received at the time of the normal
income tax returns.
EITC payments are
excluded from assets.
25. Educational Account
The Individual Education Account (IEA) is an asset accrued by JOBS Plus participants. The IEA is excluded while it accumulates, while it is saved, and when it is withdrawn for educational purposes.
The value of funds in a qualified tuition program under section 529 of the Internal Revenue Code is counted as a resource to the owner of the fund.
26. Educational Income
Educational income is income designated specifically for educational expenses (this includes including Pell Grants, scholarships, and other government or private grants).
To be considered educational income, the income must be given to one of the
- A student at a recognized institution of post-secondary education. Post-secondary
education is education offered by institutions primarily to individuals age
18 or older. Admission may or may not require a high school diploma or equivalent.
- A student at a school for people with disabilities.
- A student in a vocational education program.
- A student in a program that provides for completion of secondary school
diploma or the equivalent.
Educational funds (including non-title IV work study) used for the following education expenses is excluded:
- Mandatory fees
- Books and supplies
- Required rental or purchase of equipment or materials charged to students enrolled in a specific curriculum
- Other miscellaneous personal expenses (except room and board)
- Loan originator fees
- Insurance premiums required to obtain an educational loan
- Dependent care.
To determine the amount of educational income to exclude from the awarded amount(s), use education
expenses listed in the financial aid award letter unless one of the following
- The information is not available in the award letter, or the student
provides verification of amounts different from those listed in the award
letter. In these situations, use the verified amounts from the student. Note: Do not require additional verification
if the amounts are listed in the award letter (unless the student wants to
use different amounts and can verify those amounts).
- The student receives child care benefits (i.e., ERDC or other child
care subsidies). Exclude from educational income the amount
the student actually pays for child care (e.g., the ERDC co-pay) instead of
the amount shown in the award letter.
- The student states actual transportation costs exceed the amount allowed
for the expense in the award letter. In that situation, calculate the number
of commuting miles to and from school and multiply by $0.20. Exclude the calculated
amount or the amount from the award letter, whichever is greater.
The following educational income payments are excluded:
- Educational income from the Carl D. Perkins Vocational and
Applied Technology Education Act, Title IV of the Higher Education Act, and
the Bureau of Indian Affairs (BIA).
- All income from educational loans.
After allowing exclusions:
- Count any remaining amount of work study, fellowships and teaching-assistant income as earned income (remember this is after excluding education expenses). This may include work study provided through the VA program or other educational programs.
- Count the remaining amount of other educational income (grants, Montgomery GI Bill [VA Chapters 30, 32, 35, 1606 or 1607, Veterans Retraining Assistance Program (VRAP)], Post 9-11 (9/11) GI Bill [VA Chapter 33], etc.) by prorating it over the period it is intended to cover, then begin counting the prorated amount in the first month of the period if the client has already received the income. If income has not been received, begin counting the prorated amount in the month of the period it is expected to be received.
Count the VA Chapter 31 subsistence allowance as unearned income (see Veterans' Benefits).
Clients may be attending school under the displaced workers program. In this instance, the student will continue to receive weekly Unemployment Compensation (UC) benefits while attending school. Treat Displaced Worker payments the same as UC benefits.
27. Energy Assistance Payments
Exclude all energy assistance payments or allowances made under any
federal, state, or local law (Public Law 96-249). These payments include:
- Energy assistance payments provided through a Department of Health and Human Services Low-Income Assistance Program.
- Energy assistance payments provided through the Low-Income Energy Assistance Act of 1981 under Public Law 97-35, Section 2605(F) (LIEAP).
- Note: This includes payments made under PL99-425, Section (e), the Low Income Energy Assistance Act of 1986.
- Note: See Housing and Urban Development below
on how to treat utility payments received by the department of Housing and
Urban Development and the Rural Housing Service.
28. Family Abuse Prevention Act (FAPA) Payments
FAPA payments are court-ordered payments to victims of domestic violence made
under authority of ORS 107.718(1)(h). A payment is considered available when
actually received by the victim of abuse.
The first $2,500 is excluded. The excess
above $2,500 is counted as a resource.
29. Floating Homes and Houseboats
Floating homes and houseboats that are the individual's home are treated as a home (see 461-145-0220). Otherwise they would be treated as real property (see 461-145-0420) or income-producing property (see 461-145-0252), depending on the use.
30. Food Programs; Not SNAP Benefits
The following benefits are excluded:
- Benefits from the Special Supplemental Food Program for Women, Infants and Children (WIC), including demonstration projects (coupons exchanged for food at farmers markets) under the Hunger Prevention Act of 1988 (Pub. L. 100-435, section 501).
- The value of supplemental food assistance provided to children under the Child Nutrition Act of 1966 (Pub. L. 89-642) and the National School Lunch Act (Pub. L. 79-396, section 12(e), and Pub. L. 94-105).
- Nutrition Assistance program benefits received in Puerto Rico, American Samoa or the Commonwealth of the Northern Marianna Islands.
- The value of supplemental food assistance provided for children and seniors in the Senior Farm Direct Nutrition Program funded by grants from the United States Department of Agriculture.
Benefits from the Tribal Food Distribution Program are excluded.
31. Foster Care/Guardianship Payment
Foster care is when an individual is placed in the home of relatives or other
individuals or families by a federal, state or local governmental foster care
program. This could be child or adult foster care.
Guardianship Assistance payments are made by Child Welfare, for children under
age 18, when a person has agreed to be the guardian of the child. These payments
are authorized under a foster care waiver.
A foster care payment is:
The payment the foster care provider receives from the foster care program
For adults in foster care, this also includes their room and board payment and any service payment the client is required to pay their provider.
Treat foster care/guardianship assistance payments as follows:
- If the provider of foster care/guardianship is in the financial group:
- Exclude the amount the placement agency identifies as room and board,
clothing and personal incidental needs (including recreational expenses)
of the foster care client.
- Exclude the amount designated for special need items of the foster
- Count the remaining amount as earned income.
- If the provider of foster care/guardianship is not in the financial group,
exclude the foster care payments.
32. Gifts and Winnings
Gifts are items given to or received by an individual on or for a special occasion, such as a holiday, birthday, graduation, or wedding. They are not given or received on a regular basis. Gifts can be cash or non-cash.
Winnings are prizes given to an individual in a contest, game of chance or similar event. Winnings in the form of money may be distributed periodically (e.g., monthly) or in a lump-sum.
In-kind gifts and winnings are treated according to policy for the rule applicable to the specific type of asset; otherwise:
Gifts and winnings in the form of money are treated as periodic or lump-sum income.
Gifts and winnings in the form of a gift card or certificate are excluded.
For employment-related items, see 461-145-0130.
33. Groundfish Disaster Benefit
People working in the commercial fishing industry may qualify for Groundfish Disaster benefits. These benefits are disbursed through the Oregon Employment Department to persons involved in the commercial fishing industry in Oregon’s coastal communities.
To qualify for Groundfish Disaster benefits, a groundfisher must be working with the Oregon Employment Department as a displaced worker. They must also commit to not return to work in the commercial fishing industry.
The groundfisher eligible for these benefits may receive assistance for up to nine months. The monthly payments can be as much as $1,500 for a family or $1,000 for an individual. The payments may be less if the person is receiving unemployment compensation.
Groundfish Disaster benefits are counted as unearned income for all programs.
34. Home - Not QMB/SMB/SMF
A home is the place where the financial group lives. A home may be a house,
boat, trailer, mobile home, or other habitation. A home also includes the following:
- Land on which the home is built and contiguous property. Contiguous property is property not separated by land owned
by people outside the financial group. In addition:
- Contiguous property may be separated by public rights-of-way, such
as roads; and
- Property is contiguous even when it can be sold separately from the
- Other dwellings on the land surrounding the home that cannot be sold
separately from the home.
Exclude the value of a home when it is occupied by the group.
For purposes of this subsection, the term child refers to a biological or adoptive child who is under age 21 or who is any age and meets the SSA criteria for blindness or disability. The definition of child in rule 461-001-0000 does not apply.
For a client who has an initial month of long-term care on or after January 1, 2006, the equity value of a home is excluded when the client isn't in the home if at least one of the following is met:
- The child of the client occupies the home
- The spouse of the client occupies the home
- The equity value of the home is $560,000 or less and at least one of the following are met:
- The client occupies the home
- The home equity is excluded under OAR 461-145-0252
- The home is listed for sale per OAR 461-145-0420
- Notwithstanding OAR 461-120-0330, the equity value of the home is more than $560,000 and the client is unable to legally convert the equity value to cash.
In the case of a temporary absence, if the value of a home is excluded under the above section, the value of this home remains excluded if the client's absence is due to receiving
care in a medical institution and one of the following is true:
- The absent client has provided evidence that
they will return to the home. The evidence must reflect the subjective intent
of the client, regardless of the client's medical condition. A written statement
from a competent client is sufficient to prove the intent. See rule 461-160-0630 for more information.
- The home remains occupied by the client's spouse, child, or a relative
dependent on the client for support. The child must be under age 21 or,
if over age 21, blind or an individual with a disability as defined by SSA criteria.
- Note: If a home is sold or transferred, review
the transaction to determine its effect on the client's eligibility.
For non-excluded homes, see rule 461-145-0420.
35. Housing and Urban Development
Exclude payments from HUD made to a third party.
Exclude HUD payments made directly to a member of the financial group, except
Youthbuild Program payments and Family Investment Centers payments.
Exclude escrow accounts that are established for families participating
in the Family Self-Sufficiency (FSS) program sponsored by HUD.
Treat payments issued under Cranston-Gonzalez National Affordable Housing Act, Pub. L. No. 101-625, sec. 515, 104 Stat. 4196 (1990),
- Count wages as earned income and stipends as unearned income.
