Or. Admin. Code § 309-012-0031

Current through Register Vol. 63, No. 11, November 1, 2024

Section 309-012-0031 - Definitions

As used in these rules:

(1) "Ability to Pay" means the ability of a person in a state institution to pay past, current, or ongoing cost of care, as determined by the Division in accordance with these rules.

(2) "Assets" means, excluding income, the total value of an individual's equity in real and personal property of whatever kind or nature. Assets include, but are not limited to the individual's stocks, bonds, cash, accounts receivable, moneys due, or any other interests, whether they are self-managed, or held by the individual's authorized representative, or by any other individual or entity on behalf of the individual. "Assets" held in trust are subject to laws generally applicable to trusts.

(3) "Authorized Representative" means an individual or entity appointed under authority of ORS 125, as guardian or conservator of a person, who has the ability to control the person's finances, and any other individual or entity holding funds or receiving benefits or income on behalf of any person.

(4) "Benefits from Health Insurance" means payments from insurance programs with the limited purpose of paying for the cost of care provided to an individual by a hospital or other health care provider. Benefits of this type include, but are not limited to payments from:

(a) Private and group health insurance policies;

(b) The Medicare and Medicaid programs;

(c) Any other policies or programs with the purpose of paying for the costs of inpatient and/or outpatient care.

(5) "Charges" means the amount the Division has determined that the person is required to pay toward the cost of care based on his or her ability to pay.

(6) "Cost of Care" means the person's full liability for care as determined by the Division using the rates established in accordance with ORS 179.701.

(7) "Dependents" means individuals whom a person has a legal duty to support. "Dependents" may include non-emancipated children and spouse of a person, as well as any other individual for whom a person would be allowed a personal exemption under federal or Oregon personal income tax laws.

(8) "Division" means the Addictions and Mental Health Division of the Oregon Health Authority.

(9) "Fair Market Value" means the cash price a capable and diligent individual could obtain in a reasonable amount of time for an asset after negotiating with those accustomed to buying such property.

(10) "Funds for Personal Support Following Release" means the cash that a person will need following his/her release from a state institution to live in the community in a reasonable manner for a period of time, not normally to exceed six months.

(11) "Income" means all funds received by an individual, or for an individual by his or her authorized representative, from any source, whether earned or unearned, after making applicable deductions for state and federal taxes. "Income" includes benefits from both income protection insurance which replaces the person's earned income when he or she is unable to work, and governmental retirement or disability insurance, such as Social Security, Veterans, and Railroad Retirement benefits.

(12) "Legal Obligations" means any financial duty imposed by law. "Legal obligations" include, but are not limited to, loan or mortgage contracts for which an individual is responsible, as well as liabilities arising out of other contracts or legal duties to pay money. "Legal obligations" include administratively or judicially ordered child and/or spousal support.

(13) "Moral Obligations" means any payments that an individual feels a moral duty to pay, but for which the individual does not have a legal duty to pay.

(14) "Person" means:

(a) A current or former patient at a state institution for the mentally and emotionally disturbed;

(b) A current or former resident at a state institution for the developmentally disabled.

(15) "Person's Representative" means:

(a) Any individual who is the person's authorized representative as defined in section (3) of this rule; and/or

(b) Any other individual who has the person's written authority to represent the person.

(16) "Personal Expense Allowance" means the cash allowed for the reasonable miscellaneous expenses the person has while he or she is in the state institution, including but not limited to expenses for personal grooming and hygiene items; books, newspapers, or other publications; snacks or refreshments not provided by the state institution; and minor entertainment or excursions.

(17) "Primary Personal Automobile" means the automobile, if the person has more than one, which the person would choose to keep if required to sell all but one. If the person has only one, it is the primary personal automobile.

(18) "Primary Personal Residence" means the home the person owns, or is purchasing, and in which the person lived prior to entering the state institution, and/or in which the person will live after leaving the state institution.

(19) "Special Authorized Expense Allowance" means the cash needed for the reasonable personal expenses of the person which cannot be met by the personal expense allowance, and which the Division determines are necessary.

(20) "State Institution" means Dammasch State Hospital in Wilsonville; Eastern Oregon Psychiatric Center in Pendleton; Eastern Oregon Training Center in Pendleton; Fairview Training Center in Salem; and Oregon State Hospital in Salem.

(21) "Support for Dependents" means the cash necessary to meet the reasonable needs of the dependents, less the amounts the dependents receive from any other sources. Support for dependents excludes administratively or judicially ordered child and/or spousal support.

Or. Admin. Code § 309-012-0031

MHD 5-1980(Temp), f. & ef. 4-18-80; MHD 14-1980, f. & ef. 6-24-80; MHD 9-1991, f. 12-13-91, cert. ef. 12-16-91

Stat. Auth.: ORS 179.770, 413.042 & 431.021

Stats. Implemented: ORS 179.610 - 179.770