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Generic Program Elements

D. Decision Notices

Effective 1/1/11

1. Decision Notices

A decision notice is a written notice of a decision by the Department regarding an individual's eligibility for benefits in a program. Notices can be computer-generated or sent by the worker. A decision notice must include:

1. Specifies the date the notice is mailed.
2. Except as provided below for mass change notices, specifies the action the Department intends to take and the effective date of the action.
3. Specifies the reasons for the action.
4. In the SNAP program (except as provided below), provide the name and phone number of the Department staff person or department to contact for additional information.
5. Inform the client of the extent to which the client has a right to a hearing before an impartial person.
6. Specify the method and time frame for requesting a hearing.
7. Inform the client of their right to a prehearing conference with the branch office/unit/agency staff making the decision.
8. Inform the client of their right to representation, including legal counsel, and their right to have witnesses testify on their behalf.
9. Provide information about the availability of free legal help.
10. Cite the rules that support the action.
11. The right to continued benefits

A mass-change notice. If benefits are reduced or closed to reflect cost-of-living adjustments in benefits or other mass change under a program operated by a federal agency or to reflect a mass change to payments in a program operated by the Department:

• The requirements in (1)(b) are optional. Instead of specifying the action the Department intends to take and the effective date of the action, the decision notice may state all of the following:
  • The general nature of the change.
  • Examples of how the change affects a client's benefits.
  • The month in which the change will take place.
• The decision notice must also state the client's right to continue receiving benefits.
• In the Food Stamp program:
  • The decision notice must also state the client's right to continue benefits, under what circumstances benefits will be continued pending a hearing, and the liability the client's household will incur for any over issued benefits if the hearing decision is adverse to the client.
  • The requirements in subsection (1)(d) of this rule are optional. A decision notice may indicate instead that clients may contact their local office or worker for additional information.

If benefits are reduced or closed to reflect cost-of-living adjustments in benefits or other mass change under a program operated by a federal agency or to reflect a mass change to payments in another program operated by the Department:

• The requirements in subsection (b) above, are optional. Instead of specifying the action the Department intends to take and the effective date of the action, the decision notice may state all of the following:
  • The general nature of the change.
  • Examples of how the change affects a client's benefits.
  • The month in which the change will take place.
• In the SNAP program:
  • The decision notice must also state the client's right to continue benefits, under what circumstances benefits will be continued pending a hearing, and the liability the client's household will incur for any over issued benefits if the hearing decision is adverse to the client.
  • The requirements in subsection (1)(d) of this rule are optional. A decision notice may indicate instead that clients may contact their local office or worker for additional information.

In the SNAP program, a continuing benefit decision notice and a decision notice in the above section must also state that the client's household will incur a liability for any over issued benefits if:

• Benefits are continued pending the hearing; and
• The hearing decision is adverse to the client.

461-175-0010

When a written request for continuing benefits is required and the time frames. For all programs except SNAP, a written request is required for a hearing. An eligibility group member who requests the hearing completes an Administrative Hearings Request that is signed by that person or an authorized representative.

The Administrative Hearings Request must be received by the branch office within 10 days after the decision notice is mailed or given to the person, or on or before the effective date of the action, whichever is later. If the deadline falls on a weekend or holiday, extend the deadline to the next working day.

In addition to containing the decision notice information listed above, the continuing benefit decision notice and timely continuing benefit decision notice must inform clients of their right to continuing benefits as follows:

• Clients are entitled to continuation of benefits if they request a hearing by the later of the following:
  • Within 10 days of the mailing of the notice; OR
  • On or before the effective date of the action.
• If the deadline for requesting a hearing falls on a weekend or holiday, extend the deadline to the next working day.
• Any benefits paid while awaiting the hearing's final order are considered an overpayment if the decision is in favor of the Department's action, except as follows:
  • JOBS or JOBS Plus disqualification hearings.
  • SNAP employment program disqualifications as a result of any of the following:
    • Job quits
    • Failure to cooperate with employment programs under rule 461-130-0320 & 461-130-0330.
    • Disqualifications for noncooperation with JOBS or UC employment programs.
    • Hearings on overpayment recovery issues.

Hearing requests: 461-125-0310
Continuing benefits: 461-125-0311

2. Types of Decision Notices

Basic decision notice. Mailed no later than the planned date of action and does not give the client the right to continuation of benefits.

Continuing benefit decision notice. Mailed in time to be received by the date benefits are, or would be, received. Informs the client of the right to continuing benefits.

