The individual (or an individual's representative) must let the CAO know of changes that might affect the individual's eligibility for the Personal Care Supplement.
Exception: Changes in the individual's income and resources must be reported to the SSA. The SSA decides on the individual's continued eligibility for SSI benefits. The SSA must use (Notice of SSI Eligibility) SSA 8036 to report changes in SSI eligibility to the CAO.
Changes that might affect an individual's eligibility include, but are not limited to, the following:
The individual is permanently discharged from the PCH or Dom Care Home.
The individual passed away. The operator of the PCH or Dom Care Home must report the death.
The individual moves from a PCH to a Dom Care Home or from a Dom Care Home to a PCH.
In these cases, the AAA or PCH must send the CAO an updated Domiciliary Care/Personal Care Home Supplement Change/Discontinue Form (PA 745) that includes the changes. This does not include a short stay in a hospital or a Long-Term Care (LTC) facility. It may be necessary to contact the SSA to see whether they have confirmed that the stay is temporary. See the (Long Term Care Handbook, Section 405.2, SSI Category) for an explanation of continued SSI payments while in a LTC facility.
The CAO must send the individual and the AAA or PCH an advance notice to let the individual know he or she is no longer eligible for the supplement. A template for the PA 162 discontinue notice is available in the "Personal Care Supplement" form folder in DocuShare.
If the individual is no longer eligible for the supplement because of the change, the CAO must send a Termination: State Supplement for Domiciliary Care (PA 746) to the SSA.
NOTE: If the supplement was for a PCH, the CAO must write "PERSONAL CARE HOME" in the upper-right corner of the PA 746.
The CAO must provide a notice of a change in eligibility to the individual as it would for any other SSI recipient. ( Chapter 387, Supplemental Security Income.) The CAO must send a copy of the notice to AAA.
If the individual is ineligible for SSI benefits because of unreported income or resources, the CAO must complete an Overpayment Referral (OIG 189). ( Supplemental Handbook, Chapter 910, Restitution and Disqualification.)
Updated July 22, 2020, Replacing April 23, 2020