PURPOSE: To enunciate current policy providing that a change in the source of the State supplementary payment included in the Supplemental Security Income (SSI) monthly check is not an initial determination where such change results from the termination of an agreement for Federal administration of the State supplementary payments. In view of the issues arising from the court order in Cardinale v. Mathews, it is necessary to expressly recognize that this is not an adverse action requiring Goldberg v. Kelly due process which includes advance notice, continuation of payments and related initial appeal rights to all affected recipients. While such actions have not been interpreted as initial determinations in the past and are not directly affected by the Cardinale court order, we deem it advisable to clarify SSA's existing policy relating to the termination of an agreement for Federal administration of the State supplementary payments.
CITATIONS (AUTHORITY): Sections 1102 and 1616 of the Social Security Act; Section 212 of Public Law 93-66; Regulations No. 16, Section 416.1403.
PERTINENT HISTORY: The Secretary of Health, Education, and Welfare may enter into an agreement with a State under which the Secretary will, on behalf of such State, make supplementary payments to all individuals receiving benefits under title XVI and who are eligible for such supplementary payments. These agreements, which may apply to either mandatory or optional supplementary payments, are subject to termination by either party in accordance with the terms specified therein. As a result of such termination, the State will be responsible for making any supplementary payments on its own behalf for months after the month of termination of the agreement and the amount of the Federal SSI check will be adjusted accordingly.
In the past when one of these agreements has been terminated, notice (without any appeal rights) has been sent to the recipient explaining that the individual will now be receiving two checks, one from the Social Security Administration for the Federal SSI benefit and a separate check from the State for the State supplementation payment. In those cases where the recipient was only eligible for the supplementation, this notice reflected that the check would now be sent by the State.
POLICY DIRECTIVE STATEMENT: The termination of a Federal-State agreement for the Federal administration of the State supplementary payments is an administrative action having no adverse effect on the recipient, and therefore the reduction in the amount of the Federal SSI check does not constitute an initial determination requiring continuation of payments and appeal rights. This policy is currently in effect and will continue in the future. A notice shall be sent to each applicable recipient explaining how the regular monthly check will be affected because of the termination of the agreement. Where the terminated agreement regards the mandatory supplement, the notice will indicate that the State will not assume responsibility for these payments. Because the Social Security Administration cannot commit the State as to the course of action it will take upon assumption of administration of the optional supplement, the notice will reflect that the individual should look to the State for payment of any optional supplementary payment that may be due in the case of termination of an agreement for Federal administration of the optional supplementary payments.
FURTHER INFORMATION: An agreement with the State of Illinois has been terminated and the Social Security Administration adhered to the basic policy guides as indicated above in informing the applicable recipients how their regular monthly checks would be affected because of the termination of the agreement. In case any payments would be subsequently reduced or stopped by the State, Goldberg v. Kelly appeal rights would flow from the subsequent action on the part of the State.
The U.S. District Court for the District of Columbia issued an order on August 26, 1975, in the case of Cardinale v. Mathews enjoining the Social Security Administration from reducing, suspending, or terminating supplementary security income payments, in all situations except in the case of termination because of the death of the recipient, without following Goldberg v. Kelly procedures of advance written notice, continuation of payment at the previously established rate, and related appeal rights. Citing the U.S. Supreme Court decision in Goldberg v. Kelly, the district court found the Social Security Administration's other exceptions to this advance written notice rule to be unconstitutional deprivations of due process. The Social Security Administration has since negotiated an agreement with the plaintiff's attorney to use two other limited exceptions not here pertinent.
The Cardinale court order raises issues regarding the circumstances under which Goldberg v. Kelly advance notice, related initial appeal rights, and continuation of payment must be provided where a determination has been made with respect to an individual's benefits. Therefore, it is necessary to clearly provide that the payment actions resulting from termination of an agreement for Federal administration of the State supplementary payments, as distinguishable from the type of actions addressed in the Cardinale court order, are not initial determinations.
CROSS-REFERENCES: Claims Manual Sections 13331(b) and 13608.
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