TN 3 (11-96)

SI 01410.030 Policy for Determining the State and County of Residence

A. Definitions - Capable or Incapable of Stating Intent

The following definitions of capability and incapability apply to determining the state and county of residence.

1. Capable Individual

For residency purposes, a capable individual is one who is legally (i.e., under State law) able to indicate an intent to remain in a location permanently or for an indefinite period. Capability of handling funds is not relevant to the decision whether an individual is capable of indicating an intent regarding residence.

2. Incapable Individual

An individual who is not capable is one who is not legally able to indicate an intent regarding residence.

a. Adults

Adults who are not capable of indicating intent are those who have:

  • an IQ of 49 or less; or

  • a mental age of 7 years or less based on tests acceptable to the intellectual disability agency of the State; or

  • been judged legally incompetent; or

  • been found incapable of indicating intent based on medical documentation obtained from a physician, psychologist or other person licensed by the State in the field of intellectual disability.

b. Child

An individual who is a child for SSI purposes (SI 00501.010) is incapable of stating intent.

A child who is emancipated is considered capable of indicating intent (see D. below). A child is emancipated when the parents surrender their rights to the care, custody and earnings of the child and renounce parental duties in accordance with State law.

Because emancipation affects more than the residency decision, it is usually addressed for other purposes (such as representative payee development) before residency in routine application and posteligibility logic paths.

B. Policy - State/County Actions

The following guidelines apply to state/county action.

1. Placement

An individual who is placed in an institution in another State or county by a jurisdiction (or an agency working under contract with the jurisdiction) retains the residence of the placing jurisdiction regardless of capability until release. Upon release, if the individual is eligible for payment, SSA redetermines the State and county of residence.

Exception: An individual receiving title IV-E payments (foster care, adoption assistance, or kinship guardianship assistance) has been placed by a jurisdiction or an agent of the jurisdiction. Nonetheless, the State/county of residence is where the individual lives. States may opt to make title IV-E payments to individuals up to age 21.

EXAMPLE: A capable SSI recipient who is a Montana resident contracts AIDS. Montana Medicaid sends the individual to a hospital in Utah for treatment. Two months later, when the individual is released from the hospital, he decides to remain in Utah. He tells the SSA FO that he intends to remain permanently in Utah, and files an application for Medicaid with the State of Utah. The State of residence was Montana through the end of the month in which the recipient told SSA he wished to be a Utah resident.

2. SSP

The residence decision for Medicaid purposes flows from the jurisdiction paying SSP (if any). When an individual receives only State-administered SSP and subsequently applies for SSI or completes a redetermination following a suspension, SSA will accept the residence determination that led to the State-administered SSP allowance for Medicaid eligibility purposes. When FOs take an SSI application or redetermination from an individual who is receiving only a State-administered supplement, they should use the State which has been paying SSP as the State of residence for Medicaid purposes. If the State does not provide SSP, but provides Medicaid, use the State that provides Medicaid as the State of residence. The claimant should have an award letter or equivalent from the State agency.

If the State-administered SSP or Medicaid ceases, SSA will have to decide the State of residence.

The FO must decide the State and county of residence after eligibility is established (i.e., at the first redetermination following establishing or reestablishing eligibility, or when a change of address is reported).

EXAMPLE: A recipient abandons her State of residence of Washington and intends to relocate indefinitely in Pennsylvania. She is involved in an automobile accident in Nebraska. She is hospitalized in Nebraska for 3 weeks. Her State of residence remains Washington, and Nebraska bills Washington for her Medicaid expenses.

3. Interstate Agreements

Some States have entered into reciprocal agreements or other arrangements with other States. When States have completed these agreements, an individual may receive Medicaid from one State even though there is permanent residence in another. Regional instructions may be available for guidance.

Interstate Medicaid coverage agreements do not cover SSP. SSA determines the State and county of residence for SSP purposes.

4. State Assumes Responsibility

Sometimes a State will inform SSA that it wishes to assume responsibility for an individual or group, regardless of the actual State of residence. Regional offices will issue instructions when appropriate.

EXAMPLE: A New Hampshire mother is referred to a hospital in Massachusetts to give birth to her premature child. The New Hampshire Medicaid State agency approves payment for out-of-State services. The child is born severely disabled and will probably live in the Massachusetts hospital until death. The mother retains her residence in New Hampshire. The State of residence of the child is New Hampshire unless Massachusetts chooses to be the State of residence for the child. If Massachusetts does make that choice, the Boston regional office will so inform the servicing FO.

