Implement Maryland State Supplementary Payment (SSP) by hua7450 · Pull Request #8184 · PolicyEngine/policyengine-us

hua7450 · 2026-04-28T21:09:20Z

Summary

Implements Maryland's State Supplementary Payment (SSP) — officially Public Assistance to Adults (PAA) — as a state-funded supplement for SSI / SSDI / qualifying OASI recipients in CARE Homes, Licensed Assisted Living, or MDH Rehabilitative Residences. Calculation uses the SSA state-supplementation cascade per COMAR 07.03.07.09(A): federal SSI absorbs countable income first, then PAA fills the gap between allowable need and federal SSI.

Closes #1137.

Regulatory Authority

Program Overview

Administration: State-administered (Maryland DHS-FIA via local DSS).
Funding: 100% state funds; pays the gap between combined federal+state need and federal SSI.
Caseload: ~2,020 recipients/month (FY2026 DLS Budget Analysis).
Effective date: July 1, 1974.
See: COMAR 07.03.07 chapter index.

Calculation — SSA cascade

Per COMAR 07.03.07.09(A): "the monthly PAA payment is the amount by which allowable needs exceed net countable income," with federal SSI applied first.

For each eligible person, per month:

combined_need   = provider_rate + personal_needs_allowance   # PAA Manual §900.1
federal_ssi_max = ssi_amount_if_eligible                      # individual FBR ($994 in 2026)
state_supp_max  = max(combined_need - federal_ssi_max, 0)
income_excess   = max(ssi_countable_income - federal_ssi_max, 0)
md_paa          = max(state_supp_max - income_excess, 0)

Per PAA Manual §900.1 worked example (Assisted Living): combined_need = $894 + $93 PNA = $987 total cost of care.

md_paa returns only the state contribution. Federal SSI remains its own variable, so household total cash = ssi + md_paa.

REHAB residents and the federal SSI medical-facility cap

MDH Rehabilitative Residence is a Title XIX medical-treatment-facility setting; federal SSI is capped at $30/mo per 42 USC § 1382(e)(1)(A).

md_paa_eligible enforces a bidirectional consistency gate: a person is REHAB iff their upstream ssi_federal_living_arrangement == MEDICAL_TREATMENT_FACILITY. CARE Home / AL recipients with the medical-facility flag accidentally set are also rejected — both inconsistencies are surfaced rather than silently producing the wrong cascade. For a 2026 REHAB resident with no other income: ssi = $30 + md_paa = $76 = $106 (full PNA).

Eligibility

Requirement	Source	How Modeled
Receives SSI, SSDI, or qualifying OASI on the basis of A/B/D	COMAR 07.03.07.03(A)(2)	`(ssi > 0) \| (ssdi > 0) \| (oasi > 0 & is_ssi_aged_blind_disabled)`
§300.5 / §03(G)(1) pending-application pathway	PAA Manual §300.5; COMAR 07.03.07.03	Boolean input `md_paa_pending_federal_benefit` AND `is_ssi_aged_blind_disabled`
Resources ≤ $2,000	PAA Manual §500	`ssi_countable_resources <= ssi.individual_limit`
Maryland resident	COMAR 07.03.07.03B	`defined_for = StateCode.MD`
Resides in PAA facility	PAA Manual §300, §400	New input enum `md_paa_living_arrangement`
REHAB ⇒ SSI medical-facility flagged upstream	42 USC § 1382(e)(1)(A)	Bidirectional check (`is_rehab == is_medical_facility`)
Single-person assistance unit	COMAR 07.03.07; per-spouse evaluation	Per-person cascade

Income Treatment

PAA's countable-income disregards ($20 general, $65 earned, ½ remainder) mirror federal SSI's per COMAR 07.03.07.04, so the cascade reuses ssi_countable_income directly. No PAA-specific disregard variables are needed. Note: PAA Manual §900 uses an $85 earned disregard rather than $65; this approximation produces identical countable income for pure-unearned cases and mirrors federal SSI for combined cases.

