Implement Kentucky State Supplementary Payment

[hua7450]

Summary

Implements Kentucky's State Supplementary Payment (SSP) — a state-administered, state-funded optional supplement to federal SSI covering Personal Care Home (PCH), Community Integration Supplementation (CIS), Family Care Home (FCH), and Caretaker Services categories.

Closes #8018

Regulatory Authority

• 921 KAR 2:015 — State Supplementation (primary)
• KRS 205.245 (enabling statute)
• CHFS Division of Family Support Operation Manual, Volume V, MS 1200 (R. 3/9/26, OMTL-690) (operational payment table)

Program Overview

• Administration: State-administered (Kentucky Cabinet for Health and Family Services, Division of Family Support).
• Funding: State funds.
• Covered categories (921 KAR 2:015 §4(1)(c)): Personal Care Home, Family Care Home, Community Integration Supplementation, Caretaker Services in a private residence.
• Excluded: Medicaid/Title XIX nursing home residents are NOT supplemented by this program.

Eligibility

Requirement	Source	How Modeled
SSI categorical eligibility (ABD + resources + immigration)	§4(1)(a) / §3(3)	is_ssi_eligible
Income below state standard of need	§4(1)(b)	ky_ssp_countable_income < ky_ssp_payment_standard
Residence in a qualifying category	§4(1)(c)	ky_ssp_category != NONE
Age ≥ 18	§4(1)(c)1–4	age >= 18
Kentucky residence	Program statute	defined_for = StateCode.KY

SSI receipt NOT required — §4(1)(b) accepts applicants whose SSI categorical criteria are met but whose income is above the federal FBR yet below the state standard (Group 2 pathway).

KY-specific countable income (§8(8)): KY income is not the federal ssi_countable_income. 921 KAR 2:015 §8(8) explicitly bars the SSI $20 general exclusion: "The SSI twenty (20) dollar general exclusion shall not be an allowable deduction from income." The model implements this via ky_ssp_countable_income, which mirrors federal SSI countable income but skips the $20 general exclusion. The $65 earned exclusion and 50% earned share still apply.

Benefit Amounts (MS 1200 page 1, effective 1/1/2026)

Category	Claim Type	Monthly Standard	Annual
Personal Care Home (PCH)	Individual	$1,610	$19,320
Community Integration Supplementation (CIS)	Individual	$1,514	$18,168
Family Care Home (FCH)	Individual	$1,166	$13,992
Caretaker Services	Individual	$1,056	$12,672
Caretaker Services	Individual w/ Ineligible Spouse	$1,056	$12,672
Caretaker Services	Eligible Couple (one receives care)	$1,552 total (stored as $776/person)	$18,624 total
Caretaker Services	Eligible Couple (both receive care)	$1,606 total (stored as $803/person)	$19,272 total

Personal Needs Allowance (§9(3)–(4); informational, not deducted from benefit):

• PCH residents: $60/mo
• FCH residents: $40/mo

Couple treatment:

• PCH / CIS / FCH: each spouse receives the individual standard (no reduced couple rate in §9(1)(a),(b),(d)).
• Caretaker: couple rates stored per-person (= couple total / 2). Under SSI's joint couple equal-split, the per-person formula reproduces the §9(2)(b) "one-half of the deficit to each" outcome.

COLA: Standards updated by CHFS MS 1200 annually.

Not Modeled (by design)

What	Source	Why Excluded
Medicaid/Title XIX nursing home residents	§4(1)(c)	KY SSP explicitly limited to PCH, FCH, CIS, and Caretaker Services; nursing homes receive SSI $30 PNA federally, not a state supplement
"Private Residence with SMI" distinct from CIS	§9(1)(d)	Modeled as the CIS category (KY uses CIS as the administrative name for this standard)
Per-spouse distribution of Caretaker "Eligible Couple, One Receives Care" benefit	OMVOLV example #6	Regulation pays full supplement to the care receiver only; model distributes equally across both eligible spouses. Household total matches regulation exactly.
Historical values prior to 2026-01-01	N/A	Parameters explicitly zeroed before 2026 start date; can be backdated when historical CHFS manuals are located

