PROGRAM OPERATIONS MANUAL SYSTEMPart SI – Supplemental Security IncomeChapter 008 – IncomeSubchapter 35 – Living Arrangements and In-Kind Support and MaintenanceTransmittal No. 124, 09/24/2024
Audience
Originating Component
OISP
Effective Date
Upon Receipt
Background
The POMS has been updated to reflect a regulatory change that revises the definition of a public assistance (PA) household from a household in which every member receives some kind of public income-maintenance (PIM) payment to a household that has both an SSI applicant or recipient, and at least one other household member who receives one or more of the listed PIM payments (the any other definition) in this section. In addition, the Supplemental Nutrition Assistance Program (SNAP) has been added to the list of PA household programs, effective 09/30/2024. This update is part of a simplification project that affects living arrangement policy.
Summary of Changes
SI 00835.130 Public Assistance Households
Throughout the document the format of the titles and subtitles have been updated, per PolicyNet instructions.
Subsection A - added a "NOTE" with the effective date and the addition of SNAP to the list of PA household programs. Also added a "NOTE" stating that PIM payments also refer to PA payments in this section.
Subsection B - updated the definition of a PA household with "effective" and "prior to" language.
Subsection C - updated with subsection B information by adding the list of PA programs, which includes SNAP.
Subsection D - updated with subsection C information. Also, added a "NOTE" regarding the effects of a PA household determination and added examples.
Subsection E - added an effective date chart for determining the existence of a PA household; and updated examples to include language that reflects the regulatory change.
Subsection F - updated with subsection E chart information; and updated language for determining the existence of a PA household prior to 09/30/2024.
Subsection G - updated the documentation instructions to reflect the regulatory change.
Subsection G.3. - updated subsection with system coding info to reflect non-MSSICS cases.
Subsection H - updated with subsection F information (new reference section).
Use this section in both initial claims and post-eligibility situations when an individual alleges being a member of a public assistance (PA) household and:
PA household is the highest applicable Living Arrangement (LA) basis in the prescribed sequence of development in SI 00835.001B; or
you established an LA basis at a level higher in the prescribed sequence of development, but the existence of a PA household will eliminate development for inside in-kind support and maintenance (ISM).
NOTE:
Effective 09/30/2024, the Supplemental Nutrition Assistance Program (SNAP) is included as a public income-maintenance (PIM) program for purposes of the PA household policy.
PIM payments are also referred to as "PA payments" in this section.
A PA household is defined as:
Effective 09/30/2024, one that has both a Supplemental Security Income (SSI) applicant or recipient, and at least one other household member who receives one or more of the listed PA payments.
Prior to 09/30/2024, one in which every member of the household received a PA payment.
Prior to 09/30/2024, a SNAP benefit was not included as a PA payment.
PIM payments (or PA payments) are payments made under:
Title IV-A of the Social Security Act—Aid to Families with Dependent Children (AFDC) and Temporary Assistance for Needy Families (TANF) (For AFDC see SI 00830.400 and for TANF see SI 00830.403);
Title XVI of the Social Security Act (SSI, including federally administered State supplements and State administered mandatory supplements);
The Refugee Act of 1980 (payments based on need) (SI 00830.645);
The Disaster Relief and Emergency Assistance Act (SI 00830.620);
General assistance programs of the Bureau of Indian Affairs (SI 00830.800);
State or local government assistance programs based on need (SI 00830.175);
U.S. Department of Veterans Affairs programs (payments based on need) (SI 00830.300); or
Effective only as of 09/30/2024 - The Supplemental Nutrition Assistance Program (SNAP) (SI 01801.005).
We assume that an applicant or recipient who lives in a PA household does not receive any ISM from other household members. Therefore, an SSI applicant or recipient who lives in a PA household cannot be subject to the Value of the One-Third Reduction (VTR) rule (see SI 00835.200). If the household receives outside ISM, or if the SSI applicant or recipient receives ISM from a source outside the household, the ISM is subject to valuation under the Presumed Maximum Value (PMV) rule (see SI 00835.300).