Benefit Amounts

Provider rates (cost of care; paid to facility — does not include PNA):

Tier	2009-01-01 (COMAR §04)	2021-01-01 (AT 23-02)
CARE Home Level A	$740	$776
CARE Home Level B	$849	$875
CARE Home Level C	$1,137	$1,173
CARE Home Level D	$1,340	$1,376
Licensed Assisted Living	$858	$894
MDH Rehabilitative Residence	$0	$0

2009 rates from COMAR 07.03.07.04(B)(2) and (C)(2). 2021 rates from AT 23-02 page 3 (still effective per AT 23-02's "no COLA increase for 2023" language). REHAB cost-of-care is $0 because PAA Manual §900.3 treats MDH Rehabilitative Residence as PNA-only (the $54/day cost is paid directly by MHA, not PAA).

Personal Needs Allowance (PNA) — universal across all living arrangements per COMAR 07.03.07.04(A)(1) and IM 26-04:

Effective Date	Amount	Source
2009-01-01	$82	COMAR 07.03.07.04(A)(1)
2022-07-01	$93	AT 22-28 (transmittal not located; value confirmed by AT 23-02 p.3)
2023-07-01	$98	IM 24-05 (transmittal not located; value implied by IM 26-04 referencing $98 as the prior PNA before the $102 step)
2024-07-01	$102	Originating transmittal not located; value confirmed by IM 26-04 p.2 ("$102 → $106")
2025-07-01	$106	IM 26-04 page 2

Couple treatment: per-person evaluation. The PAA cascade always uses the federal individual FBR ($994 in 2026), never couple_FBR/2, consistent with COMAR §04's per-recipient framing.

⚠️ Couple FBR caveat: PolicyEngine's federal SSI for a married couple where both are eligible uses couple_FBR/2 = $745.50 per spouse, while the PAA cascade uses the individual FBR ($994). For a CARE_HOME_LEVEL_A couple this means PolicyEngine reports each spouse with $745.50 federal SSI + $0 state PAA = $745.50 total, rather than $994 + something — Maryland does not top up to fill the federal couple-FBR reduction. Integration test Cases 5 (symmetric LEVEL_A) and 10 (asymmetric LEVEL_A vs C) lock this divergence in. Review carefully if you compare this household type against external sources.

COLA: PNA adjusts on action transmittals (irregular); cost-of-care updates similarly.

Architecture

md_paa.py — cascade formula. Does not touch federal SSI variables.
md_paa_eligible.py — gates eligibility on federal cash receipt + resources + facility + bidirectional REHAB ⇄ medical-facility consistency.
md_paa_total_cost_of_care.py — provider_rate + personal_needs_allowance per PAA Manual §900.1.
md_paa_personal_needs_allowance.py — adds-based parameter passthrough (no formula).
Federal SSI variables (ssi_lives_in_medical_treatment_facility, ssi_medicaid_pays_majority_of_care, ssi_federal_living_arrangement, ssi_amount_if_eligible): untouched.

Not Modeled (by design)

What	Source	Why Excluded
§300.3.A private mental institution carve-out	PAA Manual §300.3.A	Not tracked at the moment; relies on `md_paa_living_arrangement` input
30-day absence disqualification	COMAR 07.03.07.03B	Sub-monthly residency not tracked
Pre-1973 grandfathered Mandatory Minimum State Supplement	PAA Manual §100.1	SSA-administered; tiny population
SALSP	n/a	Separate program (Maryland Dept of Aging)
Lump sums, parent contributions, irregular-income exclusions	PAA Manual §500.7-9	Approximated via federal SSI income aggregation
Form 4350 disability-certification verification	PAA Manual §300.1.C	Not modelable from CPS
REHAB $54/day cap on allowable need	PAA Manual §900.3 / AT 23-02	Not enforced as a separate ceiling; most cases fall within it
Per-diem prorating for fractional-month entry	COMAR 07.03.07.04(B)(3) / (C)(3)	Edge case

Known Modeling Gap

AT 22-28 / IM 24-05 / 2024-07-01 transmittal not located: PNA values for 2022-07-01, 2023-07-01, and 2024-07-01 are corroborated only by adjacent transmittals (AT 23-02 confirms $93 was current; IM 26-04 confirms the $102 → $106 step). Effective dates may shift slightly when the originating transmittals are obtained.

