SSA Benefits and Ticket to Work Community Work Incentive Coordinators Share Expertise

SSA Benefits and Ticket to Work Community Work Incentive Coordinators Share Expertise Employment Symposium 2016 Presented by Community Integrated Services Angelina Bush, CWIC, CESP Kelly Carroll, CESP

MISSION Community Integrated Services mission is to empower people with disabilities through individualized employment opportunities that foster self-sustainability, equality, and community. Through partnerships with area businesses and! organizations, CIS works to find jobs that fulfill the employment goals and desires for the people they serve.!

CIS THE EARLY YEARS

THE EARLY YEARS 1990 S Individualized Supported Employment Model!! Originally utilized 3 Employment Training Specialists! Served 10-15 individuals utilizing individual supports model! No cell phones!! Only two computers! Only one funding source, approximately $250,000 in revenue!

CIS NOW SUPPORTING 527 INDIVIDUALS IN PA! Current Funding:!! ODP (Office of Developmental Programs): Largest Funder! o IDS (Intellectual Disability Services): Philadelphia, Montgomery County, Chester County, and Delaware County (OID)! o BAS (Bureau of Autism Services): PA! OBRA (Omnibus Reconciliation Act through The Office of Long Term Living or OLTL: PA!! OVR (Office of Vocational Rehabilitation)! o Philadelphia Office and Norristown Office!! BBVS (Bureau of Blind Visual Services): PA! Private Pay! School Districts: PA! Ticket to Work!!

COMMUNITY INTEGRATED SERVICES JOB PLACEMENTS CIS has consistently grown each year in the amount of job opportunities we have been able to secure for our individuals.! 2010: 103 2011: 135 2012: 144 2013: 166 2014: 158 2015: 173 These jobs cover many employment sectors including education, federal, professional, retail, hospitality & tourism, gaming, child care, and healthcare!

COMMUNITY INTEGRATED SERVICES Non-Profit organization 501(c)3! Established in 1991 in Philadelphia, PA! Supported Employment Agency in Philadelphia, PA. Then expanded to surrounding counties, and the state of Delaware! Employment First Agency- ALWAYS!! 32 staff who have obtained CESP! 47 staff who are ACRE Certified!

Guiding Principles of Supported Employment l l l l Employment First! Full inclusion! Compensation at or ABOVE minimum wage! Focus on abilities and capacities! l Everyone Can work!! l l l Employment is community-based and inclusive! Dignity of taking risks! No readiness Model!

BEFORE CIS HAD A BENEFITS COUNSELOR

HOW DID WE HELP INDIVIDUALS BEFORE WE HAD A BENEFITS COUNSELOR? Provided very basic information, example, for every $2 you make, Social Security would deduct $1.! Tried to run an individuals BPQY, but often hard to obtain and difficult to know what it meant at times.! Ensured individuals were reporting their earnings.! The information dispensed was not always individualized.! Assumed that people knew what benefits they received.!

HARD TO UNDERSTAND AND DISPEL THE MYTHS

MYTH VS. FACT People with disabilities can t work more than 20 hours per week.! You lose your benefits if you work.! You can t get your SSI check back if you work.! You will lose your waiver if you work too much.! If I started working Social Security will decide I am no longer disabled.!

WHY DO PEOPLE NEED BENEFITS COUNSELING So people can make good decisions about their vocational goals, based on their own disability benefits.! Important that you provide accurate and up to date information about their potential earnings and health insurance.! Everyone s situation is very unique.! You need to provide 100% accurate information when you are talking about someone s money and insurance! Ask how much do you want to earn!

ELEVATING PRACTICE & SUPPORTING PEOPLE CIS realized individuals have unanswered questions about working and SSA benefits.! o Misinformation! o Confusing information! o Lack of guidance on application process! o Everyone has a very unique situation! o Important that individuals trust the people providing the information.!

