1. If Not Us, Who?

2. Objectives Increase knowledge of social programs
Increase utilization of appropriate, external resources
Meet constituent needs more effectively

3. The Reality 48 million Americans lack health insurance
Most Americans have insufficient financial resources
Disappearing employer sponsored benefits
Cancer treatment can range from 2 months to over a year
Insufficient financial resources means savings or investments to cover living expenses during periods of unpaid leave or unemployment. Employer sponsored benefits are costing more or disappearing all together.

4. The Needs Direct financial assistance Child care Transportation
Food
Rent
Utilities
Medicine
Child care
Transportation
Emotional support

5. But if we don’t do it, who will?
Filling the Gaps
But if we don’t do it, who will?

6. Community Resources
There are more than 170,000 new cancer cases diagnosed annually within the Division and more than 70,000 deaths.
The Division is home to an estimated 663,000 cancer survivors.

7. Types of Resources Federal entitlement programs
Direct cash assistance
Medical assistance
State and federal sponsored programs
Direct service provision
Local charitable organizations
Financial assistance
In-kind services
3 different types of available help. An “entitlement program” means if you meet the eligibility criteria you get the help. It is not dependant on available funding.

8. Federal Entitlement Programs
Community Resources on The Connection – the backbone of our information & referral services

9. Social Security
Provides direct cash payment to eligible individuals and families
Different types of benefits

10. Social Security Retirement Income (SSRI)
Worked 40 quarters
Eligibility dependent upon date of birth
Early benefits vs. full benefits
Not designed to meet all financial needs in retirement
Retirement age is moving from 65 y.o. to 67 y.o. over a period of years. Your birth date determines your actual date of retirement. People can elect early retirement benefits at age 62, but the payment is reduced for the duration of their life. Your payment is based on lifetime earnings.

11. Social Security Disability Insurance (SSDI)
Benefit for paying into SSRI
Worked 40 quarters
Must meet Social Security Administration (SSA) definition of disabled
Benefits for dependents and survivors
SSDI is an actual insurance policy administered by the gov’t. 40 quarters equals 10 consecutive years. The definitions of disabled are available on line at ssa.gov under the search term “Blue Book.” The blue Book lists all diagnosis and needed criteria to be labeled disabled. Payment based on lifetime earnings. Dependents of the disabled receive a payment equivalent to 50% of the SSDI recipient’s payment. So if the patient receives $1000, their child would receive $500. If they have two children, each child would receive $250 each for a total of 50%.

12. Supplemental Security Income (SSI)
Must meet requirements for SSRI or SSDI
Lack sufficient work quarters and financial resources
Monthly cash benefit of $637
This is a safety net program designed for individuals who lack sufficient work credits to qualify for SSRI or SSDI.

13. Medicare Federal health insurance program Limited eligibility
Not designed to cover all medical costs
In order to qualify for Medicare you must be 65 or older, have end stage renal failure, or have received 24 payments of SSDI. If a person takes early retirement they do not get early Medicare.

14. Medicare Part A vs. Part B
Part A – Hospitalization coverage at 80%, hospice, skilled nursing care.
Part B – Additional coverage for out-patient appointments, home health.

15. Medicare Prescriptions Benefits
Part D
Multiple plan offerings, varying levels of coverage for specific drugs
Considered a “Donut Program”
Very confusing program. Depending on the plan you select, different drugs costs different prices based on the actual drug and what pharmacy you go to. It isa donut program because there are 2 periods of coverage separated by a period of no coverage. Medication costs up to the first $2250 are covered at a percentage based on your income and the plan chosen. But the next $3600 worth of medication is not covered at all. Anything over a total of $5150 is covered at 95%.

16. Medicaid State level health insurance program Categorical eligibility
Financial eligibility
“Straight” Medicaid vs. Qualified Medicare Beneficiary (QMB)
Each state has different Medicaid programs. There are five federally mandated categories: Blind, declared disabled by SSA, a child under 18, pregnant, or 65 or older. If you meet a category, they look at your finances. An individual may own a home, a car, and have $2000 or less in liquid assets. A couple may own a home, a car, and have less than $3000 in liquid assets. Straight Medicaid is full benefits. Medicaid pays for everything. QMB is for Medicare recipients. QMB pays what is not covered by Medicare.

17. Medicaid Spend Down Program
Increases eligibility
Deductible must be met before payment for services
Deductible based on income
This is like health insurance with a deductible that must be met before Medicaid starts paying the bills. It gets it’s name from allowing patients to “Spend Down” their extra money that makes them ineligible to meet the financial requirements. The deductible is based on your income. After the deductible is met, Medicaid will pay all medical related costs. Each state has different rules regarding the Spend Down program.

