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

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

2009 AgrAbilityNational Training Workshop

NATIONAL CONSORTIUM FOR HEALTH SYSTEMS

DEVELOPMENT

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

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 at

www.nchsd.org

A project of Health & Disability Advocates, Chicago, Illinois

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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

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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

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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.

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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

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.

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

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.

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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

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◦ 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

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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

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Information and Referral

Benefit Problem Solving & Advocacy

Benefits Analysis and Advisement

Benefit Support Planning

Benefit Management

SSA’s Website

https://secure.ssa.gov/apps10/oesp/providers.nsf/bystate

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.

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

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

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To empower individuals with disabilities to maximize employment, achieve

economic self-sufficiency and independence, and to realize full

inclusion and integration into society.

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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

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Presumed eligible 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 . . .

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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

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Assessment Counseling and guidance Referral Restoration Vocational training Maintenance & transportation Interpreter services

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Reader services Transition services Personal assistance Rehabilitation Technology Supported Employment Tools & equipment Job placement

Finding Local offices of Vocational Rehabilitation

http://www.pepnetnortheast.rit.edu/publication/financing_your_education/

vr_offices.html

Education and information◦ Budgeting◦ Savings◦ Credit management◦ Education of impact of good/bad credit & debt

Inspire change in behavior

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

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.

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

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

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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)

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)

Each program has singular successes regardless of partners needed for outcome

Inherent incentives in creating asset building partnerships

No barriers to partnerships

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

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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

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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

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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

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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

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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

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There are other partners that can be beneficial partners

◦ AgrAbility◦ Vocational Rehabilitation◦ Employment Networks◦ IRS◦ Medicaid Buy-In◦ Independent Living Centers◦ One-Stops◦ Others?

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