Timely continuing benefit decision notice. Mailed no later than ten calendar days before the effective date of the action. Informs the client of the right to continuing benefits.

461-175-0010
461-175-0030

• Note: Count the day after the notice is mailed as the first calendar day. The effective date is the 11th calendar day or later. If the 10th calendar day falls on a weekend or holiday, extend the date to the first working day after the end of the 10-day period.

3. Notice Period

The notice period is used to determine the effective date for taking action when a decision notice is sent to the eligibility group:

• For a basic decision notice, the notice period is the month in which the notice is mailed.
• For a continuing benefit decision notice, the notice period is the budget month from which information is used to initiate the decision notice.
• For a timely continuing benefit decision notice, the notice period is the month in which the 10-calendar day mailing requirement ends (except as provided in 461-175-0206).
• When an overpayment is calculated, if the client failed to make a required report of change to the Department on time, the notice period for an action that results from the change is deemed to have begun the date of the change.

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461-175-0050

4. Notice Situations

Unless stated differently in a specific rule, the Department mails or otherwise provides the client with (sends) a decision notice as follows:

• Send a basic decision notice whenever an application for assistance, including retroactive medical, is approved or denied; OR
• Send a timely continuing benefit decision notice whenever benefits (including the amount, scope or duration of medical care service) are reduced or closed, or the method of payment changes to protective, vendor or two-party.

See 461-175-0230 for exceptions when a person enters a nursing home, jail or institution.

Except as provided in the above bullets or when a delay results from the client's request for a hearing, notices to reduce or close benefits become void if the reduction or closure is not initiated on the date stated on the notice. If the notice is void, a new notice is required to inform the financial group of a new date on which their benefits will be reduced or closed.

No decision notice is required in each of the following situations (all programs):

• Benefits are ended because there is no living person in the benefit group; OR
• A notice was sent, the client requested a hearing, and either the hearing request is dismissed or a final order is issued.

When the Department amends a decision notice with another decision notice, the date of the amended notice restarts the client's deadlines to request a hearing or continuing benefits, or both.

When a contested case notice extends an effective date or delays a reduction or closure, the date of the amended notice restarts a client's timeline to request continuing benefits.

When a client has a pending hearing request or is receiving continuing benefits, and the Department amends a notice under this section, the client need not re-file the hearing request or renew the request for continuing benefits.

461-175-0200

Notices approving medical benefits are computer generated. Notices ending OHP at the end of a certification period are also computer-generated.

Some forms contain all the information required for a basic decision notice. When these forms are used and contain the required OAR, they meet the requirement to provide a basic notice.

Benefits Less than 30 days. To end benefits if a client receives them for less than 30 days, send the following notice:

• For all programs except SNAP, a basic decision notice.
• For SNAP:
  • A basic notice if the information on ending benefits is included in the initial approval notice.
  • In all other situations, a timely continuing benefit decision notice.

461-175-0205

Client Moved or Whereabouts Unknown. To end benefits if a client has moved out of state, send the following notice:

• For GA(M), OHP, OSIP(M), QMB, and REF(M):
  • Send a timely continuing benefit decision notice to clients who have moved out of state. For clients in MRS, send a continuing benefit decision notice if the move is reported in the Monthly Change Report.
  • Send a basic decision notice if the client becomes eligible for benefits in another state.
• For SNAP, no decision notice is required if the Department determines that the benefit group has moved out of Oregon.

If Department mail or benefits have been returned with no forwarding address, give clients their benefits if their whereabouts become known during the period covered by the returned benefits. See 461-165-0130 for information on when SNAP benefits can be sent out of state. If the client's whereabouts are unknown, end benefits by sending the following notice to their last known address:

• For all programs except SNAP, a basic decision notice.
• For SNAP, no notice is required.

If a client fails to pick up branch-held SNAP benefits for two consecutive months, end benefits by sending a basic decision notice.

For more information on returned mail, see the Family Services Manual, MP WG.20.

461-175-0210

Disqualification. If a benefit group or individual is disqualified for SNAP voluntary job quit, or for failure to apply for or provide an SSN, pursue assets, cooperate with JOBS, JOBS Plus or OFSET, or efforts to collect support, send the following notices:

• If benefits are reduced or closed because of the disqualification:
  • Send a continuing benefit decision notice for changes reported on the Monthly Change Report or Periodic Review forms; OR
  • Send a timely continuing benefit decision notice for changes not reported on the Monthly Change Report or Periodic Review forms.
• If benefits are opened without the disqualified individual in the benefit group or if the entire benefit group is denied assistance, send a basic decision notice.

