A
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Independent Living with Cooking Facilities for an Eligible individual or couple who
meets one of the following situations:
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1.
Lives in their own household, as defined for Federal living arrangement (FLA) A purposes,
and has cooking and food storage facilities, or receives meals as part of the living
arrangement;
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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;
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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;
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4.
Is a blind individual who lives in an independent living arrangement with or without
cooking and food storage facilities; or
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5.
Lives in a private medical facility licensed by the State but not certified under
Title XIX.
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B
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Non-medical Out-of-Home Care (NMOHC) applies when an individual or couple needs non-medical
care, or supervision in the following living arrangement situations:
CHILDREN (UNDER AGE 18)
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a.
Blind child residing in a State licensed NMOHC facility;
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b.
Blind child residing in the home of a relative who is not a parent and not a legal
guardian;
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c.
Disabled child residing in a State licensed NMOHC facility;
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d.
Disabled child residing in the home of a legal guardian who is not a relative;
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e.
Disabled child residing in the home of a relative who is not a parent (Major v. McMahon decision); or
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f.
A blind or disabled child in a “certified family” home approved by a licensed home-finding
agency (“certified family home placement”); or
ADULTS (AGE 18 AND OVER)
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a.
Aged, blind or disabled individual, or couple has been determined to be in FLA A and
resides in the home of a relative, legal conservator or guardian; or
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b.
Aged, blind, or disabled individual or couple is determined to be in FLA A and resides
in a State licensed NMOHC facility.
For California optional supplement (OS) purposes, a relative is defined as a parent,
child, sibling, half-sibling, parent's sibling, sibling's child, first cousin, or
any person of the preceding generation denoted by the prefix “grand” or “great.”
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C
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Independent Living Without Cooking Facilities -- Aged or disabled individual or couple
who is neither provided any meals, nor has access to adequate cooking or food storage
facilities as part of a living arrangement. Transients, as defined in SI 00835.060, are also eligible for OS C.
An individual or couple qualifies for OS C if any of the following situations exists:
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1.
Immediate living quarters do not have cooking and food storage facilities with which
the individual or couple, or another person (who is responsible for preparing their
meals) can prepare meals on a daily basis.
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2.
Does not have access to adequate cooking and food storage facilities as part of the living
arrangement (including cooking and food storage facilities that are outside the immediate
living quarters), for the preparation of meals or having meals prepared on their behalf.
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3.
Lives in a boarding house that does not have a communal kitchen with adequate cooking and food storage facilities that they
have access to for preparation of meals.
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4.
Lives with friends or relatives in private living quarters in the same house or in
separate living quarters (for example, “over the garage”) or in a similar situation
and does not have access to the cooking and food storage facilities in the main residence for preparation
of meals.
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5.
Lives in a room and board facility and does not contract with the facility to have meals prepared and provided as part of the living
arrangement (for example, the Supplemental Security Income (SSI) recipient’s arrangement
with the facility is to purchase only shelter on a monthly basis).
“Adequate” cooking and food storage facilities exist when an individual or couple
has access to:
-
•
A working refrigerator or icebox, and a stove without a working oven, but with at least two working burners. (The capacity
of the refrigerator or icebox is not a factor of consideration. Do not consider an
ice-chest as adequate storage.)
OR
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•
A working refrigerator or icebox, and a hotplate with at least two burners with separate temperature controls, or two one-burner
hotplates with temperature controls. (Do not consider hotplates that do not have temperature
controls for warming food as adequate cooking facilities.)
OR
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•
A working refrigerator or icebox, and a stove with a working oven or functioning microwave oven, in combination with at
least one working burner on a stove, or a one-burner hotplate with a temperature control.
Eligibility for OS C begins in the month the recipient applies for this supplement
rate provided they have been without cooking and food storage facilities throughout
the month.
NOTE: For purposes of OS C, “throughout a month” does not mean the recipient must lack adequate cooking or food storage facilities from the
very first moment of the month. The recipient need only lack them from some time on
the first day of the month.
If you based eligibility on temporary loss or non-functioning of an appliance, advise
the individual of their responsibility to immediately report when the temporary condition
ceases. If the individual provides an expected repair or replacement date for the
appliance, diary the case for re-contact.
Eligibility for this supplementary payment ceases the month following the month that
the recipient receives meals, or adequate cooking and food storage facilities are
available.
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For a couple, comprised of an aged or disabled individual and a blind individual,
whose living arrangement lacks adequate cooking and storage facilities, the couple
receives the SSI and State Supplement Payment level for a blind or aged, or disabled
couple, plus the restaurant meals allowance for the disabled member of the couple.
This living arrangement requires force payment.
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D
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Living in the Household of Another -- Eligible individual or couple is living in the
household of another and receives food and shelter from that individual. Most individuals or couples who are subject to a one-third
reduction of their Federal SSI payments are eligible for OS D because the criteria
for this supplement level are the same as charging the one-third reduction. However,
when the eligible individual or couple lives in the home of a relative (other than
a spouse) and needs care and supervision, you must obtain certification for non-medical
out-of-home care (OS F) from the county welfare office since this is the highest categorical
supplement for which an individual or couple can qualify.
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E
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Disabled Child Under Age 18 – Disabled (not blind) child under age 18 who resides
with a parent or relative by blood or marriage.
NOTE: Only FLA A and C are compatible with OS E. If the value of the one-third reduction
(VTR) applies, see code G in this section.
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F
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Non-medical Out-of-Home Care Living in the Household of Another -- Applies whenever
an eligible individual or couple meets the criteria for the non-medical out-of-home
care payment rate, and is determined to receive the Federal code B payment for living
in the household of another. For the One-Third Reduction Provision see SI 00835.200.
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G
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Disabled Child Under Age 18 Living in the Household of Another -- 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 code B payment for living in the household of
another individual. For the One-Third Reduction Provision, see SI 00835.200.
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J
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Residents of Title XIX facilities.
Use this State code to supplement Section 1619 cases.
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Y
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Optional Supplementation Waived -- Individual is eligible for, but waives the right
to receive an optional supplement.
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Z
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No Supplement Cases -- Eligible recipient who is a patient:
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1.
In a medical facility where Title XIX pays more than 50 percent of the costs; or
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2.
In a private medical facility not certified under Title XIX, and not licensed by the
State.
Includes residents of publicly operated emergency shelters throughout a month.
NOTE: California is a concurrent category State, and permits SSI recipients to receive the
highest categorical supplement for which they can qualify.
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