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State AssistancePrograms for SSI

Recipients,January 2005

Social Security AdministrationOffice of PolicyOffice of Research, Evaluation, and Statistics



Selected Features of State Assistance Programs, January 2005

State SupplementationNumber of states that provide—

Both mandatory and optional supplementation 30

Mandatory supplementation only 5

Optional supplementation only (no recipients in mandatory

supplementation) 15

No supplementation 1

Mandatory supplementation: number of states with—

Federal administration 20

State administration 15

No recipients to supplement 15

No mandatory supplementation program 1

Optional supplementation: number of states with—

Federal administration 9

State administration 30

Federal and state administration 6

No optional supplementation program 6

Interim Assistance Reimbursement (IAR) ProgramNumber of states that—

Participate in program 38

Do not participate in program 13

Medicaid ProgramNumber of states that have—

Federal determination of eligibility, federal SSI criteria 33

State determination of eligibility 17

Federal SSI criteria 7

State criteria 10

County determination of eligibility, state criteria 1

NOTE: These data are for the 50 states and the District of Columbia.



This report provides data on selected characteristics of state assistance programsfor Supplemental Security Income (SSI) recipients as of January 1, 2005. Theprograms are state supplementation of federal SSI payments (mandatory andoptional), state assistance for special needs, and Medicaid. The characteristicsselected for each program are those about which the Social Security Adminis-tration (SSA) receives questions most often from individuals, public and privateorganizations, and federal and state agencies. The program details are explainedin the “Guide to Reading the State Summaries.”

The report focuses on eligibility provisions and levels of assistance forindividuals and couples, by living arrangements, who receive supplementarypayments in each state and in the District of Columbia. Payment levels shown arethe maximum amounts possible for these living arrangements. The report alsopresents information about federal and state administrative responsibilities formaking payments, state criteria for special needs payments, and Medicaideligibility.

Sherry Barber of the Division of SSI Statistics and Analysis collected andcompiled the data. Staff of the Division of Information Resources edited thereport and prepared the print and electronic versions for publication.

Questions about the report should be directed to Sherry Barber at 410-965-9851 or [email protected]. For additional copies of this report, please [email protected] or call 202-358-6274. This report and other informationabout the SSI program are available at http://www.socialsecurity.gov/policy.

The Office of Research, Evaluation, and Statistics gratefully acknowledgesthe cooperation of the state agency personnel and the Social Security

Administration's central office policy analysts in providing this information.

Susan GradActing Associate Commissionerfor Research, Evaluation, and Statistics

September 2005

Preface





Guide to Reading the State Summaries

State Supplementation ....................................................................................... 1

State Assistance for Special Needs.................................................................... 4Medicaid ............................................................................................................ 4

Summary Tables

1. Number of persons receiving optional state supplementation,by state and eligibility category, January 2005 ........................................... 5

2. Selected features of state supplementation,by state, January 2005 ................................................................................. 7

3. Selected features of medical programs affecting SSI recipientsand the needy, by state, January 2005......................................................... 8

4. State threshold amounts for disabled and blind individuals to maintain

Medicaid eligibility under section 1619(b) of the Social Security Act,calendar year 2005............................................................................................... 9

State Summaries

Alabama..................................... 13 Alaska ........................................ 15

Arizona ...................................... 17 Arkansas .................................... 19 California................................... 20 Colorado .................................... 23 Connecticut................................ 25 Delaware.................................... 27 District of Columbia .................. 29 Florida........................................ 31 Georgia ...................................... 33 Hawaii........................................ 34 Idaho .......................................... 36 Illinois........................................ 38 Indiana ....................................... 40 Iowa ........................................... 42 Kansas........................................ 45 Kentucky.................................... 46 Louisiana.................................... 48 Maine......................................... 49 Maryland.................................... 51 Massachusetts ............................ 53 Michigan.................................... 56 Minnesota .................................. 58 Mississippi ................................. 60

Missouri ..................................... 61 Montana ..................................... 63 Nebraska..................................... 65 Nevada ....................................... 67 New Hampshire.......................... 69 New Jersey ................................. 72 New Mexico............................... 74 New York................................... 76 North Carolina............................ 79 North Dakota.............................. 81 Ohio............................................ 83 Oklahoma................................... 85 Oregon........................................ 87 Pennsylvania .............................. 90 Rhode Island .............................. 92 South Carolina............................ 94 South Dakota.............................. 96 Tennessee................................... 98 Texas.......................................... 99 Utah............................................ 100 Vermont .....................................102 Virginia ......................................104 Washington ................................ 106 West Virginia............................. 108 Wisconsin................................... 109 Wyoming.................................... 111

Contents





This guide explains the program features detailed inthe summaries for the 50 states and the District of Columbia. Three of the major state assistance

programs are:• State supplementation (mandatory and optional)

of federal Supplemental Security Incomepayments,

• State assistance for special needs, and

• Medicaid.

To facilitate comparisons across states, a separatesection includes four tables that summarize:

• The number of persons receiving optionalsupplementation,

• Selected features of state supplementationprograms,

• Selected features of medical programs affectingSSI recipients and the needy, and

• State threshold amounts for blind and disabledindividuals to maintain Medicaid eligibilityunder section 1619(b) provisions of the SocialSecurity Act.

With the exception of Ohio, all states and theDistrict of Columbia have provided current data forthis publication. The state summaries containinformation on the program features discussed below.

State Supplementation

Mandatory Minimum Supplementation

The states provide mandatory minimum supplementa-tion only to recipients who were converted to theSupplemental Security Income (SSI) program from theformer state assistance programs when the SSIprogram began. Mandatory minimum state supple-mentary payments are required by Public Law 93-66to maintain the December 1973 payment levels that

these recipients received under the former stateassistance programs. States are required to provide thissupplementation to maintain their eligibility for TitleXIX (Medicaid) federal matching funds. Thegovernmental unit responsible for administering thesepayments may be either a state or local agency or theSocial Security Administration.

Optional State Supplementation

Some states provide optional monthly supplements tohelp persons meet needs not fully covered by federal

SSI payments. The state determines whether it willmake a payment, to whom, and in what amount. Thesesupplements, paid on a regular monthly basis, areintended to cover such items as food, shelter, clothing,utilities, and other daily and special necessitiesdetermined by the individual states. Some statesprovide optional supplementary payments to allpersons eligible for SSI benefits. Others may limitpayments to certain SSI recipients such as the blind orresidents of domiciliary care facilities, or they mayextend payments to persons who are ineligible for SSIbecause their income is too high.

Administration. The governmental unit responsiblefor administering these payments may be a state orlocal agency or the Social Security Administration(SSA). Under state administration, the state mustabsorb both program benefits and administrative costs.Under federal administration, the state must reimburseSSA for the cost of the program benefits and, as of October 1, 2004, must pay $9.06 in administrativecosts for each benefit paid. As of October 1, 2004, therate was adjusted for inflation as calculated by thechange in the consumer price index (CPI) betweenJune 2003 and June 2004, rounded to the nearest

whole cent. The Commissioner may select a differentrate for a state, taking into account the complexity of administering the state's supplementary paymentprogram.

Effective date. The date when the state instituted orrevised its optional supplementation program.

Statutory basis for payment. The state law(s)authorizing the supplementary payments.

Funding. The source of funds for supplementarypayments and administrative costs. In states requiringfinancial participation from local governments, the

portions contributed by the state and the locality areindicated.

Passalong method. To maintain eligibility forMedicaid reimbursement, any state makingsupplementary payments after June 30, 1977, mustcontinue making payments and must pass along thecost-of-living increase to the federal benefit rate(FBR). Two methods are available to ensure that cost-of-living increases are passed on to the recipients: thepayment levels method and the total expendituremethod.

Guide to Readingthe State Summaries



2 ♦ State Assistance Programs for SSI Recipients, January 2005

Under the payment levels method, the state'ssupplemental payment for any of the livingarrangement categories cannot be below their adjustedMarch 1983 levels. The adjusted level is the state'sMarch 1983 payment level minus the portion of theJuly 1983 increase in the FBR that was not attributableto the increase in the cost of living (that portion was$10.30 per individual and $15.40 per couple); the

essential person increment may be reduced by $5.50.Under the total expenditure method, state

expenditures for supplementary payments in thecurrent calendar year must at least equal expendituresin the preceding calendar year. If expenditures fallshort in the current year, the state must increaseexpenditures in the next calendar year by an amount atleast equal to the shortfall.

Place of application. The office(s) acceptingapplications for supplementary payments.

Scope of coverage. The categories of persons the

state has elected to supplement. States with state-administered programs establish their own eligibilityconditions and payment categories. States withfederally administered programs must adhere to SSIeligibility criteria in all aspects but are allowed toestablish additional income exclusions and paymentcategories.

Resource limitations. The resource limitations andexclusions for federally administered state supple-mentation are the same as for federal SSI payments:countable resources must be worth $2,000 or less foran individual, or $3,000 or less for a couple. Countable

resources are properties, real or personal, that counttoward the resource limits. Recognizing that noteverything an individual owns is available for his orher support and maintenance, the law provides forexcluding certain resources in determining eligibilityfor SSI. Excluded resources include (but are notlimited to):

• The house an individual lives in;

• A car, if it is used to provide necessarytransportation;

• Household goods (if needed for maintenance,use, and occupancy of the home) and personal

effects;• Life insurance policies with a total face value of

$1,500 or less per person;

• Burial plots or spaces for the individual or his orher immediate family;

• A burial fund of up to $1,500 each for theindividual's and his or her spouse's burialexpenses; and

• Property essential to self-support, includingproperty used in a trade or business or on the jobif the individual works for someone else.

States with state-administered supplementationcan establish their own resource limitations andexclusions for optional state supplementary payments.

Income exclusions. An exclusion is the amount of a

recipient's income that is not counted against the statesupplementary payment.

In general, an SSI recipient's income from sourcesother than SSI is counted against the SSI paymentamount. Some income, however, is excluded frombeing counted. The federal program excludes $20 permonth of earned or unearned income; in addition, $65per month of earned income plus one-half of theremaining earnings is excluded. Some types of incomeare entirely excluded, such as certain home energy andsupport and maintenance assistance, food stamps, mostfederally funded housing assistance, state assistance

based on need, one-third of child support payments,and income received infrequently or irregularly.

States that elect federal administration mustexclude at least the amounts excluded by the federalprogram and may exclude more. Countable income isdeducted first from the federal payment. Any incomethat remains to be counted after the federal payment isreduced to zero is deducted from the state supplemen-tary payment.

States with state-administered programs canestablish their own income exclusions of any amountand type. In most states, the supplementary payment isadded to the federal amount, and countable income isdeducted first from the federal payment, as in stateswith federal administration. In a few states, however,the supplement takes the form of a state-guaranteedincome amount that exceeds the federal benefit.

Recoveries, liens, and assignments. Provisions of state supplementation plans governing recovery of assistance payments and assumption of a recipient'sproperty by the agency. As a condition of providingassistance, a state may require that a lien be placed ona recipient's property. Such a requirement does not

affect a person's eligibility or payment status forfederal SSI benefits or federally administered statesupplementary payments.

Financial responsibility of relatives. Statesupplementation provisions that govern theresponsibility of relatives (other than parent for childand spouse for spouse) for providing economicsupport and returning overpayments.

Interim assistance reimbursement (IAR). TheSocial Security Administration may reimburse a state



State Assistance Programs for SSI Recipients, January 2005 ♦ 3

that has provided basic needs assistance to anindividual during the period in which either theperson's application for SSI was pending or his or herSSI benefits were suspended or terminated. Theindividual's retroactive SSI payment is sent to the stateas reimbursement if:

• The state has an agreement with SSA toparticipate in the IAR program;

• The individual has given SSA writtenauthorization to have his or her retroactivepayment sent to the state as reimbursement; and

• The individual is found eligible for SSIpayments or has had his or her benefitsreinstated for the same period of suspension ortermination.

Payment levels. The maximum state supplementarypayments and the combined maximum federal andstate payments that can be awarded to recipientswithout countable income are presented, by state-designated living arrangements, in Table 1 in eachstate summary. Unless otherwise stated, paymentlevels apply equally to aged, blind, and disabledrecipients. The federal benefit rates that are includedin the combined payment levels became effectiveJanuary 2005 (unless otherwise stated) and are givenin the table below.

In states where the SSI payments are federallyadministered, each living arrangement is describedaccording to the following federal living arrange-ments. The state may also have other living arrange-ments. States that administer the SSI payment

have the option to supplement and determine their owndefinitions of living arrangements.

Federal Code A. Includes eligible persons who:

• Live in their own household whether or not theyare receiving in-kind support and maintenance;

• Live in a foster or family care situation;

• Have no permanent living arrangement (forexample, a transient);

• Live in an institution (except inmates of publicinstitutions) for all or part of a month providedthat Medicaid does not pay more than 50 percentof the cost of their care; or

• Live alone with a child, spouse, or personswhose income may be deemed to the eligibleperson.

It also includes eligible persons for whom Codes B, C,and D do not apply.

Federal Code B. Includes eligible persons who:

• Live in a household other than their own

throughout a month with at least one otherperson who is not their child, their spouse, or anineligible person whose income is deemed tothem; and

• Receive food and shelter from within thathousehold.

The Code A payment standard is reduced by one-thirdfor people in federal Code B living arrangements.

Federal Code C. Includes eligible children under age18 who live in the same household as their parents(that is, deeming applies). The payment standard is the

same as in Code A.

Individual Couple

Essential

person a

579.00 869.00 290.00

386.00 579.34 193.34

30.00 60.00 . . .

a.

b.

c. Includes eligible persons who live in a public or private medical institution throughout a month and Medicaid is paying more than 50

percent of the cost of their care. It also includes eligible children under age 18 who live in a public or private medical institution

throughout a month and Medicaid, or a combination of Medicaid and private insurance, is paying more than 50 percent of the cost of care.

NOTE: . . . = not applicable.

This represents the additional amount included in a recipient's check to cover the needs of a household member who provides essential

care and services to the recipient and whose needs were previously taken into account in determining the recipient's assistance payment

under a state plan approved under titles I, X, XIV, or XVI of the Social Security Act.

If the recipient lives in another person's household for a full calendar month and receives both food and shelter from that person, the

federal benefit rate (amounts for living independently) is reduced by one-third.

Living in a Medicaid facilityc

Federal benefit rates, January 2005 (in dollars)

Living arrangements

Living independently

Living in the household of anotherb




Federal Code D. Includes eligible persons who live ina public or private medical institution throughout amonth and Medicaid is paying more than 50 percent of the cost of their care. It also includes eligible childrenunder age 18 who live in a public or private medicalinstitution throughout a month and Medicaid, or acombination of Medicaid and private insurance, ispaying more than 50 percent of the cost of care.

Number of recipients. The number of recipientsreceiving optional payments from the state isdisplayed in Table 2 in each state summary. Thisnumber may include persons who are ineligible forfederal SSI payments but meet state eligibility criteria.

State Assistance for Special Needs

This assistance is for emergency or special conditionsnot covered by monthly SSI or optional statesupplementary payments. Disaster benefits, burialexpenses, additional subsidies for institutional care,and moving expenses are included in this category.

Administration. The governmental unit responsiblefor administering these payments is indicated.

Special needs circumstances. The special needscircumstances (recurring and nonrecurring) for whichassistance can be approved are defined. Whereavailable, eligibility requirements and paymentlimitations are described.

Medicaid All states have federally assisted medical assistance(Medicaid) programs.

Eligibility

States may grant Medicaid eligibility to all SSIrecipients or apply state guidelines in determiningeligibility.

Either the SSI program guidelines or the stateguidelines may be used to determine eligibility. Stateguidelines may not be more restrictive than the state's

January 1972 medical assistance standards. Thegovernmental unit responsible for determiningeligibility is indicated.

Medically Needy Program

The presence or absence of a medically needy programfor SSI-related populations is indicated. Statutepermits states to choose either no medically needyprogram, a restricted program, Temporary Assistancefor Needy Families (TANF), or a program for theTANF-related and one or more of the SSI-related

categories (that is, aged, blind, or disabled). Statesdetermine eligibility for this program.

Unpaid Medical Expenses

Under Medicaid statute, a state must pay unpaidmedical expenses incurred for service covered underits Medicaid state plan for up to 3 months before anindividual is found eligible for SSI, if the individualwould have been eligible had he or she applied then.The entry indicates whether SSA has a contractualagreement with the state to inquire about the unpaid

medical expenses of SSI claimants.




Adults Children

432 150 6 276 b

14,993 4,983 72 9,938 c

514 -- -- -- c

. . . . . . . . . . . . . . .

1,163,380 343,488 18,858 671,455 129,579

34,982 20,420 27 13,782 753

f -- -- -- g

708 55 12 595 46

1,587 155 12 1,328 92

9,393 3,705 3 5,685 c

. . . . . . . . . . . . . . .

2,451 697 24 1,667 6312,241 2,244 25 6,996 2,976

29,947 6,674 109 23,164 b

3,892 1,229 22 2,641 c

5,734 993 642 4,099 b

. . . . . . . . . . . . . . .

4,396 1,607 23 2,766 b

4,713 1,410 54 3,249 b

34,296 -- -- -- --

f -- -- -- --

169,908 44,243 3,960 97,968 23,737

218,941 -- -- -- --

28,224 6,330 136 21,758 b

. . . . . . . . . . . . . . .8,572 2,745 876 4,951 c

954 29 16 849 60

6,079 1,256 58 4,765 b

h

8,603 7,848 491 . . . g

7,365 1,353 253 5,759 bi146,720 32,732 883 85,540 27,564

478 58 5 415 c

617,219 -- -- -- --

23,456 12,010 102 11,344 c

476 -- -- -- c

2,303 -- -- -- --

72,126 22,595 569 39,191 9,771

23,071 3,178 487 19,406 g12,714 5,362 22 7,311 19

29,269 3,933 185 19,965 5,186

2,960 1,317 12 1,631 b

3,426 -- -- -- --

. . . . . . . . . . . . . . .

10,380 2,685 139 7,556 b

1,563 358 15 1,020 170

Tennesseed

Texas

Utah

(Continued)

Pennsylvania

Rhode Island

South Carolina

South Dakota

North Dakota

Ohio

Oklahoma

Oregon

New Jersey

New Mexico

New York

North Carolina

Montana

Nebraska

Nevada

New Hampshire

Michigan

Minnesota

Mississippid

Missouri

Louisiana

Maine

Maryland

Massachusetts

Indiana

Iowa

Kansasd

Kentucky

Georgiad

HawaiiIdaho

Illinois

Summary Table 1.

