Page images

(3) Expenditures for home repairs (iv) In APTD or AABD with respect are authorized in writing by a responsible to the disabled, 18 years of age or older. agency person, records show the eligible (2) Federal determination of whether person in whose behalf the home repair an individual meets the age requirements expenditure was made, and there is suffi of the Social Security Act will be made cient evidence that the home repair was according to the common-law method performed.

(under which a specific age is attained (d) (1) Other requirements; effect on the day before the anniversary of birth), public assistance payments of the in unless the State plan specifies that the crease in OASDI benefits enacted by popular usage method (under which an Public Law 91–172. (1) In determining age is attained on the anniversary of need for and the amount of OAA, AFDC, birth), is used. AB, APTD, or AABD, the separate OASDI (3) The State agency may adopt an benefit payment made to an individual arbitrary date such as July 1 as the for January and February 1970, result point from which age will be computed ing from the increase in OASDI benefits in all instances where the month of an enacted by Public Law 91-172, shall be individual's birth is not available, but disregarded.

the year can be established. (2) In the case of any individual who

[36 F.R. 3866, Feb. 27, 1971] is a recipient of OAA, AB, APTD, or AABD for the month of April, May, or

$ 233.40 Residence. June 1970 and in such month also re Condition for plan approval: A State ceives monthly OASDI benefits, the total plan under title I, IV-A, X, XIV, or XVI of his aid or assistance for such month, of the Social Security Act may not implus OASDI benefits received in such pose any residence requirement which month, shall exceed, by $4 (or, if less, excludes any individual who is a resident the amount of the increase in his OASDI of the State. For purposes of this section: benefits under Public Law 91–172) per (a) A resident of a State is one who month, the sum of the OASDI benefits is living in the State voluntarily with the he would have received in such month intention of making his home there and without regard to the increase enacted not for a temporary purpose. A child is by Public Law 91–172 plus the supple a resident of the State in which he is liymentary aid or assistance payment he ing other than on a temporary basis. would have received for such month un Residence may not depend upon the reader the applicable State plan as in effect son for which the individual entered the for March 1970.

State, except insofar as it may bear upon [34 F.R. 1394, Jan. 29, 1969, as amended at whether he is there voluntarily or for a 35 F.R. 627, Jan. 17, 1970; 35 F.R. 4329, “temporary purpose.” Mar. 11, 1970; 35 F.R. 7302, May 9, 1970)

(b) Residence is retained until aban§ 233.30 Age.

doned. Temporary absence from the (a) Condition for plan approval. A

State, with subsequent returns to the

State, or intent to return when the purState plan under title I or XVI of the

poses of the absence have been accomSocial Security Act may not impose any

plished, does not interrupt continuity of age requirement of more than 65 years.

residence. (b) Federal financial participation. (1) Federal financial participation is

(Sec. 2, 49 Stat. 620, 74 Stat. 987, sec. 402, 49 available in financial assistance provided

Stat. 627, sec. 1002, 49 Stat. 645, sec. 1402, 64 to otherwise eligible persons who were,

Stat. 555, sec. 1602, 76 Stat. 198, sec. 1902, 79

Stat. 344; 42 U.S.C. 302, 602, 1202, 1352, 1382, for any portion of the month for which

1936a) [35 F.R. 17719, Nov. 18, 1970] assistance is paid:

(i) In OAA or AABD with respect to § 233.50 Citizenship. the aged, 65 years of age or over;

Conditions for plan approval: (ii) In AFDC, under 18 years of age; or (a) A State plan under title, I, X, XIV, under 21 years of age if a student XVI of the Social Security Act may not regularly attending a school, college, or exclude an otherwise eligible citizen of university, or regularly attending the United States, regardless of how (by course of vocational or technical train birth or by naturalization), or when, ing designed to fit him for gainful citizenship was obtained. employment;

(b) A State plan may include all per(iii) In AB or AABD with respect to sons without regard to citizenship status. the blind, any age;

Where there is an eligibility requirement


applicable to noncitizens, a State plan some treatment or services which meet may, as an alternative to excluding all some need beyond the basic provision of noncitizens, provide for qualifying non food and shelter. citizens, otherwise eligible, who have (2) "In an institution” refers to an resided in the United States for a spec individual who is admitted to particiified number of years.

pate in the living arrangements and to [36 F.R. 3867, Feb. 27, 1971)

receive treatment or services provided

there which are appropriate to his § 233.60 Institutional status.

