Independent Living with Cooking Facilities — Eligible individual or couple who:

1. 1. 

   Lives in their own household, as defined for Federal living arrangement “A” purposes, and has cooking and food storage facilities or is provided meals as part of the living arrangement; or

2. 2. 

   Is a patient in a certified private medical facility where title XIX does not pay more than 50 percent of the cost of care; or

3. 3. 

   Is a blind child under age 18 living in the household of a parent or parents or is a disabled child age 18 or over who meets sharing criteria and is living in the household of a parent or parents; or

4. 4. 

   Is a blind individual who lives in an independent living arrangement with or without cooking and food storage facilities; or

5. 5. 

   Effective July 1, 1983, lives in a private medical facility licensed by the State but not certified under title XIX. (An optional supplement “A” payment based on the new instructions is payable retroactively to July 1, 1983.)

1. 3. 

   Eligibility for OS C begins in the month the applicant/recipient applies for this supplement rate provided he/she has been without cooking and food storage facilities throughout the month.

   For purposes of OS C, “throughout a month” does not mean the applicant/recipient must lack adequate cooking/food storage facilities from the very first moment of the month. They need only lack them from some time on the first day of the month.

2. 4. 

   If eligibility is based on temporary loss or nonfunctioning of an appliance, the individual should be advised of Their responsibility to report immediately when the temporary condition has ceased. If the individual provides an expected date when the appliance will be replaced/repaired, diary the case for recontact.

3. 5. 

   Eligibility for this supplement payment ceases the month following the month in which meals are provided or adequate cooking and food storage facilities are available.

4. 6. 

   For a couple, comprised of an aged/disabled individual and a blind individual, whose living arrangement lacks adequate cooking and storage facilities, the couple is to receive the SSI/SSP level for a blind/aged or disabled couple plus the restaurant meals allowance for the disabled member of the couple. Force payment in this living arrangement is required.

Living in the Household of Another — Eligible individual/couple is living in the household of another and is receiving food and shelter from that individual. Most individuals/couples who are subject to a 1/3 reduction of their Federal SSI payments (VTR) are eligible for OS D because the criteria for this supplement level are the same as for charging the VTR. However, when the eligible individual/couple lives in the home of a relative (other than a spouse) and needs care and supervision, certification for nonmedical out-of-home care (OS F) should be obtained from the county welfare office since this is the highest categorical supplement for which an individual/couple can qualify.

Disabled Child Under Age 18 — Disabled (not blind) child under age 18 who resides with a parent or relative by blood or marriage. (Until September 30, 1979, a disabled child under age 18 living with a legal guardian also fell into this category.)

Nonmedical Out-of-Home Care Living in the Household of Another — Effective February 1, 1982. Applies whenever an eligible individual or couple meets the criteria for the nonmedical out-of-home care payment rate, and is determined to receive the Federal B payment for living in the household of another (SI 00835.200).

Disabled Child Under Age 18 Living in the Household of Another — Effective February 1, 1982. Applies to a disabled (not blind) child under age 18, who resides with a parent or relative by blood or marriage, and is determined to receive the Federal B payment for living in the household of another individual (SI 00835.200).

Optional Supplementation Waived — Individual is eligible for, but has waived their right to receive, an optional supplement.

No Supplement Cases — Eligible individual or couple who is a patient:

1. 1. 

   In a medical facility where title XIX pays more than 50 percent of the costs; or

2. 2. 

   In a private medical facility which is not certified under title XIX and not licensed by the State (effective July 1, 1983). (Prior to July 1, 1983, the facility could have been licensed by the State but not certified under title XIX.)

Includes residents of publicly operated emergency shelters throughout a month.

86.00

30.00

60.00

70.00

70.00

140.00

Independent Living — Eligible individual or couple who:

• •

  Lives in their own household as defined for Federal living arrangement A purposes. This includes living in a “half-way house,” which is a private nonmedical facility with whom the State has a purchase or services agreement for the short term care of certain needy individuals; or

• •

  Is a patient in a certified private medical facility where title XIX does not pay more than 50 percent of the cost of care; or

• •

  Is a blind or disabled child under age 18 (or age 21 if the individual qualifies as a “protected child”) living in the household of a parent or parents.

Optional supplement code A is the proper code to be used with an “intervening” Federal A code. (See SM 01301.535.)

This State code is also used to supplement Section 1619 cases.

Living in the Household of Another — Effective July 1, 1983, a supplement is no longer payable because the combined Federal/State supplementary payment level established by the State is lower than the FBR.

Domiciliary Care I — (Maximum of five residents) - Eligible individual (including a child) or couple living in a domiciliary care facility which provides varying levels of care and services. A domiciliary care facility is a private, nonmedical facility established and maintained to provide personal care and services to aged, infirm, or handicapped persons. The State provides SSA with listings of these facilities.

