Current through Register Vol. 63, No. 9, September 1, 2024
(1) In the OSIPM program, an individual
receiving any of the following is ineligible for a special diet allowance:
(a) Room and board.
(b) Residential care facility services or
assisted living facility services.
(c) Nursing facility services.
(d) Adult foster care services.
(e) An allowance for restaurant
meals.
(f) A commercial food
preparation diet.
(2) An
individual in the OSIPM program receiving Supplemental Security Income (SSI),
having an adjusted income less than the OSIPM program income standard under OAR
461-155-0250, or receiving
in-home services under OAR 411-030 -- is eligible for a special diet allowance
if all of the following requirements are met:
(a) The Department must receive verification,
as documented by a Department-approved medical authority (see OAR
461-125-0830), of all of the
following:
(A) The individual must adhere to a
special diet.
(B) The individual's
specific nutritional need (such as low carbohydrates, high protein).
(C) The individual would be in an imminent
life-threatening situation without the special diet.
(b) A licensed dietitian must provide written
documentation of the following, and a copy must be provided to the Department:
(A) The individual's current diet items being
replaced or removed, if any;
(B)
The special diet items being added, relating to the individual's specific
nutritional need described in paragraph (a)(B) of this section; and
(C) The recommended quantity of each special
diet item.
(c) The
individual requesting a special diet allowance must provide to the Department:
(A) Verification of the monthly cost for any
current diet item being replaced or removed, and
(B) The monthly cost of any special diet item
being added.
(3) The amount of a special diet allowance is
calculated as follows:
(a) The special diet
allowance is the monthly cost of the special diet items, less the monthly cost
of the current diet items being replaced or removed. If no items are being
replaced or removed, the allowance is the actual monthly cost of the special
diet items.
(b) In the OSIPM
program, a monthly amount over $300.00 must be authorized by the APD Medicaid
Financial Eligibility policy unit.
(4) Local management staff must approve or
deny any request for a special diet allowance provided under subsection (3)(a)
of this rule.
(5) Each special diet
allowance must be reviewed and reauthorized annually.
(6) Special diet items must be purchased at
the lowest cost available for that item.
Statutory/Other Authority: ORS
409.050,
411.060,
411.070,
411.404,
412.014,
412.049,
413.085 &
414.685
Statutes/Other Implemented: ORS
411.060,
411.070,
411.404,
411.706,
412.014,
412.049,
413.085 &
414.685