requirements. (a) Federal financial participation. (3) "Public institution” means an in(1) Federal financial participation stitution that is the responsibility of a under Title I, X, XIV, or XVI of the governmental unit or over which a govSocial Security Act is not available in ernmental unit exercises administrative payments to or in behalf of any in control. dividual who is an inmate of a public (4) “Inmate of a public institution” institution except as a patient in a medi means a person who is living in a public cal institution.

institution. An individual is not consid(2) (i) Federal financial participation ered an inmate when: under title X or XIV of the Social Secu (i) He is in a public educational or rity Act is not available in payments to vocational training institution, for puror in behalf of any individual who is a poses of securing education or vocational patient in an institution for tuberculosis training, or or mental diseases.

(ii) He is in a public institution for a (ii) Federal financial participation temporary emergent period pending under title XVI of the Social Security other arrangements appropriate to his Act is not available in payments to or needs. in behalf of any individual who has not (5) "Medical institution” means an attained 65 years of age and who is a institution which: patient in an institution for tuberculosis (i) Is organized to provide medical or mental diseases.

care, including nursing and convales(3) For purposes of this paragraph:

cent care; (i) Federal financial participation is (ii) Has the necessary professional available in payments for the month in personnel, equipment, and facilities to which an individual (if otherwise eli manage the medical, nursing, and other gible) became an inmate of a public health needs of patients on a continuing institution, or a patient in an institution basis in accordance with accepted for tuberculosis or mental diseases; standards;

(ii) Whether an institution is one for (iii) Is authorized under State law to tuberculosis or mental diseases will be provide medical care; determined by whether its overall char (iv) Is staffed by professional personacter is that of a facility established and nel who have clear and definite responsimaintained primarily for the care and bility to the institution in the provision treatment of individuals with tubercu of professional medical and nursing serylosis or mental diseases (whether or not ices including adequate and continual it is licensed);

medical care and supervision by a physi(iii) An institution for the mentally cian; sufficient registered nurse or liretarded is not an institution for mental censed practical nurse supervision and diseases;

services and nurse aid services to meet (iv) An individual on conditional re nursing care needs; and appropriate lease or convalescent leave from an in guidance by a physician(s) on the prostitution for mental diseases is not fessional aspects of operating the facility. considered to be a patient in such (6) “Institution for tuberculosis" institution.

means an institution which is primarily (b) Definitions. For purposes of Fed engaged in providing diagnosis, treateral financial participation under para ment, or care of persons with tuberculograph (a) of this section:

sis, including medical attention, nursing (1) "Institution” means an establish care, and related services. ment which furnishes (in single or (7) "Institution for mental diseases” multiple facilities) food and shelter to means an institution which is primarily four or more persons unrelated to the engaged in providing diagnosis, treatproprietor, and in addition, provides ment or care of persons with mental


diseases, including medical attention, § 233.80 Disability. nursing care, and related services.

(a) State plan requirements. A State (8) "Patient” means an individual

plan under title XIV or XVI of the Social who is in need of and receiving profes

Security Act must: sional services directed by a licensed

(1) Contain a definition of permapractitioner of the healing arts toward

nently and totally disabled, showing maintenance, improvement, or protection

that: of health, or alleviation of illness, dis

(i) "Permanently” is related to the ability, or pain.

duration of the impairment or combina[36 F.R. 3867, Feb. 27, 1971)

tion of impairments; and $ 233.70 Blindness.

(ii) “Totally” is related to the degree (a) State plan requirements. A State of disability plan under title X or XVI of the Social

The following definition is recommended: Security Act must:

"Permanently and totally disabled” means (1) Contain a definition of blindness that the individual has some permanent in terms of ophthalmic measurement. physical or mental impairment, disease, or The following definition is recommended:

loss, or combination thereof, this substanAn individual is considered blind if he

tially precludes him from engaging in useful has central visual acuity of 20/200 or less

occupations within his competence, such as

holding a job. in the better eye with correcting glasses or a field defect in which the peripheral

Under this definition: field has contracted to such an extent

“Permanently” refers to a condition which that the widest diameter of visual field

is not likely to improve or which will consubtends an angular distance of no

tinue throughout the lifetime of the indi

vidual; it may be a condition which is not greater than 20°.

