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567 (07/2026) Chapter 2:Eligibility • Section 11: Medical Related Payments (MRP) Oregon Administrative Rule(s) 461-155-0620 — Special Need; Property Taxes Community-based care Notwithstanding the definition at 461-001-0000, for the purposes of this section, an individual is considered living in community-based care (CBC) if the individual resides at one of the following care settings licensed by ODHS|OHA: • Adult Foster Home • Residential Care Facility • Assisted Living Facility • Specialized Living Facility, or • Group Care Home If an individual who meets the applicable income requirements begins living in a CBC facility: • Payment for room and board may be authorized during the month of admission at the initial placement, limited to the approved rate. • Room and board payments may be paid to the facility during the temporary absence of an individual if all of the following criteria are met:
The absence occurs because the individual is admitted to a hospital or nursing facility,
ODHS|OHA determines the intent of the individual to return to the CBC facility,
The CBC facility is willing to accept the room and board payment, and
The individual returns within the calendar month following the month in which the absence began. For an incapacitated individual with no financial or legal representative, who is determined eligible for community- based care, payment for room and board may be authorized for up to three months while a financial or legal representative is being established, if necessary to secure placement. The payment may be extended if additional time is needed to establish a financial or legal representative. APD Medicaid policy approval is required prior to issuing this payment or any extension. If approved by APD policy, use pay reason 13 “CBC FAC R&B Ongoing PMT”. Note: If an individual moves from one CBC facility to another mid-month, the individual should ask that the provider return the remaining room and board amount (if the individual has given sufficient notice). However, the provider is not obligated to return the funds. If necessary, this special need can be used to pay the prorated room and board amount for the first month in the new facility. Spouses who each receive SSI and receive services in a CBC facility are eligible for a payment in the amount that equals the difference between the OSIPM standard for a one-person need group and the individual’s total countable income. If one spouse has income above the OSIPM standard, the excess income is applied to the other spouse’s countable income.