- Exclude service payments for items such as child care, basic education,
literacy or computer skills training, etc.
36. Income-Producing Sales Contract
An income-producing sales contract is an agreement between two parties where one party
is to pay the other party on an ongoing basis for property or goods. A common
income-producing contract exists when an individual sells land or a home to
another party and the other party pays the individual an agreed upon monthly
For OSIPM, treat the equity value of income-producing sales contracts as follows:
- For contracts originating on or after October 1, 2012:
- The equity value of contracts resulting from the sale of anything besides a home is a countable (see OAR 461-001-0000) resource valued at the outstanding principal balance of the contract, unless the individual provides convincing evidence of a lower cash value or there is a legal bar to the sale of the contract (in which case it would be considered unavailable).
- For OSIPM service clients/applicants, if there is a legal bar to the sale of the contract, the equity value of the contract is considered a disqualifying transfer of assets (see OARs 461-140-0210 to 461-140-0300).
- The equity value of a contract resulting from the sale of a home is excluded if the entire principal portion of the payments received from the contract is used to purchase another home within three calendar months of receipt of the payments. Otherwise the equity value is treated in accordance with the bullets above.
- Contracts originating prior to October 1, 2012 are excluded.
For all programs, income received from a sales contract is treated as provided in the sale of a resource rule (OAR 461-145-0460).
37. Income-Producing Property
If it is determined that property is not used in a trade or business, it is then necessary to determine how much time is spent producing the income, or “managing the property.” This is not limited to real property; it applies to all types of property and resources.
If an individual spends more than 20 hours per week managing the property, then the income can be treated as self-employment income. This means costs can be excluded and earned income deductions applied. Again, the income is only treated as self-employment, the property itself is not considered to be used in self-employment.
If the individual does not spend at least 20 hours per week to produce the income, then it is treated as unearned income, BUT actual costs can still be excluded per OAR 461-145-0920.
- Example 1
Harry’s godfather passes away in November and leaves his family home to Harry in his will. Harry is away at school and decides to rent out the house for $500 per month. The $500 is unearned income because he’s not managing the property at least 20 hours per week. Property taxes and insurance average $80 per month and Harry sends a check for $20 to a local kid to mow the weeds every month, so his countable unearned income is $400 ($500 rent - $20 yard maintenance fees - $80 taxes/insurance).
- Example 2
Harry’s home from school for the next 3 months and can now do some work on the home and yard. He spends about 40 hours per week in June, July, and August painting, making repairs, and cleaning up the yard. He’s still only asking $500 per month, but it will be counted as earned income in June – August because he’s spending more than 20 hours a week managing the property. When he returns to school in September, it will be once again counted as unearned income.
Property - OSIPM only
Count the equity value as a resource, except:
- If part or all of the property is unavailable, the part that is unavailable is excluded (see OAR 461-140-0020)
- If the property produces annual countable income that is equal to 6% or more of its total equity value, then $6,000 of that equity value can be excluded. If the income drops below that for reasons the client cannot control, the client has 2 years from the end of the tax year in which the earnings first dropped to increase it up to 6% or more.
- Example: Harry’s home (from above) has an equity value of $75,000. 6% of $75,000 is $4,500. Harry receives $4,800 ($400 x 12) in countable income each year from renting out the house. Since the countable income ($4,800) is more than 6% of the equity value of the house ($4,500), $6,000 of the equity value can be excluded. This means that $69,000 ($75,000 - $6,000) is counted as a resource.
- Any government permits issued to the client for the purpose of making money (such as a commercial fishing permit) are excluded. This means the value of the permit is excluded, not the fishing boat, equipment, or supplies (unless we can exclude $6,000 per the previous bullet)
- Note: When a client rents out property that was formerly the home, this portion of the policy applies because it is not considered self-employment. However, if the house is up for sale while it is being rented out, the equity value of the home can be excluded (see OAR 461-145-0420).
38. Independent Living Subsidies/Chaffee Housing
Independent Living Subsidies are payments made and services provided by Child
Welfare to children ages 16 through 20. These payments also include payments
under the Chaffee Housing Program. The subsidies are to assist the individuals
to live independently when their foster care payments were discontinued on or
after the date they reached 16 years of age.
Exclude all independent living subsidies issued
by Child Welfare.
39. Indian (Native American) Benefits
- Note: If the public law number or other source of income is not present in this policy, contact a program analyst with the public law number or other income source to research and determine if the income is counted or excluded.
- See above for more information on the treatment of educational income.
- Note: The Bureau of Indian Affairs (BIA) considers
our cash programs as a prior resource to their General Assistance program.
If BIA General Assistance payments continue after the client has started receiving
benefits from the Department, remind the client to tell BIA about receiving
- Note: Public Law 100-580 is the Hoopa-Yurok Settlement
Act that explains how funds are distributed to the Hoopa Valley Tribe and
the Yurok Tribe.
The following Indian (Native American) benefits are excluded from income and resources:
- Indian lands held jointly with the tribe, or land that cannot be sold without the approval of the Bureau of Indian Affairs (BIA).
- Payments made under the Indian Judgment Funds Distribution Act (Public Law 93-134)
- Distribution of Indian Judgment Funds (Public Law 97-458)
- Indian judgment funds include interest and investment income accrued while the funds are held in trust.
- Initial purchases made with distributed judgment funds are excluded from resources.
- Per capita distributions of all funds held in trust by the Secretary of the Interior to members of an Indian tribe. (Public Law 98-64)
- The following items received from a native corporation are excluded under the Alaska Native Claims Settlement Act (ANCSA) (Public Law 100-241)
- Cash received from a native corporation (including cash dividends on stock received from a native corporation) to the extent it does not exceed $2,000 per individual per year;
- Stock (including stock issued or distributed by a native corporation as a dividend or distribution on stock);
- A partnership interest;
- Land or an interest in land (including land or an interest in land received from a native corporation as a dividend or distribution on stock);
- An interest in a settlement trust.
- Up to $2000 per year received from payments from individual interests in Trust or Restricted Lands (Public Law 103-66)
- Distribution of Per Capita Funds to the Red Lake Band of Chippewa Indians from the proceeds of the sale of timber and lumber on the Red Lake Reservation. (Public Law 85-794)
- Distribution of Per Capita Funds by the Blackfeet and Gros Ventre tribal governments to members, which resulted from judgment funds to the tribes. (Public Law 92-254)
- Distribution of Claims Settlement Funds to members of the Hopi and Navajo Tribes. (Public Laws 93-531 and 96-305)
- Receipts and distributions derived from lands held in trust for Indian tribes are excluded from the following Indian groups (Public Law 94-114):
- Seminole Indians
- Pueblos of Zia and Jimenez
- Stockbridge Munsee Indian Community
- Burns Indian Colony
- Assiniboine and Sioux Tribe
- Bad River Band of the Lake Superior Tribe of Chippewa Indians
- Blackfeet Tribe of Montana
- Cherokee Nation of Oklahoma
- Cheyenne River Sioux Tribe
- Crow Creek Sioux Tribe
- Devil’s Lake Sioux Tribe
- Fort Belknap Indian Community
- Keweenaw Bay Indian Community
- Lac Courte Oreilles Band of Lake Superior Chippewa Indians
- Lower Brule Sioux Tribe
- Minnesota Chippewa Tribe
- Navajo Tribe
- Oglala Sioux Tribe
- Rosebud Sioux Tribe
- Shoshone-Bannock Tribe
- Standing Rock Sioux Tribe
- Judgment funds distributed per capita to, or held in trust for, members of the Sac and Fox Indian Nation (Public Law 94-189)
- Judgment funds distributed per capita to, or held in trust for, members of the Grand River Band of Ottawa Indians (Public Law 94-540)
- Judgment funds distributed per capita to members of the Confederated Tribes and Bands of the Yakima Indian Nation or the Apache Tribe of the Mescalero Reservation (Public Law 95-433)
- Receipts derived from trust lands awarded to the Pueblo of Santa Ana and distributed to members of that tribe (Public Law 95-498)
- Receipts derived from trust lands awarded to the Pueblo of Zia and distributed to members of that tribe (Public Law 95-499)
- Judgment funds distributed per capita or made available for programs for members of the Delaware Tribe of Indians and the absentee Delaware Tribe of Western Oklahoma (Public Law 96-318)
- Funds and distributions to members of the Passamaquoddy Tribe, the Penobscot Nation, and the Houlton Band of Maliseet Indians under the Maine Indian Claims Settlement Act (Public Law 96-420)
- Distributions of judgment funds to members of the San Carlos Tribe of Arizona (Public Law 97-95)
- Distributions of judgment funds to members of the Wyandot Tribe of Indians of Oklahoma (Public Law 97-371)
- Distributions of judgment funds to members of the Shawnee Tribe of Indians (Absentee Shawnee Tribe of Oklahoma, the Eastern Shawnee Tribe of Oklahoma, and the Cherokee Band of Shawnee descendants) (Public Law 97-372)
- Judgment funds distributed per capita or made available for programs for members of the Miami Tribe of Oklahoma and the Miami Indians of Indiana (Public Law 97-376)
- Distributions of judgment funds to members of the Clallam Tribe of Indians of the State of Washington (Port Gamble Indian Community, Lower Elwha Tribal Community, and the Jamestown Band of Clallam Indians) (Public Law 97-402)
- Judgment funds distributed per capita or made available for programs for members of the Pembina Chippewa Indians (Turtle Mountain Band, Chippewa Cree Tribe, Minnesota Chippewa Tribe, and Little Shell Band of Chippewa Indians of Montana) (Public Law 97-403)
- Per capita distributions of judgment funds to members of the Gros Ventre and Assiniboine Tribes of Fort Belknap Indian Community, and the Papago Tribe of Arizona (Public Law 97-408)
- Up to $2,000 of per capita distributions of judgment funds to members of the Confederated Tribes of the Warm Springs Reservation (Public Law 97-436)
- Judgment funds distributed to the Red Lake Band of Chippewa Indians (Public Law 98-123)
