Work Incentives Transition Work Incentives Transition Aged Youth With Disabilities Aged Youth With Disabilities

2008 Pennsylvania Community on 2008 Pennsylvania Community on

Transition ConferenceTransition Conference

Purpose, Disclaimer, Presenter Purpose, Disclaimer, Presenter To provide information about work To provide information about work incentives for SSA qualifying youth and incentives for SSA qualifying youth and how these incentives can enhance how these incentives can enhance students’ career options and to provide students’ career options and to provide updates about these incentives.updates about these incentives.Information presented does not represent Information presented does not represent official policy of SSA and/or DPW and is official policy of SSA and/or DPW and is the responsibility of the author. the responsibility of the author. John Miller, Vice President, AHEDD John Miller, Vice President, AHEDD (717) 763-0968 ext 118, (717) 763-0968 ext 118, john.miller@ahedd.org

Problem StatementProblem Statement

““District Personnel have found that some District Personnel have found that some students are quitting work because they are students are quitting work because they are afraid they will lose their Social Security afraid they will lose their Social Security benefits, which many area families depend benefits, which many area families depend upon financially to survive. Federal and state upon financially to survive. Federal and state work incentives …can help to ease the work incentives …can help to ease the transition to competitive employment, but a transition to competitive employment, but a widespread lack of knowledge about the widespread lack of knowledge about the incentives exists among the District’s incentives exists among the District’s teachers, parents and students.”teachers, parents and students.”

SSA Income Support ProgramsSSA Income Support Programs

Social Security Disability Insurance Social Security Disability Insurance (SSDI)(SSDI) Social Security Childhood Disability Social Security Childhood Disability

Beneficiary (SSCDB)Beneficiary (SSCDB)

Supplemental Security Income (SSI)Supplemental Security Income (SSI)

SSA Disability Programs Eligibility: SSA Disability Programs Eligibility:

FIRST STEP: Demonstrate an FIRST STEP: Demonstrate an inability to earn Substantial inability to earn Substantial Gainful Activity (SGA)Gainful Activity (SGA)

Severe Impairment (Disability Severe Impairment (Disability Determination Service)Determination Service)

If Work History Credits (SSDI), If Work History Credits (SSDI), parent status (SSCDB), or parent status (SSCDB), or Asset Test (SSI)Asset Test (SSI)

Supplemental Security Income Supplemental Security Income Supplemental Supplemental Security Income Security Income (SSI):(SSI): a low income a low income program for which program for which many adults and youth many adults and youth with disabilities qualify.with disabilities qualify.Title XVITitle XVISigned into law in the Signed into law in the 1970s by President 1970s by President Nixon.Nixon.

SSI FeaturesSSI FeaturesLimited Asset (@ application, continuous)Limited Asset (@ application, continuous)

Earnings below SGA for eligibility, Earnings below SGA for eligibility, irrelevant post eligibilityirrelevant post eligibility

Monthly Benefit adjustment based on Monthly Benefit adjustment based on countable unearned and earned income countable unearned and earned income

No wait for standard federal benefit No wait for standard federal benefit

Most states -– including PA -- provide a Most states -– including PA -- provide a cash supplementcash supplement

Work Incentives (not inclusive)Work Incentives (not inclusive)

SSISSI 1619a, 1619b, state Medicaid Threshold1619a, 1619b, state Medicaid Threshold Student Earned Income Exclusion (SEIE)Student Earned Income Exclusion (SEIE) Plan for Achieving Self Support (PASS)Plan for Achieving Self Support (PASS)

Any SSA Beneficiary (SSI, SSDI, SSCDB)Any SSA Beneficiary (SSI, SSDI, SSCDB) Continuation of BenefitsContinuation of Benefits Ticket to WorkTicket to Work Expedited ReinstatementExpedited Reinstatement

A person with disability which meets the SSA A person with disability which meets the SSA level of impairmentlevel of impairment Medical Assistance for Workers with DisabilitiesMedical Assistance for Workers with Disabilities

Impact of Work on SSI (CY 2008)Impact of Work on SSI (CY 2008)

PA Provides an SSI supplement of $27.40 not included in this display!

$-

$500

$1,000

$1,500

$2,000

$2,500

Earned Income $- $300 $625 $940 $1,000 $1,359 $2,380

SSI $637 $530 $367 $210 $180 $- $-

1 2 3 4 5 6 7

1619a

1619b

PA MA Threshold

Student Earned Income Exclusion (SEIE): Student Earned Income Exclusion (SEIE): Instant Increase to Monthly Income!Instant Increase to Monthly Income!

