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APD Manual Letters

Manual Letter #78

Effective Date: January 1, 2018
Reference: SS-PT-17-023, SS-PT-17-024

Manual changes are summarized below. Click on the related links. Most changes will be indicated with red text or a red line to the right of the text (you may need to scroll to find the related policy change). There is no red indication for the corresponding changes to the Administrative Rules. Check the above listed reference for all policy updates.

SNAP program updates are covered specifically in the Family Services Manual.

Manual Letter Index

Manual

Change

Section/Item

Rule Change

(available 1-1-2018 unless otherwise indicated)

OSIP(M)

Pickle multiplier updated due to 2018 COLA

 OSIPM WG 9

461-135-0780
  Income Standards and NF PIF Updated OSIPM E.2, E.4, WG 1, Rate Schedule 461-155-0250
  Room and Board standard updated OSIPM E.2., E.4, Rate Schedule 461-155-0270
  Special Needs WG - Payments for PIF and Room and Board updated OSIPM WG 12 461-155-0270
  Community spouse resource allowance updated OSIPM E.8, OSIPM WG 2 461-160-0580
  Maximum community spouse income allowance updated OSIPM E.4, OSIPM WG 1, OSIPM WG 6 461-160-0620
  Allocating and Deeming Worker Guide updated OSIPM WG 8 461-155-0250
  The Financial Group section (under Eligibility Groups) was updated to reflect the 1/1/18 rule change clarifying the procedure for those being evaluated under protected groups. Other various changes were made for clarity. OSIPM C.3 461-110-0530
  The Verification section (under Application) was updated to reflect the 1/1/18 rule change outlining specific verification requirements, as well as the adoption of a new verification rule applying specifically to verifying citizen/noncitizen status. OSIPM B.7

461-115-0700

461-115-0704
  The Citizen/Noncitizen Status subsection of Nonfinancial Requirements section was updated to reflect newly adopted verification rule. OSIPM D.2 461-115-0704
  The Assigning and Pursuing Assets section (under Nonfinancial Requirements) was updated to reflect a 1/1/18 rule change providing an exception to those who would experience domestic violence as a result of pursuing an asset. OSIPM D.4 461-120-0330
  The Assumed Eligibility section (under Nonfinancial Requirements) was updated to reflect 1/1/18 rule change that clarifies pregnant women remain assumed eligible only for the OHP Plus program they were receiving (MAGI or OSIPM), not Medicare Savings Programs. OSIPM D.9 461-135-0010
  The Resource Limits and Disqualifying Transfer of Assets sections (under Financial Requirements) were updated to reflect 1/1/18 rule changes affecting Qualified Partnership Policies. OSIPM E.7, E.10

461-140-0220

461-160-0855
The Issuing Benefits section (under Issuing Benefits and Changes) was updated to reflect 1/1/18 rule change clarifying that benefits can continue for those in an acute care hospital if eligibility requirements continue to be met, but that the household group rule applies after 30 days. OSIPM F.3 461-165-0120
  The General Assistance worker guide was updated to reflect various 1/1/18 rule changes (including one adoption) surrounding benefits for incarcerated individuals, the effect of shelter-in-kind on housing assistance, when the 2-person payment standard applies, notice requirements, and the effective date of initial benefits. Also, Notice Requirement and Effective Date sections were added, as well as information on how to calculate benefits. OSIPM WG 13

461-135-0950

461-145-0470

461-160-0500

461-175-0210

461-175-0224 New Rule

461-180-0070
 

The Determining Adjusted Income and Client Liability section (under Financial Requirements) and the Deciding to What Extent to Allow the LDS worker guide were updated with information about how purchasing an annuity to spend down a couple's pooled resources can effect the LDS.

OSIPM E.4, WG 6

 
  The Determining Adjusted Income and Client Liability section was updated to specify that all requests to raise the monthly maintenance needs allowance must be submitted to Bill Brautigam at Central Office. OSIPM E.4  

REF(M)

See SS-PT-17-023 and SS-PT-17-024 for more information on changes to REF(M).

