Programs for Partnership: Making the most of Like -Minded Movements

1. Programs for Partnership: Making the most of Like -Minded Movements 2009 AgrAbilityNational Training Workshop National Consortium for Health Systems Development

2. Programs For Partnership Medicaid Infrastructure Grants Work Incentive Planning & Assistance Housing & Urban Development Social Security Asset Building Programs Vocational Rehabilitation The Internal Revenue Service

3. What is the National Consortium for Health Systems Development? A technical assistance center for MIGs developed by states for states to promote the development of sustainable workforce and employment supports infrastructure by: • Promoting state-to-state information sharing and disseminating promising practices through teleconferences, policy briefs and individual state consultation • Offering work incentives training and education • Facilitating communication and collaboration with federal partners agencies (CMS, DOL/ODEP, SSA, etc.) • Providing forums for national and regional MIG meetings and workshops • Hosting a comprehensive web-based resource exchange atwww.nchsd.org A project of Health & Disability Advocates, Chicago, Illinois

4. What is the Medicaid Infrastructure Grant program? • Forty-eight states have had MIG funding since 2000; about 42 have 2009 MIG award. • Annual awards from $500,000 to more than $5 million per year. • 8 states receive more than $1 million each, 2 receive more than $5 million each. • Two types of grants: “Basic Medicaid Infrastructure” and “Comprehensive Employment Systems” • States without a Medicaid Buy-In get a Basic grant

5. What do MIG projects do? Develop and enhance Medicaid Buy-In programs and Medicaid services Support benefits planning services and infrastructure Engage with businesses as employers Conduct outreach and education Evaluate state disability and workforce systems Collect and track program and outcomes data Bring state, federal and private partners together Carry out statewide strategic planning

6. What roles do MIGs play in building state infrastructure? Convener – convene stakeholders to identify systems needs and promote infrastructure development; Facilitator – facilitate discussions and relationships necessary to make sustainable changes to state’s infrastructure; Coordinator – coordinate policy development, pilot projects and initiatives to demonstrate best practices; and Leader – develop and provide leadership on workforce development for people with disabilities.

7. MIG Direction 2009 - 2012 Clear Focus • The value of People, Work and Choice • A system that maximizes resources, coordinates services (no wrong door), provides leadership and meets the needs of employers and people with disabilities • Employment-related services and supports which are person-centered and evidence based, across funding and programmatic silos

8. MIG Direction 2009 - 2012 Outcomes Tracking • Obligation to develop a management information system to track employment, economic progress and health status of people with disabilities. • Ability to track outcomes of systems change efforts funded by MIG and demonstrate efficacy of pilots and systems coordination efforts.

9. MIG Objective of Engaging Employers: National Marketing Campaign • Led by Collaboration of states who have undertaken federally-funded projects to help people with disabilities enter the workforce • To develop a national marketing campaign about the benefits of hiring people with disabilities • While several organizations have launched similar efforts at the state level, this represents the first national effort of its kind • Seeking to develop a marketing campaign that can be used nationally and can also be tailored to individual state needs to educate and increase awareness of employers on the advantages of hiring people with disabilities

10. Medicaid Infrastructure Grants • Center for Medicare and Medicaid Services (CMS) grants awarded to states • The objectives of the grant are to develop a comprehensive employment system that: • Maximizes employment for people with disabilities; • Increases the state’s labor force through the inclusion of people with disabilities; and • Protects and enhances workers healthcare, other benefits, and needed employment supports.

11. Medicaid Buy-In Programs • Programs designed to allow workers with disabilities to buy into Medicaid at higher income and asset levels • First and only Medicaid work incentive • Operating in 40 states • Program features: • Vary from state to state • Required to pay premiums • Eligible from 16-64 and above • Most offer ability to increase assets

12. Medicaid Buy-In Programs • Must have a disability to participate • Must be working to participate • Provides wrap around coverage for private insurance • More than 100,000 participants nationwide • Many offer participants the ability to retire while maintaining eligibility • Utilize net income for eligibility on self-employment

13. What’s WIPA • Provides comprehensive work incentive counseling for SSA beneficiaries • Free service, paid for by SSA • Available in every state • Provide information on the impact of work on public benefits • SSA/Medicare/Medicaid • HUD • Food stamps

14. What does WIPA have to offer? • Information and Referral • Benefit Problem Solving & Advocacy • Benefits Analysis and Advisement • Benefit Support Planning • Benefit Management

15. How to contact WIPA? SSA’s Website https://secure.ssa.gov/apps10/oesp/providers.nsf/bystate

16. Ticket to Work Program? Created by the Ticket to Work and Work Incentives Improvement Act of 1999 Purpose is to provide Social Security beneficiaries with more choices of employment services and service providers. Overall goal was to get .5% more individuals to leave the rolls.

17. How Does the Program Work? All SSI and SSDI beneficiaries in current cash status receive tickets Individuals can place their tickets with a service provider agency called an Employment Network (EN) When the individual reaches certain income levels, the EN is paid The goal is to assist the beneficiary in working off of cash benefits

18. Opportunities To Partner As EN There are many opportunities to partner with Employment Networks Also opportunities to create shared partnerships and new Employment Networks The Ticket shares the same goals as every other program in the room: facilitating transition from poverty to self-sufficiency

19. VR Program: Purpose To empower individuals with disabilities to maximize employment, achieve economic self-sufficiency and independence, and to realize full inclusion and integration into society.