18. Medicaid Transportation
Transportation provided for eligible recipients to medical appointments
Program varies state to state
Medicaid will pay for transportation for medical appts. Usually they only transport to closest facility that can provide needed care. Advanced notice is required. Not always available in every area.

19. Medicaid Transportation
GA – NET, 5 regional coordinators
SC – Broker in each county
NC – Coordinator in each county
VA & DE – State wide coordinator is Logisticare

20. Medicaid Transportation
WV – Limited taxi service, reimbursement for lodging, mileage, tolls, and meals
MD – Services and eligibility vary by locale
DC – Recipients given list of providers

21. Supplemental Nutrition Assistance Program
Formerly called Food Stamps, now called SNAP
Provides a monthly benefit for the purchase of approved food items
Eligibility based on percentage of the Federal Poverty Level (FPL)
Women, Infants, and Children (WIC)
Most Food Stamp programs now use a debit card to lessen the embarrassment associated with the program. Monthly allotment is given based on the number in the household and the total income. Woman, Infants, and Children provide dairy products and formula to mothers and their children.

22. Temporary Assistance to Needy Families (TANF)
Replaced AFDC, also known as “Welfare”
Monthly cash payment to individuals with dependent children
Strict eligibility
Maximum benefit periods
AFDC=Aid to Families with Dependant Children. If a mother has court ordered child support she will not qualify for AFDC. There is a set amount of time an individual may receive TANF payments. After exhausting TANF benefit, a recipient must wait a specific number of years before reapplying. Recipients are offered with work counseling, job training, and encouragement to locate employment.

23. Low Income Heating and Energy Assistance Program (LIHEAP)
Provides a stipend to offset heating costs
Weatherization and heating system repair
Cooling assistance in summer
Provides limited fans and A/C units
Frequently called Energy Assistance. Federal funds are given to each state to administer. Programs vary by locale.

24. State and Federal Programs
Community Resources on The Connection – the backbone of our information & referral services

25. Breast and Cervical Cancer Early Detection Program
Federal matching funds for breast and cervical cancer detection and prevention
For women ages , uninsured or underinsured
Mammograms/PAP smears
Mandated Medicaid coverage
Often call BCCEDP. If a woman gets screening through this program and develops breast or cervical cancer, they will eligible for Medicaid coverage for the cancer treatment only. THEY MUST BE IN THE PROGRAM PRIOR TO DIAGNOSIS TO GET MEDICAID!!! Some sites will accept women younger than 50.

26. State Cancer Programs
State run programs that provide for cancer treatment
More generous eligibility than Medicaid
North Carolina Cancer Assistance Fund
Delaware Cancer Treatment Act
Virginia Uninsured Medical Catastrophe Fund
Georgia Cancer State Aid
West Virginia Catastrophic Illness Commission
State programs that only help with cancer treatment.

27. Housing Section 8 Government run housing units
Housing counseling services
Strict financial eligibility
Long wait lists
Section 8 provide a monthly voucher to help pay you rent. Public housing is gov;t run housing units that base rent at 30% of your income. VERY LONG WAITING LISTS!!!

28. Local Charitable Organizations
Community Resources on The Connection – the backbone of our information & referral services

29. Community Resources Referred to as community resources
Wide ranging programs and services
Dependent on funding and/or donations
Geographic residency restrictions

30. Frequently Used United Way Salvation Army Food Banks Runs 211
Storehouse of community programs
Funds other programs
Salvation Army
Homeless shelters
Substance abuse rehabilitation
Limited financial assistance for rent and utilities
Food assistance
Food Banks
Provide direct donations of canned goods
Some fresh fruits and vegetables

31. Frequently Used Area Agency on Aging Community Action Agencies Age 60+
Transportation
Counseling
Home care
Friendly visitor
Congregate meals
Community Action Agencies
Provide counseling services
Limited financial assistance
Some transportation

32. Frequently Used Meals on Wheels Legal Aid
Provides home delivered meals
Stipends available to those with low-income
Legal Aid
Provides professional legal services to eligible individuals.
Assists with wills, POAs, custody, denial of benefits.
Does not address criminal matters
Financial eligibility requirements

33. Frequently Used Specialty Organizations Leukemia and Lymphoma Society
Brain Tumor Society
Local organizations
Johns Foundation
Cancer Services of Gaston County
Which Dollar?
Nikki Leach Foundation

34. Points to Remember There is no one resource for every need
There may not be a resource for the need
Sometimes you have to rob Peter to pay Paul
It is better to give one good resource than 7 possible resources.
An empathetic, concerned response can sometimes be just as effective as 10 possible resources

35. Questions?