218-RICR-20-00-5. Supplemental Security Income and State Supplemental Payment Rules and Regulations (version Amendment, 12/29/2008 to 01/01/2011)

0400 RHODE ISLAND STATE SUPPLEMENT TO SSI 0400.05 SUPPLEMENTAL SECURITY INCOME PROGRAM REV:01/2002 The Supplemental Security Income Program, Title XVI of the Social Security Act, established by P.L. 92-603, as amended, provides, on a national basis, a minimum income level for persons 65 or over, or blind, or disabled persons who do not have sufficient income and resources to maintain themselves at the federal minimum income level. The SSI Program, administered by the federal government through the Social Security Administration and financed from the General Fund of U.S. Treasury, became effective 1-1-74 and replaced Titles I, X, XIV, XVI of the Social Security Act which had provided assistance to aged, blind, and disabled persons under state administration. Federal law required the states to provide a mandatory supplement to those persons who, in December 1973 under the old programs, were receiving a payment greater than the new federal minimum level. Rhode Island, however, established a level of payment greater than the federal minimum payment and made it available to all eligible persons. In October 1990 Rhode Island also established a standard for eligible residents living in a licensed residential care facility. The states were given the option of state or federal administration of the state supplement payments. Rhode Island elected federal administration. In this way, the SSI recipient receives one check from the Federal Government for the federal and/or state payment. Rhode Island also provides to SSI recipients medical care, including group care through the Medical Assistance Program (Title XIX Program), and social services through a Social Services Block Grant. Payment can also be made for moving expenses, for needs resulting from an emergency of a catastrophic nature, for residence in a licensed sheltered care facility, and for burial when the criteria for these services have been met. The criteria are set forth in Section 0404. Homemaking Services are available to qualified individuals under the Social Services Program (see Section 0530). Essential spouses of eligible SSI recipients who were included in an AABD payment in December, 1973 were grandfathered into the SSI program. Essential spouses will be included in the SSI payment of the eligible SSI person as long as his/her eligibility continues. 0400.10 SSI OFFICES REV:10/1989 Information relative to eligibility requirements for the SSI Program can be obtained by contacting the appropriate Social Security Administration office listed below: 55 Broad Street Pawtucket 724-9610 380 Westminster Mall Providence 528-4501 Eugene O'Neil Dr. New London, Ct. 203-443-8454 130 Bellevue Ave. Newport 849-3487 90 Quaker Lane West Warwick 822-1456 127 Social St. Woonsocket 767-2100 The Rhode Island Level of payment for SSI is set forth in Section 0402. 0402.05 LEVEL OF PAYMENT REV: 01/2009 Total Payment Federal State Level Share Supplement Individual $ 713.92 674.00 39.92 Individual in $ 501.26 449.34 51.92 Another's Home Eligible Couple $ 1,090.38 1,011.00 79.38 Eligible Couple $ 771.30 674.00 97.30 in Another's Home Institutionalized $ 50.00 $ 30.00 $ 20.00 Individual Eligible for Federal/State Supplement Individual in $1,212.00* 674.00 538.00 Residential Care and Assisted Living Facility ** * Effective October 1, 1998, individuals living in state licensed residential care/assisted living facilities who receive SSI are allowed to retain a minimum personal needs allowance of fifty-five dollars ($55) per month from their SSI monthly benefit prior to payment of the residential care/assisted living facility monthly fee. ** Effective December 1, 1998, an individual must be screened, assessed, and certified by DHS or its agent to be residing in a residential care/assisted living facility to be within this category. All individuals who receive this category payment level in October 1998 or November 1998 will be forever exempt from the screening, assessment, and certification process. 0402.10 MEDICAL FACILITIES REV:07/1999 The standard for Personal Needs in Rhode Island is $50 for persons in medical facilities. Effective March 1, 1991, the Social Security Administration (SSA) will administer both the Federal and State SSI supplement. 