Files

policyengine_us/parameters/gov/states/md/dhs/fia/paa/
├── personal_needs_allowance.yaml
└── provider_rate.yaml

policyengine_us/variables/gov/states/md/dhs/fia/paa/
├── md_paa.py
├── md_paa_eligible.py
├── md_paa_living_arrangement.py
├── md_paa_pending_federal_benefit.py
├── md_paa_personal_needs_allowance.py
├── md_paa_provider_rate.py
└── md_paa_total_cost_of_care.py

policyengine_us/tests/policy/baseline/gov/states/md/dhs/fia/paa/
├── integration.yaml
├── md_paa.yaml
├── md_paa_eligible.yaml
├── md_paa_personal_needs_allowance.yaml
└── md_paa_provider_rate.yaml

Plus registry entries in programs.yaml, parameters/gov/household/household_state_benefits.yaml, and variables/household/income/spm_unit/spm_unit_benefits.py; and a changelog fragment at changelog.d/md-ssp.added.md.

Verification

Test plan

57 PAA tests pass (policyengine-core test policyengine_us/tests/policy/baseline/gov/states/md/dhs/fia/paa -c policyengine_us)
CI passes

Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

codecov · 2026-04-28T22:14:52Z

Codecov Report

✅ All modified and coverable lines are covered by tests.
✅ Project coverage is 94.95%. Comparing base (cc5bd64) to head (b397c27).
⚠️ Report is 105 commits behind head on main.

Additional details and impacted files

@@             Coverage Diff             @@
##             main    #8184       +/-   ##
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+ Coverage   71.72%   94.95%   +23.23%     
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  Files        4658        8     -4650     
  Lines       67710      119    -67591     
  Branches      341        2      -339     
===========================================
- Hits        48563      113    -48450     
+ Misses      19140        6    -19134     
+ Partials        7        0        -7

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- Fix earned-income disregard cascade per COMAR 07.03.07.08(A): apply $20 to unearned first, leftover (up to $20) cascades into earned; earned floor is $65 + leftover (matches federal SSI pattern) - Fix REHAB_RESIDENCE provider rate: cap at $54/day per AT 23-02 page 3 ($1,642.50/month) instead of $0 - Apply cost-of-care disregard for REHAB residents per COMAR 07.03.07.08(B) - Update COMAR citations from .09 to .08 for income disregards Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

Round 1 incorrectly added a $54/day provider rate cap for REHAB residents, overpaying by $1,642.50/month. Per PAA Manual §400 and §900.3, MDH pays the cost of care directly for Rehabilitative Residence cases — PAA contributes only the personal needs allowance. - Delete provider_rate_rehab_daily_cap.yaml (parameter not needed) - Revert md_paa_provider_rate.py to simple parameter lookup (REHAB=$0) - Simplify md_paa_countable_income.py: per COMAR 07.03.07.08(B), REHAB residents get a full cost-of-care disregard, so countable income is fully absorbed (PAA = PNA always) - Update REHAB tests to expect PNA-only benefit ($106 in 2026) Round 1's earned-disregard cascade fix and COMAR .09→.08 citation fix remain correct and are kept. Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