For purposes of this section, receipt of PA payments means that an individual:
receives a payment from, or has a vendor payment made by, a program listed in SI 00835.130C.1., in this section. (NOTE: SNAP Benefits are only considered PA payments effective 09/30/2024); or
is in the current payment cycle of a program listed in SI 00835.130C.1., (NOTE: SNAP benefits are only considered PA payments effective 09/30/2024). This applies even if a PA program's regular payment is less frequent than monthly (e.g., it pays quarterly or semiannually); or
has an initial SSI claim pending and meets all the non-disability eligibility requirements in the month for which an LA/ISM determination is being made.
The effective month of change for a household that meets the PA household criteria is the month when the change occurs. In contrast, when a household no longer meets the PA household criteria, the change is effective the following month. See SI 00835.510
The SSI Claims System will calculate the correct effective month when the change date is documented on the Living Arrangement Change page (MS 08110.016):
For example, on 09/30/2024, an SSI recipient starts living in a PA household; the change is effective 09/01/2024.
For example, on 10/15/2024, the household no longer meets the PA household criteria; the change is effective 11/01/2024.
is found ineligible for PA payments received over a retroactive period
is eligible on a current basis
continues to exist.
is also ineligible for current PA payments
no longer exists beginning the month after the PA payment stops.
This applies only if no other household member receives a PA payment (other than the SSI applicant or recipient). If a least one other member of the household is receiving a PA payment (other than the SSI applicant or recipient), then the household is still considered a PA household. Thus, further development would be needed in these situations to ensure that no other household member is receiving a PA payment before finding that the household no longer qualifies as a PA household.
has not received PA payments
is awaiting a decision on a non-SSI PA claim
does not exist.
is awaiting a decision on an SSI claim or an initial SSI payment
(This includes pending disability appeal cases.)
does exist.
EXAMPLE: Lisa files for SSI aged benefits on 10/15/2024. Lisa’s only roommate Karen filed an SSI disability claim on 07/12/2024. As of 10/2024, the month for which an LA/ISM determination is needed for Lisa, Karen has an initial claim pending and meets all non-disability requirements. Therefore, PA household status exists as of 10/2024.
If Karen's claim were denied, and she appealed, her claim would still be considered pending during the appeal period; and a PA household status still exists unless and until her appeal is denied. If the appeal is ultimately denied, and if there were no other household members receiving a PA payment, Lisa's PA household status would end the month after Karen's appeal is denied.
no longer exists beginning the month after the disability determination is made.
This applies only if no other household member receives a PA payment (other than the SSI applicant or recipient). If at least one other member of the household is receiving a PA payment (other than the SSI applicant or recipient), then the household is still considered a PA household. Thus, further development would be needed in these situations, to ensure that no other household member receives a PA payment before finding that the household no longer qualifies as a PA household.
EXAMPLE 1: Mike and Carl live together and have no additional household members. In 10/2024, Mike applies for SSI aged benefits and Carl applies for SSI disability benefits. Both meet the non-disability criteria in 10/2024 and a PA household exists. Mike begins receiving benefits in 11/2024. On 12/04/2024, Carl is determined not to be disabled, and receives no other PA payments. Because the household no longer has at least one other member receiving a PA payment, it is no longer a PA household beginning the following month. The living arrangement change date is input for 12/04/2024, and Mike is no longer in a PA household beginning 01/2025. (See SI 00835.510B.4.)
EXAMPLE 2: Continuing Example 1, Sam moves in with Mike and Carl on 02/15/2025. Sam is an eligible SSI recipient. Because the household now has at least one other member who is receiving a PA payment, it is a PA household. The living arrangement change date is input for 02/15/2025, which makes this a PA household as of 02/01/2025. (SI 00835.510B.4.)
exists if an initial SSI claim is pending and all non-disability requirements are met in the month for which an LA/ISM determination is being made.
