An individual, other than one identified in sections (1), (2), (5), or (6) of this rule, must have adjusted income (see OAR 461-001-0000 (Definitions for Chapter 461)) below the standard in this section. [see attached table]
(4)
In the OSIPM (except OSIPM-EPD) program, an individual receiving Medicaid services in a nursing facility or an ICF-ID is allowed the following amounts for clothing and personal incidentals:
(a)
For an individual who receives a VA pension based on unreimbursed medical expenses (UME), $90 is allowed.
(b)
For all other individuals, $64.94 is allowed.
(c)
For an individual identified in subsection (b) of this section with countable income (including any SSI) that is less than $64.94, the payment standard is equal to the difference between the individual’s countable income (including any SSI) and $64.94. For the purposes of this subsection, countable income includes income that would otherwise be countable for an individual who is assumed eligible under OAR 461-135-0010 (Assumed Eligibility for Medical Programs).
(5)
In the OSIPM-EPD program, an individual must have adjusted earned income equal to or below 250 percent of the federal poverty level for a family of one.