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PUBLIC BENEFITS AND EDUCATION. PROGRAMS TO HELP CHILDREN IN OUR CARE. Holistic Look at the Child. Looking at all the needs/eligibilities of a child in foster care; Issue spotting; Knowing when to refer to someone with expertise.
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PUBLIC BENEFITS ANDEDUCATION PROGRAMS TO HELP CHILDREN IN OUR CARE
Holistic Look at the Child • Looking at all the needs/eligibilities of a child in foster care; • Issue spotting; • Knowing when to refer to someone with expertise. • CLS initiative to connect dependent children with outside lawyers.
Public Benefits • These are programs administered by the federal or state government for all children, and adults, provided they meet the program’s qualifications. • Social Security • SSI • Veteran’s Benefits • Medicaid
Social Security Administration SSA administers different benefit programs: • Insured Benefits • Survivor’s Benefits • Social Security Disability Insurance (SSDI) • Welfare Benefits • Supplemental Security Income (SSI)
SSA Survivor’s Benefits • These are benefits that are paid out to surviving family members of a deceased insured worker. • Unmarried childrenwho are younger than age 18 (or up to age 19 if they are attending elementary or secondary school full time) also can receive benefits. Children can receive these benefits at any age if they were disabled before age 22 and remain disabled – therefore, need to consider applying for SSI on the child’s own account before aging out of care.
Survivor’s Benefits, cont’d • Under certain circumstances, benefits also can be paid to an insured worker’s step-children, grandchildren or step-grandchildren. • Important to identify the persons on whom the child in care was dependent before coming into care. As long as the dependency relationship existed prior to the child’s adjudication of dependency, being in care does not alter the child’s rights to benefits on the adult’s account. • Even after TPR or a subsequent adoption, the child still can receive benefits, but only if the adult is a biological or adoptive parent. (This is also true re SSDI benefits if the adult is disabled.)
Survivor’s Benefits, cont’d • If child is already receiving benefits (a question you’ll need to ask the persons from whom the child was removed), need to determine if that person who is the representative payee should continue to receive the benefits, and pay them over as child support, of if the dept./CBC should apply to become the representative payee.
What is a Representative Payee? • A representative payee is an individual or organization that receives Social Security and/or SSI payments for someone who cannot manage or direct the management of his/her money. Payees should use the funds for the current and foreseeable needs of the beneficiary and save any remaining funds for the beneficiary's future use. • Minors must have a representative payee.
Survivor’s Benefits, cont’d • If the child’s parent, or other qualifying family member dies while the child is in care, as soon as you learn of this death you will need to make the application for benefits for the child. • Waiting to apply can mean a loss of months of benefit payments.
Applying for Survivor’s Benefits • Apply for survivors benefits promptly because, in some cases, benefits will be paid from the time you apply and not from the time the worker died. • You can apply by telephone or at any Social Security office. • You will need numerous documents.
Documents needed for Survivor’s Benefits • Proof of death—either from a funeral home or death certificate; • The Social Security number of the deceased worker (the family member) • The dependent child’s Social Security number, if available, and birth certificate • The name of your bank and account number so the benefits can be direct deposited (Master Trust issues).
Survivor’s Benefits - Amount • The benefit amount is based on the earnings of the person who died. The more the worker paid into Social Security, the greater the child’s benefits will be. • This money will accumulate in the child’s Master Trust, and used accordingly. There is no limit to how much money the child can accumulate from this benefit.
Duties of the Representative Payee • Determine the beneficiary’s needs and use his or her payments to meet those needs; • Save any money left after meeting the beneficiary’s current needs in an interest bearing account or savings bonds for the beneficiary's future needs; • Report any changes or events which could affect the beneficiary’s eligibility for benefits or payment amount; • Keep records of all payments received and how they are spent and/or saved; • Provide benefit information to social service agencies or medical facilities that serve the beneficiary; • Help the beneficiary get medical treatment when necessary; • Complete written reports accounting for the use of funds.
Disability Benefits • Disability benefits are paid through two sources: • SSDI - an insurance program for workers who have paid into the system, and • SSI – a welfare program for aged, blind or disabled persons with limited income and assets. • Definition of disability is the same for both.
SSDI • Children may receive SSDI benefits when a parent or, in certain situations, a step-parent or grandparent, receives SSDI themselves. • The amount of the benefit depends on the parent’s length of covered employment and total number of beneficiaries. • Must apply to receive if child not already receiving benefits when comes into care, or apply to become representative payee. • Again, no limit to amount child may accumulate in the master trust account.
Supplemental Security Income • SSI is a welfare program for persons who are aged, blind or disabled. Children may participate in this program. • Because it is a welfare program, there are maximum income and asset limitations. Therefore, there must be more careful oversight of children in care receiving SSI, to ensure that no “overpayment” occurs.
Basic SSI Disability Rules A child must meet all of the following requirements to be considered disabled and therefore eligible for SSI: • The child must not be working and earning more than $940 a month in 2008. (This earnings amount changes every year.) • The child must have a physical or mental condition, or a combination of conditions, that results in “marked and severe functional limitations.” This means that the condition(s) must very seriously limit the child’s activities. • The child’s condition(s) must have lasted, or be expected to last, at least 12 months; or must be expected to result in death.