For JOBS, JOBS Plus and OFSET disqualifications, and SNAP voluntary job quits, the notice must include all of the following:

• The client action that resulted in disqualification.
• The length of the minimum disqualification period.
• The reduced benefit amount.
• How they can end the disqualification after the minimum period.

For SNAP IPV disqualifications:

• A basic decision notice is required if a benefit group or benefit group member is disqualified for an IPV as the result of a court of law or an administrative hearing. This is true only when the client has been notified of the court order or hearing decision.
• A continuing benefit decision notice is required if a benefit group or benefit group member is disqualified for IPV based on a signed waiver.

For notice information when a person is disqualified due to a resource transfer see below.

461-175-0220

Notice Situations – Expiration of Certification Period; SNAP. The Department must provide households certified for one month or certified in the second month of a two-month certification period a notice of expiration at the time of certification. All other households must receive a notice of expiration before the first day of the last month of the certification period, but not before the first day of the next-to-the-last month.

Notice of expiration is provided to the filing group and must contain all of the following:

• The date the certification period expires.
• The date by which a household must submit an application for recertification in order to receive uninterrupted benefits.
• The consequences of failure to apply for recertification in a timely manner.
• The right to receive an application form upon request and to have it accepted as long as it contains a signature and a legible name and address.
• Information on alternative submission methods available to households that cannot come into the certification office or do not have an authorized representative and how to exercise these options.
• The address of the office where the application must be filed.
• The household's right to request a contested case if the recertification is denied or if the household objects to the benefit issuance.
• A statement that any household consisting only of Supplemental Security Income (SSI) applicants or recipients is entitled to apply for food stamp recertification at an office of the Social Security Administration.
• A statement that failure to attend an interview may result in delay or denial of benefits.
• A statement that the household is responsible for rescheduling a missed interview and for providing required verification information.
• A statement that the client has no rights to continuation of benefits after the SNAP certification period expires; and that to receive benefits, the client must reapply and be found eligible for a new benefit amount after the end of the certification period, including a client who is receiving continuation of benefits when their SNAP certification period ends.

461-175-0222

Nonstandard Living Arrangement.

In the Food Stamp program:  

• A timely continuing benefit decision notice is sent to terminate, suspend, or reduce benefits if the notice occurs as a result of any of the following situations:
  • A client has been admitted or committed to an institution.
  • A client has been placed in foster care, skilled nursing care, intermediate care, or long term hospitalization.
  • A client is placed in official custody or a correctional facility.
  • A client enters a drug or alcohol residential treatment facility.
  • A client leaves a drug or alcohol residential treatment facility without reapplying for SNAP benefits.
• No decision notice is required if the Department determines that a resident of a drug or alcohol treatment center or a residential care facility (RCF) is ineligible as a result of one of the following actions taken against the center or facility:
  • Disqualification by Food and Nutrition Services (FNS) as an authorized representative.
  • Loss of certification with the Department.
• A resident of a facility that is disqualified or loses its certification as described in subsection above may still qualify for SNAP through a separate application. 

Except as provided below for OSIPM, for all programs except SNAP, a basic decision notice is sent to terminate, suspend, or reduce benefits in each of the following situations:

• The client has been admitted or committed to an institution.
• The client has been placed in skilled nursing care, intermediate care , or long-term hospitalization.
• The client is placed in official custody or a correctional facility.

In the OSIPM programs, a client receiving waivered or long term care services is sent a timely continuing benefits decision notice in each of the following situations:

• A reduction or closure of services occurs as the result of a process of reevaluating both the functional impairment levels of a client and the requirements of a client for assistance in performing activities of daily living.
• Services are closing because the client has not paid the client liability.
• The client receives benefits in the OSIP(M)-IC programs, and benefits will end under 411-036-0050.
• There is a change in special needs as described in 461-180-0040.

461-175-0230

Lump-Sum. If the Department establishes that a financial group received lump-sum income that will reduce or end benefits, do the following:

• Deny benefits to applicants and send a basic decision notice.
• End or reduce benefits for ongoing benefit groups and:
  • For changes reported on the Monthly Change Report or Periodic Review forms, send a continuing benefit decision notice.
  • For changes not reported on the Monthly Change Report or Periodic Review forms, send a timely continuing benefit decision notice.

