ࡱ> 5@ k_bjbj22 XXF    P8P8P888\8*|9^9"99:elAmDm$FHHHHHH$RClshelssl  9:-uuus@ "9:FusFu(uvfpBr:p9 `{P8tfD40D7t7    7$m)ou;pqmmmlld1,8$du(,8___________________________________________________________Summer 2003   This issue is the third in a series in which we Spotlight some important aspects of Medicaid under Section 1619(b) and show how a PASS can help an individual to become eligible for SSI and Medicaid. We will continue with Marys Scenario and show how the PASS Specialist would review and evaluate the Plan for Achieving Self-Support (PASS) application. We will also discuss what evidence would be needed to document the PASS. Finally, we will discuss how to determine an ending date for Marys PASS so that she will be entitled to continued Medicaid coverage under Section 1619(b). If you missed the Winter 2003 and/or the Spring 2003 issues, or wish to review the previous issues, they are available on SSAs Intranet for SSA employees or on the Neighborhood Legal Services website for anyone with Internet access. SSA Employees: HYPERLINK "http://nynet.ny.ssa.gov/poc/pass_times/newsletters.htm"http://nynet.ny.ssa.gov/poc/pass_times/newsletters.htm Not an SSA-Employee: HYPERLINK "http://www.nls.org/pass-times-index.htm"http://www.nls.org/pass-times-index.htm                  Questions: Should Marys PASS end in June 2005? What will happen to her Medicaid if her PASS exclusion is stopped as of June 2005? Will Mary qualify for Medicaid under Section 1619(b) if her PASS ends in June 2005? Think about the questions. What would you tell Mary? See Page 6 for the answers to the questions. Timing the end of Marys PASS-Points to consider: Did you remember that in order for an individual to qualify for Medicaid continuation under Section 1619(b) the individuals SSI benefit must stop because of earned income and that the individual must remain otherwise eligible for SSI? Even though Mary is working in her goal as of June 2005 and appears to have sufficient income from her wages to meet her expenses, if we end the PASS before the SSDI benefit stops, Mary will not meet the SSI eligibility requirements and would not qualify for continued Medicaid under section 1619(b). She would have to either pay her extremely high medical bills or pay a very high spenddown. Either way, Mary could not afford the medical expenses and her car payments and insurance. Answer: We need to continue Marys PASS through December 2005, the last month of the grace period, in order to bring her unearned income down enough for her to remain SSI eligible, and therefore 1619(b) eligible. Once her SSDI benefit is suspended due to SGA, the PASS can end. The goal of a Plan for Achieving Self-Support is not just getting the individual to the point of getting a job. We need to consider the clients overall situation and make sure that once the PASS ends, and the individual is working in their goal, they are actually in a better position than they were at the beginning. That is what PASS is all about! For a detailed discussion of Medicaid for working individuals with disabilities, including the new New York State buy-in provisions, see Neighborhood Legal Services Summer issue of the Benefits Planner : - HYPERLINK "http://www.nls.org/pdf/summer-2003.pdf"http://www.nls.org/pdf/summer-2003.pdf (pdf version) - HYPERLINK "http://www.nls.org/planner/summer03.htm"http://www.nls.org/planner/summer03.htm (html version) Where should I send the completed PASS application? The completed PASS application and supporting documents should be sent to the local Security Office. The local Social Security Office will copy the PASS for their records and forward the PASS and development to the servicing PASS Cadre. To find the nearest Social Security Office, call 1-800-772-1213 or go to SSAs website. HYPERLINK "http://s3abaca.ssa.gov/pro/fol/fol-home.html"http://s3abaca.ssa.gov/pro/fol/fol-home.html    PAGE  PAGE 4 CONTACT US Cheektowaga PASS Cadre-- (Northern New York State) 2875 Union Road, Suite 75 Cheektowaga NY 14227-9926 Phone: 1-800-510-5680 Fax: (716) 681-6243 New York City PASS Cadre-- New York City Southern New York State, New Jersey PO Box 1826, Church St. Station New York, NY 10008-0612 Phone: 1-800-551-9583 Fax: (212)264-5717 Whats Inside Page Marys Scenario contd- Reviewing & Evaluating the PASS: Feasibility of the Work Goal 2 Viability of the Plan 3 What should I send with the PASS Application? 4 How do I decide when the PASS should end? 5 Timing Marys PASS- When should her PASS end? 6 Where should I send the completed PASS? 6 SSA announces new position Area Work Incentive Coordinator (AWIC) As part of the Social Security Administrations ongoing dedication to assisting individuals with disabilities in their efforts to work, the agency recently announced several openings nationwide for a new Area Work Incentive Coordinator (AWIC) position. The Area Work Incentives Coordinators will provide staff support to SSAs Area Directors to ensure consistency of interpretation, coordination, application and dissemination of SSAs work incentives provisions, focusing on those contained in the Ticket to Work and Self-Sufficiency Program and the Work Incentives Outreach Program statutes. The AWICs will participate in the development, administration and assessment of Area policies and procedures to ensure that they are consistent with, and supportive of, Regional and National work incentive goals. They will serve as the Area experts on Title II and Title XVI work incentives and processes and return to work issues. Basically, as the title implies, AWICs will serve as SSAs work incentives focal point and will be responsible for their dissemination throughout the Area to entities such as: SSA field offices; employment support agencies, organizations and advocacy groups; and Ticket partners, Program Navigators, grantees, private employers and congressional staffs. After selection, the AWICs will attend training in Baltimore, Md. before undertaking this vital task.  