It is important for the CAO and the SSP CU to communicate with each other regarding SSP cases. Each CAO must have appointed an SSP Liaison to facilitate communications. The liaison will be responsible for forwarding SSP referrals from the CAO to the CU, and for communicating SSP-Only case information to the CAO from the CU. Either the CAO or the CU will contact the SSA with changes that may affect an individual’s eligibility for SSI.
The CAO liaison will refer the following individuals to the CU:
individuals who are not eligible for SSI, due to income, but are 65 or older, or under 65 and permanently disabled, AND
whose income is less than the FBR plus the appropriate SSP payment, AND
whose resources are $2000 or less for an individual or $3000 or less for a couple.
CAO referrals to the CU should use the form in Appendix F. This form may be faxed to the CU by the SSP liaison.
Communications between the CAO and the CU become particularly important during an appeal. It is necessary for the CU to be involved in appeals concerning SSP-Only budgets.
The CAO liaison will refer the following individuals to SSA:
Individuals with income under the FBR and who meet the established Disability Advocacy Program (DAP) procedures in Supplemental Handbook Chapter 820. Disability Advocacy Program.
Individuals in cases where it appears that income deemed from another person would be included in the eligibility determination. Refer to Cash Assistance Handbook Chapter 155, “Deeming Income And Resources”.
Requirements for SSP-Only budgets:
The only change an SSP-Only recipient is required to report to the CAO (or CU) is a change of address.
This change must be reported by the 10th of the month following the month of the change.
Individuals active in other budgets should comply with reporting requirements for the active budget program.
Reported changes for other programs do not affect SSP-Only budgets. However, if the CU is notified of a change by the recipient or the CAO, they will complete a reapplication based on the new information and refer any change to the CAO.
Requirements for SSI/SSP cases:
SSI/SSP recipients must report changes to the SSA. Any change reported to the CAO by the recipient should be forwarded to SSA in accordance with Medical Assistance Eligibility Handbook Section 387.12.
The SSI recipient should be advised to report changes to the SSA in accordance with Medical Assistance Eligibility Handbook Section 387.11, Responsibilities of the County Assistance Office.
Exception: If the CAO verifies that an SSI/SSP recipient has died, the CAO may update eCIS with the date of death and close the case. Auto-SSI will not reopen the case if the date of death is entered in eCIS. The CAO should advise the family of the deceased to notify the SSA of the death. The CAO should also notify the SSA of the death.
SSI/SSP budgets:
The SSA redetermines SSI/SSP cases.
CIS will not display a redetermination date for these cases.
SSP-Only budgets:
The CU completes the redetermination for these budgets.
Most SSP-Only budgets will have a redetermination period of six years, with two exceptions. Those with earned or deemed income will have a redetermination period of one year. Those individuals who become ineligible for SSI due to excess income may continue to be eligible for SSP-Only. These budgets will have their PSC system changed to 44 and the redetermination date is set for three months. The CU will make an eligibility decision for these cases within that three months.
An automated process will send a list of SSP-Only budgets to the CU when redetermination is due.
The CU will determine continued eligibility and payment amount and forward the information to the CAO. The CU will also forward the next redetermination date to the CAO.
If CIS does not automatically display the correct new redetermination date, the CAO must change the date.
The procedures for intercounty transfer of SSP budgets vary depending on whether the individual is an SSP-Only recipient, or receives both SSI and SSP.
For SSI/SSP recipients, SDX will indicate that the individual has moved. The CAO should review the record to determine if the reported new address is correct. If the new address is correct, the losing CAO should:
Update eCIS with the new address.
Discontinue SSP using Reason Code 099, Option D. (See Reason Code Text, Appendix C). This will set the closing date. Closing date for SSP is the last day of the month following the month of action when the DHS deadline date for the next benefit date has been met. If the deadline date cannot be met, the closing date is the last day of the second month following the action. This long closing period is intended to prevent SDX from reopening a case in the losing county before a new case can be opened in the gaining county.
Notify the gaining county of the transfer via email to the SSP liaison and the generic CAO email address.
Transfer the case record to the gaining county.
The gaining CAO should:
Enter the case into AP when notified of the case transfer.
Open SSP with the appropriate PSC effective the day after the closing date in the losing county. Depending on action date and deadline dates, the effective date may be up to 60 days after notice is received.
Remember that an SSI recipient must have changed his/her address with SSA before it is reflected on the SDX file. If the individual moves and does not inform the SSA, the CAO will inform the individual to notify SSA, and will assist the individual in doing so when necessary.
Notice of change of address for SSP-Only cases will generally occur when an individual informs the CAO or requests a check replacement. The losing CAO will follow the procedures outlined above. The gaining CAO will also follow the above procedures with an additional step:
Change the redetermination date on Cash Budget Authorization screen to reflect the originally scheduled redetermination date established before the case transfer.
SSP Suspensions
An A, J, or M budget is placed in suspension by CIS and a system-generated notice is sent when:
A check is not claimed and is returned to Treasury.
The EBT account is not accessed for more than 180 days.
SDX indicates the recipient is placed in a non-pay status or jurisdiction for the recipient was changed by SSA from Pennsylvania to another state/territory.
