Section 218-RICR-20-00-5.3 - Service ProvisionA. Eligibility for State Supplemental Payments1. Individuals or couples receiving SSI are eligible for an SSP and include the following: a. Grandfathered SSI recipient - Individuals who received State assistance in December 1973 and became eligible for SSI in January 1974, are called grandfathered clients by the State and a mandatory income level (MIL) client by SSI;(1) Such an individual must continue to meet the definition of blind or disabled that was in effect under the State plan in December 1973.(2) Individuals who are needed in the home to care for an eligible person are called an essential person. Such an individual is also called a grandfathered client.(3) Individuals who are an essential person must have lived continuously with the eligible person since January 1974.b. Individual who is age sixty-five (65) or older who receives SSI;c. Individual who is blind and receives SSI;d. Individual determined eligible for SSI due to disability; or e. Individual who receive SSI as a foster child receiving specific services through the State child welfare agency for part or all of a month and not eligible for foster care reimbursement under Title IV - E of the Social Security Act, 42 U.S.C. §§ 671 - 679b.2. An individual or couple, residing in Rhode Island, who has been denied SSI by SSA for excess income may be eligible for a State-only supplemental payment as an SSI "lookalike" and should complete an application at DHS to determine eligibility. a. An individual or couple must meet the technical requirements of citizenship, residence and possession of, or application for, a Social Security Number (SSN) in accordance with the Medicaid Rules, as detailed in 210-RICR-10-00-3, Medicaid and Children's Health Insurance Program (CHIP) Non-Financial General Eligibility Requirements.b. An individual or couple must apply for SSI benefits through the SSA before applying for a State-only supplemental payment.(1) The denial letter, or proof of a denial determination, from SSA is required as part of the application process.(2) A denial determination from SSA is valid for up to one (1) year for purposes of application for SSP through DHS.c. Applicants for SSP who have been denied through SSA for excess income will be processed as follows: (1) State income eligibility will be calculated (countable income must not exceed the combined Federal Benefit Rate (FBR) and applicable SSP).(2) If applicant is eligible based on income, the DHS will send a referral to the Medical Assistance Review Team (MART) for a disability determination.(3) Once a determination is made by MART, eligibility for a State-only payment is processed.(4) Once eligibility has been determined, benefits will be issued the first (1st) of the following month of eligibility.3. The DHS will notify the individual or each member of the couple of the eligibility determination for the SSP. If the eligibility for the SSP benefit has been approved, the DHS will mail a Benefit Statement to the recipient along with information on how the benefit was calculated. This Benefit Statement may be used as verification of the DHS SSP benefit and will remain valid for one (1) year or until the completion of the twelve (12) month redetermination, provided no subsequent reported or unreported changes affect the amount of the payment.4. Applicants for SSP who have been denied through SSA based on a disability will not be reevaluated by DHS for disability based solely on the application for SSP. The DHS will review such applications and notify the applicant of his/her ineligibility at application for SSP-only.B. Recertification of State Supplemental Payments 1. State-Only SSP Redeterminations a. Financial Eligibility Reviews: State-only SSP cases require a twelve (12) month financial redetermination by DHS. The redetermination for State-only SSP is completed by the DHS and in consultation with EOHHS, as appropriate for individuals receiving Category D.2. SSI/SSP Redeterminationsa. Recipients receiving SSI will have redeterminations of both their SSI and State Supplemental Payment consistent with provisions established under the SSA (www.socialsecurity.gov).3. Benefit Notice a. Once the redetermination has been completed and continuing eligibility approved, the recipient is provided with a benefit decision notice showing the amount of the State payment and the period of eligibility before the next redetermination. This notice may contain information about eligibility for other State Health and Human Services programs and is valid until the next redetermination date as specified provided there have been no subsequent reported or unreported changes affecting the amount of the payment. Electronic data sources may be used to verify income at the time of initial application, renewal and when changes are reported.
