5/30/2015. Disclosures. Veteran s Administration (V.A.) Benefits pertaining to aging and disability

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1 Elder, Disability and Public Benefits- Updates and New Developments Carol Mean Quick, J.D., Debra K. Schuster & Associates Debra K. Schuster, J.D., M.H.A., Debra K. Schuster & Associates Karen Warren, J.D., Legal Services of Eastern K. Schuster & Associates Disclosures We have no relevant financial relationships to K. Schuster & Associates Veteran s Administration (V.A.) Benefits pertaining to aging and disability Categories of Benefits: Needs based income (Can only receive one of the following) Service Pension (for low-income veterans) Housebound (substantially confined to immediate premises due to disability) Aid & Attendance Service-connected Service-connected disability pension (based on VA s rating of disability arising from military K. Schuster & Associates

2 Veteran s Administration (V.A.) Aid & Attendance Benefits Law and regulations: 38 U.S.C. chapter 15, implemented at 38 CFR (Code of Federal Regulations) through Criteria for benefit: Provides monthly income for veterans 65 and older and their surviving spouses when: Veteran served at least one (1) day of active duty Service date requirements -specified military conflicts (Mexican Border Period (May 9, 1916 April 5, 1917 for Veterans who served in Mexico, on its borders, or adjacent waters) World War I (April 6, 1917 November 11, 1918) World War II (December 7, 1941 December 31, 1946) Korean conflict (June 27, 1950 January 31, 1955) Vietnam era (February 28, 1961 May 7, 1975 for Veterans who served in the Republic of Vietnam during that period; otherwise August 5, 1964 May 7, 1975) Gulf War (August 2, 1990 through a future date to be set by law or Presidential K. Schuster & Associates Aid & Attendance Benefit Requires that the assistance of another person is required to perform activities of daily living ( ADLs ) bathing, feeding, dressing, transferring and toileting Or, if the veteran/surviving spouse is blind, in a nursing home or otherwise bed-ridden Cannot be K. Schuster & Associates Aid & Attendance Benefit Current (2015) benefit: Maximum benefit per month Veteran: $1,788 With one dependent (usually spouse) -$2,210 Each additional dependent child addtl. $183 Surviving Spouse: $1,149 One dependent child - $1,371 Each additional dependent child addtl. K. Schuster & Associates

3 Aid & Attendance Benefit Financial eligibility rules: Assets Non-countable assets same as for Medicaid (MO Health Net) Couple: approx. $80,000 (max) Individual: approx. $40,000 (max) Income Income of individual applying for benefit must be exceeded by 5% for unreimbursed medical expenses CURRENTLY -- NO LOOK-BACK FOR TRANSFER OF K. Schuster & Associates Aid & Attendance Benefit Medical expenses considered: (non-inclusive list) Medications, medical food supplements, vitamins Medical co-payments and premiums Medical supplies, adaptive equipment Caregiver services Medical transportation Smoking cessation products Adult day care costs Assisted living care services deemed medically necessary (usually for individuals with dementia) Skilled nursing care K. Schuster & Associates Aid & Attendance Benefit In 2014, Congress proposed a change in A&A rules to impose a three (3) year look-back for transfers of assets for less than fair market value (FMV) did not pass out of committee On 1/23/15, the Veteran s Affairs Dept. proposed rules to drastically change the eligibility requirements for A & A to preserve program integrity by ensuring that those individuals who are only in genuine need receive K. Schuster & Associates

