WIPA Training for AWICs

Session 4

May 13, 2015

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Providing Effective WIPA Services

The Work of the CWIC:

– Preparing for Individualized WIPA Services – Information Gathering, Benefits Verification, and BPQYs

– Resolving issues brought by the beneficiary or identified in the verification process; communication with the local field office and AWIC as needed to address issues

– Developing Benefits Summary and Analysis Reports and Work Incentives Plans

– Providing Individualized WIPA Services and Ongoing Follow-up

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Pulling it All Together

• The CWIC’s role includes:– Information gathering and verifying benefits– Planning the level and intensity of services needed by the

beneficiary– Making referrals for supports and services– Providing individualized analysis pertaining to the employment

goal– Planning action steps with the beneficiary– Guiding the beneficiary in benefits literacy and benefits

management– Facilitating the use of work incentives– Providing ongoing education and follow-up over time

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Preparing for Individualized WIPA Services

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Preparing for Individualized WIPA Services

CWICs provide individualized WIPA services to those who:– Meet the specific eligibility criteria:

• Age 14 to Full Retirement Age• Disabled per Social Security's definition• Receiving or approved to receive SSI or Title II based

on disability• Receiving Medicaid under 1619(b), or• Receiving only SSI State Supplementary payment• Receiving Medicare under EPMC as a former Title II

disability beneficiary

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Two Service Categories

Basic Information & Referral (I&R)• First contact with Help Line call

center or WIPA project• Can often be handled via

phone, mail, and email• Basic information about

benefits, work incentives, programs & services

• Beneficiary may not be ready to pursue employment

• Majority will move on to receive intensive WIPA services

Individualized Work Incentives Planning & Assistance

• Requires an in-depth intake• Long-term services• Services rendered in variety of

ways• Requires verification of benefits• Includes benefits summary &

analysis and work incentive plan development

• Continued follow up services

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Determining Eligibility and Priority

To determine where the person is on the Employment Continuum and assess importance and urgency of presenting needs, CWICs screen to answer the following questions:

– Is the caller eligible for WIPA services?– How close are they to work? – What services are needed?

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Determining Eligibility and PriorityQuestions for Beneficiaries

Determining the Priority:

• Are you currently working or actively seeking employment?

• Do you have a job offer pending or are you on the brink of starting a small business or otherwise becoming self employed?

• Are you actively seeking a job or working to start a small business?

• Are you preparing for work in any way?

• Have you taken any steps to start pursuing employment?

• Are you seriously considering pursuing paid employment or self employment in the near future?

• Do you have any interest in finding out how paid employment or self employment might affect your benefits?

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Determining Eligibility and Priority

• The beneficiary does not have to be employed, have a job offer, or be actively engaged in a return to work effort to be eligible for WIPA services, but may be lower priority.

• The beneficiary may need assistance with non-employment related needs if she/he is also employed, pursuing employment, or interested in employment.

• The beneficiary may be receiving other federal benefits in addition to receiving or approved for Social Security benefits.

• Individuals in 1619(b) status or in Title II suspension during EPE are great candidates for WIPA services.

• Individuals with a recent decision of SGA are high priority.

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Determining Type, Intensity and Duration of WIPA Services

• All beneficiaries are NOT equal in terms of presenting needs; CWICs must conduct a “triage.”

• Determination must be made as to how close the needs are to the mission of WIPA, which includes:– Increase # of Social Security beneficiaries who work,– Support beneficiaries in maintaining employment,– Provide Work Incentives assistance that enables

increased self sufficiency.

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Importance versus Urgency

Importance of a presenting need is directly related to where the individual is on the employment continuum.

• Low importance: not considering employment or in the contemplation stage

• High importance: preparatory stage, job search stage, employment stage

Urgency relates to issues that are pressing, require immediate attention or time-sensitive.

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Planning Delivery of WIPA Services

• Importance and urgency determinations guide the CWIC in determining appropriate service delivery:

– Type & Intensity: individualized work incentives counseling or generic information and referral services?

