Work Incentives Transition Aged Youth With Disabilities 2008 Pennsylvania Community on Transition Conference

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

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

SSA Income Support Programs Social Security Disability Insurance (SSDI) Social Security Childhood Disability Beneficiary (SSCDB) Social Security Childhood Disability Beneficiary (SSCDB) Supplemental Security Income (SSI)

SSA Disability Programs Eligibility: FIRST STEP: Demonstrate an inability to earn Substantial Gainful Activity (SGA) FIRST STEP: Demonstrate an inability to earn Substantial Gainful Activity (SGA) Severe Impairment (Disability Determination Service) Severe Impairment (Disability Determination Service) If Work History Credits (SSDI), parent status (SSCDB), or Asset Test (SSI) If Work History Credits (SSDI), parent status (SSCDB), or Asset Test (SSI)

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

SSI Features Limited Asset application, continuous) Earnings below SGA for eligibility, irrelevant post eligibility Monthly Benefit adjustment based on countable unearned and earned income No wait for standard federal benefit Most states -– including PA -- provide a cash supplement

Work Incentives (not inclusive) SSI 1619a, 1619b, state Medicaid Threshold 1619a, 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) Continuation of Benefits Continuation of Benefits Ticket to Work Ticket to Work Expedited Reinstatement Expedited Reinstatement A person with disability which meets the SSA level of impairment Medical Assistance for Workers with Disabilities Medical Assistance for Workers with Disabilities

Impact of Work on SSI (CY 2008) PA Provides an SSI supplement of $27.40 not included in this display! 1619a 1619b PA MA Threshold

Student Earned Income Exclusion (SEIE): Instant Increase to Monthly Income! SEIE SSI - FBR $637$637 Job (mo. income) $785$785 Net Reduction in SSI ($350)$0 Total$1,072$1,422 In this scenario, use of the SEIE resulted in 33% increase in monthly income!

Plan for Achieving Self Support A Fixed Savings Program A vocational goal that requires the beneficiary to save money over a specific time period. SSI or potentially eligible for SSI & another source of income: earned, unearned, in- kind (e.g. deemed income) PASS Application submitted to local SSA Office, approved by Regional PASS Cadre Form: pdf pdfhttp:// 545.pdf

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

PASS Example John’s goal is to be employed in a restaurant setting working in dining room preparation. He has a disability of Mental Retardation. His PASS will pay for job coaching, co-worker supports, and attendant care. This PASS is for 24 months with the yearly cost of $6,152. He is 18 and plans to stay in school for 2-3 more years. He receives the full SSI, and was just notified by SSA that he will start receiving $400 in Social Security because his father died.

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

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

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

Medicaid & SSI Federal- State Health Insurance program coordinated by CMS (federal) and state Medicaid agency, e.g. PA Department of Public Welfare; Low Income Groups; Most states, including PA, provide automatic Medicaid eligibility to SSI beneficiaries; SSI beneficiary receives cash assistance from SSA and health insurance through County Assistance Office (CAO)…the local administrator of DPW services.

PA’s Medicaid Buy-In Medical Assistanc e for Workers With Disabilitie s (MAWD) Medical Assistanc e for Workers With Disabilitie s (MAWD)

PA Medicaid Buy-In Medicaid for Workers with Disabilities (MAWD) Department of Public Welfare January 2002 Disabled per SSA guidelines, except earnings and income 250% of poverty $10K or less in assets Monthly premium 5% of countable income

MAWD – Enrollment & Earnings Government Performance & Results Act (GPRA): Status of the Medicaid Infrastructure Grants Program, Mathematica Policy Research December 2007.

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

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

Medicaid Infrastructure Grant Mini Grants up to $15,000 targeted to schools and other transition programs; Learn about work incentives; Assuming that the explicit role of transition to address career planning and getting a job, to help transition aged youth to access incentives

FY Grantees The programs selected to participate through competitive 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.

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

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

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