4 Aid & Attendance Benefit Rationale- By establishing in regulations a look-back and penalty period for claimants who transfer assets before applying for pension to create the appearance of economic need where it does not exist, the revised rules would reduce opportunities for financial advisors to provide advice for the restructuring of assets that, in many cases, renders the claimant ineligible for other needs-based benefits. Establishing a look-back and penalty period for pre-application transfers of assets would also preserve the integrity of the pension program by ensuring that VA only pays the benefit to those with genuine need. FR Vol 80, No 15, Part IV, January 23, K. Schuster & Associates Aid & Attendance Benefit Proposed Changes Proposed changes: Asset threshold VA will deny a claim if an applicant s net worth (assets plus annual income) Asset - Fair market value of all property an individual owns including all real estate and personal property, less any mortgages or loans against the property Asset limit Then-current Community Spouse Resource Allowance (CSRA) under Medicaid (with SSA COLA adjustments) Veteran and spouse s assets counted together Exclusions: Primary residence (not to exceed 2 acres; current rule allows 5 acres); personal effects suitable and consistent with a reasonable mode of K. Schuster & Associates Aid & Attendance Benefit Proposed Changes Penalty for transfer of covered assets for less than fair market value, that if not transferred would have caused the claimant s net worth to exceed the net worth limit (net worth limit for 2015 is $119, 220) penalty applies to amount in excess of net worth limit Three (3) year look-back Maximum ten (10) year K. Schuster & Associates

5 Aid & Attendance Benefit Proposed Changes Fair market value: Price a willing buyer would pay a willing seller, based on best available information including, appraisals, public records, inspections and market value of similar property Example (from federal regulations): Net worth limit: $119,220 Claimant s assets on date of application: $115,000 Prior to application, applicant transferred $30,000 Amount penalty based upon - $26,000 Penalty equals amount transferred/maximum benefit to individual for thencurrent year In 2015, $26,000/$1,788 =14.5 months ineligible for A & K. Schuster & Associates What s New with Medicare 2015 Deductibles & Copayments (see accompanying handout from Hospital Deductible: 2014: $1,216 per spell of illness (2015: $1,260) Hospital Co-Pay: Days 0-60: 2014: $0; Days 61-90: $315/day; Days : $630/day Skilled Nursing Facility Co-Pay Days 0-20: $0; Days : $157.50/day) Part B Deductible: $147/year Standard Premium: K. Schuster & Associates Medicare Updates Coverage of Speech Generating Devices (SGDs) for ALS patients: Beginning in 2001, Medicare paid for SGDs, which were delivered to the patient, fully covered by Medicare, thereby becoming the property of the recipient. The devices were delivered unlocked to permit access to the internet, and other non-speech functions and the recipient was responsible for payment of such other services. In 2/14, Medicare issued a coverage reminder prohibiting delivery of unlocked devices refused payment for delivery of SGDs that allowed access to non-speech uses. On 4/29/14 Medicare reversed its prohibition on non-speech functions in covered SGDs, but does not cover same in nursing homes, hospitals or K. Schuster & Associates

6 Medicare Updates Medicare coverage of Speech Generating Devices (cont d) 4/14 Medicare implemented a capped rental payment process, requiring ALS patients to rent the device for 13 months before it would be deemed owned by the patient. It is unclear whether during the 13 month rental period if the devices would be unlocked and still covered by Medicare. Medicare still does not pay for eye-tracking K. Schuster & Associates Medicare Updates ACA extends Medicare (Hospital Insurance) Trust Fund by 10 years due to costsharing and coverage of more individuals leading to fewer disability claims Due to Supreme Court decision in United States v. Windsor, 570 U.S. 12 (2013), CMS implemented across the board provider manual updates requiring same-sex marriages entered into in states recognizing same sex marriages be recognized and all Medicare and Medicaid benefits applied similarly, regardless of the certified provider s or supplier s location or the jurisdiction in which the spouse lives. In 8/14, CMS issued a memo to State Survey Directors announcing training modules titled Building Respect for LGBT Older Adults available immediately for dissemination to SNFs and Skilled Rehab K. Schuster & Associates Medicare Updates Observation status: Hospital patients classification as outpatients, which makes them ineligible for Medicare Part A coverage of their subsequent stay in a skilled nursing facility (SNF) when they do not have inpatient status for at least three consecutive midnights. When a Medicare beneficiary is not admitted as an inpatient for three consecutive days and nights (midnights), Medicare will not pay for any subsequent SNF/Skilled rehab stay MedPAC (Medicare Payment Advisory Committee) is advising Congress on need for hospitals to notify patients within hours of admission status Discussions of counting a portion of observation toward 3 day coverage rule so long as patient has at least one day of inpatient K. Schuster & Associates

