CAPI drops the spouse's in-kind support when only the California facility input separates a couple #10549

Summary

When only ca_in_medical_care_facility separates a married couple that SSI still computes jointly, ca_capi_person counts each spouse's own income (20 CFR 416.414(b)(3)), but that own income leaves out in-kind support and maintenance (ISM). The spouse at home who receives shelter support is overpaid by the ISM amount, up to $351.33 a month in 2026. The code's NOTE documents the gap; this issue tracks the fix. Found in the round-3 review of #10379 (G12).

Rule

• 20 CFR 416.414(b)(3): when one spouse enters a medical treatment facility, each spouse's payment is figured from "each individual's own countable income".
• 20 CFR 416.1140(a)(1): ISM is unearned income at the presumed maximum value, one-third of the federal benefit rate plus the $20 general exclusion amount (994 / 3 + 20 = $351.33 a month in 2026 for an individual).
• The model's SSI path already does this: when SSI's own arrangement (ssi_federal_living_arrangement = medical treatment facility) separates the couple, ssi_countable_income includes ISM at the individual rate.

Where

policyengine_us/variables/gov/states/ca/cdss/capi/ca_capi_person.py on main (from #10379): the separated path builds own_alone from ssi_earned_income and ssi_unearned_income only, with the NOTE "this own income leaves out in-kind support and the student earned income exclusion".

Example (January 2026)

Spouses aged 72 and 68, both lawful permanent residents with 39 qualifying quarters (CAPI-eligible), cooking facilities. person1 has ca_in_medical_care_facility: true (and not SSI's facility arrangement); person2, at home, has ssi_receives_outside_shelter_support: true.

The overpayment is $331.33 when ISM is the only income (the $20 exclusion takes part of it) and $351.33 when other unearned income uses the $20. Earnings and Social Security alone give the law's value.

Suggested fix

The review's code (run on a copy, where gov/states/ca/cdss passed): before own_alone, compute the spouse's own ISM at the individual presumed maximum value, none for a Title XIX facility resident, and add it to unearned income:

        # In-kind support counts at the individual presumed maximum value
        # (20 CFR 416.1140); a Title XIX facility resident has none.
        p_ssi = parameters(period).gov.ssa.ssi
        pmv = (
            p_ssi.amount.individual * p_ssi.income.ism.pmv_fbr_fraction
            + p_ssi.income.exclusions.general
        ) * MONTHS_IN_YEAR
        actual = person("ssi_shelter_support_value", period.this_year)
        own_ism = (
            person("ssi_pmv_applies", period.this_year)
            & ~ca_capi_in_title_xix_facility(person, period)
        ) * where(actual > 0, min_(pmv, actual), pmv)

and use person("ssi_unearned_income", period.this_year) + own_ism in own_alone. Change the NOTE to "NOTE: this own income leaves out the student earned income exclusion, which SSI's joint computation would apply." Add a case to ca_capi_person.yaml (the next free number; #10240 adds Cases 16-18 to that file):

- name: Case N, couple with one spouse in a Title XIX facility, the spouse at home counts in-kind support at the individual rate.
  period: 2026-01
  absolute_error_margin: 0.01
  input:
    people:
      person1:
        age: 72
        immigration_status: LEGAL_PERMANENT_RESIDENT
        ssi_qualifying_quarters_earnings: 39
        ca_in_medical_care_facility: true
      person2:
        age: 68
        immigration_status: LEGAL_PERMANENT_RESIDENT
        ssi_qualifying_quarters_earnings: 39
        ssi_receives_outside_shelter_support: true
    marital_units:
      marital_unit:
        members: [person1, person2]
    households:
      household:
        members: [person1, person2]
        state_code: CA
        living_arrangements_allow_for_food_preparation: true
  output:
    # Presumed maximum value 994 / 3 + 20 = 351.33; 331.33 counts after the
    # $20 exclusion (20 CFR 416.1140): 1,233.94 - 331.33 = 902.61.
    ca_capi_person: [62, 902.61]

Reach

The path needs two inputs that only a user sets: ca_in_medical_care_facility without SSI's facility arrangement, and a shelter-support input on the spouse at home. Setting SSI's facility arrangement instead gives the law's value today.

Related

• Pay California CAPI from the SSI/SSP standard per person, with spouse-to-spouse deeming #10379 (merged): added the separated path (its SA5 fix).
• Count income of aged, blind, or disabled people who fail SSI's noncitizen test #10240: carries the same code and appends Cases 16-18 to ca_capi_person.yaml; merge it before this fix, or renumber.