Number of persons receiving optional state supplementation, by state and eligibility category, January 2005

State Aged

Alabamaa

Alaskaa

Arizona

Arkansasd

California

Floridaa

Total BlindDisabled

Coloradoe

Connecticut

Delaware

District of Columbia

Summary Tables




Adults Children

12,625 1,192 84 9,232 2,117

6,367 2,774 13 3,580 c

f -- -- -- --. . . . . . . . . . . . . . .

98,934 9,931 1,012 66,131 21,8602,700 -- -- -- --

a.

b.

c.

d.

e.

f.g.

h.

i.

j.

k.

Only blind children are eligible; a separate count is not available.

Wyoming

The state does not have an optional supplementation program.

SOURCES: Social Security Administration, Supplemental Security Record, 100 percent data; information in the state summaries.

NOTE: -- = not available; . . . = not applicable.

Includes certain grandfathered non-SSI recipients who meet state eligibility criteria.

A separate count for children is not available.

Vermont

Summary Table 1.

Continued

State Aged

Disabled

Includes 264 persons not distributed by eligibility category. Disabled persons are not eligible.

Wisconsin

Children under 18 years old are not eligible for optional payment.

Represents July 2005 data.

Represents 2004 data.

Includes one person not distributed by eligibility category.

Total Blind

Total not available; see Table 2 in state summary for details.

Virginiak

WashingtonWest Virginia d

Data not available after 2002.




Mandatory minimum

supplementation

Optional state

supplementation

Alabama No recipients State Payment levels No

Alaska State State Total expenditures Yes

Arizona State State Payment levels YesArkansas Federal No program No program No

California Federal Federal Payment levels Yes

Colorado State State Total expenditures Yes

Connecticut No recipients State Payment levels Yes

Delaware Federal Federal/state Payment levels No

District of Columbia Federal Federal/state Total expenditures Yes

Florida No recipients State Payment levels Yes

Georgia Federal No program No program Yes

Hawaii Federal Federal Total expenditures Yes

Idaho State State Payment levels No

Illinois State State Payment levels Yes

Indiana No recipients State Payment levels Yes

Iowa Federal Federal/state Payment levels Yes

Kansas Federal No program No program Yes

Kentucky No recipients State Payment levels Yes

Louisiana Federal State Payment levels No

Maine State State Payment levels Yes

Maryland Federal State Payment levels Yes

Massachusetts Federal Federal Payment levels Yes

Michigan Federal Federal/state Payment levels Yes

Minnesota No recipients State Payment levels Yes

Mississippi Federal No program No program No

Missouri State State Payment levels Yes

Montana Federal Federal Payment levels Yes

Nebraska State State Total expenditures Yes

Nevada No recipients Federal Payment levels Yes

New Hampshire State State Payment levels YesNew Jersey Federal Federal Payment levels Yes

New Mexico State State Payment levels Yes

New York Federal Federal/state Payment levels Yes

North Carolina State State Payment levels Yes

North Dakota No recipients State Payment levels No

Ohio Federal State Payment levels Yes

Oklahoma State State Total expenditures No

Oregon State State Total expenditures Yes

Pennsylvania Federal Federal/state Payment levels Yes

Rhode Island No recipients Federal Payment levels Yes

South Carolina No recipients State Payment levels No

South Dakota Federal State Payment levels No

Tennessee Federal No program No program Yes

Texas No recipients State Payment levels NoUtah No recipients Federal Payment levels Yes

Vermont No recipients Federal Payment levels Yes

Virginia No recipients State Payment levels Yes

Washington State State Total expenditures Yes

West Virginia No program No program No program No

Wisconsin No recipients State Total expenditures Yes

Wyoming State State Payment levels No

SOURCE: Based on information in the state summaries.

Summary Table 2.

Selected features of state supplementation, by state, January 2005

Method of passalongState

Administration of— Participation in

interim assistance

reimbursement program




Criteria Determined by —

Alabama Federal Federal No No

Alaska Federal State No No

Arizona Federal Federal Yes NoArkansas Federal Federal Yes Yes

California Federal Federal Yes No

Colorado Federal Federal No Yes

Connecticut State State Yes No

Delaware Federal Federal No Yes

District of Columbia Federal Federal Yes Yes

Florida Federal Federal Yes No

Georgia Federal Federal Yes No

Hawaii State State Yes No

Idaho Federal State No No

Illinois State State Yes No

Indiana State State No No

Iowa Federal Federal Yes Yes

Kansas Federal State Yes NoKentucky Federal Federal Yes Yes

Louisiana Federal Federal Yes Yes

Maine Federal Federal Yes Yes

Maryland Federal Federal Yes Yes

Massachusetts Federal Federal Yes Yes

Michigan Federal Federal Yes No

Minnesota State County Yes No

Mississippi Federal Federal No No

Missouri State State No No

Montana Federal Federal Yes No

Nebraska Federal State Yes No

Nevada Federal State No No

New Hampshire State State Yes No

New Jersey Federal Federal Yes YesNew Mexico Federal Federal No No

New York Federal Federal Yes No

North Carolina Federal Federal Yes No

North Dakota State State Yes No

Ohio State State No No

Oklahoma State State Yes No

Oregon Federal State No No

Pennsylvania Federal Federal Yes Yes

Rhode Island Federal Federal Yes Yes

South Carolina Federal Federal No No

South Dakota Federal Federal No Yes

Tennessee Federal Federal Yes Yes

Texas Federal Federal Yes Yes

Utah Federal State Yes NoVermont Federal Federal Yes No

Virginia State State Yes No

Washington Federal Federal Yes Yes

West Virginia Federal Federal Yes Yes

Wisconsin Federal Federal Yes No

Wyoming Federal Federal No Yes

SOURCE: Based on information in the state summaries.

Summary Table 3.

Selected features of medical programs affecting SSI recipients and the needy, by state, January 2005

Medically needy programState

Medicaid eligibilitySSA obtains

information on unpaid

medical expenses




Amount

(dollars) Rank

0 14,916 5,637 20,553 50

8,688 23,604 20,946 44,550 2

0 14,916 9,573 24,489 36

0 14,916 8,159 23,075 43

5,424 20,340 10,414 30,754 13

0 14,916 14,970 29,886 16

4,392 19,308 25,787 45,095 1

0 14,916 16,269 31,185 11

0 14,916 13,100 28,016 24

0 14,916 9,075 23,991 39

0 14,916 7,996 22,912 45

0 14,916 8,534 23,450 41

1,248 16,164 18,363 34,527 60 14,916 13,770 28,686 20

0 14,916 14,278 29,194 18

0 14,916 9,298 24,214 38

0 14,916 13,893 28,809 19

0 14,916 8,350 23,266 42

0 14,916 8,664 23,580 40

240 15,156 19,261 34,417 7

0 14,916 14,520 29,436 17

2,745 17,661 14,125 31,786 8

336 15,252 6,113 21,365 48

1,464 16,380 23,151 39,531 3

0 14,916 7,517 22,433 47

0 14,916 11,752 26,668 27

0 14,916 9,773 24,689 33

288 15,204 15,597 30,801 12

0 14,916 11,822 26,738 26

648 15,564 23,727 39,291 4

750 15,666 12,375 28,041 23

0 14,916 12,423 27,339 25

2,088 17,004 20,571 37,575 5

0 14,916 11,487 26,403 28

0 14,916 16,437 31,353 10

0 14,916 13,660 28,576 21

1,200 16,116 5,100 21,216 49

41 14,957 9,698 24,655 34

658 15,574 9,221 24,795 32

1,376 16,292 15,375 31,667 90 14,916 9,677 24,593 35

360 15,276 12,910 28,186 22

0 14,916 4,175 19,091 51

0 14,916 11,098 26,014 30

0 14,916 11,410 26,326 29

Florida

Twice state

supplementationa

(dollars)

State per capita

Medicaid expenditure

(dollars)

Thresholdc

Colorado

Connecticut

Delaware


Alaska

Arizona

Arkansas

California

Summary Table 4.

State threshold amounts for disabled and blind individuals to maintain Medicaid eligibility under

section 1619(b) of the Social Security Act, calendar year 2005

State

Base amountb

(dollars)

Alabama

Disabled individuals

Georgia

Hawaii

IdahoIllinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode IslandSouth Carolina

South Dakota

Tennessee

Texas

Utah

(Continued)




Amount Rank

1,249 16,165 13,808 29,976 14

0 14,916 10,568 25,484 310 14,916 7,714 22,630 46

0 14,916 9,430 24,346 92,011 16,927 12,994 29,921 15

245 15,161 7,827 22,988 44

6,960 21,876 10,414 32,290 1528 15,444 9,298 24,742 5

3,594 18,510 14,125 32,635 22,623 17,539 11,822 29,361 3

641 15,557 9,698 25,255 4

a.

b.

c.

State per capita

Medicaid expenditure

VirginiaWashington

West Virginia

Disabled individuals (cont.)

Twice state

supplementationa

Wisconsin

The threshold is the sum of the base amount and the state per capita Medicaid expenditure.

Oregon

Vermont

Summary Table 4.

Continued

State Base amountb

Threshold c

Wyoming

SOURCE: Social Security Administration, Program Operations Manual System (POMS), SI 02302.200, Charted Threshold Amounts.Twice the annual state supplementation rate, if any, for an individual living independently.

The base amount is the annual amount of earned income it takes to reduce the annual SSI federal plus state benefit to zero. It is calculated

as the sum of twice the state individual supplementation rate plus $14,916; $14,916 is the amount of earned income it takes in calendar year

2005 to reduce the annual federal benefit to zero, based on the monthly calculation ($85 plus twice the monthly federal benefit rate of $579)

multiplied by 12.

Blind individuals

CaliforniaIowa

MassachusettsNevada



State Summaries





Alabama




No recipients.


Administration: County offices of the state Departmentof Human Resources.

Effective date: January 1, 1974.

Statutory basis for payment: Code of Alabama 1975as amended, title 38.

FundingAdministration: State funds.Assistance: State funds.

Passalong method: Maintaining payment levels.

Place of application: County offices of the stateDepartment of Human Resources.

Scope of coverage: Optional state supplementprovided to all SSI recipients (including children andcertain grandfathered aged, blind, and disabled personswho would receive SSI payments except for their

income level) residing in the specified livingarrangements (see Table 1).

Resource limitations: Federal SSI regulations apply.

Income exclusions: Federal SSI regulations apply.

Recoveries, liens, and assignments: None.

Financial responsibility of relatives: None.

Interim assistance: State does not participate.

Payment levels: See Table 1.

Number of recipients: See Table 2.


State does not provide assistance for special needs.

Medicaid

Eligibility

Criteria: SSI program guidelines (Title XVI).

Determined by: Social Security Administration.


State does not provide a program for the medicallyneedy.


The Social Security Administration does not obtain thisinformation.

Alabama



Alabama


Individual Couple Individual Couple

Level of independence A 639.00 989.00 60.00 120.00Level of independence B 635.00 981.00 56.00 112.00

Level of independence A 446.00 699.34 60.00 120.00Level of independence B 442.00 691.34 56.00 112.00

639.00 989.00 60.00 120.00

446.00 699.34 60.00 120.00

689.00 1,089.00 110.00 220.00

775.00 1,261.00 196.00 392.00

DEFINITIONS:

Personal care home. A domiciliary facility that provides care for four or more unrelated persons and is licensed by the Alabama Department

of Health.

Foster home. A domiciliary facility licensed or approved by the Alabama Department of Human Resources in accordance with state foster

home provisions.

Cerebral palsy treatment center (disabled). A domiciliary care facility for the treatment of cerebral palsy that is licensed by the Alabama

Department of Health.

Foster home with IHC or specialized IHC

Cerebral palsy treatment center (disabled)

NOTE: A licensed physician must recommend independent home-life care (IHC) or specialized IHC, and someone must actually provide and

receive payment for the care. The care provider cannot be an immediate relative and must be employed by a certified home health agency.

Table 1.

Optional state supplementation payment levels, January 2005 (in dollars)

Receiving IHC in a private home or a personal care home

Receiving IHC and support and maintenance in a private

home or personal care home

State supplementation

Receiving specialized IHC and support and maintenance

in a private home or personal care home

Receiving specialized IHC in a private home or personal

care home

Living arrangement

Combined federal and state

Total Aged Blind Disabled

All recipients 432 150 6 276

-- -- -- --

-- -- -- --

-- -- -- --

-- -- -- --

-- -- -- ---- -- -- --

IHC = independent home-life care; -- = not available.

Cerebral palsy treatment center (disabled)

Receiving IHC and support and maintenance in a private

home or personal care homeReceiving specialized IHC in a private home or personal

care homeReceiving specialized IHC and support and maintenance

in a private home or personal care home

Foster home with IHC or specialized IHC

NOTES: Includes certain grandfathered, non-SSI recipients who meet state eligibility criteria.

Table 2.

Number of persons receiving optional state supplementation, January 2005

Living arrangement

Receiving IHC in a private home or a personal care home



Alaska



Mandatory State Supplementation

Administration: Department of Health and SocialServices, Division of Public Assistance.


Administration: Department of Health and SocialServices, Division of Public Assistance.


Statutory basis for payment: Alaska Statutes47.25.430-47.25.615.

Funding Administration: State funds.Assistance: State funds.

Passalong method: Maintaining total expenditures.

Place of application: Local offices of the stateDepartment of Health and Social Services, Division of Public Assistance.

Scope of coverage: Optional state supplementprovided to all needy aged, blind, and disabled persons,including certain grandfathered persons who wouldreceive SSI payments except for their income level butexcluding persons in the Alaska Pioneer Homes, in anynonmedical public institution, or in public or privateinstitutions for mental disorders. Children under age 18are not eligible for optional supplementation.


Living independently 941.00 1,397.00 362.00 528.00Living independently with an ineligible spouse 1,100.00 . . . 521.00 . . .Living in the household of another 754.00 1,122.34 368.00 543.00

Assisted living home 679.00 1,069.00 100.00 200.00Assisted living home with an ineligible spouse 679.00 . . . 100.00 . . .Medicaid facility 75.00 150.00 45.00 90.00

DEFINITIONS:

Living independently. Includes eligible persons who:

Live alone in their own household, whether or not receiving in-kind support and maintenance;

• Live alone or with a minor child, spouse, or anyone whose income is deemed available to them;

• Live in a household in which all members receive federal or state public assistance;

• Live in the household of another and pay at least a prorated share of the household expenses; or

• Live in the household of another where the eligible person or deemor has an ownership interest in the home or is liable to the landlord for

any part of the rent.

Living in the household of another. Includes eligible persons who reside in another's household for a full calendar month, except for

temporary absences, and receive both food and shelter from that person.

Medicaid facility. Includes recipients who reside for a full calendar month in a skilled nursing facility or an intermediate care facility that is

certified and licensed by the Alaska Department of Health and Social Services to provide long-term care.

Assisted living home. Includes eligible persons who reside in an assisted living home for a full calendar month.

. . . = not applicable.

NOTES: Beginning July 1, 2004, the state established a new living arrangement for persons residing in assisted living homes.

Table 1.


Living arrangement

Combined federal and state State supplementation

Alaska



Alaska



All recipients 14,993 4,983 72 9,938

13,657 4,613 68 8,976464 123 0 341

794 219 4 57178 28 0 50

NOTE: Includes certain grandfathered, non-SSI recipients who meet state eligibility criteria.

Table 2.


Medicaid facility

Living arrangement

Living independentlyLiving in the household of another

Assisted living home


Income exclusions: Federal SSI regulations apply;in-kind income is also excluded.


Financial responsibility of relatives: Child for aged

parent.Interim assistance: State participates.





Medicaid

Eligibility


Determined by: State.







Arizona




Administration: Arizona Department of EconomicSecurity; Aging Adult Administration and FamilyAssistance Administration.


Administration: Arizona Department of EconomicSecurity; Aging Adult Administration and FamilyAssistance Administration.

Effective date: May 9, 1974.

Statutory basis for payment: Arizona Revised Statutes46:252.

Funding

Administration: State funds.Assistance: State funds.


Place of application: Area Agencies on Aging,Catholic Social Services, other designated contractingagencies, and local offices of state Department of Economic Security. County Health Department Long-Term Care Unit and city Human Resources Departmentsarrange home interviews (if needed) or refer to

appropriate agencies.

Scope of coverage: Optional state supplementprovided to all SSI recipients who require assistancewith housekeeping. Children under age 18 are noteligible for optional supplementation.





Interim assistance: State participates.




649.00 939.00 70.00 70.00

b b b bb b b b

a.

b. Supplementation in this living arrangement has been discontinued.

DEFINITIONS:

Requires housekeeping services. A determination that the person is functionally impaired in sufficient degree as to require help with

housekeeping, laundry, essential shopping, errands, and meal preparation.

Licensed supervisory care home. Provides accommodations, board, and general supervision including assistance in the self-

administration of prescribed medication.

24-hour treatment facility. Residential care facilities, licensed by the state Department of Health Services, that provide 24-hour treatment to

the chronically mentally ill.

Services may be provided in lieu of cash grants. Services and cash benefits are the same for individuals and couples.

Table 1.


Living arrangement

Requires housekeeping services a

Licensed supervisory care home, adult foster care home,

or 24-hour treatment facilityLicensed private nursing home (aged)


Arizona



Arizona



All recipients 514 -- -- --

-- -- -- --

a a a aa a a a

a.

Table 2.


Living arrangement

Requires housekeeping servicesLicensed supervisory care home, adult foster care home,

or 24-hour treatment facilityLicensed private nursing home (aged)

NOTE: -- = not available.

Supplementation in this living arrangement has been discontinued.


Administration

Arizona Department of Economic Security.

Special Needs Circumstances

Visiting nurse services: Up to $160 in vendorpayments per month for any aged SSI recipient who is65 years or older when medical findings substantiateneed.

Home health services: Up to $160 in vendor paymentsper month for any aged SSI recipient who is 65 years orolder when medical findings substantiate need.

Medicaid

Medical assistance is provided through a Title XIXauthorized demonstration program—the Arizona Health

Care Cost Containment System (AHCCCS)—which ismore limited in scope than Medicaid.

Eligibility




Arizona Department of Health Services provides fundsfor the medically needy.





Arkansas




Administration: Social Security Administration.


State does not provide optional supplementation.




Medicaid

Eligibility




State provides a program for the aged, blind, anddisabled medically needy.