20. Eligibility for VR Services • 1st Criteria: Must be a person with a disability • Physical or mental impairment • Substantial barrier to employment • Can benefit from services in terms of employment • 2nd Criteria: • The individual with a disability must require VR services

21. Eligibility for VR Services • Presumedeligible if • Is receiving SSI and/or SSDI • Intends to achieve employment • Is capable of achieving employment • “Employment Outcome” • Competitive full-time or part-time employment • Supported employment • Self-employment • Other employment . . .

22. The Service Delivery System A combination of rehabilitation and vocational services become the Individualized Plan for Employment • Identify the employment outcome • Select VR services • Choose service providers • Establish timelines • Identify responsibilities • Other

23. VR Services Include, But Are Not Limited To: • Assessment • Counseling and guidance • Referral • Restoration • Vocational training • Maintenance &transportation • Interpreter services • Reader services • Transition services • Personal assistance • Rehabilitation Technology • Supported Employment • Tools & equipment • Job placement 23

24. Local VR Offices Finding Local offices of Vocational Rehabilitation http://www.pepnetnortheast.rit.edu/publication/financing_your_education/vr_offices.html

25. Asset building: Financial Literacy • Education and information • Budgeting • Savings • Credit management • Education of impact of good/bad credit & debt • Inspire change in behavior

26. Individual Development Accounts • Temporary, matched savings accounts • Federal Assets for Independence Act (AFIA) funds most IDAs • Home ownership, post secondary education, or business development • Excluded as assets for Supplemental Security Income (SSI), Food Stamps, and Medicaid

27. Reasons To Build Partnerships • Similar Focus • Asset building programs encourage employment and self-sufficiency. • Asset building programs offer opportunities to save for future goals to purchase items that increase the possibility of financial security. • Asset building programs provides opportunities to learn about the impact employment and earnings can have on your life. • Asset building programs focus on planning for the future.

28. Programs For Partnership • Do you know other programs that do this? • Medicaid Infrastructure Grants • Work Incentive Planning & Assistance • Housing & Urban Development • Social Security • The Internal Revenue Service • ArgAbility

29. Profile Of Asset Building Participants Low income families Often have limited work experiences Usually under employed Often new to work Limited access to resources Little to no knowledge about good/bad credit Little to no experience with financial transactions

30. Tools of the Trade • Volunteer Income Tax Assistance (IRS) • Earned Income Tax Credit (IRS) • Individual Development Accounts (AFIA & Private) • Housing • Post-secondary education • Business start up • Debt Re-Construction/Consolidation • Medicaid Buy-Ins • Independence Accounts (State Medicaid)

31. Tools of the Trade • Social Security Work Incentives (SSA & HUD) • PASS (SSI) • Student Earned Income Exclusion (SSI) • Blind work Expenses (SSDI) • Property Essential For Self-Support (SSI) • Earned Income Disregard (SSI) • Housing and Urban Development Work Incentives (HUD) • Family Self Sufficiency (HUD) • Earned Income Disregard (SSI & HUD)

32. The Power of Partnership Each program has singular successes regardless of partners needed for outcome Inherent incentives in creating asset building partnerships No barriers to partnerships

33. Sarah’s Start • Sara works as a barista at a local coffee shop • Has been keeping income below $900 because of fear of loosing benefits • Sara receives$985 of SSDI plus Medicare • Pays $535/month for Medicaid spend-down • Met with IDA, learned about matched IDA $ • Discussed wanting a business: Organic Herbs • Total cost of business start up: $10,000

34. Starting Partnership • Sara will be getting$2 for every dollar $1 saved towards her IDA • She estimates being able to save $100/month to save towards the $4000 maximum IDA • Can reach her goal in 13 months, less than the 40 months without IDA • Utilizes $4000 to secure loan from bank for $6000 • During this time Sara completes financial literacy, valuable training for the future

35. Strengthening Partners • Sara’s IDA program suggests filing her taxes at local VITA • Sara finds out she is eligible for the EITC • Sara gets $2000 in EITC • Sara has $4000 from IDA plus $2000 in EITC • $6000 in gross assets, which now requires $4000 loan to reach $10,000 • 13 months, $6000 saved with $4000 loan, saving 27 months without help

36. The Value of Compounding • Sara learns about Family Self-Sufficiency (FSS) through HUD • Had Sara been using FSS, she would have been able to save $300/month to help support her business • Total savings in 13 months would’ve been $9600 in 13 months • Sara can use FSS for yr 2 on 50% on increase

37. Tying It All Together • Sara learns about WIPA and work incentives • Sara learns about PASS plans • Sara finds out she can put $300 a month of earnings and $800 SSDI into PASS/month • $1100 from Sara • $1100 from PASS • $2200 from IDA • $300 from FSS • Sara saves $4700 her first month

38. The Big Picture • Sara savings in month two • $1100 from Sara • $1100 from PASS • $1800 from IDA • $300 from FSS • Sara saves $4300 in her second month • By month two Sara has saved $9000 • By month three Sara has saved enough to start her business, 10 months faster than IDA alone

39. Big Picture: Everyone Benefits Through Partnership • There are other partners that can be beneficial partners • AgrAbility • Vocational Rehabilitation • Employment Networks • IRS • Medicaid Buy-In • Independent Living Centers • One-Stops • Others?