Residential Care and Assisted Living Compendium: 2007. Providing State Supplements to the SSI Payment

11/30/2007

To increase access for SSI beneficiaries in areas with high development costs, states can create a special SSI state supplement for persons in residential care facilities and limit what providers may charge to the amount of the federal payment plus the state supplement.28 Many states have such State Supplemental Payment (SSP) programs to supplement the federal SSI payment, which in 2007 is $623 a month; the payment is adjusted each January based on the cost of living. Individual states may use a specific term to refer to their supplement and some use the term SSI to refer to both the federal payment and any state supplement.

State supplements are totally state-determined and vary widely.29 States may pay different supplements based on a person’s living arrangement. A few states have developed a supplemental payment rate specifically for SSI recipients in residential care settings to provide them with sufficient income to pay for room and board.

Some policymakers might question the fiscal benefit of providing 100 percent state funding to enable residents to pay for room and board. However, it is important to consider the net state cost of services in a residential care setting compared to a nursing home. If the program diverts people from entering a nursing home or allows individuals to move from a nursing home to the community, states may fund a fairly substantial supplement to the federal SSI payment and still reduce their net cost. For example, the net cost for a state with an average nursing home payment of $3,000 a month and a 50 percent federal match is $1,500. A state could use a portion of the state match that would normally pay for nursing home care to raise the payment standard for residential care settings. Policymakers would have to determine how many people would be covered if the supplement were increased in order to calculate whether the change is “budget neutral” (or better) relative to the amount of the supplement.


  1. Many states have a state supplement for residential care settings that may be too low to cover more intense services needs and higher capital costs in some residential care settings.

  2. See http://www.ssa.gov/pubs/statessi.html.

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