EMBED MS_ClipArt_Gallery  Reviewing & Evaluating the PASS In the last 2 issues of PASS Times, we helped Mary put her Plan together and complete a PASS application. Mary submitted her Plan to her local Social Security Office when she filed her application for Supplemental Security Income (SSI) benefits. The local Social Security Office kept the initial SSI application and sent the PASS to the servicing PASS Cadre. In this issue, we will discuss how the PASS Specialist reviews and processes the PASS. (In some areas, PASS applications are developed and processed by Employment Support Representatives (ESRs). As we discussed in the last issue, each PASS must contain a single specific occupational goal. The first thing the PASS Specialist looks at is the occupational goal. The selected occupational goal must be feasible. Feasible means that: The individual must have a reasonable chance of performing the work associated with the occupational goal, taking into account his/her: impairment, and the limitations imposed by it; age, in some cases; and strengths and abilities.  HYPERLINK "http://policy.ssa.gov/poms.nsf/36f3b2ee954f0075852568c100630558/9fd6d42ff15ddb5285256ce200678d80?OpenDocument" http://policy.ssa.gov/poms.nsf/36f3b2ee954f0075852568c100630558/9fd6d42ff15ddb5285256ce200678d80?OpenDocument When making a determination about the feasibility of the selected occupational goal, the first thing the PASS Specialist looks at is the completed PASS Application. Parts I and II of the Form SSA-545-BK, Plan for Achieving Self-Support, request information about the individuals work goal, medical condition, and vocational and educational background. The PASS Specialist looks for detailed information that shows the individual knows the job requirements and has considered their own limitations as well as their own strengths and abilities and has a Plan to achieve their chosen goal. Continuing with our scenario, Mary has listed Peer Advocate as her occupational goal. Marys PASS Application form shows that she has been working with a Vocational Counselor through a local mental health provider and that because of her excellent volunteer record at the center, she has been offered a paying position. Part II, F. (SSA 545 BK page 4) shows that Mary is working with her local VR agency and has an assigned counselor. This section shows that Mary does not yet have an Individualized Plan for Employment (IPE) but expects to receive it soon. The name and telephone number of Marys VR counselor are shown. It is always important to provide complete vocational evaluation information and also complete information about the PASS preparer because, absent evidence to the contrary, a PASS Specialist can assume that an occupational goal is feasible and the plan for achieving it is viable if the PASS was prepared by any of the following: a State VR counselor; a public or private vocational counselor, case manager, social worker, or other individual who is licensed or certified by: (1) a government agency, (2) the Commission on Rehabilitation Counselor Certification (CRCC), or (3) the Certification of Insurance Rehabilitation Specialists Commission (CIRSC); or an individual acting on behalf of an agency that has been certified by the above or accredited by an appropriate but unrelated local or nationally recognized organization such as the American Association for Counseling and Development or the National Rehabilitation Association.  HYPERLINK "http://policy.ssa.gov/poms.nsf/36f3b2ee954f0075852568c100630558/3bd763fb74b3101f85256ce200678e19?OpenDocument" http://policy.ssa.gov/poms.nsf/36f3b2ee954f0075852568c100630558/3bd763fb74b3101f85256ce200678e19?OpenDocument continued on page 3 So far, Marys Plan looks very good. She has supports in place and is working with them. The PASS Specialist is elated to see that Part III, Your Plan (Page 5 of the PASS application) contains detailed milestones. As we pointed out in our last issue, a PASS must show milestones, the interval steps an individual plans to take in order to achieve their occupational goal. Mary has shown in her steps that she knows exactly what she needs to do in order to achieve her goal and the items and/or services she needs to purchase as well. Mary has incorporated the purchases into her milestones. Overall, Mary has demonstrated that she has a feasible work goal and that her Plan for Achieving Self-Support (PASS) is viable. In addition to containing a feasible work goal, the plan must be viable. Viable means that the whole plan must be realistic, taking into account: the individual's education and training needs; any assistive technology required; the interval steps (and the corresponding time frame to complete each step) necessary to actually secure employment or start a business (a detailed business plan must be submitted with any PASS that has a self-employment