likely to respond to any known therapeutic (2) Provide that, in any instance in

procedures, or a condition which is likely to which a determination is to be made remain static or to become worse unless cerwhether an individual is blind according tain therapeutic measures are carried out, to the State's definition, there will be an

where treatment is unavailable, inadvisable, examination by a physician skilled in

refused by the individual on a reasonable the diseases of the eye or by an optome

basis; “permanently” does not rule out the

possibility of vocational rehabilitation or trist, whichever the individual may

even possible recovery in light of future medselect. Under this requirement, no

ical advances or changed prognosis; in this examination is necessary when both eyes sense the term refers to a condition which are missing.

continues indefinitely, as distinct from one (3) Provide that each eye examina which is temporary or transient; tion report will be reviewed by a State

“Totally" involves considerations in addisupervising ophthalmologist who is

tion to those verified through the medical

findings, such as age, training, skills, and responsible for making the agency's

work experience, and the probable functiondecision that the applicant or recipient ing of the individual in his particular situadoes or does not meet the State's defini tion in light of his impairment; an individtion of blindness, and for deter ual's disability would usually be tested in mining if and when reexaminations are relation to ability to engage in remunerative necessary.

employment; the ability to keep house or to (b) Federal financial participation.-

care for others would be the appropriate test (1) Assistance payments. Federal finan

for (and only for) individuals, such as house

wives, who were engaged in this occupation cial participation is available in assist

prior to the disability and do not have a ance provided to or in behalf of any history of gainful employment; eligibility otherwise eligible person who is blind. may continue, even after a period of rehaBlindness may be considered as continu

bilitation and readjustment, if the individing until an examination by a qualified

ual's work capacity is still very considerably

limited (in comparison with that of a normal examiner establishes the fact that the

person) in terms of such factors as the speed recipient's vision has improved beyond with which he can work, the amount he can the State's definition of blindness.

produce in a given period of time, and the (2) Administrative expenses. Federal

number of hours he is able to work. financial participation is available in any (2) Provide for the review of each expenditures incident to the eye exami medical report and social history by nation necessary to determine whether technically competent persons-not less an individual is blind.

than a physician and a social worker [36 F.R. 3867, Feb. 27, 1971]

qualified by professional training and

pertinent experience-acting coopera and is legally obligated to support the tively, who are responsible for the agen child under State law of general applicy's decision that the applicant does or cability which requires stepparents to does not meet the State's definition of support stepchildren to the same extend permanent and total disability. Under that natural or adoptive parents are this requirement:

required to support their children. Under (i) The medical report must include this requirement, the inclusion in the a substantiated diagnosis, based either family, or the presence in the home, of on existing medical evidence or upon a “substitute parent” or “man-in-thecurrent medical examination;

house” or any individual other than one (ii) The social history must contain described in this paragraph is not an sufficient information to make it possi acceptable basis for a finding of ineligible to relate the medical findings to the bility or for assuming the availability of activities of the “useful occupation” and income by the State. In establishing to determine whether the individual is financial eligibility and the amount of totally disabled, and

the assistance payment, only such net (iii) The review physician is responsi income as is actually available for curble for setting dates for reexamination; rent use on a regular basis will be conthe review team is responsible for re sidered, and the income only of the viewing reexamination reports in con parent described in the first sentence of junction with the social data, to deter this paragraph will be considered availmine whether disabled recipients whose able for children in the household health condition may improve continue in the absence of proof of actual to meet the State's definition of perma contributions. nent and total disability.

(b) Condition for plan approval. A (3) Provide for cooperative arrange child may not be denied AFDC either ments with related programs, such as initially or subsequently “because of the vocational rehabilitation services.

conditions of the home in which the child (b) Federal financial participation resides”, or because the home is con(1) Assistance payments. Federal finan sidered “unsuitable”, unless “provision cial participation is available in pay is otherwise made pursuant to a State ments to or in behalf of any otherwise statute for adequate care and assistance eligible individual who is permanently with respect to such child". (Section and totally disabled. Permanent and total 404 (b) of the Social Security Act.) disability may be considered as continu (c) Federal financial participation. ing until the review team establishes the (1) Federal financial participation under fact that the recipient's disability is no title IV-A of the Social Security Act in longer within the State's definition of payments with respect to a “dependent permanent and total disability.

child”, as defined in section 406(a) of (2) Administrative expenses. Federal the Act, is available within the following financial participation is available in any interpretations: expenditures incident to the medical (i) Needy child deprived by reason of. examinations necessary to determine The phrase “needy child * * deprived whether an individual is permanently * by reason of” requires that both and totally disabled.

