Public Benefits Training

Winter 2011

Agenda• Overview

• Introductions

• Welcome from our Sponsor

• About Children’s Defense Fund

• Earned Income and Child Tax Credits

• Children’s Health Insurance in Texas

• Texas Health Steps

• Outreach 101

• Get Involved

ICEBREAKER

About CDF-Texas

• Raise awareness about the condition of Texas children,

• Connect children and families to programs and services that help meet their needs, and

• Work with partners statewide to coordinate broad support and form policy solutions for legislative action on behalf of Texas children.

Money Talks!Have You Heard?

Promoting the Earned Income Credit and Child Tax Credit

Cecilia Joseph

Director of Operations

713.664.4080

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Who Qualifies for the EIC and CTC?

• Workers who are:– Working full-time, part-time or self-employed

– Receiving public benefits

– Single or married

– Raising a “qualifying child”• Some workers without a “qualifying child” who are between the ages of 25- 64

may be able to claim the EIC

– Immigrants legally authorized to work

CTC ONLY:• Immigrant workers with Individual Taxpayer Identification Numbers (ITINs)

• Some non-custodial parents

Types of Families Who Claim the EIC & CTC

• Married and unmarried parents– Step-parents

• Grandparents, great-grandparents– Grandparent with child and grandchild

• Aunt or uncle

• Older brother or sister – Step-brother or step-sister

– Half-brother or half-sister

• Foster and adoptive parents

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Definition of a “Qualifying Child”

• If you are a qualifying child, you cannot claim the EIC yourself.

• If a child is claimed for both the EIC and CTC, the same worker must claim both credits.

EIC CTC

Relationship

Son, daughter, grandchild, stepchild, adopted child, brother, sister, stepbrother, stepsister (or their descendents) or foster child placed by a government or private agency

Residence Must live with worker in the U.S. for more than half the year

Age

Under 19 or 24 if full-time student or any age if totally and permanently disabled

Under 17

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What are RALs?

Refund Anticipation Loans

• Very high-interest loans – Interest rate can be over 180 percent

• Processing fee can be $80 or more– Some preparers charge a percentage of the EIC refund, driving

fees even higher

• No guarantee refund will equal the loan amount

!!!REMEMBER THIS IS A LOAN!!!

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Are There Alternatives to RALs and Commercial Tax Preparation?

Volunteer Income Tax Assistance (VITA)

Free tax filing help for low-income workers at community sites

In many communities across the city

Volunteers are trained under IRS guidance

Taxpayers can receive refund in 7-12 days through e-filing

Call 211 Helpline for more information

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Benefit EIC Does Not Count CTC Does Not Count

SNAP (food stamps) X X

Medicaid X X

Public Housing X X

Head Start X X

SSI X X

Veteran’s Benefits X X

TANF (cash assistance) States determine X

Child Care Subsidy States determine X

Energy Assistance States determine X

CHIP No state counts X

Does the EIC & CTC Count as Income for Other Public Benefits?

* The CTC doesn’t count as income for any program with federal funding.

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Standard Rule for most benefit programs:

– EIC and CTC refunds are not counted as a resource during the month the refund is received and the following month

• For CTC, applies to any federally funded program

• Allows time to spend refund

– Exceptions expand the time refunds can be saved

What do the Tax Credits Mean for Resource Limits?

Resource Rule Exceptions

Program EIC CTC Starts to Count

SNAP (food stamps)

X Standard Rule After 12 months

SSI X X After 9 months

TANF X Standard Rule State rules (most use Standard Rule)

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Notes: • Texas has resource limit for Medicaid, CHIP or SNAP.

•Refunds deposited into an Individual Development Account that follows federal guidelines will not be counted toward resource limits at all.

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Who Might Miss Out on the EIC and CTC?

• Workers not required to file returns

In 2009:– $18,700 for a married couple– $12,000 for head of household– $9,350 for a single filer

• Workers just entering labor force

• New parents – Foster, adoptive

• Divorced or separated custodial parents

• Workers newly eligible due to a reduction in income or loss of employment

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Promoting the Credits

• Alert families about the EIC and CTC and provide the basic information they need:

– Eligibility information

– Tax forms

– VITA site locations

– Help getting an SSN or ITIN

Inform families

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Everyone Can Help Promote the Tax Credits

• You do NOT have to be a tax expert to help families claim their credits.

• Incorporate outreach activities into your routine work – and encourage your partners to do the same.

• Encourage families to use to the Free TAX sites – Call the 211 Helpline for closest site in their neighborhood

Spread the Word!