– Service Method: face to face, or phone/internet/email?

– Duration of Service: multiple contacts or extensive follow-up over time?

– Service Timing: is an immediate response needed, or can services begin at a later date?

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Information Gathering

Information Gathering Involves:

• Identifying the presenting problem, needs, or questions,

• Determining the information necessary to resolve the problem or meet the beneficiary’s need,

• Verifying ALL benefits information when providing case-specific advisement & individualized WIPA services.

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Information Gathering: Family Systems Approach

• Often, return to work may affect benefits of family members receiving auxiliary benefits, or for SSI, additional work income may affect individuals in the same household, such as SSI eligible couples.

• CWICs must address the effect of return to work on Social Security benefits and other federal and state programs.

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Information Gathering:Focus on Financial Stability

• Beneficiaries generally want to know “How much can I earn?” (focus on limits) because of the belief that there are income and resource limits when working and receiving benefits.

• CWICs must focus on the person’s potential, not benefit limits by focusing on financial stability:– Exploring the beneficiary’s monthly financial requirements,– Exploring desired earnings goals,– Referring him/her to an appropriate resources for

assistance in achieving goals and addressing financial stability needs.

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Collecting Required Information

• Social Security requires that WIPA projects collect, analyze, and summarize specific data elements:– Beneficiary Information– Employment Information and Outcomes (including

employment and earnings goals)– Benefits (current and future)– Work Incentives to be Used– Services to be Used

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Verification of Benefits

• Required PRIOR to offering any specific advisement, before writing a BS&A, etc.

• ALL other federal, state and local benefits that the beneficiary may be receiving must be verified, including Ticket assignment, spouse or children’s benefits if necessary.

• CWICs clarify inconsistencies or abnormalities in information gathered.

• CWICs use signed consents to verify Social Security benefits (SSA-3288).

• Other agency releases are used to verify other state or federal benefits.

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Obtaining the Benefits Planning Query (BPQY)

• CWICs are required to obtain comprehensive information about Social Security disability benefits, earnings history, status of work incentives use for all WIPA service recipients.

• May request this from the AWIC, WIL, or have beneficiary request this themselves.

• Local office may not charge for the BPQY – consult POMS reference GN 03305.001 Disclosure With Consent – General for more information.

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Resolving Issues Identified During Verification of

Benefits

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Common Areas Where CWICs May Request Information or Assistance

• Clarification of information on the BPQY, for example: – Cash benefit discrepancies– Clarification of work incentives previously used– Work activity not listed on the BPQY

• Dual entitlement on more than one SSN—Is there another BPQY to be retrieved?

• Other information on the MBR that clarifies discrepancies in benefit amounts– Clarification of garnishments or taxes withheld

• Blind status not listed on T2 or T16 or stat blind update needed on Social Security record.

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Common Areas Where CWICs May Request Information or Assistance

• Questions about specific beneficiary issues, for example:– Deeming– Section 301– Return to work within 12 months of onset– Implications of work on T16 Married couples– Self-employment– Subsidy or IRWE development– Notices of Overpayment– Work CDRs and SGA Determinations– Changes in in-kind support and maintenance

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Common Areas Where CWICs May Request Information or Assistance

• Developing past work for beneficiaries, for example: – Work activity that has not been reported or evaluated– Reported work activity that is not recorded on the

BPQY– Work CDRs in process

• Clarification of policies, for example:– Assistance in understanding the POMS that apply to

specific work issues or uncommon benefit situations

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Helpful Information for CWICs

• Current list of AWICs – Contact information (telephone and fax)

• Current list of WILs (T2 ,T16 or both)– List of coverage for area offices– Telephone and fax numbers

• Who to contact for specific issues• Best times to reach AWIC or WILs• Best method for contacting

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Developing Benefits Summary and Analysis Reports and

Work Incentives Plans

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What is a Benefit Summary & Analysis (BS&A)?

