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Supplemental Security Income Exceptional Expense (SSI-E) Handbook Release 10-01 August 25, 2010 |
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Supplemental Security Income Exceptional Expense (SSI-E) Handbook Release 10-01 August 25, 2010 |
The purpose of the SSI-E supplement is to provide additional funds to certain SSI recipients who have exceptional expenses, as evidenced:
by their living in substitute care with monthly expenses to the person which are greater than or equal to the SSI-E payment level; or
by their living at home and needing at least 40 hours per month of primary long-term support services.
SSI recipients, regardless of their disability or age, are potentially eligible for the SSI-E supplement. When a couple is receiving SSI, one or both of them may be eligible for SSI-E. Children who receive SSI may be eligible for SSI-E whether they live in substitute care or in their parent’s home.
However, some special requirements apply to children living with parents or a person residing with a spouse (see 3.1 SSI-E for People in Natural Residential Settings).
The supplement for people living in substitute care is limited to residents of facilities which are relatively small (20 beds or less). Some larger facilities have been grandfathered-in on the basis of prior eligibility (see the list in 6.2 Grandfathered Facilities).
The aim of the supplement for people living in their own homes is to assist them to remain in the community rather than move to nursing homes. It recognizes the higher living and support expenses involved in meeting substantial long-term support needs.
Supplemental Security Income (SSI) is a program of monthly cash payments for elderly and disabled people who have limited income and assets (resources). SSI consists of a basic federal payment with a state supplement.
The federal portion is increased each year by the federal cost of living adjustment (COLA) by the same percentage as Social Security (Title II) benefits.
Federal SSI payments are administered by the federal government through the Social Security Administration (SSA). To apply for SSI, a person goes to the local Social Security office or calls the Social Security Administration at 800-772-1213.
However, to be eligible for SSI a person who has limited assets and income must meet one of two tests:
be age 65 or over; or
be disabled or blind by criteria established in the Social Security Act.
For a determination of disability or blindness, the SSA refers the person to the Bureau of Disability Determination (DDB) in the Division of Health Care Access and Accountability, Department of Health Services.
The SSI countable income limit is the federal SSI payment level for the particular living arrangement (see 6.1 SSI-E Payment Rates).
The SSI countable asset (resource) limit is $2,000 for an individual and $3,000 for couples. Certain assets, such as homestead property, are exempt from the asset limit.
State SSI, Exception Expense Supplement and Caretaker Supplement payments are administered by the Wisconsin Department of Health Services, Division of Disability & Elder Services (DDES).
The Department of Health Services contracts with HP Enterprise Services, a data processing firm, to maintain client eligibility files, conduct eligibility reviews and send benefits to eligible recipients. HP Enterprise Services maintains a toll free Recipient Services phone line at 1-800-362-3002 for State SSI recipients on behalf of the Department.
As of January, 2010, approximately 100,000 individuals received state SSI benefits. Most of these individuals also received federal SSI benefits. However, approximately 6,000 beneficiaries received only state benefits.
These "grandfathered" recipients became eligible for state only SSI under provisions which were in existence prior to January 1, 1996.
All "grandfathered" state only SSI recipients are eligible for certification for SSI-E, if they meet the eligibility requirements specified in this policy document.
SSI recipients apply for SSI-E at their county Department of Social Services (DSS), Department of Human Services (DHS), Department of Community Programs (DCP), Department of Developmental Disabilities Services (DDS) or County Aging Unit (CAU) (if the aging unit is a pubic agency).
These local authorizing agencies determine eligibility for SSI-E and send approved certifications to the Department of Health Services at P.O. Box 6680, Madison, WI 53716-0680.
This page last updated in Release Number: 10-01
Release Date: 08/25/10
Effective Date: 08/25/10