MISSION STATEMENT

1. MISSION STATEMENT The Agency Supports Persons with Developmental Disabilities in Living, Learning, and Working in their Communities. Director Barbara Palmer Governor Rick Scott

2. KATRINA WASHINGTON State Office Operations Review Specialist Phone: 850-595-8329 Cell: 850-556-5859 Fax: 850-595-8020 Katrina.Washington@apdcares.org

3. Knowledge Is Power! You are here to learn exciting new ways to help others or yourself!

4. Acronyms

5. Barriers • High unemployment rate for people with disabilities • Up to 80% unemployed • Unemployment and under-employment among working-age Americans with disabilities continues to be a problem • Fear of losing benefits is a significant barrier • SSA benefits and attached health care

6. (of the System) What if…?

7. RULES OF ENGAGEMENT “Before any rules are discussed, all parties must be clear what benefits a persons is receiving from all sources, private and public, before information is exchanged.”

8. ALWAYS CONSIDER THE FOLLOWING: • Age • SSI • SSDI • Dual eligible • Married/single • Live in HUD housing • Receiving food stamps • Over 18 and living at home • Any other information pertinent to their financial situation

9. Expert?You do NOT need to be the expert! • You do need to know how valuable this information is • You do need to educate people • You do need to know about the tools at your disposal

10. Overview SSDI (Title II) (Social Security Disability Insurance) • FICA • Medicare • Federal Rules V E R S U S SSI (Title XVI) (Supplemental Security Income) • General Revenue • Medicaid • State Rules

11. Florida is a 1634(d) State Social Security Act Section 1634(d) allows Florida to use the same eligibility criteria for SSI eligibility as for the state’s Medicaid Program

12. SGA – 2017

13. SSDI: Eligibility for Benefits

14. Medicare Federal Health Insurance Program • For people 65+ • People under 65 with certain disabilities • People with end-stage Renal Disease

15. Continuing Disability Review (CDR) – SSI and SSDI • Periodic eligibility redetermination • Answers the Question: Does the beneficiary continue to be disabled?

16. CDR Process Occurs every 3, 5, or 7 years. If you have a condition not expected to improve, SSA will review your case, but not as often as every 3 years.

17. SSDI – Title II • F.I.C.A. • Waiting Period • SGA • Eligibility • DAC/CDB • Medicare (1960’s)

18. SSDI You may receive this benefit if: Medicare is usually associated with SSDI

19. Medicare Components Part A - Hospital Insurance Part B - Medical Services Part C - Private Insurance Part D - Prescription Drug Coverage Page 28 - 29

20. SSI Title XVI (1974) • General revenue • Needs-based • No waiting period • Looks at earned and unearned income • Resources count • Medicaid

21. SSI: Eligibility for Benefits

22. HOW TO FIND BENEFIT CHANGES Social Security • www.socialsecurity.gov • www.socialsecurity.gov/disability • www.ssa.gov Medicaid • http://www.Medicaid.gov/ Federal Poverty Guidelines • http://obamacarefacts.com/federal-poverty-level.php

23. Childhood Disability Beneficiary (CDB) • Requires states to consider Title II Childhood Disability Beneficiaries (CDBs) who lose SSI eligibility as if they were still SSI recipients for Medicaid purposes (to keep Medicaid) • As long as they would have remained otherwise eligible for SSI benefits but for their entitlement to (or increase in) their SSDI (Title II) payment (CDB = DAC or Disabled Adult Child)

24. Childhood Disability Beneficiary A DAC or CDB may also be • an adopted child • a step-child • a grandchild • a step-grandchild

25. Work Incentives Comparison Chart

26. SSDI Work Incentives • Trial Work Period – 9 months with monthly gross earnings of $840.00 or more within a 60-month rolling window of time • Extended Period of Eligibility (EPE) – 36 consecutive months • Grace Period is a 3-month period which runs once upon first earning SGA during or after EPE • Extension of Medicare Coverage – minimum of 93 months

27. Student Earned Income Exclusion, SEIESSI Only • Must be under the age of 22 and regularly attending school • Can exclude earned income up to a certain amount, which changes annually • Amount earned is reviewed monthly, with a yearly maximum of $7,200.00 • This exclusion applies before any other exclusion • Can carry the balance over the following month Can make up to $1,790.00 per month.

28. SEIE – SSI

29. SEIE – SSI Report the following to the SSI claims representative: • Proof of regularly attending school at least one month during the current calendar quarter or expectation to attend school at least one month in the next quarter • Pay stubs showing the amount of earned income while considered a student and under the age of 22

30. Section 1619(a) – SSI Enables a person to continue receiving an SSI cash payment when earnings exceed SGA

31. Section 1619(a) – SSI • Eligibility for SSI will continue as long as requirements are met • SSA will continue to calculate income as before • A person continues being eligible for Medicaid • This happens automatically when wages are reported to SSI monthly

32. 1619(b) – SSI When a beneficiary earns enough income to no longer receive an SSI monthly cash payment, 1619(b) provides for the continuation of Medicaid There are qualifications: • Eligibility • Disability • Need Medicaid • Under State Income Threshold

33. Plan for Achieving Self-Support (PASS) – SSI • An income/resource exclusion • Allows a person to set aside income and/or resources for purposes of achieving an occupational objective • Helps an individual to establish or maintain SSI eligibility

34. Property Essential for Self-Support(PESS) – SSI • SSI will not count certain resources that are essential to a person’s means of self-sufficiency • Utilized when initially applying for SSI • Maintains resource eligibility for SSI/Medicaid

35. IRWE – SSI and SSDI Out-of-pocket expenses that support a disability to allow a person to earn income, even if those items or services are also needed for non-work activities IImpairment RRelated WWork EExpense

36. Impairment Related Work Expense (IRWE) – SSI and SSDI • SSI Beneficiaries: IRWE is used to reduce gross income – why? • SSDI Beneficiaries: IRWE is used to reduce countable earnings below SGA – why? What is the difference between “gross income” and “countable earnings”?