- Funds distributed per capita or family interest payments for members of the Assiniboine Tribe of the Fort Belknap Indian Community of Montana and the Assiniboine Tribe of the Fort Peck Indian Reservation of Montana (Public Law 98-124)
- Judgment funds and income therefrom distributed to members of the Shoalwater Bay Indian Tribe (Public Law 98-432)
- All distributions to heirs of certain deceased Indians under the Old Age Assistance Claims Settlement Act (Public Law 98-500)
- Judgment funds distributed per capita or made available for any tribal program, for members of the Wyandotte Tribe of Oklahoma and the Absentee Wyandottes (Public Law 98-602)
- Per capita and dividend payment distributions of judgment funds to members of the Santee Sioux Tribe of Nebraska, the Flandreau Santee Sioux Tribe, and the Prairie Island Sioux, Lower Sioux, and Shakopee Mdewakanton Sioux Communities of Minnesota (Public Law 99-130)
- Funds distributed per capita or held in trust for members of the Chippewas of Lake Superior and the Chippewas of the Mississippi (Public Law 99-146)
- Distributions of claims settlement funds to members of the White Earth Band of Chippewa Indians as allottees, or their heirs (Public Law 99-264)
- Payments or distributions of judgment funds, and the availability of any amount for such payments or distributions, to members of the Saginaw Chippewa Indian Tribe of Michigan (Public Law 99-346)
- Judgment funds distributed per capita or held in trust for members of the Chippewas of Lake Superior and the Chippewas of the Mississippi (Public Law 99-377)
- Judgment funds distributed to members of the Cow Creek Band of Umpqua Tribe of Indians (Public Law 100-139)
- Per capita restitution payments made to eligible Aleuts who were relocated or interned during World War II (Public Law 100-383)
- Per capita payments of claims settlement funds to members of the Coushatta Tribe of Louisiana (Public Law 100-411)
- Funds distributed per capita for members of the Hoopa Valley Indian Tribe and the Yurok Indian Tribe (Public Law 100-580)
- Judgment funds held in trust by the United States, including interest and investment income accruing on such funds, and judgment funds made available for programs or distributed to members of the Wisconsin Band of Potawatomi (Hannahville Indian Community and Forest County Potawatomi) (Public Law 100-581)
- All funds, assets, and income from the trust fund transferred to the members of the Puyallup Tribe under the Puyallup Tribe of Indians Settlement Act of 1989 (Public Law 101-41)
- Judgment funds distributed per capita, or held in trust, or made available for programs, for members of the Seminole Nation of Oklahoma, the Seminole Tribe of Florida, the Miccosukee Tribe of Indians of Florida, and the independent Seminole Indians of Florida, (plus any interest and investment income accruing on the funds held in trust) (Public Law 101-277)
- Payments, funds, distributions, or income derived from them under the Seneca Nation Settlement Act of 1990 (Public Law 101-503)
- Per capita distributions of settlement funds under the Fallon Paiute Shoshone Indian Tribes Water Rights Settlement Act of 1990 (Public Law 101-618)
- Settlement funds, assets, income, payments or distributions from Trust Funds to members of the Catawba Indian Tribe under the Catawba Indian Tribe of South Carolina Land Claims Settlement Act of 1993 (Public Law 103-116)
- Settlement funds held in trust, including interest and investment income accruing on such funds, and payments made to members of the Confederated Tribes of the Colville Reservation under the Confederated Tribes of the Colville Reservation Grand Coulee Dam Settlement Act (Public Law 103-436)
- Payments made or benefits granted by the Crow Boundary Settlement Act of 1994 (Public Law 103-444)
- Per capita distribution judgment funds to members of the Western Shoshone Indians (Public Law 108-270)
- Payments made or granted to the Aroostook Band of Micmacs under Public Law 102-171
- Payments made from the distribution of judgment funds to members of the Confederated Tribes of the Umatilla under Public Law 91-259
- Payments from the Tribal Trust Accounting and Management Lawsuits under Public Law 111-291 (section 101), including payments made because of the Cobell v. Salazar Class Action Settlement.
- Bureau of Indian Affairs (BIA) General Assistance payments are federally funded income based on need and are counted as unearned income, regardless of whether they are paid in cash or in kind. The $20 per month general income exclusion does not apply to these payments
- Individual Indian Money (IIM) accounts are treated as follows:
- For an account that requires BIA Authorization for withdrawal (restricted):
- A deposit required by the BIA is excluded as income and as a resource.
- A deposit not required by the BIA is counted or excluded as income in accordance with this chapter of rules based on the source of the deposit. The deposit is excluded as a resource.
- A withdrawal is treated in accordance with this chapter of rules based on the source of the funds withdrawn. When funds in the account include both excluded and non-excluded funds, the Department presumes that the non-excluded funds are withdrawn first.
- For an account that does not require BIA authorization for a withdrawal (unrestricted): Deposits and withdrawals are treated in accordance with this chapter of rules based on the source of the deposit or withdrawal. When funds in the account include both excluded and non-excluded funds, the Department presumes that the non-excluded funds are withdrawn first.
Individual Development Account (IDA)
An Individual Development Account (IDA) is a trust-like savings account established under P.L. 105-285 designed to help low-income individuals save for specified purposes. The individual makes deposits from his or her earnings, and these are matched by a combination of government and private-sector funds.
For eligibility determinations:
- Deposits from the account holder's earnings are excluded from gross earned income.
- Matching deposits from government and private-sector funds are excluded from income.
- The IDA savings account is excluded from resources.
- Interest earned by the IDA savings account is excluded from income.
For client liability calculations (see 461-160-0610), all income deposited into an IDA is counted as earned income.
If a client makes an emergency withdrawal from the account, that income is counted as lump-sum income.
An inheritance may be received in the form of monies, property, or other assets.
Treat an inheritance as follows:
Treat non-cash inheritances
according to policy for the specific type of asset. Count cash inheritances
as periodic or lump-sum income.
42. In-Kind Income
In-kind income is compensation in a form other than money (such as food, clothing,
cars, furniture, and payments made to a third party). See #66 below for information on shelter in-kind income.
Earned in-kind income is treated according
to the policy on earned income.
Unearned in-kind income (except third-party
payments) is treated as follows:
- Income from court-ordered community service work or bartering is excluded.
Bartering is the exchange of goods of equal value.
- Items such as cars and furniture are treated according to the administrative
rule for the specific type of asset (see division 145 of the OARs).
Treat unearned third-party payments as follows:
- Count payments made to a third party that should legally be paid directly
to a member of the financial group as unearned income
- Exclude payments made to a third party that the payee is not legally obligated
to pay directly to a member of the financial group and that the group does
not have the option of taking as cash, and payments made by the noncustodial
parent to a third party, that are court-ordered but not designated as child
For information on how to treat third party payments made by an absent parent,
43. Job Corps
Treat Job Corps payments as follows:
- Count living allowance payments as earned income.
- Count readjustment allowance payments as earned income.
- A support service payment for an item already covered
by the benefits of the benefit group is counted as unearned income. All other support service payments (including clothing allowances) are excluded.
- A reimbursement is treated as provided in 461-145-0440.
- Note: PIVOT (Partners in Vocational and Occupational
Training) is a Job Corps program for participants 17-21 years of age, who
have had a child by age 17. Treat PIVOT living allowance payments as (1) above.
44. Life Estate - NOT QMB/SMB/SMF
A life estate is the right to property limited to the lifetime of the person holding it or the lifetime of some other person. In general, a life estate enables the owner of the life estate to possess, use and obtain profits from property during the lifetime of a designated person while actual ownership of the property is held by another individual. A life estate is created when an individual owns property and then transfers their ownership to another while retaining, for the rest of their life, certain rights to that property. In addition, a life estate is established when a member of the financial group purchases a life estate interest in the home of another individual.
For purposes of this rule, the value of the rights conferred by the life estate is established by SPD WG E.3, Life Estate and Remainder Interest Table (use the client's current age).
A life estate owned by a member of the financial group is treated as follows:
- If a member of the financial group is living on the property the value of the life estate is treated as a home (see 461-145-0220).
- If a member of the financial group is not living on the property the value of the life estate is counted as a resource. The life estate is considered unavailable if other parties with an ownership interest in the property refuse to sell their interest or refuse to purchase the life estate interest in the property.
In the OSIP(M) programs for those in a non-standard living situation:
- A transfer for less than fair market value in which a member of the financial group retains a life estate is a disqualifying transfer. A transfer is considered for less than fair market value if the fair market value of the transferred resource on the day prior to the transfer is greater than the sum of the value of the rights conferred by the life estate plus the compensation received for the transfer.
- If a member of the financial group purchases a life estate interest in the home of another individual on or after July 1, 2006, the purchase is considered a transfer of resources unless the client resides in this home for at least 12 consecutive months after the date of the purchase. The value of the transfer for a client who does not reside in the home for at least 12 consecutive months is calculated by using the purchase price of the life estate.
- Note: It is possible for an individual to have an interest in a life estate and not reside in the home. This does not diminish the legal interest in the property. The individual's name is still on the property and they would be entitled to part of the proceeds from the sale of the home as an interest holder. Use the life estate table to determine the portion of the proceeds that would be an appropriate share. Maintenance costs, repairs, and taxes are the responsibility of the life estate holder - so the share can be offset by those. Costs of improvements to the home are not costs that a life estate holder is responsible for and can't be used to diminish the share of the proceeds.