7 Medicare Updates National Partnership to Improve Dementia Care Goal of Reducing Use of Anti-Psychotic Drugs in SNFs Slow improvements - Too many nursing home residents are given antipsychotic drugs, even though they have dementia and not a mental illness for which antipsychotic drugs are intended, The National Partnership may have helped lead to 50,000-60,000 fewer longstay residents taking antipsychotic drugs inappropriately between March 2012 and December 2014, but more than 200,000 residents continue to take these drugs today, and for the overwhelming majority of them, the drugs are inappropriate and dangerous. Antipsychotic drugs are too often used as a substitute for adequate K. Schuster & Associates Special Needs Trusts Special Needs Trusts ( SNTs ), also known as Supplemental Needs Trusts, are trusts created to hold assets for a disabled individual to supplement, not replace, public benefits. They can pay for goods and services that such public programs do not cover and for such goods and services if coverage by such programs is inadequate. Assets held in a well constructed SNT are not considered countable for the purposes of Medicaid (MO Healthnet) planning and/or Supplemental Security Income K. Schuster & Associates Special Needs Trusts Three types of SNTs: Third Party SNTs and First Party Self-Settled SNTs Sole benefit K. Schuster & Associates

8 First Party Self-settled Special Needs Trusts Created with the assets of the disabled person (per the then-current Social Security definition) inheritance, court judgment, settlement, public benefit back awards, certain types of income earned by disabled person Two (2) Types authorized by law: (d)(4)(a) trusts (see 42 U.S.C. 1396(p)) (d)(4)(c) trusts (see also 42 U.S.C. 1396(p)) )(a/k/a pooled trusts ) SNT must be created and funded before the SNT beneficiary attains age 65 and for sole benefit of SNT beneficiary Must be irrevocable and the Beneficiary cannot dictate how funds are disbursed or expended Requires payback of Medicaid K. Schuster & Associates Third Party Special Needs Trust (SNT) Created through the estate planning of a parent, grandparent, or anyone else (Testamentary Trust, Revocable Living Trust or a Stand-Alone SNT). Leaves a disabled person s inheritance to the Trustee of a SNT Should not be used for housing or food, if the Beneficiary is receiving SSI, to avoid reduction in benefits No Medicaid payback provision at the death of the K. Schuster & Associates Sole Benefit Special Needs Trusts Created by a person seeking to apply for MO Health Net benefits but has excess assets preventing them from doing so Can transfer excess assets into a Sole Benefit SNT for a disabled adult child immediately without incurring a transfer penalty Medicaid payback provision required upon death of disabled adult K. Schuster & Associates

9 Special Needs Trust -Case Law Update Draper v. Colvin, (8 th Cir., 2015) Draper, age 18, suffered traumatic brain injury in a 2006 car accident. Draper executed a durable power of attorney, authorizing her parents to fund, transfer assets to, and to instruct and advise the trustee of any trust wherein [Draper is] or may be the trustor, or beneficiary. Draper began receiving SSI payments. In February 2008, father signed a personal-injury settlement. Draper received $429, Her parents signed documents creating a Special Needs Trust, intended to qualify under 42 U.S.C. 1396p(d)(4)(A), to provide for Draper s needs without displac[ing] or supplant[ing] public assistance or other sources of support that may otherwise be available and transferred K. Schuster & Associates Special Needs Trust -Case Law Update Draper (cont d): In September 2008, Draper received notice that she had been overpaid $3,000 in SSI benefits because her trust exceeded the SSI-eligibility limit of $2,000, and that her SSI payments would cease. An ALJ found Draper s parents had to act as third-party creators when establishing it, but instead acted as agents under the power of attorney. Draper s parents obtained a state court order modifying the trust, which retroactively listed the state court, rather than Draper s parents, as the settlor. The Appeals Council denied review, finding that the order did not provide a basis for altering the ALJ s decision. The district court and Eighth Circuit K. Schuster & Associates Special Needs Trust Legislative/Regulatory Update Social Security Administration (SSA) released new guidance regarding Special Needs/Pooled Trusts determinations effective April 28, 2014 A Fact Guide for National Trust Training is available on the Missouri Bar Association website- This Guide was created to improve accuracy, consistency and the timeliness of the SSA in completing SSI trust resource determinations and K. Schuster & Associates