0404 STANDARDS FOR SUPPLEMENTATION TO SSI 0404.05 SUPPLEMENTAL PAYMENTS REV:10/1990 Persons in Rhode Island who are eligible for either Federal and State SSI payment, or only the State share of the SSI payment, are automatically eligible for Medical Assistance, Social Services, and for assistance to meet the following needs according to specified criteria: - Moving; - Homemaker Service; - Burial; - Emergency Assistance in the Event of a Catastrophe; - State Supplemental Payment to Estranged Spouses Receiving SSI as a Couple; - Assistance in the Event of Unreceived, Lost, Stolen or Destroyed SSI Checks and Lost or Stolen Cash. Supplemental payments may be made to recipients of SSI for in-state moving, homemaker service, and burial expenses. A payment for an emergency of a catastrophic nature may be made when agency requirements are satisfied. If an SSI recipient is without food or food stamps as a result of an unreceived, lost, stolen, or destroyed SSI check or for lost or stolen cash, assistance to obtain food only may be given. Agency personnel have responsibility in the authorization process to assure that recipients are properly assisted as determined by the provisions of the policy. (Social Services has the responsibility in meeting Emergency Shelter under specified conditions. See Social Service Program Manual, Section 0514.) In addition, to meet the needs for persons who do not qualify in an SSI recipient's payment as an eligible essential spouse, Rhode Island will provide General Public Assistance if the spouse is unemployable and otherwise eligible. 0404.10 MOVING REV:03/1990 Payment for in-state moving, within cost guidelines, is provided for recipients of SSI when the move is determined to be socially desirable, the move cannot be provided by the city or town or other community resources, and the recipient requests vendor payment for the move. The agency makes no provision to meet the cost of out-of-state moves. The social caseworker in Economic and Social (E&SS) Services has the responsibility for making a recommendation to E&SS eligibility staff as to the social desirability of the recipient's move based on criteria outlined in Section 0512 on Housing Services. The E&SS eligibility staff has responsibility for verifying the cost of the move and for authorizing the moving payment to the vendor. 0404.10.05 Moving Request Procedures REV:03/1990 When a request for moving is received, the eligibility technician completes, in triplicate, Part I of form DHS-48A, Request for Moving Payment to Vendor. The original and one copy are transmitted to the E&SS social caseworker for a determination of the social desirability of the move and completion of Parts II and III of the form. The social caseworker must, in consultation with the casework supervisor, assess the desirability of the move in accordance with the agency criteria, inform the latter's responsibility in the moving process if the move is approved. (See section 0512). The social caseworker must obtain the client's decision on whether to have the payment sent directly to the vendor and return the original and one copy of the DHS-48A, with the moving recommendation indicated, to the eligibility technician. The second copy is retained for the social services record. Upon receipt of the DHS-48A and if the move is recommended, the eligibility technician advises the recipient to have the moving company contact the eligibility technician for authorization. The amount of payment authorized for moving is based on the established prevailing rate. The agency can authorize payment to licensed movers only. A list of licensed movers is available in each district office. An exception to this may be made when the recipient chooses to rent a vehicle to move himself. When the moving bill is received, the eligibility technician reviews the bill with the recipient to verify the number of hours. The bill must also be checked for accuracy. If payment is approved, the eligibility technician processes an AP-57B authorizing a payment either to the vendor or to the client. The decision is confirmed in writing to the recipient as well as to the moving company. When a client is moving out of a region, the AP-57B must be processed, whenever possible, prior to transferring a record to another office. 0404.10.10 Disapproval of Moving Costs REV:03/1990 E&SS eligibility staff may deny moving payments for any of the following reasons: - Moving costs above the prevailing rate. A letter must be sent to the moving company advising them that the amount above the rate is not approved. (The amount within the rate is approved.) - More than one move a year unless approved by the Regional Manager. - Moving to a destination out of state. - Blank moving bill signed by the recipient. - Unauthorized moving. - Unauthorized packing costs and/or fumigation costs. 0404.10.15 Moving of Donated Essential Furniture REV:10/1981 When a request is received for moving essential items of furniture that have been donated to the recipient, the request is referred to the social caseworker for evaluation. If the essential item(s) of furniture is/are lacking, or if the present equipment needs replacing, the social caseworker's recommendation is referred to the Regional Manager for a decision. Approval is based on the condition of the item(s) and the cost of the moving. When the recipient has no furniture, the cost of moving the donated furniture is considered when the move will result in lower living costs such as a move to public housing or when it is determined socially desirable for the individual(s) to move from inadequate housing to improved housing and the cost of the new housing is not excessive in relation to the family's income. In lieu of the use of licensed movers, payment for moving donated items may be made to a recognized non-profit social service agency having a vehicle utilized for this purpose. The maximum allowable cost for the use of the vehicle is $10 for one item; $20 for two items; or a total of $25 for any three items or more from the same location. 