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CONNECTICUT'S "STATE SUPP" (AABD) BENEFIT

Summary for Connecticut Elder Law Attorneys

(Please read DISCLAIMER[†])

Lisa Nachmias Davis
Attorney at Law
205 Church Street, Third Floor
New Haven, CT 06510

203-776-4400
Fax 203-774-1060
davis@sharinglaw.net
www.sharinglaw.net

"State Supp" is a state welfare program designed to provide supplemental assistance to the "aged, blind or disabled," including those who are receiving federal SSI benefits or who would otherwise receive SSI but for their Social Security income. Conn. Gen. Stat. §§ 17b-600 et. seq.

1. State-State Differences. Most states "supplement" SSI with a separate benefit. In some cases, this is actually administered by the Social Security Administration, which sends out a combined check. In Connecticut, however, the benefit is entirely different, applied using completely different rules, and administered through the Department of Social Services. The state supp. benefit is determined based on a needs analysis, using a complicated formula that takes into account actual rental and other expenses.

2. Who Gets State Supp.? Recipients of state supplement fall generally into two categories: (a) very low-income people living in the community, usually disabled people receiving SSI; and (b) residents of "licensed boarding facilities," a/k/a residential care homes licensed as such by the Department of Public Health, or those living in a "licensed" facility or location as part of a state program -- such as residents of group homes for the developmentally disabled. For those in the community, the benefit takes the form of "cash assistance," accessed through a grey "Connect" Card that is also used for food stamps and for those who receive it, Medicaid. For those in residential facilities, the benefit takes the form of a rental subsidy that is paid directly to the institution as a credit towards the state rate, with the individual responsible for the difference. For an elderly person living in a "residential care home" formerly known as a "home for the aged," the benefit may look and feel like Medicaid -- payment goes to the facility directly; individual has an obligation to pay part of income to the facility; apparently same asset rules; same benefit application (the form W-1-F). In fact, nine times out of ten the facility will state that it "accepts Medicaid," and even the Department of Public Health book, which lists facilities that do and do not accept Medicaid, lists those residential care homes-- which are not facilities for which the federal Medicaid benefit is available-- which "accept Medicaid"! There are some significant differences, however, that are very important to remember.

3. State Supp. Eligibility. As with SSI, there are categorical and financial eligibility requirements. State Supp. is available to those who qualify as "aged" (65+), blind, or disabled.

(a) Category: The Department of Social Services can determine whether a person is "disabled" even if not receiving SSI or Social Security Disability, but if an application is pending with SSA, DSS may choose to wait, or to make its finding provisional only.

(b) Income. State Supplement is available to (but not necessarily awarded to) individuals whose gross income does not exceed 300% of SSI, currently, $1,911 per month. This "cap" is absolute. No matter the circumstances, no state supp. will be available to the person whose gross income is $1 over the cap. For those in the community, whether or not a benefit is available will depend on the rental expense and living arrangement, as described below. Note that the income of a spouse who lives with the applicant will be deemed available to the individual. Spouses living apart because one is in a licensed facility will not have income deemed to each other.

(c) Asset Limits. The asset limit for state supp. is $1,600 in no-exempt assets. So far, the similarity to Medicaid is clear. Excluded from consideration are the individual's home, car, funeral contract, and burial space. The assets of a spouse who is not living with the applicant are also not considered available to the applicant. However, assets in a self-settled "special needs trust" described in 42 U.S.C. § 1396p(d)(4)(A) are not exempt. Parkhurst v. Department of Social Services, 82 Conn. App. 877 (2004). Assets of the parents of a minor child may be "deemed" available to the child. UPM § 4025.55. There is no concept of a "CSPA" or spousal share that is protected. If the spouses live apart, the other spouse's assets do not count. If the spouses live together, all assets are deemed available to each and may affect eligibility. The same applies to spousal income. There are no spousal protections under AABD.