10 Special Needs Trust Legislative/Regulatory Update National Defense Authorization Act (NDAA) of 2015 The act includes provisions that allow military parents to have their survivor benefits placed into a SNT for the benefit of a disabled child. Before Congress passed this act, survivor benefits of military parents had to be distributed directly to a child, even if the child was K. Schuster & Associates Special Needs Trust Legislative/Regulatory Update Achieving a Better Life Experience Act (ABLE Act of 2014 became law on December 19, 2014 The ABLE Act amends Section 529 of the Internal Revenue Service Code of 1986 to allow individuals with disabilities to create tax-free savings accounts, similar to Section 529 College Savings Accounts. ABLE Act allows disabled individuals to have one (1) ABLE account with up to $100,000 without disqualifying them from receiving federal public benefits Earnings and distributions from the account for qualified disability expenses would not count as taxable income to the disabled K. Schuster & Associates Special Needs Trust Legislative/Regulatory Update ABLE Act (cont d): Eligibility- Individuals with significant disabilities with an age of onset before turning age 26. Individuals meeting the requirements and receiving SSI or SSDI are already eligible to create an ABLE account. If an individual does not receive SSI or SSDI already, but meets the age requirement, he/she would still be eligible under a certification process to open an ABLE K. Schuster & Associates

11 Special Needs Trust Legislative/Regulatory Update ABLE Act (cont d): While ABLE Act is beneficial to the disabled, it does not completely replace SNTs: funds in ABLE Account must be used exclusively for disability-related expenses as listed in the Act Many disabled individuals may not be eligible The annual tax-free contributions to the account may not exceed the annual gift-tax exemption amount Remaining assets after individuals death subject to Medicaid pay back. Federal regulations must be put in place before the states can establish procedures to manage ABLE Accounts within their states MO proposed regulations for ABLE accounts S.B. 174 Missouri ABLE K. Schuster & Associates Special Needs Trust Legislative/Regulatory Update Special Needs Trust Fairness Act: Introduced into the U.S. House (H.R. 670) in February 2015; referred to Subcommittee on Health Act would individual with disabilities, with mental capacity to create his/her own SNT under 42 U.S.C. 1396p(d)(4)(A) Presently, 1396p(d)(4)(A) only authorizes the creation of such trusts by parents, grandparents, legal guardians or the K. Schuster & Associates MO Healthnet Update In a nutshell: Missouri Medicaid MO Healthnet Eligibility determined by Missouri s Dept of Social Service s Family Support Division (FSD) Eligibility requirements in Income Maintenance Manual, which is updated by Memorandums published throughout the year -Case Law: Danna v. Mo. Dept of Soc. Services (Mo. App., 2014) an issue that has not been presented for determination at the administrative hearing is not preserved for appellate K. Schuster & Associates

12 MO Healthnet Update FSD Income Maintenance Manual Update 2015 (figures usually change annually) Missouri Income Limits: Monthly Personal Needs Allowance: $50 Monthly Maintenance Needs Allowance (for Community Spouse) Min $1967 Max $2981 Missouri Asset Limits: Resource Allowance Individual $ Couple K. Schuster & Associates MO Healthnet Update Missouri numbers (cont d): Community Spouse Resource Allowance: Minimum: $23,844 Maximum: One-half of all marital assets up to $119, 220, regardless of how titled Home Equity Limit Max $552,000 (allowed to use home equity loan to reduce value) Shelter Standard $590 Utility Expense K. Schuster & Associates PUBLIC BENEFITS: SUPPORTIVE SERVICES FOR SENIORS PRESENTED BY KAREN C. WARREN LEGAL SERVICES OF EASTERN MISSOURI 12