0404.15 HOMEMAKER SERVICES REV:03/1990 Homemaker Service is a social service provided through the E&SS social caseworker to recipients of SSI. Refer to the Social Services Program, Section 0530, for the criteria, determination of eligibility, cost and procedures for the authorization of Homemaker Service. 0404.20 BURIAL EXPENSES REV:03/1990 The cost of burial can be met through General Public Assistance funds for any person who dies leaving no or insufficient resources to meet the expense. See GPA Section 0620 of this Manual for the cost standards and conditions under which funeral and burial expenses can be met. 0404.25 EMERGENCY ASSISTANCE REV:09/1985 Funds for shelter, clothing, food, essential household equipment, and furnishings, if necessary, are provided in the event of a catastrophe only if all of the following conditions are met: - An emergency is defined as the occurrence of a catastrophe caused by fire, flood, lightning, or severe wind. Compensable fire damage is further restricted to that caused by flame, smoke, and subsequent secondary water damage where there is damage to the dwelling. Furthermore, the incident must be reported immediately to the fire department. Other specific exclusions under any circumstances are destruction for which a landlord can be held responsible, willful destruction or willful neglect by the recipient or a member of his/her family, damage covered by insurance policies, and isolated mechanical or electrical failures where there is no secondary damage. - Coverage is limited to possessions of the recipient or those of another member of the assistance unit. - For active cases, the catastrophe or disaster must have occurred at the address recorded in the case record. Or, if it occurred at a different address, the recipient must demonstrate that s/he had moved and was living there prior to notifying the agency. Acceptable evidence of residence may include, for example, a moving bill, rent receipt, or statement from a utility company attesting to the recipient's responsibility for service on the date and at the address in question. When the catastrophe occurred at an address other than the address of record, the facts of the situation along with verification of residence are presented to the Regional Manager for a decision on whether this condition for emergency assistance has been met. - To be considered, the incident must be reported immediately by the recipient to the Family and Adult Services staff of the district office. - Community resources must first be explored and utilized, whenever possible. - Whenever reasonable, a partially destroyed item of household goods or furnishings must be repaired rather than replaced. If replacement is required, the purchase of used items must be considered before funds for new items can be authorized. - Any repairs to the basic structure of a recipient-owned dwelling, such as roof, stairs, septic systems, plumbing, wiring, siding, etc., are specifically not covered regardless of the reason for the repair. - Thefts of clothing, food, and household furnishings and equipment are specifically not covered. - If repeated emergencies occur for one case, or the circumstances are questionable, payment may be denied. 0404.25.05 Authorization Responsibility/Documentation REV:09/1985 The recipient must report the catastrophe immediately. A social caseworker must visit the site as soon as possible to begin to help the recipient and to authorize shelter, food, and clothing as defined in Section 0404.25.10. Assistance Payments must be notified of the situation by Family and Adult Services. The eligibility technician must visit the site within a working day of the recipient's notification of the catastrophe to document the facts related to Section 0404.25, if additional food and clothing or essential household items, as defined in Section 0404.25.10 are to be authorized. The social caseworker works with Assistance Payments staff. A written report must be prepared by the eligibility technician for review by the Regional Manager or Chief Supervisor as the final approving authority for payment of the items in 0404.25.10. The report must contain the firsthand information required to support and verify each condition or requirement listed in Section 0404.25. A police or fire department official and any appropriate collateral source is contacted and a