45. Life Insurance
Life insurance policies are only a resource to the owner of the policy (or to a beneficiary when it pays out), not necessarily the person insured. For example, individuals can buy whole life policies on their immediate family members and it would be a countable resource to the individual, not the family member.
Beneficiaries of life insurance policies
Benefits paid on a life insurance policy are counted as unearned income in the month received and a resource if retained into the following month.
The Department counts benefits as paid when the insured individual dies or when the insured individual is eligible for and receives accelerated payments before death, such as when the insured individual has a terminal illness.
When the payment is a lump sum due to the death of the insured individual a deduction is allowed, not to exceed $1,500, for the cost of the deceased individual's last illness and burial if these costs were not otherwise insured.
Owners of life insurance policies - OSIPM only
Burial insurance that has cash surrender value is treated in the same manner that this rule treats life insurance.
The value of a life insurance policy is treated as follows:
- Exclude all term insurance that has no cash surrender value.
- For the purposes of this subsection, the following definitions apply:
- Cash surrender value means the equity that the policy acquires over time.
- Dividend means a payment of surplus company earnings from the insurer.
- Dividend accumulation means a dividend left with the insurer to accumulate interest that may be withdrawn without affecting the policy's face value or cash surrender value.
- Dividend addition means the amount of insurance purchased with a dividend that increases the policy's death benefit and cash surrender value.
- Face value means the amount of the death benefit contracted for at the time the policy was purchased and does not include a dividend addition added after purchase of the policy.
- Viatical settlement means an agreement allowing a third party to acquire a life insurance policy from a terminally ill individual at an agreed upon percentage of the life insurance policy's face value.
The total cash surrender value of life insurance policies owned by the financial group is excluded if the total face value of all policies for the insured individual is less than or equal to $1,500. If the total face value of all policies for the insured individual is more than $1,500, the entire cash surrender value is counted as a resource to the owner of the policy. The total face value does not include dividend addition. A dividend accumulation must count as a resource even if the face value of the policy is excluded.
The cash surrender value of a policy acquired through a viatical settlement is excluded.
Note: The cash surrender value (CSV) of a life insurance policy can be excluded if the ownership of the policy has been irrevocably assigned to a funeral home. If a funeral home is named as the irrevocable beneficiary (instead of an irrevocable transfer of ownership), the policy can only be excluded if the assignment contains specific language that prevents the owner of the policy from accessing the cash surrender value of the policy by loan or policy cancellation.
46. Loans and Repayment of Loans - CORRECTED
A loan is a debt that the borrower must repay.
This section covers proceeds of loans, loan repayments, and interest earned by a
lender. If the proceeds of a loan are used to purchase an asset, the asset is evaluated
under the policy outlined in the other sections of this manual. The following policy applies to cash loans.
- Bona fide loan agreement means an agreement that:
- Is in effect at the time the cash proceeds are provided to the borrower; and
- Includes an obligation to repay and a feasible repayment plan.
- Negotiable loan agreement means a loan agreement in which the instrument ownership and the whole amount of money expressed on its face can be transferred from one person to another (i.e., sold) at prevailing market rates.
- Reverse-annuity mortgage means a contract with a financial institution (see OAR 461-001-0000) under which the financial institution provides payments against the equity in the home that must be repaid when the homeowner dies, sells the home, or moves.
The proceeds of a home equity loan or reverse-annuity mortgage are considered bona fide agreements (see below for treatment).
- Note: A reverse mortgage can be received by a person age 62 or older as a loan against the equity in their home. The loan is due for repayment when the borrower permanently moves out or sells the property or upon death of the borrower. The loan can be received as monthly payments, as a lump sum, or as a line of credit. When it is a line of credit, only the funds the client withdraws from the line of credit are considered the client's assets.
In all programs, educational loans are treated according to the policy on educational income.
For loans that a member of the financial group receives as a borrower:
- If there is no oral or written loan agreement which states when repayment of the loan is due to the lender, the loan payments are counted as unearned income in the month received.
- If there is an oral written loan agreement with repayment terms (this includes most reverse mortgages):
- If the loan is a bona fide loan agreement, the money provided by the lender is not income but is counted as the borrower's resource if retained in the month following the month of receipt (OAR 461-140-0070 does not apply in this case).
- If the loan is not a bona fide loan agreement, the money provided by the lender is counted as income in the month received and is counted as a resource if retained in the month following the month it was received.
- If the loan is bona fide, the money provided by the lender is not considered income.
- If the loan is not bona fide, the money provided by the lender is counted as unearned income in the month received.
For loans that a member of the financial group makes as a lender:
OSIPM (standard living arrangement)
- if the loan is both a negotiable loan agreement and a bona fide agreement:
- Only the interest portion of payments made by the borrower to the lender is counted as unearned income, the principal portion of any payments is excluded.
- The outstanding principal balance is counted as a resource.
- If the loan is not both negotiable and bona fide:
- Both the principal and interest payments are treated as unearned income.
- The balance of the loan is excluded as a resource.
OSIPM (non-standard living arrangement)
- For transactions occurring before July 1, 2006, loans are treated as they are with OSIPM in a standard living arrangement (see above).
- For transactions after July 1, 2006, if a loan meets the following requirements, then the loan is still treated as they are with OSIPM in a standard living arrangement:
- The total value of the transaction is being repaid to the client or spouse of the client within three months of the client's life expectancy per SPD Worker Guide E.3.
- Payments are made in equal amounts over the term of the transaction without any deferrals or balloon payments.
- The contract is not canceled upon the death of the individual receiving the payments under this transaction.
- For transactions after July 1, 2006 if all the above requirements are not met:
- The loan balance is considered a disqualifying transfer of assets.
- When the disqualification period has been served, the principal and interest portion of payments made by the borrower are treated as unearned income.
- Transactions for this section include when a client or community spouse uses funds to:
- Purchase another's mortgage;
- Purchase a promissory note or loan from another; or
- Lend money via promissory note or loan.
- The interest portion (if any) of payments received from the borrower is treated as unearned income
- Payments made by the borrower against the principal of all loans are excluded as income
Note: Please contact the APD Medicaid financial policy unit for assistance with the treatment of loans. Click here for contact info.
47. Lodger Income
A lodger is a member of the household group who---
- Is not a member of the filing group; and
- Pays the filing group for room (rent), without or without board (meals).
Lodger income is the amount a lodger pays the filing group for either the room, or room and board in the filing group's primary residence (i.e. the client is renting out a room in their home).
Lodger income is treated as unearned income and can be reduced by the certain expenses.
The allowable expenses are prorated based on the number of rooms for rent compared to the number of rooms in the home (excluding bathrooms, but including attics and basements if they have converted to living spaces). The allowable expenses include:
- Interest and escrow portions of a mortgage payment
- If the home is rented, the monthly amount the filing group pays for rent
- Real estate insurance
- Repairs (such as a minor correction to an existing structure)
- Property taxes (if not included in the escrow portion of a mortgage payment)
- Lawn care
- Snow removal
- Advertising for tenants
Lodger income is generally not treated as self-employment unless the filing group is in the business of renting out rooms (such as with a commercial boarding house or a bed and breakfast).
48. Manufactured and Mobile Homes
Manufactured and mobile homes that are the individual's home are treated as a home (see 461-145-0220). Otherwise they would be treated as real property (see 461-145-0420) or income-producing property (see 461-145-0252), depending on the use.
49. Military Income
This policy is regarding military pay and allowances of a member of a uniformed service. This income is treated as follows:
Military income is counted as earned income of the military member's financial group, except that only the portion of military pay and allowances made available to the financial group is counted as unearned income if the member is not included in the filing group.
50. Motor Vehicle - NOT QMB/SMB/SMF
The value of disability-related apparatus, optional equipment, or low mileage is not considered in determining the fair market value of an automobile, truck, or van. The fair market value of an automobile, truck, or van is presumed to be the "average trade-in value" established in the NADA Used Car Guide. If the vehicle is not listed in the NADA Used Car Guide, the "average trade-in value" established in the Kelley Blue Book is used. If the vehicle is not listed in the NADA Used Car Guide and Kelley Blue Book, the "average trade-in value" established in a similar publication is used. A client may rebut the presumption with a statement from a car dealer, mechanic, or other reliable source. If the vehicle is not listed in the NADA Used Car Guide, Kelley Blue Book, and a similar publication, the estimate of the value by the client may be accepted unless it appears questionable, in which case additional evidence of the value is required.
The total value of a vehicle selected by the financial group is excluded if it is used for transportation of the client or a member of the client's household.
The total equity value of any vehicle not excluded above and all other vehicles is counted as a resource.
Note: Examples of vehicles that would not be excluded would be a vehicle that nobody drives because it is not licensed and/or insured or a vehicle for sale on a consignment lot.
In the EPD programs, if a vehicle was purchased as an employment and independence expense or with moneys from an approved account, the total value of the vehicle is excluded.
51. National and Community Services Trust Act (NCSTA), including AmeriCorps (other than AmeriCorps VISTA)
The National and Community Service Trust Act (NCSTA) of 1993 (P.L. 103-82)
amended the National and Community Service Act (NCSA) of 1990 (P.L. 101-610)
that established a Corporation for National and Community Service. The Corporation
administers national service programs providing living allowance, educational
award, child care and in-kind benefits.
These payments are excluded. This also includes:
- Living allowance (stipend benefits)
- Educational award and in-kind benefits
- Child care allowances
- Note: The programs administered by the corporation
under the NCSTA include AmeriCorps USA, AmeriCorps VISTA, AmeriCorps NCCC
and Research Assistance for Rural Environments (RARE). The
corporation also oversees the Senior Corps, the Earth Corps, and Learn and
52. Older Americans Act
Benefits under Title III of the Older
Americans Act of 1965 (Nutrition Program for the Elderly) are excluded.
