Page 28
126–850. Levying of Sanctions. Civil monetary penalties will be collected through an adjustment to reimbursement due nursing facilities or through other appropriate methods. Denial of payment under the state plan shall be made through suspension or termination of payment. ARTICLE 9 OPTIONAL STATE SUPPLEMENTATION PROGRAM 126–910. Program Definitions. A. Optional State Supplementation (OSS) Program —— a State-funded program that provides a cash benefit payment that supplements an eligible individual’s countable income up to the net income limitation. This supplementation, in conjunction with the individual’s countable income (less any program allowances or deductions) is intended to permit the individual to pay for services provided by a licensed community residential care facility that participates in the OSS Program, with the charges for such services being subject to the applicable OSS facility rate. B. OSS Facility Rate —— the maximum rate established by the South Carolina legislative budget- ary process that a community residential care facility participating in the OSS Program may charge an OSS recipient. This rate is intended to cover the full scope of services required to be provided under the community residential care facility licensing requirements established by the South Carolina Department of Health and Environmental Control. C. Community Residential Care Facility (CRCF) —— a facility licensed by the South Carolina Department of Health and Environmental Control as a ‘‘Community Residential Care Facility.’’ D. Net Income Limitation —— the maximum monthly countable income which an individual may have in order to qualify for OSS benefits, as such limit (cap) has been established by the South Carolina legislative budgetary process. E. Countable Income —— an individual’s gross income less those exclusions of income allowed under the provisions of the federal Supplemental Security Income (SSI) Program. F. Countable Resources —— an individual’s available assets as determined under the provisions of the federal Supplemental Security Income (SSI) Program. G. Supplemental Security Income (SSI) Program —— Title XVI of the Social Security Act. H. Personal Needs Allowance —— the specific dollar amount of countable income set by the South Carolina legislative budgetary process that an OSS recipient is allowed to retain for that individual’s personal needs. HISTORY: Added by State Register Volume 24, Issue No. 3, eff March 23, 2001. 126–920. Eligibility. A. An individual must meet the following requirements in order to be eligible for OSS benefits: (1) Be a resident of the State of South Carolina; (2) Has been determined by the Social Security Administration (SSA) or by the State in accordance with applicable SSA criteria to be aged, blind, or disabled; (3) Has countable resources that do not exceed the eligibility limitations for resources set by the federal Supplemental Security Income (SSI) Program; (4) Meets one of the following four conditions with respect to countable income: (a) Receives an SSI payment, which when combined with other countable income gives the individual total countable income that is less than the applicable net income limitation of the OSS Program; or (b) Receives countable income that exceeds the SSI payment standard, but is less than the applicable net income limitation of the OSS Program; or (c) Receives countable income that is less than the SSI payment standard and has applied for SSI benefits; or