SI SF01415.300 Nevada Optional State Supplementation (BASIC 06/2014)
Nevada provides additional payments in supplementation to the basic Federal SSI payment.
An SSI recipient in Nevada may receive either a mandatory or optional supplement depending
on individual circumstances. By agreement, SSA administers both mandatory and optional
state supplementation payments for Nevada.
The provision for mandatory supplementation requires that states provide a supplement
to maintain converted individuals/couples at their December 1973 income levels. This
was mandated to assure that no one would be reduced in income as a result of the federalization
of state welfare programs in 1974. (SI 01401.001B.4, SI 01403.001B.4, and SI 02005.082)
The mandatory level is designated Minimum Income Level (MIL) and is retained until
the converted recipient dies or is no longer blind or disabled. Optional State Supplement
(OSS) payment levels are usually higher than MILs, so most recipients in Nevada receive
payments based on optional supplement payment levels.
Nevada provides supplementation for three living arrangement variations:
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1.
Independent Living or Living in Parental Household
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2.
Living in the Household of another
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NOTE: See SI SF01415.300E. for instances where no Nevada state supplementation is paid.
A. Optional State Supplement (OSS) A – independent living or living in parental household
OSS A is paid to an aged or blind eligible individual, eligible couple, or member
of an eligible couple who:
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a.
lives in own household as defined for Federal Living Arrangement (FLA) “A” purposes;
or
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b.
is a patient in a certified private medical facility where Medicaid does not pay more than 50% of the cost of care; or
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c.
is a blind child under age 18 (age 21 for individuals who qualify as a “protected
child”) living in a parent(s) household.
2. Development and documentation
Absent evidence to the contrary, an aged or blind individual, eligible couple, or
member of an eligible couple determined to be in FLA A or a blind child in FLA C will
be determined to eligible for OSS A.
B. Optional State Supplement (OSS) B – living in the household of another
OSS B applies when an aged or blind individual, eligible couple, or member of an eligible
couple is living in the household of another and is receiving food and shelter from
within the household. Aged or blind individuals, eligible couples, or members of an
eligible couple who are subject to the 1/3 reduction (VTR) of the Federal SSI payment
are eligible for OSS B because the criteria for the supplement are the same as for
FLA B.
C. Optional State Supplement (OSS) C – domiciliary care
OSS C applies when an aged or blind eligible individual, eligible couple, or member
of an eligible couple lives in a private non-medical facility or, as of 10/76, a public
non-medical institution serving 16 or fewer persons, which provides personal care
and services to aged or disabled handicapped adults who are unrelated to the proprietor.
These facilities are licensed or authorized to receive payment by the State of Nevada.
2. Development and documentation
An individual verified to be in a domiciliary care facility is automatically entitled
to OSS C. Document in MSSICS or on a SSA-5002 stored in the Claims File User Interface
(CFUI) to show:
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a.
The facility is licensed for domiciliary care (verified with the Nevada Department
of Health and Human Services facility website). If not completed previously, prepare an SSA-8045 Facility Determination and record the licensing information.
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b.
The date the individual entered the facility (verified with the facility).
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c.
The expected release date, if any (verified with the facility).
D. Optional State Supplement (OSS) Y - OSS waived
OSS Y applies when an individual is eligible for state supplementation, but waives
the right to receive it.
E. Optional State Supplement (OSS) Z – No State supplementation
No Nevada state supplementation is paid to:
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1.
Disabled individuals or disabled members of a couple
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2.
Individuals residing in a medical facility where Title XIX (Medicaid) pays more than
50% of the cost of care
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3.
Individuals residing in a private medical facility not certified under Title XIX (Medicaid)
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4.
Individuals residing in a Public Emergency Shelter for the Homeless (PESH)