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

Example:

Ryan Stackhouse does not want to receive state supplementation and signs a statement waiving Ryan's right to receive it. The FO explains that Ryan will only remain eligible for SSI in California as long as Ryan's 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 Ryan remains federally-eligible for SSI and that Ryan will not become eligible for the Supplemental Nutrition Assistance Program (SNAP). Ryan acknowledges that Ryan understands, but still wishes to waive receipt of state supplementation.

Ryan currently lives alone and is in Federal living arrangement (FLA) A. Beginning with the month Ryan chooses to no longer receive state supplementation, Ryan's living arrangement is FLA A/OSS Y.

California does not pay a supplement to an eligible individual who is:

1. 1. 

   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

2. 2. 

   prior to July 1, 1983, a patient in a private medical facility which is not certified for Title XIX

3. 3. 

   effective December 1. 1996, a child under age 18 in FLA D based on residence in a public facility paid by private insurance

4. 4. 

   a resident of a publicly-operated emergency shelter (see SI 00520.500 Residents of Public Emergency Shelters for the Homeless)

Example:

Peony Alsace, age 10, is an inpatient in a State hospital and is expected to be hospitalized for at least six months. Peony's parents’ private medical insurance pays the full cost of care so Peony 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 Peony was not subject to the $30 payment limit. Therefore, no OSS is payable. Peony's living arrangement is FLA D/OSS Z.