POMS Reference

SI 00520: Institutionalization

TN 20 (12-94)

Citations:

Social Security Act, Section 1611(e)(1)(D);

20 CFR 416.201; 20 CFR 416.211(d);

P.L. 98-21, Section 403

A. Definitions

1. Homeless individual

One who is not under the control of any public institution and has no currently usable place to live.

2. Emergency shelter

A shelter for individuals whose homelessness poses a threat to their lives or health.

3. Public emergency shelter for the homeless (PESH)

A public institution or that part of a public institution used as an emergency shelter by the Federal Government, a State or a political subdivision of a State, primarily for making available on a temporary basis, a place to sleep, food, and some services or treatment to homeless individuals.

4. 9-month period

A period of 9 full calendar months ending with the calendar month under consideration, and including the immediately preceding 8 consecutive full calendar months.

B. Policy — eligibility while in a PESH

Payments can be made for up to 6 months throughout which an individual is a resident of a PESH in any 9-month period. The 6 months need not be consecutive.

C. Policy — when PESH exception does not apply

The following are situations in which the PESH exception does not apply.

  1. A medical treatment facility is not a PESH.

  2. An individual is not a resident of a PESH if the facility has control over the person. Examples of such facilities include:

    • a holding facility, halfway house, detoxification center, or like facilities;

    • foster care facilities which provide temporary care for children/ adults until a permanent foster home can be located;

    • facilities housing individuals awaiting discharge from an institution and placement in the community; and

    • facilities providing transitional living arrangements as part of an institution's plan to facilitate an individual's adjustment to community living.

  3. If all of the residents of a facility are there under the control of the penal system, then the institution is penal. However, if the institution also accommodates residents (other than employees) who are not subject to legal process and are free to come and go as they please, that part of the facility may be a public emergency shelter for the homeless (PESH) for these residents .

D. Policy — period of eligibility

1. Eligibility stops

Eligibility for the PESH exception stops effective with the 7th month throughout which the individual resides in a shelter in any 9-month period.

2. Ineligibility continues

Ineligibility while in a PESH continues for as long as the person has received benefits for 6 months during the applicable rolling 9-month period.

E. Policy — absence from a PESH

1. 14-Day temporary absence not applicable

The 14-day temporary absence rule (SI 00520.001B.7.) does not apply in determining residency throughout a month. Any period of a day or more during which the individual is not a resident of the PESH, breaks the continuity of stay for that month, so that the individual can be eligible for that month and the month does not count toward the 6-month payment limit.

2. Leaving a PESH during a period of ineligibility

If an individual leaves a PESH during a period of ineligibility, any SSI payment for a month in which he reattains eligibility is prorated.

F. Procedure

1. Determination of PESH status

  • Consult the precedent file at SEANET 8045. If a precedent exists, use it in the case determination. Update the precedent if the latest form is over 3 years old and there is a case which requires current information (see SI 00520.800).

  • If no precedent exists, develop a precedent for a facility which may be a PESH.

  • Use the definitions and policies in B. and C. above to determine whether a facility is a PESH.

  • Record the information and facility determination at SEANET 8045 (see SI 00520.820).

2. Reporting admissions, discharges, and referrals

  1. The parallel FO must develop and maintain procedures for PESHs to:

    • make referrals of potentially eligible persons to the FO; and

    • report admissions and discharges of SSI recipients. (Referrals to the FO should be made regardless of the amount of time the individual expects to remain in the shelter.)

  2. Additionally, the FO must:

    • explain pertinent policies and procedures to PESH management or appropriate staff;

    • provide appropriate reporting forms, such as the SSA-8150 (Reporting Events — SSI) to PESHs; and

    • maintain regular liaison with the PESH staff.

3. Rolling period of potential eligibility

Use the following chart to determine the beginning and ending months of the rolling 9-month period.

NOTE: Each recipient has an individual rolling 9-month period.

If the calendar month under consideration is:   Then use as the first month of the rolling 9-month period:
January   May
February   June
March   July
April   August
May   September
June   October
July   November
August   December
September   January
October   February
November   March
December   April

EXAMPLE: An SSI recipient enters a public emergency shelter for the homeless on May 15, 1993, and is still there on June 1, 1993. It is not known when a permanent housing arrangement can be made. June 1993 is the first full month of residency in a PESH for purposes of determining the 9-month period. The rolling 9-month period is June 1993 back through October 1992. (From May 1993 back through October 1992, the recipient was not in a public emergency shelter for the homeless.) The recipient stays in the shelter until December 5, 1993, when he moves to his own apartment. (For each month the recipient remains in the PESH, the 9-month period rolls forward a month. For example, in July 1993, the rolling 9-month period is July 1993 back through November 1992.) The recipient would receive an SSI payment under this provision for the months of June through November 1993, the 6 months throughout which he was a resident of a public emergency shelter, in addition to a payment for May 1993 and December 1993 (the months of admission and discharge).

4. Amount of benefit

Determine the amount of Federal SSI benefit and mandatory State supplementation in the usual manner (e.g., use the regular rules for proration of benefits, retrospective monthly accounting, and in-kind support and maintenance).

For optional State supplementation, see SI 01415.000 and regional instructions.

5. Effectuation of payments

  1. Use force due procedures (see SM 01701.001).

  2. Do not remove the case from force due status when:

    • the 6-month payment limit has been reached; or

    • a change in living arrangements occurs which would otherwise allow automated payments.

  3. Continue force due in order to track the number of months of payment under this provision unless:

    • a period of 9 consecutive months has passed in which no payments have been made under this provision, or

    • it is determined that the person was never a resident in a PESH for a full month.

6. Effectuation of payments

  • In these cases T-30 the record and return to automated processing.

7. Notices

  • In order to minimize overpayments, manually issue a Notice of Planned Action (SSA-L8155-U2) at least 15 days prior to the 1st day of the 1st month of ineligibility due to continued residence in a public emergency shelter. (See Goldberg/Kelly procedures in SI 02301.301)

  • Follow the general instructions for preparing manual notices in NL 00801.010E. Include the first month of ineligibility because of continued residence in a PESH, and the first month the individual will become eligible again if residence in the PESH is continuous.

  • Place a copy of the notice in the file.