1. What’s on the Horizon For Adult Services Loria Hubbard Richardson Tri-Cities Autism Conference March 12, 2016 1

2. Topics Vocational Rehabilitation Ticket to Work Postsecondary Opportunities for Students with IDD Medicaid/TennCare Medicaid Waiver Family Support Program CHOICES Waiver ECF CHOICES Waiver Social Security Disability Income Supplemental Security Income 2

3. Vocational Rehabilitation Helps people with disabilities get meaningful, paying jobs Find your local VR office: http://tn.gov/humanservices/article/office-locator-trc-ttap “Getting a Head Start with Vocational Rehabilitation” http://thearctn.org/Assets/Docs/Getting-a-Head-Start-Voc- Rehab.pdf 3

4. Vocational Rehabilitation Upcoming Changes with the Work Force Investment Opportunity Act a. 15% of VR Budget to go to Pre-Employment Transition i. Job Exploration ii. Work-Based Learning iii. Work Place Readiness iv. Self-Advocacy v. Post-Secondary Counseling and Enrollment Assistance Students do not have to be eligible for VR to access these services! 4

5. Vocational Rehabilitation 5

6. Ticket to Work 1.“Virtual Ticket.” Not a real ticket. Voluntary program of the Social Security Administration for SSI or SSDI recipients 2.Contact MAXIMUS Re: Employment Network (EN): 866/968-7842 www.yourtickettowork.com for information 3.The Arc TN’s Secondary Transition Handbook: https://www.thearctn.org/Assets/Docs/Secondary- Transition-Handbook.pdf https://www.thearctn.org/Assets/Docs/Secondary- 6

7. Ticket to Work Services 1.Interests testing 2.Skills testing 3.Job search/job development services 4.Job coaching/job training 5.Interview skills training 6.Resume writing/preparation 7

8. Ticket to Work Recipient Rights 1.Full explanation of the services offered by Employment Network (EN) 2.Confidentiality by your EN 3.Complete access to your information EN records 4.Make copies of the records using the EN’s copying equipment. 5.Work in partnership with your EN 8

9. Ticket to Work Recipient Rights 6. Receive a copy of your work plan in an accessible format 7. Receive services and support from qualified employees and providers 8.Take back or reassign your Ticket at any time 9.Appeal any decision, or use specific dispute resolution processes 10. Information and advocacy services are available from Disability Rights Tennessee 9

10. IDD Post Secondary Education Opportunities Post Secondary Education Opportunities for Students With Intellectual and Developmental Disabilities: http://vkc.mc.vanderbilt.edu/vkc/ucedd/alliance/#sthash.nBBx95rX.dpuf Edge: Union University FUTure Program: University of TN IDEAL: Lipscomb University Next Steps: Vanderbilt University Tiger Life: University of Memphis ALL ACCEPTING APPLICATIONS NOW FOR FALL 2016 10

11. Medicaid/TennCare 1.TennCare is TN’s Medicaid Program 2.Health program for eligible people with low incomes and assets 3.14 Mandatory Primary Health Care Services 4.TennCare contracts with other state agencies or private organizations to operate some of the program components 5.Medicaid dollars are used to fund healthcare, institutional care, and home and community-based services for people with intellectual disabilities 11

12. Medicaid Waiver 1.Home and Community Based Services (HCBS) Waiver Program: 2.Allows people with intellectual disabilities to live in their own community instead of living in an institution 3.Three HCBS waiver programs in Tennessee: 4.Statewide Waiver (The “Big Waiver”) 5.Arlington Waiver (closed to new enrollment) 6.Self-Determination Waiver 12

13. Medicaid Waiver: Where to Start 1.When someone with ID applies for Medicaid Waiver Services they need: a.Documentation of their intellectual diagnosed before 18 b.IEP noting the intellectual disability; or c.letter from your loved one’s physician d.Proof they live in Tennessee e.Eligibility for Medicaid f.Need the same level of care as provided in an institution for people with intellectual disabilities g.The ability to get services and supports that will keep them safe 13

14. Medicaid Waiver Intake Intake is through DIDD Regional Offices 888/531-9876 14

15. Medicaid Waiver Case Manager Decides 1.Eligibility 2.Assigns Category 3.Develops the initial plan of care 4.Helps develop a support plan specific to your loved one’s needs 15

16. Medicaid Waiver Application Process 1.Special Education or Other School Professional Makes a Referral, 2.or... 3.Intake/Application Meeting 4.Evaluations 5.Eligibility 6.Priority Category 7.Individualized Plan for Employment 8.Implement Your Plan 16