37. IRWE – SSI and SSDI Examples • Transportation • Medications • Medical Devices • PCA

38. Qualified Income Trust What is a Qualified Income Trust? • If your income is over the limit to qualify for Medicaid long-term care services (including nursing home care), a Qualified Income Trust (QIT) allows you to become eligible by placing income into an account each month that you need Medicaid. The QIT involves a written agreement, setting up a special account and making deposits into the account. • Who needs a Qualified Income Trust? • You need a QIT if your income before any deductions (such as taxes, Medicare, or health insurance premiums) is over the limit to qualify for the Institutional Care Program (ICP), Institutional Hospice, Program of All-Inclusive Care for the Elderly (PACE), or the Home and Community Based Services (HCBS) waivers.

39. Resources

40. RESOURCES • SSA Website www.ssa.gov • 2016 SSA Red Book http://www.ssa.gov/redbook/

41. Resources • Community Work Incentives Coordinator (CWIC) • Benefits specialists certified to provide SSA beneficiaries with disabilities (including transition-to-work aged youth) with benefits planning and assistance services http://www.ssa.gov/work/WIPA.html

42. Resources • Area Work Incentives Coordinator (AWIC): http://www.ssa.gov/atlanta/southeast/awic/index.htm • The AWIC coordinates work incentive initiatives and SSA’s employment support programs in a region • The AWIC is SSA Regional, and the Work Incentive Liaison (WIL) is field office staff WILs list: http://www.ssa.gov.ssi/text-work-ussi.htm

43. Resources • Social Security Handbook (The basic guide to the social security programs): http://www.ssa.gov/OP_Home/handbook/handbook.html • Ticket to Work Site: www.socialsecurity.gov/work • Choose Work for Service Providers (Ticket to Work): www.yourtickettowork.com • Social Security “Work Site”: http://www.socialsecurity.gov/work Comprehensive SSA information on work issues can also be found on the SSA website listed above.

44. Resources • Disability Definitions:http://www.ssa.gov/disability/professionals/bluebook • Disability Planner: www.socialsecurity.gov/dibplan/dqualify4.htm • General Information on how the Social Security Administration defines disability • Program Operational Manual System (POMS): https://secure.ssa.gov/poms.nsf/home!readform

45. WORK INCENTIVES • Plan for Achieving Self Support (PASS) • PASS, an SSI provision, is an income and resource exclusion that allows a person who is disabled or blind to set aside income and/or resources for an occupational objective http://www.socialsecurity.gov/disabilityresearch/wi/pass.htm

46. WORK INCENTIVES • Property Essential for Self Support (PESS) • An SSI provision in which SSI will NOT count certain resources that are essential to a person’s means of self-sufficiency • For example, SSA does not count property such as tools or equipment that are used for work, or if an individual has a trade or business, SSA does not count property such as inventory http://www.socialsecurity.gov/redbook/eng/ssi-only-employment-supports.htm#4=&a0=3

47. Work Incentives • Impairment Related Work Expense • An SSI and SSDI provision that is used to enable beneficiaries of SSI to reduce gross income and/or SSDI to reduce substantial gainful activity (SGA) due to out-of-pocket expenses that support a disability to allow a person to earn income, even if those items or services are needed for non-work activities http://www.socialsecurity.gov/ssi/spotlights/spot-impairment-relatedwork.htm

48. Work Incentives • Individual Development Accounts (IDAs) • Special savings accounts designed to help people build assets • IDA holders save their own dollars in accounts for a specified period of time • Savers receive matching funds for such purposes as buying a home, post-secondary education, starting/expanding a small business, retirement accounts

49. Work Incentives • Earned Income Tax Credit • Refundable federal income tax credit for low-income working individuals and families • Congress originally approved the tax credit legislation in 1975 in part to offset the burden of social security taxes and to provide an incentive to work • To qualify, taxpayers must meet certain requirements and file a tax return, even if they did not earn enough money to be obligated to file a tax return http://www.irs.gov/Individuals/EITC-Home-Page--It%E2%80%99s-easier-than-ever-to-find-out-if-you-qualify-for-EITC

50. Agencies, Advocates, and Resources • Agency for Persons with Disabilities (APD) • Medicaid Waiver • GR/IFS • EEP http://apd.myflorida.com/or www.apdcares.org • APD Resource Directory: http://resourcedirectory.apd.myflorida.com/resourcedirectory/ • Division of Vocational Rehabilitation (DVR) • Supported Employment Phase 1 • Employment Related Services • Abilities Work Help Desk • Department of Economic Opportunity (DEO) • Abilities Work Employment Portal