CURRENT NATIONALLY SUPPORTED MODEL: WORK INCENTIVE PLANNING AND ASSISTANCE (WIPA) SSA funded program to help individuals receiving SSA Disability Benefits who are working or thinking about going to work.! Individuals are prioritized to get services.! Promote the Ticket to Work Program and Self Sufficiency.! Conduct WISE (Work Incentive Seminars) for Beneficiaries! 93 WIPA programs across the United States (in 2014)! 11.3 m adults ages 18-64 on SSDI or SSI based on disability in United States as of 04/2015. Not including children.! hep://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/index.html?qs

LIMITATIONS OF WIPA Sheer Volume! Knowledge of WIPA/ Find WIPA/ Initiate Contact! Not Proactive! Locations of WIPA! Employment team not included! Timeliness of Services! No help with application for benefits!

LOCAL LEVEL WIPA- PHILADELPHIA REGION Philadelphia area WIPA! o Disability Rights Network of PA! o Covers Philadelphia, Bucks, Montgomery, Delaware, Chester, Northampton Counties! o 3 Staff members

CIS TRYING TO ACCESS BENEFITS COUNSELING PASS PLAN- Great candidate! o Individual working full time and wanted to go to school for accounting.! o Met with WIPA staff! o Expected to independently write and submit PASS with! minimal guidance! o Too complex for our knowledge and not enough support! o No connection to PASS Cadre!

OUR DECISION Limited options for benefits counseling! CIS invested in developing an in-house! Certified Benefits Counselor to! o People need hand holding (intensive help)! o Accurate info! o Individualized information! o Follow up! Started with 1 staff!

DEVELOPING STAFF Strong organizational skills! Very detail orientated! Good time management skills and able to prioritize work! Multitask between various tasks and consumers! Able to understand complex information that doesn t often make sense! Remember that complex information!

DEVELOPING STAFF Break it down into simple concepts! Work well with ALL consumers (funding sources, challenges, personalities, and family situations)! Develop and maintain professional relationships with other organizations and companies! Good writing skills! Can complete research and figure out new situations!

TRAINING FOR CERTIFICATION It s a commitment from! o Agency! o Staff! Funding the position! o IDS- billed as supported employment! o OVR- it s in the contract! o School Districts- negotiate in contract! o In DE- billed as separate service (at a higher rate)! Empowered the TTW program- gaining knowledge! o Increased funding for this!

TRAINING OPTIONS VCU 1 week training on site! Free! Testing & case study! Provisional Certification! 3 live case studies for! Full Certification! Provided Technical Assistance Liaison! In process of rolling out CEC! Web based training (2 months of courses)! $1450! Testing & case study! Provisional Certification! 1 live case study for Full Certification! Continuing Education Credits required! Cornell Process takes about 1 year to complete!

POSITION/ PROACTIVE CASE MANAGEMENT Work Incentive Counseling since 2011! Upfront and ongoing process! 100% of individuals offered Benefits Counseling Services! 97% of individuals receive Benefits Counseling Services! 3% of individuals refuse Benefits Counseling Services!!

CIS BENEFITS COUNSELORS TODAY Certified Community Work Incentive Coordinator! o Currently have 3 Fully Certified Staff! o 1 Provisionally Certified Staff working on full cert.! Assist individuals across agency! o In PA and DE (756 people)!

PROACTIVE CASE MANAGEMENT Individuals receive assistance with Applying for benefits (eligibility and appeals)! Verifying benefits through a BPQY! Understanding how work impacts benefits! o SSA, Medicaid, Medicare, SNAP, HUD, Childcare, Waiver!! Help with reporting work to SSA! Developing and implementing work incentives to SSA! (IRWE, PASS, Subsidy & Special Conditions, BWE, and SEIE)! Understanding overpayments! Rectifying issues on SSA records!

MIKE Working full time for several years! Was terminated from SSA benefits! Went back and added work incentive! Benefits reinstated! Received $41,000 back pay in SSDI! Receives SSDI again monthly &! work earnings! Special Needs Trust!

WHEN TO DO BENEFITS COUNSELING The earlier the better!! Preferred time is when job development starts! o Has possibility to open the door on hours/pay rate etc.! o Know when transition points are! o Maintain waiver eligibility! o Develop relationship with consumer!