Files

policyengine_us/parameters/gov/states/ky/dcbs/ssp/
├── payment_standard.yaml
└── personal_needs_allowance/
    ├── pch.yaml
    └── fch.yaml
policyengine_us/variables/gov/states/ky/dcbs/ssp/
├── ky_ssp.py
├── ky_ssp_care_receivers.py
├── ky_ssp_category.py
├── ky_ssp_claim_type.py
├── ky_ssp_countable_income.py
├── ky_ssp_eligible.py
├── ky_ssp_payment_standard.py
└── ky_ssp_personal_needs_allowance.py
policyengine_us/tests/policy/baseline/gov/states/ky/dcbs/ssp/
├── integration.yaml
├── ky_ssp.yaml
├── ky_ssp_claim_type.yaml
├── ky_ssp_countable_income.yaml
├── ky_ssp_eligible.yaml
├── ky_ssp_payment_standard.yaml
└── ky_ssp_personal_needs_allowance.yaml
policyengine_us/variables/household/income/spm_unit/spm_unit_benefits.py    # + ky_ssp in BENEFITS list
policyengine_us/parameters/gov/household/household_state_benefits.yaml      # + ky_ssp in 2023 and 2024 sections
policyengine_us/programs.yaml                                                # + KY entry under ssi_state_supplement

Verification TODO

• Verify payment amounts against CHFS MS 1200 page 1
• Verify eligibility logic against 921 KAR 2:015 §4(1)
• Verify couple rate logic against 921 KAR 2:015 §9(2) and OMVOLV examples Implement policy parameter for % of poverty line below which gross monthly income must be for SNAP #6 and Add CPS module to openfisca-data #7
• Verify Medicaid facility exclusion against §4(1)(c)
• Verify Group 2 (non-SSI) pathway against §4(1)(b) and §3(3)
• Verify §8(8) $20 exclusion handling — five OMVOLV worked examples reproduce the regulator's published values exactly
• Backdate values for 2017–2025 once historical CHFS MS 1200 manuals are located
• CI passes

Review-feedback fixes (latest push)

• §8(8) $20 general exclusion fix — 921 KAR 2:015 §8(8) and OMVOLV MS 2300 explicitly bar the federal SSI $20 general exclusion from KY SSP income computations. The formula previously read ssi_countable_income (which deducts the $20), inflating every eligible recipient's payment by $20/mo. Added ky_ssp_countable_income mirroring the federal logic but skipping the $20 general exclusion ($65 earned + 50% earned share still apply). Wired into both ky_ssp.py (§8(2) deficit) and ky_ssp_eligible.py (§4(1)(b) income test).
• Added five OMVOLV MS 1200 worked examples to integration.yaml — Bob PCH ($710), Sue CIS ($514), Dan Caretaker w/ineligible spouse ($201), Mark+Amy Caretaker couple one-care ($176 each, $352 total), and Charlie+Becky Caretaker couple both-care ($165 each) — all matching the regulator's published values exactly.
• Changed ky_ssp_category and ky_ssp_care_receivers from entity = Household to entity = Person (a person lives in a facility, not a household).
• Fixed PCH/FCH/CIS couple-standard calculation — removed erroneous / 2 that was halving couple benefits for categories with no reduced couple rate.
• Stored CARETAKER couple rates per-person in the parameter file so the formula is uniform across all categories; removed marital_unit.sum / 2 branching in ky_ssp.py.
• Added docstring and comments citing §4(1)(b) (Group 2 pathway), §4(1)(c) (covered categories; Medicaid facility exclusion), and §9(2) (couple treatment).
• Cleaned up PNA parameter descriptions to follow standard template ("provides this amount...").
• Rewrote integration tests to use real income sources (`social_security`, `employment_income`) rather than injected SSI intermediates, so the federal SSI → state SSP chain is exercised end-to-end.

Test plan

• 70 KY SSP tests pass (17 integration cases including 5 OMVOLV worked examples; unit tests for claim_type, eligible, payment_standard, personal_needs_allowance, ky_ssp, ky_ssp_countable_income)
• CI passes

[codecov]

Codecov Report

✅ All modified and coverable lines are covered by tests.
✅ Project coverage is 96.00%. Comparing base (d888043) to head (78738b1).
⚠️ Report is 44 commits behind head on main.