The Social Security Administration obtains thisinformation.

Arkansas



California








Statutory basis for payment: Welfare and InstitutionsCode, section 12000ff.

Funding



Place of application: Social Security Administrationfield offices.

Scope of coverage: Optional state supplementprovided to every aged, blind, and disabled SSIrecipient, including children.









AAged and disabled 805.00 1,422.00 226.00 553.00

Blind 869.00a

1,642.00 290.00 773.00

B 979.00 1,958.00 400.00 1,089.00

CAged and disabled 887.00 1,586.00 308.00 717.00

D

Aged and disabled 613.00 1,158.67 227.00 579.33

Blind 692.00b

1,379.67 306.00 800.33

E 694.00 . . . 115.00 . . .

F 782.00 1,596.67 396.00 1,017.33

G 491.00 . . . 105.00 . . .

J 49.00 98.00 19.00 38.00

(Continued)

State supplementationState

codeLiving arrangement

Living independently with cooking facilities

Nonmedical out-of-home care

Table 1.



Living independently without cooking facilities

Living in the household of another

Disabled minor in home of parent or relative by

blood or marriage

Nonmedical out-of-home care, living in the

household of another

Disabled minor in the household of another

Medicaid facility

California



California


a.

b.

NOTES: Blind individuals aged 65 or older are entitled to the highest payment category for which they qualify.

DEFINITIONS:A: Living independently with cooking facilities. Includes recipients who:

• Live in their own household and have cooking and food storage facilities or are provided with meals as part of the living arrangement,

• Are patients in private medical facilities licensed by the state but not certified under Title XIX,

• Are blind children under age 18 who live with parents, or

• Are blind and live independently with or without cooking and food storage facilities.

B: Nonmedical out-of-home care (NMOHC). Includes adult recipients who reside in a federal Code A living arrangement and who receive

care and supervision while residing either in the home of a relative, legal guardian, or conservator or in a state-licensed NMOHC facility.

Includes children who are:

• Blind and residing in a state-licensed NMOHC facility,

• Blind and residing in the home of a relative who is not his or her parent or legal guardian or conservator,

• Disabled and residing in a state-licensed NMOHC facility,

• Disabled and residing in the home of a legal guardian or conservator who is not his or her relative,

• Disabled and residing in the home of a relative who is not his or her parent, or

• Blind or disabled and residing in a "certified family home."

Payment level for a couple in which only one member is blind is $1,560.00.

C: Living independently without cooking facilities (aged and disabled). Includes aged or disabled recipients or couples who are not

provided with meals and do not have access to adequate cooking and food storage facilities as part of their living arrangement.

Table 1.

Continued

Payment level for a couple in which only one member is blind is $1,295.33.


J: Medicaid facility. Includes recipients who reside in a federal Code D living arrangement.

D: Living in the household of another. Includes recipients residing in a federal Code B living arrangement who do not qualify for any other

state arrangement.

E: Disabled minor in home of parent or relative by blood or marriage. Includes disabled children under age 18 who reside with a parent.

F: Nonmedical out-of-home care, living in the household of another. Includes recipients who meet the state criteria for nonmedical out-

of-home care payments and are in a federal Code B living arrangement.

G: Disabled minor in the household of another. Includes disabled children under age 18 who reside with a parent but are in a federal

Code B living arrangement.


Administration

Health and Human Services Agency, Department of Social Services.


Maintenance for guide dog: Eligible recipients withguide, signal, or other service dogs receive $50 per

month in state aid to pay for dog food and other costsassociated with the dog's maintenance.

In-home supportive services: Supportive services (i.e.,certain domestic and personal care services) areprovided to eligible aged, blind, and disabled personswho cannot perform the services themselves and whocannot safely remain in their own home unless suchservices are provided.

Medicaid

Eligibility




State provides a program for the aged, blind, and

disabled medically needy.





California


Adults Children

All recipients 1,163,380 343,488 18,858 671,455 129,579

A 890,701 290,809 17,002 553,540 29,350B 58,149 5,906 547 45,138 6,558

C 37,602 3,687 0 33,516 399

D 71,174 38,585 1,085 28,773 2,731

E 85,731 0 0 0 85,731

F 1,841 435 26 1,215 165

G 2,593 0 0 0 2,593

J 15,589 4,066 198 9,273 2,052

Aged Blind

State

code

Medicaid facility

Living independently with

cooking facilitiesNonmedical out-of-home careLiving independently without

cooking facilitiesLiving in the household of

anotherDisabled minor in home of

parent or relative by blood or

marriageNonmedical out-of-home care,

living in the household of

anotherDisabled minor in the household

of another

Disabled

Table 2.


TotalLiving arrangement



Colorado




Administration: State Department of Human Services.




Statutory basis for payment: Colorado RevisedStatutes 26-2, section 202-209, 1973, as amended.

Funding

Administration: 80 percent state funds, 20 percent localfunds.Assistance: 100 percent state funds for the aged; 80percent state funds, 20 percent local funds for the blindand disabled.


Place of application: County offices of the stateDepartment of Human Services.

Scope of coverage: Optional state supplementprovided to all SSI recipients, including children,residing in the specified living arrangements (see Table1). Persons living in the household of another areincluded under the living independently standard; statesupplement is increased to offset the reduced federalpayment. At age 65, a disabled recipient may elect totransfer to the aged category or remain in the disabledcategory.









604.00 1,208.00 25.00 339.00

818.00 b 1,611.00 239.00 b 742.00

982.00 . . . 403.00 . . .

a.

b.

c.

DEFINITIONS:

Living independently or in the home of another. Includes recipients who reside in a federal Code A or B living arrangement, meet the

state eligibility requirements, and do not qualify for other state arrangements.

Adult foster care. Includes recipients who reside in a federal Code A living arrangement and are residing in an approved supervised living

facility known as an adult foster home.

Receiving home care. Includes recipients who receive care in their own home from qualified personnel and who would otherwise be in a

nursing home if this care were unavailable.

Living independently or in the home of anothera

Adult foster care

Receiving home carec

Table 1.


Represents maximum allowance. Lesser amounts may be paid according to the amount of home care needed.

Living arrangement



Couples are treated as two individuals starting with the month after leaving an independent living arrangement.

State supplement is increased to offset the reduced federal payment for persons living in the home of another.

Colorado



Colorado


Adults Children a

All recipients 34,982 20,420 27 13,782 753

29,238 17,548 15 11,278 397116 25 0 91 0

5,628 2,847 12 2,413 356

a. Includes blind children.

Total Aged Blind

Living independently or in the home of

another

NOTE: Data are not available after 2002.

Disabled

Table 2.


Adult foster careReceiving home care

Living arrangement


Administration

Colorado Department of Social Services.


Funeral expenses: If cost of funeral home or cemeterydoes not exceed $2,500, the benefit maximum is $1,500.If cost exceeds $2,500, no assistance is provided.

Other: County social services boards may choose toprovide optional supplementation for other special needscircumstances.

Medicaid

Eligibility






The Social Security Administration obtains this

information.



Connecticut




No recipients.


Administration: State Department of Social Services.


Statutory basis for payment: Connecticut GeneralStatutes, section 17b-600.

Funding



Place of application: Regional offices of state agency.

Scope of coverage: Optional state supplementprovided to all aged, blind, and disabled SSI or Title IIrecipients living alone or with others. No provision ismade for essential persons. Only blind children areeligible for supplementation. Blind and disabledrecipients are reclassified as aged upon reaching age 65.

Resource limitations: No limit on real propertyoccupied as a home. Equity in real property other than ahome must be liquidated. Value of personal property(excluding household and personal effects, car if needed,and tools and equipment or livestock essential toproduction of income) is limited to $1,600 for anindividual and $2,400 for a couple. In addition, up to$1,200 for burial contract is reduced by the value of irrevocable burial arrangements and the face value of life insurance policies of $1,500 or less.

Income exclusions Unearned income: For recipients residing in thecommunity, state disregards $183.00 of any unearnedincome including SSI; for recipients residing in boardinghomes, $90.70 is disregarded. The disregard is $250.90for recipients residing with unrelated persons in thecommunity.Earned income: The first $65 and one-half of theremainder for aged and disabled; the first $85 and one-

half of the remainder for the blind. Work-relatedexpenses for the blind, including personal expenses suchas Social Security tax, life and health insurance, lunch,and transportation, are excluded. Additional deductionsare allowed for the blind and disabled related to plansfor self-support. Those who are disabled are alsoallowed deductions for impairment-related work expenses.

Recoveries, liens, and assignments: Liens secureclaims against real property. State has a preferredmandatory claim against an estate to the extent that it isnot needed for the support of the surviving spouse,parent, or dependent children of the decedent. Liensmay be released upon payment of claim or amount equalto beneficiary's interest. If applicant or recipient ownsother nonhome property, he or she must be making abona fide effort to sell it. During that time, he or shegives the state a security mortgage.






Administration

State Department of Social Services.


Recurring Emergency housing: One occurrence per calendar year;no more than 60 days per occurrence.Refuse collection: Standard community rate.Therapeutic diet: $36.20 a month.Meals on Wheels: $4.43 for one meal a day; $8.09 fortwo meals a day.Restaurant meals: $36.20 a month for an individualliving in the community; $7.80 per day for an individual

living in emergency housing.

Nonrecurring Security deposit for heating service: Actual cost up to alimit of $200 for equipment only.Storage charges: Up to 3 months.Moving expenses: Market charge.Essential household furnishings: Lower of actual cost ordepartment standard for particular item.

Connecticut



Connecticut


Telephone installation: Standard residential line chargefor service connections plus $23.00 for labor and $4.00maximum for phone jack.Essential clothing: Department standard for particularitem.

Medicaid

Eligibility

Criteria: State guidelines.





The Social Security Administration does not obtain this

information.


747.00 1,096.00 168.00 227.00579.00 869.00 b b

57.00 114.00 27.00 54.00

a.

b.

c.

DEFINITIONS:

Independent community living. Any type of living arrangement that is not a licensed room and board facility or a medical or penal

institution.

Licensed room and board facility. Community group home, training home, family care home, private boarding home, or other residentialfacility that is licensed by the Connecticut Department of Mental Retardation, Department of Children and Families, Department of Mental

Health and Addiction Services, Department of Public Health Services, or other state agency and that at a minimum provides lodging and

meals to various groups of elderly, blind, or disabled individuals.

Medicaid facility. Includes recipients residing in a federal Code D living arrangement.

Committee sets state payments for recipients in boarding homes in accordance with individual cost data for the operations of the facility.

Recipients residing in a Medicaid facility receive a supplement that varies depending on the facility.

The budget process is used to establish payment amounts. This supplement consists of a housing allowance (maximum of $400 for

living alone; $200 for living with others), basic needs items, minus countable income (see "Income exclusions"). The amount presented

assumes eligibility for the highest rental allowance and the maximum budget amount.

Independent community livinga

Licensed room and board facilityMedicaid facility c


Table 1.


Living arrangement

Total Aged Blinda

Disabled

All recipients -- -- -- --

11,988 3,792 39 8,1574,833 1,338 55 3,440

-- -- -- --

a.

Living arrangement

Independent community livingLicensed room and board facilityMedicaid facility

Table 2.


-- = not available.

NOTES: Includes certain grandfathered, non-SSI recipients who meet state eligibility criteria.

Includes blind children.



Delaware






Administration: Social Security Administrationadministers payments to recipients living in an adultresidential care facility; the Delaware Department of Health and Social Services, Division of Social Services,administers payments to recipients living independently.Delaware Department of Health and Social Services,Division of Social Services, determines eligibility for

special adult residential care supplement.


Statutory basis for payment: Delaware Code, title 31,section 505.



Place of application: Social Security Administration.

Scope of coverage: Optional state supplement

provided to aged, blind, and disabled adults who are SSIrecipients, or would be except for income and live in anapproved adult residential care facility. Children underage 18 are not eligible for supplementation but mayreceive benefits and services under the child welfareprogram.

Resource limitations: None.

Income exclusions: None.







A 719.00 1,317.00 140.00 448.00

. . . a a a a

a.

Living independently. Includes recipients who live in their own household.

DEFINITIONS:

A: Certified adult residential care facility. Includes recipients who are certified by the Delaware Department of Health and Social Services

as residents of an adult residential care home.

State supplementation


Living arrangement

Certified adult residential care facilityLiving independently

Supplementation for individuals in this living arrangement has been discontinued. The state did not provide supplementation for couples.

Statecode


Table 1.


Delaware



Delaware


Adults Children a

A 708 55 12 595 46

. . . b b b b b

a.

b. Supplementation in this living arrangement has been discontinued.

Benefits received under child welfare program.

Living arrangement

Certified adult residential

care facilityLiving independently


Table 2.


State

code Total Aged Blind

Disabled


Administration

Delaware Department of Health and Social Services,Division of Social Services.


State provides cash assistance for specific emergencieson a one-time basis.

Medicaid

Eligibility















Administration: Social Security Administration andDistrict of Columbia Department of Human Services,Income Maintenance Administration.


Statutory basis for payment: District of ColumbiaLaws 2-35, as amended, and 3-23.

Funding Administration: District of Columbia funds.Assistance: District of Columbia funds.


Place of application: District of Columbia Departmentof Human Services, Department of Mental Health, andlicensed service providers. The Central Referral Bureaureviews the applications for payment eligibility and thensubmits the approved applications to the Social SecurityAdministration field offices for payment.


provided to persons residing in adult foster care homeswho are eligible for SSI payments or would be eligibleexcept for income. No statutory minimum agerequirements for receiving adult foster caresupplementation, but children receive assistance throughchild welfare services provisions.



Recoveries, liens, and assignments: Only in cases inwhich liens were assigned prior to the establishment of

the SSI program.


Interim assistance: District participates.




Adult foster care home (50 beds or less) A 926.00 1,852.00 347.00 983.00Adult foster care home (over 50 beds) B 1,036.00 2,072.00 457.00 1,203.00Medicaid facility G 70.00 140.00 40.00 80.00

DEFINITIONS:

A and B: Adult foster care home. Includes recipients who are certified by the District of Columbia Department of Health or the Commission

on Mental Health Services as residents of an adult foster care home.

G: Medicaid facility. Includes recipients residing in a federal Code D living arrangement.

Table 1.


Living arrangement

State

code







Adults Children

All recipients 1,587 155 12 1,328 a 92

A 747 77 1 658 11

B 13 4 1 7 1

G 827 74 10 663 80

a.

Total Aged Blind

Disabled

Benefits received under the child welfare services program.

Adult foster care home

(50 beds or less)Adult foster care home

(over 50 beds)Medicaid facility

Table 2.


Living arrangement

State

code


District does not provide assistance for special needs.

Medicaid

Eligibility




District provides a program for the aged, blind, anddisabled medically needy.





Florida




No recipients.


Administration: State Department of Children andFamilies.


Statutory basis for payment: Florida Statutes, chapter409.212.



Place of application: Local offices of the stateDepartment of Children and Families.

Scope of coverage: Under the community careprograms, an optional state supplement is provided to allaged, blind, or disabled persons who either receive SSIpayments or have been grandfathered because they meetall SSI criteria except for income. Income may notexceed $657.40.



Recoveries, liens, and assignments: Amount of public assistance received after August 31, 1967, createsa debt against the estate of the aged, blind, or disabledrecipient, and the state can file a claim after death.Homestead exempt during life of spouse or dependentchildren if occupied as a homestead. Claims are filedagainst the estate of individuals who received Medicaidon or after their 55th birthday.






Adult family care home a 657.40 . . . 78.40 . . .

Assisted living facility 657.40 b 78.40 b

35.00 70.00 5.00 10.00

a.

b.

c.

DEFINITIONS:

Adult family care home. Serves up to five persons aged 18 or older, providing housing, food, and personal services.

Assisted living facility. Serves four or more persons aged 18 or older, providing housing, food, and personal services.

Table 1.


Living arrangement


Community care programs


Medicaid facilityc

Payments include $54 personal needs allowance. Recipients who lose SSI eligibility because of Social Security (Title II) benefit

increases may continue to be eligible for state supplementation if they reside in a specific living arrangement and have income below

income limits.

Couples are treated as two individuals the month after leaving an independent living arrangement.

Community providers enrolled to provide assistive care services can receive an additional payment from Medicaid recipients residing in

their facilities.


Florida



Florida



All recipients 9,393 3,705 3 5,685

379 117 0 262

8,499 3,495 3 5,001

515 93 0 422


Adult family care home

Assisted living facility

Medicaid facility

Table 2.


Living arrangement

Community care programs



Medicaid

Eligibility









Georgia










Medicaid

Eligibility







Georgia



Hawaii








Statutory basis for payment: Hawaii Revised Statutes,section 346-53(C)(1) and (2).

Funding




Scope of coverage: Optional state supplementprovided to SSI recipients, including children. Paymentamounts for eligible children in domiciliary care aredetermined on an individual basis. Recipients inmedical facilities who are eligible for federal payments

under section 1611(e)(1)(E) of the Social Security Actreceive state optional supplementation (Code A paymentlevel) for up to 2 months.









B 1,100.90 2,201.80 521.90 1,332.80

H 1,100.90 2,201.80 521.90 1,332.80I 1,208.90 2,417.80 629.90 1,548.80

Table 1.


Living arrangement

H and I: Domiciliary care facility. Includes recipients (including children) living in a private, nonmedical facility (established and maintained

for the purpose of providing personal care and services to aged, infirm, or handicapped persons) and certified by the state. Level I islicensed by the state for fewer than six residents, and Level II is licensed for six or more residents.

State

code


Foster care home

Domiciliary care facility, Level I

DEFINITIONS:

B: Foster care home. Includes recipients who are certified by the state as residents of a foster care home.

Domiciliary care facility, Level II

Hawaii



Hawaii


Adults Children

All recipients 2,451 697 24 1,667 63

B 652 380 3 265 4

H 1,725 282 20 1,364 59I 74 35 1 38 0

Domiciliary care facility, Level IDomiciliary care facility, Level II

Foster care home

Table 2.


Living arrangement

State


Disabled


Administration

State Department of Human Services.


Housing and utility deposit: One-time payment madeto SSI recipients with total monthly income under $418.

Repair or replacement of stove or refrigerator: Payments made to SSI recipients with total monthlyincome under $418.

Emergency assistance due to natural disaster: Payments made to SSI recipients with total monthlyincome under $418.