17. Medicaid Waiver Application Process 1.DIDD Worker Will Get Copies of Documents 2.Eligibility Determined by DIDD based on documents and information provided by family 3.Eligibility = Case Manager 17

18. The Medicaid Waiver Waiting List: 6000 + 1.Crisis: homeless, no caregiver, danger to self or others - needs services immediately 2.Urgent: Significant risk of abuse/neglect, caregiver aging or in poor health, needs services soon 3.Active: Has applied 4.Deferred: Requesting services more than 12 months in the future 18

19. Some Medicaid Waiver Services 19

20. Family Support Program 1.Families who have school-aged or younger with severe disabilities 2.Adults with severe disabilities who choose to live with their families 3.Adults with severe disabilities not supported by other state or federal funded programs 4.Amount varies each year 5.Call your legislator 6.Contact: a. Statewide: (615) 532-6552 b. West: (901) 745-7348 c. Middle: (615) 231-5057 d. East: (865) 594-9288 7. http://www.tn.gov/didd/section/family-support 20

21. CHOICES Waiver 1.Home and Community Based Service (HCBS) program managed by TennCare for people with physical disabilities 2. Individualized services 3. Long-term Services and Supports (LTSS) 4. Provides services needed to keep people living in the community 5. Income must be less than $2,094 per month 6. AND the total value of things you own cannot be more than $2,000 - The home where you live does not count 7.You can't have given away or sold anything for less than what it is worth in the last five years 21

22. Employment and Community First CHOICES Waiver 1.Target implementation date of July 1, 2016 2.Will be administered through TennCare 3.Managed by the Managed Care Organizations (MCOs) similar to the CHOICES Waiver for people who are elderly or have physical disabilities 4.People with DD other than ID will be eligible (first time this population will have full access to waiver services) 5.Focus on employment and independent living 6.Children will be eligible to receive services 7.3 capped service packages: 8.Essential supports for employment and community living ($30,00) 9.Comprehensive supports for employment and community living ($45,000- $60,000 with certain exceptions for intense medical or behavioral needs) 10.Will use nursing facility level of care to determine eligibility 22

23. Supplemental Security Income 1.Stipends to low income people 2.Eligibility: i. 65 + ii. Blind or iii. Have a disability And... 23

24. Supplemental Security Income And... 1.Limited income 2.Limited resources 3.Citizen, national, certain categories of aliens 4.Resident of the 50 States, DC, or Northern Mariana Islands 5.Not absent from the US for 30 + consecutive days 6.Apply for other cash benefits (e.g. pensions) 7.Gives SSA permission to contact any financial institution and request financial records 8.File the application for benefits; and 9.Meet certain other requirements 24

25. Social Security Disability Income Eligibility 1.Must have worked and paid Social Security taxes 2.SSDI and SSI define disability the same 3.Five Step Eligibility Requirements: 4.Person be unable to work for at least 12 months 5.Medical impairment 6.Severe medical condition that interferes with work-related activities 7.Have an impairment in the SSA Listing or equal in severity 8.If unable to do previous work, are they able to do other work? 9.No benefits for partial or short-term disability 10.Working? $1000 +? – No benefits 25

26. Supplemental Security Income 1.Under 18 with a disability or certain other categories 2.Many recipients are eligible for SSDI 3.Unnecessary to consider child's disability when deciding 4.Child may be eligible as a dependent 5.The dependent child's benefits end at 18 unless they continue to be a full-time student 6.Adults who became disabled in childhood can qualify for SSDI based on their parent’s earnings record 7.http://www.bazelon.org/LinkClick.aspx?fileticket=k4W7Msxsmv 4%3D&tabid=382 can provide additional information 26

27. Resources 1.The Arc Tennessee: Thearctn.org or 800/835-7077 2.Tennessee Disability Pathfinder : 800/640-4636 or http://kc.vanderbilt.edu/pathfinder 3.Disability Rights Tennessee: 800/342-1660 or http://www.disabilityrightstn.org/ 4.Vocational Rehabilitation: http://tn.gov/humanservices/topic/vocational-rehabilitation 5.TennCare Already: 800/535-9725 6.DIDD/Medicaid Waiver Intake: 888/531-9876 7.DIDD (Constituent Services) 615/253-4632 or susan.moss@tn.gov 8.Choices Waiver: http://www.tn.gov/tenncare/long_choices.shtml 9.Area Agency on Aging and Disability: 866/836-6678 10.Social Security Administration: https://www.socialsecurity.gov 27

28. For More Information... 28