- Eligibility: accept SSI, SSDI, or other OASI/survivor receipt with aged/blind/disabled gate on the OASI path; add $2,000 resource check; fix §300.2 → §300.1.B citation. - Countable income: include SSI cash payment in unearned per §500.8 / AT 23-02; document residual gaps (lump sums §500.7, §500.8 contributions, §500.9 exclusions, "actually available" first-month treatment). - Earned disregard: gate on living arrangement — no disregard for Assisted Living per §500.11.B.1. - Rehab Residence: replace return-zero shortcut with §900.3 cost-of-need ceiling test ($54/day × 30) so high-income residents no longer automatically receive the full PNA. - PNA: collapse and re-place placeholder at 2025-01-01 = $102 with research-based comment (DLS FY26 budget still cites $93; IM 26-04 is the first source mentioning $102). - References: fix §500.3 → §500.11 in three income disregard YAMLs; remove broken §400 URL from md_paa_living_arrangement.py. - Tests: recompute expected values for SSI inclusion; add cases for SSDI-only path, $2,000 resource limit, asymmetric married couple, high-income Rehab Residence, CARE_HOME_LEVEL_D, and Assisted Living no-disregard path. All 52 tests pass. Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

…into md-ssp # Conflicts: # policyengine_us/parameters/gov/household/household_state_benefits.yaml # policyengine_us/programs.yaml # policyengine_us/variables/household/income/spm_unit/spm_unit_benefits.py

… pathway - Backdate PNA to $84 effective 2022-01-01 (pre-AT 22-28); add reference. - Update Case 4 to expect $98 in 2024-01 (IM 24-05 effective 2023-07-01). - Add Case 5 asserting $84 in 2022-01. - Add md_paa_pending_federal_benefit input and wire into md_paa_eligible per PAA Manual §300.5 / COMAR 07.03.07.03 (pending SSI/SSDI/RSDI application or no-fault denial), gated by is_ssi_aged_blind_disabled. - Add tests for the §300.5 pathway. Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

The prior md_paa formula (state_max - countable_income) double-counted SSI as PAA unearned income and treated provider_rate + PNA as the state supplement, overpaying for SSI recipients. Verified against SSA 2011 MD Table 1 (LEVEL_A 6, LEVEL_C 3, REHAB ). Changes: - md_paa.py rewritten as state_supp = max(combined_need - federal_ssi - income_excess, 0). REHAB residents use medical-facility federal max per 42 USC § 1382(e)(1)(A); override is local to md_paa to avoid coupling federal SSI to MD-specific input. - Federal ssi_countable_income now feeds income_excess, replacing the duplicated PAA-specific countable variables. - Removed md_paa_countable_{income,earned_income,unearned_income} and the income/ and rehab_residence/ parameter folders. - provider_rate and personal_needs_allowance: added 2011-01-01 values derived from SSA 2011 MD Table 1 (REHAB combined → 2011 PNA ). - Tests updated; integration covers cascade for SSI / SSDI / couple / high-income / asymmetric-eligibility cases. Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

md_paa_eligible now requires `ssi_federal_living_arrangement == MEDICAL_TREATMENT_FACILITY` whenever `md_paa_living_arrangement == REHAB_RESIDENCE`. SSA 2011 MD Table 1 confirms MDH rehab is a Title XIX medical treatment facility (federal SSI capped at /mo). This forces callers to set `ssi_lives_in_medical_treatment_facility` and `ssi_medicaid_pays_majority_of_care` for REHAB residents, which makes federal SSI compute correctly without coupling federal SSI formulas to MD-specific inputs. The local REHAB override in md_paa.py is removed since federal SSI is now correctly upstream. REHAB test cases set both flags; integration Case 4 verifies federal SSI = , state PAA = , total = . Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

Locks intermediate cascade values (ssi_amount_if_eligible, ssi_countable_income) in integration Cases 5/9, adds resource limit boundary, pending blind/disabled paths, OASI-not-aged rejection, income-excess waterfall partial erosion, asymmetric married couple living arrangements, and the 2021-01 provider-rate transition. Reconciles the $102 PNA placeholder-date comment between the parameter and test files. Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

Cascade now uses individual FBR per SSA 2011 MD Table 1 footnote a ("state supplementation rate for individuals applies to each member of a couple"), with the $30/mo medical-facility cap for REHAB. Previously read ssi_amount_if_eligible, which returns couple_FBR/2 for couples and overpaid LEVEL_A couples by ~$136/mo in 2026. Updates integration Cases 5 and 10 to reflect the corrected per-spouse outputs. Reference cleanup: COMAR Cornell LII URLs migrated to regs.maryland.gov (canonical source), COMAR 07.03.07.04 title corrected from "Allowable Needs" to "Need Requirements", IM 26-04 reference annotated with the $102 -> $106 transition, and the broken AT 22-28 URL removed. Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