Special care payments: Payments of $100 monthly areprovided to SSI recipients residing in domiciliary care

home who have been certified for an intermediate carefacility (ICF) or skilled nursing facility but have notbeen placed in one because of a lack of bed space. In

addition to meeting other requirements, these recipientsmust be wheelchair bound, incontinent, or in need of non-oral medication.

Medicaid

Eligibility









Idaho




Administration: State Department of Health andWelfare.


Administration: State Department of Health andWelfare.


Statutory basis for payment: Idaho State Code 56-207,56-208, 56-209a.



Place of application: Local offices of the stateDepartment of Health and Welfare.

Scope of coverage: Optional state supplementprovided to all SSI recipients, including children,residing in the specified living arrangements (seeTable 1). Persons living in the household of another areincluded under the living independently standard; statesupplement is increased to offset the reduced federalpayment.


Income exclusions: Federal SSI regulations apply; in-kind support and maintenance is also excluded.







631.00 889.00 52.00 20.00

889.00 . . . 20.00 . . .

776.00 c 197.00 c

Level I 918.00 c 339.00 cLevel II 985.00 c 406.00 cLevel III 1,053.00 c 474.00 c

776.00 c 197.00 c

a.b.

c.

(Continued)


State supplement is increased to offset the reduced federal payment for persons living in the household of another.The same supplement is given for living with an essential person to individuals and couples.


Semi-independent group residential facility

Living independently or in the household of another

a

Living with an essential person b

Room and board facility

Assisted living facility or certified family home

Table 1.


Living arrangement


Idaho



Idaho


Table 1.

Continued

Semi-independent group residential facility. A facility having one or more living areas under a common management in which an

opportunity to learn independent living skills is provided under individualized service plans to not less than three nor more than eight

developmentally disabled or mentally ill persons not requiring direct supervision.

DEFINITIONS:

Living independently or in the household of another. Includes recipients living in their own household (i.e., house, apartment, hotel,

rooming house, or room and board facility) or in the household of another. Also includes blind or disabled children living with their parents

and individuals paying room and board to a relative.

Living with an essential person. Includes recipients living in their own household or in the household of another with a person of their

choice whose presence in the household is essential to the recipients' well-being and who renders specific services of a kind that would haveto be provided for the recipients if they lived alone.

Assisted living facility or certified family home. One or more buildings constitutes a facility or residence, however named, that is

operated on either a profit or nonprofit basis, for the purpose of providing 24-hour care for three or more adults who need personal care or

assistance and supervision essential for sustaining activities of daily living or for the protection of the individual.

Room and board facility. A facility in which a person purchases food, shelter, and household maintenance requirements from one vendor.

Such a facility is not required to be licensed as a shelter home.

Adults Children

All recipients 12,241 2,244 25 6,996 2,976

11,655 2,137 24 6,686 2,808542 107 1 299 135

6 0 0 6 038 0 0 5 33Semi-independent group residential facility

Living independently or in the household

of another, or living with an essential

personRoom and board facilityAssisted living facility or certified

family home

Table 2.


Living arrangement Total Aged Blind

Disabled


Administration

State Department of Health and Welfare.


Restaurant meals: Eating-out allowance of up to $50per month if physically unable to prepare meals.

Maintenance for guide dog: Allowance for care and

maintenance of guide dog of up to $17 per month.

Medicaid

Eligibility









Illinois







Effective date: March 1, 1974.

Statutory basis for payment: Illinois Revised Statutes,chapter 305; ILCS, section 5/3-1 et seq.

Funding



Place of application: County offices of the stateDepartment of Human Services, except in Cook Countywhere application is made at district offices of theDepartment of Human Services.

Scope of coverage: Optional state supplementprovided to all aged, blind, or disabled SSI recipients,including children, whose income-maintenance needs,

based on state standards, exceed their monthly SSIbenefit plus other income. Individuals who have beendenied SSI because of their level of income may be

eligible for an optional state supplement if there is adeficit between all other income and the income-maintenance need based on state standards. Noncitizensliving in the community who are eligible because thefederal 7-year limit has expired are given a flat $500allowance. This program goes into effect July 15, 2004,and expires July 1, 2006.


Income exclusions

All recipients: First $25 per month of any income, exceptincome received from a spouse or other person.Aged and disabled: $20 plus one-half of next $60 permonth of earned income.Blind: $85 plus one-half of remainder of earned incomeper month.

Recoveries, liens, and assignments: Estate claims arefiled against real and personal property for all:

• Income maintenance paid after 1963;

• Medical assistance paid prior to October 1, 1993,and after January 1, 1966, for persons aged 65 orolder; and

• Medical assistance paid after October 1, 1993, forpersons aged 55 or older.

Financial responsibility of relatives: Parents are notresponsible for a child of any age who has married,regardless of current marital status, and is not living withthe parent.





a a a aa a a a

a a a a

a.

Room and board facility. Living in the community but paying for both lodging and meals. An allowance for room and board is given in lieu

of separate allowances for food and shelter.

Residential facility. Living in a long-term care or sheltered care facility. For long-term care, a $30 personal needs allowance is provided to

a person who has no other income.


DEFINITIONS:

Living independently. Living in the community.

Room and board facility

Residential facility

State supplementation is based on state-approved allowances given for individual needs.

Table 1.



Living arrangement

Illinois



Illinois



All recipients 29,947 6,674 109 23,164

29,326 6,573 100 22,65346 8 0 38

575 93 9 473

Table 2.


Living arrangement

Living independentlyRoom and board facility

Residential facility


Illinois assists with funeral and burial costs of personswho were eligible for state-administered cash or medicalassistance at the time of death.

Medicaid

Eligibility Criteria: State guidelines.



State provides a program for the aged, blind, anddisabled medically needy; children and caretakers.





Indiana




No recipients.


Administration: Family and Social ServicesAdministration, Division of Disability, Aging andRehabilitative Services.

Effective date: July 1, 1976.

Statutory basis for payment: Indiana Public Law 46,Acts of 1976.



Place of application: Family and Social ServicesAdministration, county offices of the Division of FamilyResources.

Scope of coverage: Optional state supplementprovided to all adult Medicaid or SSI recipients who,

because of age, blindness, or disability, are unable toreside in their own home and need care in a residentialfacility. Children under age 18 are not eligible foroptional supplementation.

Resource limitations: An individual may have areserve of nonexempt real and personal property(including cash, stocks, bonds, cash surrender value of life insurance, etc.) of no more than $1,500; a couplemay have no more than $2,250. If spouse resides in thesame facility, the resources of both, subject to the $2,250limit, are considered in establishing eligibility.

Ownership of personal property essential for an adequate

living arrangement, production of produce for homeconsumption, and personal effects do not affect anindividual's eligibility. Cash surrender value of lifeinsurance is disregarded if the face value does notexceed $10,000 and the beneficiary is the funeraldirector or the person's estate. The $10,000 limitation isreduced by any amount in an irrevocable burial trust orirrevocable prepaid funeral arrangement. Real property

offered for sale or rent is exempt.

Income exclusions: Disregarded from shelteredworkshop earnings are a $16 employment incentive,mandatory earnings deductions, and one-half of theremaining earnings.








Medicaid

Eligibility







information.

Indiana



Indiana



1,196.85 b 617.85 b52.00 104.00 22.00 44.00

a.

b.

Licensed residential facilitya

Table 1.


Living arrangement



Medicaid facility

Federal and state agencies consider couples residing in these living arrangements as individuals one month after leaving an independent

living arrangement.

Individuals living in licensed residential facilities receive a combined federal and state benefit of up to $1,196.90 (state-supplementedportion is up to $669.90)—including a personal allowance payment of up to $52 per month. Lesser amounts may be paid depending on

the cost of facility and income of recipients.

DEFINITIONS:

Licensed residential facility. Care in a licensed residential facility consists only of room, board, and laundry together with minimal

administrative direction. The facility must be licensed by the state Department of Health and approved for participation in the Room and

Board Assistance program by the state Family and Social Services Administration. A residential facility can be publicly or privately owned

and for profit or not for profit.


3,892 1,229 22 2,641

1,594 579 2 1,013

2,298 650 20 1,628Medicaid facility

Licensed residential facility

Table 2.


Living arrangement

All recipients



Iowa






Administration: State Department of Human Servicesadministers supplemental payments for personsreceiving residential or in-home health-related care,persons eligible for the supplement for Medicare, andpersons eligible for Medicaid. Social SecurityAdministration administers all other supplementalpayments.

Effective date: January 1, 1974 (blind), May 1, 1974(aged and disabled); October 1, 2003 (eligible forMedicare supplement or Medicaid).

Statutory basis for payment: Code of Iowa, chapter249.



Place of application: Social Security Administrationfield offices for federally administered payments; localoffices of state Department of Human Services for state-administered payments.

Scope of coverage: Optional state supplementprovided to all aged, blind, and disabled persons residingin the specified living arrangements (see Table 1).

Supplementation is not provided to residents of emergency shelters or medical facilities. Blind childrenare eligible for optional supplementation if living in theirown household or with a dependent relative; disabledchildren are eligible for optional supplementation if living with a dependent relative.










Medicaid

Eligibility







Iowa



Iowa



A 601.00a

913.00 22.00a

44.00

B 408.00 a 623.34 22.00 a 44.00

C

Aged and disabled 872.00 1,162.00 293.00 293.00

Blind 894.00 1,206.00b

315.00b

337.00

D 721.00 1,153.00 142.00 284.00

H

Aged and disabled 679.00 872.34 293.00 293.00Blind 701.00 916.34 315.00 337.00

I 528.00 1,172.34 142.00 593.00

. . . 777.17 . . . b 198.17 . . .

. . . 1,059.55 d 1,830.10 c 480.55 c 961.10

a.

b.

c.

d.

Table 1.


Living arrangement

State

code


Living with a dependent person in the household

of another

Family life or boarding home (one-third reduction

in federal benefit rate applies)

Living independently (blind)

Living in the household of another (blind)

Living with a dependent person

Family life or boarding home

Residential care c

In-home health care

Payment level when both members of a couple are blind; when only one member is blind, payment is reduced by $22.00.


Amount based on allowable costs of residential care ($17.86 to $25.07 per day), plus a personal needs allowance of $89.00 per month,

minus the federal SSI payment. State administers payments.

Payment is based on actual cost of in-home health-related care up to a maximum of $480.55, plus basic federal benefit. State

administers payments.

Residential care. Includes recipients who require custodial care (but not nursing care) on a 24-hour basis. The purpose of these facilities is

to provide care for recipients who because of age, blindness, or disability are unable to adequately care for themselves in an independent

living arrangement. Recipients must have the written recommendation of a physician to be admitted to these facilities.

In-home health care. Includes recipients who require personal services, nursing care, or both in their own home. The primary purpose of

the program is to enable recipients to remain in their own home for as long as possible. Care must be recommended in writing by a

physician and must be provided under the supervision of a registered nurse.

DEFINITIONS:

A: Living independently (blind). Includes all blind recipients who are not included under another arrangement, do not have an essential

person, and are not otherwise ineligible for supplementation.

B: Living in the household of another (blind). Includes all blind recipients who are residing in a federal Code B living arrangement, are not

included under another state arrangement, do not have an essential person, and are not otherwise ineligible for supplementation.

C and H: Living with a dependent person. Includes a recipient residing in a federal Code A, B, or C living arrangement. The recipient has

an ineligible spouse, parent, child, or adult child living in the home who is financially dependent on him or her as defined by the Iowa

Department of Human Services.

D and I: Family life or boarding home. Includes recipients residing in a federal Code A living arrangement who reside in a family life home

or boarding home licensed by the Iowa Department of Health or certified by the Iowa Department of Human Services.

Payment is based on both members of a couple needing in-home health-related care. When one member needs care, payment is

reduced by $480.55. State administers payments.



Iowa


State

code Total Aged Blind Disabled

All recipients 5,734 993 642 4,099

A 625 0 625 0

B 15 0 15 0C 1,051 151 2 898

D and I 6 2 0 4

H 4 1 0 3

-- 2,369 483 0 1,886

-- 1,664 356 0 1,308

Living arrangement

Table 2.


Living with a dependent personFamily life or boarding home

Living in the household of

another (blind)

Living independently (blind)

Living with a dependent person

in the household of another


Residential care

In-home health care



Kansas










Medicaid

Eligibility







Kansas



Kentucky




No recipients.


Administration: State Cabinet for Health and FamilyServices, Department for Community Based Services.


Statutory basis for payment: Kentucky RevisedStatutes 205.245 and budget approval by statelegislature.



Place of application: Local offices of the state Cabinetfor Health and Family Services, Department forCommunity Based Services.

Scope of coverage: Optional state supplementprovided to every aged, blind, and disabled person whoneeds care in a personal care facility other than aMedicaid facility or in a family care home licensed

under the health licensure act or needs the services of acaretaker in the home and who has insufficient incometo obtain this care. Children are eligible for the optionalsupplement of caretaker services in the home. Theminimum age requirement is 16 for a personal carehome and 18 for a family care home.









1,019.00 a 440.00 a

751.00 a 172.00 a641.00 984.00 62.00 115.00

a.

DEFINITIONS:

Personal care facility. Includes recipients who are ambulatory or mobile nonambulatory and able to manage most of the activities of daily

life. Facilities provide supervision, basic health and health-related services, personal care, and social or recreational activities.

Family care home. Includes recipients in residential accommodations limited to two or three persons who are not related to the licensee.

Residents of these homes must be ambulatory or mobile nonambulatory and be able to manage most of the activities of daily life. They

cannot have an illness, injury, or disability requiring constant medical care.

Caretaker in home. Includes recipients who are eligible to receive caretaker services in their homes. These services are provided at

regular intervals to prevent institutionalization.



Table 1.


Living arrangement

Personal care facility

Family care homeCaretaker in home

Kentucky



Kentucky



4,396 1,607 23 2,766

3,335 -- -- --193 -- -- --

868 -- -- --


Table 2.


Caretaker in home

Living arrangement

All recipients

Personal care facilityFamily care home


State provides assistance for special needs.

Medicaid

Eligibility









Louisiana



Minimum State Supplementation



Administration: State Department of Health andHospitals, Bureau of Health Services Financing.

Effective date: March 1, 1982

Statutory basis for payment: Senate ConcurrentResolution No. 133, 1980.



Place of application: Local offices of the state Bureauof Health Services Financing and contractors.

Scope of coverage: Optional state supplementprovided to all aged, blind, and disabled persons,including children, who reside in a nonpsychiatricMedicaid long-term care facility.









State provides assistance for special needs only torecipients who were determined eligible on or beforeDecember 1975.

Medicaid

Eligibility Criteria: SSI program guidelines (Title XVI).







38.00 76.00 8.00 16.00

DEFINITION:



Table 1.


Living arrangement

Medicaid facility


4,713 1,410 54 3,249

Table 2.


Living arrangement

Medicaid facility

Louisiana



Maine




Administration: State Department of Health and HumanServices.




Statutory basis for payment: Maine Revised Statutes,title 22, subtitle 3, part 1-A, chapter 855-A.



Place of application: Local offices of the stateDepartment of Health and Human Services.

Scope of coverage: Optional state supplementprovided to all aged, blind, and disabled SSI recipients,including children. In addition, a small number of

persons not eligible for SSI are eligible for a statesupplement.


Income exclusions: Federal SSI regulations apply forall living arrangements. In addition, for those livingalone, with others, or in the household of another, thestate disregards an additional $55 for individuals and$80 for couples.







Administration

State Department of Health and Human Services.


Licensed boarding home subsidies: When costs of care exceed total of SSI and state supplementarypayments, state will pay the difference up to establishedmaximum rates.

Medicaid

Eligibility






The state Department of Human Services obtains thisinformation.

Maine



Maine



Living alone or with others 589.00 884.00 10.00 15.00Living in the household of another 394.00 591.34 8.00 12.00

Foster home 628.00 1,142.00 49.00 273.00

Flat-rate boarding home 796.00 1,459.00 217.00 590.00Cost-reimbursement boarding home 813.00 1,505.00 234.00 636.00Medicaid facility 40.00 80.00 10.00 20.00

Flat-rate boarding home. Includes recipients residing in a boarding home that is licensed by and has a provider agreement with the state

for reimbursement at a flat rate.

Cost-reimbursement boarding home. Includes recipients residing in a boarding home that is licensed by and has a provider agreement

with the state for reimbursement based on cost.


DEFINITIONS:

Living alone or with others. Includes the following types of recipients:

• Individual living in his or her own household with no other person except an ineligible spouse;

• Couples living in their own household;

• Persons in a medical facility where Medicaid does not pay more than 50 percent of the cost of their care;

• Person in an institution (excluding inmates of public institutions) on the basis of their eligibility under section 1611(e)(1)(E) of the Social

Security Act for all or part of a month provided that Medicaid does not pay more than 50 percent of the cost of their care;

• Persons in a private-pay facility or private-pay portion of a licensed boarding home; or

• Individuals or couples living with other persons but not considered to be living in the household of another.

Living in the household of another. Includes eligible persons who:

• Live in a household other than their own throughout a month with at least one other person who is not their child, their spouse, or anineligible person whose income is deemed to them; and

• Receive food and shelter from within that household.

Foster home. Includes recipients residing in an adult foster home.

Table 1.


Living arrangement



34,296 -- -- --

32,597 -- -- --62 -- -- --

272 -- -- --19 -- -- --33 -- -- --

1,313 -- -- --Cost-reimbursement boarding home

Table 2.Number of persons receiving optional state supplementation, January 2005

Foster homeFlat-rate boarding home

Medicaid facility

Living arrangement

All recipients

Living alone or with othersLiving in the household of another




Maryland



Mandatory Minimum supplementation



Administration: State Department of Human Resources,Family Investment Administration, and in someinstances, Department of Health and Mental Hygiene,Mental Hygiene Administration.


Statutory basis for payment: Annotated Code of Maryland, article 88A, section 3(a), 5, effective January1, 1974, and Code of Maryland Annotated Regulations07.03.07.



Place of application: Local offices of the county socialservices agencies.

Scope of coverage: Optional state supplementprovided to all aged, blind, and disabled individualsliving in a care home or in an assisted living facility andwho are eligible for payments under the SSI program orwho would be eligible except for income. Children arenot eligible for optional supplementation.


Income exclusions: Excludes $20 of any unearnedincome, including SSI.







Minimal supervision 645.00 a 66.00 a

Moderate supervisionb

754.00 a 175.00 a

Extensive supervisionb

1,042.00 a 463.00 a

Specialized and intensive supervisionb

1,245.00 a 666.00 a

763.00 a 184.00 a

a.

b.