written report requested. If a written report cannot be obtained, an oral report will suffice, provided that the official's name, title, telephone number, and all the relevant facts are recorded by the eligibility technician in a memorandum. Unless there is a delay in obtaining a police or fire report, the eligibility technician must submit his/her report within three working days of the recipient's notification. The eligibility technician's report must also contain a statement signed by the recipient attesting to the circumstances of the catastrophe and the extent of the damage. Also required is a detailed list of damaged or destroyed major items of household equipment and furnishings by room, including an indication as to whether each item is to be obtained from a non- agency community resource, repaired, replaced with a used item, or replaced with a new item. If repair or replacement is indicated, only items contained in "Household Furniture and Furnishings Emergency Replacement List," a copy of which is in the possession of each Regional Manager, can be replaced at agency expense. Also included should be a brief narrative describing the immediate action taken (such as use of emergency shelter, the extent of any personal injury, whether hospitalization was required, etc.) and any other data needed to further evaluate the situation and to better assist the recipient. The Regional Manager or Chief Supervisor reviews the report and discusses it, if necessary, with the eligibility technician and determines the final amount of the payment. 0404.25.10 Items Provided in Event of Catastrophe REV:10/1987 Social Services has the responsibility of making an immediate determination of the need for emergency shelter, initial food and initial clothing, and may authorize the following, as required: - Emergency shelter, on a temporary basis, will be provided only where the damage to cooking or heating or plumbing facilities is severe enough to prevent their use in a minimally acceptable manner or the existing damaged structure either cannot provide adequate protection from the elements or is not safe to occupy. Approval for use of emergency shelter must be made on a daily basis by the social worker assigned to help the recipient relocate to permanent shelter. - Initial food and transportation for each recipient in the amount of $5.00 per person per day, if meals are home-prepared, or $15.00 per person per day, if restaurants are used, are provided from the date of the catastrophe through the fifth working day (or to the date of the next recurring SSI check, if earlier). - Initial clothing, if an individual recipient's clothing has been destroyed, can be authorized only to meet immediate clothing need. (Maximum combined initial and additional clothing allowance is $123. See below.) Assistance Payments has the responsibility to verify and document the need for essential household items, additional food, additional clothing, and storage of household goods. - Essential Household Items If repair is unreasonable and second-hand items are not available, household items contained in "Household Furniture and Furnishings, Emergency Replacement List," a copy of which is in the possession of each Regional Manager, are provided. Items not on the list, such as a television, are not replaced. - Additional Food Funds for additional food and transportation for each recipient are provided at the rate of $5.00 per person per day, if meals are home-prepared, or $15.00 per person per day, if restaurants are used, from the sixth working day to the date of the next income or SSI check, if damage to the food supply occurred. - Additional Clothing The maximum amount that can be authorized for clothing for a recipient is $123. Assistance Payments can authorize up to this amount, less any amount previously authorized by Social Services, if an individual recipient's clothing was destroyed. - Stored Household Goods Storage expenditures can be authorized when it is necessary to store household goods to prevent further damage. 0404.30 MEDICAL CARE REV:10/1987 The SSI recipient is certified for Medical Assistance automatically concurrent with the determination of eligibility for SSI and/or the State Supplement. Refer to the Medical Assistance Program (Section 0300) for further information regarding medical care. 0404.35 LOST OR STOLEN SSI CHECKS OR CASH REV:10/1987 This section outlines policy regarding lost, stolen, destroyed, or not received SSI checks and lost or stolen cash. Checks When an SSI recipient requests assistance because his/her SSI check is lost, stolen, destroyed, or not received for other reasons, the recipient must be referred to the SSA office to report the fact. The SSA office determines whether: - the payee is in a current payment status or was at the time of the alleged non-receipt; and - the check was issued to him/her. If both these criteria are met, the Treasury Department reissues and