A wage or salary paid to persons 55 years of age and
older under Title V of the Older Americans Act of 1965 is considered earned income.
Note: Organizations receiving Title V funds are: Green Thumb, Experience Works,
American Association of Retired Persons, National Association for
Spanish-Speaking Elderly, National Council on Aging, National Council on Black
Aging, National Council of Senior Citizens, National Urban League, U.S. Forest
Service. In Oregon, some seniors working for Easter Seals may also be paid using Title V funds. Confirm the funding source before excluding the income.
53. Pension and Retirement Plans
Pension and retirement plans include the following:
- Benefits employees receive only when they retire. These benefits can
be disbursed in lump-sum or monthly payments.
- Benefits that employees are allowed to withdraw when they leave a job
- The following retirement plans if purchased by a client with funds from the plans authorized by section 401 of the Internal Revenue Code of 1986:
- Traditional Defined-Benefit Plan
- Cash Balance Plan
- Employee Stock Ownership Plan
- Keogh Plan
- Money Purchase Pension Plan
- Profit-Sharing Plan
- Simple 401(k)
- Retirement plans authorized by section 403 of the Internal Revenue Code of 1986 at subsections (a) or (b).
- The following retirement plans and annuities if purchased by a client with funds from the plans (authorized by section 408 of the Internal Revenue Code):
- Individual Retirement Annuity.
- Individual Retirement Account (IRA).
- Deemed Individual Retirement Account or Annuity under a qualified employer plan,
- Accounts established by employers and certain associations of employees.
- Simplified Employee Pension (SEP).
- Simple Individual Retirement Account (Simple IRA).
- Roth IRA
- The following retirement plans offered by governments, nonprofit organizations, or unions:
- 457(b) Plan.
- 501(c)(18) Plan.
- Federal Thrift Savings Plan under 5 USC 8439.
Payments the financial group receives from pension and retirement plans are treated as follows:
- Monthly payments are counted as unearned income.
- All other payments are counted as periodic or lump-sum income.
An annuity purchased by the spouse of an individual with funds from a retirement plan authorized by section 408 of the Internal Revenue Code described above is not considered a retirement plan and is treated in accordance with OAR 461-145-0020 and OAR 461-145-0022.
Except for QMB/SMB/SMF, and except for an annuity purchased by an individual with funds from a retirement plan authorized by section 408 of the Internal Revenue Code described above:
- The equity value of a pension or retirement plan is excluded as a resource if the individual is eligible for monthly or periodic payments under the terms of the plan and has applied for those payments. When an individual is permitted to choose or change a payment option, the individual must select the option that:
- Provides payments commencing on the earliest possible date; and
- Completes payments within the actuarial life expectancy. See the Period Life Table, published by the SSA.
- The equity value of all other pension and retirement plans that allow clients to withdraw funds, minus any penalty for withdrawal, is counted as a resource.
- If the equity value of the pension or retirement plan is counted as a resource, any payments taken or received are considered a conversion of a resource (from the retirement plan to cash, for instance) and are not counted as income.
See OSIPM D.4 and QMB D.3 about changes to the requirement of benefit group members to pursue payments from pension or retirement plans effective July 1, 2016.
The equity value of an annuity purchased by an individual with funds from a retirement plan authorized by section 408 of the Internal Revenue Code described above is excluded as a resource if it meets the payout requirements in the annuity section of this worker guide. Otherwise, the equity value is counted as a resource.
For individuals in a standard living arrangement, the equity value of pension and retirement plans owned by a non-applying spouse is excluded as a resource for OSIPM. Dividends and interest earned on pension funds owned by a non-applying spouse are excluded as income in the OSIPM and QMB programs.
Note: Clients who choose to begin receiving payments from a retirement plan so that it will not be counted as a resource, should seek financial advice on the Internal Revenue Code Section 72(t). When the client arranges equal periodic payments over the life expectancy, this tax code allows access to the retirement funds early without incurring a 10% tax penalty.
- A member drawing PERS retirement benefits may be entitled to increased payments when the following criteria are met:
- The PERS member is age 80 or more.
- The beneficiary named by the PERS member is deceased.
- The PERS member chose option 2 or 3 or lump sum option 2 or 3 when he or she retired.
In order for the PERS member to claim the increased payments, he or she will need to send a copy of the deceased beneficiary’s death certificate and a letter to PERS requesting the “age 80 increase.” If eligible, the monthly PERS payments will be increased and there may be a retroactive payment issued.
In addition, when a PERS member dies, the surviving spouse or other beneficiary may be entitled to PERS benefits. Within 90 days of the PERS member’s death, the spouse or other beneficiary should contact PERS to inquire about eligibility for payments or continued health insurance coverage.
The contact information for PERS is as follows:
P.O. Box 23700
Tigard, OR 97281-3700
Toll free: 1-888-320-7377
54. Personal Belongings
Personal belongings are such items as household furnishings, clothing, heirlooms,
keepsakes, and hobby equipment.
The value of personal belongings is excluded.
55. Personal Injury Settlement
For all programs, treat personal injury settlements as follows:
- Monthly payments are counted as unearned income.
- For all programs except grandfathered OSIPM, count all other
payments as periodic or lump-sum income.
- For grandfathered OSIP(M) clients, count the balance from personal
injury claims after the Department's lien is satisfied as lump-sum income.
If the lien was not filed due to the recipient's failure to notify the Department
of the claim, count the payment as unearned income.
This policy does not apply to workers compensation payments.
56. Plan for Self-Support
A plan for self-support allows a client to retain a part of his or her assets
for a specific period of time so they can meet specific occupational goals.
Social Security Administration may establish a plan for self-support with SSI
recipients. APD may also establish a plan for self-support OSIPM and QMB/SMB/SMF clients who meet disability criteria (established by SSA or PMDDT) but are not eligible for SSI (see OAR 461-135-0708).
Assets listed in an approved plan for self-support are excluded.
57. Program Benefits
Treat OSIP (except OSIP-IC), Post-TANF, REF, SFPSS, TANF, and tribal-TANF payments as follows:
- Exclude these payments in the month received and, except for QMB/SMB/SMF, count as a resource
any cash remaining in the months after receipt.
- Exclude payments made to correct an underpayment.
REF and TANF client incentive payments are treated as follows:
- The cooperation incentive payment (see OAR 461-135-0210) is counted as unearned income.
- Progress and outcome incentive payments other than in-kind payments are counted as lump-sum income. All other incentives are excluded.
Exclude payments or benefits from the following programs:
- JOBS (including support service payments)
- OCCS medical
- OFFSET service payments
- REF support service payments
- Pre-TANF program payments
- TANF child care (unless the client is the provider)
- TANF JOBS Plus support service payments
- TANF-related medical.
Treat JOBS Plus wages received after the individual's last month of work under a TANF-PLS JOBS Plus agreement as earned income (see OAR 461-145-0130)
Payments from OSIP-IC and funds held in a contingency fund are excluded.
58. Qualified Partnership Policy (OSIPM only)
When a client in a non-standard living arrangement applies for OSIPM, exclude a resource amount equal to the insurance payments received under a qualified partnership policy, as of the initial month of eligibility, unless the policy was purchased in a state that does not participate in reciprocity.
The resources excluded under this provision can be any resources that would otherwise be counted, except for a home with equity that exceeds the limit in 461-145-0220 (2)(a).
(see WG.10 for additional information)
59. Radiation Exposure Compensation Act
Radiation Exposure Compensation Act payments are issued to compensate individuals for injuries or deaths resulting from exposure to radiation from nuclear testing or uranium mining. For all programs, exclude these payments.
60. Railroad Retirement Payments
Railroad Retirement payments made by the Railroad Retirement Board are counted as unearned income.
The Research Assistance for Rural Environments (RARE) is an AmeriCorps program administered through the University of Oregon. The program assists rural communities in their efforts to improve their economic, social and environmental conditions. Local communities request the assistance of this program and provide part of the funding. The program is supported through grants from various federal and state agencies.
RARE participants are graduate-level people who reside in the local community. They work in this program for 11 months and receive monthly living stipend and medical health insurance.
The monthly stipends are treated as AmeriCorps benefits and excluded.
62. Real Property- NOT QMB/SMB/SMF
For purposes of this rule, manufactured and mobile homes and floating homes are treated in the same manner as real property.
The applicant has the burden of proof of establishing the fair market value of real property. Fair market value may be established by any methodology determined to accurately reflect the fair market value of the real property, including the provision of an appraisal or comparative market analysis performed by an impartial individual who is certified or licensed in the applicable jurisdiction.
- Note: The key to determining fair market value is making sure that the value you arrive at is the most accurate one. A current market value given by a tax assessor is a good starting point. When reviewing tax assessor records, be sure not to confuse reduced (or “assessed”) property values with values that are supposed to reflect the current value (“real market value” is the term used in Oregon).
Sometimes tax assessor records are not the best way to determine fair market value. For example, current property tax records may overvalue property that has deteriorated. An appraisal may reflect a more realistic property value. Alternatively, property tax records may sometimes undervalue property, such as homes, farmland, and timberland. If property is appraised at or sells for more than the tax assessor’s listed current market value then the most accurate property value is the greater of the appraisal’s value or what it sold for.
If property sells for less than either the tax assessor’s current market value or an appraisal’s value, then that is a red flag to investigate why a sale was for less than fair market value. Sales or transfers of property for less than fair market value are potentially disqualifying transfers. Generally, the following methods can help to accurately determine fair market value:
- Using the highest value identified by the county assessor on the most recent property tax record.
- Using the value established by an appraisal or comparative market analysis as the current amount the real property would sell for on the open market.
- Using the gross sale price of property that has sold.