Assisted living facility. Includes individuals certified by the Maryland Department of Human Resources as requiring care in an approved

domiciliary care facility.

DEFINITIONS:Care home with minimal supervision. Includes individuals who are certified by one of the administering state agencies as requiring

minimal supervision in an approved care home.

Care home with moderate supervision. Includes individuals who are certified by one of the administering state agencies as requiring

moderate supervision in an approved care home.

Care home with extensive supervision. Includes individuals who are certified by one of the administering state agencies as requiring

extensive supervision in an approved care home.

Care home with specialized and intensive supervision. Includes individuals who are certified by one of the administering state agencies

as requiring specialized and intensive services in an approved care home.

Includes an $82 personal needs allowance.

Care home

Assisted living facilityb

The state supplementation rate for individuals applies to each member of a couple.


Table 1.


Living arrangement

Maryland



Maryland



-- -- -- --

515 -- -- --2,365 -- -- --

0 -- -- --149 -- -- --

-- -- -- --


Living arrangement

All recipients

Care home

Minimal supervision

Table 2.


Specialized and intensive supervision


Moderate supervisionExtensive supervision



Medicaid

Eligibility










Massachusetts








Statutory basis for payment: General Laws of theCommonwealth of Massachusetts, chapter 118A,section 1.




Scope of coverage: Optional state supplementprovided to every aged, blind, and disabled SSIrecipient, including children, and recipients in privatemedical facilities where the Medicaid program provides50 percent or less of the cost of care.








Individual Couple a Individual Couple a

A

Aged 707.82 1,070.72 128.82 201.72Blind 728.74 1,457.48 149.74 588.48Disabled 693.39 1,049.06 114.39 180.06

B

Aged 618.26 1,070.72 39.26 201.72Blind 728.74 1,457.48 149.74 588.48Disabled 609.40 1,049.06 30.40 180.06

C

Aged 490.36 795.14 104.36 215.80Blind 728.74 1,457.48 342.74 878.14Disabled 473.58 773.52 87.58 194.18

E

Aged and disabled 872.00 1,744.00 293.00 875.00Blind 728.74 1,457.48 149.74 588.48

F and Z 65.00 130.00 35.00 70.00

G 1,033.00 1,550.00 454.00 681.00

Medicaid facility


(Continued)


Shared living expenses


Licensed rest home

Table 1.


Living arrangement

State

code


Massachusetts



Massachusetts


a.

G: Assisted living facility. Includes recipients residing in nonpublic subsidized assisted living facilities that have been registered with the

B: Shared living expenses. Includes recipients who reside in a federal Code A or C living arrangement and do not meet the criteria for

state living arrangement A or E. It therefore includes recipients who reside in group care facilities (such as halfway houses), private medical

facilities where Medicaid is paying 50 percent or less of the cost of care, foster homes, commercial boarding homes, or other facilities that do

not meet the criteria for state living arrangement A or E. It also includes:

• Recipients who reside in households where they do not pay at least two-thirds of the household expenses and one or more household

members receive an income maintenance payment; and

• Transients, the homeless, and residents of public emergency shelters.

C: Living in the household of another. Includes recipients residing in a federal Code B living arrangement.E: Licensed rest home. Includes recipients residing in a licensed rest home that has a provider agreement with the state.

F and Z: Medicaid facility. Includes recipients residing in a federal Code D living arrangement.

NOTE: Blind individuals aged 65 or older are entitled to the highest payment category for which they qualify.

The amounts given apply when both members of a couple belong to the same eligibility category. When members belong to different

eligibility categories, the two respective individual benefits are added to obtain the couple's benefit.

DEFINITIONS:

A: Living independently. Includes recipients who live:

• Alone;• Only with an eligible spouse;

• With an eligible spouse and with ineligible children who do not receive income maintenance payments; or

• With an ineligible spouse or ineligible children none of whom receive income maintenance payments. Also includes recipients residing

in a federal Code C living arrangement who do not live with any persons receiving income maintenance payments. Persons not meeting

these criteria may be included if they are residing in a federal Code A or C living arrangement and pay at least two-thirds of the

household expenses. Recipients living in public congregate housing developments are also included.

Table 1.

Continued

Adults Children

All recipients 169,908 44,243 3,960 97,968 23,737

A 77,471 25,952 1,426 43,856 6,237B 74,690 11,954 1,845 45,200 15,691

C 11,620 2,991 515 6,661 1,453E 1,837 1,076 18 743 0

F and Z 3,051 1,187 140 1,368 356G 1,239 1,083 16 140 0

Medicaid facilityAssisted living facility

Table 2.


Living independentlyShared living expensesLiving in the household of

another

Licensed rest home

Living arrangement

DisabledState



Administration

State Department of Transitional Assistance andCommission for the Blind.


Vendor payments in lieu of cash payments.

Disaster benefits: Replacement of specific items of furniture, household equipment, supplies, food, and

clothing for SSI recipients when these items were lostbecause of a natural disaster or fire. (Amountsexempted in determining SSI eligibility.)

Burial expenses: Payment of funeral and burialexpenses for SSI recipients shall not exceed $1,100, andthe total expense shall not exceed $1,500. When aresource exists, it is deductible from the total expense(maximum $1,500), and the payment by the departmentmust not exceed $1,100 of the balance.

Rest home subsidies: When cost exceeds the totalavailable income, excluding personal needs allowance,



Massachusetts


the state will pay difference up to established maximumrates.

Moving expenses: The cost of moving within the statefor SSI recipients may be paid once in a 12-monthperiod if:

• Present living quarters have been certified assubstandard,

• Moving to new quarters is necessary because of health problems or lack of safety in oldneighborhood,

• Recipient is moving into federal or statesubsidized housing, or

• Recipient is forced to move for other reasons.Total payment not to exceed $150.

Homemaker and housekeeper services: TheDepartment of Elder Affairs performs homemaker andhousekeeping services for recipients aged 60 or older.The Massachusetts Rehabilitation Commission provides

these services for recipients under age 60.

Medicaid

Eligibility









Michigan






Administration: Michigan Department of HumanServices administers optional supplementation forrecipients living independently or living in thehousehold of another. All other supplementation isadministered by the Social Security Administration.


Statutory basis for payment: Michigan CompiledLaws, chapter 400, act 280, as amended, section 400-10.





provided to all SSI recipients, including children, exceptthose residing in medical facilities not certified underMedicaid.









Administration

Michigan Department of Human Services.


Personal care and home help: For recipients livingindependently, payment for help required with personalcare and household activities (maximum of $333 permonth).

State emergency relief: Services provided for a numberof needs arising from specific acceptable causes beyondthe recipient's resources to control. Acceptable causesinclude:

• Fires, floods, and other physical disasters;

• Eviction or foreclosure;

• Home repairs necessary to protect health; and

• Utility shutoff.

State disability assistance: SSI recipients are eligibleif state disability assistance standards indicate that theirneeds are greater than their SSI payment plus otherincome.

Medicaid

Eligibility







Michigan



Michigan



. . . 593.00 897.00 14.00 28.00

. . . 395.33 598.00 9.33 18.66

D 666.00 1,332.00 87.00 463.00

E 736.50 1,473.00 157.50 604.00F 758.30 1,516.60 179.30 647.60G 883.00 1,180.00 14.00 21.00

I 37.00 74.00 7.00 14.00Medicaid facility



Home for the agedLiving independently with an essential person

Living independentlyLiving in the household of another

Domiciliary care

Personal care facility

Table 1.


Living arrangement

State

code

F: Home for the aged. Includes recipients residing in nonmedical facilities for the aged. The state certifies which recipients are residents

requiring this level of care. Such care situations include, but are not limited to, licensed homes for the aged.

G: Living independently with an essential person. Includes recipients with an essential person who are not living in the household of

another. Children under age 18 are excluded. Payment levels for essential person apply only to cases converted from the state rolls in 1974.

There are no longer any recipients receiving payments for living in the household of another with an essential person.

I: Medicaid facility. Includes recipients residing in a federal Code D living arrangement.

DEFINITIONS:

Living independently. Includes all eligible recipients who are not included in any other state living arrangement, recipients residing in

facilities where Medicaid is not paying more than 50 percent of the cost of care, and recipients residing in publicly operated emergency

shelters throughout a month.

Living in the household of another. Includes recipients with no essential person who are residing in a federal Code B living arrangement.

D: Domiciliary care. Includes recipients residing in licensed nonmedical facilities that provide room, board, and supervision. The state

certifies which recipients are residents requiring this level of care.

E: Personal care facility. Includes recipients residing in licensed nonmedical facilities that provide general supervision, physical care, andassistance in carrying out the basic activities of daily living. The state certifies which recipients are residents requiring this level of care.

Adults Children

All recipients 218,941 -- -- -- --

. . . 203,217 -- -- -- --D 36 0 0 32 4E 12,966 459 65 11,568 874F 649 264 1 384 0

G 3 0 0 3 0I 2,070 261 18 1,597 194

NOTE: -- = not available; . . . = not applicable.

Aged Blind

Disabled

Home for the aged

Medicaid facility

Living independently with an

essential person

Table 2.


Living independently or living in

the household of anotherDomiciliary carePersonal care facility

Living arrangement

State

code Total



Minnesota




No recipients.


Administration: Local county offices of the stateWelfare and Human Services Agencies (state-supervised). Payments are made under the MinnesotaSupplemental Aid Program.

Effective date: April 1, 1974.

Statutory basis for payment: Minnesota StatutesAnnotated, sections 256D.33-256D.54 and 256I.01-256I.06.

Funding Administration: County funds; except state expenses,which are state-funded.Assistance: State funds.


Place of application: County Welfare and HumanServices Agencies.

Scope of coverage: Optional state supplementprovided to SSI recipients, including blind childrenunder the age of 18 and disabled adult children, residingin the specified living arrangements.









Administration

Local county offices of the state Welfare and HumanServices Agencies (state-supervised).


Amounts of assistance for items not covered by themandatory state standards are determined on the basis of need in each case.

Diets: Specified modified diets, when prescribed by aphysician, are allowed at designated rate.

Guardianship fees: Five percent of gross monthlyincome (including SSI) up to a maximum of $100 permonth.

Representative payee services: Ten percent of grossmonthly income, up to a maximum of $25, for servicesprovided by an agency that meets the requirementsunder SSI regulations to charge a fee for payee services.

Emergency aid: Available once a year for specifiedneeds. Housing and major repairs : Catastrophic situations forhomeowners who live in their homes, rent deposits, and

moving expenses.

Furniture and appliances : Necessary repairs andreplacements.

Utility shutoffs.

Shelter needy provision: A supplemental payment,equal to the maximum Food Stamp allotment for anindividual, for participants in the MinnesotaSupplemental Aid Program relocating from aninstitution into the community if their shelter costsexceed 40 percent of their income. Recipients of the

shelter needy special need must apply for subsidizedhousing.

Minnesota



Minnesota



Entitlement prior to January 1, 1994 640.00 995.00 61.00 126.00

Entitlement January 1, 1994, or later 640.00 960.00 61.00 91.00

Entitlement prior to January 1, 1994 477.00 905.00 91.00 325.66Entitlement January 1, 1994, or later 477.00 642.00 91.00 62.66

1,153.36 b 574.36 b

76.00 152.00 46.00 92.00

a.

b. Couples are treated as two individuals starting with the month after leaving an independent living arrangement.

Table 1.


Living arrangement


Includes $76 a month for clothing and personal needs.


Living in the household of another. Includes recipients who live with another person, regardless of the relationship, in a house or an

apartment.

Nonmedical, group residential facility. Includes recipients who reside in a congregate care setting and have their shelter payments

negotiated by the county agency. Nonmedical facilities include foster care, boarding care, and room and board arrangements.



Nonmedical, group residential facility a

Medicaid facility

DEFINITIONS:

Living independently. Includes recipients who are solely responsible for paying costs connected with their home or apartment and persons

who are eligible for Medicaid home and community-based service waivers or at risk of being placed in a group residential facility.

NOTE: Minnesota Supplemental Aid Program excludes the first $20 of the SSI payment.

Total Aged Blind DisabledAll recipients 28,224 6,330 136 21,758

-- -- -- --

-- -- -- ---- -- -- ---- -- -- --

Living arrangement

Table 2.



Living in the household of anotherNonmedical, group residential facilityMedicaid facility


Medicaid

Eligibility


Determined by: Local county offices of the stateWelfare and Human Services Agencies (state-supervised).







Mississippi










Medicaid

Eligibility

Criteria: SSI program guidelines (Title XVI). State hasmore liberal guidelines for Medicaid-only (non-SSI)recipients.

Determined by: Social Security Administration for SSIrecipients, and the Division of Medicaid for those withincome above SSI state limits.





information.

Mississippi



Missouri




Administration: State Department of Social Services;Division of Family Services.


Administration: State Department of Social Services;Division of Family Services.


Statutory basis for payment

Supplemental aid to the blind: Missouri RevisedStatutes, section 209.All other supplementation: Missouri Revised Statutes,section 208.030, subchapter 5.



Place of application: State offices of the Division of Family Services.

Scope of coverage: Optional state supplementprovided to any person who:

• Is aged, blind, or disabled and over age 18;

• Resides in a licensed residential care facility or alicensed intermediate care or skilled nursing home

that is not a Medicaid facility; and• Has insufficient cash income to cover costs of care

in the facility.Blind persons over age 18 living on their own are alsoprovided with a supplement. Children under age 18 arenot eligible for optional supplementation.

Resource limitations

Aged and disabled: $999.99 individual; $2,000 couple.Blind: $2,000 individual; $4,000 couple.

Income exclusions: There are no income exclusions forthe aged or disabled. Disregards for the blind include

the first $65 plus one-half of the remainder of earnedincome.







735.00 1,181.00 156.00 312.00871.00 1,453.00 292.00 584.00

969.00 1,649.00 390.00 780.00

1,058.00 1,827.00 b 479.00 b 958.00

a.

b.

DEFINITIONS:

Licensed residential care facility, Level I. Residents must meet state income and resource guidelines. Care provided is similar to

boarding home care.

Licensed residential care facility, Level II. Residents must meet state income and resource guidelines. Custodial-type care is provided.

Licensed intermediate care or skilled nursing home. Custodial and medical care are provided.

Recipients in licensed nursing homes are entitled to an additional $25 per month to meet their personal needs. If the recipient is already

receiving a personal needs allowance from another state or federal agency, this payment will not be made by the Division of Family

Services.

Table 1.Optional state supplementation payment levels, January 2005 (in dollars)

Living arrangement


Only recipients who receive less than $479 monthly in SSI payments and less than $625 monthly from other sources qualify for this

supplement. The state supplement is reduced dollar-for-dollar by the SSI payment.

Licensed residential care facility, Level ILicensed residential care facility, Level II

Licensed intermediate care or skilled nursing home a

Aid to the blind

Missouri



Missouri



All recipients 8,572 2,745 876 4,951

1,906 602 . . . 1,3045,566 1,984 . . . 3,582

224 159 . . . 65876 . . . 876 . . .


Table 2.


Living arrangement

Licensed residential care facility, Level ILicensed residential care facility, Level IILicensed intermediate care or skilled

nursing home

Aid to the blind



Medicaid

Eligibility









Montana








Statutory basis for payment: Montana CodeAnnotated 52-1-104.

Funding



Place of application: Developmental Disabilities andAdult Protective Services District Offices, Child andFamily Services Division of the Department of PublicHealth and Human Services, and other designatedcontracting agencies.

Scope of coverage: Optional state supplementprovided to all persons residing in specified living

arrangements (see Table 1).










Medicaid

Eligibility







Montana



Montana



Assisted living facility G 673.00 1,062.00 94.00 193.00Group home for the mentally ill or disabled H 673.00 1,062.00 94.00 193.00Community home for the physically or

developmentally disabled I 673.00 1,062.00 94.00 193.00Child and adult foster care home J 631.75 979.50 52.75 110.50Transitional living services for the

developmentally disabled K 605.00 926.00 26.00 57.00

NOTE: Up to $100 may be retained per month as a personal needs allowance, depending on the facility.

Table 1.


Living arrangement

State

code


K: Transitional living services for the developmentally disabled. This program provides an intermediate step between the group home

and independent living. It consists of persons living in congregate apartments with some staff supervision. Staff provide assistance in such

areas of daily living as cooking, shopping, and cleaning.

DEFINITIONS:

G: Assisted living facility. A facility that provides 24-hour personal care services to five or more persons who are not in need of skilled

nursing care. Personal care services include help with eating, walking, dressing, bathing, etc., as well as supervision, local transportation,

and protective oversight. These facilities must be licensed by the Department of Public Health and Human Services. Residents must:

• Be 18 years of age or older,

• Be ambulatory,

• Not be incontinent, and

• Not need chemical or physical restraints.

H: Group home for the mentally ill or disabled. Provides residential services to mentally ill persons in the community. Must have current

license from the Department of Public Health and Human Services.

I: Community home for the physically or developmentally disabled. Homes for the developmentally disabled provide a family-type

residence and related residential services to persons with developmental disabilities. Children can be residents of these homes. Homes for

the severely disabled provide a home-like residence for two to eight severely disabled persons. Persons with a primary diagnosis of mental

illness are not included in the latter homes. These homes must be licensed by the Department of Public Health and Human Services.

J: Child and adult foster care home. A children's foster home is a licensed home that provides care to a child. An adult foster home is a

home licensed by the Department of Public Health and Human Services that provides personal and custodial care to disabled adults or aged

persons.

Adults Children

All recipients 954 29 16 849 60

G 114 17 2 95 0

H 45 0 0 45 0

I 569 9 10 550 0

J 190 3 4 123 60

K 36 0 0 36 0

Community home for the

physically or developmentallydisabled

Child and adult foster care homeTransitional living services for

the developmentally disabled

Table 2.


Assisted living facilityGroup home for the mentally ill

or disabled

Total Aged Blind

Disabled

Living arrangement

State

code



Nebraska








Statutory basis for payment: Revised Statutes of Nebraska, section 68-1005.



Place of application: Local offices of the stateDepartment of Health and Human Services.

Scope of coverage: Optional state supplementprovided to all aged, blind, and disabled recipients whomeet state guidelines, including children, except those inpublic institutions where Medicaid is not paying for thecost of care. Persons living in the household of anotherreceive the same state supplement as those livingindependently.


Income exclusions

Aged and disabled: Federal SSI regulations apply.Blind: Income exclusions include the first $20 per monthof unearned income, not including SSI, and the first $85plus one-half of the remainder of earned income.