  

 
Counting Client Assets Home equity exclusion limit was updated CCA B.34 461-145-0220
  The In-Kind Income section was updated to specify in-kind income is excluded when calculating GA housing assistance payments. CCA B.43 461-160-0500
  The Lodger section was updated to reflect the 1/1/18 rule change clarifying that a lodger lives with a client rather than is considered part of the household group (this was necessary because EPD and in-home service clients are in their own household group but may still have lodger income). CCA B.48

461-001-0000
  The Qualified Partnership Policy section was updated to reflect the 1/1/18 rule changes surrounding how much can be excluded. CCA B.60

461-140-0220

461-160-0855
The Shelter-In-Kind section was updated to reflect 1/1/18 rule change establishing that shelter-in-kind in the form of rent or other housing costs paid by a third party are countable when determining the GA housing assistance payment amount. CCA B.70 461-145-0470
  The Veterans' benefits section was updated to reflect the 1/1/18 rule change adding housebound benefits and exclusions for two additional types of VA income. CCA B.84

461-145-0580
  A new Foreign Income section was added (Under General Information about Assets). CCA A.8  
SNAP

See SS-PT-17-023 and SS-PT-17-024 for more information on changes to SNAP.

 

 
APD MAGI Manual

A note was added reminding staff that CAWEM recipients are also entitled to Due Process.

APD MAGI B.2

 
  The APD Referrals from 5503 section was updated with clarification about how tasks are generated. APD MAGI E.1  
  This manual will be updated frequently, check periodically for new information. APD MAGI Manual  
QMB

The Verification section (under Application) was updated to reflect the 1/1/18 rule change outlining specific verification requirements, as well as the adoption of a new verification rule applying specifically to verifying citizen/noncitizen status.

QMB B.11

461-115-0700

461-115-0704
 

The Interviews section (under Application) and the Redetermination section (under Issuing Benefits and Changes) were updated to reflect the 1/1/18 rule change specifying that interviews are not necessary at redetermination in the QMB, SMB, and SMF programs for those whose eligibility can be redetermined electronically.

QMB B.10, F.4

461-115-0230
 

The Citizen/Noncitizen Status subsection of Nonfinancial Requirements section was updated to reflect newly adopted verification rule.

QMB D.8

461-115-0704
  The Issuing Benefits section (under Issuing Benefits and Changes) was updated to reflect 1/1/18 rule change clarifying that benefits can continue for those in an acute care hospital if eligibility requirements continue to be met, but that the household group rule applies after 30 days. QMB F.2

461-165-0120
  The Household Group section (under Eligibility Groups) was updated to reflect the 10/1/17 rule change that clarified those absent for more than 30 days are no longer part of the household group, regardless of admission to an acute care medical facility. QMB C.2 461-110-0210 (eff 10/1/17)
  The Assignment of TPR and Support and Pursuing Assets section (under Nonfinancial Requirements) was updated to reflect a 1/1/18 rule change providing an exception to those who would experience domestic violence as a result of pursuing an asset. QMB D.3 461-120-0330
APD Worker Guide OSIPM income standards updated APD E.5

461-155-0250
  10-day notice calendar was updated APD.G.7  
 

The Non-Service Eligibility, Service Eligibility, and MSP Eligibility flowcharts have been updated.

APD A.3

461-135-0730
  English translation of a document in a foreign language required to determine eligibility was added to the list of documents subject to the written translation service procedures in the Written Translation Services section. APD A.2  
  Scenarios were added to the Decision Notice Preparation tips to address an individual moving from SBI to CBI. APD G.9  
  A new subsection labeled Effect of Purchasing Annuities to Spend Down Resources was added to the Treatment of Annuities section (under Financial Eligibility) to provide information about how purchasing an annuity to spend down a couple's pooled resources can affect the LDS. APD E.1  
  The Verifying Client Information section (under Application) was updated to reflect the 1/1/18 rule change outlining specific verification requirements, as well as the adoption of a new verification rule applying specifically to verifying citizen/noncitizen status. APD B.1

461-115-0700

461-115-0704
  The Redetermination section (under Eligibility and Application Processes) was updated to reflect the 1/1/18 rule change specifying that interviews are not necessary at redetermination in the QMB, SMB, and SMF programs for those whose eligibility can be redetermined electronically. APD B.8 461-115-0230
Miscellaneous LIS amounts and RX co-payments were updated in the MMA manual MMA.B  
  2018 Part D Stand-Alone Plan list was updated MMA.C  
  2018 Medicare Advantage Plan Prescription Drug Plan List will be updated when available MMA.C  
  2018 CCO and Affiliated Medicare Advantage Plan List will be updated when available MMA.C  
  LIS Reference Sheet updated in MMA manual MMA.B.3  
 

2018 APD Financial Eligibility Training Calendar was added

2018 APD LTC Case Management Training Calendar was added

 APD Training  
MMIS

 


 
Generic Program Elements The Notice Situations section (under Decision Notices) was updated to reflect the 12/1/17 rule change allowing a continuing benefit decision notice to increase service liability resulting from a COLA or other mass change.