Domiciliary Care II — Same as H except care is provided for six or more residents.

Optional Supplementation Waived — Eligible for, but has waived his/her right to receive, an optional supplement.

No Supplement Cases — Eligible individual (or couple) who is living in the household of another (see explanation in definition for optional supplement B) and an eligible individual (or couple) who is a patient:

1. 1. 

   In a medical facility where title XIX pays more than 50 percent of the costs; or

2. 2. 

   In a private medical facility which is not certified under title XIX.

Also includes residents of publicly operated emergency shelters throughout a month.

30.00

60.00

30.00

Full Cost-of-Living:

1. 1. 

   An individual who is in Federal living arrangement A is in State living arrangement A, if they are living in their own household¹ and are:

   1. a. 

      Living alone — Individuals who live alone, who rent rooms in commercial rooming houses which openly advertise to the public and which do not provide board, or who live in a hotel. Also, those who rent only rooms in private residences will be considered living alone provided they do not use the residential kitchen facilities for preparation of meals; or

   2. b. 

      Living only with their eligible spouse; or

   3. c. 

      Living with their eligible spouse and ineligible child/children ² none of whom (children) receive public income maintenance
      
      payments; ³ or

   4. d. 

      Living only with their ineligible spouse and/or their ineligible child/children, none of whom (spouse and children) receive public income maintenance payments.

   NOTE: For purposes of a. through d. above, foster children placed with anyone other than their parents are not considered to be living with the foster parent.

2. 2. 

   An individual who is in Federal living arrangement C is in State living arrangement A if none of the other people with whom he/she is living receive public income maintenance payments.

3. 3. 

   An individual who is in Federal living arrangement A or C and who does not meet the criteria contained in 1. or 2. above will be in State living arrangement A if he/she pays at least two-thirds of the household expenses. In making a determination as to whether the individual pays two-thirds or more of the expenses, use the method defined in
   
   SI 00835.160. Only the household expenses shown in that section are to be used. An ineligible spouse's income (except any assistance based upon need) may be used to determine if the eligible person is paying two-thirds of the household expenses.

4. 4. 

   A person living in a public congregate housing development is in A. The State makes the determination that a public congregate housing development is eligible for listing.

   Optional supplement code A is the proper code to be used with an “intervening” Federal A code. (See SM 01301.535.)

Independent Living or Living in Parental Household — Aged or blind eligible individual or couple who:

1. 1. 

   Lives in his/her own household as defined for Federal living arrangement A purposes; or

2. 2. 

   Is a patient in a certified private medical facility where title XIX does not pay more than 50 percent of the cost of care; or

3. 3. 

   Is a blind child under age 18 (age 21 for individuals who qualify as a “protected child”) living in a parent's household.

Used with an “intervening” Federal A code. (See SM 01301.535.)

1. 1. 

   Disabled eligible individuals or disabled members of eligible couples; or

2. 2. 

   Eligible individuals or members of eligible couples in a medical facility where title XIX pays more than 50 percent of the cost; or

3. 3. 

   Eligible individuals or members of eligible couples who are patients in a private medical facility which is not certified under title XIX; or

4. 4. 

   Residents of publicly operated emergency shelters throughout a month.

30.00

60.00

Likewise, any child meeting the criteria for a Federal code C will automatically be entitled to optional supplement B.

This category includes, but is not limited to, those eligible adults/couples who are:

1. 1. 

   Living physically alone; or

2. 2. 

   Living with others in a private dwelling, but meeting some criteria for Federal living arrangement A; or

1. 3. 

   Living in the Transitional Residency Program when the placement is through the Division of Mental Health and Hospitals, Department of Human Services

Optional supplement code B is the proper code to be used with an “intervening” Federal A code. (See SM 01301.535.)

This State code is also used to supplement Section 1619 cases.

Living Alone with an Ineligible Spouse — Used when an individual lives with their ineligible spouse and there are no other persons who are part of the household. An ineligible spouse for State supplementation purposes is determined by using Federal criteria; i.e., a spouse, either by marriage or holding out who is either not eligible for SSI or who chooses not to apply. The State uses this category to ensure that an individual with an ineligible spouse will receive the same total payment as an eligible couple or an individual with an EP. Once other persons, even minor children, are present in the household, this supplementary payment variation cannot exist. However, it is possible that a claimant and their ineligible spouse live with others and allege that they are a separate “household” by virtue of the fact that they eat their meals out or have separate purchase and preparation of food. In this instance, an optional supplement C is permissible as long as no other person is in their “household.” There is no couple counterpart in this category.

35.00

70.00

30.00

60.00

50.00

100.00

40.00

80.00

30.00

This arrangement does not cover:

1. 1. 