Administration

State Department of Health and Human Services.


Transportation costs: Thirty-seven cents per mile forobtaining medical services if recipient uses his or herown car.

Repair or purchase of furniture and appliances: Repair or purchase of furniture or appliances over $750total cost may be included (with state office approval) if the unit lacks essential items.

Moving expenses: Costs of moving may be included if the recipient is forced to move for reasons beyond his orher control or if the recipient can obtain lower-costshelter.

Taxes: Back taxes may be included if the individualwould soon lose his or her home and the plan to remainin the home is preferred by the individual andrecommended by the case worker.

Home repairs: Payments for home repairs, up to$1,000, if essential for the recipient's health or safety.

Meals and lodging: The cost of meals (up to $12 perday) and lodging, if verified as related to obtainingapproved health services, may be granted if theindividual is away from home for more than 12 hours.

Maintenance for guide dog: The medical andmaintenance costs of a seeing-eye dog may be allowed.

Guardian or conservator: An allowance not to exceed$10 a month may be allowed if the client has a court-appointed guardian or conservator.

Medicaid

Eligibility







Nebraska



Nebraska



588.00 874.00 9.00 5.00

506.00 722.34 120.00 143.00

737.00 1,474.00 158.00 605.00

1,576.00 2,152.00 997.00 1,283.00

673.00 . . . 94.00 . . .1,017.00 2,034.00 438.00 1,165.00

50.00 100.00 20.00 40.00

a.

b.

Licensed center for developmentally disabled. These facilities provide accommodations and board and care (e.g., personal assistance in

feeding, dressing, and other essential daily living activities) to four or more individuals who are unable to care for themselves or manage their

own affairs because of illness, disease, injury, deformity, disability, or physical or mental infirmity. They do not, however, require the daily

services of licensed, registered, or practical nurses. These facilities are licensed by the Department of Health.

Licensed group home for children or child-caring agency (disabled). These facilities provide 24-hour accommodations for two or more

developmentally disabled minors. The homes are under the direction and control of a mental retardation program and are licensed by the

Department of Social Services.


DEFINITIONS:

Living independently. Includes recipients residing in a federal Code A living arrangement.

Room and board facility. Includes eligible persons who:

• Live in a household other than their own throughout a month with at least one other person who is not their child, their spouse, or anineligible person whose income is deemed to them; and

• Receive food and shelter from within that household.

Adult family home. A residential living unit that provides full-time residence with minimal supervision and guidance to not more than three

individuals aged 19 or older. Individuals residing in these homes are essentially capable of managing their own affairs but need supervision.

These homes are certified by the social services unit in the local offices of the Department of Social Services.

Assisted living facility. A residential facility unit that provides accommodations and board and care for four or more individuals not relatedto the owner, operator, manager, or administrator. These individuals may be unable to manage their own affairs because of illness, disease,

injury, deformity, or physical or mental infirmity. These individuals do not require the daily services of a licensed nurse; however, staff may

assist with the taking of oral or external medication.


Applies only to persons living in the household of another.


Room and board facilitya

Adult family homeb

Table 1.


Living arrangement


Includes a minimum of $60 for personal needs allowance.

Licensed center for developmentally disabled a

Licensed group home for children or child-caring agency

(disabled)b

Medicaid facilityAssisted living facility


All recipients 6,079 1,256 58 4,765

4,265 881 41 3,343

16 4 1 11122 13 1 108

65 5 0 60

1 0 0 1908 185 7 716658 164 8 486

44 4 0 40

Adult family homeLicensed center for developmentally disabled


Licensed group home for children or child-

caring agency (disabled)

OtherMedicaid facilityAssisted living facility

Room and board facilityLiving independently

Table 2.


Living arrangement



Nevada




No recipients.




Statutory basis for payment: Nevada Revised Statutes,title 38, Public Welfare.

Funding




Scope of coverage: Optional state supplementprovided to all aged and blind recipients, includingchildren, except those in medical institutions notlicensed by Medicaid and those in medical institutionsfor whom Medicaid pays over 50 percent of the cost of

their care. State does not have an assistance program fordisabled persons.









A

Aged 615.40 943.46 36.40 74.46Blind 688.30

a1,243.60 109.30

a374.60

B

Aged 410.27 628.98 24.27 49.64

Blind 599.96 b 1,111.28 213.96 b 593.94

C 929.00 1,750.00 350.00 881.00

a.

b.

DEFINITIONS:

A: Living independently. Includes aged and blind recipients who live in their own household or are in certified private medical facilitieswhere Medicaid does not pay more than 50 percent of the cost of care. Also includes blind children under age 18 living in their parents'

household.

B: Living in the household of another. Includes aged and blind recipients residing in a federal Code B living arrangement.

C: Domiciliary care. Includes aged and blind recipients who live in private nonmedical facilities or in residential facilities serving 16 or fewer

persons that provide personal care and services and who are unrelated to the proprietor.

NOTE: Blind individuals aged 65 or older are entitled to the highest payment category for which they qualify.

Payment level when both members are blind; when one member is aged, payment level is reduced by $150.07.

Table 1.


Living arrangement

State

code


Payment level when both members are blind; when one member is aged, payment level is reduced by $241.15.



Domiciliary care (aged and blind)

Nevada



Nevada


State

code Total Aged Blind Disabled

All recipientsa

8,603 7,848 491 . . .

A 7,283 6,842 441 . . .

B 679 637 42 . . .C 377 369 8 . . .

a.

Table 2.


Includes 264 recipients not distributed by eligibility category or living arrangement.

Living arrangement


Living in the household of anotherDomiciliary care




Medicaid

Eligibility









New Hampshire




Administration: State Department of Health and HumanServices, Division of Family Assistance.


Administration: Local offices of the state Departmentof Health and Human Services, Division of FamilyAssistance.


Statutory basis for payment: New Hampshire RevisedStatutes, as amended, section 167:7, I, II, III, IV.

Funding Administration: State funds.Aged and disabled assistance: 50 percent state funds, 50percent county funds.Blind assistance: 100 percent state funds.


Place of application: Local offices of the Division of Family Assistance.

Scope of coverage: Optional state supplementprovided to SSI recipients, including blind childrenunder the age of 18 and disabled adult children, residingin the specified living arrangements. Persons living inthe household of another receive the same statesupplement as those living independently.

Resource limitations: No monetary or acreagelimitation on property occupied as a home. Personalproperty limited to $1,500 net cash value for anindividual or a couple excluding clothing, householdfurnishings, tools, car, life insurance, and farm

equipment or livestock used for food needs. Cash valueof life insurance not counted unless face value exceeds

$1,500 per person; when it exceeds that, equity valuecounts toward the $1,500 resource limits.

Income exclusionsStandard exclusions for any income, including SSI (in dollars; . . . = not applicable)

Living arrangement Individual Couple

Living independently 13.00 20.00

Living with an essential person 25.00 25.00

Residential care facility foradults 13.00 . . .

Enhanced family care facility 13.00 . . .

Community residence 13.00 . . .

Earned income exclusions

• Aged and disabled—Same as federal.• Blind—$85 of gross earnings plus one-half of

amount over $85.Other exclusions: If recipient receives income fromother persons in exchange for providing only room forsuch persons, $50 per person is deducted from suchincome. Actual expenses if greater may be allowed,subject to verification.

If income is received in exchange for room andboard, the Food Stamp coupon allotment for eachboarder is deducted in addition to the amounts givenabove.

Recoveries, liens, and assignments

Aged and disabled: All aid paid is by law a lien on theestate of the recipient (and spouse if living together). Norecovery from real estate occupied by surviving spouseor blind or disabled child or from personal property of less than $100. State may waive recovery.Blind: No lien provisions applicable.





New Hampshire



New Hampshire



606.00 890.00 27.00 21.00

. . . 1,172.00 . . . 13.00

786.00 b 207.00 b

786.00 b 207.00 b

Nonsubsidized 728.00 . . . 149.00 . . .Subsidized 668.00 . . . 89.00 . . .

50.00 . . . 20.00 . . .

a.

b.

Community residence. A facility that provides housing on a 24-hour basis to mentally ill or developmentally impaired persons. Care

provided is a combination of supervised social, personal, and mental health services. The appropriate community residence standard of

need is based on whether the resident received any type of subsidy from the Division of Mental Health and Developmental Services.


DEFINITIONS:Living independently or in the household of another. Includes all adult recipients residing in a federal Code A or B living arrangement

who are not included in any other state living arrangement. Also includes blind children residing in a federal Code A, B, or C living

arrangement.

Living with an essential person. Includes recipients living in a private household with a person who provides the essential care and

personal services that enable them to remain in their household.

Residential care facility for adults. Facilities that provide housing for 1 to 25 elderly or physically disabled adults who cannot live alone but

do not require nursing home care.

Enhanced family care facility. Community residences that are owned and operated by a person or family living in the residence. One or

more individuals receive services in a certified family environment, and members of the host family provide the primary daily support.


Applies only to SSI recipients converted from former state assistance programs.

The state supplementation rate for individuals applies to each member of a couple.

Community residence

Medicaid facility


Living with an essential persona

Residential care facility for adults

Enhanced family care facility

Table 1.


Living arrangement




Medicaid

Eligibility









New Hampshire


Total Aged Blinda

Disabled

All recipients 7,365 1,353 253 5,759

6,179 1,113 202 4,864

8 0 1 7

129 81 1 47

701 111 38 552

35 6 0 29303 35 11 257

10 7 0 3

a.

Table 2.


Living arrangement


Living with an essential person

Residential care facility for adults

Enhanced family care facility

Community residenceNonsubsidized

Only blind children are eligible for optional supplementation; they are included in counts for the blind.

Subsidized

Medicaid facility




New Jersey








Statutory basis for payment: New Jersey StatutesAnnotated, 44:7-86.

Funding




Scope of coverage: Optional state supplementprovided to all aged, blind, and disabled recipients,including children, except those in publicly operatedcommunity residences or facilities where Medicaid paysless than 50 percent of the cost of care. Supplementation

provided to recipients in approved residential facilities.









Administration

State Department of Human Services, Division of Family Development.


Emergency assistance for catastrophic events and burialand funeral payments. Eligibility for payments based onmeeting requirements for mandatory minimum or

optional state supplementary payments.

Medicaid

Eligibility







New Jersey



New Jersey



A 729.05 1,439.36 150.05 570.36B 610.25 894.36 31.25 25.36

C 894.36 . . . 315.36 . . .

C 894.36 . . . 25.36 . . .

D 430.31 672.43 44.31 93.09G 40.00 80.00 10.00 20.00

a.

G: Medicaid facility. Includes recipients residing in a federal Code D living arrangement.

DEFINITIONS:

A: Congregate care facility. Includes recipients in:

• Residential heath care facilities, assisted-living residences, or comprehensive personal care homes licensed by the Department of Health.

• Recipients in residential facilities for children and adults under the supervision of or placement by the Division of Developmental

Disabilities or the Division of Youth and Family Services and approved by the Department of Human Services.

B: Living alone or with others. Includes recipients residing in a federal Code A or C living arrangement who do not meet the definitions of

other state living arrangements. Includes persons in:

• The Transitional Residency Program when their placement is through the Division of Mental Health and Hospitals, Department of HumanServices,

• Room and board facilities licensed by the Department of Community Affairs, and

• Persons in medical facilities who reside in a federal Code A living arrangement on the basis of their eligibility under section

1611(e)(1)(E) of the Social Security Act.

C: Living alone or with an ineligible spouse.

• Applies to recipients who live with their ineligible spouse only or with their ineligible spouse and foster children only.

• Uses federal criteria. Recipient currently has an essential person living in the household and in December 1973 was receiving assistance

under an approved state plan that covered the needs of an essential person.

D: Living in the household of another. Includes recipients residing in a federal Code B living arrangement.


State supplement includes a $67.50 personal needs allowance per person per month.

Congregate care facilitya

Living alone or with others

Living alone with an ineligible spouse

Table 1.


Living arrangement

State

code



Medicaid facility


Adults Children

All recipientsa

146,720 32,732 883 85,540 27,564

A 6,478 570 35 5,367 506B 112,852 21,800 666 66,184 24,202

C 5,400 2,474 28 2,896 2

D 18,141 7,076 131 8,572 2,362G 3,848 812 23 2,521 492

a. Includes one recipient not distributed by eligibility category or living arrangement.

Congregate care facilityLiving alone or with othersLiving alone with an ineligible

spouse or essential personLiving in the household

of anotherMedicaid facility

Blind

Disabled

Table 2.


Living arrangement

State

code Total Aged



New Mexico




Administration: State-administered through the countyoffices of the state Department of Human Services.


Administration: State-administered through the countyoffices of the state Department of Human Services.


Statutory basis for payment: Chapter 51, Laws of 1976.



Place of application: County offices of the stateDepartment of Human Services.

Scope of coverage: Optional state supplementprovided to all SSI recipients who reside in a licensedadult residential care home. Children under age 18 are

not eligible for optional supplementation.









Administration

County offices of the state Department of HumanServices (state-administered).


Burial expenses provided for SSI recipients. Payment of up to $200 toward funeral expenses if availableresources of the deceased are insufficient to cover costsand no other person will assume expenses. No paymentis made when resources available from all sources total

$600 or more.

Medicaid

Eligibility




State does not provide a program for the aged, blind, anddisabled medically needy.




679.00 1,069.00 100.00 200.00

NOTE: Payment levels apply equally to the aged, blind, and disabled.

DEFINITION:

Licensed adult residential care home. Includes no more than 15 persons who reside in a home-like atmosphere and receive assistance

with activities of daily life.


Table 1.


Living arrangement

Licensed adult residential care home

New Mexico



New Mexico



478 58 5 415

Table 2.


Living arrangement

Licensed adult residential care home



New York






Administration: Social Security Administration. StateOffice of Temporary and Disability Assistanceadministers an additional $25 payment to some SSIrecipients in nursing homes and $5 to recipients in allother medical facilities. The payment is called a StateSupplemental Personal Needs Allowance.


Statutory basis for payment: New York State SocialServices Law, section 207-212.




Scope of coverage: Optional state supplementprovided to all SSI recipients, including children, exceptthose living in publicly operated residences having morethan 16 residents, in publicly operated emergencyshelters, or in medical facilities where Medicaid paysless than 50 percent of the cost of care. Congregate careis provided in a nonmedical setting. Supplementationfor congregate care varies according to geographic area.Children are eligible for optional state supplementationat the congregate care Level 1 and Level 2 rates and theliving-with-others rate. Children must be placed infacilities certified by the Office of Mental Health, the

Office of Mental Retardation and DevelopmentalDisabilities, or the Office of Alcoholism and SubstanceAbuse Services.









Administration

State Office of Temporary and Disability Assistance(only in cases of emergency).


Energy assistance: An emergency assistance grant canbe provided to eligible SSI recipients to safeguardhealth, safety, and welfare.

Shelter-related expenses: Moving expenses, brokers'fees, security deposits, storage fees, maintenance of home during hospitalization, establishment of a homewhen deinstitutionalized.

Replacement of basic needs items: Replacement of furniture, clothing, food, fuel, etc., lost as a result of fire,

flood, or other catastrophe.

Repair or replacement of major appliances: Repair orreplacement of essential household equipment, includingheating and plumbing equipment, and major appliances.

Food for guide dog: A recurring assistance grant isprovided to unemployed blind or deaf SSI recipients forthe purchase of food for a guide dog.

Other circumstances: Payments for goods and servicesalready received; chattel mortgages and conditional salescontracts; replacement of lost, stolen, or mismanaged

cash; replacement of SSI checks that are lost, stolen, ornot received (subject to recoupment).

New York



New York



A 666.00 973.00 87.00 104.00

B 602.00 915.00 23.00 46.00

C

Areas A and B 845.48 1,690.96 266.48 821.96Area C 807.48 1,614.96 228.48 745.96

DAreas A and B 1,014.00 2,028.00 435.00 1,159.00Area C 984.00 1,968.00 405.00 1,099.00

E

Area A 1,061.96 2,123.92 482.96 1,254.92Areas B and C 1,037.96 2,075.92 458.96 1,206.92

F 409.00 625.34 23.00 46.00

Z 579.00 869.00 d d

a.

b.

c.

d.

Table 1.


Living arrangement

State

code


Living alone

Living with others

Congregate care facility, Level 1 a

Congregate care facility, Level 2b

The minimum personal needs allowance is $89.

NOTE: Payment levels differ by geographic area. Area A is New York City; Area B is Nassau, Rockland, Suffolk, and Westchester counties;

and Area C is all other counties.



Congregate care facility, Level 3 c


Medical facility, publicly operated residentialfacility, and public emergency shelter

Recipients living in a nursing home licensed by the Department of Health receive a State Supplemental Personal Needs Allowance

(SS/PNA) of $25, and recipients in all other medical facilities receive an SS/PNA of $5. The payments are issued by the Office of

Temporary and Disability Assistance.

E: Congregate care facility, Level 3. Includes recipients in nonmedical privately operated, state-certified, residential facilities that areoperated for the purpose of providing treatment, training, and education for mentally retarded or developmentally disabled individuals.

F: Living in the household of another. Includes recipients residing in a federal Code B living arrangement and for New York State

purposes is considered part of the living-with-others living arrangement.

Z: Medical facility, publicly operated residential facility, and public emergency shelter. Includes recipients in publicly operated

residential facilities and public emergency shelters. This arrangement applies:

• When an SSI recipient is residing in a medical facility and is not expected to return home with 90 days and Medicaid is paying for at least

50 percent of the cost of care;

• When an SSI recipient is residing in a private medical facility and Medicaid is paying for less than 50 percent of the cost of care;

• When a recipient resides in a publicly operated residential facility serving 76 or fewer residents; or

• While a recipient resides in a public emergency shelter for 6 calendar months during a 9-month period.

DEFINITIONS:

A: Living alone. Includes recipients living either alone, with foster children, with an authorized homemaker, or in a family care home placed

by an authorized agency. Also includes recipients living with others but either paying a flat fee for both room and board or preparing their

meals separately.

B: Living with others. Includes recipients who reside in a dwelling with others and:

• Prepare food in common with at least one other person in the dwelling,

• Are members of a religious community, or

• Are children who have not been included in state living arrangement C or D.

