1. Definitions of State living arrangement variations for Iowa

Code Definition A Living in own household (blind only) Only apply OS code “A” to an eligible blind recipient and the blind member of a couple who: • does not live in any other State living arrangement variation, does not have an essential person (EP); and is not otherwise excepted from supplementation; or • is a blind recipient living in a Title XIX facility where Medicaid pays 50 percent or less of the cost of their care. Optional supplement code “A” is also compatible with Federal codes “A” and “C.” OS code “A” is the proper code to use with an “intervening” Federal code “A.” For optional State supplement codes, see SM 01301.535. B Living in the household of another (blind only) OS code “B” is only for an eligible blind recipient and the blind member of a couple who does not live in any other State living arrangement variation, lives in the household of another for Federal purposes, does not have an EP, and is not otherwise excepted from supplementation. C Living with a dependent Use OS code “C” for an eligible recipient or each member of an eligible couple in Federal living arrangement “A” or “C”: • who has an ineligible spouse, parent, child, or adult child living in the home with them, and • who is financially dependent upon the eligible recipient as defined by the State Department of Human Services. The payment level for this variation increases by $22 for each blind recipient or blind member of a couple to reflect the categorical blind supplement. D Living in a family life or boarding home Use OS code “D” for an eligible recipient or each member of an eligible couple in Federal living arrangement “A” who resides in a family life home or boarding home licensed by the State Department of Health or certified by the State Department of Human Services. H Living with a dependent person Use OS code “H” for an eligible recipient or each member of an eligible couple in Federal living arrangement “B”: • who has an ineligible spouse, parent, child, or adult child living in the home with them, and • who is financially dependent upon the eligible recipient as defined by the State Department of Human Services. Increase the payment level for this variation by $22 for each blind recipient or blind member of a couple to reflect the categorical blind supplement. I Living in a family life or boarding home - eligible recipient or each member of an eligible couple in FLA “B,” who resides in a family life home or boarding home licensed by the State Department of Health, or certified by the State Department of Human Services. Y Optional supplementation waived Use OS code “Y” to indicate that a recipient is eligible for an optional supplement, but waived their right to receive supplementation. Z No supplement cases Use OS code “Z” to address: • SSI recipients residing throughout a month in publicly operated emergency shelters; • aged or disabled recipients living in their own households or living in the households of others; • recipients living in medical facilities not certified under Title XIX; • recipients whose Federal payments are reduced to $30 or $60 due to living in a Title XIX facility; or • aged or disabled recipients whose Federal payments are not reduced but who live in a Title XIX facility where Medicaid pays 50 percent or less of the cost of care. NOTE: The State Department of Human Services administers three optional supplementation programs: 1. In-home health related care; 2. Residential care; and 3. Supplement for Medicare and Medicaid Eligible.

NOTE: Iowa is a concurrent category State and permits SSI recipients to receive the highest categorical supplement for which they can qualify. For more information on multi-category eligibility, see SI 00501.300B.3.

Blind recipients (either individuals or member of a couple) whose records include an EP have a supplementary payment level that includes $22 for each recipient in addition to the FBR and EP increment and must be force paid.