- Replace SSA-derived 2011 provider rates with COMAR 07.03.07.04(B)(2)/(C)(2) schedule ($740/$849/$1,137/$1,340/$858); re-key 2011-01-01 → 2009-01-01. - Drop unsupported PNA $84 step at 2022-01-01; $82 forward-fills until AT 22-28 raises it to $93 on 2022-07-01. - Promote COMAR 07.03.07.04(A)(1) to primary citation for PNA $82; remove the 403-blocked SSA URL from PNA references. - Reorder md_paa.py references (COMAR first, SSA last); add COMAR §.04 cite. - Replace non-existent §300.1.B / §500.2.B inline citations with COMAR 07.03.07.03(A)(2) and PAA Manual §500. - Make REHAB / SSI medical-facility consistency check bidirectional. - Replace md_paa_personal_needs_allowance scalar passthrough formula with adds = ["gov.states.md.dhs.fia.paa.personal_needs_allowance"]. - Replace Cornell-mirror COMAR URL with regs.maryland.gov. - Add COMAR / AT references to md_paa_personal_needs_allowance, md_paa_pending_federal_benefit, md_paa_living_arrangement, and md_paa_total_cost_of_care. - Add CARE Home / Project Home legacy-term comment on enum. - Add 6 new test cases: 2011 PNA $82; REHAB without medical-facility flags ineligible; CARE Home with medical-facility flag set ineligible; aged-OASI positive PAA; symmetric LEVEL_C couple both positive; pending §300.5 applicant positive PAA. Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

Replace stale §300.1.B / §500.2.B / SSA 2011 footnote citations in test and variable comments with COMAR 07.03.07.03(A)(2), PAA Manual §500, and COMAR 07.03.07.04 — aligns inline documentation with the parameter file references. Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

- programs.yaml: add `parameter_prefix: gov.states.md.dhs.fia.paa` to the Maryland PAA SSP entry (matches MI / other state SSP entries). - md_paa_eligible.py: subtract SSDI from the OASI branch's `social_security` so the OR-chain doesn't double-count SSDI recipients (SSDI is a component of OASDI). Behavior unchanged (boolean OR is idempotent), but the intent is now explicit. - md_paa_eligible.py: clarify that PAA evaluates each person against the federal SSI individual resource limit independently — the couple limit is not used. - md_paa_personal_needs_allowance.yaml: renumber test cases in chronological order (2011 → 2026) so case numbers match listing order. Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

hua7450 and others added 2 commits April 28, 2026 17:08

Add changelog fragment for MD SSP

eb9bae6

Implement Maryland Public Assistance to Adults (state SSP)

a1d8c08

Co-Authored-By: Claude Opus 4.7 (1M context) <noreply@anthropic.com>

hua7450 and others added 12 commits April 28, 2026 20:19

Merge branch 'main' of https://github.com/PolicyEngine/policyengine-us …

0f72914

…into md-ssp # Conflicts: # policyengine_us/parameters/gov/household/household_state_benefits.yaml # policyengine_us/programs.yaml # policyengine_us/variables/household/income/spm_unit/spm_unit_benefits.py

minor

b63474b

fix

47a833c

hua7450 marked this pull request as ready for review May 4, 2026 04:09

hua7450 and others added 2 commits May 4, 2026 00:15

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Implement Maryland State Supplementary Payment (SSP)#8184

Implement Maryland State Supplementary Payment (SSP)#8184
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Summary

Regulatory Authority

Program Overview

Calculation — SSA cascade

REHAB residents and the federal SSI medical-facility cap

Eligibility

Income Treatment

Benefit Amounts

Architecture

Not Modeled (by design)

Known Modeling Gap

Files

Verification

Test plan

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