13 DISCLOSURE STATEMENT I HAVE NO RELEVANT FINANCIAL RELATIONSHIP TO DISCLOSE. LEGAL SERVICES OF EASTERN MISSOURI Goals for Today s Discussion Provide a basic understanding of Medicaid and other related programs that may provide support to seniors. Provide information regarding basic eligibility criteria. LEGAL SERVICES OF EASTERN MISSOURI THE MO HEALTHNET PROGRAM: RESPONSIBLE AGENCIES & ROLES DEPARTMENT OF SOCIAL SERVICES (DSS) MISSOURI FAMILY SUPPORT DIVISION (FSD) MO HEALTHNET DIVISION (MHD) LEGAL SERVICES OF EASTERN MISSOURI

14 WHAT DOES MO HEALTHNET ELIGIBLE MEAN? MO HealthNet eligible means that a person has been approved for healthcare benefits under one of the programs administered by Family Support Division (FSD). MO HealthNet funding comes from both federal and state revenues. Some programs are state funded only. FSD makes the eligibility determination. The MO HealthNet Division (MHD) formerly the Division of Medical Services makes the payments for medical services received by MO HealthNet eligible individuals. LEGAL SERVICES OF EASTERN MISSOURI THE MO HEALTHNET PROGRAM: WHAT IS IT? MO HEALTHNET FOR KIDS MO HEALTHNET FOR FAMILIES MO HEALTHNET FOR PREGNANT WOMEN MO HEALTHNET FOR AGED, BLIND AND DISABLED HOME & COMMUNITY BASED SERVICES LEGAL SERVICES OF EASTERN MISSOURI MO HEALTHNET PROGRAMS Differ based on population covered (families, children, seniors, visually impaired and individuals with disabilities). Differ in eligibility criteria. Differ in service models: fee for service v. managed care. Provides varying levels of coverage depending upon category of Medicaid. LEGAL SERVICES OF EASTERN MISSOURI

15 MO HealthNet for Kids: Eligibility A child: Who is under 19 years of age who lives in Missouri and intends to remain; who is a United States citizen or an eligible qualified non citizen and whose countable family income meets the income guidelines below. Uninsured children whose family income is over the above limits, and whose monthly gross family income is under 300% FPL, also are eligible under CHIP. Income Guidelines: 185% FPL for children under age 1 133% FPL for ages % FPL for ages 6 18 LEGAL SERVICES OF EASTERN MISSOURI CHIP no cost and CHIP with Premium: Eligibility To qualify for CHIP: Have to be uninsured for 6 months (special needs exception) Have family assets with a net worth of less than $250,000 CHIP no cost Family gross income between % FPL CHIP with premium family gross income between % FPL Up to 185% FPL premium is no more than 1% of income Up to 225% FPL premium is no more than 3% of income Up to 300% FPL premium is no more than 5% of income LEGAL SERVICES OF EASTERN MISSOURI MHABD Eligibility Requirements REQUIREMENT: OAA (Aged) PTD (Disabled) AGE Age 65 or over Not applicable must meet disability requirement RESIDENCE Reside in Missouri and intend to remain Reside in Missouri and intend to remain INSTITUTIONAL RESIDENCE RESOURCES PROPERTY TRANSFER SS# Cannot reside in certain public institutions $ single $2000 couple Investigated but does not effect eligibility unless institutionalized. Must provide or apply for SS# Cannot reside in certain public institutions $ single $2000 couple Investigated but does not effect eligibility unless institutionalized. Must provide or apply for SS# CITIZENSHIP Must be US citizen or qualifying alien Must be US citizen or qualifying alien DISABILITY Not applicable must be age 65 or over Must be permanently & totally disabled. LEGAL SERVICES OF EASTERN MISSOURI