SEIESEIE

SSI - FBRSSI - FBR $637$637 $637$637

Job (mo. income)Job (mo. income) $785$785 $785$785

Net Reduction in SSINet Reduction in SSI ($350)($350) $0$0

TotalTotal $1,072$1,072 $1,422$1,422

In this scenario, use of the SEIE resulted in 33% increase in monthly income!

Plan for Achieving Self SupportPlan for Achieving Self SupportA Fixed Savings ProgramA Fixed Savings Program

A vocational goal that requires the beneficiary A vocational goal that requires the beneficiary to save money over a specific time period. to save money over a specific time period.

SSI or potentially eligible for SSI & another SSI or potentially eligible for SSI & another source of income: earned, unearned, in-kind source of income: earned, unearned, in-kind (e.g. deemed income)(e.g. deemed income)

PASS Application submitted to local SSA PASS Application submitted to local SSA Office, approved by Regional PASS CadreOffice, approved by Regional PASS Cadre

Form: Form: http://www.ssa.gov/online/ssa-545.pdf

Sample of Approved PASSSample of Approved PASS

Michael has Fetal Alcohol Syndrome, Michael has Fetal Alcohol Syndrome, Cerebral Palsy and communication Cerebral Palsy and communication impairments. His PASS will be used to impairments. His PASS will be used to create a vocational profile, a series of (3) create a vocational profile, a series of (3) Community Based Work Experiences, job Community Based Work Experiences, job coach supports during the summer. This coach supports during the summer. This PASS is for one year and a total amount of PASS is for one year and a total amount of $2,250. $2,250. He receives partial SSI payments which is He receives partial SSI payments which is reduced by $280 due to child support. reduced by $280 due to child support.

Adapted from University of Montana Rural Institute

PASS ExamplePASS Example

John’s goal is to be employed in a restaurant John’s goal is to be employed in a restaurant setting working in dining room preparation. He setting working in dining room preparation. He has a disability of Mental Retardation. His PASS has a disability of Mental Retardation. His PASS will pay for job coaching, co-worker supports, will pay for job coaching, co-worker supports, and attendant care. This PASS is for 24 months and attendant care. This PASS is for 24 months with the yearly cost of $6,152.with the yearly cost of $6,152.

He is 18 and plans to stay in school for 2-3 more He is 18 and plans to stay in school for 2-3 more years. He receives the full SSI, and was just years. He receives the full SSI, and was just notified by SSA that he will start receiving $400 notified by SSA that he will start receiving $400 in Social Security because his father died. in Social Security because his father died.

Continuation of BenefitsContinuation of Benefits

If a “Continuing Disability Review” (CDR) or Age 18 Re-If a “Continuing Disability Review” (CDR) or Age 18 Re-determination determines the beneficiary’s impairment no determination determines the beneficiary’s impairment no longer qualifies…longer qualifies…Continued payment under a program of vocational Continued payment under a program of vocational rehabilitation, employment services, or other support rehabilitation, employment services, or other support services (Section 301). services (Section 301). In July 2005, SSA extended the continuation of payments In July 2005, SSA extended the continuation of payments for students whose disability or blindness medically ceases for students whose disability or blindness medically ceases if they are age 18-21 and participating in an individualized if they are age 18-21 and participating in an individualized education program (IEP). Benefits will continue until they education program (IEP). Benefits will continue until they complete the IEP or stop participating for any reason. This complete the IEP or stop participating for any reason. This provides students with the opportunity to continue provides students with the opportunity to continue receiving benefits while they complete school. receiving benefits while they complete school.

Work Incentive Planning Assistance (WIPA)Work Incentive Planning Assistance (WIPA)

•Community based Community based Work Incentive Work Incentive Coordinators working Coordinators working under an SSA under an SSA cooperative agreement;cooperative agreement;•Available to current Available to current beneficiaries age 14-64;beneficiaries age 14-64;•Individualized work Individualized work incentive counseling to incentive counseling to complement efforts to complement efforts to become employed, become employed, increase earned income increase earned income and possibly terminate and possibly terminate from cash benefits.from cash benefits.

