VA DARS, Ticket to Work Partnership Plus, 1619B and...
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VA DARS, Ticket to Work Partnership Plus, 1619B and Medicaid Works October 17,2017 VASWP Services Staff Training Day
Transcript of VA DARS, Ticket to Work Partnership Plus, 1619B and...
VA DARS, Ticket to Work Partnership Plus, 1619B and Medicaid Works
October 17,2017 VASWP
Services Staff Training Day
David Leon
Ticket to Work Coordinator, VA DARS
Jonathan May
Ticket to Work/WISA supervisor, The Choice Group
Christian Wiscovitch, VR Counselor, DARS
Reggie Herndon, EN Specialist, LACIL
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Presenters
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Poverty and Disability
* Reference: Department of Health and Human Services (January 2017) | https://aspe.hhs.gov/poverty-guidelines
2017 Poverty Guidelines for the 48 Contiguous States and the District of Columbia
Persons in Family/Household Poverty Guideline
(For families/households with more than 8 persons, add $4,180 for each additional person)
1 $12,060
2 $16,240
3 $20,420
4 $24,600
5 $28,780
6 $32,960
7 $37,140
8 $41,320
Utilizing the Ticket to Work and Partnership Plus creates
additional resources for SVRA clients and service providers.
People with disabilities are considerably more likely to
experience poverty relative to those without disabilities.
The Ticket to Work program is a path out of poverty!
Additional resources for VR, EN and Clients.
Work Incentives are available to protect critical health
benefits
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Why is this Important?
Vocational Rehabilitation Overview and Points of
contact for each DSS office
Functional Definition of Ticket to Work and Partnership
Plus
Virginia Model
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Objectives
V R Counselor
Division of Rehabilitative Services
October 17th,2017
Virginia’s federally mandated Vocational Rehabilitation (VR) program
Assists individuals with disabilities to prepare for, enter, and maintain employment
Focus is on EMPLOYMENT
Participation is VOLUNTARY
An expert in disability and career counseling
Determines eligibility for DRS services
Identifies barriers to competitive employment
Helps develop employment goal
Develops Individualized Plan for Employment (IPE) with
steps to achieve student’s employment goal
Referral
Intake
Eligibility
Order of Selection*
Individualized Plan for Employment (IPE)
Services
Closure
Post Employment Services
* When a state does not have sufficient funds to meet the needs of all
individuals seeking services, a plan must be initiated to serve those clients with the most need first.
Determines eligibility for DRS services
Identifies barriers to competitive employment
Helps develop employment goal
Develops Individualized Plan for Employment (IPE)
with steps to achieve consumer’s employment goal
Implements plan and co-ordinates services to help
consumer prepare for, find, and
maintain employment
Eligible to work in the US
Documented disability
Barrier to employment caused by disability
Be able to benefit from services
Require services to prepare for, enter and engage in or retain employment
Mobility
Self Direction
Self Care
Interpersonal Skills
Communication
Work Tolerance
Work Skills
Modifications or accommodations
Effective communication skills
Organizational skills
Assistance needed to get from place to place
Training or supervision to obtain/maintain work skills
Work stamina
Work habits
Adaptive/assistive technology
Money management
Medication management
Self-care capability
Ability to plan and initiate activities
Problem solving skills
Interactions and relationships with others
Self advocacy skills
Developed after DRS eligibility is established
Created collaboratively with Client, family, service
providers, and DRS Counselor
Parallel to the student’s IEP (for Transition
students)
Focuses on the goal of employment
Outlines steps needed for employment goal
Plans for necessary services and funding
Eligible clients must complete financial needs
process
Some services can be provided without regard to
financial need
Some services involve financial participation on
the part of the student and family
If the consumer is recipient of SSI or SSDI, there
is no financial needs test and they
automatically qualify for all services
Counseling and guidance
Assessment
Career exploration
Benefits Analysis through WISA
Job readiness skills
Job seeking and placement
On-the-Job Training, Unpaid Work Experiences
Disability awareness counseling
Follow-along services after job placement
Higher education
Vocational/technical training
Durable medical equipment or other goods
Assistive Technology (A.T.)
