Current through Register Vol. 63, No. 9, September 1, 2024
(1) A decision
notice:
(a) Specifies the date the notice is
mailed, which is the effective date for a basic decision notice.
(b) Except as provided in section (2) of this
rule, specifies the action the Department intends to take and the effective
date of the action.
(c) Specifies
the reasons for the action.
(d)
Informs the individual of the extent to which the individual has a right to a
hearing before an impartial person.
(e) Specifies the method and deadline for
requesting a hearing.
(f) Informs
the individual of the right to representation, including legal counsel, and the
right to have witnesses testify on his or her behalf.
(g) Provides information about the
availability of free legal help.
(h) Cites the rules that support the action,
or includes a notification of the rules that support the action.
(2) If benefits are reduced or
closed to reflect cost-of-living adjustments in benefits or any other mass
change under a program operated by a federal agency or to reflect a mass change
to payments in a program operated by the Department:
(a) The requirements in subsection (1)(b) of
this rule are optional. Instead of specifying the action the Department intends
to take and the effective date of the action, the decision notice may state all
of the following:
(A) The general nature of
the change.
(B) Examples of how the
change affects a individual's benefits.
(C) The month in which the change will take
place.
(b) The decision
notice must also state the individual's right to continue receiving
benefits.
(3) The notice
period is used to determine the effective date for taking action when a
decision notice is sent to the filing group:
(a) For a basic decision notice, the notice
period is the month in which the notice is mailed.
(b) For a continuing benefit decision notice,
the notice period is the budget month from which information is used to
initiate the decision notice.
(c)
For a timely continuing benefit decision notice, the notice period is the month
in which the mailing requirement ends.
(d) Except as provided under section (3)(e)
of this rule, the timely continuing benefit decision notice mailing requirement
is no later than the 15th day of the month.
(e) If the basis for a decision to reduce,
suspend, or close ERDC benefits is a change to a benefit standard, the timely
continuing benefit decision notice mailing requirement is:
(A) At least 30 calendar days before the
effective date of the action, or
(B) If the Department has fewer than 60 days
before the effective date to implement a change to a benefit standard, the
mailing requirement is as provided under section (4) of this rule. For purposes
of this section, the term "change to a benefit standard" means a change to the
applicable inflation-adjusted contribution, income, or payment standard. It
does not include the annual adjustment to a standard based on a federal or
state inflation rate.
(4) Each household must receive a notice of
expiration prior to the last month of the certification period containing:
(a) The date the certification period
expires.
(b) A statement that to
receive benefits, the individual must reapply and be found eligible for a new
benefit amount.
(c) The household's
right to request a contested case hearing if the reapplication is denied or if
the household objects to the benefit amount.
(5) Notwithstanding any rule in Chapter 414,
to the extent permitted by OAR 137-003-0530, the Department may take any of the
following actions:
(a) Amend a decision notice
with another decision notice or a contested case notice including to clarify
the rules that support the decision.
(b) Amend a contested case notice.
(c) Delay a reduction or closure of benefits
as a result of an individual's request for hearing.
(d) Extend the effective date on a decision
notice or contested case notice.
(6) Except as provided in section (5) or when
a delay results from the individual's request for a hearing, a notice to reduce
or close benefits becomes void if the reduction or closure is not initiated on
the date stated on the notice. If the notice is void, a new notice is sent to
inform the financial group of a new date on which their benefits will be
reduced or closed.
(7) No decision
notice is required in each of the following situations:
(a) Benefits are ended because there is no
living person in the benefit group.
(b) A notice was sent, the individual
requested a hearing, and either the hearing request is dismissed or a final
order is issued.
(c) The individual
has signed a voluntary agreement that qualifies as a final order under ORS
183.417(3)(b)
except as provided otherwise in this rule.
(d) No decision notice is required based on
prior notice.
(8) When
the Department amends a decision notice with another decision notice under
subsection (4) of this section, the date of the amended notice restarts the
individual's deadlines to request a hearing or continuing benefits, or
both.
(9) When a contested case
notice extends an effective date or delays a reduction or closure, the date of
the amended notice restarts a individual's timeline to request continuing
benefits.