(d) Transfer Penalties. State Supp. has a 24-month look-back period (although, for practical purposes, it is common to require a shorter period of time to be verified through production of financial records). UPM § 3025.05. Any transfer subject to penalty during that period incurs penalty at the rate of $500 = 1 month of ineligibility. UPM § 3025.35 There is no cap on the penalty; however, the penalty starts to "run" in the month it is made, as the rules of DRA have not been applied to state supp. transfer penalties. Important to note:

Transfers of assets to a self-settled special needs trust may also be subject to penalty to the extent that the transfer puts the assets out of the applicant's reach; arguably, as the assets are considered available, no transfer may have occurred. Parkhurst v. Department of Social Services, 82 Conn. App. 877 (2004). At a minimum, spending down the trust should negate the penalty.

<>Transfers between spouses may be subject to penalty. An exception will be making a spouse a joint owner of property. UPM § 3025.15, or division of property pursuant to a prenuptial agreement when the spouses begin to live separately (because one is in a licensed boarding facility). UPM § P-3025.18.<>

(e) Rules for Applying. Other differences with Medicaid that can trap the unwary: eligibility begins the first day on which both are true: (i) the individual has applied; and (ii) assets are reduced to the permitted limit. Thus: no retroactive benefits -- one must apply ASAP; and (ii) no ability to "spend down" by month's end and have the entire month covered.

(f) Lien. State Supp. is not limited by Medicaid law limiting liens. Anyone living in a home in the community will have a lien placed on the home as a condition of receiving State Supp.

(g) Estate Recovery. State Supp. is also not limited by Medicaid restrictions on estate recovery. A current or former recipient of state supp. who receives anything of value during lifetime is liable for repayment during lifetime, limited only by state law limitations on recovery from inheritances and personal injury settlements up to 50% of the amount received or recovered. Conn. Gen. Stat. § 17b-93, 17b-95. The State also has a claim against the estate of any decedent who received these benefits at any time during life. There are no spousal protections.

4. Computing Benefit under State Supp.

(a) Licensed Facility. The AABD budget is calculated by adding the monthly state rate of the particular facility to a personal needs allowance of $28.90* (UPM § 4520.10) to reach the applicant's "Basic Needs." This is compared to the applicant's income, disregarding $148.70.* UPM § 5030.15; P-5030.15 (Transmittal UP 08-03). The balance is deducted from the total needs and the facility receives a check for the difference. The applicant's award letter will not say "Medicaid has been granted eff. (date); your obligation to pay applied income is $2,002 in June, $2,000 in July, $2,000 in August (etc.)." Rather, the award letter may say "we will pay $3,500 per month to the facility." The facility and the individual must then agree about what is left over. The upshot, however, is that the applicant keeps $28.90* + $148.70* or $177.60* and the rest goes to the facility. Note: there is no ability to deduct for supplemental insurance premiums. These must either be paid by the individual out of the $177.60,* or the insurance must be dropped. However, eligibility for state supp. makes a person "categorically" eligible for Medicaid.

(b) State Supp. in the Community. For the resident of a licensed facility, the "basic need" is the $28.90* PNA plus the boarding facility monthly rate. For the person in the community the "basic need" is actual rent up to a maximum of $400 (if living alone) or $200 (if sharing) plus a personal needs allowance of $164.10* ($165.10* for a married individual). UPM § 4520.15. Income (net of any disregard) is compared to the "Basic Need," and AABD makes up the difference. In 2008, the unearned income disregard for an individual in the community, living as a roomer in someone else's home, or in a skilled nursing facility, is $241.00*; for someone sharing with a non-relative was $308.90* (increasing each year to reflect Social Security Administration adjustments). UPM § P-5030.15. There are also "earned income" disregards. As with SSI, these will be the first $65 of earned income plus 1/2 the remainder; in some cases, work-related expenses are also added to the disregard.

(c) Additional Benefits. Recipients of AABD, both in the community and in licensed boarding facilities, are entitled to assistance with moving expenses (UPM § 4525.15); special clothing assistance (UPM § 4525.20); and help with purchase or repair of essential household items (UPM § 4525.25).

*2008 VALUES