Treat real property that is not income-producing
or the financial group's home as follows:
- The equity value of real property that was the home of the financial
group is excluded if the financial group is making a good-faith effort
to sell the property at a reasonable price, unless the equity value in
the home makes the client ineligible under 461-145-0220(2)(a).
- Count the equity value of all other real property as a resource unless
the financial group is making a good faith effort to sell the property. The
equity value is counted after the property is excluded for nine months unless
the failure to sell it is for reasons beyond the reasonable control of the
Note: A good-faith effort to sell property includes
listing the property for sale in the local newspaper, putting a "For
Sale" sign on the property, and/or listing the property with a real estate
The treatment of real property that is income-producing is covered in income-producing property.
The treatment of the home of the financial group is covered in the policy on homes.
63. Recreational Vehicles - NOT QMB/SMB/SMF
A recreational vehicle includes:
- A vehicle (a means for carrying or transporting something) if---
- The vehicle is used primarily for amusement and not for day-to-day transportation; and
- The vehicle cannot be licensed as a motor vehicle for use on a public highway (even if the vehicle is registered or licensed as a non-motor vehicle).
- An ATV, boat, camper, dune buggy, plane, snowmobile, and trailer, unless the item qualifies as a capital asset or as work-related equipment.
The equity value of recreational vehicles is counted as a resource.
Exclude the following refunds in the month they are received:
- Refunds on merchandise that was purchased or received as a gift.
- Refunds of utility and rental deposits.
Except for QMB/SMB/SMF, count any refund amount remaining after the month of receipt as a resource.
See rule 461-145-0530
for information on tax refunds.
A reimbursement is money or in-kind compensation provided specifically for an
For the treatment of USDA meal reimbursements, see 461-145-0570.
The reimbursement of a business expense for a self-employed client is treated as self-employment income.
Reimbursements are treated as follows:
- An in-kind reimbursement is excluded.
- A reimbursement in the form of money is excluded if used for the identified expense, unless
the expense is covered by program benefits.
- A reimbursement is counted as periodic or lump-sum income if not used for
the identified expense.
- A reimbursement for an item already covered by the benefit group's benefits
is counted as periodic or lump-sum income.
- Note: Payments for extra expenses, such as meal
reimbursements for training or conferences, JTPA lunch payments, Department
shelter payments for attendants or housekeepers and premiums for cost-effective
employer-sponsored health insurance are not considered to be expenses paid
by program benefits and are excluded as reimbursements. Exclude all jury-duty
66. Resettlement and Placement Grants
A Resettlement and Placement (R & P) grant is a payment made by the
United States Department of State through national refugee resettlement agencies
to local resettlement agencies, refugee sponsors and refugees. The R&P grants
are provided to the resettlement agencies to help with the costs of initial
resettlement of refugees in the United States. The resettlement agencies provide
a part of this grant to refugees, usually in their first month after arrival,
for their initial resettlement needs, and not for ongoing living expenses.
R & P grants determined to be available
to the refugee case are considered unearned income.
67. Sale of a Resource
For grandfathered OSIPM clients (see OAR 461-135-0771) refer to OAR 461-145-0460.
Proceeds from the sale of a resource other than a home occurring prior to October 1, 2012
- For all programs, count proceeds received
on a monthly basis as unearned income.
- Treat proceeds received on a lump sum basis as follows:
- For OSIPM, if the proceeds are from the sale of an excluded resource, exclude
the amount reinvested in another excluded resource. Count the remainder
as a resource.
- For OSIPM, count the proceeds from all other sales as a resource. If the proceeds
put the benefit group over the resource limit, treat the monies as periodic or lump-sum income.
- For QMB/SMB/SMF, lump-sum proceeds are excluded as income.
Proceeds from the sale of a resource other than a home occurring on or after October 1, 2012
- For proceeds received on a monthly or periodic basis:
- For all programs, count the interest portion as unearned income
- For OSIPM, count the principal portion as a resource.
- For QMB/SMB/SMF, the principal portion is excluded as income.
- For proceeds received on a lump-sum basis:
- For OSIPM, if the proceeds are from the sale of an excluded resource, exclude
the principal portion amount reinvested in another excluded resource. Count the remainder
of the principal portion amount as a resource.
- For OSIPM, count the principal portion of the proceeds from all other sales as a resource. If these proceeds
put the benefit group over the resource limit, treat the monies as periodic or lump-sum income.
- For all programs, all interest portions of proceeds are counted as unearned income.
- For QMB/SMB/SMF, the principal portion of proceeds are excluded as income.
Proceeds from the sale of the home of the financial group occurring before October 1, 2012
- For OSIPM:
- Proceeds are excluded for three months if the financial group intends to use the proceeds to buy another home.
- Proceeds not reinvested in another home are counted as a resource.
- For QMB/SMB/SMF, proceeds are excluded as income.
Proceeds from the sale of the home of the financial group occurring on or after October 1, 2012
- For OSIPM:
- The principal portion of proceeds, including lump-sum payments, are excluded for three full calendar months from the date of receipt if the financial group intends to use the proceeds to buy another home or for associated costs including:
- Down payments;
- Settlement Costs;
- Loan and processing fees and points;
- Moving expenses;
- Necessary repairs to or replacement of the new home’s structure or fixtures (including roof, furnace, plumbing, built-in appliances) that are identified and documented prior to occupancy; and
- Mortgage Payments.
- Funds for the above costs obligated by contract within three full calendar months are also excluded (see example below).
- Example: Sam sells his home and receives a lump sum payment of $100,000. One month after he received the proceeds from the sale of his home, he purchased a new home for $95,000.
At the same time, he entered into a contract with a roofing company to repair the roof on the new home. The contract terms state that Sam will pay the contractor $5000 once the roof is repaired and the work is completed. The contractor has stated that it will be 5 months before the work is completed.
Even though Sam has not “spent” the $5000 within 3 months of receiving the funds from the sale of his home, this amount is still excluded. Because he entered into the roofing contract, and became obligated to pay $5000 upon completion of the work, the funds are considered to have been reinvested in the purchase of another home, and are therefore excluded. In this instance, Sam reinvested the entirety of the proceeds of the sale of his home in another home. The entire proceeds are excluded.
- The principal portion of proceeds not reinvested in another home is counted as a resource.
- For all programs, the interest portion of proceeds are counted as unearned income, regardless of their use.
Note: See rule 461-145-0240 for information on how to treat the proceeds from a resource sold on contract.
68. Shelter-in-Kind Income
Shelter-in-kind (see OAR 461-001-0000) is when an agency or person outside the financial group provides
the financial group's shelter, or makes a payment to a third party for some
or all of the group's shelter costs.
Shelter-in-kind does not include temporary shelter provided by a domestic violence shelter, homeless shelter, residential alcohol and drug treatment facilities or situations where no shelter is being provided, such as sleeping in a doorway, park or bus station.
- Unearned shelter-in-kind income is excluded for all OSIPM and Medicare Savings Programs when determining eligiblity and calculating service liability.
- Earned shelter-in-kind income is treated as follows:
- If shelter is provided for services related to the employer's trade or business and acceptance of the shelter is a condition of employment, the shelter-in-kind income is treated as unearned shelter-in-kind and excluded.
- If the shelter isn't employment-related or if it is but acceptance isn't required as a condition of employment, the fair market value of the shelter is counted as earned income.
- A payment for which there is a legal obligation to pay to a member of the financial group that is made to a third party for shelter expenses of a member of the financial group is counted as unearned income.
69. Social Security Benefits
- Social Security Benefits include Title II - Federal Old-Age (SSB), Survivors (SSB), and Disability Insurance (SSDI) Benefits through the Social Security Administration trust fund.
- This section does not apply to Title XVI - Supplemental Security Income for the Aged, Blind, and Disabled (SSI). A Federal supplemental income program funded by general tax revenues (not Social Security taxes). See #70 below for more information on SSI.
- This section does not apply to Social Security death benefits. See #68 below for more information on death benefits.
- For more information visit Social Security Online.
For the purposes of this section, a payment is retroactive if it is issued in any month after the calendar month for which it is intended.
Social Security benefits (SSB) are treated as follows:
- Monthly payments are counted as unearned income.
- Note: The amount that displays on BEIN is the net gross amount and may include deductions for several things, including the overage for the Medicare Part D premiums. Use WQY2 to see the true gross amount.
- All payments other than monthly payments (including retroactive payments) are counted as periodic or lump-sum unearned income in the month received, except:
- When retroactive payments are made through the representative payee of an individual who is required to have a representative payee because of drug addiction or alcoholism, the retroactive payments may be required to be made in installments. If the payments are made in installments, the total of the benefits to be paid in installments is considered unearned income in the month in which the first installment is made.
- For OSIPM, any remaining amount from a retroactive payment after the month of receipt is counted as an excluded resource for nine calendar months following the month in which the payment is received. After the nine-month period, any remaining amount is a countable resource.
70. Social Security Death Benefit
Money remaining from Social Security death benefits after the payment of burial costs is treated as lump-sum income.
71. Spousal Support
Spousal support is income paid (voluntarily, per court order or per administrative
order) by a separated or divorced spouse to a member of the financial group.
Spousal support is counted as unearned income. Do not allow spousal support paid by the group as
an income deduction, except as provided in 461-160-0620.
SSI payments are not counted as income in the traditional sense for the individual receiving SSI; instead, they are considered inasmuch as the receipt of SSI benefits results in assumed eligibility for OSIPM and QMB-BAS.
For a married individual applying for benefits who is not receiving SSI, the spouse's SSI benefits are countable if the spouse is included in the financial group.
