OAR 461-135-0708: Criteria for Developing a Plan for Self-support; Medicare Savings Programs and OSIPM

(1) An individual and the Department may develop a plan for self-support for Medicare Savings Programs (see OAR 461-001-0000) and Oregon Supplemental Income Program Medical (OSIPM) for an individual who meets both of the following: (a) Meets the applicable disability or impairment criteria. (b) Is not eligible for Supplemental Security Income (SSI). (2) A plan for self-support allows an individidual to retain a portion of their non-excluded assets for a specific period of time to meet a specific occupational goal. The plan may provide for specialized or advanced education or training for individuals with a severe disability. (3) To be approved, a plan for self-support must meet all of the following criteria: (a) The plan must be in writing and approved by the Department. (b) The plan must identify a realistic occupational goal, considering the individual's physical limitations and capabilities. (c) The goal of the plan must be to provide the individual with income necessary to meet his or her needs, not just for improving potential earning capability or increasing self-sufficiency within the home. (d) Resources designated to support the plan must be kept in a separate bank account with a specific savings or planned disbursement goal for using the resources. Previously commingled funds must be put in a separate bank account in order for them to be considered designated for the plan. (e) The duration of the plan must be limited to the time necessary to complete the plan but cannot exceed 36 months plus an additional 12 months if necessary for completion of education or training. (4) An individual must do all of the following to comply with a plan for self-support: (a) Report any changes in circumstances that require a change to the current plan. (b) Follow through with the plan without any break in excess of the longer of the following: (A) Normal vacations from school or training. (B) Three months, unless the reasons are beyond their control. (5) If an individual fails to comply with the requirements of section (4) of this rule, program eligibility is redetermined without the resource exclusions allowed by OAR 461-145-0405. (6) The individual and the Department may revise a plan for self-support or may agree to a new plan. To be new, the plan must not have any relationship to the old plan. When a plan is revised or a new plan established: (a) Resources designated to support the old plan may become a part of the revised or new plan. (b) If changes are made to the amount of resources to support the plan, eligibility and the payment amount for program benefits are redetermined. (c) If the duration of the revised plan in addition to the months the old plan was in effect exceeds the time limits in subsection (3)(e) of this rule, approval is limited to the remainder of the maximum period only.