• A Benefits Summary & Analysis is a formal written report developed for beneficiaries enrolled in intensive WIPA services who:– have an earnings goal, and – need individualized, case-specific work incentives information or

advice that is customized to the earnings goal• Summarizes current benefits and offers case-specific information

about the use of work incentives.• Outlines the beneficiary’s employment options and use of work

incentives.• Assesses the potential impact of employment and other changes on

federal, state and local benefits.

Who Receives a BS&A? • Beneficiaries are considered to have an earnings goal and need a

BS&A if there is: – A defined employment goal but no earnings amount in mind,– No employment goal defined, but an indication of monthly

earnings needed to meet financial goals,– No specific job goal, but the beneficiary knows how many hours

per week they’d like to work and how much they would like to earn per hour,

– A range of hours and/or hourly wage the beneficiary would like to work,

– No employment goal but is interested in knowing how work may impact benefits,

– A desire to eliminate the need for disability benefits and the beneficiary wants to know what level of earnings would accomplish this.

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Who Does NOT Require a BS&A?

• Beneficiary has no immediate plans to pursue employment and is currently seeking only general information on the potential effect of earnings on disability payments.

• CWIC provides only basic information and referral services.

• An earnings goal has not been identified and cannot be defined through probing questions.

• Beneficiary states that individualized services are NOT wanted, or refuses to allow verification of benefits.

• Alternatives to the BS&A can be considered.

BS&A Considerations

• CWICs must determine where the person is on their journey to employment and consider the following:– What is the next step on the road to employment and

what does the person need in order to take the next step?– How much information is needed to facilitate taking the

next step?– Are there any barriers to employment?– What specific services and supports does this person

need?– What other members of the Employment Support team

should the CWIC coordinate with to support the beneficiary?

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The BS&A Development Process

To develop an individualized BS&A, CWICs must:

•Gather information and identify present problems•Verify all benefits information•Analyze the information – provide specific information about how earnings goal will impact Social Security benefits and other federal and state benefits; explain past/future use of work incentives; •Summarize the analysis in a formal, written report with supporting documents:

– SSI calculation sheets– Illustrations of use of TWP, etc

•Advise beneficiary – based on the analysis of the beneficiary’s specific situation.

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Information in the BS&A

The BS&A is a narrative that describes: • Verification of current Social Security benefits and other

federal or state benefits,• Current employment situation and/or future employment

plans and earnings goal,• How the current employment situation and/or future

earnings goal will affect Social Security benefits,• How the current employment situation and/or future

earnings goal will affect public health insurance (Medicare and Medicaid),

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Information in the BS&A (continued)

• How the current employment situation and/or future earnings goal will affect other benefits received (HUD rental subsidies, SNAP), and/or other benefit issues not related to employment,

• Employment services and supports the beneficiary may need to attain the employment and earnings goal,

• Important things to remember or next steps (important dates or deadlines, reporting, recordkeeping).

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Presenting the BS&A to the Beneficiary

• CWICs thoroughly review the BS&A with the beneficiary and any other concerned parties that the beneficiary desires to be included to ensure understanding.

• Services do not end with the BS&A, rather, it is a starting point to define services going forward.

• The CWIC and beneficiary review all options, and outline next steps.

• This is the framework that determines the route going forward in development of the Work Incentives Plan.

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What is a Work Incentive Plan?

• A Work Incentive Plan (WIP) is a written document developed by a CWIC in collaboration with the beneficiary, and other key stakeholders, which delineates an individualized action plan for using work incentives to further the beneficiary’s employment and self-sufficiency goals.

• It is developed after the BS&A has been completed and reviewed with the beneficiary.

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Purpose of the WIP

The WIP provides the framework for ongoing direct service to guide the effective use of federal, state, and local benefits and work incentives, and includes:

– Desired return to work and self-sufficiency outcomes– Related steps or activities necessary to achieve the

outcomes– Associated target dates or timeframes

The WIP guides the beneficiary towards the goal and refers back to the items identified in the BS&A.