goal, and the business plan itself must be viable). These steps or milestones, which demonstrate the person's progress towards achieving the goal, should be described sufficiently so that completion of the steps can be readily discernible and, if appropriate, measurable; other needs that become apparent during evaluation of the PASS; and whether the person will have sufficient means to cover PASS expenses, living expenses, and other necessary expenses. Mary has taken a very realistic approach toward achieving her goal. She plans to start slowly and increase school hours and work hours so that she has a chance to adjust personally and financially. Mary also has a network of support to help her. She has considered her limitations (e.g. difficulty concentrating) and has outlined her means of compensating (purchasing a home computer). Mary has a feasible work goal and a well-defined realistic plan. The PASS Specialist moves on to reviewing and evaluating the expenses and funding of the expenses. As described in our last issue, Mary did a lot of research and sent in documentation supporting the necessity of the items she wanted to include in her PASS as well as cost estimates for each item. The PASS Specialist is ready to contact Mary to discuss her plan. The PASS Specialist contacts Mary by telephone to discuss the Plan. First, the PASS Specialist reviews the general requirements of the PASS program, explains the various other work incentives, and discusses the expected outcome of the plan. The PASS Specialist reviews the details of Marys plan with her and explains exactly what Mary needs to do in order to follow her plan, including how to set up her PASS account. The PASS Specialist informs Mary about any additional information that is needed in order to make a decision to approve the PASS and explains that a detailed written request will also be sent to her. The PASS Specialist responds to any questions or concerns Mary may have. It is very important to establish a good working relationship between the PASS Specialist and the PASS client as in many cases the individual works with the same PASS Specialist throughout the PASS. Finally, at the point the PASS Specialist informs Mary that her PASS will be approved, Mary is advised that her PASS will be closely monitored through periodic progress reviews and Mary is advised of what will be needed during each progress review. Basically, during periodic progress reviews, the PASS Specialist will request evidence to show that Mary is following her plan. For most individuals whose plan includes additional education or training, a progress review is conducted at the end of each semester. The PASS Specialist reviews the grades for the completed semester and registration for the next semester. The PASS Specialist makes sure the individual is taking the courses required in order to complete their degree program and is following any other steps outlined in the plan. If the individual is saving up money in a PASS Account, the deposits and balances are verified as well. What do I send with the PASS Application? As a general rule, if you have something that explains or supports any part of the PASS, you should send it with the PASS. Below, we identify some of the documentation that you may wish to send with the PASS application. We cannot cover all situations in a general discussion. The specific evidence needed for each PASS differs because each PASS is specifically designed for the individual. If you do not yet have all of the items you want to submit with your plan, do not delay sending the plan. You can send the PASS right away and send in supporting documents when you get them. The PASS Specialist will be looking for evidence that supports the statements on the application. Feasibility of the work goal: A letter from the individuals VR counselor or other vocational specialist stating that he/she has identified the selected occupational goal as feasible for the client and supports the overall plan; (If the supporting evidence is not from a source listed on page 2, additional evidence may be required. If the individual is working with the State VR agency, a copy of the Individualized Plan for Employment (IPE) should be sent with the PASS. If the IPE is not available at the time the PASS is submitted, it should be sent when it become available.) A copy of a vocational evaluation ; A letter from a current employer that shows the individual would be able to work more hours, or get a better paying position if, for example, the individual had their own tools or their own transportation, or additional training. Documenting expenses: Before any expenses requested in a PASS can be authorized, documentation must be submitted showing that the item and/or service is necessary in order to achieve the work goal and reasonable in cost. Documentation may include such items as statements from the individuals treating medical source or counselor outlining why a specific item is needed. (e.g. Mary might include a letter from her school counselor showing that because of her anxiety and difficulty concentrating, she would have difficulty using the school computer lab and requires a personal computer.) Documentation of cost can include such items as newspaper ads, catalog pages, on-line printouts, and written estimates from dealerships. 