1. Definitions of State living arrangement variations for California

Code Definition A Use optional supplement (OS) code “A” for independent living with cooking facilities for an eligible recipient or couple who meet one of the following situations: • live in their own household, as defined for Federal living arrangement (FLA) “A” purposes, and have cooking and food storage facilities or living arrangement provides meals; • a patient in a certified private medical facility where Title XIX does not pay more than 50 percent of the cost of care; • a blind child under age 18 living in the household of a parent or parents, or is a disabled child age 18 or over who meets sharing criteria and is living in the household of a parent or parents; • a blind recipient who lives in an independent living arrangement with or without cooking and food storage facilities; or • lives in a private medical facility licensed by the State but not certified under Title XIX. B Apply OS code “B” for non-medical out-of-home care (NMOHC) when a recipient or couple needs non-medical care or supervision in the following living arrangement situations: Children (under age 18) • blind child residing in a State licensed NMOHC facility; • blind child residing in the home of a relative who is not a parent and not a legal guardian; • disabled child residing in a State licensed NMOHC facility; • Disabled child residing in the home of a legal guardian who is not a relative; • disabled child residing in the home of a relative who is not a parent (Major v. McMahon decision); or • blind or disabled child in a “certified family” home approved by a licensed home-finding agency (“certified family home placement”). Adults (age 18 and over) An aged, blind, or disabled recipient: • or couple is determined to be in FLA “A” and resides in the home of a relative, legal conservator, or guardian; • is determined to be in FLA “A” and resides in a State licensed NMOHC facility; or • is determined to be in FLA “A” and resides in a family home certified by a family home agency under State law. For California optional supplement (OS) purposes, a relative is defined as a: • parent, • child, • sibling, • half- • sibling, • parent's sibling, • sibling's child, • first cousin, or • any person of the preceding generation denoted by the prefix “grand” or “great.” C Independent living without cooking facilities Apply OS code “C” to aged or disabled recipient or couples who are: • not given meals, and • do not have access to adequate cooking or food storage facilities as part of a living arrangement. Transients, as defined in SI 00835.060 , are also eligible for OS “C.” A recipient or couple qualifies for OS “C” if any of the following situations exists: • Immediate living quarters do not have cooking and food storage facilities that the recipient, couple, or another person (who is responsible for preparing their meals) can prepare meals on a daily basis; • Does not have access to adequate cooking and food storage facilities as part of the living arrangement (including cooking and food storage facilities, which are outside the immediate living quarters) for the purpose of preparing meals or having them prepared on their behalf; • Lives in a boarding house that does not have a communal kitchen with adequate cooking and food storage facilities that they can access for preparing meals; • Lives with friends or relatives in private living quarters in the same house or in separate living quarters (for example, “over the garage”) or in a similar situation and does not have access to the cooking and food storage facilities in the main residence for preparing meals; or • Lives in a room and board facility and does not contract with the facility to have meals prepared and provided as part of the living arrangement (for example, the Supplemental Security Income (SSI) recipient’s arrangement with the facility is to purchase only shelter on a monthly basis). “Adequate” cooking and food storage facilities exist when a recipient or couple has access to the following: • both a working refrigerator or icebox and a stove without a working oven but with at least two working burners. (Do not consider the capacity of the refrigerator or icebox when making this determination. Also, do not consider an ice chest to be adequate storage.); • both a working refrigerator or icebox and a hotplate with at least two burners with separate temperature controls, or two one-burner hotplates with temperature controls. (Do not consider hotplates without temperature controls used for warming food as “adequate cooking facilities.”); or • both a working refrigerator or icebox and a stove with a working oven or functioning microwave oven in combination with at least one working burner on a stove, or a one-burner hotplate with a temperature control. Eligibility for OS “C” begins in the month the recipient applies for this supplement rate, provided they have been without cooking and food storage facilities throughout the month. NOTE: For purposes of OS “C,” “throughout a month” does not mean the recipient must lack adequate cooking or food storage facilities from the very first moment of the month. The recipient need only lack them from some time on the first day of the month. If you based eligibility on temporary loss or non-functioning of an appliance, advise the recipient of their responsibility to report immediately when the temporary condition ceases. If the recipient provides an expected date when someone will replace or repair the appliance, diary the case for re-contact. Eligibility for this supplementary payment ceases the month following the month in which the individual or couple receives meals or adequate cooking and food storage facilities are available. For a couple, comprised of an aged or disabled recipient and a blind recipient, whose living arrangement lacks adequate cooking and storage facilities, the couple must receive the Supplemental Security Income and State Supplement Payment level for a blind, aged, or disabled couple plus the restaurant meals allowance for the disabled member of the couple. This living arrangement requires force due payment. D Living in the household of another Apply OS code “D” when an eligible individual or couple is living in the household of another and receives food and shelter from that person. Most recipient or couples who are subject to a one-third reduction of their Federal SSI payments are eligible for OS “D” because the criteria for this supplement level are the same as for charging the one-third reduction. However, when the eligible recipient or couple lives in the home of a relative (other than a spouse) and needs care and supervision, you must obtain certification for non-medical out-of-home care (OS “F”) from the county welfare office since this is the highest categorical supplement that a recipient or couple can qualify. E Disabled child under age 18 Apply OS code “E” to a disabled (not blind) child under age 18 who resides with a parent or relative by blood or marriage. NOTE: Only FLA “A” and “C” are compatible with OS “E.” If the value of the one-third reduction (VTR) applies, see code “G.” F Non-medical out-of-home care living in the household of another OS code “F” applies whenever an eligible recipient or couple meets the criteria for the non-medical out-of-home care payment rate, and is determined to receive the Federal code “B” payment for living in the household of another. For the one-third reduction provision, see SI 00835.200 . G Disabled child under 18 living in the home of another OS code “G” applies to a disabled (not blind) child under age 18, who resides with a parent or relative by blood or marriage, and is determined to receive the Federal code “B” payment for living in the household of another person. For the one-third reduction provision, see SI 00835.200 . J Residents of Title XIX facilities Effective July 1, 1987, apply OS State code “J” to an eligible recipient who is a patient in a medical facility where Title XIX pays more than 50 percent of the costs. Apply OS State code “J” to supplement Section 1619 cases. 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 the supplement. Z No supplement cases Apply OS code “Z” to an eligible recipient who is a patient in a private medical facility not certified under Title XIX and not licensed by the State. Include in this category those recipients who are residing throughout a month in a publicly operated emergency shelter. For periods prior to July 1, 1987, apply OS code “Z” to an eligible recipient who is a patient in a medical facility where Title XIX pays more than 50 percent of the costs.