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QMB Program Manual

E. Financial Requirements

Effective 1/1/16

1. Overview of Assets

Unearned income, earned income and resources are assets. For QMB/SMB/SMF, treat assets as follows unless otherwise specified in other administrative rule(s): Effective 1/1/16, all resources are excluded in the QMB/SMB/SMF programs, so an asset is either counted as income or excluded in any given month. "Excluded” means an asset is not counted as either income or as a resource. When determining financial eligibility, count all income not excluded or otherwise considered unavailable. Exclude all assets as resources.

For information on specific assets, see Counting Client Assets A.2.

For information on the excluded income, see 461-140-0070.

For information on the availability of income, see 461-140-0040. Unavailable income does not affect a benefits group’s eligibility or benefit level.

461-140-0010

2. Income Limits

The adjusted income standards are as follows.

QMB-BAS Adjusted Income Standard 100% FPL

No. in Need Group
Amount
1
$981
2
1,328
3
1,675
4
2,021
5
2,368
6
2,715
7
3,061
8
3,408
9
3,755
10
4,101
Each additional person
347


461-155-0290

QMB-DW Adjusted Income Standard 200% of FPL

No. In Need Group
Amount
1
$1,962
2
2,655
3
3,349
4
4,042
5
4,735
6
5,429
7
6,122
8
6,815
9
7,509
8
8,202
Each additional person
694


461-155-0291

SMB Adjusted Income Standard
Income greater than 101% but less than 120% FPL

No. In Need Group
Amount
1
$ 1,177
2
1,593
3
2,009
4
2,425
5
2,841
6
3,257
7
3,673
8
4,089
9
4,505
10
4,921
Each additional person
416


SMF Adjusted Income Standard
Income equal to or greater than 120% but less than 135% FPL

No. in Need Group
Amount
1
$ 1,325
2
1,793
3
2,261
4
2,729
5
3,197
6
3,665
7
4,133
8
4,601
9
5,069
10
5,537
Each additional person
468

461-155-0295

Shelter-in-kind standards. For a definition of shelter-in kind see 461-145-0470. If a client receives shelter-in-kind, the following amounts are added to the adjusted income, then compared to the appropriate standard above. Shelter-in-kind standards can be found in 461-155-0300.

For information on lump sum and periodic income policy see Counting Client Assets A.4 and A.5, respectively.

3. Income Deductions

Use this section to determine financial eligibility and adjusted income for all QMB clients. Determine which income deductions to allow and calculate adjusted income by subtracting allowable deductions from countable income.

In the QMB-BAS program, a client is eligible if his or her adjusted income is equal to or less than the QMB adjusted income standard.

In the QMB-SMB program, a client is eligible if his or her adjusted income is less than the adjusted income standard.

Allow income deductions from the financial group's income in the following order:

One standard deduction of $20 (see note below).

Financial eligibility: 461-160-0540
Adjusted income: 461-160-0552

4. Resource Limits

All resources are excluded for QMB-BAS, QMB-SMB, and QMB-SMF effective 1/1/16.

Use of Resources in Determining Financial Eligibility 461-160-0010

Resource Limits 461-160-0015

5. Prospective Eligibility and Budgeting

arrow Click here for definitions used in determining eligibility and budgeting

To determine when to use prospective eligibility and budgeting:

For prospective eligibility and budgeting:

 

Prospective: 461-150-0020
QMB Specific: 461-150-0050

Prospective Use of Variable Earned and Unearned Income

Income that can be defined as variable (see OAR 461-001-0000) should be averaged and converted to a monthly amount.  See CCA A.6 for examples of calculating and budgeting variable income.

461-150-0080

Prospective Budgeting of Periodic Income

Periodic income is received on a regular basis but less often than monthly.  It is not converted or averaged; instead it is counted in the month it is received.  This means that benefits may have to be reduced or closed (depending on the program) during that month, but only if the amount does not vary.  Because of MAGI and due process, by the time the first referral is made and returned by 5503, it will be too late to take action; however, the referral is only needed once.  After the initial referral, the branch can close or reduce for the month in question as needed with timely notice (narrate that MAGI was already addressed). 

If the amounts vary, the reporting requirements apply.  If the client reports the amount ahead of time and there is time to close or reduce with a timely notice (remember the MAGI referral must be done the first time) then close or reduce for that month as needed. If the client exercises his/her right to report the change within 10 days of receipt, there is no time to take action on the change and benefits will remain as-is.   

461-140-0110

Averaging and Anticipating Self-employment Income

Income from self-employment, is averaged over 12 months in accordance with 461-150-0095.  If past income is not representative of future income or when a substantial change is expected in next year's income, income can be anticipated. See the Treatment of Self Employment Income section of Counting Client Assets (CCA C.4) for more detailed information about how to determine how to anticipate income and costs.

461-150-0095

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