CA SSP: payment standard double-counts for facility residents and stores combined totals requiring annual updates

[hua7450]

Summary

Two architectural issues in the CA State Supplement (SSP) implementation:

1. Double-counting: The payment standard sums all components via adds, but per WIC 12200, subdivisions (a)-(d), (f), (g), and (h) are mutually exclusive payment standards by living arrangement. Only subdivision (e) (food allowance) is explicitly additive.

2. Combined totals: Parameters store the combined federal+state payment standard, which changes every year with federal COLAs even when the state supplement is unchanged. This caused the program to produce $0 for all modern years before PR Backdate California State Supplement (SSP) parameters #7787 backdated ~150 entries, and forces annual maintenance going forward.

Issue 1: Double-counting for facility residents

ca_state_supplement_payment_standard sums:

• aged_blind_disabled_amount — always non-zero for any eligible aged/blind/disabled person
• medical_care_facility_amount — non-zero when ca_in_medical_care_facility = true
• out_of_home_care_facility_amount — non-zero when in_out_of_home_care_facility = true
• food_allowance — additive (correct per statute)
• dependent_amount

The aged_disabled_count formula does not exclude facility residents, so a facility resident triggers both their facility amount and the aged/blind/disabled amount.

Impact (2026 values from SSA EN-05-11125):

Scenario	Correct ca_state_supplement	Current code
Aged single, independent	$239.94	$239.94 (correct)
Aged single, out-of-home care	$632.07	$1,380.25 (overpaid $748)
Aged single, Medicaid facility	$32	$301.94 (overpaid $270)

Independent living (the common case) is unaffected.

Fix: Exclude facility residents from aged_disabled_count and blind_amount:

# In ca_state_supplement_aged_disabled_count
in_medical = person("ca_in_medical_care_facility", period)
in_out_of_home = person("in_out_of_home_care_facility", period)
not_in_facility = ~in_medical & ~in_out_of_home
aged_or_disabled = (is_aged | is_disabled) & not_in_facility

Issue 2: Parameters store combined totals, forcing annual updates

Parameters store the combined federal+state payment standard (e.g., $1,233.94 = $994 FBR + $239.94 SSP). This changes every year with the federal COLA, even when the state supplement is unchanged.

Before PR #7787, each parameter only had the 1991 base amount (e.g., 1991-01-01: 630). Since the 1991 combined standard ($630) is below modern federal SSI ($943+), the formula max(0, 630 - 943) = 0 produced zero state supplement for all modern years. The program was completely broken.

PR #7787 fixes this by backdating ~150 combined-total entries across 10 files. But this architecture means every federal COLA requires updating all 10 parameter files.

Alternative: Store just the state SSP portion and compute the combined standard dynamically using the existing federal FBR parameter (gov.ssa.ssi.amount.individual/couple):

# Current: stores combined total, needs annual updates
payment_standard = p.combined_total  # 25+ date entries per file
state_supplement = max(0, payment_standard - ssi - countable_income)

# Proposed: stores state portion only
federal_fbr = parameters(period).gov.ssa.ssi.amount.individual
payment_standard = federal_fbr + p.state_ssp  # computed dynamically
state_supplement = max(0, payment_standard - ssi - countable_income)

Benefits:

• ~5-6 date entries per file instead of 25+ (only actual state policy changes: 2009 budget cuts, 2011 freeze, 2022 increase, etc.)
• No annual updates needed for federal COLAs
• Even the 1991-only entry would have produced reasonable modern results (~$1,166 instead of $0)
• Food allowance already follows this pattern (stores SSP differential, rarely changes)

Statutory basis

WIC 12200: "An aged, blind or disabled applicant or recipient shall be paid an amount of aid which when added to his or her federal benefit... equals the following:"

Subdivision	Category	1991 base	Nature
(a)-(d)	Blind / Aged / Disabled (independent)	$630-$1,372	Alternative
(e)	No cooking facilities	$68-$136	Additive ("in addition to any other amount")
(f)	Disabled minor with parent	$499	Alternative
(g)	Non-medical out-of-home care	$709	Alternative
(h)	Medical facility personal needs	$30 + $12 = $42	Alternative
(i)	Household of another	Reduction from (a)-(d)	Modifier (not implemented)

Related gaps (separate issues)

• Federal SSI does not implement Code D ($30/month for Medicaid facility residents, 42 USC 1382(e)(1)(B)) or Code B (1/3 reduction for household of another, 42 USC 1382a(a)(2)(A)(i))
• WIC 12200(i) (state standard reduced when federal applies 1/3 reduction) is not implemented

References

• WIC Section 12200
• SSA Publication EN-05-11125 (SSI in California, 2026)
• SSA POMS SI 01415.055 (CA payment levels, Jan 2023)
• PR Backdate California State Supplement (SSP) parameters #7787 (backdating that exposed these issues)