• Inserts, flyers, and posters are available in:

• English

• Spanish

• Vietnamese

• Additional information is available at the website:

www.eitcoutreach.org

QUIZ

Children’s Health CoverageIn Texas Schools

CHIP, Children’s Medicaid and CHIP Perinatal Application Training

The Problem

• There are 1.2 million uninsured Texas children

• 600,000 are eligible for but not enrolled in CHIP or Medicaid

• Every state dollar invested in CHIP is matched by $2.64 in federal tax dollars; every dollar invested in Medicaid is matched by $1.47.

Why It Matters?

• Eligibility is similar to Free & Reduced Lunch program - Family of 4 up to $44,700 (eff. March 1, 2011). Many school district teachers and support staff may qualify.

• Students who lack health care coverage have lower academic achievement rates and miss more school days (Kaiser Family Foundation).

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To read these reports, visit: www.cdftexas.org

Barriers to Coverage

The Application/Renewal Process

Paper

4-page, mail/fax-in application.

OnlineApplication may be

downloaded or completed online at

www.chipmedicaid.org(Online renewal for CHIP ONLY)

Qualifications

Children must be:

• 0-18

• U.S. Citizens/Legal Permanent Residents (CHIP/Children’s Medicaid)

Note: Pregnant undocumented teenagers may apply for CHIP

Perinatal

• Most children living with their grandparents or other caregivers should qualify for Children’s Medicaid.

• If the grandparent/caregiver has ADOPTED the child, qualification will be based on income.

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COST TO FAMILIES

Children’s Medicaid is a FREE federal program. There are no monthly premiums or co-pays for doctors or prescriptions. Must renew every 6 months.

CHIP is a cost-sharing program that is based on a sliding scale (household income). Must renew every 12 months.

CHIP Perinatal has NO FEES. The co-paymentand assets test that applies to traditional CHIP does not apply to CHIP Perinatal. Programcovers pregnancy until child is delivered.

QUALIFICATIONSCHIP Perinatal

– Pregnant women, including teens, who are not otherwise eligible for CHIP or Medicaid.

– Household income up to 200% FPL.

Note: This program provides coverage to the unborn childNOT to the pregnant woman.

ELIGIBILITY

– Children must be U.S. citizens, refugees or legal permanent residents to qualify.

– Mothers applying for CHIP Perinatal for their unborn child do not need to prove citizenship.

– Refugee children are automatically enrolled in Medicaid for 6-8 months upon entry but must renew after that time.

– Undocumented and immigrant parents can safely apply for their children. Parents’ residency status does not matter for children applying for CHIP or Children’s Medicaid.

– These programs also do not count as “public charge” for those applying for citizenship.

CHIP and Children’s Medicaid Benefits

– Doctor’s office visits (i.e. check-ups, well-baby)

– Dental check-ups/braces

– Eye exams/glasses

– Immunizations

– Physical, speech and occupational therapies

– Transplants

– Hospital Care and surgery

– Specialist Care

– Labs and X-rays

– Prescription drugs

– Mental health services and substance abuse treatment

– Emergency services

Both programs cover pre-existing conditions!

CHIP Perinatal Benefits

– Up to 20 prenatal visits

– Pharmacy

– Limited laboratory testing

– Assessments

– Planningservices, education and counseling

– Prescription drugcoverage based on thecurrent CHIP formulary

After birth, the child continues to receive benefits similiar to traditional CHIP for the duration of his/her 12 month coverage period.

WHAT IS NOT COVERED UNDER CHIP PERINATAL?

– Medical treatment for the mother

– False labor and preterm labor that does not resultin birth

– Charges related to the delivery for those who meetthe income guidelines for Medicaid but could notreceive services because of their citizenship status.

CHIP Cost Sharing

NO Monthly Premiums

– 1 enrollment fee ($0-$50) per 12 month period

– Effective March 1, 2011 new fees apply for families over 150% FPL ( ) except for well child visits.

New CHIP Cost-Sharing

CHIP Cost-Sharing Effective September 1 2007 –February 28, 2011

Increases Effective March 1, 2011

Above 150% up to and including 185% FPL

Office Visit $7.00 $12.00

Generic Drug $5.00 $8.00

Brand Drug $20.00 $25.00

Above 195% up to and including 200% FPL

Office Visit $10.00 $16.00

Generic Drug $5.00 $8.00

Brand Drug $20.00 $25.00

2011 Income Guidelines

Medicaid CHIP

Family Size 100% 150% 200%

1 $10,890 $16,335 $21,780

2 $14,710 $22,065 $29,420

3 $18,530 $27,795 $37,060

4 $22,350 $33,525 $44,700

Section 1 – Adult Applicant or Independent Minor Info

Section 2 - CHIP Perinatal

Section 3 – Children

List ALL the children under

19 living in the home, even

if not applying.

Section 4 – Prior Insurance

If the child has insurance or had it during the last 90 days a coverage

end date must be provided.

90 Day waiting period exception:More than 10% of their gross annual income on health insurance, children are NOT subject to a 90 day wait.