For OSIPM only (and only for those not assumed eligible), a retroactive SSI payment is excluded as a resource for nine months after the month of receipt. After the nine-month period, any remaining amount is a countable (see OAR 461-001-0000) resource. For the purposes of this section, a payment is retroactive if it is issued in any month after the calendar month for which it is intended. This would only apply to someone who receives a retroactive payment during a time when he/she is no longer receiving ongoing SSI benefits (again, not assumed eligible).
73. Stocks, Bonds and Other Securities - NOT QMB/SMB/SMF
Except as provided in the paragraph below, the equity value (see OAR 461-001-0000) of mutual funds, and, securities (including stocks, bonds, educational savings bonds), and
certificates of deposit (CDs), is counted as a resource. Interest and dividends on these items are treated as provided in the interest and dividend rule (OAR 461-145-0108).
The value of a savings bond issued by the United States Department of the Treasury
is excluded during the minimum retention period if the owner has received a denial
of a request for a hardship waiver based on financial need.
A request for a hardship waiver may be made to the United States Department of
the Treasury, Bureau of Public Debt, Accrual Services Division, PO Box 1328,
Parkersburg, West Virginia 26106-1328.
74. Strikers' Benefits
Strikers' benefits are payments made to strikers by their union, whether or
not based on the striker's participation in picketing.
Count strikers' benefits as unearned income.
75. Tax Refund - NOT QMB/SMB/SMF
Income tax refunds and property tax refunds, including Elderly Rental Assistance (ERA) are counted as a resource.
76. Ticket to Work
Ticket to Work is a Social Security Program mandated under the Ticket to Work
and Work Incentives Improvement Act of 1999. The intent is to enable social
security beneficiaries to obtain, regain or maintain employment and to reduce
their dependency on cash assistance.
Ticket to Work is for most Social Security Disability (SSD) and Supplemental
Security Income (SSI) clients who are between age 18 and 65. The program is
voluntary. Recipients may use the “ticket” to obtain vocational
rehabilitation, employment or other support services from an approved provider
of their choice to help them to go to work and achieve their employment goals.
The recipient may be placed in on-the-job training or in school.
Most recipients participating in the Ticket to Work program are not receiving
money from SSA for Ticket to Work. Instead, SSA is sending payments to the provider
to reimburse the provider for their costs to provide the services. The recipient
may continue to get SSD or SSI while in the training, etc. They may be paid
a wage when work begins. They lose SSD or SSI when their income exceeds the
allowable limits for SSD or SSI.
Some recipients of Ticket to Work will receive a stipend or training allowance.
The stipend is counted as unearned income.
Count the income from employment as earned income. Count
SSD or SSI as unearned income.
77. Transfer on Death Deed
- Effective January 1, 2012, Oregon will allow real estate to be transferred to another person at the owner's death through a Transfer on Death deed. The change of ownership in the deed takes effect only upon the original owner’s death and avoids probate.
- Transfer on Death deeds are always revocable.
The transfer will not supersede recovery by the Estates Administration Unit
Trust funds are money, securities or similar property held by a person
or institution for the benefit of another person.
For QMB/SMB/SMF, trust funds are excluded as a resource and distributions from trusts which benefit an individual are counted as unearned income. The rest of this section applies to OSIPM.
Trusts other than special needs trusts, income cap trusts, and pooled trusts.
- Trust funds established before October 1, 1993
- Count trust funds as a resource if the fund is legally available for
use by a member of the financial group for items covered by program benefits. The amount of the trust that is considered legally
available is the maximum amount that could be distributed to the beneficiary
under the terms of the trust, regardless of whether or not the trustee
exercises his or her authority to actually make the distributions.
- Exclude trust funds if the fund is not available for use by a member
of the financial group. Require the group to pursue removing legal restrictions
on the trust, unless this will cause an expense to them.
- Count as a resource the part of the fund available for use for
medical expenses covered by the medical program for which the financial group
- Trust funds established on or after October
- A trust shall be considered established if the financial group used their
resources to form all or part of the trust and if any of the following established
a trust, other than by a will:
- The client.
- The client's spouse.
- Any other person, including a court or administrative body, with legal
authority to act in place of or on behalf of the client or the client's spouse.
- Any other person, including a court or administrative body, acting at
the direction or upon the request of the client or the client's spouse.
- If the trust contains resources or income of another person, only the share
attributable to the client will be considered as available.
- The following factors are ignored when determining
how to treat a trust:
- The purpose for which the trust was established.
- Whether or not the trustees have or exercise any discretion under the
- Any restrictions on when or if distributions may be made from the trust.
- Any restrictions on the use of distributions from the trust.
- If the trust is revocable, treat it as follows:
- The total value of the trust shall be considered a resource available
to the client.
- Any payments made from the trust to or for the benefit of the client
shall be excluded as income.
- Payments from the trust other than to or for the benefit of the client
are considered as a transfer of assets covered in the 140 section of the OARs (beginning with 461-140-0210).
- If the trust is irrevocable, treat it as follows:
- For OSIPM clients in a non-standard living situation, if, under any circumstances, the funds transferred into the trust are
unavailable and the trustee has no discretion in which to distribute funds
to or for the benefit of the client, the client is subject to a transfer of
resources penalty as outlined the 140 section of the OARs (beginning with 461-140-0210).
- If, under any circumstances, payments could be made to or on behalf of
the client, the share of the trust from which the payment could be made shall
be considered a resource. For OSIPM clients in a non-standard living situation, payments made for any reason other than to or for
the benefit of the client shall be considered a transfer of assets subject
to disqualification per the 140 section of the OARs (beginning with 461-140-0210).
- If, under any circumstances, income is generated by the trust and could
be paid to the client, such income will be considered as unearned income.
For OSIPM clients in a non-standard living situation, payments made for any reason other than to or for the benefit of the client
shall be considered a transfer of assets subject to disqualification per the 140 section of the OARs (beginning with 461-140-0210).
- If any change in circumstance makes assets (income or resources) from
the trust unavailable to the client, a disqualifying transfer will be assessed
as of the date of the change (again, for OSIPM clients in a non-standard living situation).
- The provisions of this rule may be waived for an irrevocable trust if the Department determines that denial of benefits would create an undue hardship
on the client.
- The local branch may determine undue hardship if, among other things:
The absence of the services requested may result in a life-threatening
- The client was a victim of fraud or misrepresentation.
- An Assistant Director of the Department or their designee may otherwise determine
that an undue hardship exists, based on the facts presented.
Special needs trust
Special needs trusts are not considered in determining eligibility for OSIPM.
A special needs trust is characterized by all of the following:
- It contains the assets of a client determined disabled by SSI
criteria that was created prior to age 65
- It is established by one
of the following:
- The client's parent or grandparent
- The client's legal guardian or conservator
- A court
- It specifies that the state will receive all funds remaining in the trust
upon the death of the client up to the amount of medical benefits provided
on behalf of the client
Income cap trusts established between October 1, 1993 and March 31, 1995
This applies to trusts established between October 1, 1993 and March 31, 1995 for the
benefit of the client and containing only the current and accumulated income
of the client. The accumulated amount remaining in the trust shall be paid
directly to the state upon the death of the client up to the amount of medical
benefits provided on behalf of the client. The trust is the total income
in excess of the income standard for OSIPM. The remaining income not deposited
into the trust shall be available for the following deductions in the order
they appear prior to applying the patient liability:
- Personal needs allowance.
- Community spouse monthly maintenance needs allowance.
- Medicare and other private medical insurance premiums.
- Other incurred medical.
Income cap trusts established on or after April 1, 1995
These trusts are established for the benefit of the
client whose income is above 300 percent of the full SSI standard and containing the current and accumulated income of the client. The
accumulated amount remaining in the trust shall be paid directly to the state
upon the death of the client up to the amount of medical assistance provided
on behalf of the client. The trust contains all of the client's income. The income
deposited into the trust shall be distributed monthly in the following order:
- Personal needs allowance and applicable room and board standard.
- Reasonable administrative costs of the trust, not to exceed a total
of $50 per month, including the following:
- Trustee fees. Note: If the client is the trustee, it is not reasonable to allow a trustee fee because that fee is meant for hiring another person to manage the trust, and any such income would raise the client's income, which would of course have to be run through the income cap trust.
- A reserve for administrative fees and costs of the trust, including
bank service charges, copy charges, postage, accounting and tax preparation
fees, future legal expenses, and income taxes attributable to trust income
- Conservatorship and guardianship fees and costs
- Community spouse and family monthly maintenance needs allowance.
- Medicare and other private medical insurance premiums.
- Other incurred medical care costs as allowed under 461-160-0030 and 461-160-0055.
- Contributions to reserves or payments for child support, alimony, and income taxes.
- Monthly contributions to reserves, outside of the trust, or payments for the purchase of an irrevocable burial plan with a maximum value of $5,000. The client may use one of the following for a burial fund:
- Up to $1,500, which may be excluded from resources; or
- Up to $5,000, if the client has an income cap trust, which can be held in reserve (this must be in an account outside of the trust, not part of the income cap trust), as described under 461-145-0540(9)(c)(G).
- Contributions to a reserve or payments for home maintenance if the client meets the criteria of 461-155-0660 or 461-160-0630.
- Patient liability not to exceed the cost of home and community based care or nursing facility services.
Note: If there is an accumulated excess amount equal to or more than the transfer of assets divisor, a disqualification should be calculated.
For more information on trusts, see OSIP WG.5.
Pooled trusts are not considered in determining eligibility for OSIPM (with one exception below) as long as they meet the following criteria:
- The trust is signed on or after July 1, 2006.
- The trust is established and managed by a non-profit association.
- A separate account is maintained for each beneficiary of the trust, but, for purposes of investment and management of funds, the trust pools these accounts.
- The trust is established by the client, client's parent, grandparent, or legal guardian or a court for clients who have disabilities.
