SI SF01415.180 California Optional State Supplement (OSS) Y – OSS Waived and Z – No State Supplementation (RTN 01, 05/2015)
A. OSS Y - OSS Waived
OSS Y applies when a recipient is eligible for state supplementation, but waives the right to receive it.
Mr. Stackhouse does not want to receive state supplementation and signs a statement waiving his right to receive it. The FO explains to him that he will only remain eligible for SSI in California as long as his countable income does not equal or exceed the Federal Benefit Rate (FBR). In addition, the FO explains that waiving state supplementation will not affect Medi-Cal eligibility as long as he remains federally-eligible for SSI and that he will not become eligible for the Supplemental Nutrition Assistance Program (SNAP). Mr. Stackhouse acknowledges that he understands, but still wishes to waive receipt of state supplementation.
He currently lives alone and is in Federal living arrangement (FLA) A. Beginning with the month he chooses to no longer receive state supplementation, his living arrangement is FLA A/OSS Y.
B. OSS Z - No State Supplementation
California does not pay a supplement to an eligible individual who is:
effective July 1, 1983, a patient in a private medical facility which is not licensed as a skilled nursing facility by the Licensing and Certification District Office of the California Department of Public Health and is not certified for Title XIX by the Department of Health Care Services
prior to July 1, 1983, a patient in a private medical facility which is not certified for Title XIX
effective December 1. 1996, a child under age 18 in FLA D based on residence in a public facility paid by private insurance
a resident of a publicly-operated emergency shelter (see SI 00520.500 Residents of Public Emergency Shelters for the Homeless)
Peony Alsace, age 10, is an inpatient in a State hospital and is expected to be hospitalized for at least six months. Her parents’ private medical insurance pays the full cost of care so she is subject to the $30 payment limit and is in FLA D. The policy in SI 00520.011C.6. applies, which states that children subject to the $30 payment limit because of private health insurance payments will receive the OSS amount that would apply to them if they were not subject to the $30 payment limit. Peony would have been in an N02 payment status based on residence in a public institution if she was not subject to the $30 payment limit. Therefore, no OSS is payable. Her living arrangement is FLA D/OSS Z.