WHEN TO DO BENEFITS COUNSELING Touch point- when offered position! Reporting to SSA- ensuring it s happening! Access to a benefits counselor if there are questions or concerns over time! Track out Trial Work Period / SSI calculations!

HOW TO BUILD TRUST Helping people when they have heard otherwise from! o SSA! o OVR! o Supports Coordinators! o Other support team members! o Their mom! o All well intended but not fully trained and knowledgeable!

HOW TO BUILD TRUST Very individualized, all situations are different! Breaking down the information into simplest terms! o Developing relationships with SSA! Using a Certified Benefits Counselor!

APPLYING FOR BENEFITS WIPA is not allowed to assist individuals with applying for benefits! Many Individuals turning 18 are applying for the first time; if not they are transitioning from child benefits to adult benefits.! Many families of all backgrounds have questions and are unsure of the process!

APPLYING FOR BENEFITS CIS Benefits Counselors assist with explaining! o The process of applying for benefits! o What SSA is looking at for disability and financial criteria! o Help determine what benefit individuals may be eligible for! o Answer questions as they come!

REPRESENTATIVE PAYEE Many individuals have a Representative Payee to help them keep track of their finances!! Duties and responsibilities! o Ensure food and shelter needs are met! o Report changes in living situation! o Report earnings to SSA monthly! o Report to SSA what SSI is used for! o Assisting with reporting to the IRS! Coordinate with individual and Rep Payee on who is reporting earnings and how it s being done!!

WHY WOULD YOU FLIP A TABLE? PROCEED WITH CAUTION!

EBONIE Working at Rite Aid in a part time position! Not reporting wages to SSA! o After working for about 15 months! She has a Rep Payee and wasn t doing this! Benefits counselors from CIS stepped in! Provided Benefits Counseling and assistance with reporting to SSA!

EBONIE Received overpayment from SSA- $3,000! Meeting to tell individual had overpayment and SSI going to be reduced! Angry and tried to flip a table! True story!

! RESIDENTIAL SUPPORTS Often are Rep Payees for individuals! Benefits Counselors work with Residential Providers to help individuals understand benefits! Particularly with! o Rent amount! o Spend downs and resource issues! o Budgeting! o Reporting to SSA!! If develop Special Needs Trusts- individuals will NOT have to spend down to maintain eligibility!

ACCESSING MEDICAID WAIVERS Must meet disability criteria! Must also be eligible for Medicaid:! o Several ways to access Medicaid! 1.SSI eligibility! 2. 300% rule! 3. MAWD!

MEDICAID WAIVERS Income Limit Resource Limit Cost to individual SSI Related Group 1619b limit $36,567 in 2016 (per year amount) $3,047 per month $2,000 $0 300% Group (this is not the official name) MAWD (Medical Assistance for Workers with DisabiliFes) In 2016 $2,199 per month (300% of SSI) *total income: work income + benefits Countable income below 250% of Federal Poverty Level. $60,420 per year or $5,035 per month in 2016 if individual doesn t have any other income. $8,000 $0 $10,000 5% of countable income. Ex: Income $2500. Cost of MAWD: $60 per month

ANDY Receives SSDI based on his work history! Receives the Medicaid Adult Autism Waiver! Benefits Counseling while in job development! Started working full time as a Machinist at! an Engineering company! (wants to work himself off SSA benefits!)! Benefits Frustration and Nightmare!!! Currently using MAWD to maintain Waiver eligibility!!

Earning Power & Developing Resources To retain Waiver services, SSI, and other governmental benefits- individuals must follow strict resource limits.! Resources are any funds that an individual has or has access to.! Examples: money in checking or savings accounts, 401k, some life insurance policies,! Creates a problem as individuals start to earn money at work!