Generic D.4

461-175-0230 (eff 12/1/17)
Case Management Tools

APD Client Pay-In section:

  • 2018 COLA amounts were applied
  • Information was added about how to code special needs so that the correct benefit amount is issued
 APD Client Pay-In  
 

APD Program October 2017 Changes section –

  • Updated the following:
    • APD Program Changes October 2017 Q & A Document
    • HCW Payroll Calendar 2017 – 2019 in list format and color calendar format in the following languages –
      • English
      • Arabic
      • Chinese
      • Russian
      • Somali
      • Spanish
      • Vietnamese
  • Added the following:
    • Transmittals –
      • APD-IM-17-074: Online Trainings Delayed: APD October Changes
      • APD-IM-17-077: Oregon ACCESS SPL Display Issue
      • APD-IM-17-094: Updated 546PC Posted
      • APD-IM-15-075: MMIS POC Billing Updates for In-Home Care Agencies
      • APD-PT-17-037: OPI Service Planning
    • 2 Week Letter to HCWs in the following languages –
      • English
      • Arabic
      • Chinese
      • Russian
      • Somali
      • Spanish
      • Vietnamese
    • EWE Assessment Form
    • EWE Planning Form
    • Task List Form SDS 598N
    • In-Home Service Plan Form SDS 546N
    • Service Plan Form SDS 001N
    • Mandatory EWE Webinar Q & A
    • EWE Tracking Spreadsheet for local office use
    • EWE Webinar – Audio Recording
    • EWE Training Material – Power Point
    • ADRC OAA Services
 APD Program October 2017 Changes  
 

Client Details, Treatment, Forms & Miscellaneous LTC Info section –

  • Updated the following:
    • SDS 0546PC SPPC Service Plan & Task List Word Version
    • SDS 0546PC SPPC Service Plan & Task List pdf Version
    • SDS 0546SF Short Form Word Version
    • SDS 0546SF Short Form pdf Version
  • Added the following:
    • Transmittals –
      • APD-IM-17-094: Updated 546PC Posted
      • APD-IM-17-079: SDS 546SF Short Form Updated on CM Tools
 Client Details, Treatment, Forms & Miscellaneous LTC Info  
 

Exceptions section –

  • Updated the following:
    • In-Home Exceptions Calculator
Exceptions Chap. 411, Div. 027
 

Extended Waiver Eligibility (EWE) Section -

  • Added the following:
    • EWE Assessment Form
    • EWE Planning Form
    • Task List Form SDS 598N
    • In-Home Service Plan Form SDS 546N
    • Service Plan Form SDS 001N
    • Mandatory EWE Webinar Q & A
    • EWE Tracking Spreadsheet for local office use
    • EWE Webinar – Audio Recording
    • EWE Training Material – Power Point
    • ADRC OAA Services
 Extended Waiver Eligibility (EWE)

411-015-0030
 

Facilities section –

  • Updated the following:
    • AFH & RCF Rate Add-ons
    • ALF Levels 1-5
  • Added the following:
    • Transmittals –
      • APD-AR-17-081 & 070: New Facilities, CBC Change of Ownership, and Name Changes for CBC, New Specific Needs Contracts, and In-Home Care Agencies
      • APD-AR-17-072: Keys Amendment – Annual Public Notification for Standards for Residential Facilities
      • APD-AR-17-071: Admission Criteria for Dementia Contracted Adult Foster Homes
 Facilities  
 

Homecare Worker section:

