As reported in the June 2014 edition of this newsletter, New York State will take over administration of the Supplemental Security Income (SSI) state supplement effective October 1, 2014. For decades, New York State has paid an additional state supplement to recipients of SSI, but contracted with the Social Security Administration (SSA) to administer payment of the supplement. Most beneficiaries – and maybe even advocates – had no idea there even was a separate payment.
New York recently determined that it could save more than $90 million annually to administer the state supplement directly. Legislation passed in 2012 allowed New York to administer its own State Supplement Program (SSP) through the Office of Temporary and Disability Assistance (OTDA).
With the takeover imminent, the State published final regulations on September 24, 2014, which can be found at http://otda.ny.gov/legal/Adoption-State-Supplement-Program.pdf. The final regulations reflect a number of changes to the proposed regulations, based in large part on comments offered by the Empire Justice Center and other advocates. The state has issued a GIS to local Social Services Districts informing them of the takeover, available at http://otda.ny.gov/policy/gis/2014/14DC036.pdf. OTDA has also created a webpage devoted to SSP at http://otda.ny.gov/programs/ssp/#benefits. In addition, in conjunction with SSA, OTDA has held a number of informational meetings for advocates, including a session at the recent Partnership Conference.
So what will or won’t happen when this change goes into effect on October 1st? Most significantly, the amount of the state supplement will remain the same, $87 or $104 for individuals or SSI couples living alone, respectively, and $23 or $46 for individuals or couples living with others. The most visible practical difference will be that SSI recipients in New York will receive two payments, one for the federal SSI benefit rate ($721 for individuals and $1,082 for couples in 2014), and a separate payment for the SSI state supplement. The payments will be made in the same manner as recipients are currently paid, either by direct deposit, Direct Express, or paper checks. Representative payees will also remain the same.
Initially, the State will continue payments at current levels. If OTDA learns of living arrangement changes through the State Data Exchange (SDX) or from the beneficiary, at this point it will accept an attestation from the beneficiary without doing its own investigation (e.g., contacting landlords, etc.). The attestation can be made using the SSP Living Arrangement form. It is available at http://otda.ny.gov/programs/applications/5030.pdf. Eventually, this form will be used for redeterminations, and presumably for new “SSP only” applications. (“SSP only” beneficiaries, of whom there are about 40,000, have income such as Title II or VA benefits that is more than the federal benefit but less than the combined federal benefit rate and SSP.) According to OTDA, it will rely on information already in its system to verify living arrangements. If it cannot discern the living arrangement, it will assign the claimant to the “B” category (“living with others”) until a Living Arrangement form is returned. (See the 2014 NYS Benefits Level Chart at http://otda.ny.gov/programs/ssp/Maximum-Monthly-Benefit-Amounts.pdf)
Most SSI recipients should already have received notices from both the State and SSA informing them of the expected changes. Unfortunately, the SSA notices probably caused more concern for beneficiaries, as they indicated a change in benefits. These notices, like the State notices, direct all questions to the New York SSP Customer Support Center at 1-855-488-0541, which operates Monday – Friday from 8:30 – 4:45. The number is toll-free.
All aspects of the SSP will now be handled by telephone through the Support Center, and not at local DSS offices. Questions can also be emailed to email@example.com, although inquiries containing personally identifiable information should not be made this way at this point. OTDA anticipates adding a fax number to its website as well. Information in other languages and in other formats is available on the website.
But where should SSI recipients now report changes in income or living arrangements? Most changes should be reported to SSA. The State will receive the information daily through the electronic State Data Exchange (SDX). Beginning October 1st, however, changes in living arrangements that affect the amount of the state supplement only should be reported directly to New York State. Similarly, SSP-only recipients will need to report all changes directly to OTDA’s Support Center.
What if a beneficiary reports to OTDA instead of SSA, or vice versa in those situations where only the SSP would be affected by the reported change? Here is where things get a bit murky. OTDA has stressed that a claimant must appeal in a timely manner to SSA to preserve due process rights and continued benefits when available. It is not yet clear if each agency will keep a record of inquiries by a claimant about a possible appeal that could be used to show good cause for a late filing with the appropriate agency. Ideally, individuals should be referred to the proper agency by either OTDA or SSA.
Again, OTDA has stressed that it will rely primarily on information gathered by SSA, and will generally follow SSA’s determinations. But for the “SSP only” claims, OTDA will have to gather information about living arrangements directly. And in the presumably small number of claims where no disability determination has been done by SSA (e.g., claimant is not eligible for Title II benefits and has other income above the SSI federal benefit rate), OTDA will have to make disability determinations. The State plans on contracting with the Division of Disability Determination (DDD) for these cases, which would follow the same rules used for all SSA determinations.
What about appeals? OTDA assumes that most appeals will go through SSA, but there will be some situations that only affect the SSP. Additionally, SSP-only applications could be denied. These appeals will be conducted under OTDA’s current rules and regulations. On a number of issues, such as excess resources, OTDA anticipates tracking SSA’s appeal process. Similarly, it anticipates following SSA’s lead in decisions on overpayments. Here again, the details remain murky. But there are provisions covering some of these topics in the OTDA regulations. Additionally, OTDA has indicated in the preamble to the regulations and at meetings that it is planning to develop its own waiver and overpayment procedures, presumably in accord with SSA’s.
OTDA has made clear that unlike SSI installment payments, SSP retroactive payments will be made in one payment. OTDA will reimburse local counties out of the SSP retroactive amount if the full interim assistance is not satisfied by the SSI retroactive award. In SSP-only cases, OTDA will reimburse local DSSs if there has been “duplicate assistance.”
OTDA will also issue benefit verification information on the SSP amount, as that amount will no longer be included in SSI verifications. (See page 7 of this newsletter for information on SSA’s current policies regarding benefits verification.) At this point, beneficiaries will need to contact the Customer Support Center. OTDA hopes to develop on-line access to this information.
Finally, how will an advocate be able to get information about a client’s SSP case? OTDA is not able to access the SSA 1696 Appointment of Representative form in SSA’s system. It will, however, accept an executed 1696 submitted directly by a representative. Eventually, it intends to develop its own authorization form, which will be available online.
Advocates and beneficiaries will undoubtedly have questions as this major change goes into effect. Please contact us with your concerns. Representatives from OTDA continue to meet with advocates and have expressed willingness to work together to resolve issues that arise.