Presumptive illnesses • If a child has the following conditions, SSA will begin making the SSI payments immediately, while the State processes the application. If the State eventually denies the application, the child will not have to repay the benefits paid out before the non-disabled determination.
Presumptive illnesses • HIV infection • Total blindness • Total deafness • Cerebral palsy • Down syndrome • Muscular dystrophy • Severe mental retardation (child age 7 or older) • Birth weight below two pounds, 10 ounces
Applying for SSI • The application needs to include information about the child’s medical situation, both current and historical, and functioning at home and in school through records and other relevant facts as to whether the child is unable to perform the normal daily activities of a child. • You may be asked to take the child to a medical exam or test, which SSA pays for.
Information to Provide • When you apply for benefits for a child, SSA will ask you for detailed information about the child’s medical condition and how it affects his or her ability to function on a daily basis. SSA also will ask you to give permission for the doctors, teachers, therapists and other professionals who have information about the child’s condition to send the information to them. • If you have any of the child’s medical or school records, take them with you. This will help speed up the decision on the application
What Happens Next? • The application will be processed, which can take many months. • During this process, the child may be asked to submit additional medical or school records, or to submit to medical exams or testing or evaluations. SSA will pay for any such services. • If the child has one of the listed presumptive conditions, benefits will begin immediately. Otherwise, you wait for a determination letter.
If the Application is Accepted • If SSA agrees that the child is disabled, as the representative payee, you will receive a letter telling you when the child is deemed disabled, what date the monthly benefits will start and their amount, as well as the retroactive lump-sum benefit. • If lump sum benefit is for more than six months of payments, must open a “dedicated account” for those payments.
Dedicated SSI Account • This must be a separate account, and no other funds can be mingled in the account. • These funds may only be used for specific types of expenses, and may not be used for “basic monthly maintenance,” such as food, clothing or shelter. This means that the dept./CBC cannot deduct the “cost of care” for the months this money represents.
Uses of Dedicated Funds You can use the money only for the following expenses: medical treatment; and education or job skills training. The following expenses are also allowed, if they benefit the child and are related to the child's impairment: personal needs or assistance (e.g., in–home nursing care needed); special equipment; housing modification; therapy or rehabilitation; or other items or services approved by your local Social Security office.
SSI Income and Asset Limitations • SSI = a welfare program. (SSDI is an insurance program.) • Income: • SSA does not count most of the child’s income once disability is determined. If the child is younger than age 22 and a student who regularly attends school, SSA excludes even more of earnings each month. In 2008, disabled students younger than age 22 may exclude $1,550 of their monthly earnings, with an annual limit of $6,240. These limits increase each year. But the $ 2000 asset limit still applies. • The rep payee (case manager) must report this income to SSA.
SSI Income and Asset Limitations • Assets cannot exceed $2000 at any given time. • Excluded assets: • Individual Development Account, • Dedicated lump sum account, and • Money in a PASS account. • DCF Master Trust CFOP 175-59 requires an “Expenditure plan”, to avoid losing any benefits.
PASS Accounts • Plan to Achieve Self-Support. • A tool to set aside income or resources that exceed the normal maximum for a work or education goal. • PASS money must be set aside separately from SSI benefits, and accumulated (or spent) to purchase the goods and services necessary to achieve the stated goal. • For youth ages 15 and older.
PASS, cont’d • PASS Plan must be approved by SSA; • Must have a specific work or education goal which the child can probably reach; • State how long it will take to reach the goal; • State what income or resources will be set aside and how it will be spent; • Explain how you will keep the income or resources set aside separate from other money the child has; and • Describe any goods and services that will be needed to reach the goal and explain why they are needed. • Seek help with the PASS application.
What if SSA Denies the Claim? • Many valid claims are denied by SSA. • Go through an appeals process. • Includes a denial of a PASS application. • Refer the child to an attorney (or paralegal) who specializes in Social Security Appeals. • CLS initiative • Legal Aid or Contingency Fee Attorneys
What if SSA Denies the Claim? • Do not try to handle the appeal yourself. • Very specialized work; requires a specialist to handle correctly. • Do not decide on your own not to appeal. Let a specialist (attorney or paralegal) decide if an appeal is worthwhile. • Doing the child (and the agency – “cost of care”) a disservice if don’t explore appeal.
