Effective Dates: 07/30/2014 - Present Previous | Next

SI SF01415.210 Hawaii Optional State Supplementation – Current Living Arrangements (BASIC 07/2014)

A. Optional State Supplement (OSS) B – Community Care Foster Family Home (effective 1/2003)

1. General

Effective 1/2003, Hawaii pays Optional State supplement B to adults living in a Community Care Foster Family Home (CCFFH).

2. Development and Documentation

The Hawaii Department of Health (DOH) is responsible for certification of each CCFFH and placement of individuals in the foster homes (prior to July 2014, the Department of Human Services was responsible for certification). Each individual placed in a CCFFH has a case manager who is responsible for sending the certification to the SSA field office.

For cases in which the individual alleges living in a CCFFH, but SSA has not received certification, the field office should contact the case manager.

B. Optional State Supplement (OSS) D - Resident of a Public or Private Institution with Title XIX (Medicaid) paying more than 50 percent of the cost of care (effective 1/2008)

See SI 00520.011 Determination of Applicability of $30 Payment Limit

   

Hawaii pays OSS D to:

  • •

    a resident of a public or private institution where Title XIX is paying more than 50 percent of the cost of care

  • •

    a resident of a public or private institution where Medicare Part A pays or is expected to pay over 50 percent of the cost of care for that month and the Part A coverage was purchased for the recipient under a State plan approved under Title XIX of the Social Security Act (i.e., “State buy-in”).

Confinement for medical treatment must always be developed and documented following SI 00520.011.

C. Optional State Supplement (OSS) H – Domiciliary Care I (fewer than 6 residents) and Optional State Supplement (OSS) I – Domiciliary Care II (six or more residents)

1. General

OSS H and I apply when an eligible individual (including a child) is living in a domiciliary care facility that provides varying levels of care and services. A domiciliary care facility is a private non-medical facility established and maintained to provide personal care and services to aged or disabled persons. Hawaii has established two levels of supplementation based on the level of care as defined by the State.

2. Development and Documentation

The Hawaii Department of Human Services (DHS) is responsible for certification of domiciliary care. Each individual placed in domiciliary care has a case manager who is responsible for sending the certification to DHS, who is then responsible for sending it to the SSA field office.

For cases in which the individual alleges living in domiciliary care, but SSA has not received certification, the field office should contact either the case manager or DHS. Contact the individual case manager for other needed information.

D. Optional State Supplement (OSS) Y- OSS Waived

OSS Y applies when a recipient is eligible for state supplementation, but waives the right to receive it.

E. Optional State Supplement (OSS) Z – No State Supplementation

Hawaii pays no supplement to an eligible individual who is:

  • •

    a patient in a private medical facility which is not certified for Title XIX; or

  • •

    effective January 1, 1996, a child under age 18 in FLA D based on residence in a medical treatment facility paid by private insurance

  • •

    prior to January 1, 2008, a resident of a public or private institution where Title XIX is paying more than 50 percent of the cost of care

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0501415210SF
SI SF01415.210 - Hawaii Optional State Supplementation – Current Living Arrangements (BASIC 07/2014) - 07/30/2014
Batch run: 04/21/2023
Rev:07/30/2014