Screening for other health care services

Section 6 - Who Cares for the Child?

Boyfriend/

GirlfriendGRANDPARENT

Section 7 – Household Income

Wages, social

security, child

support, TANF, etc.

Section 8 – Household Expenses

Section 9 - Assets

Section 9 - Asset TestCash assets (limit = $10,000) include:

Cash on handChecking/Savings accountsStocks/Bonds/CD’s

Vehicle asset limits:First vehicle = $18,000Second vehicle = $7,500

Notes: – A house is not considered an asset.

– 401K is not considered an asset; an IRA is an asset.

– A co-signed vehicle is an asset.

Section 10 – Past Due Medical Bills

Medicaid may retro-actively cover unpaid medical bills, up to 3 months.

CHIP coverage is NOT retroactive.

Section 11 - Authorized Representative

Section 12 – Rights & Responsibilities

Section 13 – Document Reminder

Supporting Documents

Gross Income (before taxes)– One recent pay stub (last 60 days) OR Most recent tax return

(including Schedule C, if applicable) OR Dated/signed letter from an employer verifying income OR Proof of self-employment

US Citizenship or Immigration status for all Children– Copy of birth certificate – Copy of resident card (both sides)

Expenses – Childcare/disabled adult care expenses (if applicable)– Child support/and or alimony (if applicable)

Remember: Send copies, not originals.

Section 14 – Signature & Date

TIPS

Leave NO section blank.

Make a copy of their application.

Families can report changes to household information:• By phone (800-647-6558)

• At the local office (ask for a receipt).

Write down the name and date whenever they talk with an HHSC representative.

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www.chipmedicaid.org

Next StepsIn 45 days or less:

– Family should hear from Medicaid/CHIP whether the application has been approved– Call 1-877-KIDS-NOW (543-7669) to check application status

after 3 weeks

– Complete and return enrollment packet ASAP, including enrollment fee (if required)

– Choose a health plan – each region of the state has different plans available.

– Receive insurance card

Renewals

The pre-populated renewal packet should arrive at least two months before coverage ends. CHIP families ONLY are allowed to renew online.

To renew a family must:

•Verify and provide new documents proving their income and expenses (deductions)

•Update any other information as necessary

•Sign and date the application

•Return the renewal application and verification documents by the due date

Troubleshooting

What to do when there is a problem:

1. Call HHSC – 800-647-6558 (CHIP) or 1-800-335-8957 (Medicaid)

2. Call the Office of the Ombudsman – 877-787-8999

3. Call HHSC Office of Eligibility Services - 800-500-4266

4. Call CDF 713-664-4080

How to know there is a problem:

• Have not heard anything in 45 days

• Called and was told application was never received

• Denied even though income is within the guidelines

• Coverage ends before the enrollment period (6 or 12 months)

CHIP/Children’s MedicaidHotline: 1-877-KIDS-NOW (543-7669)

Fax: 1-877-542-5951

Web: www.CHIPmedicaid.org

Download or order applications: http://www.chipmedicaid.org/cbo/application.htm

Need Additional Information?

For a list of Health Plans providing CHIP, Children’s Medicaid and CHIP Perinatal visit –

http://www.chipmedicaid.org/english/healthPlan.asp

Texas Health Steps

WHAT IS OUTREACH?

The Basics

Send home a flyer

Leave them a message/send them an email

Invite them to a school or community

event

Internal Partners

Free Lunch

Employee

Benefits

Title IHomeless Services

Drop out Prevention

Above and Beyond

Host an event - pick a location (transportation, copier, family friendly)

Allow for 4-6 weeks of planning including 2-3 weeks

of promotion

Send home flyers, make automated phone calls, invite the press, recruit volunteers

External Partners

Strategic Partners

Community Clinics

Health Plans

State Subcontractor

Other social service &

faith nonprofits

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Texas 82nd Legislature

“Cover Texas Now” Advocacy Day• Who: YOU• What: Let your representatives know that you want them

to protect CHIP and Medicaid! • When: Wednesday, March 30, 2011• Where: Texas State Capitol (Austin)• Why: With a big budget deficit, the state has proposed

cuts up to 30% to Health and Human Services – which includes vital children’s health coverage.

• How: Training will be provided, and buses will be available from Houston to Austin.

RSVP to cdftexas@childrensdefense.org or 1-877-664-4080!

–Legislative Advocacy

–Child Health Outreach

–Other Programs

Ways YOU can join CDF’s efforts

Stay connected with regular updates from Children’s Defense Fund by subscribing to our monthly newsletter at

www.cdftexas.org

Children’s Defense Fund

4500 Bissonnet, Suite 260Bellaire, Texas 77401T: 713-664-4080F: 713-664-1975

www.cdftexas.org

GET IT! CHOOSE IT! USE IT! RENEW IT!