diff --git a/changelog.d/tx-ssi-supplement-history.fixed.md b/changelog.d/tx-ssi-supplement-history.fixed.md new file mode 100644 index 00000000000..4d6a460dcfd --- /dev/null +++ b/changelog.d/tx-ssi-supplement-history.fixed.md @@ -0,0 +1 @@ +Backfill the Texas SSI supplement's personal needs allowance at $30 from July 1988 (no supplement before September 1999), so `tx_ssi_state_supplement` returns $0 instead of raising `ParameterNotFoundError` for July 1988 through August 1999, and document the supplement's sources from 1999 to 2026. diff --git a/policyengine_us/parameters/gov/states/tx/hhsc/ssi_state_supplement/personal_needs_allowance.yaml b/policyengine_us/parameters/gov/states/tx/hhsc/ssi_state_supplement/personal_needs_allowance.yaml index eea60dbf67f..0fa05f76148 100644 --- a/policyengine_us/parameters/gov/states/tx/hhsc/ssi_state_supplement/personal_needs_allowance.yaml +++ b/policyengine_us/parameters/gov/states/tx/hhsc/ssi_state_supplement/personal_needs_allowance.yaml @@ -1,6 +1,13 @@ description: Texas provides this amount as the personal needs allowance for Supplemental Security Income recipients in Medicaid-funded long-term care facilities under the Optional State Supplement program. values: + # H-1500 and the 2002 DHS handbook give $30 before September 1999 without a + # start date. The modeled backfill starts July 1, 1988, when the $30 federal + # minimum in 42 USC 1396a(q)(2) took effect: Pub. L. 100-203 section + # 9119(d)(2), in the statutory note to 42 USC 1396a, applies it to "calendar + # quarters beginning on or after July 1, 1988". Texas's own adoption date is + # not in these sources. + 1988-07-01: 30 1999-09-01: 45 2001-09-01: 60 2003-09-01: 45 @@ -16,3 +23,17 @@ metadata: href: https://statutes.capitol.texas.gov/Docs/HR/htm/HR.32.htm - title: HHSC MEPD Handbook Section H-1500 - Personal Needs Allowance href: https://www.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/h-1500-personal-needs-allowance + - title: 1 Texas Administrative Code Section 358.381(c) + href: https://www.law.cornell.edu/regulations/texas/1-Tex-Admin-Code-SS-358-381 + - title: 42 USC 1396a(q)(2) - Minimum monthly personal needs allowance + href: https://www.law.cornell.edu/uscode/text/42/1396a#q_2 + - title: Texas DHS Medicaid Eligibility Handbook Revision Notice 02-1 (December 21, 2001), Personal Needs Allowance - Effective September 1, 2001 + href: https://web.archive.org/web/20020504200936/http://www.dhs.state.tx.us:80/handbooks/archives/meh/02-1/memo.htm + - title: H.B. 2292, 78th Texas Legislature (2003), Section 2.207 + href: https://capitol.texas.gov/tlodocs/78R/billtext/html/HB02292F.htm + - title: Texas DHS Medicaid Eligibility Handbook Item 3231, Personal Needs Allowance (Revision 03-7, effective September 1, 2003) + href: https://web.archive.org/web/20030910100506/http://www.dhs.state.tx.us:80/handbooks/meh/3000/3231.htm + - title: HHSC MEPD Handbook Section H-6000 (Revision 09-4, effective December 1, 2009) + href: https://web.archive.org/web/20100126020411/http://www.dads.state.tx.us/handbooks/mepd/H/H-6000.htm + - title: H.B. 54, 88th Texas Legislature (2023) + href: https://capitol.texas.gov/tlodocs/88R/billtext/html/HB00054F.htm diff --git a/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.yaml b/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.yaml index 12f2413e89b..4d48d38aed6 100644 --- a/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.yaml +++ b/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.yaml @@ -1,6 +1,14 @@ # Unit tests for Texas SSI State Supplement benefit amount -# Supplement = max(0, (PNA - Federal institutional SSI