   Institutional Living — Regardless of whether custodial care is needed in addition to the medical, training, rehabilitation, educational or similar services as the primary function of the institution.

2. 2. 

   A person whose Federal living arrangement is based on home ownership or rental liability. (A flat fee for room and board per SI 00835.120B. is not considered as rental liability for this arrangement.)

3. 3. 

   A child under l8 years of age not placed by a Vermont Community Mental Health Agency or the Vermont Department of Mental Health.

4. 4. 

   Custodial care or supervision provided by a spouse (as defined by Federal regulations).

5. 5. 

   Any home or boarding arrangement which does not meet the Federal (SSI) definition of independent living, Federal code A.

47.25

94.50

90.00

Living Alone — Recipients who are “living in own household” under title XVI. If an eligible individual/couple is determined to be living in own household (Federal living arrangement A) for title XVI, the eligible individual /couple will usually be in a living alone arrangement for State supplementation purposes.

This variation includes:

• •

  Eligible individuals or eligible couples living in private households, whether they are renting, buying, own their home, or have an interest in the home (e.g., a life estate). The household may be in a house, room, college dormitory, apartment, hotel, motel, etc.

• •

  Eligible individuals or eligible couples living in board and room situations. This includes commercial, benevolent, religious, or fraternal board and room accommodations.

• •

  Eligible individuals or eligible couples residing in homes approved as congregate care facilities (group homes).

• •

  Eligible individuals or eligible couples residing in publicly operated community-based residences of 16 or fewer beds.

• •

  Eligible individuals and eligible couples residing in adult family homes. Adult family homes are homes that provide board, room, laundry. They may also provide necessary supervision, personal and social services, and, when appropriate, a minimum of nursing care, and are approved for payment and licensed by the State Department of Social and Health Services.

• •

  An eligible individual living with an ineligible spouse when natural, step, adoptive or foster children under age 18 whose needs are included in determining an AFDC grant are residing in the same household. In these cases we assume that the ineligible spouse's income has been considered in determining the AFDC payment unless the couple is living in a holding-out relationship. (Where the holding-out spouse has income, the local Department of Social and Health Services office must be contacted to determine whether that income has been considered in an AFDC payment.) This variation does not include an eligible individual living with an ineligible spouse and grandchildren under age 18 whose needs are included in determining an AFDC grant.

• •

  A child in a Federal code A or C living arrangement.

Optional supplement code A is the proper code to be used with an “intervening” Federal A code. (See SM 01301.535.)

Exceptions

Optional supplement A is not paid when:

1. a. 

   An individual is living in a medical care facility throughout an entire calendar month;

1. b. 

   An eligible individual has more than one EP;

2. c. 

   An eligible couple has one or more EP's; and

3. d. 

   An eligible individual or couple is residing in a public emergency shelter for the homeless (effective 5/83).

Living Alone with an Ineligible Spouse — Eligible individual who is the head of the household and who lives alone as described in A above and is living with an ineligible spouse. An ineligible spouse is a spouse who has either not applied for SSI benefits, has been denied or terminated, or has withdrawn their application. It is not material whether the ineligible spouse is aged, blind, or disabled. An ineligible spouse includes:

• •

  Legally married and common law spouses;

• •

  “Holding-out” spouses;

• •

  Alien spouses not lawfully admitted to the U.S., and

• •

  Refugee spouses receiving payments.

•  

  NOTE: Refugee payments are not deemable to the eligible individual.

In determining whether an ineligible spouse is a member of the household for the purpose of paying the optional supplement B to the eligible individual, use the same rules for making Federal determinations. If an eligible individual marries, or a separated spouse returns home, the ineligible spouse supplement is paid beginning with the month after the month of the arrival of the ineligible spouse in the household.

Exceptions

Optional supplement B is not paid when: (1) an individual with an ineligible spouse also has child(ren) under the age of 18 whose needs are considered in determining an AFDC grant. Rather, the optional supplement A is paid. This is true whether or not the ineligible spouse is actually included on the AFDC grant; (2) an eligible individual resides in a public emergency shelter for the homeless (effective 5/83). In this case, use optional supplementation code Z.

• •

  An individual with more than one EP.

• •

  A couple with one or more EP's.

• •

  Individuals residing in a medical facility throughout a month, regardless of whether private or public, or if Medicaid is involved in reimbursement for the cost of the care. (If only one member of an eligible couple is in a medical facility, determine the optional supplement variation that applies to the other member separately.) The term “medical facility” includes hospitals, nursing homes, and extended care facilities, but does not include boarding schools, congregate care facilities, and half-way houses.

• •

  Residents of publicly operated emergency shelters throughout a month, effective May 1983.