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Household of Another (HOA)- Reduced Need Payment Standard
Applicant or recipients who are living in another person’s household for an entire month and receive BOTH food and shelter from that person, are considered to be living in the “Household of Another,” if they don’t pay their pro rata share.
Note: EWs are required to calculate the total monthly household expenses (TMHE) to determine the client’s pro rata share and document it in the “FOR OFFICIAL USE ONLY” section of the SOC 453 as well in a journal entry when the client(s) are in the household of another and qualify for the reduced needs payment standard.
A Household of Another living situation NEVER applies when the CAPI applicant/recipient:
- Has ownership interest in the property; or
- Has his or her name on the rental agreement (with rental liability); or
- If the person providing the support and maintenance is the spouse of the applicant/recipient, or the parent if the applicant/recipient is a minor child.
Reduced Need Payment Standard
The reduced need payment standard applies for applicants/recipients living in an HOA situation when the applicant/recipient:
- resides in the household of another (related or unrelated) for the entire calendar month, and
- receives food and shelter from that person.
Important: It is not necessary for all of the shelter and all the food to be provided by a member of the household in order for the reduced needs payment standard to apply. As long as at least some of the shelter and some of the food is provided by a member of the household, the reduced needs payment standard will apply.
The reduced needs payment standard does not apply if an applicant/recipient pays for ALL of his or her food with CalFresh benefits and/or with the assistance of food banks, government or church food distributions, free senior meals or similar community-based alternative resources, (because he/she does not receive any food from anyone else in the household). However, if the his/her food is supplemented with food provided by one member of the household, the reduced need payment standard will apply (if at least some shelter is provided).
The following categories (and their associated questions on SOC 453) can help the EW to determine if the reduced payment standard applies or not: Rent (Questions 8, 9, and 10), Household Organization (Questions 11, 12, and 13), Access (Questions 14 and 15), Meals (Questions 17, 18, and 19). If a client answers “Yes” to the Rent, Access, and Meals categories in addition to answering “No” to the Household Organization category, this typically indicates the client is eligible for the independent living pay rate instead of reduced needs. However, the final determination must be based on the EWs judgment after considering all of the facts in the case.
The reduced needs payment standard, does not apply in HOA situations when the CAPI person also receives non-medical care from one or more members of the household. These CAPI individuals are subject to the higher CAPI non-medical out-of-home care payment rate.
Refer to Non-Medical Out-of-Home Care (NMOHC).
Below are some examples of Household of Another Living Arrangements/Reduced Needs Payment Standards.
Example 1 - Does not pay pro rata shareExample 1 - Does not pay pro rata share
Mrs. Jones lives with her daughter. The total number of members in the household is five. The total expenses of the household are $2,500. To determine the pro rata share, divide $2,500 ÷ 5 = $500. Mrs. Jones pays only $250 for her share of the expenses. Since Mrs. Jones receives BOTH food and shelter from her daughter and pays less than her pro rata share, she would be considered to be living in the “Household of Another” and the reduced needs payment standard will apply.
Example 2 - Pays nothing towards shelter and foodExample 2 - Pays nothing towards shelter and food
A CAPI applicant receives free shelter from her daughter and pays for most of her food with a CalFresh grant. Her daughter provides some food when her CalFresh benefits are exhausted towards the end of the month. Since she receives free shelter and some food, the reduced needs payment standard applies.
NOTE: If the CAPI applicant makes up her food deficit with contributions from food banks or other charitable organizations, the reduced needs payment standard would not apply. This will not be a HOA situation because even though she is receiving all shelter, she is not receiving any food from her daughter, as all of the food is being provided to her from outside of the household.
The CAPI applicant receives shelter from her daughter and eats breakfast and dinner at home. Most days, she is served lunch at the local senior center. Even though she receives some of her food outside the home, she receives both shelter and some food from within the household. Her living situation is Household of Another and the Reduced Needs Payment standards apply.
Example 4 - Claimant has rental liabilityExample 4 - Claimant has rental liability
A disabled adult applicant resides with her aunt in a non-public assistance household. The applicant’s name is on the rental agreement because the landlord would not allow her to live there otherwise. The aunt does not charge the applicant for shelter or food. Although the applicant has rental liability (if the aunt stopped paying the rent, the claimant would be legally liable to do so), she receives both
shelter and food from within the household. Therefore, the reduced needs payment standard applies.