Follow procedures in Section 720.6, SSP Replacements, for OTI and check replacements if the recipient contacts the CAO for a check replacement under the first two circumstances stated above.
IEVS Dispositions
The budget goes into a non-pay status in SDX and the SSA does not refer the budget to the CU for an SSP-Only eligibility determination. Review IEVS Exchange 6 as follows:.
If the A, J, or M budget has a PSC of 44:
Clear the IEVS disposition and wait for continued eligibility information from the CU. The redetermination is set for three months when the CU determines eligibility. CIS suspends the budget only when benefits are returned.
Do not close these budgets unless directed to do so by the CU, or as listed in Section 720.46, Closing A, J or M budgets/ PSC 44.
Follow current policy in Using IEVS Chapter 9 unless the IEVS disposition indicates a change in current pay status.
Check CIS to determine the PSC and whether the budget has been suspended.
If the A, J or M budget has a PSC of 00 or 31-33, 35-37 or 64, review IEVS exchange 6 and check the first position code of the Current Pay Status. There may have been a change in payment status after the budget suspension. If the first position code of the SDX Payment Status Code is:
H or S: clear the disposition and await further action – these codes indicate that SSA is still processing something in this record.
T: clear the disposition and review for Medicaid eligibility in other categories before the A, J or M budget is closed. Refer to Section 720.7, Medical Benefits.
E: review the Federal Living Arrangement Code (FLAC) on Exchange 6.
> If the FLAC is “D” – this indicates the individual is now residing in a Title XIX Institution. Close the A, J or M budget and open the appropriate Medicaid (PA, PJ, PM) or nursing home (PAN, PJN, PMN) category.
NOTE: If the Medicaid eligibility code is “D”, this indicates Disabled Adult Child (DAC) eligibility. Refer to Medical Assistance Eligibility Handbook Section 387.62, TITLE II – Social Security Disabled Adult Child (DAC) Benefits, for DAC eligibility rules.
> If the FLAC is not “D” – this indicates the individual is eligible for SSI but no SSI payment is due because net countable income is equal to the Federal Benefit Rate. Refer to Appendix G for processing instructions.
N: Review the state code on Exchange 6 to make sure that the person is still residing in Pennsylvania. The State Jurisdiction Code must be “39” for residents of Pennsylvania.
> If the payment status code is N01 and the Medicaid eligibility code is not “Y”, the case does not get referred to the CU, and the CAO should review for other Medicaid eligibility according to Medical Assistance Eligibility Handbook Section 387.5, MA Coverage For SSI Recipients.
>If the payment status code is N01 and the SDX shows a Medicaid eligibility code of “Y”, review payments on page 3 of the SDX. If the individual has received an SSI payment (C01 status) in the last six months, the CAO should refer the case to the CU to review for SSP-Only. Indicate on the referral that the budget is suspended in CIS and that the individual is not currently receiving SSI, but has in the last six months. If these individuals are eligible for SSP-Only, the CU will annualize their income to derive a consistent monthly SSP.
> If the payment status code is not equal to N01, the individual is not eligible for a referral to the CU. If the budget has been suspended for more than two payment cycles, review the Medicaid eligibility code on Exchange 6. Before closing the A, J, or M budget, the CAO will make a determination whether continued Medicaid eligibility can be established according to Medical Assistance Eligibility Handbook sections 387.53, Termination of SSI MA Benefits or 387.62, TITLE II – Social Security Disabled Adult Child (DAC) Benefits.
The recipient moves out of state. The State Jurisdiction Code will not be “39” on Exchange 6.
If the State Jurisdiction Code is not “39”, change the eCIS address to the SDX address. Send an Advance Notice, Reason Code 052, Option D explaining that the SSA has notified the Department that the individual no longer lives in Pennsylvania and is not eligible for benefits from Pennsylvania. If the individual has not moved out of state, the budget remains in suspension until the address is corrected on the SDX. When the next issuance is processed, the budget will be automatically reinstated.
NOTE: In cases where the recipient moves out of the state temporarily (such as in cases where the individual is placed out of state for treatment not available in PA), the CAO should change the category to the appropriate Medicaid category. The SSA should be notified by the recipient and by the CAO to advise of the temporary change in residency status. The individual is removed from suspended status and continues Medicaid eligibility. When the individual returns to PA and the SDX file is updated, SSI is reopened.
For dispositions on Exchange 10, Criminal History:
Continue to report criminal history information that may affect SSI eligibility to the SSA.
Clear the disposition and narrate contact with the SSA.
For SSP-Only recipients, review the disposition and close the budget when verification is received that the individual is no longer eligible for SSP.
The CAO should not close an A, J or M budget with a program status code of 44 unless directed to do so by the Central Unit except for the following reasons:
The recipient moves out of state – Notice Code 052, Option D. This notice is CAO initiated to close an SSP-Only budget for the cash benefit and Medicaid, once it is confirmed that the individual does not reside in Pennsylvania.
Close due to death – Notice Code 090, Option B. This notice is CAO initiated to close an SSP-Only budget.
Inter-county transfer – Notice Code 099, Option D.
See Appendix C for Reason Code Text.
Reissued September 11 2012, replacing March 16, 2012