C. Policy - Capable Individuals

The following policy applies to capable individuals.

1. General Rule—State/County of Residence

The State and county of residence is where an individual resides with an intention to remain there permanently or indefinitely.

2. Exception

If an individual capable of stating intent moved to another jurisdiction because of a job offer or to look for work, the residence is where the individual lives because of that job search. This rule is especially important for determining the residence of migrant workers and their families, since each move to look for or accept work can result in a different jurisdiction of residence.

D. Policy - Incapable Individuals

These rules only apply to individuals who have not been placed in an institution by another jurisdiction as described in B.1. above.

1. Children

a. With Parents

A child who is subject to deeming from a parent has the State and county of residence of the parent/deemor. Otherwise, a child has the residence of the parent with whom he or she lives.

Children may be temporarily absent from the parent's household to attend school or visit relatives. As long as parental control continues, there is no change of residence during a temporary absence as defined in SI 01310.165. However, an emancipated child is not treated as a child.

b. With Legal Guardians

A child with a legal guardian retains the State and county of residence of the parent unless parental rights have been terminated. If terminated, and there is a legal guardian, the child has the residence of the legal guardian. Termination of parental rights and appointment of legal guardians are actions accomplished by judicial proceedings, so these cases should involve written court documentation. Information about legal guardianship is developed during the representative payee application process; documentation should therefore be available and/or recorded.

c. With No Parents or Legal Guardian

The State and county of residence of a child without parents or a legal guardian is the jurisdiction where the child is living.

2. Adults

As defined in A.2. above, incapability for residency purposes is a mental inability to form an intent to remain in a location permanently or indefinitely. This differs from usual SSA concept that incapability is an inability to manage funds.

a. Not Institutionalized

The State and county of residence of an incapable adult who is not institutionalized is where the individual is living.

b. Institutionalized

  • Became incapable of stating intent as a child - the State and county of residence of the parent at the time of the SSI application.

    If parental rights are terminated and a legal guardian has been appointed, use the residence of the legal guardian at the time of the Medicaid application.

    If parental rights are terminated and there is no legal guardian, use the residence of the individual who filed the SSI application.

    NOTE: To obtain information about the State and county of residence of a parent, legal guardian or person who filed an SSI application on behalf of the child, ask the institution for help. This information should be available in the institution's files.

  • Became incapable of stating intent as an adult - if the individual resides in a Medicaid institution and is receiving Medicaid at the time of SSI application, use the State and county which pays the Medicaid bills.

3. Relative Responsibility Laws

Some States have laws which require relative responsibility for an incapable adult. In these cases, a parent or relative is legally responsible for the welfare of the incapable adult and the State and county of residence will remain that of the parent or relative with legal responsibility (see D.2.b., above).

There should be regional instructions should this apply to any State in your region.

E. Policy - County of Residence

The policy and procedures for determining the county of residence are the same as for determining the State of residence. See F.2. below.

F. Policy - Changes of Residence

The policy below applies to changes of residence.

1. Initial Claims

In initial claims, the State and county of residence are determined as of the date of effective filing (Application Effective Date, SI 00601.009). Any change after the date of effective filing is a posteligibility change.

The amount of federally-administered OSS and/or Medicaid coverage and retroactivity (SI 01715.001C.3.) may play a part in an individual's choice of effective filing date.

2. Posteligibility Changes

Posteligibility changes of residence are effective the month after the month of arrival at the new residence.

An individual retains the former residence until the new State/county of residence becomes effective.

Residency changes and OSS codes are input by the new servicing FO.

a. Interstate Moves

When there are moves through interim States in a posteligibility situation, the individual retains the original State and county of residence and federally-administered OSS code (when appropriate) until the month after arrival at the new (“final”, not interim) residence.

After the individual/couple arrives at the new residence, the new servicing FO determines the most advantageous OSS code applicable (if any) from the former ("original") State and county of residence during each of the months of the move.

