The intent of the OSIP and related OSIPM program is to provide low income aged and disabled Oregonians with cash and medical benefits through a state and federally funded program that offers financial, acute and long-term care. Those that qualify can expect assistance in selecting a managed care provider and in the case of placement outside their home setting, a choice in care options. All applicants have the right to a decision on their application and a determination on all benefits for which they are entitled within the time frames outlined in the chapter on applications.
The Oregon Supplemental Income Program offers cash and medical assistance to eligible individuals who qualify by meeting various means tested income and resource requirements. Other nonfinancial eligibility prerequisites such as residency and citizen/alien status must also be considered prior to granting benefits.
In general, the Oregon Supplemental Income Program Medical (OSIPM) is provided to two groups of individuals. The first group are those eligible for Supplemental Security Income (SSI) as provided for under Section XVI of the Social Security Act. This group is assumed eligible for Medicaid due to age or disability, as long as they also meet specific Medicaid requirements such as residency, pursuing health care coverage and cash medical support, the resource limit for a couple determined through a resource assessment, etc. These individuals receive the basic SSI standard from the Social Security Administration and OSIPM (OHP plus benefit package) from the Department.
The second group are eligible for the medical coverage as an OSIPM recipient either when the individual receives home or community-based services or when the individual resides in a nursing facility or state institution. The income standard for this group is based on 300% of the SSI standard for an individual. Those with income above the standard can be eligible by means of an income cap trust discussed in 461-145-0540 of this manual.
Both OSIPM groups can receive cash payments called "special needs payments" if the individual meets the requirements of the rules. The individual may receive a one-time special need payment for a home repair or a monthly, ongoing special need payment for a laundry allowance, for example. See 461-155-0500 through 461-155-0710 of this manual for more information on special needs payments.
This program is the basis under which Medicaid is granted under the Old Age
Assistance, Aid to the Disabled and Aid to the Blind Programs whereby the individual
receives medical assistance through a managed care provider. Depending on the
individual’s living arrangement, case management services are provided
either by the Department, Area Agencies on Aging or county mental health or developmental disabilities programs. Eligible OSIP and OSIPM individuals can be qualified for
other programs while receiving cash or medical benefits. These programs include
the Qualified Medicare Beneficiary Program (QMB) or the Specified Low-Income
Medicare Beneficiary Program (SMB).