Manual |
Change |
Section/Item |
Rule Change
(available 10-1-2017 unless otherwise indicated) |
| OSIP(M) |
The FUA amount was updated in the LTC income deduction sections |
WG 1, WG2, WG6, and WG 12 |
461-160-0420 |
| |
The Special Needs section was updated to reflect rule changes to home repairs, moving costs, accommodation allowance, and the supplemental telephone allowance. |
OSIPM WG H.5, H.6, H.10, H.12 |
461-155-0600, 461-155-0610, 461-155-0660, 461-155-0680 |
| |
The Issuing Benefits and Changes section was updated to reflect the 10/1/17 rule change clarifying that retroactive benefits are only appropriate when the applicant actually received Medicaid-covered services prior to the month in which the date of request falls. |
OSIPM F.4 |
461-135-0875 |
| |
The EPD section was updated to add information about the process for refunding participant fees. |
OSIPM WG 11 |
|
| |
The household group, filing group, and financial group sections (under Eligibility Groups); the Long-Term Care and Acute Care or Nursing Facility Settings sections (under Nonfinancial Requirements); and the Income Standards and Use of Income sections (under Financial Requirements) were all updated to reflect the rule changes related to clarifying that if not otherwise eligible, those applying under the Acute Care Setting rule should be treated as though they were applying for services. Also, rules were updated to clarify that ACS/service applicants should be evaluated under the nonstandard living arrangement OSIPM programs before the 300% SSI income standard is used. |
OSIPM C.1, C.2, C.3, D.11, D12, E.2, E.3 |
461-110-0210, 461-110-0410, 461-110-0530, 461-135-0745, 461-135-0750, 461-155-0250 |
| |
The Assigning and Pursuing Assets section (under Nonfinancial Requirements) was updated to reflect the changes to the medical assignment and assignment of support rights rules. The July changes to the good cause for noncooperation rule were also added. |
OSIPM D.4 |
461-120-0310, 461-120-0315 |
| |
The Assigning and Pursuing Assets section was also updated to reflect the rule change which clarifies that the penalty for failure to comply with converting a pension and retirement plan to income can only be applied while it’s still possible to do so (i.e. after they cash out or close the pension or retirement plan), and that cashing out would constitute a conversion of a resource. Lanuage was also added to the WG to clarify that these requirements do not apply to a non-applying/ineligible spouse or parent. |
OSIPM D.4 |
461-120-0330 |
| |
The Overview of Assets section (under Financial Requirements) was updated to reflect the rule change to the Treatment of Excluded Income rule (renamed Treatment of Excluded Assets) that specifies excluded assets must be identifiable from other funds but do not have to be physically separate |
OSIPM E.1 |
461-140-0070 |
| |
The Determining Adjusted Income and Client Liability section (under Financial Requirements) was updated to reflect the rule change that eliminates the $85 earned income deduction for the blind and the elimination of public and private health insurance premiums of the spouse and any dependents as a medical deduction. The term "mentally retarded" was also replaced "people with intellectual disabilities". |
OSIPM E.4 |
461-160-0620 |
| |
The Pickle section in the Protected Eligibility worker guide was updated to reflect the rule change that added lanuguage regarding the treatement of a spouse of an individual being evaluated under the Pickle Amendment. |
OSIPM WG 9 |
461-135-0780 |
| |
Outdated information was removed from the Application Process Overview and Application Requirements sections and (under Application), and it was updated with the current policy, including clarifying that a new application is not needed to add an APD programs to existing APD benefits (in addition to changing between APD programs). |
OSIPM B.1, B.2 |
|
| QMB |
The Assigning and Pursuing Assets section (under Nonfinancial Requirements) was updated to reflect the changes to the medical assignment and assignment of support rights rules. The July changes to the good cause for noncooperation rule were also added. |
QMB D.3 |
461-120-0310, 461-120-0315 |
|