Veteran’s Benefits • Benefits for death during service • Dependency and Indemnity Compensation • When there is a surviving spouse, the 2008 monthly benefit for each child is $271. This will be paid to the spouse. • Children are eligible for this compensation under the following conditions: • until they marry or turn 18 (or 19 if still in secondary school) • if they are between the ages of 18 and 23 and are attending a VA approved institution of higher learning • for life, if they are disabled
Veteran’s Benefits, cont’d • If there is no surviving spouse, DIC will be paid in equal shares to the children of the deceased veteran. • Life Insurance (SGLI). If no surviving spouse, will be paid to the children in equal shares. • Dependent’s Educational Assistance • Ages 18 – 26 • Ages 14 – 18, with physical or mental disabilities may receive benefits for special restorative training to lessen or overcome impairment
Veteran’s Benefits, cont’d To apply: • This is a very specialized area. The best way to apply is to go through your local County VA service office. • Offices are listed by county at this link: • http://www.floridavets.org/organization/cvso.pdf • As with all federal programs, if you are denied, you can (and probably should) appeal.
Education Issue • Challenge: § 39.4085(17), F.S. establishes a goal for foster children that they will have • minimal disruption to their education and • Retention in their school of origin, if appropriate. • This is the school the child attended immediately before becoming homeless. (E.g., the school the child attended while living with parents before shelter placement.)
Education • Possible Solution • Use of the McKinney-Vento Act. • This is a federal law that applies to Florida because we take dollars from that program. • This Act provides for educational services of children who are “homeless” • Definition of “homeless” is very broad and includes “children awaiting foster care placement”.
Awaiting Foster Care Placement • The federal government allows the states to define what this means. • Clearly, when a child is taken into shelter care. • Possibly, when a child returns from non-licensed care, DJJ placements, residential treatment, hospitalization, etc.
Benefits of McKinney-Vento • The right to remain in one school, even if their temporary living situation is located in another school district or attendance area, as long as remaining in that school is in their best interest. The school is known as the school of origin (defined as the school in which the student was last enrolled or where the student attended when permanently housed). Or the school of choice. • The right to receive transportation to and from the school of origin. • The right to enroll in school and begin participating fully in all school activities immediately, even if they cannot produce normally required documents, such as birth certificates, proof of guardianship, school records, immunization records, or proof of residency. • Supplemental services such as tutoring and mentorship.
Benefits of McKinney-Vento • Once determined to be homeless, a child remains homeless for the remainder of the school year. • E.g., if a child is taken into shelter care, moved into foster care, then moved into relative placement in one school year, child can remain in the school of origin despite these 3 different placements, if this is in child’s best interest.
School of Origin Issue • While the law allows the child to remain in the school of origin, it does not require this. • If the child or legal custodian decides this in not in the child’s best interest, then the child may enroll in the school of the child’s choice, provided the child otherwise qualifies for this school.
How to access this program • Contact the local homeless education liaison, from the school district of the school of origin. • Liaisons are listed by county at: http://www.fldoe.org/bsa/title1/homeless_coordinators.asp
Disagreements • If there are any disagreements with the school board, e.g., as to • Status of child as homeless • Choice of school enrollment • Transportation • Other services • A dispute resolution process exists. • As usual, speaker’s advice is to appeal any adverse decisions for the child • Seek help of an attorney – through CLS
Medicaid Issue • Numerous categories for Medicaid coverage for children. See Rule 65A-1.703, F.A.C.: Family-Related Medicaid Coverage Groups. Categories include: • Children in foster care; • Children placed for adoption or adopted; • Children in poverty • Different categories have different eligibility requirements.
Medicaid for Dependent Children When a dependent child is placed into non-licensed care, i.e., relative or non-relative custody, the Medicaid coverage is important to continue for the child’s benefit. Coverage is in the child-only category. Issue: what can DCF and its partners do to ensure the child’s Medicaid coverage continues?
Medicaid for Dependent Children • Custodians must be told that the children in their custody are eligible for Medicaid on their own, i.e., the custodian’s assets and income are not counted. • Many times relatives don’t want to apply for cash assistance (relative caregiver benefits) because they may not need the money and don’t want to take their time to do this. • They don’t realize that the child is still eligible for Medicaid, and therefore don’t apply.
Custodians and Medicaid, cont’d • Non-relative custodians are not eligible for cash assistance, so they usually do not know that the children are Medicaid-eligible. They clearly need to be told this, and encouraged (and helped) to apply. • Although custodian’s income and assets are not counted, the child’s own income is counted, but the child’s assets are not.
Benefits of Continued Medicaid • This ensures the child’s medical and psychiatric/psychological care can continue with the same providers, to avoid disruption of treatment. • Trust issues for the child; • Knowledge issues for the medical providers. • Coverage greater than with private insurance.
Helping Custodians Apply • Case Managers should assist the non-licensed custodians in dealing with ESS to ensure continued Medicaid coverage. • Case Managers should ensure that the non-licensed custodian understands the benefits of Medicaid coverage.
Questions? • Materials written by Deborah A. Schroth, Esq. Director of Training, CLS Deborah_schroth@dcf.state.fl.us (904) 251-5330 The author welcomes and will respond to your inquiries. 8/22/08
Resources • http://www.socialsecurity.gov/ • http://www.socialsecurity.gov/disabilityresearch/wi/pass.htm • http://www.passplan.org/ • http://www.vba.va.gov/survivors/index.htm • http://www1.va.gov/opa/vadocs/fedben.pdf • http://www.vba.va.gov/bln/21/