SPECIAL NEEDS TRUST/ABLE Can shelter resources to protect eligibility for benefits!! o Funds in these accounts are NOT subjected to the resource test!! There are several types (private and pooled) and (1 st party and 3 rd party)- need to work with a lawyer to set up.! No limit on the amount of funds in the account! Funds can be used on a variety of things except food and shelter! Funds are to be used for the individual! Parents and families can leave inheritances in the trust.!

ABLE ACT Achieving a BeEer Live Experience Passed in Congress in December 2014! Can shelter resources to protect eligibility for benefits! Funds in these accounts are NOT subjected to the resource test!! Money in ABLE account is to be used for disability related expenses

ABLE ACT Achieving a BeEer Live Experience Each state sets up own ABLE accounts, individuals can shop around! Individual needs to be disabled prior to age 26! Maximum contribution of $14,000 per year! Maximum amount total is $100,000! Some state will have active ABLE accounts soon!!

ALLISON Receiving SSI and working full time! Wanted to go to school to become a Social Worker! Benefits Counselors helped write PASS to pay for! o Tuition, books, computer, internet! o Car for transportation to class and work!

ALLISON Individual on her own, had tried PASS in the past! for another work goal. Didn t get approved! To write PASS application and get it approved! o Have a clear work goal and steps to reach the goal! o Supplemental documentation (school schedule etc.)! o 8 hours to write plan and prepare for submission!

JUSTINE Working with as a student through a School District! Applying for benefits when turned 18! Working 2 jobs! Utilized the Student Earned Income Exclusion for her SSA benefits!

INVESTMENT It s worth it! Helping our consumers make informed choices! Increasing the earnings of consumers! Hand hold with SSA! Lead to more knowledge of TTW program and direct growth of program! Leads to better job outcomes when individuals are not afraid to work maximum hours earning maximum wages.! It s OKAY if consumers want to work themselves off benefits! Higher total income for our consumers and their families!

TICKET TO WORK Social Security Program to help individuals access services to find and keep a job! Funding comes from SSA when individuals go to work and earn above specific thresholds! Funding can be used in conjunction with waiver and other funding sources!! Anyone who is 18-64 and receiving SSA benefits is eligible!! Providers have to become and Employment Network to join the program.!

TICKET TO WORK GROWTH 2008- became an Employment Network (Provider)! o Didn t understand rules and how to do it! o Make relatively low amounts of money per year! o $10,000! After gaining knowledge of SSA from the Benefits Counseling certification. Lead to growth in Ticket to Work revenue!! Current fiscal year, over $100,000 in revenue! Ticket to work funding is UNRESTRICTED!!

BENEFITS TO INDIVIDUALS Get help to find and keep a job! In addition to Waiver programs! After OVR closes the case! If they otherwise don t have funding! Excused from a medical review if making timely progress! No risk in using the Ticket to Work program!

SOUNDS GREAT,

BECOMING AN EMPLOYMENT NETWORK Work with SSA to submit proposal, business plan, and other documentation! Must complete extensive criminal background check on all staff working on Ticket to Work! When individuals assign their ticket, must complete an Individual work plan. Similar to OVR s IPE.! Can request payments when consumers have assigned their ticket and earn above thresholds.! Rules can be confusing and difficult to understand.!

ADMINISTRATIVE EN CIS is and Administrative Employment Network! Fully understands the complexities of the Ticket to Work program! Act as the EN on record for the individuals! Employment Providers keep helping consumers find and keep jobs! CIS processes ticket payments and pays the employment provider.! Goal is to help the employment provider become familiar with Ticket to Work and when ready become their own EN.!

RESOURCES Social Security Red Book - A Guide To Work Incentives! o The Red Book serves as a general reference source about the employment-related provisions of Social Security Disability Insurance and the Supplemental Security Income Programs for educators, advocates, rehabilitation professionals, and counselors who serve people with disabilities. http://www.ssa.gov/redbook/! Work Incentives Planning & Assistance (WIPA)! 1-800-692-7443 ext. 309! Benefits Planning Query (BPQY)!! Yourtickettowork.com!

QUESTIONS Angelina Bush Angelina.bush@cisworks.org 215-238-7411 Ext. 117