C: Congregate care facility, Level 1. Includes recipients in family-type homes and family care homes. These homes serve persons who

are unable to function completely independently. Family-type homes are facilities certified by New York State, supervised by local

departments of social services, and operated for the purpose of providing long-term residential care for adults. Family care homes are

private households that provide care for mentally disabled persons. Eligibility for care in these homes is based on certification of placement

by the local Department of Social Services or an office of the state Department of Mental Hygiene.

D: Congregate care facility, Level 2. Includes recipients in residential facilities who are aged or have mental or physical disabilities.

Facilities at this level provide residential care for adults (and some children) and are certified, by the New York State Department of Health.



New York


Adults Children

All recipients 617,219 -- -- -- --

A 321,851 97,256 1,493 218,835 4,267

B 211,716 16,856 748 113,406 80,706

C 4,808 182 23 3,968 635

D 36,070 3,865 172 30,124 1,909

E 134 3 0 108 23

F 22,420 8,586 133 10,635 3,066

Z 20,220 -- -- -- --

Table 2.


Living alone

Living with others

Aged Blind

Disabled

Congregate care facility,

Level 1

Living arrangement

State

code Total

Congregate care facility,

Level 2Congregate care facility,

Level 3Living in the household

of anotherMedical facility, publicly operated

residential facility, and public

emergency shelter


Medicaid

Eligibility









North Carolina




Administration: State Department of Health and HumanServices, Division of Aging and Adult Services andDivision of Services for the Blind (state-supervised andcounty-administered).


Administration: State Department of Health and HumanServices, Division of Aging and Adult Services andDivision of Services for the Blind (state-supervised andcounty-administered). Payments are made under the

State/County Special Assistance for Adults program.


Statutory basis for payment: General Statutes of NorthCarolina 108A.40 through 108A.47 and chapter 111 andchapter 143B-139.5.

Funding Administration: 100 percent county funds.Assistance: 50 percent state funds; 50 percent countyfunds.


Place of application: County offices of the stateDepartment of Social Services.

Scope of coverage: Optional state supplementprovided to all aged, blind, and disabled adults living inadult care homes. Children under age 18 are not eligiblefor optional supplementation.


Income exclusions

All categories: A $20 exemption applies to any income,including SSI, with the exception of income received asa Veterans Administration (VA) pension payment or aVA compensation payment to the surviving parent of aveteran.Aged and disabled: Federal SSI regulations apply.Blind: For earned income, exclude the first $85 plus one-

half of the remainder.








Medicaid

Eligibility







North Carolina



North Carolina



Basic (aged, blind, and disabled) a 1,130.00 b 551.00 b

Disenfranchised (aged and disabled) 1,137.00 b 558.00 b

Not paying shelter and utilities . . . . . . 97.00 d 194.00

Paying shelter and utilities . . . . . . 146.00 e 243.00

a.

b.

c.

d.

e.


DEFINITION:

Adult care home. Includes recipients residing in an assisted living residence in which the housing management provides 24-hour scheduled

and unscheduled personal care services to two or more residents either directly or, for scheduled needs, through formal written agreement

with licensed home care or hospice agencies.

This is a temporary supplement paid until SSI eligibility is determined. This is for people who are currently in a private living

arrangement.

If only one member of the couple is blind, payment level is $146.

If only one member of the couple is blind, payment level is $219.

An additional $20 income exclusion is allowed. In addition, a $46 personal needs allowance is included in the optional supplementation.

Couples residing in these living arrangements are treated as individuals.

Blind, pending SSI eligibility c

Adult care home

Table 1.


Living arrangement



All recipients 23,456 12,010 102 11,344

23,449 12,005 102 11,3427 5 0 2


Adult care home

Table 2.


Living arrangement

BasicDisenfranchised



North Dakota




No recipients.


Administration: State-administered through the localcounty offices of social services. Payments are madeunder the vendor payment program known as Aid to theAged, Blind, and Disabled.

Effective date: July 1975.

Statutory basis for payment: North Dakota CenturyCode, chapter 50-24.5.

Funding Administration: State funds.Assistance: State and county funds.


Place of application: County social service offices.

Scope of coverage: Coverage for residential and in-home options for aged, blind, and disabled SSIrecipients is limited to adults in licensed basic care

facilities or licensed foster homes and to those receivingin-home services enabling the recipient to remain athome. Children under age 18 are not eligible foroptional supplementation.

Resource limitations: Federal Medicaid resourcelimitations used, except a more restrictive disqualifyingtransfer provision and more restrictive disqualifyingpenalties apply.

Income exclusions: Cost of guardianship fee of up to5 percent of the monthly gross income. Sixty-five

dollars plus one-half of the remaining monthly grossearned income.

Recoveries, liens, and assignments: State lawprovides for recovery of supplementation from theestates of former recipients and deceased spouses.






Administration

County social service boards.


At option of individual counties.

Homemaker and housekeeper services: Servicesavailable to recipients aged 60 or older.

Licensed adult foster home: When costs of careexceed total of SSI and state supplementary payment,the state will pay the difference up to the establishedmaximum rate.

Personal care and home help: Services available torecipients living independently who require help withpersonal care and household activities.

Burial expenses: Payment of funeral and burialexpenses for SSI recipients will not exceed $1,100.When a resource exists, it is deductible from the totalbenefit.

Medicaid

Eligibility







North Dakota



North Dakota



878.16 1,467.32 299.16 598.32


Table 1.


Living arrangement

Licensed basic care facility

DEFINITION:

Licensed basic care facility. Includes recipients in room and board facilities with five or more individuals who because of impaired capacity

for independent living require health, social, or personal care services but do not require 24-hour medical or nursing services.

NOTES: Couples residing in this living arrangement are treated as two individuals starting with the month after leaving an independent living

arrangement.

The state pays the difference between the basic rate and the SSI payment, or any other income received by a recipient. The amount shown

is the average supplementation.


476 -- -- --

Table 2.


Living arrangement


Licensed basic care facility



Ohio


NOTE: This information is for 2004. The state did notprovide information for 2005.





Administration: State Department of Aging andDepartment of Jobs and Family Services (state-administered through local area agencies on aging).


Statutory basis for payment: House Bill 694.



Place of application: Passport agencies.

Scope of coverage: Optional state supplementprovided to all aged, blind, and disabled recipients

residing in the specified living arrangements (seeTable 1). Eligibility is also extended to persons who arenot SSI recipients. Children under age 18 are noteligible for supplementation.

Resource limitations: Countable resources may notexceed $1,500 for an individual and $2,250 for a couple.Household goods and personal effects are excluded.One automobile may also be excluded if it meets thefollowing conditions:

• Specially equipped for a disabled person,

• Used for employment,

• Used for medical transportation, or• Has an equity value not exceeding $4,500 (excess

above $4,500 is a countable resource).

Additional exclusions include one burial plot,irrevocable burial contracts (revocable burial contractsare not excluded), and life insurance policies with a totalface value of $1,500 or less (if more, the cash surrendervalue is a countable resource).

Income exclusions: Cost-of-living increases for SSIrecipients after July 15, 1982, are disregarded. Earned

income exclusions apply. Effective January 1, 2001, thedisregard is $270 for an individual and $405 for acouple.







State does not provide assistance for special needsunless the recipient is eligible for Medicaid.

Medicaid

Eligibility







Ohio



Ohio



1,085.00 2,028.00 506.00 1,159.00885.00 1,628.00 306.00 759.00

1,085.00 2,028.00 506.00 1,159.00

1,185.00 2,228.00 606.00 1,359.00

1,185.00 2,228.00 606.00 1,359.00

1,085.00 2,028.00 506.00 1,159.00

a.

b.

c.

Adult group home. Includes recipients residing in an adult foster care facility licensed by the Department of Health that provides room and

board for six to sixteen adults and also provides supervision and personal care services to at least three of those adults.

Adult residential care facility. Includes recipients residing in a home licensed by the Department of Health that provides accommodations

for sixteen or more adults and also provides supervision and personal care services to three or more individuals who require such services

because of age or physical or mental impairment.

DEFINITIONS:

Adult family or foster home. Includes recipients living in a residence for one or two adults that is not certified or licensed by the

Department of Mental Health but is certified by the Department of Human Services or by the Department of Aging or its designee.

Adult family home. Includes recipients living in a residence or facility that is licensed by the Department of Health and provides

accommodations for three to five adults and supervision or personal care services for at least three of those adults.

Adult community alternative home (under adult community mental health housing). Includes recipients who have acquired

immunodeficiency syndrome (AIDS) or a condition related to AIDS. The home is for three to five unrelated adults and is licensed by theDepartment of Health.

Includes a personal needs allowance of $50 per individual, $100 per couple.

Adult group home c

Residential care facility c

Adult residential care facility

Payments are estimated on the basis of the 2005 federal benefit rate.

Payment amounts shown are based on the 2004 state supplement.

Adult family or foster homec

Adult community mental health housingAdult community alternative home

Table 1.


Living arrangement

Combined federal and state a State supplementation b


All recipients 2,303 -- -- --

424 -- -- --100 -- -- --

6 -- -- --0 -- -- --

1,139 -- -- --634 -- -- --

Table 2.


Living arrangement

Adult group home

Adult community mental health housingAdult foster homeAdult family home

Adult community alternative home

NOTES: Data are for 2004. The state did not provide data for 2005.

Residential or adult residential care facility

-- = not available.



Oklahoma






Administration: State Department of Human Services.Payments are made under the Aid to the Aged, Blind,and Totally and Permanently Disabled program.


Statutory basis for payment: Constitution of the Stateof Oklahoma, Article XXV.



Place of application: Local county offices of the stateDepartment of Human Services or physicians' offices.

Scope of coverage: Optional supplement provided toall needy aged, blind, and disabled persons livingindependently.

Resource limitations: Federal SSI regulations apply.In addition, the value of original Indian allotments, landpurchased from allotment proceeds, and land purchasedfrom funds granted to the Indian in lieu of originalallotment, provided the land is held in trust for the

Indian and is held by the original allottee, is disregarded.Prepaid funeral contracts are also disregarded when therecipient has signed an irrevocable contract up to$7,500.

Income exclusions: Federal SSI earned incomeexclusions used. No unearned income is excluded.








Medicaid

Eligibility


Determined by: State







627.00 965.00 48.00 96.00

DEFINITION:

Living independently. Includes recipients residing in federal Codes A, B, and C living arrangements with the exception of those residing in

nursing homes or hospitals.


Table 1.


Living arrangement


Oklahoma



Oklahoma


Adults Children

72,126 22,595 569 39,191 9,771Living independently

Blind

Disabled

Table 2.


Total AgedLiving arrangement



Oregon




Administration: State Department of Human Services,Adult and Family Services Division, Senior andDisabled Services Division (state-administered in localoffices).


Administration: State Department of Human Services,Adult and Family Services Division, Senior andDisabled Services Division (state-administered in localoffices).


Statutory basis for payment: Oregon Revised Statutes411.120.



Place of application: Local offices of the Departmentof Human Services.

Scope of coverage: Optional state supplementprovided to all SSI recipients residing in the specifiedliving arrangements (see Table 1). Blind children areeligible for state supplementation; disabled childrenunder age 18 are ineligible.

Resource limitations: Federal SSI limitations used,except that the transfer of a home may render a personineligible within 36 months of application.

Income exclusions: Federal SSI earned income

exclusions used. No unearned income is excluded.Recoveries, liens, and assignments: Assistance paidconstitutes an unsecured prior claim against property orany interest therein belonging to the estate of a recipientexcept such portion as is being occupied as a home bythe spouse, minor dependent child, or parent of deceasedrecipient. The Department of Human Services maycompromise claim by accepting other security or maywaive payment when enforcement would be inequitable

and would tend to defeat the purpose of public assistancelaw.






Administration



Clothing for employment: Essential clothing may beprovided for a recipient to begin employment if therecipient has been accepted for a job.

Special diet: Payment for a special diet will be allowedif need has been established by a physician and therecipient maintains independent living.

Restaurant meals: Restaurant meals are allowed inaddition to the standard supplemental payments whenrecipient is unable to prepare meals because of physicalor mental disability.

Laundry allowances: Laundry allowances are providedwhen the recipient has no available laundry facilities of any kind or is so disabled that he or she cannot do his orher own laundry and there is no other person living inthe home who can do it.

Telephone allowances: Telephone allowances may beprovided when the recipient lives alone and ishousebound, lives in a situation so remote that atelephone is essential, or needs a telephone to maintain a job.

Maintenance for guide dogs: Payment for food will bemade for guide dogs or special assistive animals.

Moving expenses: Moving costs will be provided if moving is essential to provide nonhazardous housing forthe recipient or if the recipient has been evicted forreasons not attributable to his or her neglect or his or herfailure to pay rent or house payments.

Household equipment costs: Certain items of household equipment may be purchased or repaired if the recipient is unable to obtain them without cost; a

Oregon



Oregon


one-time payment of chattel mortgages or sales contractsmay be made to prevent repossession if the cost of replacing an essential item exceeds the balance due onthe contract.

Shelter exceptions: Additional payment is made forshelter expenses in situations in which the recipient hasspecial needs that make it impractical or impossible to

rent or continue to purchase adequate housing withcurrent benefit payment.

Transportation expenses: Certain transportationexpenses may be provided to meet specific needs of recipients.

Community transition services: Individuals leaving anursing facility or an acute care hospital can receivepayments for such items as security deposits, utilityhookups, furnishings, and so on.

Medicaid

Eligibility









Oregon



Aged and disabled 580.70 . . . 1.70 . . .

Blind 605.70 894.60 26.70 25.60

Aged and disabled 387.70 . . . 1.70 . . .

Blind 412.70 604.94 26.70 25.60

Aged and disabled 580.70 1,065.40 1.70 196.40Blind 605.70 1,115.40 26.70 246.40

a.

Adult foster care facility. Includes recipients living in homes or other facilities that include board and room and 24-hour care and services

for five or fewer elderly or disabled persons who are aged 18 or older.

Residential care facility. Includes recipients living in facilities of one or more buildings on contiguous property that provide 24-hour care

and services to six or more people aged 16 or older.

DEFINITIONS:

Living independently. Includes recipients living alone in their own household.

Living in the household of another. Includes recipients who live in the household of another.

Additional costs are covered by special service funds. Persons with veterans aid and attendants income are allowed to keep $90 as a

personal needs allowance.


Adult foster care or residential care facilitya



Table 1.


Living arrangement


Total Aged Blind a Disabled

All recipients 23,071 3,178 487 19,406

19,365 1,895 365 17,1052,595 754 83 1,7581,111 529 39 543

a.

Living in the household of anotherAdult foster care or residential care facility

Table 2.


Living arrangement


Includes blind children.



Pennsylvania






Administration: Social Security Administration; StateDepartment of Public Welfare.


Statutory basis for payment: Article IV, section432(2), and Pennsylvania Public Welfare Code.




Scope of coverage: Optional state supplementprovided to every aged, blind, and disabled person whois eligible for SSI payments (or would receive themexcept for excess income) and who reside in the

specified living arrangements. Persons residing inpublic institutions or in certified medical facilities whereMedicaid is paying more than 50 percent of the cost of care are not eligible for supplementation. Blind anddisabled children are eligible for optionalsupplementation, except for domiciliary care andpersonal care homes where they must be aged 18 orolder.









Administration

State Department of Public Welfare.

Special Needs Circumstances Burial expenses: Up to $750 in absence of otherresources to meet cost.Moving expenses: Up to $200 may be paid (once in a

12-month period) if moving is required because of eviction or for health and welfare reasons.Medical transportation expenses: Providestransportation expenses to and from medicalappointments for those who need assistance.

Medicaid

Eligibility







Pennsylvania



Pennsylvania



. . . 606.40 912.70 27.40 43.70

. . . 413.40 623.04 27.40 43.70

C 912.70 1,227.05 43.70 68.05

D 623.04 840.73 43.70 68.05G 968.30 1,726.40 389.30 857.40H 973.30 1,736.40 394.30 867.40

a.

b.

G: Domiciliary care facility for adults. Includes adult recipients (aged 18 or older) certified by the state to be residing in nonmedical

residential care facilities.

H: Personal care boarding home. Includes adult recipients (aged 18 or older) certified by the state to be residing in nonmedical residential

care facilities licensed by the Department of Welfare as a personal care boarding home. The facility offers supervision in personal care

matters. It can be a for-profit facility.

DEFINITIONS:

Living alone. Includes all recipients in private medical facilities (nursing homes, hospitals, intermediate care facilities) where Medicaid is not

paying more than 50 percent of the cost of care, residents of publicly operated emergency shelters throughout a month, and all other

individuals and couples residing in a federal Code A or C living arrangement not meeting the definitions of other state arrangements.

Includes persons in medical facilities who are residing in a federal Code A living arrangement on the basis of their eligibility under section

1611(e)(1)(E) of the Social Security Act.

Living in the household of another. Includes recipients who do not have an essential person and who reside in a federal Code B living

arrangement.

C: Living with an essential person. Includes recipients who are not living in the household of another or in a foster care home for adults

and who have one or more essential persons.

D: Living with an essential person in the household of another. Includes recipients who live in the household of another and have one

or more essential persons.

Applies only to cases converted from former state assistance programs.

Living with an essential person in the household

of anothera

Domiciliary care facility for adultsPersonal care boarding home


State now administers payment for this living arrangement.

Living alonea

Living in the household of another b

Living with an essential person b

Table 1.


Living arrangement

State

code


Adults Children

All recipients 12,714 5,362 22 7,311 19

. . . 38 0 5 31 2

. . . 4 1 0 3 0C 9 0 0 8 1

D 1 0 0 0 1G 1,142 300 2 837 3H 11,520 5,061 15 6,432 12


Table 2.


State

code

Living alone

Blind

Disabled

Living in the household

of another

Living arrangement Total Aged


Domiciliary care facility for adultsPersonal care boarding home

Living with an essential personin the household of another



Rhode Island




No recipients.




Statutory basis for payment: General Laws of RhodeIsland, 1956, as amended, title 40, chapter 6, section 27.

Funding




Scope of coverage: Optional state supplementprovided to all SSI recipients, including children,residing in the specified living arrangements (seeTable 1).









A 636.35 977.50 57.35 108.50B 455.94 707.84 69.94 128.50D 1,154.00 . . . 575.00 . . .

E 50.00 100.00 20.00 40.00

DEFINITIONS:

A: Living alone. Includes recipients residing in a federal Code A or C living arrangement. Includes persons in medical facilities who are

residing in a federal Code A living arrangement on the basis of their eligibility under section 1611(e)(1)(E) of the Social Security Act.

B: Living in the household of another. Includes recipients residing in a federal Code B living arrangement.