- Upon the death of the beneficiary or by termination of the trust, the trust pays to the State an amount equal to the total medical assistance paid on behalf of the beneficiary under the State plan for Medicaid. The amount paid to the state may be reduced by administrative costs directly related to administering the sub-trust account of the beneficiary.
- The trust contains the resources or income of a client who has a disability that meets the SSI criteria.
For OSIPM clients in a non-standard living situation, if the client is age 65 or older when the trust is funded or a transfer is made to the trust, the transfer may constitute a disqualifying transfer of assets under 461-140-0210 and following.
79. Unemployment Compensation Benefits
Unemployment compensation benefits are treated as follows:
- Retroactive payments are counted as periodic or lump-sum income.
- Disaster Unemployment Assistance is treated as provided in the section on disaster relief.
- All payments not covered above are counted as unearned income.
80. Uniform Relocation Act
Reimbursements from the Federal Uniform Relocation Assistance Act (42 U.S.C. 4621 - 4625) and from the Real Property Acquisition Policies Act of 1970 (42 U.S.C. 4651 - 4655) are excluded.
81. USDA Meal Reimbursement
USDA meal reimbursements are cash reimbursements for family day care providers
who serve snacks and meals. The reimbursements are made by the Department of
Education and the amount of the reimbursement is determined by family size and
USDA meal reimbursements to child care providers for children in their care are counted as self-employment income.
The portion of USDA meal reimbursements made for children in the filing group is excluded.
Child care providers often have young children of their own who are present at the same time as children in care. When the provider receives the USDA meal reimbursement, they submit the voucher for both the children in care and their own children who were present for the snacks and meals. Exclude the part of the meal reimbursement for the provider's own children as follows:
- Determine the total number of children (not in filing group) who receive meals or snacks.
- Determine the total number of children (in filing group) also receiving meals or snacks.
- Total (1) and (2) above.
- Determine the total amount of monthly meal reimbursements.
- Divide the total from (3) into the meal reimbursement in (4) to arrive at the amount of reimbursement per child.
- Multiply the result of (5) by the number of children in (1) to arrive at the countable USDA meal reimbursement. Count as SEC.
Note: Family day care providers can exclude the
cost of meals they provide. See 461-145-0920
for more information.
82. Veterans' Benefits
Code disability and Aid and Attendance benefits in ACCESS as Veteran benefits and retirement benefits as Military pension.
Veteran benefits – The N/R Type will be blank when you bring it down after clicking Change N/R List during integration. Enter UME or VET based on the individual's situation as indicated below.
- Enter VET if any of the following is true:
- The individual is receiving disability and/or Aid & Attendance (A&A) and NOT residing in a nursing facility;
- The individual is receiving disability and/or A&A, is residing in a nursing facility, but the A&A benefit (if any) has not been reduced to $90; or
- The individual is receiving disability and/or A&A and residing in a state-run Veterans’ nursing facility.
- Enter the UME N/R Type only if the client receives Aid and Attendance payments of $90 AND is residing in either a traditional nursing facility or a federally-run Veterans’ nursing facility.
Military Pension – the N/R Type will be blank when you bring it down after clicking Change N/R List during integration, so you must manually enter VET.
Treat veterans' benefits, other than Aid and Attendance and educational
benefits, as follows:
- Count monthly payments as unearned income.
- Count other payments as periodic or lump-sum income.
Treat veterans' Aid and Attendance payments as follows:
- For OSIPM, and QMB/SMB/SMF clients in a non-standard living arrangement:
- When determining eligibility, the entire veterans' benefit payment is excluded when it includes Aid and Attendance.
- Count as unearned income the entire veterans' benefit when calculating monthly benefits or patient
liability. Note: If a client's Aid and Attendance
income makes the total income over the 300% of SSI, an income cap trust is
not needed; however, you must code CMS with an INT case descriptor to prevent the case form going NA.
- Exclude payments for services not covered by the Department's programs.
- For OSIPM and QMB/SMB/SMF clients in standard living arrangements:
- The aid-and-attendance payments are excluded. The remaining benefits are counted unless excluded under another rule or another section of this rule.
- Reimbursements paid to the client for costs and services already paid
for by the Department are third-party resources and should be recovered
from the client as an overpayment of public assistance in accordance with 461-195-0501, 461-195-0521 and 461-145-0551. Count any unrecovered third-party resource or payment above
the actual cost as lump-sum or periodic income.
- Retroactive Aid and Attendance Payments - clients in standard living arrangements:
- Any payments not subject to Department reimbursement for past services (see bullet below) are counted as lump-sum or periodic income.
- Retroactive Aid and Attendance Payments - clients in a non-standard living arrangement:
- If the client receives a payment covering a previous period of eligibility, the client is required to turn over to the Department the lesser of either the full amount of the Aid and Attendance payment, or the Department’s portion of the cost of institutional and home and community based care provided to the client during each of the individual months covered by the payment including any amount received for the current month (we consider the current month to be a previous period of eligibility for the purposes of this policy since the client is billed for their portion of the cost for Medicaid LTC services at the beginning of the month). A client's failure to reimburse the Department in this instance constitutes an overpayment of public assistance in accordance with 461-195-0501 and 461-195-0521 and ORS 411.640 and 411.690. Any excess veterans' benefit payment made to the client is counted as lump-sum income in the month received per OAR 461-140-0120(4).
For newly approved Aid and Attendance clients, do not increase the client liability or pay-in for the following month unless there is time to mail a continuing benefit decision notice per OAR 461-175-0230(3)(b). Even if there is not time to send notice the client is still required to turn any aid and attendance received in the following month to the Department as a payment covering a previous period of eligibility, but we cannot include it in the client’s liability calculation until we give adequate notice.
Use the SCLM screens for CBF clients and the HINQ and SFMU screens for in-home service clients to determine the amount of the Department’s service payment. For NF cases, search for the appropriate time frame under CLAIMS in MMIS.
Click here for detailed instructions (including screen shots) on how to determine the amount of the Department's portion of the cost of institutional and home and community based care provided to the client during each of the individual months covered by the payment.
Treat educational benefits from the Veterans Administration according
to rule 461-145-0150.
- Note: Educational benefits from the VA include the Montgomery GI bill (Chapter 30), Survivors and Dependents Educational Assistance (DEA) (Chapter 35), Selected Reserve Educational Assistance Program (Title 10, Chapter 1606), Active Duty Veterans Educational Assistance Program (VEAP) (Chapter 32), and VA Work Study. There are other types of VA educational assistance. Please call central office for more information.
The following payments are excluded:
- Payments under 38 U.S.C. 1805 to biological children of Vietnam veterans
who are born with spina bifida.
- Payments under 38 U.S.C. 1815 to children with birth defects born to female Vietnam veterans.
A subsistence allowance from a training and rehabilitation program of the United States Veterans Administration is treated as unearned income.
- Note: The Chapter 31 VA Vocational Rehabilitation program is for disabled veterans and a few dependents. Look for VA disability income also.
Vocational rehabilitation payments: 461-145-0585
83. Victims' Assistance
Payments to victims of Nazi persecution covered by Public Law 103‑286 and payments to victims of crime under 42 U.S.C. 10602 (The Crime Act of 1984) are excluded as income, and amounts retained are excluded as a resource as long as the amounts are not commingled with other funds.
For other types of victims' assistance:
- Treat payments that are considered a reimbursement for a lost item according
- Treat payments for pain and suffering as personal injury settlements
according to 461-145-0400.
84. Vocational Rehabilitation Payment
Except for benefits from the United States Veterans Administration:
- Vocational rehabilitation maintenance payments for food, shelter and clothing are counted as unearned income.
- A training allowance or stipend is treated as unearned income.
- Educational income not considered a training allowance or stipend is treated as provided in the section on educational income.
- Vocational rehabilitation payments for special itemized needs connected with the evaluation, planning or placement activity are treated as a reimbursement. These payments include payments for:
- Child care.
- Second residence.
- Special diet.
Benefits from the United States Veterans Administration are treated as provided in the section on Veterans' benefits.
Treat Workforce Investment Act (WIA) (see OAR 151-010-0020) payments made under
Title I-B as follows:
- Count need-based (stipend) payments as unearned income.
- Count OJT and work experience payments as earned income.
- Count support service payments for items already covered
by the benefit group's benefits as unearned income. Exclude all other support service payments (including lunch payments and clothing allowances).
- A reimbursement is treated as provided in 461-145-0040.
86. Workers' Compensation
For workers' compensation payments received monthly or more frequently, count as unearned income.
All other workers' compensation payments are counted as periodic or lump-sum income.
87. Work-Related Capital Assets, Equipment and Inventory - Not QMB/SMB/SMF
Capital asset means property that contributes toward earning self-employment income, including self-employment income from a microenterprise (see OAR 461-001-0000), either directly or indirectly. A capital asset generally has a useful life of over one year and a value, alone or in combination, of $100 or more.
Inventory means goods that are in stock and available for sale to prospective customers.
Work-related equipment means property essential to the employment or self-employment of a financial group member. Examples are a tradesman's tools, a farmer's machinery, and equipment used to maintain an income-producing vehicle.
Capital assets, inventory, and work-related equipment are excluded.
The rule specifically states that inventory is only excluded as long as the client is engaged in self-employment activities; however, if the client is not engaged in self-employment activities, property no longer meets the definition of a capital asset or work-related equipment and would be treated according to the specific rule which covers the type of property.
For example, a truck used in Larry's landscaping business would be excluded as a capital asset as long as he's in business. If Larry closes his business, the truck would be no longer be defined as a capital asset; it would be considered a motor vehicle and treated according to OAR 461-145-0360.
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Oregon Department of Human Services
500 Summer St. NE E02, Salem, OR 97301-1073
Phone: (503) 945-5811
Toll-free: (800) 282-8096 (V/TTY)