WIP Template Sections

• Accessing Employment Services and Supports

• Resolving Existing Benefit Issues

• Managing Social Security Benefits and Work Incentives

• Managing Federal, State or Local Benefit Programs

• Planning for Future Healthcare Needs

• Follow-Up Contact Plan

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Providing Individualized WIPA Services and Ongoing

Follow-Up

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Follow-Up Services

• Services do not stop once the Benefits Summary & Analysis and Work Incentive Plan are completed!

• Services delivered from this point forward involve the actual implementation of the WIP.

• Benefits Management is driven by the Work Incentives Plan– Time spent and supports provided depends completely on what is

agreed upon in the Work Incentives plan– Intensity of assistance will vary depending on the needs and

preferences of the beneficiary.

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Proactive Benefits Management

• Proactive follow-up has the following characteristics:– Services are pre-planned;– Contact occurs at scheduled intervals as agreed upon by

the CWIC and the beneficiary;– Interaction between the CWIC and the beneficiary or other

key stakeholders is predicated on events previously identified in the Work Incentive Plan;

– Interaction provides an opportunity to reassess the individual’s employment and benefit situation and revise the WIP if necessary; and

– Follow-up anticipates changes in advance and reduces the likelihood for negative affects or benefit complications.

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Ongoing Follow-Up• Critical touch-points are points in a beneficiary’s experience at which

a transition or change may be expected to occur.

• Touch-points vary depending on the individual, their employment goal, the type of benefits they receive and myriad of additional factors.

• The Work Incentive Plan is a valuable tool in which these anticipated touch-points would be documented and plans made for follow-up.

Touch-point examples:– Completion of the TWP, EPE. Cessation month– Identification of a Subsidy or IRWE– 1619b status– Age 18 redetermination

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Supports CWICs Provide Related to Work Incentives

• Trial Work Period– Verifying any previous usage– Helping beneficiaries track TWP usage– Prepare beneficiary for next steps toward end of TWP

• Extended Period of Eligibility– Tracking use of EPE months– Assist beneficiary with completing the SSA 821 or 820– Paying attention to patterns of work that may indicate

SGA– Preparing beneficiary for the SGA notices– Updating WIP action steps

Supports CWICs ProvideRelated to Specific Work

Incentives• Work CDRs and SGA Determination

– Ensuring the beneficiary understands SGA and is prepared– Helping beneficiaries understand when income averaging or

unsuccessful work attempt is used– Helping with subsidy/special condition development

• Asking questions to identify the subsidy/special condition early in employment

• Meeting with employer or employment specialist, if needed for development

– Helping with IRWE development• Helping with documentation of IRWEs• Reviewing and verifying changes in IRWEs

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Supports CWICs ProvideRelated to Specific Work

Incentives• Helping beneficiaries document SSI Work Incentives

– SEIE, IRWE, BWE, PASS• Supporting beneficiaries to understand changes in Medicaid or Medicare

– 1619 (b), Medicaid Buy-In, Extended Period of Medicare Coverage, Low Income Subsidy and Medicare Savings Programs (MSP), Extra-help and LIS Support

• Supporting beneficiaries to understand Expedited Reinstatement of Benefits– Providing information on the EXR– Tracking the 24 months of cash benefit receipt– Refreshing beneficiary’s understanding of TWP, EPE, etc.

• Supporting Beneficiaries with Ticket to Work – Locating Employment Networks– understanding timely progress

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Supports CWICs Provide in Reporting Earnings

Teaching beneficiaries how to report income is one of the most important jobs of CWICs. They should help beneficiaries develop methods to organize, prepare and submit earnings reports. Special considerations include:

– Work Reports within the Title II Disability Program– Resolving BPQY Issues when Work Reports are not

Timely– Reporting for the SSI Program– Using the Automated Reporting System

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Pulling it All TogetherThe Employment Supports Team

• CWICs partner with a variety of entities to promote successful outcomes

• Ongoing collaboration among the Employment Support Team results in enhancing the beneficiary’s self-sufficiency and successful employment

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