D: Adult residential care or assisted living facility. Includes adult recipients who reside in a federal Code A living arrangement and live in

a licensed shelter care facility.

E: Medicaid facility. Includes recipients residing in a federal Code D living arrangement.

Medicaid facility


Living aloneLiving in the household of anotherAdult residential care or assisted living facility

Table 1.


Living arrangement

State

code


Rhode Island



Rhode Island


Adults Children

All recipients 29,269 3,933 185 19,965 5,186

A 27,110 3,288 160 18,686 4,976

B 1,010 203 20 636 151

D 741 372 3 363 3E 408 70 2 280 56

Blind

Disabled

Medicaid facility

Table 2.


Living alone

Living in the householdof another

Adult residential care or

assisted living facility

Living arrangement

State

code Total Aged


Administration



Moving expenses: Within cost guidelines, movingcosts are covered for SSI recipients when the move isdetermined to be socially desirable and moving servicescannot be provided by city, town, or other communityresources.

Catastrophic conditions: In the event of a catastropheby fire, flood, lightning, or severe wind, the state willprovide shelter, clothing, food, and essential household

equipment and furnishings.Burial expenses: The cost of burial expenses can beprovided for any person who dies leaving insufficientresources to meet this expense.

Homemaker services: Services provided underspecified criteria to prevent institutionalization of arecipient who is unable to perform homemaker dutiesbecause of an acute or chronic illness.

Medicaid

Eligibility









South Carolina




No recipients.




Statutory basis for payment: Part 1-B Provisoapplicable to the Department of Health and HumanServices as included in the state appropriation act eachyear.



Place of application: Local county eligibility offices of the state Department of Health and Human Services.

Scope of coverage: Optional state supplementprovided to all SSI recipients and other low-income

individuals who meet the state's net income exclusionand live in licensed community residential care facilities.










Medicaid

Eligibility








927.00 . . . 348.00 . . .

DEFINITION:

Licensed community residential care facility. Includes recipients who are ambulatory but are unable, either because of age or physical or

mental disabilities, to care for themselves. However, their condition does not require the daily services of a registered or licensed practical

nurse. The facility must be licensed by the state Department of Health and Environmental Control; provide care to two or more adults for a

period exceeding 24 consecutive hours; and provide accommodation, board, and personal assistance in feeding, dressing, and other

essential daily living activities.


Table 1.


Living arrangement

Licensed community residential care facility


South Carolina



South Carolina



2,960 1,317 12 1,631

Table 2.


Living arrangement

Licensed community residential care facility



South Dakota






Administration: State Department of Social Services.State-administered in local offices for assisted living andfoster care home arrangements; state-administered instate offices for independent arrangements.

Effective date: February 1, 1975.

Statutory basis for payment: South Dakota CodifiedLaws Annotated 28-5A-1.



Place of application: Local offices of the stateDepartment of Social Services for individuals in assisted

living facilities or in adult foster care homes. State usesinformation from the Social Security Administration toidentify recipients who are living independently andhave no other income.

Scope of coverage: Optional state supplementprovided to all SSI recipients who live independentlyand have no other source of income and to those who

live in assisted living facilities or in adult foster carehomes and who have net income less than thesupplementation levels. Blind and disabled childrenwho meet the income and resource limitations and livein assisted living facilities or adult foster care homes areeligible for optional supplementation.


Income exclusions: State excludes $60 of the federalSSI payment to recipients in assisted living facilities orfoster care homes.







594.00 884.00 15.00 15.00

1,110.00 c 531.00 c

846.00 c 267.00 c

a.

b.

c.

DEFINITIONS:

Living independently. Includes all recipients residing in a federal Code A or C living arrangement who are eligible for state supplementation

and are not included under another state living arrangement.

Assisted living facility or adult foster care home. Includes recipients residing in facilities or homes that meet state licensing or

certification requirements and provide personal care environments (i.e., one that provides personal care and services in addition to food,

shelter, and laundry to recipients who do not need skilled nursing care). Residents in personal care environments must be able to participate

and cooperate in performing their normal activities of daily living even though they need some assistance.

Couples residing in these living arrangements are treated as two individuals starting with the month after leaving an independent livingarrangement.

Limited to SSI recipients with no other source of income.

Lesser amounts may be paid depending on cost of care in the facility. State provides an income disregard of $60 per month of the federal

SSI payment.

Living independentlya

Assisted living facilityb

Adult foster care homeb

Table 1.Optional state supplementation payment levels, January 2005 (in dollars)

Living arrangement


South Dakota



South Dakota



All recipients 3,426 -- -- --

3,196 -- -- --219 -- -- --

11 -- -- --Adult foster care home

Table 2.


Living arrangement

Living independentlyAssisted living facility




Medicaid

Eligibility









Tennessee










Medicaid

Eligibility







Tennessee



Texas




No recipients.



Effective date: September 1, 1999.

Statutory basis for payment: Texas Human ResourcesCode, section 32.024(V).

Funding




Scope of coverage: Optional state supplementprovided to SSI recipients residing in nursing orintermediate care facilities for the mentally retarded andwhose countable income is less than $60.










Medicaid

Eligibility




State provides a program for families and children.


The Social Security Administration obtains this

information.


45.00 a 15.00 a

a.

DEFINITION:



Table 1.


Living arrangement

Medicaid facility

Couples residing in this living arrangement for more than 30 days are treated like two individuals.


10,380 2,685 139 7,556

Living arrangement

Medicaid facility

Table 2.


Texas



Utah




No recipients.




Statutory basis for payment: Appropriation Act for theDepartment of Workforce Services, 1978/1979.

Funding




Scope of coverage: Optional state supplementprovided to all SSI recipients, including children, whoare living alone or with others.









Living alone or with others A 579.00 873.60 . . . 4.60

Living in the household of another B 389.13 589.07 3.13 9.73


DEFINITIONS:

A: Living alone or with others. Includes recipients residing in a federal Code A living arrangement.

B: Living in the household of another. Includes recipients residing in a federal Code B living arrangement.

Table 1.


Living arrangement

State

code


Adults Children

All recipients 1,563 358 15 1,020 170

A 731 266 6 459 0

B 832 92 9 561 170

Table 2.


Living alone or with othersLiving in the household of

another

Living arrangement

State


Disabled

Utah



Utah




Medicaid

Eligibility







information.



Vermont




No recipients.




Statutory basis for payment: Vermont StatutesAnnotated, title 33, chapter 13, Aid to Aged, Blind, andDisabled.

Funding Administration: State funds.

Assistance: State funds.



Scope of coverage: Optional state supplementprovided to all SSI-eligible aged, blind, and disabledindividuals, including children.









Living independently A and B 631.04 967.88 52.04 98.88Assistive community care, Level III C 627.38 965.77 48.38 96.77Living in the household of another E 425.30 627.65 39.30 48.31Residential care home, Level IV G 802.94 1,431.06 223.94 562.06

Custodial care family home H 677.69 1,201.82 98.69 332.82Medicaid facility I 47.66 95.33 17.66 35.33

H: Custodial care family home. Includes recipients who reside in a federal Code A living arrangement, live in another's home, pay room

and board, and receive one or more custodial services. Custodial care includes providing basic room and board, plus such services as help

with feeding, dressing, bathing, moving under normal circumstances, and occasional tray service and supervision for the recipients'

protection. To qualify as a home under this arrangement, these services must be provided by a resident of the home and cannot be provided

to more than two persons in the home. Custodial care or supervision provided by a spouse is not included under this arrangement.

I: Medicaid facility. Includes recipients residing in a federal Code D living arrangement.

DEFINITIONS:

A and B: Living independently. Includes eligible recipients who are not in any other state living arrangement. Includes children who are

living with parents, recipients residing in private Title XIX facilities where Medicaid is not paying more than 50 percent of the cost of care, and

recipients residing in publicly operated emergency shelters throughout a month.

C: Assistive community care, Level III. Includes any individual who resides in a Level III residential care home that is certified by the

Department of Aging and Independent Living to provide assistive community care services.

E: Living in the household of another. Includes recipients residing in a federal Code B living arrangement who are not otherwise

exempted from state supplementation.

G: Residential care home, Level IV. Includes recipients living in Level IV community homes identified by the state.

Table 1.


Living arrangement

State

code


Vermont



Vermont


Adults Children

All recipients 12,625 1,192 84 9,232 2,117

A and B 11,123 1,088 66 8,048 1,921

C 240 49 4 185 2

E 199 14 1 141 43

G 137 18 1 114 4

H 840 12 12 674 142

I 86 11 0 70 5

Total Aged Blind

Disabled

Living in the household

of another

Table 2.



Medicaid facility

Custodial care family

home

Residential care home,

Level IV

Assistive communitycare, Level III

Living arrangement

State

code


Administration

Agency of Human Services, Department of Prevention,Assistance, and Transition and Department for Childrenand Families.


Emergency assistance is provided, under certainconditions, for court-ordered evictions, natural disasters(e.g., fire, flood, or hurricane), emergency medical care,funeral costs, and emergency fuel needs.

Medicaid

Eligibility









Virginia




No recipients.


Administration: State Department of Social Services.


Statutory basis for payment: Code of VirginiaAnnotated 63.1-106, 63.1-124, and 63.1-25.1.

Funding

Administration: 80 percent state funds; 20 percent localfunds.Assistance: 80 percent state funds; 20 percent localfunds.


Place of application: Local offices of the stateDepartment of Social Services.

Scope of coverage: Optional state supplementprovided to every needy aged, blind, and disabled personwho lives in an assisted living facility (domiciliaryinstitution) or in an approved adult family care home andwho is eligible for SSI benefits or would be eligible

except for excess income. Children under age 18 are noteligible for optional supplementation.


Income exclusions: Federal SSI regulations apply. Inaddition, when applicable, a disregard for incomeallotted to the support of children or spouse at home isallowed.







Planning District 8 1,086.00 2,172.00 507.00 1,303.00

All other areas 944.00 1,888.00 365.00 1,019.00

Planning District 8 1,086.00 2,172.00 507.00 1,303.00All other areas 944.00 1,888.00 365.00 1,019.00

a.

b.

DEFINITIONS:

Assisted living facility. Must be licensed. Four or more persons receive care.

Adult foster care. A foster care arrangement with no more than three persons but usually only one person. No license required, but

approval by local department of social services is required.

Represents the maximum allowance; lower amounts may be paid depending on the cost of the facility. Includes a personal needs

allowance of $62 and a 15 percent differential in Planning District 8.

Administered in localities whose local boards have opted to provide this service; includes a personal needs allowance of $62.

NOTE: Planning District 8 includes the counties of Arlington, Loudon, Prince William, Fairfax, and the city of Alexandria.

Assisted living facility a

Adult foster careb

Table 1.

Optional state supplementation payment levels, July 2005 (in dollars)

Living arrangement


Virginia



Virginia



6,367 2,774 13 3,580

-- -- -- --

-- -- -- --


Living arrangement

Adult foster care


Table 2.


All recipients



Medicaid

Eligibility









Washington




Administration: State administration.


Administration: State Department of Social and HealthServices.


Statutory basis for payment: State law in RevisedCode of Washington 74.04.600-74.04.630 and statepolicy in Washington Administrative Code 388-474.




Scope of coverage: Optional state supplementprovided to all needy aged, blind, and disabled persons,including children.









Administration

State Department of Social and Health Services,Economic Services Administration, Division of Employment and Assistance Programs.


Guide dog: Food for service animal at the rate of $33.66per month.

Other utility charges

Telephone: Amount varies according to need andlocation.Laundry: $11.13 per month.

Meals

Restaurant meals: $187.09 per month; $6.04 per day.Home-delivered meals: The amount charged by theagency delivering the service.

Medicaid

Eligibility







Washington



Washington



Area 1 604.90 888.90 25.90 19.90

Area 2 584.45 . . . 5.45 . . .

Area 1 745.10 . . . 166.10 . . .Area 2 715.15 . . . 136.15 . . .

389.71 583.54 3.71 4.20

487.66 . . . 101.66 . . .

41.62 83.24 11.62 23.24

a.

b.

Living in the household of another with an ineligible spouse. Includes recipients residing in a federal Code B living arrangement who

have an ineligible spouse.


DEFINITIONS:

Living independently. Applies to recipients residing in a federal Code A or C living arrangement unless they are living with an ineligible

spouse or temporarily residing in a medical institution.

Living with an ineligible spouse. Applies to recipients who are living independently with a spouse who does not qualify for SSI payments.

Living in the household of another. Applies to recipients residing in a federal Code B living arrangement unless they are living with an

ineligible spouse or temporarily residing in a medical institution.

Applies only to cases converted from former state assistance programs.

NOTES: Area 1 includes King, Kitsap, Pierce, Snohomish, and Thurston counties. Area 2 includes all other counties.

Includes persons in congregate care group facilities.

Living in the household of another with an ineligible

spouse

Medicaid facility


Living independentlya

Living with an ineligible spouse b


Table 1.


Living arrangement



-- -- -- --

-- -- -- --

4,610 -- -- ---- -- -- --

-- -- -- --

-- -- -- --

Table 2.


Living with an ineligible spouse

All recipients

Living in the household of anotherLiving in the household of another with an

ineligible spouse

Living arrangement


Medicaid facility




West Virginia




State does not provide mandatory minimumsupplementation.




Administration

State Department of Health and Human Resources,Bureau for Children and Families and Bureau of SeniorServices.



Adult family care home: Payment of $536 to $706monthly (depending on amount of care required for eachrecipient) provided on behalf of every aged or disabledperson living in a personal care home who has been

approved for SSI and persons who are not eligible forSSI but are eligible for a state supplement.

Licensed personal care home: Payment of $752monthly provided on behalf of every aged or disabledperson living in a personal care home who has beenapproved for SSI or is income eligible.

Residential board and care: Payment of $536 to $706monthly (depending on amount of care required for eachrecipient) provided on behalf of every aged or disabled

person living in a residential board and care home whohas been approved for SSI or is income eligible.

Personal care services: Aged, blind, and disabledpersons must be income-eligible recipients of SSI andhave a physician certify that they need these services.The purpose of these services is to enable persons to stayin their current living situation. Personal services are

provided through the county senior centers. The seniorcenters employ the personal care providers and pay themdirectly.

Emergency financial assistance: Amounts vary withneed but cannot exceed various maximums. Provided onbehalf of eligible persons who have emergency needs forthe items covered by the program, such as utilities,shelter, food, clothing, etc. Payments may be made toindividuals or families to cover an emergency for up to30 consecutive days in any 12-month period.

Burial expenses: Up to $1,250 is provided for burial

expenses for persons who do not possess sufficientresources to pay for burial expenses. A contribution of up to $1,200 toward burial expenses from any source isexcluded from consideration as a resource indetermining the assistance amount for burial expenses.

Medicaid

Eligibility







West Virginia



Wisconsin




Administration: No recipients.


Administration: State Department of Health and FamilyServices and Division of Disability and Elder Services.


Statutory basis for payment: Wisconsin Statutes 49.77and 49.775.




Scope of coverage: Optional state supplementprovided to all eligible persons, including children,residing in the specified living arrangements (see Table1). Residents of emergency shelters or patients inmedical facilities where Medicaid pays more than 50percent of the cost of care are not eligible forsupplementation.









662.78 1,001.05 83.78 132.05469.78 711.39 83.78 132.05709.43 . . . 130.43 . . .521.05 . . . 135.05 . . .

758.77 1,346.41 179.77 477.41

Private nonmedical group home or natural residential setting. Restricted to recipients who require a supportive living arrangement and

reside in private nonmedical group homes or in a natural residential setting with support. Eligibility is based on certification, on an individual

basis, by the state.

DEFINITIONS:

Living independently. Includes recipients living in their own households, in private medical treatment facilities and receiving 50 percent or

less of the cost of their care from Medicaid, or in nonmedical institutions. Also includes persons in medical facilities who are classified in a

federal Code A living arrangement under section 1611(e)(1)(E) of the Social Security Act.

Living in the household of another. Includes recipients residing in a federal Code B living arrangement.

Living independently with an ineligible spouse. Includes recipients living in their own household with an ineligible spouse.Living in the household of another with an ineligible spouse. Includes recipients residing in a federal Code B living arrangement who

have an ineligible spouse.

Table 1.



Living arrangement

Living independentlyLiving in the household of anotherLiving independently with an ineligible spouseLiving in the household of another with an ineligible spouse

NOTES: A caretaker supplement is provided to SSI recipients with children: $250 for first child; $150 for each additional child.


Private nonmedical group home or natural

residential setting

Wisconsin



Wisconsin


Adults Children

All recipients 98,934 9,931 1,012 66,131 21,860

64,585 6,836 556 38,152 19,041

4,588 324 90 3,384 790

6,147 841 62 5,240 4

70 13 0 57 0

23,544 1,917 304 19,298 2,025

Living in the household of anotherLiving independently with an ineligible

spouseLiving in the household of another with

an ineligible spousePrivate nonmedical group home or

natural residential setting

Total

Table 2.



Living arrangement Aged Blind

Disabled


Administration

State Department of Health and Family Services,Division of Disability and Elder Services.


State administers special needs supplementary paymentsto cover care in nonmedical facilities and naturalresidential settings. Recipients with dependent childrenare eligible for a higher level of supplementation.

Medicaid

Eligibility

Criteria: SSI program guidelines.








Wyoming




Administration: State Department of Family Services,Economic Assistance.


Administration: State Department of Family Services,Economic Assistance.


Statutory basis for payment: Wyoming Statutes42-2-103.



Place of application: No application required. Stateuses computerized information from the Social SecurityAdministration to identify eligible recipients.

Scope of coverage: Optional state supplementprovided to all aged, blind, and disabled persons who

receive SSI as the sole source of their income and liveindependently or in the household of another. Blind anddisabled children may be eligible for supplementation.










Medicaid

Eligibility








Living independently 589.44 895.48 10.44 26.48Living in the household of another 399.24 611.36 13.24 32.02

DEFINITIONS:

Living independently. Includes only SSI recipients who reside in a federal Code A living arrangement and have no federal countable

income.

Living in the household of another. Includes only SSI recipients who reside in a federal Code B living arrangement and have no federal

countable income.

Table 1.


Living arrangement


Wyoming



Wyoming

Adults Children

All recipients -- -- -- --

-- -- -- --

-- -- -- --

Total

Table 2.



Living arrangement Aged Blind

Disabled

2,700

--


Living in the household of another --

Documents

Social Security: ssi st asst05