rate) * 12) -# For 2024: ($75 - $30) * 12 = $45/month * 12 = $540/year +# Monthly supplement = max(0, PNA - federal reduced SSI benefit of $30). +# Annual periods sum the months, so years with a September 1 change mix +# two amounts. +# PNA history (HHSC MEPD Handbook H-1500): +# $30 before Sept. 1, 1999 (no supplement) +# $45 Sept. 1, 1999 - Aug. 31, 2001 ($15 supplement) +# $60 Sept. 1, 2001 - Aug. 31, 2003 ($30 supplement) +# $45 Sept. 1, 2003 - Dec. 31, 2005 ($15 supplement) +# $60 Jan. 1, 2006 - Dec. 31, 2023 ($30 supplement) +# $75 from Jan. 1, 2024 ($45 supplement) # Reference: Texas Human Resources Code Section 32.024(w) - name: Case 1, eligible individual receives full supplement. @@ -27,3 +35,306 @@ # PNA = $60/month (2006-2023), Federal reduced SSI = $30/month # Supplement = ($60 - $30) * 12 = $360/year tx_ssi_state_supplement: 360 + +- name: Case 4, 1998, before the supplement began. + period: 1998 + input: + tx_ssi_state_supplement_eligible: true + output: + # H-1500: before Sept. 1, 1999 the PNA was $30, equal to the reduced + # federal benefit, so there was no supplement. + tx_ssi_state_supplement: 0 + +- name: Case 5, 1999, supplement starts September 1. + period: 1999 + input: + tx_ssi_state_supplement_eligible: true + output: + # Jan.-Aug.: $30 - $30 = $0; Sept.-Dec.: $45 - $30 = $15 + # 4 * $15 = $60/year + tx_ssi_state_supplement: 60 + +- name: Case 6, 2000, $45 PNA all year. + period: 2000 + input: + tx_ssi_state_supplement_eligible: true + output: + # SSA, State Assistance Programs for SSI Recipients, January 2002 (Texas): + # combined federal and state $45, state-supplemented portion $15. + # $15 * 12 = $180/year + tx_ssi_state_supplement: 180 + +- name: Case 7, 2001, supplement rises to $30 on September 1. + period: 2001 + input: + tx_ssi_state_supplement_eligible: true + output: + # DHS Revision Notice 02-1: PNA $60 effective Sept. 1, 2001; "the state + # will supplement their incomes by $30 per month". + # 8 * $15 + 4 * $30 = $240/year + tx_ssi_state_supplement: 240 + +- name: Case 8, 2002, $60 PNA all year. + period: 2002 + input: + tx_ssi_state_supplement_eligible: true + output: + # DHS Medicaid Eligibility Handbook Item 3231 (40 TAC 15.450(h)): + # "the state supplements their incomes by $30 per month". + # $30 * 12 = $360/year + tx_ssi_state_supplement: 360 + +- name: Case 9, 2003, supplement falls to $15 on September 1. + period: 2003 + input: + tx_ssi_state_supplement_eligible: true + output: + # H.B. 2292 (2003) Section 2.207 and Item 3231 (Revision 03-7): PNA $45 + # from Sept. 1, 2003. + # 8 * $30 + 4 * $15 = $300/year + tx_ssi_state_supplement: 300 + +- name: Case 10, 2005, $45 PNA all year. + period: 2005 + input: + tx_ssi_state_supplement_eligible: true + output: + # SSA January 2005 (Texas): combined $45, state $15. + # $15 * 12 = $180/year + tx_ssi_state_supplement: 180 + +- name: Case 11, 2006, PNA restored to $60 on January 1. + period: 2006 + input: + tx_ssi_state_supplement_eligible: true + output: + # SSA January 2006 (Texas): combined $60, state $30. + # $30 * 12 = $360/year + tx_ssi_state_supplement: 360 + +- name: Case 12, 2011, $30 supplement despite SSA's $60 listing. + period: 2011 + input: + tx_ssi_state_supplement_eligible: true + output: + # SSA's January 2007-2011 Texas tables list a $60 state supplement + # ($90 combined). HHSC's own handbook for the same years (MEPD H-6000, + # Revision 09-4 of Dec. 2009 and Revision 11-2 of June 2011) says "HHSC + # supplements the reduced SSI payment standard by $30 per month so that + # SSI persons also have a $60 personal needs allowance." + # $30 * 12 = $360/year + tx_ssi_state_supplement: 360 + +- name: Case 13, 2026, $75 PNA. + period: 2026 + input: + tx_ssi_state_supplement_eligible: true + output: + # H-6000 (Revision 26-1): "HHSC supplements the reduced SSI payment + # standard by $45 per month". + # $45 * 12 = $540/year + tx_ssi_state_supplement: 540 + +- name: Case 14, facility resident with a pension gets the full supplement. + # A $40/month pension less the $20 general exclusion is $20 of countable + # income, so SSI pays $30 - $20 = $10/month. The supplement is still $45: + # H-6000 states it as a fixed amount on the reduced standard, and no Texas + # source reduces it by the recipient's income. + period: 2024 + input: + people: + person1: + age: 80 + pension_income: 480 + is_in_medicaid_facility: true + ssi_lives_in_medical_treatment_facility: true + ssi_medicaid_pays_majority_of_care: true + tax_units: + tax_unit: + members: [person1] + spm_units: + spm_unit: + members: [person1] + households: + household: + members: [person1] + state_code: TX + output: + ssi_countable_income: 240 + ssi: 120 + tx_ssi_state_supplement_eligible: true + # ($75 - $30) * 12 = $540/year + tx_ssi_state_supplement: 540 + +- name: Case 15, facility resident with earnings gets the full supplement. + # $100/month of earnings less the $20 general and $65 earned income + # exclusions, halved, is $7.50 of countable income, so SSI pays + # $30 - $7.50 = $22.50/month. + period: 2024 + input: + people: + person1: + age: 70 + employment_income: 1_200 + is_in_medicaid_facility: true + ssi_lives_in_medical_treatment_facility: true + ssi_medicaid_pays_majority_of_care: true + tax_units: + tax_unit: + members: [person1] + spm_units: + spm_unit: + members: [person1] + households: + household: + members: [person1] + state_code: TX + output: + ssi_countable_income: 90 + ssi: 270 + tx_ssi_state_supplement_eligible: true + tx_ssi_state_supplement: 540 + +- name: Case 16, 2011 facility resident with no other income. + # Federal SSI is the $30 reduced benefit; HHSC adds $30 for a $60 PNA. + period: 2011 + input: + people: + person1: + age: 80 + is_in_medicaid_facility: true + ssi_lives_in_medical_treatment_facility: true + ssi_medicaid_pays_majority_of_care: true + tax_units: + tax_unit: + members: [person1] + spm_units: + spm_unit: + members: [person1] + households: + household: + members: [person1] + state_code: TX + output: + ssi: 360 + tx_ssi_state_supplement_eligible: true + tx_ssi_state_supplement: 360 + +- name: Case 17, 1988-07. + period: 1988-07 + input: + tx_ssi_state_supplement_eligible: true + output: + # First modeled month: PNA $30 equals the reduced federal benefit. + tx_ssi_state_supplement: 0 + +- name: Case 18, 1999-08. + period: 1999-08 + input: + tx_ssi_state_supplement_eligible: true + output: + # Last month before the supplement began. + tx_ssi_state_supplement: 0 + +- name: Case 19, 1999-09. + period: 1999-09 + input: + tx_ssi_state_supplement_eligible: true + output: + # 25 TexReg 558: $15 supplement retroactive to Sept. 1, 1999. + tx_ssi_state_supplement: 15 + +- name: Case 20, 2001-08. + period: 2001-08 + input: + tx_ssi_state_supplement_eligible: true + output: + # Last month of the $45 PNA. + tx_ssi_state_supplement: 15 + +- name: Case 21, 2001-09. + period: 2001-09 + input: + tx_ssi_state_supplement_eligible: true + output: + # DHS Revision Notice 02-1: $30 effective Sept. 1, 2001. + tx_ssi_state_supplement: 30 + +- name: Case 22, 2003-08. + period: 2003-08 + input: + tx_ssi_state_supplement_eligible: true + output: + # Last month of the $60 PNA. + tx_ssi_state_supplement: 30 + +- name: Case 23, 2003-09. + period: 2003-09 + input: + tx_ssi_state_supplement_eligible: true + output: + # H.B. 2292 Section 2.207: $45 PNA from Sept. 1, 2003. + tx_ssi_state_supplement: 15 + +- name: Case 24, 2005-12. + period: 2005-12 + input: + tx_ssi_state_supplement_eligible: true + output: + # Last month of the $45 PNA. + tx_ssi_state_supplement: 15 + +- name: Case 25, 2006-01. + period: 2006-01 + input: + tx_ssi_state_supplement_eligible: true + output: + # PNA restored to $60 on Jan. 1, 2006. + tx_ssi_state_supplement: 30 + +- name: Case 26, 2023-12. + period: 2023-12 + input: + tx_ssi_state_supplement_eligible: true + output: + # Last month of the $60 PNA. + tx_ssi_state_supplement: 30 + +- name: Case 27, 2024-01. + period: 2024-01 + input: + tx_ssi_state_supplement_eligible: true + output: + # IL 2023-45: $45 from January 2024. + tx_ssi_state_supplement: 45 + +- name: Case 28, facility resident with a pension and earnings gets the full supplement. + # $30/month pension less the $20 general exclusion is $10 of countable + # unearned income; $100/month of earnings less the $65 earned income + # exclusion, halved, is $17.50. Countable income is $27.50, so SSI pays + # $30 - $27.50 = $2.50/month. The supplement does not depend on income. + period: 2024 + input: + people: + person1: + age: 80 + pension_income: 360 + employment_income: 1_200 + is_in_medicaid_facility: true + ssi_lives_in_medical_treatment_facility: true + ssi_medicaid_pays_majority_of_care: true + tax_units: + tax_unit: + members: [person1] + spm_units: + spm_unit: + members: [person1] + households: + household: + members: [person1] + state_code: TX + output: + ssi_countable_income: 330 + ssi: 30 + tx_ssi_state_supplement_eligible: true + tx_ssi_state_supplement: 540 diff --git a/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.py b/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.py index e1d858ee45e..ef6f2e4c6fa 100644 --- a/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.py +++ b/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.py @@ -10,11 +10,25 @@ class tx_ssi_state_supplement(Variable): defined_for = "tx_ssi_state_supplement_eligible" reference = ( "https://statutes.capitol.texas.gov/Docs/HR/htm/HR.32.htm", + "https://www.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/h-1500-personal-needs-allowance", "https://www.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/h-6000-co-payment-ssi-cases", + "https://www.law.cornell.edu/regulations/texas/1-Tex-Admin-Code-SS-358-381", ) def formula(person, period, parameters): - # Per 42 USC 1382(e)(1)(B) and Texas HR Code 32.024(w) + # 1 TAC 358.381(c)(2): "For a person receiving the reduced SSI federal + # benefit rate, HHSC issues a supplement to give the person a PNA at + # the minimum level set by the HHSC executive commissioner." MEPD + # Handbook H-6000: "HHSC supplements the reduced SSI payment standard + # by $45 per month to ensure SSI recipients also have a $75 personal + # needs allowance", i.e. the allowance (Texas HR Code 32.024(w)) less + # the $30 reduced federal benefit (42 USC 1382(e)(1)(B)). + # H-6000 states the supplement as a fixed amount on the reduced + # standard and, separately, has workers check SSI recipients for other + # income and calculate a co-payment; no Texas source subtracts the + # recipient's income from the supplement. For an individual paid SSI + # on the reduced standard, federal SSI plus countable income equals + # the $30 standard, so the allowance less both is the same amount. p = parameters(period).gov.states.tx.hhsc.ssi_state_supplement pna = p.personal_needs_allowance federal_reduced = parameters(period).gov.ssa.ssi.amount.institutional.individual