The Assigning and Pursuing Assets section was also updated to reflect the Pursuit of Assets rule change that clarifies that the penalty for failure to comply with converting a pension and retirement plan to income only be applied while it’s still possible to do so (i.e. after they cash out or close the pension or retirement plan). |
QMB D.3 |
461-120-0330 |
|
The Issuing Benefits and Changes section was updated to reflect the 10/1/17 rule change clarifying that retroactive benefits are only appropriate when the applicant actually received Medicare-covered services prior to the month in which the date of request falls, and that individuals can be retroactively enrolled in Medicare if eligible for SMB/SMF in retroactive months. |
QMB D.7 |
461-135-0875 |
| |
The Overview of Assets section (under Financial Requirements) was updated to reflect the rule change to the Treatment of Excluded Income rule (renamed Treatment of Excluded Assets) that specifies excluded income must be identifiable from other funds but does not have to be physically separate |
QMB E.1 |
461-140-0070 |
| |
Outdated information was removed from the When to Use an Application section (under Application), and it was updated with the current policy, including clarifying that a new application is not needed to add an APD programs to existing APD benefits (in addition to changing between APD programs). |
QMB B.4 |
|
| APD MAGI Manual |
A reminder was added to the MAGI Service Cases section that MAGI recipients are not eligible for special needs payments, they must get needs met through the K-Plan. |
APD MAGI D.1 |
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| |
Corrections were made to various scenarios to reflect the current process for MAGI/APD medical conversions when services are involved. |
APD MAGI B.4, C.4 |
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| |
Language was added to the APD Referrals from 5503 section to clarify that the 90-day timeline applies to APD determinations as well as MAGI determinations. If the MAGI case was not closed after an APD review and it has been more than 90 days since it was originally completed (including when there was no response or the 539A was not returned), APD must attempt another review before the MAGI can end. The exception to the 90-day expiration date is when APD medical benefits are approved.
Clarification was added regarding the need to email 5503 after the APD review has been completed or a task has been marked invalid, regardless of the results. |
APD MAGI E.1 through E.7 |
|
| |
This manual will be updated frequently, check periodically for new information. Revision dates were added to the individual sections. |
APD MAGI Manual |
|
| Counting Client Assets |
The Treatment of Excluded Assets section (under General Information About Assets) was updated to reflect the rule change to the Treatment of Excluded Income rule (renamed Treatment of Excluded Assets) that specifies excluded assets must be identifiable from other funds but do not have to be physically separate. |
CCA A.3 |
461-140-0070 |
| |
The Animals section was updated to reflect the rule change specifying animals used for self-employment are excluded. |
CCA B.5 |
461-145-0010 |
| |
The Child Support and Cash Medical Support section was updated to reflect the rule change outlining new exclusions to child support income. |
CCA B.14 |
461-145-0080 |
| |
The Earned Income Tax Credit section was updated to reflect the rule change which limits the exclusion of EITC payments as a resource for a total of 12 months after the month of receipt for OSIPM. |
CCA B.24 |
461-145-0140 |
| |
The Individual Development Account section was updated to reflect the rule change that excludes emergency withdrawals for OSIPM and QMB. |
CCA B.40 |
461-145-0261 |
| |
The Loans and Interest on Loans section was updated to reflect the rule change that removed a section dealing with how to treat certain loans for those in NSLA. This rule is also being amended to change language in section (6)(a)(A)(i) clarifying that the life expectancy of the owner of the loan is used to determine whether the requirements are met, and also clarify that if the loan is jointly owned, the repayment must be paid over either the spouse’s or the client’s life expectancy. |
CCA B.47 |
461-145-0330 |
| |
The Older Americans Act section was updated to reflect the rule change that clarifies how benefits are counted. |
CCA B.54 |
461-145-0370 |
| |