Additional details and impacted files

@@            Coverage Diff             @@
##             main    #8019      +/-   ##
==========================================
+ Coverage   86.04%   96.00%   +9.95%     
==========================================
  Files           3        9       +6     
  Lines          43      150     +107     
  Branches        2        2              
==========================================
+ Hits           37      144     +107     
  Misses          6        6              

Flag	Coverage Δ
unittests	96.00% <100.00%> (+9.95%)	⬆️

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[PavelMakarchuk]

Program Review — PR #8019: Kentucky State Supplementary Payment

Source Documents

• CHFS OMVOLV (MS 1200): Kentucky Cabinet for Health and Family Services, Office of Medicaid and Volume Operations Manual — payment standards table effective 1/1/2026 (file page 5; 55 pp total). Revision tag OMTL-690, R. 3/9/26.
• 921 KAR 2:015: Kentucky Administrative Regulations Title 921, Chapter 2, Section 015 — eligibility regulations (HTML only; no PDF available).
• KRS 205.245: Kentucky Revised Statutes — enabling statute for the State Supplementary Payment program (1 page).
• CI: All checks passing on PR #8019.

Critical (Must Fix)

1. §8(8) $20 general exclusion overstatement — REAL BUG, +$20/mo per eligible person
   • Files: ky_ssp.py, ky_ssp_eligible.py; tests at integration.yaml Cases 1, 3, 5.
   • 921 KAR 2:015 §8(8): "The SSI twenty (20) dollar general exclusion shall not be an allowable deduction from income."
   • The PR's countable-income computation flows through ssi_countable_income, which already deducts the $20 federal general exclusion before passing to the SSP deficit formula. KY regulation specifically bars this deduction for SSP. Result: every eligible person with at least $20/mo of unearned income receives a benefit $20/mo too high.
   • Fix: add the $20 back inside the KY-specific countable-income path, or build a ky_ssp_countable_income variable that mirrors ssi_countable_income minus the §8(8) addback.
   • Test fix: integration.yaml Cases 1, 3, 5 lock in the wrong expected values and must be updated. Case 6 has zero income and is unaffected.
2. ky_ssp_category.py OMVOLV reference points to wrong page (#page=23)
   • #page=23 lands inside MS 1800 (case-status overview), not the category enumeration.
   • Should anchor to #page=5 (MS 1200, where SSP categories and Caretaker examples appear) and add a citation to 921 KAR 2:015 §4(1)(c).