(10) When an individual
has a pending hearing request or is receiving continuing benefits, and the
Department amends a notice under this section, the individual need not re-file
the hearing request or renew the request for continuing benefits.
(11) To end benefits if an individual
receives them for less than 30 days, a basic decision notice is sent.
(12) The Department sends a continuing
benefit decision notice when:
(a) Benefits are
calculated in accordance with OAR 414-175-0075.
(b) To remove an individual from the need
group.
(13) To end
benefits for an individual who has moved out of Oregon and no longer meets
residency requirements under OAR 414-175-0020, the Department sends the
following decision notice:
(a) The Department
sends a timely continuing benefit decision notice to the individual who has
moved out of Oregon.
(b) The
Department sends a basic decision notice if the individual becomes eligible for
benefits in another state.
(14) The Department does not send a notice of
termination to an individual disqualified for an IPV after a court order, a
final order from an administrative hearing, or a signed waiver (see section
(7)(c) and OAR 461-195-0621(2)) that imposes the disqualification.
(15) If benefits are reduced or closed to
reflect cost-of-living adjustments in benefits or other mass change under a
program operated by a federal agency or to reflect a mass change to payments in
a program operated by the Department, the type of decision notice used is the
same as otherwise applies to the reduction or closure of benefits under the
rules of this division. Section 2 of this rule modifies the content
requirements for a decision notice sent because of a cost-of-living adjustment
or mass change that apply to other decision notices under Section 1.
(16) When the Department takes action on
information reported on the Periodic Report form, the Department sends a
continuing benefit decision notice. The notice includes the amount of income
used to determine the benefits or ineligibility.
(a) For all changes not reported on the
Periodic Report form, which result in a closure or reduction in benefits, the
Department sends a timely continuing benefit decision notice.
(b) When the Department changes the reporting
system from one reporting system to another reporting system, the Department
provides a continuing benefit decision notice if the change occurs at a time
other than at the start of a certification period.
(17) The Department sends a continuing
benefit decision notice to close benefits when the benefit group fails to
return the reapplication form. The case is closed on the last day of the last
month of the certification period.
(18) When benefits are reduced for recovery
of an overpayment (see OAR 414-175-0097 and 461-195-0551) a timely continuing
benefit decision notice is sent for the first month of the reduction.
(19) Except as provided in section (22) of
this rule, when benefits will end or be reduced after a specific period of
time, the Department may issue a decision notice informing the benefit group of
the date benefits will end or be reduced, and no further decision notice is
required.
(20) Except as provided
in section (22) of this rule, if the benefit group was informed in writing when
the benefits began that the benefit group would receive benefits only for a
specific period of time a basic decision notice may be used to-
(a) Deny an application to start or continue
benefits after the completion of a certification period or to approve benefits
at a level lower than the prior certification period.
(b) Indicate that benefits have been ended or
reduced when no timely application is submitted.
(21) A basic decision notice is used when a
special need allowance granted for a specific period of time is removed at the
end of the specified period and the benefit group was informed of this in
writing when the allowance began. A timely continuing benefit decision notice
is required if stopping the special need allowance results in benefit
closure.
(22) Relating to sections
(19), (20), and (21) of this rule, no additional decision notice is required
when:
(a) Notwithstanding OAR 414-175-0005,
when a benefit group submits an application for a program from which they
currently are receiving benefits.
(b) When a filing group is receiving priority
processing but does not return postponed verification to the Department by the
last day of the month in which the application period ends.
(c) A decision notice that included the
eligibility begin and end dates was given for the reduced ERDC copay described
in OAR 414-175-0050 and the three-month eligibility period ends.
(23) If the caregiver, another
adult member of the need group, or the authorized representative:
(a) Makes an oral request to end or reduce
benefits, a timely continuing benefit decision notice is sent.
(b) Makes a signed, written request to
withdraw, end, or reduce benefits, a basic decision notice is sent.
(c) Makes an oral request to withdraw an
application for benefits, a basic decision notice is sent. The Department may
reduce or terminate benefits to an individual when the individual completes a
voluntary agreement on a Department form used for this purpose.
Statutory/Other Authority: ORS
329A.500
Statutes/Other Implemented: ORS
329A.500