The Pension and Retirement section was updated to reflect the rule change that adds references to the pursuit of assets rule, removes language suggesting the rule only applies to pension and retirement plans that are purchased with funds from other pension and retirement plans (rather than to a self-funded IRA, for example), and added language to specify that the equity value of a non-applying spouse’s or parent's retirement plan would be excluded as a resource for non-service applicants/recipients. Also, the dividends and interest earned by a spouse's or parent's funds are excluded as income. |
CCA B.55 |
461-145-0380 |
REF |
SeeSS-PT-17-011 and SS-PT-17-012 for more information on changes to REF and REFM |
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| SNAP |
See SS-PT-17-011 and SS-PT-17-012 for more information on changes to SNAP |
|
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| APD Worker Guide |
The Verifying Client Information section was updated to reflect that individuals can self-attest to pregnancy and due date. |
APD B.1 |
|
| |
A Children with IDD Services Requiring Nursing Facility Respite section was added to the DD Services and Benefits for Children section. |
APD D.9 |
|
| |
Two service scenarios related to the denial of in-home exception hours were updated in The Decision Notice Preparation Tips section was updated with s |
APD G.9, Service Denial (scenario #10) and Service Reduction (scenario #9) |
|
| |
The 10-Day Notice Deadline Section (under Miscellaneous) was corrected for October and November |
APD G.7 |
|
| Miscellaneous |
The Incarcerated clients page was updated to reflect a rule change that changed the 12-month suspension to an indefinite suspension. Central office contact information was also updated. |
Incarcerated clients (found under Program/Policy tools on main APD Staff Tools) |
461-135-0950 (eff 7/1/17) |
| MMIS |
|
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|
| Generic Program Elements |
The Decision Notices section was updated to reflect the rule change specifying that a timely notice has to be sent when service liability increases. |
Generic D.4
|
461-175-0230
|
| Case Management Tools |
Diversion/Transition section:
- Updated - Transition Team Contact List
|
Diversion/Transition |
|
| |
Homecare Worker section:
- Added: HCW Payroll Calendar Effective October 2017-2019 List Format in English (For HCWs/PSWs)
- Added: HCW Payroll Calendar Effective October 2017-2019 (Calendar format)
- APD-IM-17-061: Communications to Providers: 14 Day Service Authorizations / Communications to Consumers: October 1, 2017 Changes
- APD-PT-17-033: In-Home Services – 14 Day Service Authorization
- APD-AR-17-045: Oregon ACCESS HCW Provider Enrollment Enhancements
- APD-PT-17-024: Homecare Worker Guide and instructions to use of appendix and signature page
|
Homecare Worker |
411-031
Homecare Worker Guide |
| |
In-Home Support Services section:
- Added: Representative Choice Form SDS 0737
- APD-AR-17-059: Notices for Individuals Currently Receiving the Live-in Service Option
- APD-IM-17-061: Communications to Providers: 14 Day Service Authorizations / Communications to Consumers: October 1, 2017 Changes
- APD-PT-17-033: In-Home Services – 14 Day Service Authorization
- APD-PT-17-031: In-Home Services Hour Authorization Changes
- APD-IM-17-053: Letter for Individuals Currently Receiving Live-in Services
|
In-Home Support Services |
411-030 |
| |
In-Home Care Agencies section:
- APD-AR-17-045: Oregon ACCESS HCW Provider Enrollment Enhancements
|
In-Home Care Agencies |
|
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Independent Choices section:
- APD-IM-17-053: Letter for Individuals Currently Receiving Live-in Services
|
Independent Choices |
|
| |
Oregon Project Independence section:
- Added: Overtime & Travel Time for OPI HCWs
|
Oregon Project Independence |
|
| |
K-Plan Services section:
- Updated: K Plan Ancillary Services Guidance
- Added: APD-PT-17-029: K-State Plan Ancillary Services
|
K-Plan Services |
|
| |
Emergency Response System section:
- APD-AR-17-047: Oregon Lifeline
- APD-PT-17-029: K-State Plan Ancillary Services
|
Emergency Response System |
|
| |
Specialized Services / Specific Needs Contracts section:
- Specialized Service Vacancy Report
|
Specialized Services / Specific Needs Contracts |
|
| |
APD Program October 2017 Changes section:
- Added:
- APD Program Changes October 2017-YouTube Video with Ashley Carson-Cottingham