mails the check within the following time frames: - A lost or destroyed check for the current month is reissued within fifteen (15) days of the date the check was reported lost or destroyed. - If the check was not received for unexplained reasons, SSA requires the recipient to report back after the third mailing day from the date the check was due. If it is still not received, a substitute check is issued within fifteen (15) days from the time the client notified SSA. - If the current month's check is reported stolen, it may take up to twenty-one (21) days for an investigation to be completed before a replacement check can be issued. - If a client receives a mutilated or smudged check, s/he should return it to an SSA district office. If there is enough information remaining to identify the check (i.e., check number and amount), it can be replaced by the Treasury Department within 48 hours. However, if it is not identifiable, it is processed in the same manner as a destroyed check and may take up to eighteen (18) days to be reissued. When the recipient has not been placed on the payroll because of a computer error, replacement of a check takes considerably longer. Contact with the SSA office should be made as often as necessary to determine whether the SSI check is to be issued. This helps in planning for the needs of the recipient. The above policy of the SSA office on replacement of SSI checks does not apply to advance payment checks; one-time payment checks; lost, stolen or destroyed checks that have been endorsed; or cash that is lost, stolen or destroyed. Lost or Stolen Cash When a recipient of SSI reports that s/he has lost cash or has had cash stolen, s/he must report the loss or theft to the police department before assistance can be given. S/He must also sign an affidavit (AP-55A) attesting to the fact. 0404.35.05 Authorization of Food Assistance REV:09/1988 Before any food assistance can be given to the SSI recipient, the agency staff member must verify that the following criteria have been met: - the recipient has reported to the SSA office that his/her SSI check was lost, stolen or destroyed and is participating in any requirements determined to be necessary for replacing the check; and - the recipient has signed the Affidavit, AP-55A, attesting to the above. If the above conditions have been met, and if the recipient is without food or food stamps, assistance to obtain food only may be given. The allowance is based on the standards below for the appropriate number of days that food is required for each person in the SSI plan. However: - at no time will the food allowance exceed the actual amount of the SSI check; - nor will the number of days for which food will be provided extend beyond the receipt of SSI, SSA, or any other source of income. Payment may only be made through the AP-57B authorization process. In each situation the authorization should be identified to indicate that payment is for an SSI recipient who reported a lost or stolen check or cash. DAILY STANDARDS FOR FOOD FOR SSI RECIPIENTS __________________________________________________ Group Size 1 2 3 4 ADULT $2.33 $2.14 $1.94 $1.75 __________________________________________________ 0404.40 ASSISTANCE TO ESTRANGED SSI SPOUSES REV:12/1990 Persons eligible for and receiving SSI benefits less than the appropriate GPA Standard of Need (see Section 0618), due to Federal SSI regulations which treat estranged spouses as a couple for SSI purposes until the month after the month they begin living apart are eligible for cash assistance, if they meet the financial criteria outlined in Sections 0610 and 0612. When there is an initial SSI application or an SSI reinstatement following a period of ineligibility, and the couple is not living together on the date of the application or date of request for reinstatement, the SSI regulations treat each member of the couple as an individual as of the date of the application or request regardless of how recently the separation occurred. Such individuals are not eligible for cash assistance from DHS. 0404.40.05 The Application Procedure REV:01/1991 The application process starts when a person or his/her representative contacts the agency to request assistance, and ends with either the decision by the agency to approve or to deny a payment, or the decision by the person to withdraw his/her request for assistance. A request for assistance may be received in the district office in person, by phone or by mail. The adult service worker gives, or mails, to the applicant, the application packet which includes: - Application for Assistance (MA-1) - Information for Applicants (MA-1A) The adult service worker plans for an intake appointment with the applicant. If an emergency intake is needed immediately, the adult service worker plans for the intake according to the district office system for handling emergencies. The applicant is asked to prepare the MA-1 prior to the interview. The adult service worker must witness the signature at the interview. The applicant is advised of the documentation of information required in the determination of eligibility. The applicant is also made aware that, in completing the MA-1, s/he may be helped by a relative or friend, or the adult service worker. 