For GA, OSIP and REF, the decision notice must include:

• The amount of the countable lump-sum income.
• The calculation of this income on a monthly basis.
• The length of time that the benefit group is ineligible because of receipt of lump-sum income and the amount (if any) that will be carried over as countable income to the first eligible month.

461-175-0240

Mass-change notice. Except as provided for SNAP below, the type of decision notice used is the same as otherwise applies to the reduction or closure of benefits for the program. 461-175-0010(2) and (3) modify the content requirements for the decision notice that apply to other decision notices under 461-175-0010(1).

In the SNAP program, a continuing benefits decision notice may be used if a timely continuing benefits decision notice would otherwise be required.

In the SNAP program, no decision notice is required when the Department makes the following mass changes:

• An annual adjustment to income limits, the shelter deduction, or the standard deduction.
• An annual adjustment to a standard utility allowance in the Food Stamp program.

461-175-0250

Change Reporting System

When the Department takes action on an interim change report, send a continuing benefit decision notice for clients in the SNAP, OSIP(M), QMB, and REF(M) programs. Except in the SNAP program, the notice includes:

• The amount of income used to determine the benefits or ineligibility; and
• The amount of each deduction; or
• The reported nonfinancial changes that affect eligibility.

461-175-0270

Prior Notice. Send a basic decision notice if the benefit group was informed in writing when their benefits began that they would receive benefits only for a specific period of time.

Send a basic decision notice when a special need allowance granted for a specific period of time is removed at the end of the specified period and the benefit group was informed of this in writing when the allowance began. A timely continuing benefit decision notice is required if removal results in benefit closure.

For SNAP, no decision notice is required if the client received a written notification at the time of application or redetermination stating that:

• The benefit group's allotment would vary from month to month and listed the anticipated changes;
• In the case the client applied for both cash assistance and Food Stamp benefits, the Food Stamp benefits would be reduced or closed upon approval of the cash assistance; or
• In the case of a benefit group that has applied for expedited benefits, receipt of benefits beyond the month of application depends on the client providing required verification (see 461-115-0690). In such cases, the Department many act on the verified information without further notice.

461-175-0300

Removing a Person. To remove a person from an ongoing benefit group, send a continuing benefit decision notice.

For all changes not reported on the Monthly Change Report forms, send a timely continuing benefit decision notice (unless a child is removed from the benefit group as a result of a court order or a voluntary placement in foster care by the child's caretaker relative, a basic decision notice is used).

461-175-0305

Resource Transfer Disqualification. When the Department disqualifies a filing group due to an invalid transfer of resources (see 461-140-0210), send the following notice:

• For new applicants, a basic decision notice for a denial of benefits.
• For ongoing clients, a timely continuing benefit decision notice if benefits are reduced or closed.

The notice must include:

• The action that resulted in the disqualification, including the amount of uncompensated value used to calculate the disqualification period.  
• The length of the disqualification.  
• Information that the client, or the facility in which the client resides (on behalf of the client), may apply for a waiver of the disqualification on the basis of undue hardship.

461-175-0310

Voluntary Action. Use the following criteria to determine if a decision notice must be sent when the filing group states they wish to withdraw their request for benefits, or the benefit group states they wish to reduce or no longer receive benefits:

• For all programs except the SNAP program, if the primary person, another adult member of the filing group, or the authorized representative:
  • Makes an oral request to end or reduce benefits, a timely continuing benefit decision notice is sent.
  • Makes a signed, written request to withdraw, end, or reduce benefits, a basic decision notice is sent.
  • Makes an oral request to withdraw an application for benefits, a basic decision notice is sent.
• In the SNAP program, when the filing group states it wishes to withdraw its benefits request, or states it wishes to reduce or no longer receive benefits:
  • If the request is made by phone to end or reduce benefits, a timely continuing benefit decision notice is sent.
  • If the request is made in person to reduce benefits, a basic decision notice is sent.
  • If the request to reduce benefits is signed by the primary person, another adult member of the filing group, or the authorized representative, a basic decision notice is sent.
  • If the request to end benefits is signed by the primary person, another adult member of the filing group, or the authorized representative in the presence of a worker, no notice is required. If it is not signed in the presence of a worker, a basic decision notice is sent.
  • If the client withdraws a signed request for benefits, a basic decision notice is sent.

In the SNAP program, a timely continuing benefit decision notice is sent if the filing group returns a signed Change Report form with information that requires a reduction or closure of benefits.

461-175-0340

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