Therapeutic Intervention
Job Coaching
Campus located in Fishersville, VA
PERT program for high school youth
Life Skills Training Program
Vocational Evaluations
Therapeutic Evaluations
Vocational Training Programs
Driver Evaluation and Training (including modified)
Physical Therapy, Speech Therapy, Occupational
Therapy
Successfully closed 4060 cases
Average hourly earnings of $10.24
For 2017… 18902 Current Open Cases
Consumer referred from DSS Lynchburg
Receiving TANF and struggling to find
employment
Provided Counseling and Guidance, Employment
Services, Job Placement, Interview Preparation,
and resume services.
Employed through Sodexo at Liberty University
earning $9.00 per hour
Stable in employment and working for over a full
year.
DARS Contacts
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What is Ticket to Work?
Ticket to work is a program designed to assist beneficiaries go to work and get off of the federal benefit roles.
Ticket holder’s are individuals receiving SSI or SSDI and between the ages of 18 and 64.
VADARS is currently working with almost 7,000 ticket holders.
Commonwealth of Virginia –over 315,000 beneficiaries.
https://www.ssa.gov/work/tickettracker.html
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A mechanism for sequential provision of services
Office of Vocational Rehabilitation (OVR) > Employment
Network (EN)
EN > OVR > EN
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What is Partnership Plus?
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How Partnership Plus Works
Virginia Model
Partnership Plus and Administrative EN Models
Fee for Service Work Incentive Services
Work Incentive Specialist Advocates (WISA)
WorkWORLD for the Web
Work Incentive Specialist Position and Manual
National Employment Network Association (NENA) and National Association of Benefits and Work Incentives Specialists (NABWIS) membership and participation
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Ticket to Work in Virginia
Ticket to Work Coordinator
Formalized Partnership Plus agreement
Benchmark Retention payments
21 current agreements
12 Administrative EN agreements
FFY 2015: Over $930,000 to our partners around the state though Ticket to Work funding
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Who Participates in the Ticket to Work program in Virginia?
Workforce Development Boards
Centers for Independent Living
Employment Service Organizations
Community Service Boards
Private nonprofit and for-profit Organizations
Community Rehabilitation Programs
DSS?
Ticket to Work Strategies
Present at DSS conferences to build collaborative relationships
• This has led to an increased referral stream for appropriate clients ……….
Co-present at specialty meetings, staff meetings, district meetings, statewide and national conferences.
Conduct quarterly meetings with Partnership Plus stakeholders
Current Initiatives to make the Ticket program Stronger
Work Incentive Manual – contract added
State Specific trainings developed
WorkWORLD Enhancements
Financial Competency
Motivational Interviewing
Potential Ongoing Support Services
Career Planning and Advancement
Advocacy Assistance
Understanding and accessing SSA Work Incentives
Budgeting & Financial wellness coaching
Help arranging for support services such as transportation or medication
Other services that will help maintain job
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Lynchburg Area Center for Independent Living Became an EN in 2011
Currently serving 87 TtW clients
Member of NENA
2 WISAs on staff
Participates in partnership Plus with DARS
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LACIL – Core Services
Peer Counseling
Independent Living Skills Training
System and Individual Advocacy
Transition
Information and Referral
• Additional services available through the LACIL Employment Network
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The Choice Group
Currently 13 WISAs on staff, located strategically throughout the state
One WISA credentialed as a Community partner Work Incentive Coordinator (CpWIC)
Manager serves on the Board of the National Employment Network Association (NENA)
Cross-trained (WISA and TTW)
Dedicated WISA/TTW Program Specialist
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The Choice Group Became an Employment Network (EN) in
February 2009
One of the original 6 Partnership Plus organizations in Virginia
Over 75 job coaches located throughout VA
Have served over 200 Ticket holders to date
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The Choice Group
Ticket to Work
Unique opportunity to serve beneficiaries
Collaboration with DARS, DBVI, CSBs, CILs, WIPAs
o Referrals in both directions
Partnership Plus
o All Counselors involved
o Access to clients for WISA services
Administrative EN agreements
Suitability
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TTW interaction with DSS
Medicaid
• Identify applicable eligibility so we can explain effects of earned income
○ SSI, Waiver, QMB, SMLB, QI, etc.
• Assist with 1619(b)
• Assist with Medicaid Works
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1619(b) Medicaid Protection for Working Individuals
Allows beneficiary to continue to receive Medicaid, even without receiving a cash benefit, as long as they meet the following criteria:
Still have a disability;
Need the Medicaid coverage to pay expenses that allow beneficiary to work;
Accumulate no more than $2000 in resources;
Earn less than $35,684 gross per year.