need and deprivation of parental support [36 F.R. 3867, Feb. 27, 1971]

or care exist in the individual case but

does not require an affirmative showing § 233.90 Factors specific to AFDC.

that a causal relationship exists in the (a) State plan requirement. A State individual case. The phrase encompasses plan under title IV-A of the Social the situation of any child who is in Security Act must provide that the de need and otherwise eligible, and whose termination whether a child has been parent_father or mother-either has deprived of parental support or care by died, has a physical or mental incapacity, reason of the death, continued absence or is continually absent from the home. from the home, or physical or mental This interpretation is equally applicable incapacity of a parent, or (if the State whether the parent was the chief breadplan includes such cases) the unemploy winner or devoted himself or herself ment of his father, will be made only in primarily to the care of the child, and relation to the child's natural or adoptive whether or not the parents were married parent, or in relation to the child's step to each other. The determination parent who is ceremonially married to whether a child has been deprived of the child's natural or adoptive parent parental support or care is made in re


lation to the child's natural parent or, as appropriate, the adoptive parent or stepparent described in paragraph (a) of this section.

(ii) Death of a parent. If either parent of a child is deceased, the child is deprived of parental support or care, and may, if he is in need and otherwise eligible, be included within the scope of the program.

(iii) Continued absence of the parent from the home. Continued absence of the parent from the home constitutes the reason for deprivation of parental support or care when the parent is out of the home, the nature of the absence is such as either to interrupt or to terminate the parent's functioning as a provider of maintenance, physical care, or guidance for the child, and the known or indefinite duration of the absence precludes counting on the parent's performance of his function in planning for the present support or care of the child. If these conditions exist, the parent may be absent for any reason, and he may have left only recently or some time previously.

(iv) Physical or mental incapacity. “Physical or mental incapacity” of a parent may be deemed to exist when one parent has a physical or mental defect, illness, or disability, whatever its cause, degree, or duration, or accompanying factors.

(v) Living with [a specified relative] in a place of residence maintained as his *

own home". (a) A child may be considered to meet the requirement of living with one of the relatives specified in the Act if his home is with a parent or a person in one of the following groups:

(1) Any blood relative, including those of half-blood, and including first cousins, nephews, or nieces, and persons of preceding generations as denoted by prefixes of grand, great, or great-great:

(2) Stepfather, stepmother, stepbrother, and stepsister.

(3) Persons who legally adopt a child or his parent as well as the natural and other legally adopted children of such persons, and other relatives of the adoptive parents in accordance with State law.

(4) Spouses of any persons named in the above groups even after the marriage is terminated by death or divorce.

(b) A home is the family setting maintained or in process of being established,

as evidenced by assumption and continuation of responsibility for day to day care of the child by the relative with whom the child is living. A home exists so long as the relative exercises responsibility for the care and control of the child, even though either the child or the relative is temporarily absent from the customary family setting. Within this interpretation, the child is considered to be “living with” his relative even though

(1) He is under the jurisdiction of the court (e.g., receiving probation services or protective supervision); or

(2) Legal custody is held by an agency that does not have physical possession of the child.

(vi) “Regularly attending a school, college, or university, or regularly attending a course of vocational or technical training designed to fit him for gainful employment.A child may be considered in regular attendance at school or a training course in months in which he is not attending because of official school or training program vacation, illness, convalescence, or family emergency, and for the month in which he completes or discontinues his school or training program.

(2) Federal financial participation is available in:

(i) Initial payments made on behalf of a child who goes to live with a relative specified in section 406(a)(1) of the Social Security Act within 30 days of the receipt of the first payment, provided payments are not made for a concurrent period for the same child in the home of another relative or as AFDC-FC;

(ii) Payments with respect to an unborn child when the fact of pregnancy has been determined by medical diagnosis;

(iii) Payments made for the entire month in the course of which a child leaves the home of a specified relative, provided payments are not made for a concurrent period for the same child in the home of another relative or AFDC-FC; and

(iv) Payments made to persons acting for relatives specified in section 406(a) (1) of the Act in emergency situations that deprive the child of the care of the relative through whom he as been receiving aid, for a temporary period necessary to make and carry out plans for the child's continuing care and support.

(3) Federal financial participation


« PreviousContinue »