C. Reporting Change in Circumstances 1. SSI/SSP Recipients - Individuals/couples who receive SSI are required to report changes directly to the SSA, refer to www.socialsecurity.gov.2. State-Only Supplemental Payment - Individuals/couples are required to report changes in income, resources and living arrangement to the DHS within ten (10) calendar days of the occurrence.D. Representative Payee 1. An SSP is paid to a representative payee if:a. The SSA determined that a representative payment is applicable under 20 C.F.R. Part 404, Subpart U (relating to representative payment) or 20 C.F.R. Part 416, Subpart F (relating to representative payment).b. At the time of application for State-only SSP, the applicant and/or recipient authorizes someone to manage funds and to receive automated notices about the applicant's SSP benefit.2. For SSI/SSP recipients, a representative payee is responsible for reporting to the SSA any changes in the recipient's circumstances affecting eligibility including changes in income, resources, living arrangement, marital status and address. For State-only SSP, a representative payee must report an address change to the DHS. All automated notices will be sent to the representative payee.E. Scope of Services 1. Persons in Rhode Island who are eligible for either the Federal SSI payment and State Supplemental Payment, or the State-only share of the SSP payment, may be eligible for Medicaid, Social Services, and for assistance to meet the following needs according to specified criteria:a. Food Assistance (1) In the event of un-received, lost, stolen or destroyed SSI checks and/or lost or stolen cash, the applicant/recipient is encouraged to complete an application for expedited food assistance through the Supplemental Nutrition Food Assistance Program (SNAP).2. Moving Assistance a. Payment for in-state moving, within cost guidelines, is provided for recipients of SSI when the move is determined to be socially desirable, the move cannot be provided by the city or town or other community resources, and the recipient requests vendor payment for the move.b. The agency makes no provision to meet the cost of out-of-State moves, as detailed in the DHS Social Services Rules (Part 7 of this Subchapter).3. Homemaker Services a. Homemaker Service is a social service available through DHS to recipients of SSI.b. Refer to the DHS Social Services Rules (Part 7 of this Subchapter), for the criteria, determination of eligibility, cost and procedures for the authorization of Homemaker Service.4. Burial Expenses a. The cost of burial can be met through General Public Assistance (GPA) funds for any person who dies leaving no or insufficient resources to meet the expense.b. Refer to General Public Assistance Program Rules as detailed in § 3.4 of this Subchapter, for the cost standards and conditions under which funeral and burial expenses can be met.5. Emergency Assistance in the Event of a Catastrophe: Funds for shelter, clothing, food, essential household equipment, and furnishings, if necessary, are provided in the event of a catastrophe when all of the following conditions are met: a. An emergency is defined as the occurrence of a catastrophe caused by fire, flood, lightning, or severe wind. Compensable fire damage is further restricted to that caused by flame, smoke, and subsequent secondary water damage where there is damage to the dwelling. (1) The incident must be reported immediately to the fire department.(2) Other specific exclusions under any circumstances are destruction for which a landlord can be held responsible, willful destruction or willful neglect by the recipient or a member of his/her family, damage covered by insurance policies, and isolated mechanical or electrical failures where there is no secondary damage.b. Coverage is limited to possessions of the recipient or those of another member of the assistance unit.c. For active cases, the catastrophe or disaster must have occurred at the address recorded in the case record, or, if it occurred at a different address, the recipient must demonstrate that he/she had moved and was living there prior to notifying the agency.(1) Acceptable evidence of residence may include a moving bill, rent receipt, or statement from a utility company attesting to the recipient's responsibility for service on the date and at the address in question.d. To be considered, the incident must be reported by the recipient within ten (10) calendar days of the date the loss to the DHS.e. Community resources must first be explored and utilized, whenever possible.f. Whenever reasonable, a partially destroyed item of household goods or furnishings must be repaired rather than replaced. If replacement is required, the purchase of used items must be considered before funds for new items can be authorized.g. Any repairs to the basic structure of a recipient-owned dwelling, such as roof, stairs, septic systems, plumbing, wiring, siding, etc., are specifically not covered regardless of the reason for the repair.h. Thefts of clothing, food, and household furnishings and equipment are specifically not covered.i. If repeated emergencies occur for one (1) case, or the circumstances are questionable, payment may be denied.6. Items Provided in Event of Catastrophea. Emergency shelter, on a temporary basis, will be provided only where the damage to cooking or heating or plumbing facilities is severe enough to prevent their use in a minimally acceptable manner or the existing damaged structure either cannot provide adequate protection from the elements or is not safe to occupy. Approval for use of emergency shelter must be made on a daily basis by the social worker assigned to help the recipient relocate to permanent shelter.b. Initial food and transportation for each recipient are provided from the date of the catastrophe through the fifth (5th) working day (or to the date of the next recurring SSI check, if earlier).c. Initial clothing, if an individual recipient's clothing has been destroyed, can be authorized only to meet immediate clothing need.7. Medical Care a. The SSI recipient is certified for Medicaid concurrent with the determination of eligibility for SSI and may be eligible if receiving the State-only supplemental payment.F. Estranged Spouses Receiving SSI as a Couple1. Persons eligible for and receiving SSI benefits less than the appropriate GPA Standard of Need due to Federal SSI Regulations which treat estranged spouses as a couple for SSI purposes until the month after the month they begin living apart are eligible for cash assistance, if they meet the financial criteria outlined in General Public Assistance Program Rules (§§3.2.3 and 3.2.4 of this Subchapter).2. When there is an initial SSI application or an SSI reinstatement following a period of ineligibility, and the couple is not living together on the date of the application or date of request for reinstatement, the SSI Regulations treat each member of the couple as an individual as of the date of the application or request regardless of how recently the separation occurred. Such individuals are not eligible for cash assistance from DHS.3. Termination of Assistance a. Starting in the month after the month of the separation, each estranged spouse is treated as an individual claimant by the SSA for SSI payment purposes.b. Termination of program eligibility will, therefore, occur at the end of the month of separation.218 R.I. Code R. 218-RICR-20-00-5.3
Amended effective 1/1/2019
Amended effective 6/2/2019
Amended effective 3/2/2022
Amended effective 2/18/2023
Amended effective 11/2/2023
Amended effective 12/17/2023