16 What Medical Services are covered? Primary, acute and preventive care Health screenings and medical exams Immunizations Inpatient hospital care Outpatient hospital services Laboratory and x-ray services Physical, occupational and speech therapy* Home and community-based services (nursing and personal care)* Medical equipment and supplies Non-emergency medical transportation Pharmacy Mental health services (outpatient counseling and inpatient psychiatric treatment) Dental services* LEGAL SERVICES OF EASTERN MISSOURI HOW IS DISABILITY DEFINED? FSD commonly refers to disability in terms of permanent and total disability. FSD s policy manual defines disability as follows: Disability, as defined by SSA and used by them and the FSD Medical Review Team (MRT), is the individual's inability to be gainfully and substantially employed for one year or longer due to a physical or mental incapacity. Reference: Missouri Family Support Division s Income Maintenance Manual Section DISABILITY (PTD eligibility criteria) LEGAL SERVICES OF EASTERN MISSOURI Financial Eligibility for MHABD NON SPENDDOWN: If the adjusted gross income is equal to or less than the income maximum the case is eligible for Medicaid as a non spenddown. SPENDDOWN: If the adjusted gross income is greater than the income maximum, the case is a spenddown case. The monthly spenddown amount is the amount by which the adjusted gross income exceeds the income maximum. LEGAL SERVICES OF EASTERN MISSOURI

17 Spenddown Income Limits for 2015 Individual: $ Couple: $ LEGAL SERVICES OF EASTERN MISSOURI Prior Quarter Medicaid Coverage When an individual has unpaid medical bills for any of the three months prior to the application month eligibility for prior quarter Medicaid coverage is explored. The individual must qualify on all eligibility requirements to qualify for prior quarter coverage. LEGAL SERVICES OF EASTERN MISSOURI Other Benefit Programs for the Elderly and Individuals with Disabilities Blind Pension (BP) Financed entirely by state funds. Provides assistance for blind persons (not eligible for SAB and SSI benefits). Provides a monthly cash grant and MO HealthNet benefits ($718 per month). Must meet visual standard set by statute. Blindness is defined as up to 5/200 or visual field of less than 5 degrees. LEGAL SERVICES OF EASTERN MISSOURI

18 Other Benefit Programs for the Elderly and Individuals with Disabilities Supplemental Aid to the Blind (SAB) Companion program to BP Same visual standard Need of assistance due to insufficient income (must apply for SSI) Must meet other eligibility criteria common to both programs. LEGAL SERVICES OF EASTERN MISSOURI HOME AND COMMUNITY BASED MEDICAID WAIVERS Created by the Omnibus Budget Reconciliation Act (Section 2176 of Public Law of the Social Security Act). Waives provisions of Medicaid law regarding state wideness, comparability of services and income and resource rules. Must promote cost effectiveness and efficiency. HCBS Waivers are known as Section 1915 (c) waivers. Initial waivers are approved for 3 years and are renewed for 5 year intervals. Source: LEGAL SERVICES OF EASTERN MISSOURI What are Waivers? Special programs created and administered by the single state Medicaid agency to serve targeted populations. The State Medicaid agency must file an application for the waiver with the Centers for Medicare and Medicaid Services for review and approval. Programs are called waivers because specific provisions of Medicaid law have been waived. LEGAL SERVICES OF EASTERN MISSOURI

19 What are Home & Community Based Waivers? Waivers typically are created to provide traditional medical services and nonmedical services to individuals that would otherwise require institutionalization. Institutionalization=nursing home, hospital or intermediate care facility for individuals with intellectual disability. LEGAL SERVICES OF EASTERN MISSOURI Benefits of HCBS Waiver Programs Providing care to individuals with disabilities in the least restrictive setting. Consistent with the objectives of the Americans with Disabilities Act. Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581, 119 S.Ct Cost savings: providing care in home v. in long term care setting. LEGAL SERVICES OF EASTERN MISSOURI HCBS Waivers in Missouri Examples of Medicaid Waivers Available in Missouri: Aged & Disabled Independent Living Waiver Lopez Waiver (MO Children with Developmental Disabilities Waiver) DD Comprehensive Waiver DD Community Support Waiver Adult Day Care LEGAL SERVICES OF EASTERN MISSOURI

20 Common Eligibility Components Financial Eligibility (Medicaid) Functional Ability (Varies) Services (Varies) LEGAL SERVICES OF EASTERN MISSOURI Determination of Eligibility Eligibility determination is 2 prong process. Department of Social Services, Family Support Division determines financial eligibility. Department of Health & Senior Services determines functional eligibility. LEGAL SERVICES OF EASTERN MISSOURI How is Functional Eligibility Determined? Must meet long term care facility level of care. Determination of LOC is made by the Department of Health & Senior Services (DHSS). 19 CSR (4)(A) Long term care facility LOC is a score of 21 points or higher on DHSS assessment tool. 19 CSR (5)(c) LEGAL SERVICES OF EASTERN MISSOURI

