Benefits Planning 101: Youth with Disabilities

1. Benefits Planning 101:Youth with Disabilities Rachel Stewart Program Manager California Health Incentives Improvement Project Rachel.Stewart@dhcs.ca.gov

2. California Health Incentives Improvement Project (CHIIP) Funded by a Medicaid Infrastructure Grant from the federal Centers for Medicare and Medicaid Services Collaborative effort Goal: To increase the employment rate of people with disabilities by making sure necessary supports are in place, such as access to health care and the ability use personal assistance services at work Collaborative effort � work with many different agencies to meet this goal. I am housed in the Dept. of Health Services in Sacramento in the Medi-Cal eligibility Branch, while other CHIIP staffers are in the Employment Development Department. Also work very closely with the Ca. Governors committee on the employment of PWD Collaborative effort � work with many different agencies to meet this goal. I am housed in the Dept. of Health Services in Sacramento in the Medi-Cal eligibility Branch, while other CHIIP staffers are in the Employment Development Department. Also work very closely with the Ca. Governors committee on the employment of PWD

3. My Story Wheelchair-user since the age of 5 Pathway to independence = UC Berkeley Disabled Students Residence Program Benefits: Supplemental Security Income (SSI) and In-Home Supportive Services (IHSS � pays for personal care attendants) SSI as an employment support vs. poverty trap Can I work and keep the benefits I need to live independently (Medi-Cal and IHSS)? Grew up in the San Francisco bay area Wheelchair user since age of 5 due to muscular dystrophy On IHSS and SSI benefits the minute I turned 18 DoR client Graduated from UC Berkeley with degree in psychology � now what? Worried that once I started working, I�d lose my Medi-Cal benefits. Grew up in the San Francisco bay area Wheelchair user since age of 5 due to muscular dystrophy On IHSS and SSI benefits the minute I turned 18 DoR client Graduated from UC Berkeley with degree in psychology � now what? Worried that once I started working, I�d lose my Medi-Cal benefits.

4. Benefits Planning DisabilityBenefits101.org (www.db101.org) Easy to use and understand online resource for information on disability benefits and programs (Social Security, Medi-Cal, Medicare, IHSS, workers comp, etc.) 5 Benefits Planning Calculators: Great tools for determining how working (or changing jobs) will impact benefits � �connects the dots� Local Independent Living Center (www.cfilc.org) A benefits counselor helped to further explain the work incentives available to me

5. Working woman� Private health benefits, current salary still doesn�t equal complete self sufficiency Access to Medi-Cal and IHSS via SSI-work incentive: 1619B Typical earnings threshold is $35,906/year Individualized earnings threshold because I had higher than average medical costs Social Security Representatives don�t always know all the rules� Great private health benefits, but no PAS funding 1619B: zero cash benefit, but continued medi-cal coverageGreat private health benefits, but no PAS funding 1619B: zero cash benefit, but continued medi-cal coverage

6. Current situation Use employer-sponsored health coverage primarily, with Medi-Cal for �wraparound� coverage and IHSS Important to be a well-informed, and well-organized consumer �Benefits binder�: all notices of action from Social Security and Medi-Cal, call log of interactions with benefits staff, printouts from Disability Benefits 101 website, paycheck stubs, etc.

7. The Medi-Cal Working Disabled Program Next step to self sufficiency = the Medi-Cal 250% Working Disabled Program Allows people with disabilities, who otherwise qualify for Medi-Cal, the ability to work and buy-in to the Medi-Cal Program by paying an affordable monthly premium based on their earned income Can make up to $52,092/year and still qualify for Medi-Cal! There is no minimum work requirement - no job is too small to qualify Premiums range between $20-250 for individuals, and $30-375 for couples $1,400/month from work, premium = $25/month.$1,400/month from work, premium = $25/month.

8. Earnings How much can you earn? Approximately $4,300/month in gross wages No minimum earnings requirement Disability income from Social Security, state or private disability insurance, or workers compensation is exempt and not counted in this program when determining: Premium amount Maximum earnings

9. Eligibility To qualify for the WD program, you must: Be a resident of the United States living in California Meet Social Security�s definition of disability (medical definition only, does not count the ability to earn income) Be employed full-time or part-time, including self-employment, with countable earnings below 250% of the Federal Poverty Level Work is undefined � can find a job that fits with your disability Social security�s definition of disability: [inability to work and earn SGA due to] any medically determinable physical or mental impairment which can be expected to result in death or last for a continuous period of at least 12 months. Work undefined � found jobs that worked for me� few hours a week, on my own time. Social security�s definition of disability: [inability to work and earn SGA due to] any medically determinable physical or mental impairment which can be expected to result in death or last for a continuous period of at least 12 months. Work undefined � found jobs that worked for me� few hours a week, on my own time.

10. Eligibility, cont. To qualify for the WD program, you must: Meet all other eligibility requirements for Medi-Cal (asset and resource limits) Under $2000 in assets, one car, and the home you live in * Do not have to currently be on any public benefits to qualify for the Working Disabled Program

11. Unique Features of the Medi-Cal Working Disabled Program Ability to have IRS-approved retirement plans and deferred compensation plans � these kinds of savings do not count towards the $2,000 (or $3,000) asset limit for Medi-Cal Disability Income is exempt in this program for determining eligibility and premium amount However, disability income may be impacted by earning income from work

12. IHSS at Work Assembly Bill 925 (2002): can now use IHSS in workplace settings Transfer previously authorized personal assistance services hours for use in the home, to use in the workplace Does not provide any additional hours In-Home Supportive Services social workers don�t always know all the rules I had to advocate for myself and educate my IHSS worker. Gave my social worker a brochure on workplace personal assistance services

13. Knowledge is power Dispel old myths � people with disabilities can work and retain the benefits they need Use Disability Benefits 101 and the benefits calculators Knowledge of the resources and programs available is key when working with social services staff Knowing how working may or may not affect benefits can affect employment decisions and overall quality of life