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1619(b) continued
Maintains an active SSA account – even without cash benefits for more than 12 months
Allows a beneficiary to return to SSI cash benefits if financially eligible
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1619(b) continued
Have been eligible for an SSI cash payment for at least 1 month;
Still meet the disability requirement; and
Still meet all other non-disability SSI requirements; and
Need Medicaid benefits to continue to work; and
Have gross earnings that are insufficient to replace SSI, Medicaid and publicly funded attendant care services.
1619 B
MEDICAID WORKS Virginia’s Medicaid Buy-In Program Eligibility Requirements
• Disabled
• 16 through 64 years of age
• Meet all requirements of the “ABD with Income ≤ 80% of the Federal Poverty Level” covered group
• Income limit $804/month, $9,648/year in 2017
○ Only income of applicant is counted
○ SSI beneficiaries are considered income eligible
• Resource limit $2,000 for individual, $3,000 for couple
○ SSI beneficiaries do not have resource test for Medicaid unless they
have countable real property ( i.e. that is excluded for SSI)
• Employed or have offer of employment letter
Disabled for Medicaid Works Purposes Means:
Current enrollment in SSI or SSDI programs,
Finding of disability by the Social Security Administration
(SSA) that has not been reversed, or
Finding of disability for Medicaid by the Disability
Determination Services (DDS) Unit
Sign the MEDICAID WORKS Agreement
Establish Work Incentive (WIN) account(s)
• Deposit all earned income and resources from earnings
Submit payment of a premium, if required
• Monthly premium continues to be waived
• If implemented, on a sliding scale
Additional Eligibility Requirements
DARS or Ticket to Work Employment Network
Recommend contacting a Work Incentive Specialist
Advocate (WISA)
WorkWORLD
Before Enrollment
• For earnings accumulated after enrollment in MEDICAID WORKS, up to $35,684 in 2017 is disregarded if deposited and retained in a WIN account.
Also excluded when placed in WIN account:
• Increases in Social Security benefits due to participation
in MW
• SSA Cost of Living Adjustments (COLAs)
• Unemployment Compensation received when participant
loses job through no fault of his or her own.
Upon Enrollment
Upon Enrollment
Resources accumulated while in MEDICAID WORKS and held in IRS approved retirement accounts, medical savings accounts and other similar State-approved accounts are excluded.
• Other resources evaluated with regular ABD Medicaid rules
• Resource assistance unit = 1
Upon Enrollment
Safety net
• Allow 6 months continued coverage if
unemployed due to unavoidable employment
interruptions
Upon Enrollment
Safety net (continued)
• Resources in WIN account disregarded in evaluation
for other covered groups
○ If eligible and enrolled in another group, enrollee
has one year to dispose of excess resources
Upon Enrollment
Safety net (continued)
• Amounts in IRS-approved accounts established as
WIN accounts disregarded in all future Medicaid
determinations
Alternative Benefits Package
Added Personal Assistance Services in June 2008
• Service eligibility requirements same as for waivers
• Process to access same as for waivers
• In-home and in the workplace
• Workplace supports are not provided if:
○ provided by the Department of Rehabilitative Services, under IDEA, or
○ they are an employer's responsibility under the Americans with Disabilities Act or Section 504 of the Rehabilitation Act.
Relationship Between Medicaid Works and 1619(B)
Medicaid Works offers higher income and resource limits, but more stringent eligibility criteria if not on SSI.
1619(B) has lower limits, but offers a “link” to the SSI system that Medicaid Works does not provide.
MEDICAID WORKS (MW) Enrollee Demographics
As of April 2017, 42 workers with disabilities enrolled.
• Age range: 20 to 64 years
• Gender: 18 Female and 24 Male
• Hourly wage range: $7.25/hr. to $20.00/hr.
• Average number of hours worked: over 20 weekly (range 16 to 40)
Enrollment by DSS regions:
• Central 8
• Eastern 16
• Northern 10
• Piedmont 3
• Western 5
Meet Client X
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Meet client Q
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Questions
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Contact Information
David Leon
Jonathan May
Christian Wiscovitch
Reggie Herndon
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