Notice Situation; Nonstandard Living Situations

(a) A timely continuing benefit decision notice

(see OAR 461-001-0000) is sent to terminate, suspend, or reduce benefits if the notice occurs as a result of any of the following situations:

(A) An individual has been admitted or committed to an institution.

(B) An individual has been placed in foster care, skilled nursing care, intermediate care, or long-term hospitalization.

(C) An individual is placed in official custody or a correctional facility.

(D) An individual enters a drug or alcohol residential treatment facility.

(E) An individual leaves a drug or alcohol residential treatment facility without reapplying for SNAP benefits.

(b) No decision notice

(see OAR 461-001-0000) is required if the Department determines that a resident of a group living

(see OAR 461-001-0015) facility or a drug or alcohol treatment center is ineligible as a result of one of the following actions taken against the center or facility:

(A) Disqualification by Food and Nutrition Services (FNS) as an authorized representative.

(B) Loss of certification with the Department.

(c) A resident of a facility that is disqualified or loses its certification as described in subsection (b) of this section may still qualify for SNAP benefits through a separate application.

(2) Except as provided in section (3) of this rule, for all programs except the SNAP program, a basic decision notice

(see OAR 461-001-0000) is sent to terminate, suspend, or reduce benefits in each of the following situations:

(a) The individual has been admitted or committed to an institution, or the individual loses Medicaid eligibility while in the institution.

(b) The individual has been placed in skilled nursing care, intermediate care, or long-term hospitalization.

(c) The individual is placed in official custody or a correctional facility.

(3) Except as provided in OAR 461-175-0300, in the OSIPM program, a individual receiving home and community-based care

(see OAR 461-001-0030) or long-term care services is sent –

(a) A timely continuing benefit decision notice in each of the following situations:

(A) A reduction or closure of services occurs as the result of a process of reevaluating both the functional impairment levels of an individual and the requirements of an individual for assistance in performing activities of daily living.

(B) Services are closing because the individual has not paid the patient liability under OAR 461-160-0610 or participant fee

(see OAR 461-001-0035).

(C) The individual receives OSIPM-ICP benefits, and benefits will end under OAR 411-030-0100.

(D) There is a change in special needs as described in OAR 461-180-0040.

(E) Except as provided in subsection (b) of this section, when there is an increase in the patient liability or participant fee as described in OAR 461-160-0610 and OAR 461-160-0800.

(b)A continuing benefit decision notice

(see OAR 461-001-0000) when there is an increase in a patient liability or participant fee as a result of any of the following:

(A) A cost-of-living adjustment (COLA).

(B) A mass change under a program operated by a federal agency.

(C) A mass change to payments in a program operated by the Department.

(c) A basic decision notice when there is a decrease in the patient liability or participant fee .