21 How is LOC Determined? Face to face interview conducted at permanent residence of applicant or recipient. Interview conducted by Home & Community Services worker within the Division of Senior & Disability Services. Worker to observe applicant s living conditions & environment. Applicant/recipient answers questions posed by HCS worker. LEGAL SERVICES OF EASTERN MISSOURI How are Points Assigned? Assignment of Points to Specific Categories Based Upon Applicant/Recipient s Responses: Mobility Dietary Restorative Services Monitoring Medications Treatments Personal Care Rehabilitative Services Behavior and Mental Condition 19 CSR (4)(B) LEGAL SERVICES OF EASTERN MISSOURI Significance of Assessed Points The number of points assessed indicates the applicant/recipient s level of need in a given area. Points range from 0 9. The higher the score, the higher the need. Total level of care=sum of points assigned to each category. LEGAL SERVICES OF EASTERN MISSOURI

22 SUPPLEMENTAL SECURITY INCOME (SSI) Created in 1972 as supplement to income for persons ineligible for Social Security. Differs from Social Security Disability Insurance (SSDI). Means tested program for individuals in financial need. LEGAL SERVICES OF EASTERN MISSOURI SSI ELIGIBILITY CRITERIA Individuals who are 65 years or older, blind or with disability. Disability has specific definition. Resource limit for single person ($2,000) and married couple ($3,000). Must be U.S. citizen or qualified alien. Must not be incarcerated. Cannot have given away resources. LEGAL SERVICES OF EASTERN MISSOURI SSI SPECIAL RULES Compassionate Allowances special initiative that provides for expedited processing of certain disability related claims. Presumptive Eligibility provides for immediate approval of SSI benefits with submission of proper proof of eligibility. LEGAL SERVICES OF EASTERN MISSOURI

23 Food Stamps = SNAP As of Oct. 1, 2008, Supplemental Nutrition Assistance Program (SNAP) is the new name for the federal Food Stamp Program. SNAP is the federal name for the program. At this time, Missouri continues to refer to the program as Food Stamps. You may see the SNAP logo at merchants who accept Food Stamp benefits. LEGAL SERVICES OF EASTERN MISSOURI Food Stamp Program The purpose of the Food Stamp program is to raise the nutrition level of low income families. Families access a more nutritious diet using food stamps. Allotment is based on the thrifty food plan. 68 LEGAL SERVICES OF EASTERN MISSOURI 2015 Food Stamp Basic Eligibility Requirements Reside in county of application Identity of applicant must be verified Must be citizens of the US or eligible aliens All household members must supply or apply for a social security number All members not meeting an exception must participate in Work Registration (METP) LEGAL SERVICES OF EASTERN MISSOURI

24 Food Stamp Basic Eligibility Requirements Household must have income below the appropriate maximum Gross Income must be less than 130% of FPL Net Income must be less than 100% of FPL Elderly/Disabled individuals do not have to meet gross income test 70 LEGAL SERVICES OF EASTERN MISSOURI 2015 Food Stamp Basic Eligibility Requirements All household members age 18 to 50 who are not exempt must meet the FS Work Requirement (This requirement has been waived in all counties of Missouri but waiver will be ending). Household s resources cannot exceed permitted limits $3250 if one member is elderly or disabled $2250 for all other households 71 LEGAL SERVICES OF EASTERN MISSOURI 2015 Food Stamp Certification Periods Certification Period Mid-Certification Review All Adult Members Elderly or Disabled with No Earned Income : All other Food Stamp Households: 24 Months 12 Months 12 Months 6 Months 72 LEGAL SERVICES OF EASTERN MISSOURI

25 Helpful Websites LEGAL SERVICES OF EASTERN MISSOURI Questions & Answers CONCLUSION LEGAL SERVICES OF EASTERN MISSOURI