EXAMPLE: Sarah files for SSI aged benefits on 02/15/2024. Sarah is determined to be eligible for payments beginning with 03/01/2024. Sarah's only roommate, Jenny, filed an SSI disability claim on 11/12/2023. As of 02/2024, the month for which an LA/ISM determination is needed for Sarah, Jenny has an initial claim pending and meets all non-disability requirements. Therefore, PA household status exists as of 02/2024.
no longer exists for any other SSI member of the household beginning the month after the disability determination is made.
EXAMPLE 1: Mike and Carl, who live in a household by themselves, file for SSI benefits in 5/2023 on the basis of age and disability, respectively. Both meet the non-disability criteria in 05/2023, and a PA household exists. Mike receives his first SSI check in 06/2023 for SSI aged benefits. In 08/2023, Carl is determined not to be disabled and his claim for SSI disability is denied. Carl does not appeal that decision. Therefore, Mike is no longer in a PA household beginning 09/2023.
Prior to 9/30/2024, if a member of an otherwise all-PA household is a child who does not receive AFDC or TANF because of a payment cap, see SI 00835.340B.2.b.
Effective 09/30/2024, if there is only one SSI applicant or recipient in the household, document the file for each month in question, to substantiate receipt of one or more PA payments by at least one household member other than the SSI applicant or recipient. Claims Specialist should consider any available evidence or combination of evidence that reflects the individual's name, type of public assistance, and period of eligibility. Such evidence may take the form of, for example, an award letter or a Report of Contact page with the paying agency.
Prior to 09/30/2024, you must document that every member of the household receives a PA payment (other than the SSI applicant, who must meet all of the non-disability eligibility requirements) to establish a PA household.
Record the applicant's or recipient's statement on a Report of Contact page. For non-MSSICS cases use a signed SSA-5002 (Report of Contact) paper form and fax into the Evidence Portal (EP).
Effective 09/30/2024:
First, check whether there is a household member (other than the SSI individual whose claim is under consideration) who is an SSI recipient. If there is, then a PA household exists for the SSI individual whose claim is under consideration. Document the file accordingly for the month an LA/ISM determination is being made, and do not proceed to the second step.
Second, check whether there is a household member (other than the SSI individual whose claim is under consideration) who is an SSI applicant and meets all the non-disability eligibility requirements. If there is, then a PA household exists for the SSI individual whose claim is under consideration. Document the file accordingly for the month an LA/ISM determination is being made, and do not proceed to the third step.
Third, if neither of the above applies, follow the instructions in section G.1.a., and develop whether there is a household member (other than the SSI individual whose claim is under consideration) who is receiving a PIM payment other than SSI.
Prior to 09/30/2024, you must verify and document that each household member receives a PA payment. If any household members are SSI applicants (and receive no other PA payments), you must verify and document that each SSI applicant has a pending SSI claim and meets all of the non-disability eligibility requirements
Develop the existence of a PA household, per SI 00835.130G.1., in this section, only if:
an individual alleges a PA household has come into existence; or
an individual alleges a change in household composition involving a household member who receives PA payments described in SI 00835.130C.1., (i.e., the household member moves out, payments stop, or their SSI application is denied) (see b. below if the only change is that someone moved out); or
there is a material discrepancy between the individual's allegation and information in the file or on the SSR.
If the only alleged change is that a member of the PA household has moved out, and:
effective 09/30/2024, there is an SSI applicant or recipient and at least one other household member who continues to receive a PA payment (or there is at least one other household member with a pending SSI application who meets all of the non-disability criteria), then determine that a PA household still exists. No further development of inside ISM is required.
prior to 09/30/2024, all remaining members of the household continue to receive PA payments (or have SSI claims pending and meet all of the non-disability criteria), then determine that a PA household still exists.
For cases that are excluded from the SSI Claims System (CCE/MSSICS), code a CG entry of “LA22” if you establish existence of a PA household. (See SM 01005.525 and SM 01301.785.)
SI 00830.165 - Assistance Programs With Governmental Involvement - General
SI 01320.640 - Multiple Deeming Situations — Operating Procedures