2 or 3 estimates for each item should be provided. Other documentation: If a PASS involves additional education and/or training, an outline of the courses required to complete the degree program will be needed. This can be obtained from the school and is also usually available online if the school has a website. Proof of acceptance and registration will be required as well. In addition, the individual may be advised to file for benefits from other programs such as TAP, PELL, and VESID. If an individual is requesting assistance with purchasing a vehicle, it will be necessary to establish that the vehicle is necessary in order to achieve the work goal (e.g. no public transportation available). Business plan: A plan with a self-employment work goal must contain a detailed business plan. The PASS application, business plan, and supporting documentation, must show how the business will generate the income outlined in the plan.  HYPERLINK "http://policy.ssa.gov/poms.nsf/36f3b2ee954f0075852568c100630558/e288b4c817fcbf6485256ce200678ed3?OpenDocument" http://policy.ssa.gov/poms.nsf/36f3b2ee954f0075852568c100630558/e288b4c817fcbf6485256ce200678ed3?OpenDocument As previously mentioned, this is a brief outline of some of the items that are necessary in order to approve a PASS. Each case is individually developed and determined and the PASS Specialist will advise the individual of the specific documentation needed for their specific case. How do I decide when the PASS should end? (Timing Marys PASS) As a general rule, the PASS should end when the individual is working in their chosen goal and all PASS approved expenses have been funded. So, for most individuals who successfully complete their PASS, the PASS ends when they get their job. For some individuals, continued Medicaid eligibility depends on proper timing of the PASS. Getting back to our scenario, Mary is not eligible for Supplemental Security Income (SSI) without a PASS as her Social Security Disability Insurance (SSDI) is too high. What we need to do for Mary is make sure that she remains SSI eligible throughout her PASS and long enough to complete the 9-month trial work period (TWP) and 3-month grace period. At that point, her SSDI checks will stop and she will continue to qualify for Medicaid under the 1619(b) provisions as discussed in detail in the January 2003 issue. According to Marys Plan, she will work 15 hours weekly from February 2003 through December 2004 at $8.50 per hour. She will increase her work hours to 20 hours weekly from January 2005 through May 2005 and then begin working full-time (40 hours per week) in June 2005. Based on this information, her trial work period (TWP) months will be January 2005 through September 2005. She would not use any TWP months prior to January 2005 as her earnings would be below the TWP limits. Her 3 grace period months would be October 2005 through December 2005. Marys SSDI benefits should be suspended beginning January 2006 because her work activity would be determined to be substantial gainful activity (SGA). For more detailed information on SSDI & SSI work incentives visit SSAs website:  HYPERLINK "http://mwww.ba.ssa.gov/work/index.html"  INCLUDEPICTURE "http://mwww.ba.ssa.gov/work/graphics/oesp_logo_small_transparent.gif" \* MERGEFORMATINET  HYPERLINK "http://www.ssa.gov/work/ResourcesToolkit/workincentives.html" http://www.ssa.gov/work/ResourcesToolkit/workincentives.html Mary purchased her car in September 2003 using $2500.00 that she saved in her PASS for a downpayment. Beginning October 2003, Marys PASS exclusion was reduced to $ 505.00 per month ($305.00 per month for the car payment and $200.00 per month for the insurance). Yes! Car insurance for new drivers is outrageous. Her SSI payments will be computed as follows: $760.00 SSDI benefit (unearned income) $ 510.00 wages - 20.00 Unearned income disregard - 65.00 $740.00 Countable unearned income $ 445.00 / 2 = 222.50 Countable earned income - 505.00 PASS exclusion + 235.00 Countable unearned income $235.00 Countable unearned income $ 457.00 Total SSI countable income $639.00 Marys SSI rate in NY State - 457.00 Marys SSI countable income $182.00 Marys SSI payment amount for with a PASS Plus Medicaid! In January 2005 Marys wages will increase to $680.00 per month. Her countable earned income will be $307.50 per month. Her total countable income will be $542.50. Mary will still qualify for a small SSI check-Plus Medicaid! Moving forward a bit more, in June 2005, Marys wages will increase to $1360.00 monthly. Her income is now too high to receive any SSI checks and she is working in her goal. Coming in our Fall issue Marys situation changes- Amending a PASS Final Accounting-Ending a PASS Please let us know what you think! Do you have any questions you would like us to answer in our newsletter? Are there any topics you would like to see us cover? Please send any questions and/or comments to:  HYPERLINK "mailto:Carol.Wingate@ssa.gov" Carol.Wingate@ssa.gov Our mailing address and telephone number are on page 1. =HIJ  A B C y z | ζάzj^KjBjzh Ac0J5CJ%jh Ac5B*CJUphh Ac5B*CJphjh Ac5B*CJUphh Ac5B* CJphh Ac5B*CJph h AcCJ&jh Ac5B* UmHnHphuh Ac5B* phjh AcUmHnHuh Ac5B*phh AcB*CJph'jh AcB*CJUmHnHphu&jh Ac5B*UmHnHphuI  |         $^a$ $^`a$$a$j_          0 1 2 3 5 6 9 B C K L O P U V W X Z \ ^ ` 䰠xtphjh jhjUmHnHtH uh Acjh AcUmHnHu h AcCJjh AcCJUmHnHuh Ac5B*CJphh Ac0J5CJ%jh Ac5B*CJUphh Ac5B*CJphjh Ac5B*CJUphh Ac5B* CJph,           ! 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