EXAMPLE: Mr. Smith, an aged individual, leaves Nevada after informing the former servicing FO of his intention to move permanently to a specific address in Washington, D.C. The former servicing FO sends an administrative message to the future servicing FO and changes the mailing address of the directly deposited check as requested, reinputting his current residence and OSS information. Over the next 5 months, Mr. Smith travels through several States, spending an entire calendar month in Texas and 2 weeks in a West Virginia hospital following an automobile accident. Mr. Smith's State of residence for the entire period is Nevada. Because of the correct input of the former servicing FO, Mr. Smith's checking account continues to receive his SSI check each month during the move, including Nevada OSS.

After Mr. Smith arrives in Washington, he visits the new servicing FO which changes his residence of record to Washington, D.C. effective the month after the month of arrival and determines the highest applicable Nevada OSS amount payable during the period of the move and posts it to the system.

b. Intrastate Moves

The rules for interstate moves in F.2.a. above apply in intrastate moves. The new OSS rate applies the month after the month of arrival in the new county of residence.

G. Policy - Temporary Absence

Individuals may be temporarily absent from their residence for many reasons. Among these reasons may be vacations, school attendance, job training and family needs. Such absences can be protracted, yet as long as they are temporary, absences should not affect the State and county of residence posted to the system.

Temporary absence rules for residency purposes differ from the temporary absence rules for living arrangements (SI 00835.040) and absence from the home (SI 01130.100B.). A decision whether an individual is temporarily absent from the State/county of residence may differ in result from a decision whether an individual is temporarily absent from a living arrangement and/or the home.

A child who is temporarily absent from the household and under parental control (as explained in SI 01310.165A.4.) will retain the State and county of residence of the parent.

NOTE: The information in the preceding paragraph is a change of position effective with publication of this transmittal for initial claims and following the rules in SI 02305.030 for redetermination. Previous to the publication of this transmittal, the State and county of residence of a child was where the child was residing, regardless of temporary absence from the deemor's household.

A new State and county of residence determination is warranted at the first redetermination after the individual no longer meets the SSI definition of a child.

H. Policy - Unresolved Residence

When more than one State and/or county could be an individual's residence, and you cannot determine the jurisdiction of residence according to the rules above, the residence is where the individual is physically located at present.

EXAMPLE: A homeless individual generally resides on a street split between two counties. The State of residence is not in dispute, and the individual is capable, but gives the name of the street as the residence. The county of residence is determined by where in the street the individual currently considers himself located (e.g., at the nearest specific cross street, building, etc.).

I. References

  • Capability Determinations, GN 00502.060

  • Change of Address (Posteligibility), SI 02306.010

  • Child for SSI Purposes, SI 00501.010

  • Computation History (CMPH) Segment of the SSR,

    SM 01601.790

  • Application Effective Date, SI 00601.009

  • Effective Dates for Policy Changes (Redeterminations),

    SI 02305.030

  • Eligible Child for Deeming Purposes, SI 01310.115

  • “Grandfathered” Income and Resources Provisions,

    SI 01210.100 and SI 01220.001

  • Home Exclusion—Continued Exclusion from Resources of Home Property Based on Intent to Return,

    SI 01130.100B.

  • Incompetency Decisions, GN 00502.010

  • Institutionalization and SSI Payment, SI 00520.011

  • Interviewing, Other Benefits—Applications, SI 00601.060

  • Interviewing, Other Benefits—Posteligibility, SI 02305.094 and SI 02305.099

  • Legal Guardian Recorded on the SSR, SM 01601.505

  • LRES (Residence Address), MSOM MSSICS 010.002

  • Medicaid Retroactivity, SI 01715.001C.3.

  • Overkeying Prefilled State and County Codes, MSOM MSSICS 010.002

  • Redeterminations and Changes of Residence, SI 02305.115

  • Representative Payee (RP) Data on the SSR, SM 01601.565

  • Residence Address (LRES), MSOM MSSICS 010.002

  • SSI2 Query, SM 01601.175 ff., MSOM QUERIES 003.006

  • Systems Input of Address Changes, SM 01301.390 ff.,

    SM 01301.485 ff., SM 01301.540 ff.

  • Temporary Absence from the Household, SI 01310.165

  • Temporary Absence from a Federal Living Arrangement, SI 00835.040 - SI 00835.043

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SI 01410.030 - Policy for Determining the State and County of Residence - 01/04/2017
Batch run: 01/11/2017