Should Address

1. ky_ssp_claim_type.py OMVOLV #page=41 reference is wrong — lands in MS 2400 (income calc), not the claim-type enumeration. Should be #page=5 or #page=6 (MS 1200, Caretaker examples).
2. §4(1)(c) Medicaid nursing-home exclusion is implicit-only — model relies on ky_ssp_category = NONE for nursing-home residents. Add an explicit nursing-home check to harden behavior in household-app contexts where category may be user-set.
3. §3(3) AABD mandatory pathway not modeled — functionally extinct cohort (December 1973 recipients), but should be documented as out of scope rather than silently omitted.
4. period vs period.this_year inconsistency — is_ssi_eligible and is_adult are YEAR-defined booleans accessed with period from MONTH formulas in ky_ssp_eligible.py and ky_ssp_claim_type.py. Functionally correct (policyengine-core auto-resolves YEAR variables) but inconsistent with DE / AL / IA / CT / DC / HI SSP siblings, which use period.this_year explicitly. Cosmetic, not a bug.
5. No pre-2026 zero-value test — every YAML test uses period: 2026-01. Add a 2025 test to verify the parameter zero-defaults flow correctly end-to-end.
6. Boundary trio (=, ±$1) missing on ky_ssp_eligible — boundaries exist for the benefit amount in ky_ssp.yaml but not for the eligibility flag itself.
7. §9(2)(b) half-deficit math never exercised with nonzero income for caretaker couples — all caretaker-couple tests use ssi_countable_income: 0. Add a nonzero-income caretaker-couple case.
8. Group 2 pathway (SSP without SSI receipt) is integration-only — needs a focused unit test asserting ky_ssp_eligible = true while ssi = 0.
9. Age 18 inclusive boundary not tested — only <18 cases exist; add age = 18 boundary.
10. Parameter redundancy in payment_standard.yaml — PCH / CIS / FCH branches duplicate the same value across 6 enum slots; only CARETAKER differentiates by claim_type / care_receivers. Refactor to flatten, or add a structural-redundancy comment.
11. Per-person $776 / $803 storage convention is fragile — encodes §9(2)(b) half-deficit implicitly via SSI's couple equal-split rather than explicitly. Consider AK SSP's explicit marital_unit.sum / 2 pattern, or add a strong inline comment near the formula.
12. ky_ssp_personal_needs_allowance is orphaned — declared but does not feed any downstream calculation. Either consume it (deduct from countable income, surface in household-level info) or document why it is stored.
13. 2000-01-01: 0 placeholder dates — describe these as "backdate-zero" in the parameter description, or backfill with COLA-escalated §9(1) base values.
14. PNA 2026-01-01 effective date is too late — §9(3) / (4) flat PNA amounts are not subject to §9(1) COLA. Add an earlier effective date or document the backdate-zero choice.
15. Reference subsection citations missing — payment_standard.yaml lacks §9(1)(a), (b), (c)1–3, (d) sub-citations; ky_ssp_eligible.py lacks §3, §4(1)(a) / (b) / (c) sub-citations; ky_ssp.py lacks §8(2); ky_ssp_care_receivers.py lacks §9(1)(c)2–3.
16. §9(1)(d) SMI separate from CIS — regulation has a Specialized Medical Institution standard ($1,313 base) distinct from CIS. PR notes KY uses CIS as the administrative umbrella name; confirm this is intentional or consider separating SMI.

Suggestions

1. Title polish — "Kentucky State Supplementary Payment" (full official name) in description fields.
2. household_state_benefits.yaml adds ky_ssp to 2023 / 2024 sections (no 2026 key exists yet); a 2026 key would be cleaner.
3. KRS 205.245 reference: use full statutory title in citations.
4. Add OMTL-690, R. 3/9/26 revision tag to OMVOLV titles in PNA YAMLs and variable .py files.
5. §6(1) CIS clinical sub-tests (DSM diagnosis, dementia exclusion, functional impairment) not modeled — likely out of scope, but worth noting.
6. §5(4)(b) caretaker disqualifying relationships (spouse / parent / adult-child caregivers) not modeled — likely out of scope.
7. §10 temporary medical-facility 3-month continuation not modeled — likely out of scope.
8. CIS variable .py files use bare URLs in the reference tuple — consider adding titles for reviewer scanning.

PDF Audit Summary

Category	Count
Confirmed correct values	10
Mismatches (numeric)	0
Page-anchor errors	2 (ky_ssp_category.py#page=23, ky_ssp_claim_type.py#page=41)
Unmodeled regulatory features	5 (§3(3), §4(1)(c) explicit nursing exclusion, §6(1) CIS clinical, §5(4)(b) caretaker DQ, §10 medical-facility)
Methodological deviation	1 (§8(8) $20 exclusion — wrong output)

Validation Summary

Check	Result
Numeric values match PDF	Yes
Page anchors correct	2 wrong (C2, S1)
Hard-coded values in formulas	None
Reused existing variables	Yes
Vectorization	Clean
Period handling	Cosmetic inconsistency (S4)
Pre-2026 defaults	Set but not tested (S5)
Boundary tests	Partial (S6)
Mandatory §3(3) pathway	Not modeled (S3)
§8(8) $20 exclusion (KY-specific)	NOT applied — REAL BUG (C1)
CI status	All passing

Review Severity: REQUEST_CHANGES

C1 produces a $20/mo overstatement per eligible person and is locked in by integration tests at Cases 1, 3, 5. The bug must be fixed and the affected expected values updated. C2 is a real reference error that misleads reviewers reading the manual anchor.

Next Steps

To auto-fix issues: /fix-pr 8019