  • Updated the following:
    • HCW Payroll Calendar 2017 – 2019 in list format and color calendar format in the following languages –
      • English
      • Arabic
      • Chinese
      • Russian
      • Somali
      • Spanish
      • Vietnamese
    • HCW Travel Time Tracking Sheet
  • Added the following:
    • 2 Week Letter to HCWs in the following languages –
      • English
      • Arabic
      • Chinese
      • Russian
      • Somali
      • Spanish
      • Vietnamese
    • Transmittals –
      • APD-IM-17-085: Homecare Benefit Trusts-Open Enrollment Materials for Homecare and Personal Support Workers
      • APD-IM-17-078: Available Translated Consumer-Employer Provider Publications and Requests for Interpreter Services for HCW Orientation and Direct Communication with HCWs
 Homecare Worker

Chap. 411, Div. 031
 

Independent Choices section:

  • Updated the following:
    • ICP Benefit Calculation form SDS 0546IC2Wk
    • ICP  Benefit Calculation form SDS 0540ICP
 Independent Choices 411-030-0100
 

In-Home Care Agencies section:

  • Updated the following:
    • List of In-Home Care Agencies
  • Added the following:
    • Transmittals –
      • APD-AR-17-070: New Facilities, CBC Changes of Ownership, and Name Changes, New Specific Needs Contracts, and In-Home Care Agencies
      • APD-IM-17-075: MMIS POC Billing Updates for In-Home Care Agencies
In-Home Care Agencies

Chap. 411, Div. 033
 

In-Home Support Services section:

  • Updated the following:
    • HCW Travel Time Tracking Sheet
  • Added the following:
    • Transmittals –
      • APD-IM-17-094: Updated 546PC Posted
      • APD-PT-17-058: Individuals managing Medicaid or OPI consumer employer duties
      • APD-IM-17-090: Service Plan Update for In-Home Services
      • APD-PT-17-050: In-Home and PACE Rates Updated
 In-Home Support Services

Chap. 411, Div. 030
 

K-Plan Services section:

  • Updated the following:
    • K-Plan Ancillary Services Provider List
K-Plan Services Chap. 411, Div. 035
 

Long Term Care Rates

 Long Term Care Rates

Chap. 411: Div 027, Div. 030, Div. 031
 

Mental or Emotional Disorder Review Team (MED) section-

  • Updated the following:
    • Checklist for Preparing Referrals to MED
 Mental or Emotional Disorder Review Team (MED) Chap. 411, Div. 015
 

Nursing Facilities & PAS section:

  • Added the following:
    • Transmittals –
      • APD-PT-17-052: Community Based PACE Rates
 Nursing Facilities & PAS  
 

Oregon ACCESS & CA/PS Information section –

  • Updated the following:
    • Examples of Good Comments in CA/PS
  • Added the following:
    • Transmittals –
      • APD-IM-17-091: Oregon ACCESS Release 24.15 – Friday, December 15, 2017
      • APD-IM-17-090: Service Plan Updated for In-Home Services
      • APD-IM-17-088: APD End of Year (2017) Processing Schedule and Updates
      • APD-IM-17-077: Oregon ACCESS SPL Display Issue
 Oregon ACCESS & CA/PS Information  
 

Oregon Project Independence:

  • Updated the following:
    • Overtime & Travel Time for OPI HCWs
Oregon Project Independence Chap. 411, Div. 032
 

Program of All-Inclusive Care for the Elderly (PACE) section:

  • Added the following:
    • Link to the National PACE Association
    • Link to the Code of Federal Regulations, Title 42: Public Health, Part 460.2 through 460.210
    • Link to the CMS PACE Manual
    • Transmittals –
      • APD-PT-17-052: Community Based & PACE Rates
      • APD-PT-17-050: In-Home & PACE Rates Updated
 PACE Chap. 411, Div. 045
 

Provider Time Capture (PTC) Information section –

  • Updated the following:
    • HCW Payroll Calendar 2017 – 2019 in list format in the following languages –
      • English
      • Arabic
      • Chinese
      • Russian
      • Somali
      • Spanish
      • Vietnamese
 Provider Time Capture (PTC) Information  
 

Specialized Services/Specific Needs Contracts section –

  • Added the following:
    • Specialized Service Vacancy Report (New Excel Version)

Specialized Services/Specific Needs Contracts

  
 

State Plan Personal Care section –

  • Updated the following:
    • SPPC Service Plan & Task List Word Version Form SDS 0546PC
    • SPPC Service Plan & Task List pdf Version Form SDS 0546PC
  • Added the following:
    • Transmittals –
      • APD-IM-17-094: Updated 546PC Posted
 State Plan Personal Care Chap. 411, Div. 034


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