WIPA Service ModelWIPA Service Model

Confirm current status with SSA (optional);Confirm current status with SSA (optional);Work history and / or current strategy, Work history and / or current strategy, education, relevant personal facts (e.g. education, relevant personal facts (e.g. marriage, age);marriage, age);Scenario Analysis of Income;Scenario Analysis of Income;Applicable Work Incentives;Applicable Work Incentives;Address unusual circumstances (e.g. Address unusual circumstances (e.g. overpayments);overpayments);Recommended form letters & benefit Recommended form letters & benefit management strategies;management strategies;Delivered via individualized report!Delivered via individualized report!

Medicaid & SSIMedicaid & SSI

Federal- State Health Insurance program Federal- State Health Insurance program coordinated by CMS (federal) and state Medicaid coordinated by CMS (federal) and state Medicaid agency, e.g. PA Department of Public Welfare;agency, e.g. PA Department of Public Welfare;

Low Income Groups;Low Income Groups;

Most states, including PA, provide automatic Most states, including PA, provide automatic Medicaid eligibility to SSI beneficiaries;Medicaid eligibility to SSI beneficiaries;

SSI beneficiary receives cash assistance from SSI beneficiary receives cash assistance from SSA and health insurance through County SSA and health insurance through County Assistance Office (CAO)…the local administrator Assistance Office (CAO)…the local administrator of DPW services.of DPW services.

PA’s Medicaid Buy-InPA’s Medicaid Buy-In Medical Medical

AssistancAssistance for e for Workers Workers With With DisabilitieDisabilities (MAWD)s (MAWD)

PA Medicaid Buy-InPA Medicaid Buy-In

Medicaid for Workers with Disabilities (MAWD)Medicaid for Workers with Disabilities (MAWD)

Department of Public Welfare Department of Public Welfare www.dpw.state.pa.us

January 2002January 2002

Disabled per SSA guidelines, except earnings Disabled per SSA guidelines, except earnings and incomeand income

250% of poverty250% of poverty

$$10K or less in assets10K or less in assets

Monthly premium 5% of countable income Monthly premium 5% of countable income

MAWD – Enrollment & EarningsMAWD – Enrollment & Earnings

PA MAWD

$-

$10,000,000

$20,000,000

$30,000,000

$40,000,000

$50,000,000

$60,000,000

$70,000,000

$80,000,000

CY 02 CY 03 CY 04 CY 05 CY 06

To

tal

Ear

nin

gs

-

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

En

roll

men

t w

/ ea

rnin

gs

Total Earnings Enrollees with Earnings

Government Performance & Results Act (GPRA): Status of the Medicaid Infrastructure Grants Program,

Mathematica Policy Research December 2007.

Ticket to Work ProgramTicket to Work ProgramA Work Incentive via a A Work Incentive via a non-monetary vouchernon-monetary voucherDistributed to SSI Distributed to SSI and/or SSDI and/or SSDI beneficiaries (18-64)beneficiaries (18-64)Encouraged to seek Encouraged to seek employment services employment services through an approved through an approved “Employment “Employment Network”(EN) and/or Network”(EN) and/or State VRState VRVoluntary (both Voluntary (both parties);parties);New Regulations New Regulations effective July 21, 2008effective July 21, 2008

Questions From the CommunityQuestions From the Community

How much money does SSA let me make?How much money does SSA let me make?How long am I allowed to keep my health care if I go How long am I allowed to keep my health care if I go back to work?back to work?My therapist says that if I work more than 20 hours that My therapist says that if I work more than 20 hours that SSA will stop my benefits.SSA will stop my benefits.Someone told me I should use my ticket so that I can Someone told me I should use my ticket so that I can keep my full benefits and don’t have a medical review.keep my full benefits and don’t have a medical review.My case manager says I should only work part-time so My case manager says I should only work part-time so that I don’t get an overpayment.that I don’t get an overpayment.My brother is my representative payee. He says I should My brother is my representative payee. He says I should not go to work because my benefits will stop. not go to work because my benefits will stop. What if I am able to work but later my disability causes What if I am able to work but later my disability causes me to stop working?me to stop working?