0404.40.10 Determining Program Eligibility REV:01/1993 When an SSI estranged spouse applies for assistance at a district office, the adult service worker: - Determines that the couple has separated in the same month or before the month the application for assistance is received; - Refers the applicant to the SSA office to notify the SSA of the change in the couple's living arrangements and to ensure the increase in the SSI payment begins the month after the separation; - Reviews the MA-1, Application for Assistance, to determine whether or not the applicant's resources are within the limits outlined in Section 0610; specifically, ownership of only one automobile with an equity value not in excess of fifteen hundred ($1,500) dollars, and liquid assets not in excess of four hundred ($400) dollars; and, - Determines if the applicant's income (Section 0612) is less than the appropriate GPA Standard of Need as outlined in Section 0618. Note that only the income and resources that are attributable to the applicant are used in the determination of eligibility. 0404.40.10.05 Examples of Program Eligibility REV:01/1994 Since most assistance to estranged spouses will be prorated for a portion of a month, beginning on the day the application is date stamped in a district office, a daily GPA Standard is calculated. This is the GPA Standard divided by thirty. EXAMPLE 1 Mr. & Mrs. H are each disabled and are receiving the SSI couple standard of $789.50 per month. Each receives a check for one-half of the couple standard or $394.75 per month. Mrs. H. leaves the home on January 12th. Mr. H. applies for the State Supplemental Payment on January 15th due to his receiving only his share of the SSI couple standard. Although it is verified that his resources are within the GPA standards, his SSI payment of $394.75 is in excess of the GPA Standard of Need and, therefore, eligibility for assistance does not exist. EXAMPLE 2 Mr. and Mrs. C. are both over 65 years of age. Mr. C. receives a partial disability pension from the Veterans Administration which reduces the SSI couple payment to $199.50 per month. Mr. C. leaves the home on March 8th, leaving Mrs. C. with her share of the SSI payment which amounts to $99.75 for the remainder of the month. She applies for assistance on March 9th. She has no resources and her income is within the prorated amount of the correct GPA Standard of Need. Therefore, eligibility for assistance exists. Computation GPA Standard $ 327.00 Mrs. C's SSI payment - 99.75 __________ Deficit $ 227.25 Counting the day the application is filed, March 9th through March 31st, there are 22 days of potential eligibility. The deficit of $227.25 divided by 30 days multiplied by 22 equals a prorated payment for the month of $166.65. 0404.40.15 Procedure for Authorizing Assistance REV:12/1990 A completed MA-1 Application is required to determine if eligibility exists. When eligibility is determined to exist, the monthly assistance payment is computed by deducting the SSI payment, plus any other countable income from the appropriate GPA Standard of Need converted to a monthly amount. The balance is then compared to the prorated share of the GPA Standard. The prorated share is calculated by multiplying the correct daily GPA Standard by the number of days for which the individual is eligible, beginning the day the application is date stamped. If eligibility for the program exists, an AP-57B is completed by the adult service worker, in accordance with the instructions outlined in Section 1220. It is especially important to correctly complete Item #15, Payment to Recipient. In this item: - Print and underline the phrase, "State Payment Only"; - Print the term, "SSI Spouse"; and - Enter the total amount of the assistance payment. If, in the month of eligibility, the recipient claims that his/her assistance payment check is not received: - An AP-59 must be completed to stop payment on the check. - To issue a replacement check, an AP-57B is completed according to the procedure outlined above. 0404.40.20 Provision of Social Services REV:12/1990 The changes in both marital and financial status may have a detrimental effect on the recipient. The adult service worker should be sensitive to these issues and be available to provide supportive and/or referral services as necessary. 0404.40.25 Termination of Assistance REV:12/1990 Starting in the month after the month of the separation, each estranged spouse is treated as an individual claimant by the SSA for SSI payment purposes. Termination of program eligibility will, therefore, occur at the end of the month of separation.