- APD October Changes – Local Office Support Plan
- October HCW Voucher & Hour Adjustment Changes (Power Point training material 9/6 & 9/20)
- October 2017 Changes (Power Point presentation for field staff)
- APD-AR-17-051: APD Required Training: October Changes: ADL/Two Week Authorization/Hour Rebalance
- Changes to ADLs and Level of Care Assessment – Fact Sheet
- Buckley Notice Insert: ADL Changes and In-Home Hours Rebalancing
- APD-PT-17-032: Service Priority Level Changes Effective October 1, 2017
- APD-PT-17-031: In-Home Services Hour Authorization Changes
- HCW Pay Periods Changing – Office Poster
- 2 Week Letter sent to Consumers
- HCW Payroll Calendar Effective October 2017-2019 List Format in English – For local offices
- HCW Payroll Calendar Effective October 2017-2019 List Format in English – For HCWs/PSWs
- HCW Payroll Calendar Effective October 2017-2019 calendar format
- 2 Week Letter sent to HCWs and PSWs
- APD-AR-17-056: Local Office Posting: 14 Day Pay Periods
- APD-IM-17-061: Communications to Providers: 14 Day Service Authorizations / Communications to Consumers: October 1, 2017 Changes
- APD-IM-17-059: Voucher issuance for pay period beginning October 1, 2017
- APD-IM-17-033: In-Home Services – 14 Day Service Authorization
- APD-AR-17-059: Notices for Individuals Currently Receiving the Live-in Service Options
- APD-PT-17-019: In-Home Services Live-in Options Closure
- OPI 14-Day Change Handout-Excel Spreadsheet
- Sample OPI Consumer Notification
|
APD Program October 2017 Changes
|
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| |
Assessment Tools section:
- APD-AR-17-054: DHS and Department of Corrections re-entry program
|
Assessment Tools |
|
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Client Details, Treatment, Form & Miscellaneous LTC Info section:
- Updated: APD Long Term Care Services Form Requirements
|
Client Details, Treatment, Form & Miscellaneous LTC Info |
|
| |
Oregon ACCESS & CA/PS Information section:
- APD-IM-17-062: Email address issue identified in Oregon ACCESS
- APD-IM-17-056: Oregon ACCESS Release 24.05-Friday, July 28, 2017
- APD-IM-17-055: Oregon ACCESS Enhancements for July 31, 2017
- APD-AR-17-045: Oregon ACCESS HCW Provider Enrollment Enhancements
- APD-AR-17-040: Side-by-Side Comparison to Assess Impact of Cognition Changes
|
Oregon ACCESS & CA/PS Information |
|
| |
Service Planning section:
- APD-PT-17-031: In-Home Services Hours Authorization Changes 10/1/17
- APD-IM-17-052: New brochure available for consumers considering moving into a LTC facility
|
Service Planning |
|
| |
Service Priority Level Information section:
- APD-PT-17-032: Service Priority Level Changes Effective October 1, 2017
|
Service Priority Level Information |
411-015 |
| |
Facilities section:
- APD-AR-17-052: New Facilities, and CBC Change of Ownerships, and Name Changes for CBC and new Specific Needs Contracts
- APD-PT-17-028: Definition of Harm
- APD-AR-17-046: New Facilities, and CBC Change of Ownerships, and Name Changes for CBC and new Specific Needs Contracts
- APD-PT-17-026: Community Based Care Draft Report Distribution
- APD-IM-17-052: New brochure available for consumers considering moving into a LTC facility
|
Facilities |
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Home and Community Based Services (HCBS) section:
- Added: Extended Timeline for APDs Transition Plan
- Added: Ways to Report HCBS-Related Concerns About APD Providers
- Added: Representative Choice Form SDS 0737
- Added: Q & A Person-Centered Consumer HCBS Education
- APD-AR-17-041: Identifying Client Representative for Long-term Care decision-making and educating consumers regarding Home and Community-Based Services rights and freedoms
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Home and Community Based Services (HCBS) |
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APD Training section:
- APD-IM-17-057: SPL Training
|
APD Training |
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Mandatory Case Manager In-Service Webinars section:
- Added: October 2017 Changes (7/2017 & 8/2017) PP training material and audio recording
- APD-IM-17-051: Mandatory Webinar information for case managers and managers that supervise case managers
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Mandatory Case Manager In-Service Webinars |
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