Medicaid Infrastructure GrantMedicaid Infrastructure Grant

Mini Grants up to $15,000 targeted to Mini Grants up to $15,000 targeted to schools and other transition programs;schools and other transition programs;

Learn about work incentives;Learn about work incentives;

Assuming that the explicit role of transition Assuming that the explicit role of transition to address career planning and getting a to address career planning and getting a job, to help transition aged youth to access job, to help transition aged youth to access incentivesincentives

FY 07-08 Grantees FY 07-08 Grantees The programs selected to participate through competitive The programs selected to participate through competitive mini grants include: mini grants include:

Colonial Intermediate Unit, Easton, PA; Colonial Intermediate Unit, Easton, PA; Community Integrated Services, Philadelphia, PA; Community Integrated Services, Philadelphia, PA; Luzerne Intermediate Unit, Kingston, PA; Luzerne Intermediate Unit, Kingston, PA; State College Area School District, State College, PA; State College Area School District, State College, PA; Center for Independent Living, Williamsport, PA; Center for Independent Living, Williamsport, PA; School District of Lancaster, Lancaster, PA; School District of Lancaster, Lancaster, PA; Berks Personnel Network, West Reading, PA; Berks Personnel Network, West Reading, PA; Lancaster-Lebanon Intermediate Unit, Lancaster, PA; Lancaster-Lebanon Intermediate Unit, Lancaster, PA; Dickinson Mental Health Center, Ridgway, PA; Dickinson Mental Health Center, Ridgway, PA; Hopewell Area School District, Aliquippa, PA; Hopewell Area School District, Aliquippa, PA; Bedford Area School District, Bedford, PA.Bedford Area School District, Bedford, PA.

AccomplishmentsAccomplishments

Transition Staff learned fundamentals about SSI Transition Staff learned fundamentals about SSI and Work Incentives;and Work Incentives;Networking with Community Work Incentive Networking with Community Work Incentive Coordinators (WIPA) and Area Work Incentive Coordinators (WIPA) and Area Work Incentive Coordinators (SSA). Understanding roles and Coordinators (SSA). Understanding roles and how to access these resources;how to access these resources;Materials Developed;Materials Developed;School Website – Special Education: Internet School Website – Special Education: Internet links to sites about work incentives;links to sites about work incentives;Some success with the Student Earned Income Some success with the Student Earned Income ExclusionExclusion

Problems/ConcernsProblems/Concerns

Parental engagement and securing a level of Parental engagement and securing a level of trust from parents to allow their son/daughter to trust from parents to allow their son/daughter to explore competitive employment and work explore competitive employment and work incentives has been difficult;incentives has been difficult;In some instances, other community In some instances, other community professionals discourage employment among professionals discourage employment among students who receive SSI: i.e. inconsistent students who receive SSI: i.e. inconsistent messages to students and families;messages to students and families;Incorporating work incentives into transition Incorporating work incentives into transition program will not bring instant results nor solve program will not bring instant results nor solve all employment related concerns for youth.all employment related concerns for youth.

RecommendationsRecommendations

Career Planning is influenced when youth are applying for or receiving SSA Career Planning is influenced when youth are applying for or receiving SSA benefits. Develop and post a statement about how your school/transition benefits. Develop and post a statement about how your school/transition program/agency is responding to youth who receive SSA benefits. program/agency is responding to youth who receive SSA benefits. Anticipate that many parents have experienced a challenging process to Anticipate that many parents have experienced a challenging process to qualify their child for benefits. They are likely to have fears and concerns qualify their child for benefits. They are likely to have fears and concerns about “paid employment” because of beliefs that this puts eligibility at risk.about “paid employment” because of beliefs that this puts eligibility at risk.Initiate a discussion about benefits and career planning Initiate a discussion about benefits and career planning as early as possibleas early as possible..Transition staff should have a basic understanding of the SSA Programs, Transition staff should have a basic understanding of the SSA Programs, especially SSI. especially SSI. Have information about Work Incentive resources available for transition Have information about Work Incentive resources available for transition youth and parents, including Work Incentive Planning Assistance (WIPA), youth and parents, including Work Incentive Planning Assistance (WIPA), Ticket to Work, and Medical Assistance for Workers with Disabilities Ticket to Work, and Medical Assistance for Workers with Disabilities (MAWD).(MAWD).Track progress of students who use these incentives. Measureable Track progress of students who use these incentives. Measureable progress that you can share with future students and parents will provide progress that you can share with future students and parents will provide reassurance to counter fear and/or concerns. Progress reporting might reassurance to counter fear and/or concerns. Progress reporting might include the use of specific work incentive (e.g. Student Earned Income include the use of specific work incentive (e.g. Student Earned Income Exclusion, PASS, MAWD, TTW).Exclusion, PASS, MAWD, TTW).For some students, monitoring incentives can represent an excellent set of For some students, monitoring incentives can represent an excellent set of educational activities including math, reading, and tracking personal educational activities including math, reading, and tracking personal finances. finances.